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Sample records for quality indicators longitudinal

  1. The impact of removing financial incentives from clinical quality indicators : longitudinal analysis of four Kaiser Permanente indicators

    NARCIS (Netherlands)

    Lester, H.; Schmittdiel, J.; Selby, J.; Fireman, B.; Campbell, S.M.; Lee, J.; Whippy, A.; Madvig, P.

    2010-01-01

    OBJECTIVE: To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN: Longitudinal analysis. SETTING: 35 medical facilities of Kaiser Permanente Northern California, 1997

  2. Quality indicators

    DEFF Research Database (Denmark)

    Hjorth-Andersen, Christian

    1991-01-01

    In recent literature it has been suggested that consumers need have no knowledge of product quality as a number of quality indicators (or signals) may be used as substitutes. Very little attention has been paid to the empirical verification of these studies. The present paper is devoted...... to the issue of how well these indicators perform, using market data provided by consumer magazines from 3 countries. The results strongly indicate that price is a poor quality indicator. The paper also presents some evidence which suggests that seller reputation and easily observable characteristics are also...

  3. Data Quality and Indicators

    Directory of Open Access Journals (Sweden)

    Jorge Matute

    2007-01-01

    Full Text Available This study highlights the importance of collecting good quality data from multidisciplinary studies. Bias in data may be the result of instrument inaccuracies, imprecise data recording techniques, inaccurate data entry to computers or inappropriate statistical analysis and presentation. Recommendations for good data quality control are given. Different types of data are discussed: raw data, simple indicators and complex indicators. It is shown how measurements from the components of multidisciplinary systems can be combined to form complex indicators and a specific example is given using Z-scores and dot charts. Finally the accumulated effect of bias in the individual component measurements upon the combined indicator is shown.

  4. Factors Affecting Journal Quality Indicator in Scopus (SCImago Journal Rank) in Obstetrics and Gynecology Journals: a Longitudinal Study (1999-2013).

    Science.gov (United States)

    Jamali, Jamshid; Salehi-Marzijarani, Mohammad; Ayatollahi, Seyyed Mohammad Taghi

    2014-12-01

    Awareness of the latest scientific research and publishing articles in top journals is one of the major concerns of health researchers. In this study, we first introduced top journals of obstetrics and gynecology field based on their Impact Factor (IF), Eigenfactor Score (ES) and SCImago Journal Rank (SJR) indicator indexed in Scopus databases and then the scientometric features of longitudinal changes of SJR in this field were presented. In our analytical and bibiliometric study, we included all the journals of obstetrics and gynecology field which were indexed by Scopus from 1999 to 2013. The scientometric features in Scopus were derived from SCImago Institute and IF and ES were obtained from Journal Citation Report through the Institute for Scientific Information. Generalized Estimating Equation was used to assess the scientometric features affecting SJR. From 256 journals reviewed, 54.2% and 41.8% were indexed in the Pubmed and the Web of Sciences, respectively. Human Reproduction Update based on the IF (5.924±2.542) and SJR (2.682±1.185), and American Journal of obstetrics and gynecology based on the ES (0.05685±0.00633) obtained the first rank among the other journals. Time, Index in Pubmed, H_index, Citable per Document, Cites per Document, and IF affected changes of SJR in the period of study. Our study showed a significant association between SJR and scientometric features in obstetrics and gynecology journals. According to this relationship, SJR may be an appropriate index for assessing journal quality.

  5. Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals.

    Science.gov (United States)

    Mumford, Virginia; Greenfield, David; Hogden, Anne; Debono, Deborah; Gospodarevskaya, Elena; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

    2014-09-23

    The study aims are twofold. First, to investigate the suitability of hand hygiene as an indicator of accreditation outcomes and, second, to test the hypothesis that hospitals with better accreditation outcomes achieve higher hand hygiene compliance rates. A retrospective, longitudinal, multisite comparative survey. Acute public hospitals in New South Wales, Australia. 96 acute hospitals with accreditation survey results from two surveys during 2009-2012 and submitted data for more than four hand hygiene audits between 2010 and 2013. Our primary outcome comprised observational hand hygiene compliance data from eight audits during 2010-2013. The explanatory variables in our multilevel regression model included: accreditation outcomes and scores for the infection control standard; timing of the surveys; and hospital size and activity. Average hand hygiene compliance rates increased from 67.7% to 80.3% during the study period (2010-2013), with 46.7% of hospitals achieving target compliance rates of 70% in audit 1, versus 92.3% in audit 8. Average hand hygiene rates at small hospitals were 7.8 percentage points (pp) higher than those at the largest hospitals (phygiene rates, accreditation outcomes and infection control scores is less clear. Our results indicate that accreditation outcomes and hand hygiene audit data are measuring different parts of the quality and safety spectrum. Understanding what is being measured when selecting indicators to assess the impact of accreditation is critical as focusing on accreditation results would discount successful hand hygiene implementation by smaller hospitals. Conversely, relying on hand hygiene results would discount the infection control related research and leadership investment by larger hospitals. Our hypothesis appears to be confounded by an accreditation programme that makes it more difficult for smaller hospitals to achieve high infection control scores. Published by the BMJ Publishing Group Limited. For permission to

  6. Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals

    Science.gov (United States)

    Mumford, Virginia; Greenfield, David; Hogden, Anne; Debono, Deborah; Gospodarevskaya, Elena; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

    2014-01-01

    Objectives The study aims are twofold. First, to investigate the suitability of hand hygiene as an indicator of accreditation outcomes and, second, to test the hypothesis that hospitals with better accreditation outcomes achieve higher hand hygiene compliance rates. Design A retrospective, longitudinal, multisite comparative survey. Setting Acute public hospitals in New South Wales, Australia. Participants 96 acute hospitals with accreditation survey results from two surveys during 2009–2012 and submitted data for more than four hand hygiene audits between 2010 and 2013. Outcomes Our primary outcome comprised observational hand hygiene compliance data from eight audits during 2010–2013. The explanatory variables in our multilevel regression model included: accreditation outcomes and scores for the infection control standard; timing of the surveys; and hospital size and activity. Results Average hand hygiene compliance rates increased from 67.7% to 80.3% during the study period (2010–2013), with 46.7% of hospitals achieving target compliance rates of 70% in audit 1, versus 92.3% in audit 8. Average hand hygiene rates at small hospitals were 7.8 percentage points (pp) higher than those at the largest hospitals (phygiene rates, accreditation outcomes and infection control scores is less clear. Conclusions Our results indicate that accreditation outcomes and hand hygiene audit data are measuring different parts of the quality and safety spectrum. Understanding what is being measured when selecting indicators to assess the impact of accreditation is critical as focusing on accreditation results would discount successful hand hygiene implementation by smaller hospitals. Conversely, relying on hand hygiene results would discount the infection control related research and leadership investment by larger hospitals. Our hypothesis appears to be confounded by an accreditation programme that makes it more difficult for smaller hospitals to achieve high infection control

  7. Quality assurance monitoring of a citywide transportation protocol improves clinical indicators of intravenous tissue plasminogen activator therapy: a community-based, longitudinal study.

    Science.gov (United States)

    Atsumi, Chihiro; Hasegawa, Yasuhiro; Tsumura, Kohtaro; Ueda, Toshihiro; Suzuki, Kazunari; Sugiyama, Makoto; Nozaki, Hiroyuki; Suzuki, Shinichi; Nakane, Makoto; Nagashima, Goro; Kitamura, Takayuki; Nikaido, Hirofumi; Sasanuma, Jinichi

    2015-01-01

    Stroke-bypass transportation to the stroke center by paramedics is important to maximize the efficiency of intravenous tissue plasminogen activator (iv-tPA) therapy. To improve access to stroke thrombolysis, a citywide protocol was launched on January 2007 in Kawasaki City (population 1.4 million) using the Maria Prehospital Stroke Scale (MPSS), and quality assurance monitoring has been performed every 6 months. The aim was to identify whether the citywide quality assurance monitoring improves the process and outcome of iv-tPA therapy. All of the MPSS-based transportation data prospectively recorded by the Kawasaki City Fire Department and the associated clinical data in the 11 hospitals that accept stroke-bypass transfers were merged every 6 months for the quality assurance monitoring. Clinical indicators such as ambulance call-to-door time, onset-to-needle time, door-to-needle time, frequency of thrombolytic use, and outcome of thrombolytic therapy were analyzed. These clinical indicators were also compared between patients transferred on weekdays and on weekends. A total of 2049 patients was registered from April 2009 to March 2013. Their mean age was 70.4 ± 13.2 (range, 24-98) years, and 64.3% were male. Ambulance call-to-door time decreased gradually from 37.5 ± 12.5 minutes to 33.9 ± 11.7 minutes over 4 years (P = .000, analysis of variance with the post hoc Dunnett test). Onset-to-needle time and door-to-needle time were similar over the 4 years. Good outcome (modified Rankin Scale score protocol significantly decreased the delay in the ambulance call-to-door time. The implementation of standardized cross-institutional quality assurance programs for acute stroke therapy may improve the process and outcome of iv-tPA therapy in the community. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. Power Quality Indices Estimation Platform

    Directory of Open Access Journals (Sweden)

    Eliana I. Arango-Zuluaga

    2013-11-01

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

  9. Quality Indicators for Learning Analytics

    Science.gov (United States)

    Scheffel, Maren; Drachsler, Hendrik; Stoyanov, Slavi; Specht, Marcus

    2014-01-01

    This article proposes a framework of quality indicators for learning analytics that aims to standardise the evaluation of learning analytics tools and to provide a mean to capture evidence for the impact of learning analytics on educational practices in a standardised manner. The criteria of the framework and its quality indicators are based on…

  10. Quality Indicators in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Albert, Jeffrey M. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Das, Prajnan, E-mail: prajdas@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-03-15

    Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts to define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts.

  11. The Belgian policy of funding antimicrobial stewardship in hospitals and trends of selected quality indicators for antimicrobial use, 1999-2010: a longitudinal study.

    Science.gov (United States)

    Lambert, Marie-Laurence; Bruyndonckx, Robin; Goossens, Herman; Hens, Niel; Aerts, Marc; Catry, Boudewijn; Neely, Fiona; Vogelaers, Dirk; Hammami, Naima

    2015-02-13

    In order to improve antimicrobial (AM) use, a policy of providing technical and financial support to AM management teams (AMTs) was rolled out in all Belgian hospitals between 2002 and 2008. We aimed to analyse the association of this policy with AM use for the two indications accounting for the largest number of patients receiving AM: prophylaxis for major lower limb orthopaedic surgery and pneumonia. We used patient-level data routinely collected in all Belgian acute care hospitals between 1999 and 2010. We modelled trends for selected quality indicators (QIs) using the year of AMT implementation in each hospital as the main 'change point', with fine-tuned case-mix adjustment. Of all admissions for lower limb orthopaedic surgery, and pneumonia between 1999 and 2010, 90% (325 094) and 95% (327 635), respectively, were found eligible for analyses. The surgery QI was defined as: cefazolin, dose in the expected range, and no use of other AM. For pneumonia, QIs were: ratio of oral/parenteral defined daily doses (DDD, O/P QI), and mean number of DDD minus penicillin, per 100 days of hospitalisation (DDD QI). Between 1999 and 2010, the surgery QI improved from 59% to 71%, the O/P QI from 0.72 to 0.97, and the DDD QI from 96 to 64. Heterogeneity between hospitals was high. Overall, no association was found with the year of implementation of the AMT. Improvements have been observed but could not be related at the national level to the policy under study. However, these results cannot be extrapolated to other QIs for AM use in hospitals. Our findings do not question the need for AMT, nor the need for continuation of AMT funding. Several recommendations can be made in order to make the best of Belgium's unique political and financial commitments in that field. 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.

  12. [Adherence to treatment after kidney transplantation as quality indicator of the information received: Longitudinal study of 2 years follow-up].

    Science.gov (United States)

    Costa-Requena, G; Cantarell, M C; Moreso, F; Parramon, G; Seron, D

    Transplantation is an optimal form of treatment for end-stage renal disease, but requires lifelong adherence to immunosuppressive therapy. The aim of this study was to longitudinally assess the adherence to treatment after kidney transplant, as well as to compare the amount of information about the treatment received at one month and 18 months post-transplantation, and its influence on adherence to treatment. The Self-Reported Measure of Medication Adherence was administered at month (T1), 6 months (T2), 12 months (T3), 18 months (T4), and 24 months (T5) post-transplantation. Survey about aspects of knowledge and attitudes about medication, was administered at one month and 18 months post-transplant. Measures of central tendency and non-parametric tests were used to compare the data. The study included a total of 73 patients with a median age of 57 years. The percentage of patients non-adherent to medication was 9.6% (T1), 22.5% (T2), 29.2% (T3), 29.8% (T4), and 28.1% (T5). One month after transplantation "not consulting with the doctor on forgetting to take medication (P=.034) significantly influenced the non-adherence to treatment. At 18 months post- transplantation, none of the issues raised on medication knowledge had an influence on non-adherence to treatment. Longer times since transplantation increased the non-adherence to treatment. Some issues regarding the information of treatment influenced the non-adherence in the immediate transplant period, but not in the follow-up. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Analysis of aircraft longitudinal handling qualities

    Science.gov (United States)

    Hess, R. A.

    1981-01-01

    The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion for determining the susceptibility of an aircraft to pilot induced oscillations (PIO) is formulated. Finally, a model-based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

  14. A quality by design approach for longitudinal quality attributes.

    Science.gov (United States)

    Lebrun, Pierre; Giacoletti, Katherine; Scherder, Tara; Rozet, Eric; Boulanger, Bruno

    2015-01-01

    The concept of quality by design (QbD) as published in ICH-Q8 is currently one of the most recurrent topics in the pharmaceutical literature. This guideline recommends the use of information and prior knowledge gathered during pharmaceutical development studies to provide a scientific rationale for the manufacturing process of a product and provide guarantee of future quality. This poses several challenges from a statistical standpoint and requires a shift in paradigm from traditional statistical practices. First, to provide "assurance of quality" of future lots implies the need to make predictions regarding the quality given past evidence and data. Second, the quality attributes described in the Q8 guidelines are not always a set of unique, independent measurements. In many cases, these criteria are complicated longitudinal data with successive acceptance criteria over a defined period of time. A common example is a dissolution profile for a modified or extended-release solid dosage form that must fall within acceptance limits at several time points. A Bayesian approach for longitudinal data obtained in various conditions of a design of experiment is provided to elegantly address the ICH-Q8 recommendation to provide assurance of quality and derive a scientifically sound design space.

  15. Price as indicator for quality?

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Ulff-Møller; Hansen, Jørgen Drud

    This paper examines the relation between price differences and quality differences in an oligopoly model with intra-industry trade, where goods are horizontally as well as vertically differentiated. The analysis demonstrates that the ratio of prices is not linked to the ratio of qualities in any ...

  16. Price as indicator for quality?

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Ulff-Møller; Hansen, Jørgen Drud

    This paper examines the relation between price differences and quality differences in an oligopoly model with intra-industry trade, where goods are horizontally as well as vertically differentiated. The analysis demonstrates that the ratio of prices is not linked to the ratio of qualities in any...... simple way. The paper therefore questions the procedure of using unit value differences between exported and imported goods as criteria for disentangling intra-industry trade in a vertical and a horizontal part....

  17. Performance indicators of Indoor Environmental Quality (IEQ ...

    African Journals Online (AJOL)

    Performance indicators of Indoor Environmental Quality (IEQ) assessment in hospital buildings: a ... Four-factor parameters of IEQ were assessed; such as thermal quality, acoustic quality, ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  18. Quality indicators for breast cancer

    DEFF Research Database (Denmark)

    Poortmans, Philip; Aznar, Marianne; Bartelink, Harry

    2012-01-01

    Radiation therapy for breast cancer has considerably changed over the years, from simple simulator-based 2-dimensional techniques to sophisticated image-guided individualized treatments, with maximally protected normal structures. This has led to a substantial improvement in the outcome of breast...... cancer patients in terms of disease control, survival, and quality of life. This progress is based on clinical research and paralleled by progress in delivering sophisticated radiation treatment. Clinical trials resulted in identifying patients groups who will benefit from radiation treatment. They also...

  19. Quality Indicators and Outcomes of Emergency Caesarean ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Abstract. The objective of this research study is to identify quality indicators of cesarean deliveries and determine their ... Quality of Cesarean Deliveries at a District-level Maternity Hospital .... complex surgical management i.e. uterine rupture.

  20. [Hospital readmissions: A reliable quality indicator?].

    Science.gov (United States)

    van Galen, Louise S; Nanayakkara, Prabath W B

    2016-01-01

    The percentage of readmissions within 30 days after discharge is an official quality indicator for Dutch hospitals in 2016. In this commentary the authors argue why readmissions cannot be regarded as a reliable way of assessing quality of healthcare in a hospital. To date, policy makers have been struggling with its precise definition and the indicator has not been properly formulated yet. It does not distinguish between planned and unplanned readmissions and does not take into account the 'preventability'. Therefore the authors believe that the indicator in its current form might falsely interpret the quality of care of a hospital and it is questionable to use readmissions as a quality indicator.

  1. Bibliometric indicators: quality measurements of scientific publication.

    Science.gov (United States)

    Durieux, Valérie; Gevenois, Pierre Alain

    2010-05-01

    Bibliometrics is a set of mathematical and statistical methods used to analyze and measure the quantity and quality of books, articles, and other forms of publications. There are three types of bibliometric indicators: quantity indicators, which measure the productivity of a particular researcher; quality indicators, which measure the quality (or "performance") of a researcher's output; and structural indicators, which measure connections between publications, authors, and areas of research. Bibliometric indicators are especially important for researchers and organizations, as these measurements are often used in funding decisions, appointments, and promotions of researchers. As more and more scientific discoveries occur and published research results are read and then quoted by other researchers, bibliometric indicators are becoming increasingly important. This article provides an overview of the currently used bibliometric indicators and summarizes the critical elements and characteristics one should be aware of when evaluating the quantity and quality of scientific output.

  2. [Indicators of quality in the critical patient].

    Science.gov (United States)

    Martín, M C; Cabré, Ll; Ruiz, J; Blanch, Ll; Blanco, J; Castillo, F; Galdós, P; Roca, J; Saura, R M

    2008-01-01

    The utility of using quality indicators as a tool to measure the common practice and evaluate efficacy of measures established to improve quality has been demonstrated, making it possible to identify and make known the improvements carried out. The project "Quality indicators in the critical patient" has been conducted by the Spanish Society of Intensive and Critical Medicine (SEMICYUC) under the methodological management of the Foundation Avedis Donabedian (FAD) of Barcelona. Its objective was to develop key indicators in the care of the critical patient, considering the following as added values: reaching an agreement on the quality criteria in these patients and providing the professionals with a potent and reliable instrument for clinical evaluation and management, introducing common evaluation methods that make it possible to unify the measure, making a comparative evaluation (benchmarking), having information that makes it possible to develop quality plans (quantitative, objective, reliable and valid data) and having a system that assures total quality of care to the critical patient.

  3. Water quality indicators: bacteria, coliphages, enteric viruses.

    Science.gov (United States)

    Lin, Johnson; Ganesh, Atheesha

    2013-12-01

    Water quality through the presence of pathogenic enteric microorganisms may affect human health. Coliform bacteria, Escherichia coli and coliphages are normally used as indicators of water quality. However, the presence of above-mentioned indicators do not always suggest the presence of human enteric viruses. It is important to study human enteric viruses in water. Human enteric viruses can tolerate fluctuating environmental conditions and survive in the environment for long periods of time becoming causal agents of diarrhoeal diseases. Therefore, the potential of human pathogenic viruses as significant indicators of water quality is emerging. Human Adenoviruses and other viruses have been proposed as suitable indices for the effective identification of such organisms of human origin contaminating water systems. This article reports on the recent developments in the management of water quality specifically focusing on human enteric viruses as indicators.

  4. Quality indicators for physiotherapy in Parkinson's disease.

    NARCIS (Netherlands)

    Nijkrake, M.J.; Keus, S.H.J.; Ewalds, H.; Overeem, S.; Braspenning, J.C.C.; Oostendorp, R.A.B.; Hendriks, E.J.; Bloem, B.R.; Munneke, M.

    2009-01-01

    AIM: The aim of this study was to develop quality indicators for physiotherapy in Parkinson's disease (PD) according to international criteria. METHODS: Indicators were based on an evidence-based guideline for physiotherapy in PD. Guideline recommendations were transformed into indicators and rated

  5. Quality indicators for acute myocardial infarction

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  6. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

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

    2005-01-01

    In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of valid...... and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel......; an independent medical doctor tested the feasibility and reliability of these clinical indicators, assessing the quality of medical technical care on 100 consecutive venous leg ulcer patients. Main outcome measures were healing, recurrence, pain, venous disease diagnosis, differential diagnosis and treatment...

  7. Evaluation of headache service quality indicators

    DEFF Research Database (Denmark)

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

    2015-01-01

    -Essen in Essen, Germany, and the Hospital da Luz in Lisbon, Portugal. Using seven previously-developed enquiry instruments, we interrogated health-care providers (HCPs), including doctors, nurses, psychologists and physiotherapists, as well as consecutive patients and their medical records. RESULTS......BACKGROUND: Evaluating quality of health care is increasingly recognized as an important contributor to the advancement of health-care delivery. We recently developed a set of quality indicators for headache care, intended to be applicable across countries, cultures and settings so...... that deficiencies in headache care worldwide might be recognized and rectified. These indicators themselves require evaluation and proof of fitness for purpose. This pilot study begins this process. METHODS: We tested the quality indicators in the tertiary headache centres of the University of Duisburg...

  8. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

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

    2005-01-01

    and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel......%) were assessed for venous surgery. Distal arterial pressure was measured following initial examination in 33 of the patients (34%). All patients (100%) were prescribed compression therapy. Of the 98 patients, 11 (11%) had ulcers recur in 3 months and 72 (73%) healed in 12 months, which is in line......; an independent medical doctor tested the feasibility and reliability of these clinical indicators, assessing the quality of medical technical care on 100 consecutive venous leg ulcer patients. Main outcome measures were healing, recurrence, pain, venous disease diagnosis, differential diagnosis and treatment...

  9. Soil Quality Indicator: a new concept

    Science.gov (United States)

    Barão, Lúcia; Basch, Gottlieb

    2017-04-01

    During the last century, cultivated soils have been intensively exploited for food and feed production. This exploitation has compromised the soils' natural functions and many of the soil-mediated ecosystems services, including its production potential for agriculture. Also, soils became increasingly vulnerable and less resilient to a wide range of threats. To overcome this situation, new and better management practices are needed to prevent soil from degradation. However, to adopt the best management practices in a specific location, it is necessary to evaluate the soil quality status first. Different soil quality indicators have been suggested over the last decades in order to evaluate the soil status, and those are often based on the performance of soil chemical, physical and biological properties. However, the direct link between these properties and the associated soil functions or soil vulnerability to threats appears more difficult to be established. This present work is part of the iSQAPER project- Interactive Soil Quality Assessment in Europe and China for Agricultural Productivity and Environmental Resilience, where new soil quality concepts are explored to provide better information regarding the effects of the most promising agricultural management practices on soil quality. We have developed a new conceptual soil quality indicator which determines the soil quality status, regarding its vulnerability towards different threats. First, different indicators were specifically developed for each of the eight threats considered - Erosion, SOM decline, Poor Structure, Poor water holding capacity, Compaction, N-Leaching, Soil-borne pests and diseases and Salinization. As an example for the case of Erosion, the RUSLE equation for the estimate of the soil annual loss was used. Secondly, a reference classification was established for each indicator to integrate all possible results into a Good, Intermediate or Bad classification. Finally, all indicators were

  10. VNIR Spectroscopy Estimation of Soil Quality Indicators

    Science.gov (United States)

    Knowledge of within-field spatial variability in soil quality indicators is important to assess the impact of site-specific management on the soil. Standard methods for measuring these properties require considerable time and expense, so sensor-based approaches would be useful. The purposes of this ...

  11. Soil quality indicators in Urban watersheds.

    Science.gov (United States)

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

    2015-12-01

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

  12. The advanced flame quality indicator system

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-09-01

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

  13. FIELD TEST OF THE FLAME QUALITY INDICATOR

    Energy Technology Data Exchange (ETDEWEB)

    Rudin, Andrew M; Butcher, Thomas; Troost, Henry

    2003-02-04

    The flame quality indicator concept was developed at BNL specifically to monitor the brightness of the flame in a small oil burner and to provide a ''call for service'' notification when the brightness has changed from its setpoint, either high or low. In prior development work BNL has explored the response of this system to operational upsets such as excess air changes, fouled atomizer nozzles, poor fuel quality, etc. Insight Technologies, Inc. and Honeywell, Inc. have licensed this technology from the U.S. Department of Energy and have been cooperating to develop product offerings which meet industry needs with an optimal combination of function and price. Honeywell has recently completed the development of the Flame Quality Monitor (FQM or Honeywell QS7100F). This is a small module which connects via a serial cable to the burners primary operating control. Primary advantages of this approach are simplicity, cost, and ease of installation. Call-for-service conditions are output in the form of front panel indicator lights and contact closure which can trigger a range of external communication options. Under this project a field test was conducted of the FQM in cooperation with service organizations in Virginia, Pennsylvania, New Jersey, New York, and Connecticut. At total of 83 field sites were included. At each site the FQM was installed in parallel with another embodiment of this concept--the Insight AFQI. The AFQI incorporates a modem and provides the ability to provide detailed information on the trends in the flame quality over the course of the two year test period. The test site population was comprised of 79.5% boilers, 13.7% warm air furnaces, and 6.8% water heaters. Nearly all were of residential size--with firing rates ranging from 0.6 gallons of oil per hour to 1.25. During the course of the test program the monitoring equipment successfully identified problems including: plugged fuel lines, fouled nozzles, collapsed combustion

  14. Quality indicators for woodwind reed material

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-04-02

    For the generation of sound, some woodwind musical instruments, e.g. oboe, bassoon, clarinet and saxophone, are provided with mouthpieces made from reeds. These reeds are the culms of Arundo donax, a tall, cane-like perennial grass. A general problem is that the material is of varying quality, yet externally differences cannot be observed. Hence, large proportions of the prepared reeds are unusable. One hypothesis is that the changes in quality are correlated with differences in the chemical and anatomical structure of the tissue. Therefore, a comparison of superior and inferior mouthpieces, used by professional musicians, was undertaken to determinate potential indicators of quality. Nuclear microprobe analysis of reeds was carried out and complemented by scanning electron and light microscopy. The elemental levels of Si, P, S, Cl, K and Ca were compared between good and poor mouthpieces using appropriate statistical tests. No statistically significant differences could be identified. Microscopical observations showed that partial occlusion of vessels by tylose formation was associated with material deemed unusable.

  15. Quality indicators for woodwind reed material

    Science.gov (United States)

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

    1999-04-01

    For the generation of sound, some woodwind musical instruments, e.g. oboe, bassoon, clarinet and saxophone, are provided with mouthpieces made from reeds. These reeds are the culms of Arundo donax, a tall, cane-like perennial grass. A general problem is that the material is of varying quality, yet externally differences cannot be observed. Hence, large proportions of the prepared reeds are unusable. One hypothesis is that the changes in quality are correlated with differences in the chemical and anatomical structure of the tissue. Therefore, a comparison of superior and inferior mouthpieces, used by professional musicians, was undertaken to determinate potential indicators of quality. Nuclear microprobe analysis of reeds was carried out and complemented by scanning electron and light microscopy. The elemental levels of Si, P, S, Cl, K and Ca were compared between good and poor mouthpieces using appropriate statistical tests. No statistically significant differences could be identified. Microscopical observations showed that partial occlusion of vessels by tylose formation was associated with material deemed unusable.

  16. Image Quality Indicator for Infrared Inspections

    Science.gov (United States)

    Burke, Eric

    2011-01-01

    The quality of images generated during an infrared thermal inspection depends on many system variables, settings, and parameters to include the focal length setting of the IR camera lens. If any relevant parameter is incorrect or sub-optimal, the resulting IR images will usually exhibit inherent unsharpness and lack of resolution. Traditional reference standards and image quality indicators (IQIs) are made of representative hardware samples and contain representative flaws of concern. These standards are used to verify that representative flaws can be detected with the current IR system settings. However, these traditional standards do not enable the operator to quantify the quality limitations of the resulting images, i.e. determine the inherent maximum image sensitivity and image resolution. As a result, the operator does not have the ability to optimize the IR inspection system prior to data acquisition. The innovative IQI described here eliminates this limitation and enables the operator to objectively quantify and optimize the relevant variables of the IR inspection system, resulting in enhanced image quality with consistency and repeatability in the inspection application. The IR IQI consists of various copper foil features of known sizes that are printed on a dielectric non-conductive board. The significant difference in thermal conductivity between the two materials ensures that each appears with a distinct grayscale or brightness in the resulting IR image. Therefore, the IR image of the IQI exhibits high contrast between the copper features and the underlying dielectric board, which is required to detect the edges of the various copper features. The copper features consist of individual elements of various shapes and sizes, or of element-pairs of known shapes and sizes and with known spacing between the elements creating the pair. For example, filled copper circles with various diameters can be used as individual elements to quantify the image sensitivity

  17. [Patient satisfaction as a quality indicator in mental health].

    Science.gov (United States)

    Fernández-Martín, L C; Iglesias-de-Sena, H; Fombellida-Velasco, C; Vicente-Torres, I; Alonso-Sardón, M; Mirón Canelo, J A

    2016-01-01

    To improve the quality of care in a Mental Health Hospital and identify the level of patient satisfaction. A descriptive, longitudinal, and retrospective study was conducted on 666 patients who completed treatment in the Mental Health Day Hospital of Salamanca, during the period 1994-2012, using the Hospital Management Annual Reports. A questionnaire designed for this purpose was used as the measurement tool. Most of the patients satisfactorily valued aspects, such as the general impression of the treatment (90% said «good/fairly good») and perception of being helped (94% perceived «very/fairly helped»); with 83% believing that the hospital is accessible. As regards empathy-understanding, it was noted that 14% feel discontent. While 18% of patients expected to be completely cured, the 83% of patients that finished their treatment have said that, in their opinion, the symptoms have subsided «very or somewhat». As regards the knowledge that they have about their disease, 30% believe it has advanced «a lot.» Based on the perceptions reported by patients, it may be said that in general, the level of user satisfaction in the Mental Health Day Hospital is high. Assessing quality through the user opinions helps control the quality, considering that patient satisfaction is a good indicator of result of the care received during their hospitalisation. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Analytical quality, performance indices and laboratory service

    DEFF Research Database (Denmark)

    Hilden, Jørgen; Magid, Erik

    1999-01-01

    analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control......analytical error, bias, cost effectiveness, decision-making, laboratory techniques and procedures, mass screening, models, statistical, quality control...

  19. Longitudinal Indicators of the Social Context of Families: Beyond the Snapshot

    Science.gov (United States)

    Moore, Kristin Anderson; Vandivere, Sharon

    2007-01-01

    Longitudinal indicators are measures of an individual or family behavior, interaction, attitude, or value that are assessed consistently or comparably across multiple points in time and cumulated over time. Examples include the percentage of time a family lived in poverty or the proportion of childhood a person lived in a single-parent family.…

  20. Quality Indicators for Hospital Care : Reliability and validity

    NARCIS (Netherlands)

    C. Fischer (Claudia)

    2015-01-01

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

  1. Indicators of quality in primary healthcare.

    NARCIS (Netherlands)

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

    2004-01-01

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

  2. Physician wellness: a missing quality indicator.

    Science.gov (United States)

    Wallace, Jean E; Lemaire, Jane B; Ghali, William A

    2009-11-14

    When physicians are unwell, the performance of health-care systems can be suboptimum. Physician wellness might not only benefit the individual physician, it could also be vital to the delivery of high-quality health care. We review the work stresses faced by physicians, the barriers to attending to wellness, and the consequences of unwell physicians to the individual and to health-care systems. We show that health systems should routinely measure physician wellness, and discuss the challenges associated with implementation.

  3. Evaluation of Soil Quality: Application of Fuzzy Indicators

    Science.gov (United States)

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

  4. Using breast cancer quality indicators in a vulnerable population.

    NARCIS (Netherlands)

    Chen, F.; Puig, M.; Yermilov, I.; Malin, J.; Schneider, E.C.; Epstein, A.M.; Kahn, K.L.; Ganz, P.A.; Gibbons, M.M.

    2011-01-01

    BACKGROUND: Adherence to quality indicators may be especially important to disease-specific outcomes for uninsured, vulnerable patients. The objective of this study was to measure adherence to National Initiative for Cancer Care Quality (NICCQ) breast cancer quality indicators in a public hospital

  5. Prescribing quality indicators of type 2 diabetes mellitus ambulatory care

    NARCIS (Netherlands)

    Martirosyan, L.; Braspenning, J.; Denig, P.; de Grauw, W. J. C.; Bouma, M.; Storms, F.; Haaijer-Ruskamp, F. M.

    2008-01-01

    Background: Existing performance indicators for assessing quality of care in type 2 diabetes mellitus (T2DM) focus mostly on registration of measurements and clinical outcomes, and not on quality of prescribing. Objective: To develop a set of valid prescribing quality indicators (PQI) for internal u

  6. Improvement of quality service based on common benchmarks and indicators

    Directory of Open Access Journals (Sweden)

    Pohaydak, Olha Bohdanivna

    2011-11-01

    Full Text Available Consider ways to improve the quality management system based on common criteria and indicators for evaluating the quality of products, works and services in housing and domestic service.

  7. Identifying unintended consequences of quality indicators: a qualitative study

    NARCIS (Netherlands)

    Lester, H.E.; Hannon, K.L.; Campbell, S.M.

    2011-01-01

    Background For the first 5 years of the UK primary care pay for performance scheme, the Quality and Outcomes Framework (QOF), quality indicators were introduced without piloting. However, in 2009, potential new indicators were piloted in a nationally representative sample of practices. This paper de

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

    Science.gov (United States)

    Jenkins, Charles Cordell, III; Kitchel, Tracy

    2009-01-01

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

  9. Identifying unintended consequences of quality indicators: a qualitative study

    NARCIS (Netherlands)

    Lester, H.E.; Hannon, K.L.; Campbell, S.M.

    2011-01-01

    Background For the first 5 years of the UK primary care pay for performance scheme, the Quality and Outcomes Framework (QOF), quality indicators were introduced without piloting. However, in 2009, potential new indicators were piloted in a nationally representative sample of practices. This paper

  10. Does Viewing Pornography Reduce Marital Quality Over Time? Evidence from Longitudinal Data.

    Science.gov (United States)

    Perry, Samuel L

    2017-02-01

    Numerous studies have examined the connection between pornography viewing and marital quality, with findings most often revealing a negative association. Data limitations, however, have precluded establishing directionality with a representative sample. This study is the first to draw on nationally representative, longitudinal data (2006-2012 Portraits of American Life Study) to test whether more frequent pornography use influences marital quality later on and whether this effect is moderated by gender. In general, married persons who more frequently viewed pornography in 2006 reported significantly lower levels of marital quality in 2012, net of controls for earlier marital quality and relevant correlates. Pornography's effect was not simply a proxy for dissatisfaction with sex life or marital decision-making in 2006. In terms of substantive influence, frequency of pornography use in 2006 was the second strongest predictor of marital quality in 2012. Interaction effects revealed, however, that the negative effect of porn use on marital quality applied to husbands, but not wives. In fact, post-estimation predicted values indicated that wives who viewed pornography more frequently reported higher marital quality than those who viewed it less frequently or not at all. The implications and limitations of this study are discussed.

  11. A set of care quality indicators for stroke management.

    Science.gov (United States)

    Navarro Soler, I M; Ignacio García, E; Masjuan Vallejo, J; Gállego Culleré, J; Mira Solves, J J

    2017-06-22

    This study proposes a set of quality indicators for care outcomes in patients with acute cerebral infarction. These indicators are understandable and relevant from a clinical viewpoint, as well as being acceptable and feasible in terms of time required, ease of data capture, and interpretability. The method consisted of reaching consensus among doctors after having reviewed the literature on quality indicators in stroke. We then designed and conducted a field study to assess the understandability and feasibility of the set of indicators. Consensus yielded 8 structural indicators, 5 process indicators, and 12 result indicators. Additionally, standards of reference were established for each indicator. This set of indicators can be used to monitor the quality care for stroke patients, identify strengths, and potentially to identify areas needing improvement. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. MEASURES AND INDICATORS OF VGI QUALITY: AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    V. Antoniou

    2015-08-01

    Full Text Available The evaluation of VGI quality has been a very interesting and popular issue amongst academics and researchers. Various metrics and indicators have been proposed for evaluating VGI quality elements. Various efforts have focused on the use of well-established methodologies for the evaluation of VGI quality elements against authoritative data. In this paper, a number of research papers have been reviewed and summarized in a detailed report on measures for each spatial data quality element. Emphasis is given on the methodology followed and the data used in order to assess and evaluate the quality of the VGI datasets. However, as the use of authoritative data is not always possible many researchers have turned their focus on the analysis of new quality indicators that can function as proxies for the understanding of VGI quality. In this paper, the difficulties in using authoritative datasets are briefly presented and new proposed quality indicators are discussed, as recorded through the literature review. We classify theses new indicators in four main categories that relate with: i data, ii demographics, iii socio-economic situation and iv contributors. This paper presents a dense, yet comprehensive overview of the research on this field and provides the basis for the ongoing academic effort to create a practical quality evaluation method through the use of appropriate quality indicators.

  13. A longitudinal examination of re-employment quality on internalizing symptoms and job-search intentions.

    Science.gov (United States)

    Monfort, Samuel S; Howe, George W; Nettles, Christopher D; Weihs, Karen L

    2015-01-01

    Underemployed workers-those receiving less pay, working fewer hours, or using fewer skills than they would prefer-appear to experience negative mental health outcomes similar to the unemployed. Prior cross-sectional research provides mixed empirical evidence for this conclusion, however. The current study sought to clarify the impact of underemployment longitudinally, assessing mental health 5 times over 8 months after job loss. In addition to the commonly used indicators of underemployment, we designed a measure of cognitive complexity using the Occupational Information Network (O*NET), an extensive government database used to organize and categorize occupational information. Replicating past research, we found concurrent associations between all indexes of reemployment job quality and internalizing symptoms in the period immediately after reemployment. However, when controlling for quality of prior employment, all indicators except our measure for cognitive complexity became nonsignificant. As participants transitioned from unemployment to reemployment, only reductions in cognitive complexity were associated with sustained general internalizing symptoms. We also found that although changes in cognitive complexity had an immediate impact on the well-being of the recently reemployed, only the number of available weekly hours (full-time vs. part-time status) was relevant 6 to 12 weeks later. Our longitudinal model thus provides significant nuance to the current understanding of underemployment and mental health. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  14. Personality effects on romantic relationship quality through friendship quality: A ten-year longitudinal study in youths

    OpenAIRE

    Branje, S.T.J.; Keijsers, L.; Meeus, W. H. J.

    2014-01-01

    This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality in young adulthood, via friendship quality development in adolescence. The study employed six waves of longitudinal questionnaire data from Dutch youths who had a romantic relationship when they we...

  15. Personality Effects on Romantic Relationship Quality through Friendship Quality : A Ten-Year Longitudinal Study in Youths

    OpenAIRE

    Rongqin Yu; Susan Branje; Loes Keijsers; Meeus, Wim H. J.

    2014-01-01

    This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality in young adulthood, via friendship quality development in adolescence. The study employed six waves of longitudinal questionnaire data from Dutch youths who had a romantic relationship when they we...

  16. Bibliometric indicators for evaluating the quality of scientifc publications.

    Science.gov (United States)

    Joshi, Medha A

    2014-03-01

    Evaluation of quality and quantity of publications can be done using a set of statistical and mathematical indices called bibliometric indicators. Two major categories of indicators are (1) quantitative indicators that measure the research productivity of a researcher and (2) performance indicators that evaluate the quality of publications. Bibliometric indicators are important for both the individual researcher and organizations. They are widely used to compare the performance of the individual researchers, journals and universities. Many of the appointments, promotions and allocation of research funds are based on these indicators. This review article describes some of the currently used bibliometric indicators such as journal impact factor, crown indicator, h-index and it's variants. It is suggested that for comparison of scientific impact and scientific output of researchers due consideration should be given to various factors affecting theses indicators.

  17. Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery.

    Science.gov (United States)

    Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke

    2015-12-01

    Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

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

    OpenAIRE

    Al-Awa, Bahjat

    2011-01-01

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

  19. Price as an Indicator for Quality in International Trade?

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Nielsen, Jørgen Ulff-Møller

    This paper examines the relation between price differences and quality differences in an oligopoly model with intra-industry trade, where goods are horizontally as well as vertically differentiated. The analysis demonstrates that the ratio of prices is not linked to the ratio of qualities in any...... simple way. The paper therefore questions empirical trade studies using unit values as an indicator for the quality of the traded goods....

  20. The development of quality indicators for community pharmacy care.

    NARCIS (Netherlands)

    Bie, J. de; Kijlstra, N.B.; Daemen, B.J.G.; Bouvy, M.L.

    2011-01-01

    Aims: To develop a national system of quality indicators for community pharmacy care, reported by community pharmacies. Methods: After preliminary validation, an online consensus study was conducted. Pharmacy practice experts (round 1) and practising pharmacists (round 2) were approached.

  1. Performance indicators: A tool for continuous quality improvement

    National Research Council Canada - National Science Library

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

    2016-01-01

    ... (both critical and routine) to number of donors reactive for TTI. We conducted a study to measure the impact of monitoring Performance Indicators and how it could be used as a tool for Continuous Quality Improvement (CQI...

  2. Design Quality Indicator for Schools in the United Kingdom

    Science.gov (United States)

    PEB Exchange, 2006

    2006-01-01

    In December 2005, the United Kingdom launched a process for evaluating the design quality of primary and secondary school buildings. The Design Quality Indicator (DQI) for Schools is a tool that can assist stakeholders--teachers, parents, school governors, students, community members, local authority clients and building professionals--to achieve…

  3. Elements and indicators for identification of quality of primary education

    Directory of Open Access Journals (Sweden)

    Sučević Vlasta M.

    2015-01-01

    Full Text Available Education is one of the main pillars of the quality of knowledge, and, in turn, social progress in general. There are numerous positions concerning quality of education, some more, and some less detailed. In order to determine the quality of a primary school, for example as 'poor', 'mediocre' or 'excellent', we use, more or less precisely, a certain idea about the value, and thus identify, again with a certain extent of accuracy, the position of the school in question in relation to other schools. In terms of the quality of education, it is necessary to analyze all segments of educational process. This includes the analysis of objectives of educational process, products of quality education as well as adequate and accessible technical-instrumental, that is, operational-procedural level of quality of educational process. Most authors connect the quality of primary education to results, that is, outcomes of education. In order to achieve quality of education, we need to achieve quality of particular components or elements of the whole of education. This paper deals with theoretical review of elements and indicators of quality of basic education, and provides a review of pedagogical strategies and their effect on certain components of quality with the aim to improve the effects on pedagogical and didactical resources of the quality of education.

  4. Does self-efficacy mediate the relationship between transformational leadership behaviours and healthcare workers' sleep quality? A longitudinal study.

    Science.gov (United States)

    Munir, Fehmidah; Nielsen, Karina

    2009-09-01

    This paper is a report of a study conducted to investigate the longitudinal relationship between transformational leadership behaviours and employees' sleep quality, and the mediating effects of self-efficacy. Although there is evidence for the influential role of transformational leadership on health outcomes, researchers have used either attitude outcomes (e.g. job satisfaction) or softer health measures, such as general well-being. Specific measures of well-being such as sleep quality have not been used, despite its association with working conditions. A longitudinal design was used to collect data from Danish healthcare workers at time 1 in 2005 (n = 447) and 18 months later at time 2 in 2007 (n = 274). Structural equation modelling was used to investigate the relationships between transformational leadership, self-efficacy and sleep quality at both time points independently (cross-sectionally) and longitudinally. For all constructs, time 2 measures were influenced by the baseline level. Direct relationships between transformational leadership and sleep quality were found. This relationship was negative cross-sectionally at both time points, but positive between baseline and follow-up. The relationship between leadership and employees' sleep quality was not mediated by employees' self-efficacy. Our results indicate that training managers in transformational leadership behaviours may have a positive impact on healthcare workers' health over time. However, more research is needed to examine the mechanisms by which transformational leadership brings about improved sleep quality; self-efficacy was not found to be the explanation.

  5. Price as an indicator for quality in international trade?

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Nielsen, Jørgen Ulff-Møller

    2011-01-01

    This paper examines the relation between price differences and quality differences in an oligopoly model with intra-industry trade, where goods are horizontally as well as vertically differentiated. The analysis demonstrates that the ratio of prices is not linked to the ratio of qualities in any ...... simple way. The paper therefore questions empirical trade studies using unit values as an indicator for the quality of the traded goods. However, we also show that the ratio of prices is a reasonable proxy for the ratio of qualities if sunk cost is dominating in the cost structure....

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

    Science.gov (United States)

    Moshammer, Hanns; Wallner, Peter

    2011-09-01

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

  7. A primer on quality indicators of distance education.

    Science.gov (United States)

    Chaney, Beth H; Eddy, James M; Dorman, Steve M; Glessner, Linda L; Green, B Lee; Lara-Alecio, Rafael

    2009-04-01

    In the past decade, there has been an enormous growth of distance education courses and programs in higher education. The growth of distance education is particularly evident in the field of health education. However, the enormous potential of distance education is tempered by one overriding question: How does one ensure that distance education coursework and degrees are of high quality? To this end, the purpose of this study is twofold: to identify quality indicators of distance education and to provide implications of the identified quality indicators for health education researchers and practitioners. The results of the study reveal common benchmarks and quality indicators that all parties deem important in designing, implementing, and evaluating distance education courses and programs.

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

    Directory of Open Access Journals (Sweden)

    Jaffe Dena H

    2012-01-01

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

  9. Baby-MONITOR: A Composite Indicator of NICU Quality

    Science.gov (United States)

    Kowalkowski, Marc A.; Zupancic, John A. F.; Pietz, Kenneth; Richardson, Peter; Draper, David; Hysong, Sylvia J.; Thomas, Eric J.; Petersen, Laura A.; Gould, Jeffrey B.

    2014-01-01

    BACKGROUND AND OBJECTIVES: NICUs vary in the quality of care delivered to very low birth weight (VLBW) infants. NICU performance on 1 measure of quality only modestly predicts performance on others. Composite measurement of quality of care delivery may provide a more comprehensive assessment of quality. The objective of our study was to develop a robust composite indicator of quality of NICU care provided to VLBW infants that accurately discriminates performance among NICUs. METHODS: We developed a composite indicator, Baby-MONITOR, based on 9 measures of quality chosen by a panel of experts. Measures were standardized, equally weighted, and averaged. We used the California Perinatal Quality Care Collaborative database to perform across-sectional analysis of care given to VLBW infants between 2004 and 2010. Performance on the Baby-MONITOR is not an absolute marker of quality but indicates overall performance relative to that of the other NICUs. We used sensitivity analyses to assess the robustness of the composite indicator, by varying assumptions and methods. RESULTS: Our sample included 9023 VLBW infants in 22 California regional NICUs. We found significant variations within and between NICUs on measured components of the Baby-MONITOR. Risk-adjusted composite scores discriminated performance among this sample of NICUs. Sensitivity analysis that included different approaches to normalization, weighting, and aggregation of individual measures showed the Baby-MONITOR to be robust (r = 0.89–0.99). CONCLUSIONS: The Baby-MONITOR may be a useful tool to comprehensively assess the quality of care delivered by NICUs. PMID:24918221

  10. Quality indicators in digestive endoscopy: introduction to structure, process, and outcome common indicators.

    Science.gov (United States)

    López-Picazo, Julio; Alberca de Las Parras, Fernando; Sánchez Del Río, Antonio; Pérez Romero, Shirley; León Molina, Joaquín; Júdez, Francisco Javier

    2017-06-01

    The general goal of the project wherein this paper is framed is the proposal of useful quality and safety procedures and indicators to facilitate quality improvement in digestive endoscopy units. This initial offspring sets forth procedures and indicators common to all digestive endoscopy procedures. First, a diagram of pre- and post-digestive endoscopy steps was developed. A group of health care quality and/or endoscopy experts under the auspices of the Sociedad Española de Patología Digestiva (Spanish Society of Digestive Diseases) carried out a qualitative review of the literature regarding the search for quality indicators in endoscopic procedures. Then, a paired analysis was used for the selection of literature references and their subsequent review. Twenty indicators were identified, including seven for structure, eleven for process (five pre-procedure, three intra-procedure, three post-procedure), and two for outcome. Quality of evidence was analyzed for each indicator using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification.

  11. [Assessment indicators of soil quality in hilly Loess plateau].

    Science.gov (United States)

    Xu, Mingxiang; Liu, Guobin; Zhao, Yunge

    2005-10-01

    By the methods of sensitivity analysis, main component analsis and discriminant analysis, this paper screened the sensitive indicators from 32 soil attributes to assess the productivity and erosion-resistance ability of the soils in hilly Loess Plateau. The results showed that soil available phosphorus content, anti-scouring ability, infiltration coefficient, labile organic carbon content, organic matter content and urease activity were the most sensitive indicators for soil quality assessment and the main targets for soil quality management and improvement, while soil biological indicators were with high and medium sensitivity. Five soil quality factors were summed up from 29 soil chemical, physical and biological attributes, i. e., organic matter, texture, phosphorus, porosity and microstructure. Except the factor porosity, the other four factors were significantly different between different land use types. Eight indicators including soil organic matter content, infiltration coefficient, anti-scouring ability, CEC, invertase activity, mean weight diameter (MWD) of aggregates, available phosphorus, and MWD of microaggregate were identified as the assessment indicators of the soil quality in hilly Loess Plateau, with the organic matter content, infiltration coefficient and anti-scouring ability as the key indicators.

  12. Quality indicators for colonoscopy: Current insights and caveats

    Institute of Scientific and Technical Information of China (English)

    Hendrikus; JM; Pullens; Peter; D; Siersema

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Burke Martyn

    2011-08-01

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

  14. How Teachers' Self-Efficacy Is Related to Instructional Quality: A Longitudinal Analysis

    Science.gov (United States)

    Holzberger, Doris; Philipp, Anja; Kunter, Mareike

    2013-01-01

    This study extends previous research on teachers' self-efficacy by exploring reciprocal effects of teachers' self-efficacy and instructional quality in a longitudinal panel study. The study design combined a self-report measure of teacher self-efficacy with teacher and student ratings of instructional quality (assessing cognitive activation,…

  15. Child Care Quality and Children's Cognitive and Socio-Emotional Development: An Australian Longitudinal Study

    Science.gov (United States)

    Gialamas, Angela; Mittinty, Murthy N.; Sawyer, Michael G.; Zubrick, Stephen R.; Lynch, John

    2014-01-01

    There is growing evidence that high-quality non-parental child care can contribute to children's learning, development and successful transition to school. Research examining the quality of child care and the effect on children's development is not well documented outside the USA. We used data from the Longitudinal Study of Australian Children to…

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    The application of the two-stage Newton Type Algorithm for the tracking of the power quality indicators (in accordance with IEEE Standard 1459-2000) is presented in the paper. To estimate their spectra and fundamental frequency, the current and voltage signals are first processed and then the power...... quality indicators calculated. The algorithm considers frequency as an unknown parameter and estimates it whilst determining the input signal spectrum; this ensures the algorithm is insensitive to frequency changes. The proposed algorithm was evaluated using signals acquired during a wind farm islanding...

  17. Soil organic matter stratification as an indicator of soil quality

    OpenAIRE

    Franzluebbers, A.J.

    2002-01-01

    Metadata only record This paper explores the potential for using a ration of the stratification of soil organic C and N pools by depth as an indicator of soil quality. Stratification ratios offer a more universal indicator of soil quality, allowing comparison of soils across different soil types and climates. The ratios calculated for Georgia, Texas, and Alberta/British Colombia were, respectively, 1.1, 1.2, and 1.9 under conventional tillage, and 3.0, 2.0, and 2.1 under no tillage. High s...

  18. Irrigation water quality as indicator of sustainable rural development

    Directory of Open Access Journals (Sweden)

    Trajković Slaviša

    2004-01-01

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

  19. Assessment of quality indicators in spanish higher military education

    Directory of Open Access Journals (Sweden)

    Olmos Gómez Maria del Carmen

    2016-01-01

    Full Text Available The quality assessment is subject to multiple interpretations of its content and purpose, and also regarding to methods and techniques used to develop it. Although purposes of assessment are varied, usually pursuit three goals: Improvement, accountability and information. Currently, the concept of quality evaluation has been replaced by the management of educational quality, as Matthew [6] point “the new culture of evaluation is no longer oriented to penalty, ranking or selection of people, as provide a reasoned and reasonable information to guide the management of educational improvement”. Military Training Centres are externally evaluated by an experts External Evaluation Unit to identify strengths and weaknesses on their self-evaluation system and focus on important aspects related to the organization of the Centre, development of work plans, teacher’s style and students learning strategies, system of evaluation and qualification and accurate recommendations to improve all that. This research focuses on the evaluation of quality indicators for the external evaluation of higher education at Military Education Centres in Spain and it is funded by a joint project between University of Granada and MADOC. The technique used for collecting and analysing information was a content description of several documents provided by these military educational authorities, arising the identification and extraction of relevant indicators on the evaluation of higher education. This analysis was primarily based on standards and indicators systems by ANECA (National Agency for Quality Assessment and Accreditation adapted to the Military Higher Education, but also it was consider other standards by international agencies and evaluative institutions, such as University of Chile, University of Paraguay, Canarias Agency for Quality Assessment and Accreditation and Agency for Quality Education System University of Castilla y León. The analysis realize a usual

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  1. A Framework of Quality Indicators for Learning Analytics

    NARCIS (Netherlands)

    Scheffel, Maren

    2017-01-01

    The LACE project has established a first version of a framework of quality indicators for learning analytics, based on a group concept mapping study with experts. The group concept mapping approach is explained, and steps in the framework creation process described, as well as the framework itself.

  2. Developing an Evaluation Framework of Quality Indicators for Learning Analytics

    NARCIS (Netherlands)

    Scheffel, Maren; Drachsler, Hendrik; Specht, Marcus

    2017-01-01

    This paper presents results from the continuous process of developing an evaluation framework of quality indicators for learning analytics (LA). Building on a previous study, a group concept mapping approach that uses multidimensional scaling and hierarchical clustering, the study presented here

  3. Developing an Evaluation Framework of Quality Indicators for Learning Analytics

    NARCIS (Netherlands)

    Scheffel, Maren; Drachsler, Hendrik; Specht, Marcus

    2017-01-01

    This paper presents results from the continuous process of developing an evaluation framework of quality indicators for learning analytics (LA). Building on a previous study, a group concept mapping approach that uses multidimensional scaling and hierarchical clustering, the study presented here app

  4. River Quality Investigations, Part 1: Some Diversity and Biotic Indices.

    Science.gov (United States)

    Hewitt, G.

    1991-01-01

    The following indices for assessing river water quality are described: Shannon-Weiner Diversity Index, Sorenson Quotient of Similarity, Czekanowski's Index of Similarity, Trent Biotic Index, Chandler Score, and Biological Monitoring Working Party Score. Their advantages and disadvantages are outlined. (Author)

  5. Finding the right indicators for assessing quality midwifery care

    NARCIS (Netherlands)

    Bruin-Kooistra, M. de; Amelink-Verburg, M.P.; Buitendijk, S.E.; Westert, G.P.

    2012-01-01

    OBJECTIVE: To identify a set of indicators for monitoring the quality of maternity care for low-risk women provided by primary care midwives and general practitioners (GPs) in the Netherlands. DESIGN: A Project Group (midwives, GPs, policymakers and researchers) defined a long list of potential

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

    NARCIS (Netherlands)

    A.M. van Dishoeck (Anne-Margreet)

    2015-01-01

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

  7. SUSTAINABLE COMPETITIVENESS THROUGH QUALITY TRANSFORMATION: A LONGITUDINAL ANALYSIS OF QUALITY AWARD WINNERS AND A PROPOSED FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Mohd Ashari Idris

    2002-01-01

    Full Text Available Quality management is a dynamic philosophy that underlines the organisational adaptation and proactive transformation that enables firms to reap real benefits from market opportunities. The faster the market changes, the quicker the transformation that is required for sustaining the firm's internal capabilities and its external competitiveness. Under a competitive pressure, a firm will need to learn faster and lead in best practice for operational excellence and continuously finding ways to shield its advantage from imitation.In the search for determinants for sustainability, this article analyses best practices adopted by quality award-winning organisations and synthesises a collection of critical factors that could assist organisations in improving their performance. From a longitudinal learning on how these leading organisations led themselves into a new sustaining paradigm, the article makes explicit the factors that were considered of paramount importance to sustainability. These success factors become a basis for others to leapfrog ahead into a new performance orbit. A proposed model for sustaining competitiveness has been developed from the creative learning of best practices of leading organisations. This proposed framework presents companies with an opportunity to emulate successful implementation of TQ-based initiatives, and to embed these pioneering concepts, particularly in the context of emerging countries.

  8. Sterols indicate water quality and wastewater treatment efficiency.

    Science.gov (United States)

    Reichwaldt, Elke S; Ho, Wei Y; Zhou, Wenxu; Ghadouani, Anas

    2017-01-01

    As the world's population continues to grow, water pollution is presenting one of the biggest challenges worldwide. More wastewater is being generated and the demand for clean water is increasing. To ensure the safety and health of humans and the environment, highly efficient wastewater treatment systems, and a reliable assessment of water quality and pollutants are required. The advance of holistic approaches to water quality management and the increasing use of ecological water treatment technologies, such as constructed wetlands and waste stabilisation ponds (WSPs), challenge the appropriateness of commonly used water quality indicators. Instead, additional indicators, which are direct measures of the processes involved in the stabilisation of human waste, have to be established to provide an in-depth understanding of system performance. In this study we identified the sterol composition of wastewater treated in WSPs and assessed the suitability of human sterol levels as a bioindicator of treatment efficiency of wastewater in WSPs. As treatment progressed in WSPs, the relative abundance of human faecal sterols, such as coprostanol, epicoprostanol, 24-ethylcoprostanol, and sitostanol decreased significantly and the sterol composition in wastewater changed significantly. Furthermore, sterol levels were found to be correlated with commonly used wastewater quality indicators, such as BOD, TSS and E. coli. Three of the seven sterol ratios that have previously been used to track sewage pollution in the environment, detected a faecal signal in the effluent of WSPs, however, the others were influenced by high prevalence of sterols originating from algal and fungal activities. This finding poses a concern for environmental assessment studies, because environmental pollution from waste stabilisation ponds can go unnoticed. In conclusion, faecal sterols and their ratios can be used as reliable indicators of treatment efficiency and water quality during wastewater

  9. Quality indicators for all dimensions of infertility care quality: consensus between professionals and patients

    NARCIS (Netherlands)

    Dancet, E.A.; D'Hooghe, T.M.; Spiessens, C.; Sermeus, W.; Neubourg, D. De; Karel, N.; Kremer, J.A.M.; Nelen, W.L.D.M.

    2013-01-01

    STUDY QUESTION: What is the relative importance of the six dimensions of quality of care according to different stakeholders and can a quality indicator set address all six quality dimensions and incorporate the views from professionals working in different disciplines and from patients? SUMMARY ANS

  10. Assessing quality in European educational research indicators and approaches

    CERN Document Server

    Åström, Fredrik; Hansen, Antje

    2014-01-01

    Competition-based models for research policy and management have an increasing influence throughout the research process, from attracting funding to publishing results. The introduction of quality control methods utilizing various forms of performance indicators is part of this development. The authors presented in this volume deal with the following questions: What counts as ‘quality’ and how can this be assessed? What are the possible side effects of current quality control systems on research conducted in the European Research Area, especially in the social sciences and the humanities?

  11. A systematic review of health-related quality of life in longitudinal studies of myeloma patients

    DEFF Research Database (Denmark)

    Nielsen, Lene Kongsgaard; Jarden, Mary Ellen; Andersen, Christen Lykkegaard

    2017-01-01

    OBJECTIVES: Multiple myeloma (MM) patients report high symptom burden and reduced health-related quality of life (HRQoL) compared to patients with other haematological malignancies. The aim of this review was to analyse published longitudinal studies including MM patients according to a change...... in HRQoL scores, which is perceived as beneficial to the patient according to two published guidelines. METHODS: A literature search was performed May 2016. Publications with longitudinal follow-up using the EORTC QLQ-C30 instrument for HRQoL measurement of physical functioning, global quality of life...

  12. Quality indicators for technologies applied to the hospital pharmacy.

    Science.gov (United States)

    Negro Vega, Eva; Álvarez Díaz, Ana María; Queralt Gorgas, María; Encinas Barrios, Carmen; De la Rubia Nieto, Amelia

    2017-07-01

    The TECNO group of the Sociedad Española de Farmacia Hospitalaria (Spanish Society of Hospital Pharmacy) has addressed the definition of a catalogue of indicators for performance, quality and safety in the use of technologies applied to the logistic activity of Hospital Pharmacy Units.The project was developed with a methodology of qualitative techniques by consensus, with the members of the TECNO Group participating as experts. Once indicators had been defined, a validation phase was conducted, and standards were established based on the result of the sampling carried out in the hospitals of the group members.A total of 28 indicators were obtained, with their corresponding quality standards applied to the use of technologies in the processed for medication storage, dispensing and preparation.The definition of quality indicators and their standards for measuring technologies in the use of medication represents a step forward in the improvement of their safety. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  13. Biological and biochemical soil quality indicators for agricultural management

    Science.gov (United States)

    Bongiorno, Giulia

    2017-04-01

    Soil quality is defined as the capacity of a soil to perform multiple functions. Agricultural soils can, in principle, sustain a wide range of functions. However, negative pressure exerted by natural and anthropogenic soil threats such as soil erosion, soil organic matter losses and soil compaction have the potential to permanently damage soil quality. Soil chemical, physical and biological parameters can be used as indicators of soil quality. The specific objective of this study is to assess the suitability of novel soil parameters as soil quality indicators. We focus on biological/biochemical parameters, due to the unique role of soil biota in soil functions and to their high sensitivity to disturbances. The novel indicators are assessed in ten European long-term field experiments (LTEs) with different agricultural land use (arable and permanent crops), management regimes and pedo-climatic characteristics. The contrasts in agricultural management are represented by conventional/reduced tillage, organic/mineral fertilization and organic matter addition/no organic matter addition. We measured two different pools of labile organic carbon (dissolved organic carbon (DOC), and permanganate oxidizable carbon (POXC)), and determined DOC quality through its fractionation in hydrophobic and hydrophilic compounds. In addition, total nematode abundance has been assessed with qPCR. These parameters will be related to soil functions which have been measured with a minimum data set of indicators for soil quality (including TOC, macronutrients, and soil respiration). As a preliminary analysis, the Sensitivity Index (SI) for a given LTE was calculated for DOC and POXC according to Bolinder et al., 1999 as the ratio of the soil attribute under modified practices (e.g. reduced tillage) compared to the conventional practices (e.g. conventional tillage). The overall effect of the sustainable management on the indicators has been derived by calculating an average SI for those LTEs

  14. ADHD and Sleep Quality: Longitudinal Analyses From Childhood to Early Adulthood in a Twin Cohort.

    Science.gov (United States)

    Gregory, Alice M; Agnew-Blais, Jessica C; Matthews, Timothy; Moffitt, Terrie E; Arseneault, Louise

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is associated with poor sleep quality, but there is more to learn about the longitudinal association and aetiology of this association. We investigated the following: (a) Is there an association between childhood ADHD and poor sleep quality in young adulthood? (b) Is this driven by the long-term effects of childhood ADHD or concurrent associations with ADHD in young adulthood? (c) To what extent do genetic and environmental influences explain the overlap between symptoms of ADHD and poor sleep quality? Participants were from the Environmental Risk Longitudinal Twin Study of 2,232 twin children born in the United Kingdom in 1994-1995. We ascertained ADHD diagnoses at ages 5, 7, 10, 12, and 18. We assessed sleep quality using the Pittsburgh Sleep Quality Index at age 18. We used regression models to examine longitudinal associations and bivariate twin modelling to test genetic and environmental influences. Children with ADHD had poorer sleep quality in young adulthood, but only if their ADHD persisted. Adults with ADHD had more sleep problems than those without ADHD, over and above psychiatric comorbidity and maternal insomnia. ADHD and sleep problems in young adulthood were associated because of genetic (55%) and nonshared environmental influences (45%). Should ADHD remit, children with ADHD do not appear to have an increased risk of later sleep problems. Good quality sleep is important for multiple areas of functioning, and a better understanding of why adults with ADHD have poorer sleep quality will further the goal of improving treatments.

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

    Directory of Open Access Journals (Sweden)

    Márcio Flávio Moura de Araújo

    2014-12-01

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

  16. Quality indicators from laboratory and radiology information systems.

    Science.gov (United States)

    Schuers, Matthieu; Joulakian, Mehr B; Griffon, Nicolas; Pachéco, Joanne; Périgard, Carine; Lepage, Eric; Watbled, Ludivine; Massari, Philippe; Darmoni, Stéfan J

    2015-01-01

    Consequences of the computerization of laboratory and radiology information system (LIS and RIS) are not well documented. The aim of this study was to evaluate the impact of computerization of LIS and RIS of four hospitals on performance and quality of care. The study was divided into three phases. First, the subprocesses and information flows of LIS and RIS were described. Then, a literature review was performed in order to identify the indicators used to assess the impact of computerization. Finally, comparisons were made between 2 hospitals. Using the initial framework, each partner described its process mapping concerning LIS and RIS. The review identified a wide panel of indicators. Only 41 were useful to assess the impact of information systems. For each two by two comparison, lists of relevant indicators have been selected from the identified indicators and according to the process mapping comparison. Two by two comparisons have to be completed. Eventually, these indicators may be integrated in the quality process of hospital information systems.

  17. Faculty Perceptions of Online Teaching Effectiveness and Indicators of Quality

    Science.gov (United States)

    Sullivan, Debra Henline; Weatherspoon, Deborah; Hussey, Leslie

    2017-01-01

    Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants (n = 11) included nurse educators from an online university with an average of 15 years of experience teaching in nursing academia and 6 years in an online environment. Teaching effectiveness, indicators of quality, and student success were three categories that emerged from the analysis of data. What materialized from the analysis was an overarching concept of a “dance” that occurs in the online environment. Effective online teachers facilitate, connect, lead, and work in synchrony with students to obtain indicators of quality such as student success, student improvement over time, and student application of knowledge to the professional role.

  18. Faculty Perceptions of Online Teaching Effectiveness and Indicators of Quality

    Directory of Open Access Journals (Sweden)

    Christine Frazer

    2017-01-01

    Full Text Available Online education programs in nursing are increasing rapidly. Faculty need to be competent in their role and possess the skills necessary to positively impact student outcomes. Existing research offers effective teaching strategies for online education; however, there may be some disconnect in the application of these strategies and faculty perceptions of associated outcomes. Focus groups were formed to uncover how nursing faculty in an online program define and describe teaching effectiveness and quality indicators in an asynchronous online environment. A semistructured interview format guided group discussion. Participants (n=11 included nurse educators from an online university with an average of 15 years of experience teaching in nursing academia and 6 years in an online environment. Teaching effectiveness, indicators of quality, and student success were three categories that emerged from the analysis of data. What materialized from the analysis was an overarching concept of a “dance” that occurs in the online environment. Effective online teachers facilitate, connect, lead, and work in synchrony with students to obtain indicators of quality such as student success, student improvement over time, and student application of knowledge to the professional role.

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

    Directory of Open Access Journals (Sweden)

    Ochuko Lucky Erukainure

    2016-04-01

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

  20. Longitudinal associations between relationship quality and coparenting across the transition to parenthood: A dyadic perspective.

    Science.gov (United States)

    Le, Yunying; McDaniel, Brandon T; Leavitt, Chelom E; Feinberg, Mark E

    2016-12-01

    The couple and coparenting relationship are theorized to influence each other in a reciprocal manner over time. Empirical evidence demonstrates cross-sectional associations between the 2 as well as prospective predictions of coparenting by relationship quality and vice versa. However, less is known about the longitudinal reciprocity between the couple relationship and coparenting from the perspective of both parents. The current study sought to examine longitudinal associations between relationship quality and coparenting support/undermining across the transition to parenthood from a dyadic perspective. Participants were 164 cohabiting heterosexual couples expecting their 1st child, assessed during pregnancy and at 6 and 36 months after birth. Actor partner interdependence modeling was used to examine, for both men and women, (a) stability over time in relationship quality and coparenting, (b) reciprocal associations between relationship quality and coparenting support/undermining, and (c) the gender differences in those associations. Moderate rank-order stability in relationship quality and coparenting support/undermining across the 1st 3 years of parenthood was demonstrated. For women, but not men, findings suggested longitudinal reciprocal associations between relationship quality and coparenting support/undermining. Specifically, our findings suggested that prenatal relationship quality sets the stage for coparenting functioning after birth for both men and women but that coparenting functioning is then connected to subsequent feelings about the romantic relationship for only women. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Effects of an Incentive Based Budgeting System on Institutional Performance Indicators: An Exploratory Longitudinal Case Study of a Public University

    Science.gov (United States)

    Willett, Michael S.

    2013-01-01

    The purpose of this exploratory longitudinal case study was to examine how the implementation of an Incentive Based Budgeting (IBB) system (i.e., Responsibility-Centered Management [RCM]) affected selected institutional performance indicators at the campus level and two comparable schools at a large Mid-Western public University. The value of…

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

    Science.gov (United States)

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

    2013-01-01

    The assessment of the health state in patients and changes in their health state for the purpose of diagnosis, prognosis and monitoring of treatment response plays a central role in clinical practice. Quality criteria for measurements in medicine include validity, reliability, responsiveness, interpretability, and feasibility. High-quality measurement instruments are a prerequisite for evidence-based medicine. Therefore, international outcomes research groups have developed methods for quality assurance and for the standardisation of measurement instruments. Quality indicators are instruments to measure the quality of care. Due to the increasing relevance of quality assessment for all stakeholders in healthcare and due to the political intention to draw relevant conclusions from the assessment of the quality of care, quality indicators must at least meet the same high standards that are required for clinical trial end points. However, independent researchers and clinicians do not engage in the validation and standardisation of quality indicators in Germany; currently, only the AQUA institute (as assigned by the German GBA) deals with this important issue. Current activities concerning the validation of quality indicators do not meet the requirements of evidence-based healthcare. This is a critical barrier to achieving the political goals of quality medicine. Therefore, the authors propose a multi-step, multi-professional, evidence-driven and evidence-generating consensus process on the basis of established methods of outcomes research for the advancement of quality assessment with quality indicators in Germany. All relevant stakeholders should participate in this process. Copyright © 2013. Published by Elsevier GmbH.

  3. Educational Level and the Quality of Life of Heart Failure Patients : A Longitudinal Study

    NARCIS (Netherlands)

    Barbareschi, Giorgio; Sanderman, Robbert; Lesman-Leegte, Ivonne; Van Veldhuisen, Dirk J.; Jaarsma, Tiny

    2011-01-01

    Background: Lower education in heart failure (HF) patients is associated with high levels of anxiety, limited physical functioning, and an increased risk of hospitalization. We examined whether educational level is related to longitudinal differences in quality of life (QoL) in HF patients. Methods

  4. A Longitudinal Analysis of Rural and Urban Veterans' Health-Related Quality of Life

    Science.gov (United States)

    Wallace, Amy E.; Lee, Richard; MacKenzie, Todd A.; West, Alan N.; Wright, Steven; Booth, Brenda M.; Hawthorne, Kara; Weeks, William B.

    2010-01-01

    Context: Cross-sectional studies have identified rural-urban disparities in veterans' health-related quality-of-life (HRQOL) scores. Purpose: To determine whether longitudinal analyses confirmed that these disparities in veterans' HRQOL scores persisted. Methods: We obtained data from the SF-12 portion of the veterans health administration's…

  5. Longitudinal Associations between Perceived Parent-Child Relationship Quality and Depressive Symptoms in Adolescence

    Science.gov (United States)

    Branje, Susan J. T.; Hale, William W., III; Frijns, Tom; Meeus, Wim H. J.

    2010-01-01

    This longitudinal study examined bidirectional paths between perceived parent-adolescent relationship quality and depressive symptoms, as well as the moderating role of sex, age, and personality type. 1313 Dutch adolescents (51% girls) from two cohorts (923 12-year olds and 390 16-year olds at Wave 1) reported on their personality, depressive…

  6. Friendship Quality and School Achievement: A Longitudinal Analysis during Primary School

    Science.gov (United States)

    Zucchetti, Giulia; Candela, Filippo; Sacconi, Beatrice; Rabaglietti, Emanuela

    2015-01-01

    This study examined the longitudinal relationship between friendship quality (positive and negative) and school achievement among 228 school-age children (51% girls, M = 8.09, SD = 0.41). A three-wave cross-lagged analysis was used to determine the direction of influence between these domains across school years. Findings revealed that: (a) school…

  7. Educational Level and the Quality of Life of Heart Failure Patients : A Longitudinal Study

    NARCIS (Netherlands)

    Barbareschi, Giorgio; Sanderman, Robbert; Lesman-Leegte, Ivonne; Van Veldhuisen, Dirk J.; Jaarsma, Tiny

    2011-01-01

    Background: Lower education in heart failure (HF) patients is associated with high levels of anxiety, limited physical functioning, and an increased risk of hospitalization. We examined whether educational level is related to longitudinal differences in quality of life (QoL) in HF patients. Methods

  8. A longitudinal, multi-level comparative study of quality and safety in European hospitals

    DEFF Research Database (Denmark)

    Robert, Glenn B; Anderson, Janet E; Burnett, Susan J

    2011-01-01

    these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. METHODS/DESIGN: in-depth multi-level (macro, meso...... and micro-system) analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness...

  9. Work Stressors, Perseverative Cognition and Objective Sleep Quality: A Longitudinal Study among Dutch Helicopter Emergency Medical Service (HEMS) Pilots

    NARCIS (Netherlands)

    Radstaak, M.; Geurts, S.A.E.; Beckers, D.G.J.; Brosschot, J.F.; Kompier, M.A.J.

    2014-01-01

    Objectives: This longitudinal study examined the associations between work stressors, perseverative cognition and subjective and objective sleep quality. We hypothesized work stressors to be associated with (i) poor nocturnal sleep quality and (ii) higher levels of perseverative cognition during a

  10. Global quality indicators for primary care Electronic Patient Records.

    Science.gov (United States)

    De Clercq, Etienne; Moreels, Sarah; Van Casteren, Viviane; Bossuyt, Nathalie; Goderis, Geert

    2013-01-01

    Electronic Patient Records can be interfaced with medical decision support systems and quality of care assessment tools. An easy way of measuring the quality of EPR data is therefore essential. This study identified a number of global quality indicators (tracers) that could be easily calculated and validated them by correlating them with the Sensitivity and Positive Predictive Value (PPV) of data extracted from the EPR. Sensitivity and PPV of automatically extracted data were calculated using a gold standard constructed using answers to questions GPs were asked at the end of each contact with a patient. These properties were measured for extracted diagnoses, drug prescriptions, and certain parameters. Tracers were defined as drug-disease pairs (e.g. insulin-diabetes) with the assumption that if the patient is taking the drug, then the patient is suffering from the disease. Four tracers were identified that could be used for the ResoPrim primary care research database, which includes data from 43 practices, 10,307 patients, and 13,372 contacts. Moderately positive correlations were found between the 4 tracers and between the tracers and the sensitivity of automatically extracted diagnoses. For some purposes, these results may support the potential use of tracers for monitoring the quality of information systems such as EPRs.

  11. Longitudinal changes in health related quality of life in children with migrant backgrounds

    Science.gov (United States)

    Villalonga-Olives, Ester; Kawachi, Ichiro; Almansa, Josue; von Steinbüchel, Nicole

    2017-01-01

    Background Little is known about longitudinal changes in the Health Related Quality of Life (HRQoL) among children with migrant backgrounds. Methods The sample comprised 350 children with predominantly migrant backgrounds enrolled in 7 kindergartens in Frankfurt and Darmstadt, Germany. At baseline, the participants’ mean age was 4.4 years (SD 0.9). Data collection started in May 2009. Two waves of data were collected one year apart (94% response rate). HRQoL was evaluated with the Kiddy-KINDL. The other variables under study were sex, age, socioeconomic status, country of origin, developmental status (WET) and individual behavior (VBV). Data were collected from the children, parents and teachers. Structural equation modeling (SEM) was used to assess the Wilson and Cleary theoretical framework on changes in HRQoL and Generalized Estimated Equations (GEE) to model the longitudinal trend in HRQoL. Results Overall HRQoL remained stable between baseline and follow-up. SEM model fit was χ2 = 8.51; df = 5; p = 0.13; SRMR = 0.02 RMSEA = 0.06 and indicated that there were differences in kindergarten activities (p<0.05). The GEE model elucidated that the differences in HRQoL between the baseline and follow-up varied according to kindergarten activities that the children were assigned to (music, art, or no activities) (p<0.05), but that there were no differences in terms of country of origin. On average, girls reported better HRQoL. Conclusion Overall HRQoL scores remained stable over follow-up in a sample of migrant children and there were no differences in terms of origin. However, there was heterogeneity in the results depending on the kindergarten activities that the children were assigned to. PMID:28151986

  12. Water quality evaluation of Al-Gharraf river by two water quality indices

    Science.gov (United States)

    Ewaid, Salam Hussein

    2016-12-01

    Water quality of Al-Gharraf river, the largest branch of Tigris River south of Iraq, was evaluated by the National Sanitation Foundation Water Quality Index (NFS WQI) and the Heavy Metal Pollution Index (HPI) depending on 13 physical, chemical, and biological parameters of water quality measured monthly at ten stations on the river during 2015. The NSF-WQI range obtained for the sampling sites was 61-70 indicating a medium water quality. The HPI value was 98.6 slightly below the critical value for drinking water of 100, and the water quality in the upstream stations is better than downstream due to decrease in water and the accumulation of contaminants along the river. This study explains the significance of applying the water quality indices that show the aggregate impact of ecological factors in charge of water pollution of surface water and which permits translation of the monitoring data to assist the decision makers.

  13. Assessing groundwater quality for irrigation using indicator kriging method

    Science.gov (United States)

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

    2016-11-01

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

  14. A longitudinal examination of sleep quality and physical activity in older adults.

    Science.gov (United States)

    Holfeld, Brett; Ruthig, Joelle C

    2014-10-01

    The relationship between sleep quality and physical activity is bidirectional, yet prior research on older adults has mainly focused on investigating whether increasing levels of physical activity leads to improvements in sleep quality. The current longitudinal study examined both directional relationships by assessing sleep quality and physical activity twice over a two-year period among 426 community-dwelling older adults (ages 61-100). A cross-lagged panel analysis that included age, gender, perceived stress, functional ability, and severity of chronic health conditions as covariates, revealed that better initial sleep quality predicted higher levels of later physical activity beyond the effects of prior physical activity; whereas initial physical activity did not predict later sleep quality after accounting for prior sleep quality. These findings highlight sleep quality as an important contributor to a physically active lifestyle among older adults.

  15. Evaluating the Effect of Software Quality Characteristics on Health Care Quality Indicators

    Directory of Open Access Journals (Sweden)

    Sakineh Aghazadeh

    2015-07-01

    Full Text Available Introduction: Various types of software are used in health care organizations to manage information and care processes. The quality of software has been an important concern for both health authorities and designers of Health Information Technology. Thus, assessing the effect of software quality on the performance quality of healthcare institutions is essential. Method: The most important health care quality indicators in relation to software quality characteristics are provided via an already performed literature review. ISO 9126 standard model is used for definition and integration of various characteristics of software quality. The effects of software quality characteristics and sub-characteristics on the healthcare indicators are evaluated through expert opinion analyses. A questionnaire comprising of 126 questions of 10-point Likert scale was used to gather opinions of experts in the field of Medical/Health Informatics. The data was analyzed using Structural Equation Modeling. Results: Our findings showed that software Maintainability was rated as the most effective factor on user satisfaction (R2 =0.89 and Functionality as the most important and independent variable affecting patient care quality (R2 =0.98. Efficiency was considered as the most effective factor on workflow (R2 =0.97, and Maintainability as the most important factor that affects healthcare communication (R2 =0.95. Usability and Efficiency were rated as the most effectual factor affecting patient satisfaction (R2 =0.80, 0.81. Reliability, Maintainability, and Efficiency were considered as the main factors affecting care costs (R2 =0.87, 0.74, 0.87. Conclusion: We presented a new model based on ISO standards. The model demonstrates and weighs the relations between software quality characteristics and healthcare quality indicators. The clear relationships between variables and the type of the metrics and measurement methods used in the model make it a reliable method to assess

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

    Science.gov (United States)

    Braga, Glaucia Karime; Fonseca, Maria Jose Viera

    2010-01-01

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

  17. The Quality of Mixing in Mixers with Bars and Radial and Longitudinal Scrapers

    Directory of Open Access Journals (Sweden)

    Andrievschi Serghei

    2013-07-01

    Full Text Available The process of division - combining of streams in mixers with bars and radial and longitudinal scrapers was studied. The number of unique streams that are formed after passing each row of longitudinal bars and the total amount of them were determined. This is demonstrated by migration of the particles along the mixer from left to right and vice versa, from the center of the drum towards the periphery and vice versa. In the process of mixing the particles in the center gain normal distribution and the ones on the side - sectioned normal distribution. The sum of normal distribution with the sectioned normal distribution leads to an equable distribution along the drum and transverse planes and to a homogeneous mixing of the components. The quality of mixing had been investigated and an optimal mixing regime for the mixer with radial and longitudinal bars and scrapers was proposed.

  18. Toward the Next Generation of Air Quality Monitoring Indicators

    Science.gov (United States)

    Hsu, Angel; Reuben, Aaron; Shindell, Drew; deSherbinin, Alex; Levy, Marc

    2013-01-01

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

  19. Changes in autistic trait indicators in parents and their children with ASD: A preliminary longitudinal study.

    Science.gov (United States)

    Hasegawa, Chiaki; Kikuchi, Mitsuru; Yoshimura, Yuko; Hiraishi, Hirotoshi; Munesue, Toshio; Takesaki, Natsumi; Higashida, Haruhiro; Oi, Manabu; Minabe, Yoshio; Asada, Minoru

    2015-08-30

    This study investigated whether the longitudinal changes in symptom severity in children with autism spectrum disorder (ASD) are associated with changes in the parents׳ autistic traits. The results demonstrated two significant correlations between the changes in children׳s Social Responsiveness Scale (SRS) scores and the Social Responsiveness Scale (SRS) score changes in either the father or both parents. Autistic symptom mitigation in ASD children was associated with increased empathy levels in their parents. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Molzahn Tanja

    2007-09-01

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

  1. Effects of higher order control systems on aircraft approach and landing longitudinal handling qualities

    Science.gov (United States)

    Pasha, M. A.; Dazzo, J. J.; Silverthorn, J. T.

    1982-01-01

    An investigation of approach and landing longitudinal flying qualities, based on data generated using a variable stability NT-33 aircraft combined with significant control system dynamics is described. An optimum pilot lead time for pitch tracking, flight path angle tracking, and combined pitch and flight path angle tracking tasks is determined from a closed loop simulation using integral squared error (ISE) as a performance measure. Pilot gain and lead time were varied in the closed loop simulation of the pilot and aircraft to obtain the best performance for different control system configurations. The results lead to the selection of an optimum lead time using ISE as a performance criterion. Using this value of optimum lead time, a correlation is then found between pilot rating and performance with changes in the control system and in the aircraft dynamics. It is also shown that pilot rating is closely related to pilot workload which, in turn, is related to the amount of lead which the pilot must generate to obtain satisfactory response. The results also indicate that the pilot may use pitch angle tracking for the approach task and then add flight path angle tracking for the flare and touchdown.

  2. Effects of higher order control systems on aircraft approach and landing longitudinal handling qualities

    Science.gov (United States)

    Pasha, M. A.; Dazzo, J. J.; Silverthorn, J. T.

    1982-01-01

    An investigation of approach and landing longitudinal flying qualities, based on data generated using a variable stability NT-33 aircraft combined with significant control system dynamics is described. An optimum pilot lead time for pitch tracking, flight path angle tracking, and combined pitch and flight path angle tracking tasks is determined from a closed loop simulation using integral squared error (ISE) as a performance measure. Pilot gain and lead time were varied in the closed loop simulation of the pilot and aircraft to obtain the best performance for different control system configurations. The results lead to the selection of an optimum lead time using ISE as a performance criterion. Using this value of optimum lead time, a correlation is then found between pilot rating and performance with changes in the control system and in the aircraft dynamics. It is also shown that pilot rating is closely related to pilot workload which, in turn, is related to the amount of lead which the pilot must generate to obtain satisfactory response. The results also indicate that the pilot may use pitch angle tracking for the approach task and then add flight path angle tracking for the flare and touchdown.

  3. Assessing longitudinal quality of life in prostate cancer patients and their spouses: a multilevel modeling approach

    Science.gov (United States)

    Northouse, Laurel L.; Braun, Thomas M.; Zhang, Lingling; Cimprich, Bernadine; Ronis, David L.; Mood, Darlene W.

    2013-01-01

    Purpose This study aimed at examining the relationship between quality of life (QOL) in prostate cancer (PCa) patients and partners and how baseline demographics, cancer-related factors, and time-varying psychosocial and symptom covariates affect their QOL over time. Methods Guided by a modified Stress-Coping Model, this study used multilevel modeling to analyze longitudinal data from a randomized clinical trial that tested a family-based intervention to improve QOL in couples managing PCa. Patients and partners from the usual-care control group (N = 134 dyads) independently completed the measurements at baseline, and at 4-, 8-, and 12-month follow-ups. Results Correlations of QOL between patients and partners over time were small to moderate. Patients’ lower education level, partners’ older age, higher family income, and localized cancer at baseline were associated with better QOL in couples. Over time, couples’ QOL improved as their social support and cancer-related dyadic communication increased and as couples’ uncertainty, general symptoms, and patients’ prostate cancer-related sexual and hormonal symptoms decreased. Conclusions Evidence indicates that couples’ QOL during cancer survivorship is affected by multiple contextual factors (e.g., baseline demographics and time-varying psychosocial factors and symptoms). Intervention research is needed to explore comprehensive strategies to improve couples’ QOL during the continuum of PCa survivorship. PMID:20927648

  4. Towards a standardized method of developing quality indicators for palliative care: protocol of the Quality indicators for Palliative Care (Q-PAC) study

    National Research Council Canada - National Science Library

    Leemans, Kathleen; Cohen, Joachim; Francke, Anneke L; Vander Stichele, Robert; Claessen, Susanne Jj; Van den Block, Lieve; Deliens, Luc

    2013-01-01

    .... In this Quality Indicators for Palliative Care study (Q-PAC study) we have applied a scientifically rigorous method to develop a comprehensive and valid quality indicator set which can contribute to a standardized method for use in other countries...

  5. The Danish National Database for Asthma: establishing clinical quality indicators

    Directory of Open Access Journals (Sweden)

    Susanne Hansen

    2016-11-01

    Full Text Available Asthma is one of the most common chronic diseases worldwide affecting more than 300 million people. Symptoms are often non-specific and include coughing, wheezing, chest tightness, and shortness of breath. Asthma may be highly variable within the same individual over time. Although asthma results in death only in extreme cases, the disease is associated with significant morbidity, reduced quality of life, increased absenteeism, and large costs for society. Asthma can be diagnosed based on report of characteristic symptoms and/or the use of several different diagnostic tests. However, there is currently no gold standard for making a diagnosis, and some degree of misclassification and inter-observer variation can be expected. This may lead to local and regional differences in the treatment, monitoring, and follow-up of the patients. The Danish National Database for Asthma (DNDA is slated to be established with the overall aim of collecting data on all patients treated for asthma in Denmark and systematically monitoring the treatment quality and disease management in both primary and secondary care facilities across the country. The DNDA links information from population-based disease registers in Denmark, including the National Patient Register, the National Prescription Registry, and the National Health Insurance Services register, and potentially includes all asthma patients in Denmark. The following quality indicators have been selected to monitor trends: first, conduction of annual asthma control visits, appropriate pharmacological treatment, measurement of lung function, and asthma challenge testing; second, tools used for diagnosis in new cases; and third, annual assessment of smoking status, height, and weight measurements, and the proportion of patients with acute hospital treatment. The DNDA will be launched in 2016 and will initially include patients treated in secondary care facilities in Denmark. In the nearby future, the database aims

  6. [Application of subjective quality indicators in intensive care].

    Science.gov (United States)

    de Souza, Sônia Regina Oliveira e Silva; da Silva, Cláudia Aparecida; de Mello, Ursula Magliano; Ferreira, Carolina Neris

    2006-01-01

    Our aim is to describe the clients'perception related to to the admission in the Intensive Care. We have developed a descriptive study based on a qualitative approach in the intensive care in a university hospital in RJ, from May, 2003 to May, 2004. Thirty-two clients participated in this study just after hospital discharge. Data collection was possible through a questionaire. We consider that the clients showed some kind of satisfaction related to nursing intensive care, and the problem that really annoys them is the physical and ambiental stressors. The study shows questions that need a continuous discussion considering the stress, once it is a part of the activities and the atmosphere of intensive care and it also detaches the relavence of a work using indicatives of subjective quality in the intensive care.

  7. Comparisons of prediction models of quality of life after laparoscopic cholecystectomy: a longitudinal prospective study.

    Directory of Open Access Journals (Sweden)

    Hon-Yi Shi

    Full Text Available BACKGROUND: Few studies of laparoscopic cholecystectomy (LC outcome have used longitudinal data for more than two years. Moreover, no studies have considered group differences in factors other than outcome such as age and nonsurgical treatment. Additionally, almost all published articles agree that the essential issue of the internal validity (reproducibility of the artificial neural network (ANN, support vector machine (SVM, Gaussian process regression (GPR and multiple linear regression (MLR models has not been adequately addressed. This study proposed to validate the use of these models for predicting quality of life (QOL after LC and to compare the predictive capability of ANNs with that of SVM, GPR and MLR. METHODOLOGY/PRINCIPAL FINDINGS: A total of 400 LC patients completed the SF-36 and the Gastrointestinal Quality of Life Index at baseline and at 2 years postoperatively. The criteria for evaluating the accuracy of the system models were mean square error (MSE and mean absolute percentage error (MAPE. A global sensitivity analysis was also performed to assess the relative significance of input parameters in the system model and to rank the variables in order of importance. Compared to SVM, GPR and MLR models, the ANN model generally had smaller MSE and MAPE values in the training data set and test data set. Most ANN models had MAPE values ranging from 4.20% to 8.60%, and most had high prediction accuracy. The global sensitivity analysis also showed that preoperative functional status was the best parameter for predicting QOL after LC. CONCLUSIONS/SIGNIFICANCE: Compared with SVM, GPR and MLR models, the ANN model in this study was more accurate in predicting patient-reported QOL and had higher overall performance indices. Further studies of this model may consider the effect of a more detailed database that includes complications and clinical examination findings as well as more detailed outcome data.

  8. Are geographical indications a worthy quality label? A framework with endogenous quality choice

    OpenAIRE

    Desquilbet, Marion; Monier-Dilhan, Sylvette

    2011-01-01

    We analyze the effects of Geographical Indication (GI) labeling on quality choices and welfare with two vertically differentiated goods, one labelable, the other not. We consider two attributes of these goods: gustatory quality and geographical origin. We investigate two extreme cases of the Protected Designation of Origin (PDO) label: a denomination standard, which guarantees only the origin of the product, without any requirement on production specifications; and a minimum qu...

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

    Directory of Open Access Journals (Sweden)

    Ho Ngoc Pham

    2015-01-01

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

  10. A longitudinal study of the indicators and factors for successful six sigma deployment in the South African mining industry

    Directory of Open Access Journals (Sweden)

    Keeley, A. L.

    2013-05-01

    Full Text Available The Six Sigma deployment methodology is known for its results in operational excellence associated with improved business practices. Organisations worldwide have shown significantly reduced costs and increased profits when successfully deploying Six Sigma. This paper reports a longitudinal study of a set of indicators and success factors for Six Sigma deployment, using Lonmin PLC, a mining company in South Africa, as a case. The results suggest a shift of indicators from heartfelt personal involvement in 2006 to a mechanistic performance-based culture in 2010. Practical recommendations are made regarding the nine success factor components to be included during Six Sigma deployment

  11. Is surgery indicated for asymptomatic or mildly myelopathic patients with significant ossification of the posterior longitudinal ligament?

    Science.gov (United States)

    Yonenobu, Kazuo

    2012-03-01

    Review article. To discuss indications and timing of surgery for patients with significant ossification of the posterior longitudinal ligament (OPLL) who show no or only mild myelopathic symptoms. Among patients with cervical spinal cord injury, the incidence of patients with OPLL is relatively high, and most had no obvious symptoms of cervical myelopathy. These topics were discussed on the basis of clinical practice guidelines for ossification of the posterior longitudinal ligament as published in 2005 by the Japanese Orthopaedic Association and the Committee on Research into OPLL under the auspices of the Ministry of Health, Labor and Welfare. No evidence supports the usefulness of surgery for patients with significant OPLL without or with only mild cervical myelopathy. "Prophylactic" surgery for patients with significant OPLL without or with only mild cervical myelopathy cannot be recommended on the basis of the existing evidence.

  12. Personality effects on romantic relationship quality through friendship quality: a ten-year longitudinal study in youths.

    Science.gov (United States)

    Yu, Rongqin; Branje, Susan; Keijsers, Loes; Meeus, Wim H J

    2014-01-01

    This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality in young adulthood, via friendship quality development in adolescence. The study employed six waves of longitudinal questionnaire data from Dutch youths who had a romantic relationship when they were young adults. Two age cohorts were followed, from 12 to 21 years and from 16 to 25 years, respectively. Findings showed that resilients reported higher mean levels of friendship quality during adolescence (i.e., more support from, less negative interaction with and less dominance from their best friend) than both overcontrollers and undercontrollers. Through the mean levels of friendship quality throughout adolescence, resilients indirectly experienced higher romantic relationship quality during young adulthood than both overcontrollers and undercontrollers. Thus, results provide support for a developmental model in which adolescent friendship quality is a mechanism linking personality types with young adulthood romantic relationship quality.

  13. Personality effects on romantic relationship quality through friendship quality: a ten-year longitudinal study in youths.

    Directory of Open Access Journals (Sweden)

    Rongqin Yu

    Full Text Available This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality in young adulthood, via friendship quality development in adolescence. The study employed six waves of longitudinal questionnaire data from Dutch youths who had a romantic relationship when they were young adults. Two age cohorts were followed, from 12 to 21 years and from 16 to 25 years, respectively. Findings showed that resilients reported higher mean levels of friendship quality during adolescence (i.e., more support from, less negative interaction with and less dominance from their best friend than both overcontrollers and undercontrollers. Through the mean levels of friendship quality throughout adolescence, resilients indirectly experienced higher romantic relationship quality during young adulthood than both overcontrollers and undercontrollers. Thus, results provide support for a developmental model in which adolescent friendship quality is a mechanism linking personality types with young adulthood romantic relationship quality.

  14. Enzyme activities by indicator of quality in organic soil

    Science.gov (United States)

    Raigon Jiménez, Mo; Fita, Ana Delores; Rodriguez Burruezo, Adrián

    2016-04-01

    The analytical determination of biochemical parameters, as soil enzyme activities and those related to the microbial biomass is growing importance by biological indicator in soil science studies. The metabolic activity in soil is responsible of important processes such as mineralization and humification of organic matter. These biological reactions will affect other key processes involved with elements like carbon, nitrogen and phosphorus , and all transformations related in soil microbial biomass. The determination of biochemical parameters is useful in studies carried out on organic soil where microbial processes that are key to their conservation can be analyzed through parameters of the metabolic activity of these soils. The main objective of this work is to apply analytical methodologies of enzyme activities in soil collections of different physicochemical characteristics. There have been selective sampling of natural soils, organic farming soils, conventional farming soils and urban soils. The soils have been properly identified conserved at 4 ° C until analysis. The enzyme activities determinations have been: catalase, urease, cellulase, dehydrogenase and alkaline phosphatase, which bring together a representative group of biological transformations that occur in the soil environment. The results indicate that for natural and agronomic soil collections, the values of the enzymatic activities are within the ranges established for forestry and agricultural soils. Organic soils are generally higher level of enzymatic, regardless activity of the enzyme involved. Soil near an urban area, levels of activities have been significantly reduced. The vegetation cover applied to organic soils, results in greater enzymatic activity. So the quality of these soils, defined as the ability to maintain their biological productivity is increased with the use of cover crops, whether or spontaneous species. The practice of cover based on legumes could be used as an ideal choice

  15. Assessing Quality of Care of Elderly Patients Using the ACOVE Quality Indicator Set: A Systematic Review

    NARCIS (Netherlands)

    Askari, M.; Wierenga, P.C.; Eslami, S.; Medlock, S.; de Rooij, S.E.; Abu-Hanna, A.

    2011-01-01

    Background: Care of the elderly is recognized as an increasingly important segment of health care. The Assessing Care Of Vulnerable Elderly (ACOVE) quality indicators (QIs) were developed to assess and improve the care of elderly patients. Objectives: The purpose of this review is to summarize studi

  16. Pursuing Quality Evidence: Applying Single-Subject Quality Indicators to Non-Experimental Qualitative Educational Research

    Science.gov (United States)

    Stodden, Robert A.; Yamamoto, Kathryn K.; Folk, Eric; Kong, Eran; Otsuji, Derek N.

    2013-01-01

    The need for quality evidence in support of strategies used while working with persons with autism and intellectual disability (ID) has been long been recognized by researchers and practitioners. The authors reviewed and applied a number of evidence-based indicators, developed through the "What Works Clearinghouse" (WWC), to the conduct…

  17. [Job Satisfaction: a quality indicator in nursing human resource management].

    Science.gov (United States)

    Siqueira, Vera Thânia Alves; Kurcgant, Paulina

    2012-02-01

    This descriptive study addresses the job satisfaction of nurse managers and clinical nurses working at the Hematology and Hemotherapy Services of a public hospital in São Paulo. The study objectives were to identify the factors that caused job satisfaction among nurse managers and clinical nurses, and support the results in the development of indicators to evaluate the quality of nursing human resource management. The components of the study were: autonomy, interaction, professional status, job requirements, organizational norms and remuneration. Participants were 44 nurses. Data were collected using a Job Satisfaction Index (JSI) questionnaire. In conclusion, this study permitted the identification of the clinical nurse group, which was the most satisfied, with a JSI of 10.5; the managerial group scored 10.0. Regarding the satisfaction levels in regards to the current activity, 88.9% of the nurse managers reported feeling satisfied, as did 90.9% of clinical nurses. For both groups, autonomy was the component with the highest level of professional satisfaction.

  18. Assessing quality of care of elderly patients using the ACOVE quality indicator set: a systematic review.

    Directory of Open Access Journals (Sweden)

    Marjan Askari

    Full Text Available BACKGROUND: Care of the elderly is recognized as an increasingly important segment of health care. The Assessing Care Of Vulnerable Elderly (ACOVE quality indicators (QIs were developed to assess and improve the care of elderly patients. OBJECTIVES: The purpose of this review is to summarize studies that assess the quality of care using QIs from or based on ACOVE, in order to evaluate the state of quality of care for the reported conditions. METHODS: We systematically searched MEDLINE, EMBASE and CINAHL for English-language studies indexed by February 2010. Articles were included if they used any ACOVE QIs, or adaptations thereof, for assessing the quality of care. Included studies were analyzed and relevant information was extracted. We summarized the results of these studies, and when possible generated an overall conclusion about the quality of care as measured by ACOVE for each condition, in various settings, and for each QI. RESULTS: Seventeen studies were included with 278 QIs (original, adapted or newly developed. The quality scores showed large variation between and within conditions. Only a few conditions showed a stable pass rate range over multiple studies. Overall, pass rates for dementia (interquartile range (IQR: 11%-35%, depression (IQR: 27%-41%, osteoporosis (IQR: 34%-43% and osteoarthritis (IQR: 29-41% were notably low. Medication management and use (range: 81%-90%, hearing loss (77%-79% and continuity of care (76%-80% scored higher than other conditions. Out of the 278 QIs, 141 (50% had mean pass rates below 50% and 121 QIs (44% had pass rates above 50%. Twenty-three percent of the QIs scored above 75%, and 16% scored below 25%. CONCLUSIONS: Quality of care per condition varies markedly across studies. Although there has been much effort in improving the care for elderly patients in the last years, the reported quality of care according to the ACOVE indicators is still relatively low.

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

    Directory of Open Access Journals (Sweden)

    Sayyed Farooq Shah

    2015-03-01

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

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

    Science.gov (United States)

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

    2007-12-01

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

  1. MALOCCLUSIONS AND QUALITY OF LIFE. Cross-sectional and longitudinal studies in children.

    Science.gov (United States)

    Dimberg, Lillemor

    2015-01-01

    There are few longitudinal studies of the prevalence of malocclusions and possible self-correction of malocclusions during the development of the dentition. Early intervention might be unnecessary if self-correction of the malocclusion occurs during the transition from the primary to the permanent dentition. Most studies are cross-sectional and in those of longitudinal design, the results are inconsistent and difficult to interpret. Malocclusions may or may not influence the quality of life in children and adolescents. Thus, evaluations of the influence of different malocclusions on quality of life will certainly underpin a broader understanding and knowledge about how malocclusions affect the daily life of young patients. This information may also be important when it comes to assessing the most appropriate time for starting orthodontic treatment, not only from a professional point of view, but also, most importantly, from the patients' perspective. The overall aim of this thesis was therefore to evaluate the prevalence of malocclusions, and to document changes occurring during the development of the dentition, from the primary dentition stage at age 3, through the mixed dentition at age 7, to the early permanent dentition at age 11.5 years. Further aims were to review the current state of knowledge about the impact of malocclusions on oral health related quality of life (OHRQoL) and to investigate how malocclusions affect the quality of life in a cohort of children, aged 11.5 years, whose dental care is provided by the Swedish Public Dental Service.

  2. Circular and longitudinal muscles shortening indicates sliding patterns during peristalsis and transient lower esophageal sphincter relaxation.

    Science.gov (United States)

    Patel, Nirali; Jiang, Yanfen; Mittal, Ravinder K; Kim, Tae Ho; Ledgerwood, Melissa; Bhargava, Valmik

    2015-09-01

    Esophageal axial shortening is caused by longitudinal muscle (LM) contraction, but circular muscle (CM) may also contribute to axial shortening because of its spiral morphology. The goal of our study was to show patterns of contraction of CM and LM layers during peristalsis and transient lower esophageal sphincter (LES) relaxation (TLESR). In rats, esophageal and LES morphology was assessed by histology and immunohistochemistry, and function with the use of piezo-electric crystals and manometry. Electrical stimulation of the vagus nerve was used to induce esophageal contractions. In 18 healthy subjects, manometry and high frequency intraluminal ultrasound imaging during swallow-induced esophageal contractions and TLESR were evaluated. CM and LM thicknesses were measured (40 swallows and 30 TLESRs) as markers of axial shortening, before and at peak contraction, as well as during TLESRs. Animal studies revealed muscular connections between the LM and CM layers of the LES but not in the esophagus. During vagal stimulated esophageal contraction there was relative movement between the LM and CM. Human studies show that LM-to-CM (LM/CM) thickness ratio at baseline was 1. At the peak of swallow-induced contraction LM/CM ratio decreased significantly (2). The pattern of contraction of CM and LM suggests sliding of the two muscles. Furthermore, the sliding patterns are in the opposite direction during peristalsis and TLESR.

  3. Quality indicators and performance measures in diabetes care.

    Science.gov (United States)

    Aron, David C

    2014-03-01

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

  4. World assumptions, posttraumatic stress and quality of life after a natural disaster: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Nygaard Egil

    2012-06-01

    Full Text Available Abstract Background Changes in world assumptions are a fundamental concept within theories that explain posttraumatic stress disorder. The objective of the present study was to gain a greater understanding of how changes in world assumptions are related to quality of life and posttraumatic stress symptoms after a natural disaster. Methods A longitudinal study of 574 Norwegian adults who survived the Southeast Asian tsunami in 2004 was undertaken. Multilevel analyses were used to identify which factors at six months post-tsunami predicted quality of life and posttraumatic stress symptoms two years post-tsunami. Results Good quality of life and posttraumatic stress symptoms were negatively related. However, major differences in the predictors of these outcomes were found. Females reported significantly higher quality of life and more posttraumatic stress than men. The association between level of exposure to the tsunami and quality of life seemed to be mediated by posttraumatic stress. Negative perceived changes in the assumption “the world is just” were related to adverse outcome in both quality of life and posttraumatic stress. Positive perceived changes in the assumptions “life is meaningful” and “feeling that I am a valuable human” were associated with higher levels of quality of life but not with posttraumatic stress. Conclusions Quality of life and posttraumatic stress symptoms demonstrate differences in their etiology. World assumptions may be less specifically related to posttraumatic stress than has been postulated in some cognitive theories.

  5. Effects of Prairie Restoration on Soil Quality Indicators

    Science.gov (United States)

    Characterization of soil ecosystem functioning based on soil quality assessments of native prairie may provide a reference for evaluating improvement in soil quality of cultivated agroecosystems converted to perennial vegetation during prairie restoration. Our objective was to determine the effect o...

  6. Quality indicators for international benchmarking of mental health care

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  7. Longitudinal Trend Analysis of Performance Indicators for South Carolina's Technical Colleges

    Science.gov (United States)

    Hossain, Mohammad Nurul

    2010-01-01

    This study included an analysis of the trend of performance indicators for the technical college sector of higher education in South Carolina. In response to demands for accountability and transparency in higher education, the state of South Carolina developed sector specific performance indicators to measure various educational outcomes for each…

  8. Longitudinal Trend Analysis of Performance Indicators for South Carolina's Technical Colleges

    Science.gov (United States)

    Hossain, Mohammad Nurul

    2010-01-01

    This study included an analysis of the trend of performance indicators for the technical college sector of higher education in South Carolina. In response to demands for accountability and transparency in higher education, the state of South Carolina developed sector specific performance indicators to measure various educational outcomes for each…

  9. A longitudinal study of emotional adjustment, quality of life and adaptive function in attenuated MPS II.

    Science.gov (United States)

    Shapiro, Elsa G; Rudser, Kyle; Ahmed, Alia; Steiner, Robert D; Delaney, Kathleen A; Yund, Brianna; King, Kelly; Kunin-Batson, Alicia; Eisengart, Julie; Whitley, Chester B

    2016-06-01

    The behavioral, adaptive and quality of life characteristics of attenuated mucopolysaccharidosis type II (MPS II) have not been well studied. Understanding changes over time in the attenuated phenotype may assist in helping achieve better outcomes in long-term function. This longitudinal study investigates these outcomes in relation to age, somatic disease burden, and IQ. Specifically, somatic disease burden is a major challenge for these patients, even with treatment with enzyme replacement therapy. 15 patients, 10 between ages 6 and MPS II patients have increasing somatic disease burden and poor physical quality of life as they develop as well as decreasing self-esteem and sense of adequacy. Psychosocial quality of life, adaptive skills, and attention improve. Recognition of and intervention around these issues will be beneficial to MPS II attenuated patients who have the resources to use such assistance to improve their long-term outcomes.

  10. BENTHIC INVERTEBRATES AS PAPAGAIO RIVER WATER QUALITY INDICATOR – CAMPO MOURÃO – PR

    Directory of Open Access Journals (Sweden)

    Alexandre Monkolski, Janet Higuti, Luiz Alberto Vieira, Roger Paulo Mormul e Sidnei Pressinatte Junior

    2006-06-01

    Full Text Available The pollutant substance poured in the environment causes negative impacts for life forms that inhabit the sources. The biological monitoring of aquatic ecosystems has as objective the evaluation of the quality of water, in function of alterations of the community of macroinvertebrates. Among these communities Benthic is distinguished, because it reflects the state of conservation or degradation of the sources, changing their morphophysiological characteristics and its presence or absence in water. The quality of Papagaios’ river water was evaluated by physical-chemistry analysis and by density of Benthic macroinvertebrates. Four colleting stations from a stretch of the river were analyzed and samples of sediment and water were collected. At 2nd and 3rd stations there are two cold storage rooms installed at the river’s margins, which treat their effluents in stabilizing lagoons. The 4th station receives the ousting directly from a textile after it has passed by a treatment. Results obtained by biological methods indicated the presence of polluting elements in water. The river’s longitudinal gradient showed a typical sucessorial process of macroinvertebrates from polluted environments, with a significant increase in the density of Oligochaeta and Chironidade, organisms that are tolerant to impacts in water. Considering the four stations that were analyzed, the unwished impacts are occurring in three last ones with more intensity.

  11. Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

    Science.gov (United States)

    Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

    2016-12-01

    The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

  12. Longitudinal diet quality is not associated with depressive symptoms in a cohort of middle-aged Australian women.

    Science.gov (United States)

    Lai, Jun S; Oldmeadow, Christopher; Hure, Alexis J; McEvoy, Mark; Byles, Julie; Attia, John

    2016-03-14

    There is increasing evidence for the role of nutrition in the prevention of depression. This study aims to describe changes in diet quality over 12 years among participants in the Australian Longitudinal Study on Women's Health in relation to changes in depressive symptoms. Women born between 1946 and 1951 were followed-up for 12 years (2001-2013). Dietary intake was assessed using the Dietary Questionnaire for Epidemiological Studies (version 2) in 2001, 2007 and every 2-3 years after that until 2013. Diet quality was summarised using the Australian Recommended Food Score (ARFS). Depressive symptoms were measured using the ten-item Centre for Epidemiologic Depression Scale at every 2-3-year intervals during 2001-2013. Linear mixed models were used to examine trends in diet quality and its sub-components. The same model including time-varying covariates was used to examine associations between diet quality and depressive symptoms adjusting for confounders. Sensitivity analyses were carried out using the Mediterranean dietary pattern (MDP) index to assess diet quality. Minimal changes in overall diet quality and its sub-components over 12 years were observed. There was a significant association between baseline diet quality and depression (β=-0·24, P=0·001), but this was lost when time-varying covariates were added (β=-0·04, P=0·10). Sensitivity analyses showed similar performance for both ARFS and MDP in predicting depressive symptoms. In conclusion, initial associations seen when using baseline measures of diet quality and depressive symptoms disappear when using methods that handle time-varying covariates, suggesting that previous studies indicating a relationship between diet and depression may have been affected by residual confounding.

  13. Longitudinal beam parameters and quality checks of the LHC beam in the SPS

    CERN Document Server

    Papotti, G; Linnecar, T; Shaposhnikova, E; Tückmantel, Joachim; CERN. Geneva. AB Department

    2008-01-01

    Controlled emittance blow-up is used, along with other measures, for stabilizing the LHC nominal beam in the SPS. The aim of this study, based on data acquired during the SPS long Machine Develpment (MD) on 2007-08-22, is to evaluate the effectiveness of different noise settings for controlling the longitudinal blow-up of the beam. At the same time, figures of merit are introduced that allow rapid evaluation of the quality of the beam at extraction as for example stability and bunch length uniformity across batches.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  15. Measuring quality of life in Macedonia - using human development indicators

    Directory of Open Access Journals (Sweden)

    Dimitar Eftimoski

    2006-12-01

    Full Text Available By the end of the 1980s, the central issue of development was focused on the growth of income and not on the growth of quality of life. Therefore, the development strategies were oriented towards production and left no significant space for improving the welfare of individuals.In the beginning of the 1990s, the human development concept emerged, stressing that economic development ultimately should result in growth of quality of life of individuals, while the goal of the development process was to expand the capabilities of individuals by placing them in the focus of the efforts for development.This paper if focused on the quality of life of the individuals. Moreover, in addition to the previous practice in Macedonia of calculating the human development index (HDI - as a measure of quality of life, an attempt will be made to calculate the humanpoverty index (HPI-2 - as a measure of non-income poverty, gender development index (GDI - as a measure of inequality between men and women, as well as the human development index at the level of aggregated urban and rural municipalities.We hope that it will contribute to the improvement of the quality of decisions made by the state and local authorities in Macedonia when it comes to issues concerning the human development.

  16. Rheumatologists' perception of systemic lupus erythematosus quality indicators: significant interest and perceived barriers.

    Science.gov (United States)

    Casey, Carolyn; Chung, Cecilia P; Crofford, Leslie J; Barnado, April

    2017-01-01

    Differences in quality of care may contribute to health disparities in systemic lupus erythematosus (SLE). Studies show low physician adherence rates to the SLE quality indicators but do not assess physician perception of SLE quality indicators or quality improvement. Using a cross-sectional survey of rheumatologists in the southeastern USA, we assessed the perception and involvement of rheumatologists in quality improvement and the SLE quality indicators. Using electronic mail, an online survey of 32 questions was delivered to 568 rheumatologists. With a response rate of 19% (n = 106), the majority of participants were male, Caucasian, with over 20 years of experience, and seeing adult patients in an academic setting. Participants had a positive perception toward quality improvement (81%) with a majority responding that the SLE quality indicators would significantly impact quality of care (54%). While 66% of respondents were familiar with the SLE quality indicators, only 18% of respondents reported using them in everyday practice. The most commonly reported barrier to involvement in quality improvement and the SLE quality indicators was time. Rheumatologists had a positive perception of the SLE quality indicators and agreed that use of the quality indicators could improve quality of care in SLE; however, they identified time as a barrier to implementation. Future studies should investigate methods to increase use of the SLE quality indicators.

  17. A longitudinal study of student-teacher relationship quality, difficult temperament, and risky behavior from childhood to early adolescence.

    Science.gov (United States)

    Rudasill, Kathleen Moritz; Reio, Thomas G; Stipanovic, Natalie; Taylor, Jennifer E

    2010-10-01

    This study examines the mediating role of student-teacher relationship quality (conflict and closeness) in grades 4, 5, and 6 on the relation between background characteristics, difficult temperament at age 4 1/2 and risky behavior in 6th grade. The longitudinal sample of participants (N=1156) was from the NICHD Study of Early Child Care and Youth Development. Structural equation modeling was used to estimate paths from (a) background characteristics to student-teacher relationship quality and risky behavior, (b) temperament to student-teacher relationship quality and risky behavior, and (c) student-teacher relationship quality to risky behavior. Findings indicate that students' family income, gender, receipt of special services, and more difficult temperament were associated with risky behavior. In addition, student-teacher conflict was a mediator. Students with more difficult temperaments were more likely to report risky behavior and to have conflict in their relationships with teachers. More conflict predicted more risky behavior. Closer student-teacher relationships were associated with less risky behavior. Results suggest negative relationships, specifically student-teacher relationships, may increase the risk that certain adolescents will engage in risky behavior.

  18. Effects of process parameters and die geometry on longitudinal welds quality in aluminum porthole die extrusion process

    Institute of Scientific and Technical Information of China (English)

    LIU Jian; LIN Gao-yong; FENG Di; ZOU Yan-ming; SUN Li-ping

    2010-01-01

    By using the rigid-visco-plasticity finite element method,the welding process of aluminum porthole die extrusion to form a tube was simulated based on Deform-3D software.The welding chamber height(H),back dimension of die leg(D),process velocity and initial billet temperature were used in FE simulations so as to determine the conditions in which better longitudinal welding quality can be obtained.According to K criterion,the local welding parameters such as welding pressure,effective stress and welding path length on the welding plane are linked to longitudinal welds quality.Simulation turns out that pressure-to-effective stress ratio(p/σ)and welding path length(L)are the key factors affecting the welding quality.Higher welding chamber best and sharper die leg give better welding quality.When H=10 mm and D=0.4 mm,the longitudinal welds have the best quality.Higher process velocity decreases welds quality.The proper velocity is 10 mm/s for this simulation.In a certain range,higher temperature is beneficial to the longitudinal welds.It is found that both 450 and 465℃ can satisfy the requirements of the longitudinal welds.

  19. Comparison of radiogrammetrical metacarpal indices in children and reference data from the First Zurich Longitudinal Study

    Energy Technology Data Exchange (ETDEWEB)

    Martin, David D.; Heckmann, Conrad; Neuhof, Julia; Ranke, Michael B.; Binder, Gerhard [University Children' s Hospital Tuebingen, Pediatric Endocrinology and Diabetology, Tuebingen (Germany); Jenni, Oskar G. [University Children' s Hospital, Child Development Centre, Zurich (Switzerland)

    2012-08-15

    A number of radiogrammetrical metacarpal indices are in use, some of which have been adapted for children. The purpose of this study was to compare four known indices - bone mineral density (BMD), relative cortical area, Exton-Smith index, bending breaking resistance index - and the more recently defined pediatric bone index (PBI) according to the two criteria of minimum height dependence and minimum variability in children of equal bone age. A total of 3,121 left-hand radiographs from 231 healthy Caucasian children ranging in age from 3 to 19 years old were analysed using BoneXpert {sup registered}, a programme for automatic analysis of hand radiographs and assessment of bone age. Dependence on height for chronological age or bone age and the mean relative standard deviation were lowest in the PBI for both genders pooled. The differences in height dependence were statistically significant and are shown to be clinically relevant. Reference data for PBI are presented. PBI may be a better indicator than BMD for bone health in children; however, verification in a clinical group is needed. (orig.)

  20. Towards a standardized method of developing quality indicators for palliative care: protocol of the Quality indicators for Palliative Care (Q-PAC) study.

    NARCIS (Netherlands)

    Leemans, K.; Cohen, J.; Francke, A.L.; Stichele, R. Vander; Claessen, S.J.J.; Block, L. van den; Deliens, L.

    2013-01-01

    Background: In recent years, there have been several studies, using a wide variety of methods, aimed at developing quality indicators for palliative care. In this Quality Indicators for Palliative Care study (Q-PAC study) we have applied a scientifically rigorous method to develop a comprehensive an

  1. Towards a standardized method of developing quality indicators for palliative care: protocol of the Quality indicators for Palliative Care (Q-PAC) study.

    NARCIS (Netherlands)

    Leemans, K.; Cohen, J.; Francke, A.L.; Stichele, R. Vander; Claessen, S.J.J.; Block, L. van den; Deliens, L.

    2013-01-01

    Background: In recent years, there have been several studies, using a wide variety of methods, aimed at developing quality indicators for palliative care. In this Quality Indicators for Palliative Care study (Q-PAC study) we have applied a scientifically rigorous method to develop a comprehensive

  2. Estimating soil quality indicators with diffuse reflectance spectroscopy

    Science.gov (United States)

    Rapid estimation of soil quality is needed for determining and mapping soil variability in site-specific management. One technology that can fulfill this need is diffuse reflectance spectroscopy, which measures light reflected from the soil in the visible and near infrared wavelength bands. Reflecta...

  3. Cesarean section indications and anthropometric parameters in Rwandan nulliparae: preliminary results from a longitudinal survey.

    Science.gov (United States)

    Kakoma, Jean-Baptiste

    2016-01-01

    Maternal anthropometric parameters as risk factors for cesarean section have always been a matter of interest and concern for obstetricians. Some of these parameters have been shown to be predictors of dystocia. This study aims at showing the relationship between cesarean section indications and anthropometric parameters sizes in Rwandan nulliparae for the purpose of comparison and appropriate recommendations. A cross-sectional and analytical study was made on data collected from 32 operated patients among 152 nulliparae with singleton pregnancy at term and vertex presentation. Concerned anthropometric parameters were height, weight and six pelvic distances. Fisher exact and Student's tests were used to compare observed proportions and mean values, respectively. Findings were as follows: 1) the overall cesarean section rate was 21.05%; 2) acute fetal distress (31.3 %), generally contracted pelvis (28.1 %), and engagement failure (25%) were the most frequent indications of cesarean section; 3) all patients ≤ 145 cm tall were operated on for general pelvis contraction whose proportion was significantly higher in them than in the others (p < 0.01); 4) more than half of pelvis contraction cases were observed in patients weighing ≤ 50 kg, but the difference with other weight categories was not significant; 5) considered external pelvic diameters but the Biiliac Diameter displayed average measurements smaller in clinically contracted pelvis than in other CS indications. External pelvimetry associated with specific other anthropometric parameters could be helpful in the screening of generally contracted pelves, and consequently pregnancies at high risk of cephalopelvic disproportion in nulliparous women, particularly in developing countries with limited resources. Further investigations are requested to deal with this topic in depth.

  4. The EFQM Model as a framework for total quality management in healthcare : Results of a longitudinal quantitative study

    NARCIS (Netherlands)

    van Schoten, Steffie; de Blok, Carolien; Spreeuwenberg, Peter; Groenewegen, Petrus; Wagner, Cordula

    2016-01-01

    Purpose – To guide organizations toward total quality management (TQM), various models have been developed such as the European Foundation for Quality Management Excellence Model (EFQM Model). The purpose of this paper is to conduct a longitudinal investigation of whether the EFQM Model can serve as

  5. Measuring Quality: Education Indicators--United Kingdom and International Perspectives.

    Science.gov (United States)

    Riley, Kathryn A., Ed.; Nuttall, Desmond L., Ed.

    Nationally set indicators of performance have increasingly become a medium for exercising choice and decision making in the new education market place. Contributors to this book suggest that such a framework is not unproblematic. This book offers some insights into the general debate about performance indicators in education. It explores the…

  6. Development and validation of prescribing quality indicators for patients with type 2 diabetes

    NARCIS (Netherlands)

    Smits, Kirsten P. J.; Sidorenkov, Grigory; Kleefstra, Nanno; Bouma, Margriet; Meulepas, Marianne; Voorham, Jaco; Navis, Gerjan; Bilo, Henk J. G.; Denig, Petra

    2017-01-01

    Aim: Quality indicators are used to measure whether healthcare professionals act according to guidelines, but few indicators focus on the quality of pharmacotherapy for diabetes. The aim of this study was to develop and validate a set of prescribing quality indicators (PQIs) for type 2 diabetes in p

  7. Development and validation of prescribing quality indicators for patients with type 2 diabetes

    NARCIS (Netherlands)

    Smits, Kirsten P J; Sidorenkov, Grigory; Kleefstra, Nanno; Bouma, Margriet; Meulepas, Marianne; Voorham, Jaco; Navis, Gerjan; Bilo, Henk J G; Denig, Petra

    2017-01-01

    AIM: Quality indicators are used to measure whether healthcare professionals act according to guidelines, but few indicators focus on the quality of pharmacotherapy for diabetes. The aim of this study was to develop and validate a set of prescribing quality indicators (PQIs) for type 2 diabetes in p

  8. Development and validation of prescribing quality indicators for patients with type 2 diabetes

    NARCIS (Netherlands)

    Smits, Kirsten P. J.; Sidorenkov, Grigory; Kleefstra, Nanno; Bouma, Margriet; Meulepas, Marianne; Voorham, Jaco; Navis, Gerjan; Bilo, Henk J. G.; Denig, Petra

    2017-01-01

    Aim: Quality indicators are used to measure whether healthcare professionals act according to guidelines, but few indicators focus on the quality of pharmacotherapy for diabetes. The aim of this study was to develop and validate a set of prescribing quality indicators (PQIs) for type 2 diabetes in p

  9. Active and Intelligent Packaging: The Indication of Quality and Safety.

    Science.gov (United States)

    Janjarasskul, Theeranun; Suppakul, Panuwat

    2016-09-19

    The food industry has been under growing pressure to feed an exponentially increasing world population and challenged to meet rigorous food safety law and regulation. The plethora of media consumption has provoked consumer demand for safe, sustainable, organic, and wholesome products with "clean" labels. The application of active and intelligent packaging has been commercially adopted by food and pharmaceutical industries as a solution for the future for extending shelf life and simplifying production processes; facilitating complex distribution logistics; reducing, if not eliminating the need for preservatives in food formulations; enabling restricted food packaging applications; providing convenience, improving quality, variety and marketing features; as well as providing essential information to ensure consumer safety. This chapter reviews innovations of active and intelligent packaging which advance packaging technology through both scavenging and releasing systems for shelf life extension, and through diagnostic and identification systems for communicating quality, tracking and brand protection.

  10. Rationale for indicator quality of integrated information security system

    Directory of Open Access Journals (Sweden)

    Z. P. Stashevskiy

    2014-04-01

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

  11. SOME INDICATORS OF WATER QUALITY OF THE TAMIŠ RIVER

    Directory of Open Access Journals (Sweden)

    DRAGAN MARKOVIĆ

    2011-03-01

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

  12. Quality of Care Indicators in the AMEDD (Army Medical Department)

    Science.gov (United States)

    1983-09-01

    Evaluation, Indicators 6 7rACT (Ceate - re,,vee sfr ,f d ideif y bio\\onb,) Ihis study looked at the feasibility of thev(MEDD)constructing a list of...affect the final list chosen. 7. The list of indicators should not be limited to " failures " or "errors" in medical practice. 6.p, 8. The list of...PATIENTS TRANSFUSED . TH WEIGHT RECORDED 100 1 PIN RNU3 1ED WITH ELECTROLYTE DETERMINATION 00 1 1 WITH INDICATION FOR TRANSFLS ON 100 I 2 2 WiTH ANEMIA EX

  13. Comparing phosphorus indices and process models with water quality data

    Science.gov (United States)

    Phosphorus (P) indices in the southern United States frequently produce different recommendations for similar conditions. After assembling data from benchmark southern sites (Arkansas, Georgia, Mississippi, North Carolina, Oklahoma, and Texas), land treatment information was used in the 12 southern...

  14. Developing the Use of Quality Indicators in Sterilization Practices

    Directory of Open Access Journals (Sweden)

    E Mehrabi

    2012-07-01

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

  15. [Quality of life and mortality of patients in intensive care. Indices of quality of life].

    Science.gov (United States)

    Ortiz, D; Galguera, F; Jam, M R; Vilar, S; Castella, X; Artigas, A

    1998-01-01

    At present there is no single practical standardized scale for measuring quality of life (QL). Any proposal should include the patient's physical impairment, level of independence, and subjective perception of happiness. We combined three previously published scales to define a quality of life index (QLI) that we propose as a standard quantitative instrument. The applicability and usefulness of QLI for the measurement of the level of deterioration of patients after admission to an intensive care unit (ICU) was examined. We prospectively evaluated QL before patient admission to determine if it influences mortality, as well as long-term changes in the QL and the factors conditioning te deterioration of patients released from the UCI as evaluated by QL indicators. To calculate QLI, we combined the Karnofsky scale, daily life activities index, and the perception of quality of life scale. The resulting percentage (QLI) was used to evaluate 536 patients after admission to the ICU and 6 and 12 months after release. QLI was compared with the severity of disease (Apache II), probability of death (MPM), diagnostic group, and socioeconomic variables. Using multivariate methods, four significant variables related with mortality were identified: Apache II--MPM, duration of the stay in the unit, age, and QLI. Our analysis of long-term deterioration showed that advanced age, high QLI before admission, and the patient's diagnostic group explained the degree of deterioration. QLI was a useful instrument for obtaining a quantitative estimate of the QL of critically ill patients.

  16. Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges.

    Science.gov (United States)

    Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W

    2017-08-08

    A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products' quality, availability, safety, as well as challenges related to a GFD are discussed.

  17. [Study on the optimization of monitoring indicators of drinking water quality during health supervision].

    Science.gov (United States)

    Ye, Bixiong; E, Xueli; Zhang, Lan

    2015-01-01

    To optimize non-regular drinking water quality indices (except Giardia and Cryptosporidium) of urban drinking water. Several methods including drinking water quality exceed the standard, the risk of exceeding standard, the frequency of detecting concentrations below the detection limit, water quality comprehensive index evaluation method, and attribute reduction algorithm of rough set theory were applied, redundancy factor of water quality indicators were eliminated, control factors that play a leading role in drinking water safety were found. Optimization results showed in 62 unconventional water quality monitoring indicators of urban drinking water, 42 water quality indicators could be optimized reduction by comprehensively evaluation combined with attribute reduction of rough set. Optimization of the water quality monitoring indicators and reduction of monitoring indicators and monitoring frequency could ensure the safety of drinking water quality while lowering monitoring costs and reducing monitoring pressure of the sanitation supervision departments.

  18. Using Insects as Bio-Indicators to Assess Water Quality of Albanian Rivers

    OpenAIRE

    , Anila Paparisto; , Elton Halimi; , Erjola Keçi; , Etleva Hamzaraj; , Odeta Laknori

    2016-01-01

    The communities of aquatic insects are affected by several factors related to water quality, stream morphology, food availability and quality. Among aquatic insects, Ephemeroptera, Plecoptera and Trichoptera CEPT) are very important in assessing water quality. As well as chemical indicators, bio-indicators are used in to deŞne the water quality. EPT (Ephemeroptera, Plecoptera and Trichoptera) richness biotic index and TV are used to classify the water quality level of three Albanian rivers (V...

  19. Cognitive changes and quality of life in neurocysticercosis: a longitudinal study.

    Directory of Open Access Journals (Sweden)

    Mitchell T Wallin

    2012-01-01

    Full Text Available BACKGROUND: Few studies have focused on the cognitive morbidity of neurocysticercosis (NCC, one of the most common parasitic infections of the central nervous system. We longitudinally assessed the cognitive status and quality of life (QoL of patients with incident symptomatic NCC cases and matched controls. METHODOLOGY/PRINCIPAL FINDINGS: The setting of the study was the Sabogal Hospital and Cysticercosis Unit, Department of Transmissible Diseases, National Institute of Neurological Sciences, Lima, Peru. The design was a longitudinal study of new onset NCC cases and controls. Participants included a total of 14 patients with recently diagnosed NCC along with 14 healthy neighborhood controls and 7 recently diagnosed epilepsy controls. A standardized neuropsychological battery was performed at baseline and at 6 months on NCC cases and controls. A brain MRI was performed in patients with NCC at baseline and 6 months. Neuropsychological results were compared between NCC cases and controls at both time points. At baseline, patients with NCC had lower scores on attention tasks (p<0.04 compared with epilepsy controls but no significant differences compared to healthy controls. Six months after receiving anti-parasitic treatment, the NCC group significantly improved on tasks involving psychomotor speed (p<0.02. QoL at baseline suggested impaired mental function and social function in both the NCC and epilepsy group compared with healthy controls. QoL gains in social function (p=0.006 were noted at 6 months in patients with NCC. CONCLUSIONS/SIGNIFICANCE: Newly diagnosed patients with NCC in this sample had mild cognitive deficits and more marked decreases in quality of life at baseline compared with controls. Improvements were found in both cognitive status and quality of life in patients with NCC after treatment.

  20. The choice of indicators to assess the quality of educational services of the institution

    Directory of Open Access Journals (Sweden)

    Елена Егоровна Кулик

    2015-07-01

    Full Text Available On the basis of well-known international and national systems of indicators that make it possible to assess the development of the education system, educational system identified indicators to assess the quality of educational services to secondary schools. In the article the author formulated the original definition of concepts such as quality, quality of education, educational service, quality of education services and indicators of education.

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

    Science.gov (United States)

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

    2011-01-01

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

  2. CHEMICAL WATER QUALITY INDICATORS IN BASIN FOREST PARCZEW

    Directory of Open Access Journals (Sweden)

    Antoni Grzywna

    2014-10-01

    Full Text Available This paper presents the characteristics of the chemistry of surface and ground water in the bottom of the river valley reclaimed Ochoza. Drained grassland accounts for 20% of the total catchment area and are located on organic soils in the valley Tyśmienica classified to the Natura 2000 sites. Analysis of physico-chemical properties of water are to assess the effects of anthropogenic transformation and identify factors that influence water quality in the study area. Water samples were collected in the years 2011–2012 in several points. The walls were characterized by surface water stagnant in the trenches, in July, blueberry plantation. Characterized by the highest quality of surface water runoff river with the test object. Occurring here throughout the growing season water flow reed growing on the bed and temporary impoundment of water contribute to the self-cleaning effect of water. Conducted at different times of the growing season (winter, spring, summer, autumn of water chemistry analysis allows to assess the impact of vegetation on the process of self-purification of water. Based on the survey it was found that the river is reduced by 26% BOD 5, COD by 37%, 12% phosphate and potassium by 13%. Concurrently, an increase in the content of nitrogen compounds – ammonia at 27% and 15% nitrate. The increase in the content of nitrogen compounds is particularly evident in the bottom of the object, which is probably associated with the deep trench causing excessive drying of the soil. The highest values of pollutants were recorded mostly in the spring probably due to the outflow of water from the drans.

  3. Longitudinal beta regression models for analyzing health-related quality of life scores over time

    Directory of Open Access Journals (Sweden)

    Hunger Matthias

    2012-09-01

    Full Text Available Abstract Background Health-related quality of life (HRQL has become an increasingly important outcome parameter in clinical trials and epidemiological research. HRQL scores are typically bounded at both ends of the scale and often highly skewed. Several regression techniques have been proposed to model such data in cross-sectional studies, however, methods applicable in longitudinal research are less well researched. This study examined the use of beta regression models for analyzing longitudinal HRQL data using two empirical examples with distributional features typically encountered in practice. Methods We used SF-6D utility data from a German older age cohort study and stroke-specific HRQL data from a randomized controlled trial. We described the conceptual differences between mixed and marginal beta regression models and compared both models to the commonly used linear mixed model in terms of overall fit and predictive accuracy. Results At any measurement time, the beta distribution fitted the SF-6D utility data and stroke-specific HRQL data better than the normal distribution. The mixed beta model showed better likelihood-based fit statistics than the linear mixed model and respected the boundedness of the outcome variable. However, it tended to underestimate the true mean at the upper part of the distribution. Adjusted group means from marginal beta model and linear mixed model were nearly identical but differences could be observed with respect to standard errors. Conclusions Understanding the conceptual differences between mixed and marginal beta regression models is important for their proper use in the analysis of longitudinal HRQL data. Beta regression fits the typical distribution of HRQL data better than linear mixed models, however, if focus is on estimating group mean scores rather than making individual predictions, the two methods might not differ substantially.

  4. A fuzzy-logic based decision-making approach for identification of groundwater quality based on groundwater quality indices.

    Science.gov (United States)

    Vadiati, M; Asghari-Moghaddam, A; Nakhaei, M; Adamowski, J; Akbarzadeh, A H

    2016-12-15

    Due to inherent uncertainties in measurement and analysis, groundwater quality assessment is a difficult task. Artificial intelligence techniques, specifically fuzzy inference systems, have proven useful in evaluating groundwater quality in uncertain and complex hydrogeological systems. In the present study, a Mamdani fuzzy-logic-based decision-making approach was developed to assess groundwater quality based on relevant indices. In an effort to develop a set of new hybrid fuzzy indices for groundwater quality assessment, a Mamdani fuzzy inference model was developed with widely-accepted groundwater quality indices: the Groundwater Quality Index (GQI), the Water Quality Index (WQI), and the Ground Water Quality Index (GWQI). In an effort to present generalized hybrid fuzzy indices a significant effort was made to employ well-known groundwater quality index acceptability ranges as fuzzy model output ranges rather than employing expert knowledge in the fuzzification of output parameters. The proposed approach was evaluated for its ability to assess the drinking water quality of 49 samples collected seasonally from groundwater resources in Iran's Sarab Plain during 2013-2014. Input membership functions were defined as "desirable", "acceptable" and "unacceptable" based on expert knowledge and the standard and permissible limits prescribed by the World Health Organization. Output data were categorized into multiple categories based on the GQI (5 categories), WQI (5 categories), and GWQI (3 categories). Given the potential of fuzzy models to minimize uncertainties, hybrid fuzzy-based indices produce significantly more accurate assessments of groundwater quality than traditional indices. The developed models' accuracy was assessed and a comparison of the performance indices demonstrated the Fuzzy Groundwater Quality Index model to be more accurate than both the Fuzzy Water Quality Index and Fuzzy Ground Water Quality Index models. This suggests that the new hybrid fuzzy

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  6. Meeting Resident Scholarly Activity Requirements Through a Longitudinal Quality Improvement Curriculum.

    Science.gov (United States)

    Simasek, Madeline; Ballard, Stephanie L; Phelps, Phillip; Pingul-Ravano, Rowena; Kolb, N Randall; Finkelstein, Alan; Weaver-Agostoni, Jacqueline; Takedai, Teiichi

    2015-03-01

    Quality improvement (QI) skills are learned during residency, yet there are few reports of the scholarly activity outcomes of a QI curriculum in a primary care program. We examined whether scholarly activity can result from a longitudinal, experiential QI curriculum that involves residents, clinic staff, and faculty. The University of Pittsburgh Medical Center Shadyside Family Medicine Residency implemented a required longitudinal outpatient practice improvement rotation (LOPIR) curriculum in 2005. The rotation format includes weekly multidisciplinary work group meetings alternating with resident presentations delivered to the entire program. Residents present the results of a literature review and provide 2 interim project updates to the residency. A completed individual project is required for residency graduation, with project results presented at Residency Research Day. Scholarly activity outcomes of the curriculum were analyzed using descriptive statistics. As of 2014, 60 residents completed 3 years of the LOPIR curriculum. All residents satisfied the 2014 Accreditation Council for Graduate Medical Education (ACGME) scholarly activity and QI requirements with a literature review presentation in postgraduate year 2, and the presentation of a completed QI project at Residency Research Day. Residents have delivered 83 local presentations, 13 state/regional presentations, and 2 national presentations. Residents received 7 awards for QI posters, as well as 3 grants totaling $21,639. The educational program required no additional curriculum time, few resources, and was acceptable to residents, faculty, and staff. LOPIR is an effective way to meet and exceed the 2014 ACGME scholarly activity requirements for family medicine residents.

  7. Aggregating Indices of Governance Quality: An Exploratory Factor Analysis

    Science.gov (United States)

    2011-03-01

    AF) pour examiner 24 indices de gouvernance de source générale qui visent à mesurer les niveaux de démocratie, de développement économique et de...conforme aux définitions déjà établies de la bonne gouvernance . Nous avons mis à profit les travaux antérieurs en effectuant une analyse plus...et formulant des conseils supplémentaires pour l’usage de ces mesures dans l’évaluation de la gouvernance étatique. DRDC Toronto TR 2011-022

  8. Water quality of hydrologic bench marks; an indicator of water quality in the natural environment

    Science.gov (United States)

    Biesecker, James E.; Leifeste, Donald K.

    1974-01-01

    Water-quality data, collected at 57 hydrologic bench-mark stations in 37 States, allow the definition of water quality in the 'natural' environment and the comparison of 'natural' water quality with water quality of major streams draining similar water-resources regions. Results indicate that water quality in the 'natural' environment is generally very good. Streams draining hydrologic bench-mark basins generally contain low concentrations of dissolved constituents. Water collected at the hydrologic bench-mark stations was analyzed for the following minor metals: arsenic, barium, cadmium, hexavalent chromium, cobalt, copper, lead, mercury, selenium, silver, and zinc. Of 642 analyses, about 65 percent of the observed concentrations were zero. Only three samples contained metals in excess of U.S. Public Health Service recommended drinking-water standards--two selenium concentrations and one cadmium concentration. A total of 213 samples were analyzed for 11 pesticidal compounds. Widespread but very low-level occurrence of pesticide residues in the 'natural' environment was found--about 30 percent of all samples contained low-level concentrations of pesticidal compounds. The DDT family of pesticides occurred most commonly, accounting for 75 percent of the detected occurrences. The highest observed concentration of DDT was 0.06 microgram per litre, well below the recommended maximum permissible in drinking water. Nitrate concentrations in the 'natural' environment generally varied from 0.2 to 0.5 milligram per litre. The average concentration of nitrate in many major streams is as much as 10 times greater. The relationship between dissolved-solids concentration and discharge per unit area in the 'natural' environment for the various physical divisions in the United States has been shown to be an applicable tool for approximating 'natural' water quality. The relationship between dissolved-solids concentration and discharge per unit area is applicable in all the physical

  9. An association of platelet indices with blood pressure in Beijing adults: Applying quadratic inference function for a longitudinal study.

    Science.gov (United States)

    Yang, Kun; Tao, Lixin; Mahara, Gehendra; Yan, Yan; Cao, Kai; Liu, Xiangtong; Chen, Sipeng; Xu, Qin; Liu, Long; Wang, Chao; Huang, Fangfang; Zhang, Jie; Yan, Aoshuang; Ping, Zhao; Guo, Xiuhua

    2016-09-01

    The quadratic inference function (QIF) method becomes more acceptable for correlated data because of its advantages over generalized estimating equations (GEE). This study aimed to evaluate the relationship between platelet indices and blood pressure using QIF method, which has not been studied extensively in real data settings.A population-based longitudinal study was conducted in Beijing from 2007 to 2012, and the median of follow-up was 6 years. A total of 6515 cases, who were aged between 20 and 65 years at baseline and underwent routine physical examinations every year from 3 Beijing hospitals were enrolled to explore the association between platelet indices and blood pressure by QIF method. The original continuous platelet indices were categorized into 4 levels (Q1-Q4) using the 3 quartiles of P25, P50, and P75 as a critical value. GEE was performed to make a comparison with QIF.After adjusting for age, usage of drugs, and other confounding factors, mean platelet volume was negatively associated with diastolic blood pressure (DBP) (Equation is included in full-text article.)in males and positively linked with systolic blood pressure (SBP) (Equation is included in full-text article.). Platelet distribution width was negatively associated with SBP (Equation is included in full-text article.). Blood platelet count was associated with DBP (Equation is included in full-text article.)in males.Adults in Beijing with prolonged exposure to extreme value of platelet indices have elevated risk for future hypertension and evidence suggesting using some platelet indices for early diagnosis of high blood pressure was provided.

  10. Development and initial validation of prescribing quality indicators for patients with chronic kidney disease

    NARCIS (Netherlands)

    Smits, Kirsten P J; Sidorenkov, Grigory; Bilo, Henk J G; Bouma, Margriet; van Ittersum, Frans J; Voorham, Jaco; Navis, Gerjan; Denig, Petra

    2016-01-01

    BACKGROUND: Quality assessment is a key element for improving the quality of care. Currently, a comprehensive indicator set for measuring the quality of medication treatment in patients with chronic kidney disease (CKD) is lacking. Our aim was to develop and validate a set of prescribing quality ind

  11. Development and initial validation of prescribing quality indicators for patients with chronic kidney disease

    NARCIS (Netherlands)

    Smits, Kirsten P J; Sidorenkov, Grigory; Bilo, Henk J G; Bouma, Margriet; van Ittersum, Frans J; Voorham, Jaco; Navis, Gerjan; Denig, Petra

    2016-01-01

    BACKGROUND: Quality assessment is a key element for improving the quality of care. Currently, a comprehensive indicator set for measuring the quality of medication treatment in patients with chronic kidney disease (CKD) is lacking. Our aim was to develop and validate a set of prescribing quality ind

  12. Physician group cultural dimensions and quality performance indicators: not all is equal.

    Science.gov (United States)

    Smalarz, Amy

    2006-01-01

    A group practice culture survey measured the cultural dimensions of physician groups, and their relationship to group quality performance was explored. Cultural dimensions were statistically significant in explaining variance of quality performance among the physician groups studied. However, different cultural dimensions contributed to each of the quality performance indicators measured. Thus, cultural dimensions are important factors influencing physician groups' quality performance.

  13. Genetic testing for inherited heart diseases: longitudinal impact on health-related quality of life.

    Science.gov (United States)

    Ingles, Jodie; Yeates, Laura; O'Brien, Lisa; McGaughran, Julie; Scuffham, Paul A; Atherton, John; Semsarian, Christopher

    2012-05-03

    Purpose:A genetic diagnosis is an extremely useful tool in the management and care of families with inherited heart diseases, particularly in allowing clarification of risk status of asymptomatic family members. The psychosocial consequences of genetic testing in this group are poorly understood. This longitudinal pilot study sought to determine changes in health-related quality of life in patients and asymptomatic family members undergoing genetic testing for inherited heart diseases.Methods:Individuals attending two specialized multidisciplinary cardiac genetic clinics in Australia were invited to participate. Patients undergoing proband or predictive genetic testing for an inherited cardiomyopathy or primary arrhythmogenic disorder were eligible. The Medical Outcomes Short Form-36 (version 2) was administered before the genetic result was given, and follow-up surveys were completed 1-3, 6, and 12 months after the result was given.Results:A total of 54 individuals with hypertrophic cardiomyopathy, familial dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and long QT syndrome completed baseline and at least one follow-up survey, including 33 probands and 21 asymptomatic relatives. Physical and mental component scores analyzed at baseline and 1-3 months were found to be unchanged in all groups. Furthermore, no significant differences were observed up to 12 months after result.Conclusion:In this longitudinal pilot study, no change in health-related quality of life was observed up to 12 months after the result was given in patients and their asymptomatic family members undergoing genetic testing for an inherited heart disease.Genet Med 2012 advance online publication 3 May 2012.

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

    Science.gov (United States)

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

    2016-11-01

    (e.g. anti-C1inhibitor, anti-factor H) are important in defining autoimmune processes and diseases based on complement dysregulation. To improve the quality of complement laboratory analysis a standardization commmittee of the International Complement Society (ICS) and the International Union of Immunological Societies (IUIS) was formed to provide guidelines for modern complement analysis and standards for the development of international testing programs.

  15. Standardization and reference intervals of platelet volume indices: Insight from the Brazilian longitudinal study of adult health (ELSA-BRASIL).

    Science.gov (United States)

    Maluf, Chams B; Barreto, Sandhi M; Vidigal, Pedro G

    2015-01-01

    Platelet volume indices (PVI) are associated with hematological and non-hematological diseases, notably cardiovascular and cerebrovascular diseases. The establishment of PVI reference intervals (RIs) are essential to evaluate whether these indices are useful in clinical practice. Healthy-associated RIs have not yet been established for the Brazilian population. Here, we determined RIs of PVI for a health adult population, participants of the Brazilian Longitudinal Study of Adult Health ELSA-Brasil. A total of 580 individuals out of an initial sample of 3115 subjects constituted the healthy reference sample. To be part of the study, individuals had to fulfill the following criteria: blood count within 2 hours of collection, no use of continuous medication, self-rated health as good or very good, no reported diagnosis of diabetes and/or arterial hypertension, not smoking, lack of metabolic syndrome, body mass index (BMI) Brasil reported herein may contribute to future efforts aiming to evaluate whether PVI values are associated with clinical conditions in the Brazilian population.

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

    Directory of Open Access Journals (Sweden)

    Vivek Shukla

    2015-03-01

    Full Text Available Aim: The aim was to develop an indicator sensor for real-time monitoring of meat quality and to compare the response of indicator sensor with meat quality parameters at ambient temperature. Materials and Methods: Indicator sensor was prepared using bromophenol blue (1% w/v as indicator solution and filter paper as indicator carrier. Indicator sensor was fabricated by coating indicator solution onto carrier by centrifugation. To observe the response of indicator sensor buffalo meat was packed in polystyrene foam trays covered with PVC film and indicator sensor was attached to the inner side of packaging film. The pattern of color change in indicator sensor was monitored and compared with meat quality parameters viz. total volatile basic nitrogen, D-glucose, standard plate count and tyrosine value to correlate ability of indicator sensor for its suitability to predict the meat quality and storage life. Results: The indicator sensor changed its color from yellow to blue starting from margins during the storage period of 24 h at ambient temperature and this correlated well with changes in meat quality parameters. Conclusions: The indicator sensor can be used for real-time monitoring of meat quality as the color of indicator sensor changed from yellow to blue starting from margins when meat deteriorates with advancement of the storage period. Thus by observing the color of indicator sensor quality of meat and shelf life can be predicted.

  17. Concurrent Indicators of Gait Velocity and Variability Are Associated with 25-Year Cognitive Change: A Retrospective Longitudinal Investigation

    Science.gov (United States)

    MacDonald, Stuart W. S.; Hundza, Sandra; Love, Janet A.; DeCarlo, Correne A.; Halliday, Drew W. R.; Brewster, Paul W. H.; Lukyn, Timothy V.; Camicioli, Richard; Dixon, Roger A.

    2017-01-01

    Background/Objectives: Physical function indicators, including gait velocity, stride time and step length, are linked to neural and cognitive function, morbidity and mortality. Whereas cross-sectional associations are well documented, far less is known about long-term patterns of cognitive change as related to objective indicators of mobility-related physical function. Methods: Using data from the Victoria Longitudinal Study, a long-term investigation of biological and health aspects of aging and cognition, we examined three aspects of cognition-physical function linkages in 121 older adults. First, we examined a simple marker of physical function (3 m timed-walk) as a predictor of cross-sectional differences and up to 25-year change for four indicators of cognitive function. Second, we tested associations between two markers of gait function derived from the GAITRite system (velocity and stride-time variability) and differences and change in cognition. Finally, we evaluated how increasing cognitive load during GAITRite assessment influenced the associations between gait and cognition. Results: The simple timed-walk measure, commonly used in clinical and research settings, was a minor predictor of change in cognitive function. In contrast, the objectively measured indicator of walking speed significantly moderated long-term cognitive change. Under increasing cognitive load, the moderating influence of velocity on cognitive change increased, with increasing variability in stride time also emerging as a predictor of age-related cognitive decline. Conclusion: These findings: (a) underscore the utility of gait as a proxy for biological vitality and for indexing long-term cognitive change; and (b) inform potential mechanisms underlying age-related linkages in physical and cognitive function.

  18. Reliability and validity of an indicator system for assessing the quality of ophthalmic nursing

    Directory of Open Access Journals (Sweden)

    Jing-Hua Shi

    2016-12-01

    Conclusions: The indicator system for evaluating the quality of ophthalmic nursing has favorable reliability and validity, which means that it is a suitable clinical tool for assessing the quality of ophthalmic nursing.

  19. Measures of Quality of Care for People with HIV: A Scoping Review of Performance Indicators for Primary Care.

    Science.gov (United States)

    Johnston, Sharon; Kendall, Claire; Hogel, Matthew; McLaren, Meaghan; Liddy, Clare

    2015-01-01

    The healthcare of people with HIV is transitioning from specialty care to the primary healthcare (PHC) system. However, many of the performance indicators used to measure the quality of HIV care pre-date this transition. The goal of this work was to examine how existing HIV care performance indicators measure the comprehensive and longitudinal care offered in a PHC setting. A scoping review consisting of peer-reviewed and grey literature searches was performed. Two reviewers evaluated study eligibility and indicators in documents meeting inclusion criteria were extracted into a database. Indicators were matched to a PHC performance measurement framework to determine their applicability for evaluating quality of care in the PHC setting. The literature search identified 221 publications, of which 47 met inclusion criteria. 1184 indicators were extracted and removal of duplicates left 558 unique indicators. A majority of the 558 indicators fell under the 'secondary prevention' (12%) and 'care of chronic conditions' (33%) domains when indicators were matched to the PHC performance framework. Despite the imbalance, nearly all performance domains in the PHC framework were populated by at least one indicator with significant concentrations in domains such as patient-provider relationship, patient satisfaction, population and community characteristics, and access to care. Existing performance frameworks for the care of people with HIV provide a comprehensive set of indicators that align well with a PHC performance framework. Nonetheless, some important elements of care, such as patient-reported outcomes, are poorly covered by existing indicators. Advancing our understanding of how the experience of care for people with HIV is impacted by changes in health services delivery, specifically more care within the PHC system, will require performance indicators to capture this aspect of HIV care.

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

    DEFF Research Database (Denmark)

    Sorensen, Line P; Krog, Birgitte R; Kongsted, Alice;

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Geoffrey C Nguyen

    2014-01-01

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

  2. Quality indicators in intensive care medicine for Germany – third edition 2017

    Directory of Open Access Journals (Sweden)

    Kumpf, Oliver

    2017-08-01

    Full Text Available Quality improvement in medicine is depending on measurement of relevant quality indicators. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI from the year 2013 underwent a scheduled evaluation after three years. There were major changes in several indicators but also some indicators were changed only minimally. The focus on treatment processes like , , and , as well as the number of 10 indicators were not changed. Most topics remained except for which was introduced instead of . was added as an outcome indicator. These quality indicators are used in the peer review in intensive care, a method endorsed by the DIVI. A validity period of three years is planned for the quality indicators.

  3. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice:

    DEFF Research Database (Denmark)

    Plejdrup, Malene; Bjerrum, Lars; Gahrn-Hansen, Bente

    indicators were considered. The experts were asked to rate the relevance of 59 quality indicators with regard to reducing antimicrobial resistance and improving patient health. Consensus for a quality indicator was reached if ≥ 75 % of experts scored the item ≥ 5 on a 7-point Likert scale, ranging from 1...

  4. Quality of Life Indicators for Individuals with Intellectual Disabilities: Extending Current Practice

    Science.gov (United States)

    Brown, Ivan; Hatton, Chris; Emerson, Eric

    2013-01-01

    Quality of life is a social construct that is measured by what are considered to be its most appropriate indicators. Quality of life measurement in intellectual disability reflects a variety of indicators, often grouped under life domains. Subjective and objective methods of measuring indicators each have strengths and drawbacks, but it is…

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

    Science.gov (United States)

    Stalpers, Dewi; Kieft, Renate A M M; van der Linden, Dimitri; Kaljouw, Marian J; Schuurmans, Marieke J

    2016-04-06

    Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive screening indicators and nurse-perceived quality of care. To calculate a composite performance score for each of six Dutch non-university teaching hospitals, the percentage scores of the publicly reported nurse-sensitive indicators: screening of delirium, screening of malnutrition, and pain assessments, were averaged (2011). Nurse-perceived quality ratings were obtained from staff nurses working in the same hospitals by the Dutch Essentials of Magnetism II survey (2010). Concordance between the quality measures was analyzed using Spearman's rank correlation. The mean screening performances ranged from 63% to 93% across the six hospitals. Nurse-perceived quality of care differed significantly between the hospitals, also after adjusting for nursing experience, educational level, and regularity of shifts. The hospitals with high-levels of nurse-perceived quality were also high-performing hospitals according to nurse-sensitive indicators. The relationship was true for high-performing as well as lower-performing hospitals, with strong correlations between the two quality measures (rS = 0.943, p = 0.005). Our findings showed that there is a significant positive association between objectively measured nurse-sensitive screening indicators and subjectively measured perception of quality. Moreover, the two indicators of quality of nursing care provide corresponding quality rankings. This implies that improving factors that are associated with nurses' perception of what they believe to be quality of care may also lead to better screening processes. Although convergent validity seems to be established, we emphasize that different kinds of quality measures could be used to complement each other

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

    Directory of Open Access Journals (Sweden)

    Desi Kartikasari

    2013-12-01

    Full Text Available This research aims to determine the water quality of tertiary irrigation in several subdistricts in Malang, namely Kepanjen, Karangploso, and Tumpang. The water quality depends on the water quality indices (National Sanitation Foundation’s-NSF Indices and O’Connor’s Indices based on variables TSS, TDS, pH, DO, and Nitrate concentrate and ecological indices of benthic macroinvertebrate (Diversity Indices Shannon-Wiener, Hilsenhof Biotic Indices-HBI, Average Score per Taxon-ASPT which is calculated by Biological Monitoring Working Party-BMWP, Ephemeroptera Indices, Plecoptera, Trichoptera-EPT. Observation of the physico-chemical water quality and benthic macroinvertebrate on May 2012 to April 2013. The sampling in each subdistrict was done at two selected stations in tertiary irrigation channel with three plot at each station. The data of physico-chemical quality of water were used to calculate the water quality indices, while the benthic macroinvertebrate data were used to calculate the ecological indices. The research findings showed that 27 taxa of benthic macroinvertebrates belong 10 classes were found in the three subdistrict. The pH, DO, Nitrate, TSS and TDS in six tertiary irrigation channels in Malang still met the water quality standards based on Government Regulation No. 82 of 2001 on Management of Water Quality and Water Pollution Control Class III. Based on NSF-WQI indices and O'Connor's Indices, water qualities in these irrigation channels were categorized into medium or moderate (yellow to good (green category. However, based on benthic macroinvertebrate communities which was used to determine the HBI, the water quality in the irrigation channels were categorized into the fair category (fairly significant organic pollution to fairly poor (significant organic pollution, while based on the value of ASPT, the water were categorized into probable moderate pollution to probable severe pollution. The irrigation water which was

  7. Longitudinal pathways linking family factors and sibling relationship qualities to adolescent substance use and sexual risk behaviors.

    Science.gov (United States)

    East, Patricia L; Khoo, Siek Toon

    2005-12-01

    This 3-wave, 5-year longitudinal study tested the contributions of family contextual factors and sibling relationship qualities to younger siblings' substance use, sexual risk behaviors, pregnancy, and sexually transmitted disease. More than 220 non-White families participated (67% Latino and 33% African American), all of which involved a younger sibling (133 girls and 89 boys; mean age = 13.6 years at Time 1) and an older sister (mean age = 17 years at Time 1). Results from structural equation latent growth curve modeling indicated that qualities of the sibling relationship (high older sister power, low warmth/closeness, and low conflict) mediated effects from several family risks (mothers' single parenting, older sisters' teen parenting, and family's receipt of aid) to younger sibling outcomes. Model results were generally stronger for sister-sister pairs than for sister-brother pairs. Findings add to theoretical models that emphasize the role of family and parenting processes in shaping sibling relationships, which, in turn, influence adolescent outcomes.

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

    OpenAIRE

    Stalpers, Dewi; Kieft, Renate A. M. M.; Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke

    2016-01-01

    textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive screening indicators and nurse-perceived quality of care. Methods: To calculate a composite performance score for each of six Dutch non-university teaching hospitals, the percentage scores...

  9. Sexual quality of life in Hodgkin Lymphoma: a longitudinal analysis by the German Hodgkin Study Group

    Science.gov (United States)

    Behringer, K; Müller, H; Görgen, H; Flechtner, H-H; Brillant, C; Halbsguth, T V; Thielen, I; Eichenauer, D A; Schober, T; Nisters-Backes, H; Fuchs, M; Engert, A; Borchmann, P

    2013-01-01

    Background: Health-related quality of life (HRQoL) comprises different domains of physical, mental, and social well-being. In this analysis, we focus on sexual quality of life in Hodgkin Lymphoma (HL) patients. Methods: Four-thousand one-hundred and sixty patients enroled in the HD10–HD12 trials underwent HRQoL assessment. Instruments included the Quality of Life Questionnaire for survivors (QLQ-S), combining the European Organisation for Research and Treatment of Cancer QLQ-C30, Multidimensional fatigue (FA) inventory (MFI-20) and an additional sexual functioning (SX) scale. We describe SX up to 27 months after therapy and analyse relationship to stage, age, gender, FA, social functioning, and therapy. Statistical methods range from descriptive statistics to a classification of SX courses, and a longitudinal structural equations model with full information maximum likelihood estimation of missing data. In the analysis, a score below 50 was used to describe severe sexual dysfunction. Results: Three-thousand two-hundred and eight patients provided data on SX. Patients in advanced stages reported lower SX than patients in early stages both, before and after the treatment. During follow-up, an improvement of SX compared with baseline was detected, except for those ⩾50 years. Patients in early stages reached normal SX, whereas advanced-stage patients remained below the reference value for healthy controls. Sexual functioning during follow-up was significantly and strongly related to previous SX, other HRQoL measures, age, and stage, and to lesser degree with gender and chemotherapy. Conclusion: Overall, HL patients have a decreased sexual quality of life at baseline, which improves after therapy and normalises in early-stage patients. Importantly, long-term SX is more closely related to patient characteristics and SX at baseline than to the intensity of treatment. PMID:23321510

  10. Longitudinal Trajectories of Health Related Quality of Life in Danish Family Members of Individuals with Severe Brain Injury

    DEFF Research Database (Denmark)

    Norup, Anne; Snipes, Daniel J.; Siert, Lars

    2013-01-01

    Scant research has examined health-related quality of life (HRQoL) in family members of patients with severe brain injury, even less has been done in Scandinavian countries, and none has examined this construct longitudinally. The current study therefore used multilevel modelling to investigate...

  11. The Longitudinal Relationship Between Satisfaction with Transitional Care and Social and Emotional Quality of Life Among Chronically Ill Adolescents

    NARCIS (Netherlands)

    J.M. Cramm (Jane); M.M.H. Strating (Mathilde); H.M. Sonneveld (Henk); A.P. Nieboer (Anna)

    2013-01-01

    textabstractThis study aimed to identify the relationship between satisfaction with transitional care and quality of life of chronically ill adolescents over time. This longitudinal study included adolescents with type I diabetes, juvenile idiopathic arthritis (JIA), and neuromuscular disorders (NMD

  12. Longitudinal Associations between Perceived Parent-Adolescent Attachment Relationship Quality and Generalized Anxiety Disorder Symptoms in Adolescence

    Science.gov (United States)

    van Eijck, Fenna E. A. M.; Branje, Susan J. T.; Hale, William W., III; Meeus, Wim H. J.

    2012-01-01

    This longitudinal study examined the direction of effects between adolescents' generalized anxiety disorder (GAD) symptoms and perceived parent-adolescent attachment relationship quality, as well as the moderating role of gender and age. 1,313 Dutch adolescents (48.5% boys) from two age cohorts of early (n = 923, M[subscript age] = 12 at W1) and…

  13. The analysis of longitudinal quality of life measures with informative drop-out : A pattern mixture approach

    NARCIS (Netherlands)

    Post, W.J.; Buijs, C.; Stolk, R.P.; de Vries, E.G.E.; le Cessie, S.

    The analysis of longitudinal health-related quality of life measures (HRQOL) can be seriously hampered due to informative drop-out. Random effects models assume Missing At Random and do not take into account informative drop-out. We therefore aim to correct the bias due to informative drop-out.

  14. Health related quality of life in renal transplantation: 2 years of longitudinal follow-up.

    Science.gov (United States)

    Costa-Requena, Gema; Cantarell, M Carmen; Moreso, Francesc; Parramon, Gemma; Seron, Daniel

    2017-08-10

    Health related quality of life (HRQoL) is recognized as an outcome measure in kidney transplantation. In this study was assessed changes on HRQoL and kidney-specific symptoms, also was evaluated the effect of socio-demographic and clinical parameters on patient's perceived HRQoL. A longitudinal study was done, at 5 time-points over 2 years after transplantation. To evaluate HRQoL the Kidney Disease Quality of Life Questionnaire Short Form was administrated, and Hospital Anxiety and Depression Scale was used to assess psychological distress. At 6-months after transplantation, patients had similar HRQoL scores compared to the general population. The improvement on effects of kidney disease domain could be considered as large (η(2)=0.29), and medium on burden of kidney disease domain (η(2)=0.12), work status domain (η(2)=0.12), and sexual function domain (η(2)=0.13). Psychological distress, depressive symptoms, haemoglobin, and serum creatinine had significant influence on patient's perceived HRQoL over 2 years after transplantation. An improvement of HRQoL was observed on general and specific-targeted symptoms over 2 years after renal transplantation. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Diversity assessment of benthic macroinvertebrates, yeasts, and microbiological indicators along a longitudinal gradient in Serra do Cipó, Brazil

    Directory of Open Access Journals (Sweden)

    M. Callisto

    Full Text Available The main goals of this study were: 1 to evaluate the structure, diversity, and functional trophic group composition of benthic macroinvertebrate communities; 2 to characterize water quality in the headwaters of the Doce river watershed, based on physical, chemical, and biological parameters (benthic macroinvertebrates, fecal coliforms, heterotrophic bacteria, and yeasts; and 3 to contribute to the knowledge of the structure and function of longitudinal gradients in lotic ecosystems in Brazil. A total of 60 benthic macroinvertebrate taxa were identified, the dominant group being the aquatic insects, with 50 families distributed in 8 orders. The dry period presented higher values of taxonomic richness and total density of benthic macroinvertebrates. A decreasing gradient was observed in these variable values from the 3rd order stretch down to the 6th order stretch. The highest Shannon-Wiener diversity values were found in the rainy period in the 3rd order stretches, which presented well-developed riparian forest. Besides the 3rd order stretches, the Pielou evenness index values were also high in the 6th order stretch. The collectors, together with the scrapers, predominated in the benthic macroinvertebrate communities in all river stretches, except in the 2nd, 4th, and 5th order stretches in the rainy period, where communities were dominated by filterers. The shredders and predators presented low densities for all river stretches. All microbiological variables presented low levels. Due to the high counts of heterotrophic bacteria and coliforms, the studied river stretches presented inadequate potability but adequate balneability levels. The results suggest that the structure, diversity, and composition of the benthic macroinvertebrate communities are influenced by the trophic resource availability, seasonality, and sediment heterogeneity. The microbiological results of this study allow inferring that the waters from Serra do Cipó have excellent

  16. CHEMICAL AND BIOLOGICAL AIR POLLUTANTS, AS PARAMETERS OF COMPLEX AIR QUALITY INDICES

    Directory of Open Access Journals (Sweden)

    TEKLA EÖTVÖS

    2007-12-01

    Full Text Available Human health is essentially influenced by air quality. Atmospheric air in residential areas contains many pollutants. The monitoring and the plain publishing of the measured values are important both for the authorities and the public. Air quality is often characterized by constructing air quality indices, and these indices are used to inform the public. The construction of an advanced air quality index is usually done by averaging the measured data usually in time and space; hereby important aspects of the data can be lost. All known indices contain only chemical pollutants, while certain biological pollutants can enhance the effects of the chemical pollutants and vice versa. In this paper we discuss the importance of integrating biological pollutants into air quality indices. In order to increase efficacy of these indices to the civil society we aim to introduce geographic information system (GIS methods into publishing air quality information.

  17. SYNTHETIC ANALYSIS OF INDICATORS USED IN THE ANALYSIS OF PRODUCT QUALITY DIFFERENTIATED AND NON-DIFFERENTIATED ON QUALITY CLASSES

    Directory of Open Access Journals (Sweden)

    ECOBICI MIHAELA LOREDANA

    2016-12-01

    Full Text Available Product quality has been and will remain one of the most important indicators of increasing economic and financial performance of a company. Quality is that which ensures the greatest part of the competitiveness of a product or service, this being the result of some important aspects such as: products and services of quality to meet consumers requirements, low costs without affecting the quality level, the performance of contractual obligations, customer satisfaction and last but not least obtaining profit. Research and results concerning this issue will result in the prerequisites in the process for quality assurance that can develop both internally and externally. The purpose of this article lies in the approach and illustration of the aspects of products differentiated and non-differentiated in quality classes. In launching this research I will try to highlight some aspects that most efficiently the indicators mentioned above, indicators that read to what extent a certain product meets the characteristics specified to its destination.

  18. Health-related quality of life and functional status quality indicators for older persons with multiple chronic conditions.

    Science.gov (United States)

    Dy, Sydney M; Pfoh, Elizabeth R; Salive, Marcel E; Boyd, Cynthia M

    2013-12-01

    To explore central challenges with translating self-reported measurement tools for functional status and health-related quality of life (HRQOL) into ambulatory quality indicators for older people with multiple chronic conditions (MCCs). Review. Sources including the National Quality Measures Clearinghouse and National Quality Forum were reviewed for existing ambulatory quality indicators relevant to functional status, HRQOL, and people with MCCs. Seven informants with expertise in indicators using functional status and HRQOL. Informant interviews were conducted to explore knowledge about these types of indicators, particularly usability and feasibility. Nine important existing indicators were identified in the review. For process, identified indicators addressed whether providers assessed functional status; outcome indicators addressed quality of life. In interviews, informants agreed that indicators using self-reported data were important in this population. Challenges identified included concerns about usability due to inability to discriminate quality of care adequately between organizations and feasibility concerns regarding high data collection burden, with a correspondingly low response rate. Validity was also a concern because evidence is mixed that healthcare interventions can improve HRQOL or functional status for this population. As a possible first step, a structural standard could be systematic collection of these measures in a specific setting. Although functional status and HRQOL are important outcomes for older people with MCCs, few relevant ambulatory quality indicators exist, and there are concerns with usability, feasibility, and validity. Further research is needed on how best to incorporate these outcomes into quality indicators for people with MCCs. © Published 2013. This article is a U.S. Government work and is in the public domain in the U.S.A.

  19. EPHT air quality (county PM2.5 and Ozone) indicators, 2001-2006

    Data.gov (United States)

    California Environmental Health Tracking Program — The EPHT air quality indicator files are from a SAS program which calculates the air indicators as developed by CDC's Environmental Public Health Tracking (EPHT) Air...

  20. Developing quality indicators for family support services in community team-based mental health care.

    Science.gov (United States)

    Serene Olin, S; Kutash, Krista; Pollock, Michele; Burns, Barbara J; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E

    2014-01-01

    Quality indicators for programs integrating parent-delivered family support services for children's mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components.

  1. HON label and DISCERN as content quality indicators of health-related websites.

    Science.gov (United States)

    Khazaal, Yasser; Chatton, Anne; Zullino, Daniele; Khan, Riaz

    2012-03-01

    Content quality indicators are warranted in order to help patients and consumers to judge the content quality of health-related on-line information. The aim of the present study is to evaluate web-based information on health topics and to assess particular content quality indicators like HON (Health on the Net) and DISCERN. The present study is based on the analysis of data issued from six previous studies which assessed with a standardized tool the general and content quality (evidence-based health information) of health-related websites. Keywords related to Social phobia, bipolar disorders, pathological gambling as well as cannabis, alcohol and cocaine addiction were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality (evidence-based information). "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of 874 websites identified, 388 were included. Despite an observed association with higher content quality scores, the HON label fails to predict good content quality websites when used in a multiple regression. Sensibility and specificity of a DISCERN score >40 in the detection of good content quality websites were, respectively, 0.45 and 0.96. The DISCERN is a potential quality indicator with a relatively high specificity. Further developments in this domain are warranted in order to facilitate the identification of high-quality information on the web by patients.

  2. 78 FR 13365 - Prospective Grant of Exclusive License: Food Quality Indicators

    Science.gov (United States)

    2013-02-27

    ... HUMAN SERVICES National Institutes of Health Prospective Grant of Exclusive License: Food Quality... thereto) intended for licensure describe and claim indicator strips for monitoring food quality and... color. Thus a rapid and informed decision can be made about quality of food and its shelf life under...

  3. Disease-specific quality indicators, guidelines, and outcome measures in systemic lupus erythematosus (SLE).

    Science.gov (United States)

    Mosca, M; Bombardieri, S

    2007-01-01

    The assessment of quality of care is becoming increasingly important, but as yet no standard set of measures to assess quality has been developed. The ACR Quality Measures Committee has selected the following areas of study to develop quality indicators: diagnostic/classification criteria, outcome measures/response criteria, treatment guidelines/management recommendations, definition of quality indicators, and definition of data collection systems. The aim of the present review is to evaluate existing guidelines and outcome measures concerning disease/activity monitoring, autoantibody and laboratory assessment, outcomes, and therapy in systemic lupus erythematosus (SLE) that could be used to define disease-specific quality indicators. Much data is available in the literature that could serve to define a starter set of quality indicators for SLE. Monitoring issues are discussed in the ACR and EULAR recommendations. As far as therapy is concerned, the ACR has provided indicators for rheumatoid arthritis that could also be applied to SLE, as well as indications for anti-malarial monitoring. The outcomes measures most frequently used in SLE are damage and death, but organ-specific definitions of outcome and response are being evaluated. The development of quality measures for SLE is just beginning; existing information could serve to construct a starter set of indicators such as the one proposed here. Certainly much progress will be made in the near future. A practical, user-friendly tool for physicians that will help them deliver high quality care to populations is also needed.

  4. Motivational Gaps and Perceptual Bias of Initial Motivation Additional Indicators of Quality for e-Learning Courses

    National Research Council Canada - National Science Library

    Rosário Cação

    2017-01-01

    ...s: attitudes, courses, expectations, e-learning, gaps, motivational gap, motivation, motivation to learn, perception bias, quality, quality indicators, quality of e-learning, satisfaction, service...

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

    Directory of Open Access Journals (Sweden)

    Edgar Oliver Cardoso Espinosa

    2011-11-01

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

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

    NARCIS (Netherlands)

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

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  8. Biological indicators of soil quality and soil organic matter characteristics in an agricultural management continuum

    Science.gov (United States)

    Relationships among biological indicators of soil quality and soil organic matter characteristics in a claypan soil were evaluated across a continuum of long-term agricultural practices in Missouri, USA. In addition to chemical and physical soil quality indicators, dehydrogenase and phenol oxidase a...

  9. Annotated Bibliography of Publications Dealing with Qualitative and Quantitative Indicators of the Quality of Science.

    Science.gov (United States)

    Stowe, Robert C.

    Designed to assist in the study of techniques for and approaches to the evaluation of scientific research, this annotated bibliography of publications deals with qualitative and quantitative indicators of the quality of science. Entries are provided in the following categories: (1) bibliometric indicators of the quality of scientific research; (2)…

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  12. European Surveillance of antimicrobial consumption (ESAC) : quality indicators for outpatient antibiotic use in Europe

    NARCIS (Netherlands)

    Coenen, Samuel; Ferech, Matus; Haaijer-Ruskamp, Flora M.; Butler, Chris C.; Stichele, Robert H. Vander; Verheij, Theo J. M.; Monnet, Dominique L.; Goossens, Paul Little Herman

    2007-01-01

    Background and objective: Indicators to measure the quality of healthcare are increasingly used by healthcare professionals and policy makers. In the context of increasing antimicrobial resistance, this study aimed to develop valid drug- specific quality indicators for outpatient antibiotic use in E

  13. [Evaluation of the quality of performance of general practitioners. What is the problem with primary care quality indicators in Hungary?].

    Science.gov (United States)

    Kolozsvári, László Róbert; Rurik, Imre

    2016-02-28

    The Hungarian primary care quality indicator system has been introduced in 2009, and has been continuously developed since then. The system offers extra financing for family physicians who are achieving the expected levels of indicators. There are currently 16 indicators for adult and mixed practices and 8 indicators are used in paediatric care. Authors analysed the influencing factors of the indicators other than those related to the performance of family physicians. Expectations and compliance of patients, quality of outpatient (ambulatory) care services, insufficient flow of information, inadequate primary care softwares which need to be updated could be considered as the most important factors. The level of financial motivations should also be significantly increased besides changes in the reporting system. It is recommended, that decision makers in health policy and financing have to declare clearly their expectations, and professional bodies should find the proper solution. These indicators could contribute properly to the improvement of the quality of primary care services in Hungary.

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

    Science.gov (United States)

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

    2016-08-01

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

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

    NARCIS (Netherlands)

    Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2016-01-01

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

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

    NARCIS (Netherlands)

    Dimitri van der Linden; Prof. Dr. Marieke J. Schuurmans; Dewi Stalpers; Marian J. Kaljouw; Renate A.M.M. Kieft

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

    Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2016-01-01

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

  1. Nutritional status and quality of life of cancer patients needing exclusive chemotherapy: a longitudinal study.

    Science.gov (United States)

    Salas, Sebastien; Mercier, Sophie; Moheng, Benjamin; Olivet, Sandrine; Garcia, Marie-Eve; Hamon, Sophie; Sibertin-Blanc, Camille; Duffaud, Florence; Auquier, Pascal; Baumstarck, Karine

    2017-04-27

    The aims of this study were to report nutritional status in a large panel of patients with cancer requiring exclusive chemotherapy and to study the influence of nutritional status on their quality of life (QoL). This work was a longitudinal cohort study performed at a French university teaching hospital. Eligible patients were individuals with a cancer needing treatment based on exclusive chemotherapy. Three work-ups were performed: i) before the administration of the first course of chemotherapy: T1, ii) before the administration of the second (for patients with 3 planned courses) or third (patients with 6 planned courses) course: T2, and iii) before the administration of the last planned course: T3. The following data were collected: general health (performance status) and nutritional status (weight, anorexia grading, albuminemia, pre-albuminemia, and C-reactive protein) and QoL. The nutritional status of patients with cancer was preserved. Functional impairment, the presence of anorexia, the palliative nature of the chemotherapy, and an elevated C-reactive protein dosage were independent predictive factors of a lower QoL among patients assessed at the end of chemotherapy. Although larger studies should corroborate these findings, clinicians may include this information in the management of patients with cancer requiring exclusive chemotherapy to identify the most vulnerable patients. Current controlled trials NCT01687335 (registration date: October 6, 2011).

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Potential palliative care quality indicators in heart disease patients: A review of the literature.

    Science.gov (United States)

    Mizuno, Atsushi; Miyashita, Mitsunori; Hayashi, Akitoshi; Kawai, Fujimi; Niwa, Koichiro; Utsunomiya, Akemi; Kohsaka, Shun; Kohno, Takashi; Yamamoto, Takeshi; Takayama, Morimasa; Anzai, Toshihisa

    2017-10-01

    In spite of the increasing interest in palliative care for heart disease, data on the detailed methods of palliative care and its efficacy specifically in heart disease are still lacking. A structured PubMed literature review revealed no quality indicators of palliative care in heart disease. Therefore, we performed a narrative overview of the potential quality indicators in heart disease by reviewing previous literature concerning quality indicators in cancer patients. We summarize seven potential categories of quality indicators in heart disease: (1) presence and availability of a palliative care unit, palliative care team, and outpatient palliative care; (2) human resources such as number of skilled staff; (3) infrastructure; (4) presence and frequency of documentation or family survey; (5) patient-reported outcome measure (PROM) data and disease-specific patient quality of life such as The Kansas City Cardiomyopathy Questionnaire (KCCQ); (6) questionnaires and interviews about the quality of palliative care after death, including bereaved family surveys; and (7) admission-related outcomes such as place of death and intensive care unit length of stay. Although detailed measurements of palliative care quality have not been validated in heart disease, many indicators developed in cancer patients might also be applicable to heart disease. This new categorization might be useful to determine quality indicators in heart disease patients. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  4. Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2012-01-01

    Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

  5. Use of Longitudinal Regression in Quality Control. Research Report. ETS RR-14-31

    Science.gov (United States)

    Lu, Ying; Yen, Wendy M.

    2014-01-01

    This article explores the use of longitudinal regression as a tool for identifying scoring inaccuracies. Student progression patterns, as evaluated through longitudinal regressions, typically are more stable from year to year than are scale score distributions and statistics, which require representative samples to conduct credibility checks.…

  6. Practice-based collection of quality indicator data for a comprehensive quality assessment programme in Canadian family practices.

    Science.gov (United States)

    Price, David; Howard, Michelle; Dolovich, Lisa; Laryea, Stephanie; Hilts, Linda; Barbara, Angela

    2010-12-01

    Quality improvement in primary care can be facilitated by the ability to measure indicators in practice. This paper reports on the process and impacts of data collection on indicators of a quality assessment tool in seven interprofessional group family practices in Ontario, Canada. The programme addressed indicators and collected data across multiple domains of practice including clinical quality, physical factors, and patient and staff perceptions. A system audit of the practice, a patient survey, a staff satisfaction survey and chart audits (on hypothyroidism and hyperlipidaemia) were designed to measure selected indicators across the domains. Practices were trained and collected their own data. Practices provided feedback on the process and impacts during a postprogramme workshop and on a survey 1 year later. Four-hundred charts audits were completed for each of hyperlipidaemia and hypothyroidism, 319 patient satisfaction surveys were administered in four practices, and the staff satisfaction survey was completed by 77 staff in six practices. Most practices demonstrated indicators of privacy, access and safety. There was more variability in indicators relating to staff professional development and team involvement in meetings. Patient satisfaction with providers was rated highly, whereas some aspects of practice access were rated lower. Practices approached the challenge of participation by engaging multidisciplinary team members and dividing tasks. Most practices reported continued participation in various quality improvement initiatives 1 year later. Using a set of indicators, structured processes and training, family practices find the process of gathering and reviewing their data useful for quality improvement.

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

    Science.gov (United States)

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

    2014-01-01

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

  8. Impact of Trichiasis Surgery on Quality of Life: A Longitudinal Study in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Esmael Habtamu

    2016-04-01

    Full Text Available Trachomatous trichiasis significantly reduces vision and health related quality of life (QoL. Although trichiasis surgery is widely performed to treat trichiasis, there is little data on the effect of surgery on QoL. We measured the impact of trichiasis surgery on vision and health related QoL in a longitudinal study from Amhara Region, Ethiopia.We recruited 1000 adult participants with trichiasis (cases and 200 comparison participants, matched to every fifth trichiasis case on age (+/- two years, sex and location. Vision-related quality of life (VRQoL and health-related quality of life (HRQoL were measured using the WHO/PBD-VF20 and WHOQOL-BREF questionnaires respectively, at enrolment and 12 months after enrolment. All trichiasis cases received free standard trichiasis surgery immediately after enrolment. The mean difference in QoL scores between enrolment and follow-up for cases and comparison participants, and the difference-in-differences by baseline trichiasis status was analysed using random effects linear regression, the later adjusted for age, sex and socioeconomic status. At 12-months follow-up, data was collected from 980 (98% and 198 (98% trichiasis cases and comparison participants respectively. At this follow-up visit, VRQoL and HRQoL scores of trichiasis cases improved substantially in all subscales and domains by 19.1-42.0 points (p<0.0001 and 4.7-17.2 points (p<0.0001, respectively. In contrast, among the comparison participants, there was no evidence of improvement in VRQoL and HRQoL domain scores during follow-up. The improvement in VRQoL and HRQoL in cases was independent of the presence of visual acuity improvement at 12 months.Trichiasis surgery substantially improves both VRQoL and HRQoL regardless of visual acuity change. Unprecedented effort is needed to scale-up trichiasis surgical programmes not only to prevent the risk of sight loss but also to improve overall wellbeing and health perception of affected individuals.

  9. Impact of Trichiasis Surgery on Quality of Life: A Longitudinal Study in Ethiopia

    Science.gov (United States)

    Habtamu, Esmael; Wondie, Tariku; Aweke, Sintayehu; Tadesse, Zerihun; Zerihun, Mulat; Mohammed, Aderajew; Zewudie, Zebideru; Callahan, Kelly; Emerson, Paul M.; Bailey, Robin L.; Mabey, David C. W.; Rajak, Saul N.; Kuper, Hannah; Polack, Sarah; Weiss, Helen A.; Burton, Matthew J.

    2016-01-01

    Background Trachomatous trichiasis significantly reduces vision and health related quality of life (QoL). Although trichiasis surgery is widely performed to treat trichiasis, there is little data on the effect of surgery on QoL. We measured the impact of trichiasis surgery on vision and health related QoL in a longitudinal study from Amhara Region, Ethiopia. Methodology/Principal Findings We recruited 1000 adult participants with trichiasis (cases) and 200 comparison participants, matched to every fifth trichiasis case on age (+/- two years), sex and location. Vision-related quality of life (VRQoL) and health-related quality of life (HRQoL) were measured using the WHO/PBD-VF20 and WHOQOL-BREF questionnaires respectively, at enrolment and 12 months after enrolment. All trichiasis cases received free standard trichiasis surgery immediately after enrolment. The mean difference in QoL scores between enrolment and follow-up for cases and comparison participants, and the difference-in-differences by baseline trichiasis status was analysed using random effects linear regression, the later adjusted for age, sex and socioeconomic status. At 12-months follow-up, data was collected from 980 (98%) and 198 (98%) trichiasis cases and comparison participants respectively. At this follow-up visit, VRQoL and HRQoL scores of trichiasis cases improved substantially in all subscales and domains by 19.1–42.0 points (p<0.0001) and 4.7–17.2 points (p<0.0001), respectively. In contrast, among the comparison participants, there was no evidence of improvement in VRQoL and HRQoL domain scores during follow-up. The improvement in VRQoL and HRQoL in cases was independent of the presence of visual acuity improvement at 12 months. Conclusions/Significance Trichiasis surgery substantially improves both VRQoL and HRQoL regardless of visual acuity change. Unprecedented effort is needed to scale-up trichiasis surgical programmes not only to prevent the risk of sight loss but also to improve

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

    Directory of Open Access Journals (Sweden)

    Milca PETROVICI

    2012-01-01

    Full Text Available Present paper approach the issue of assessing the water quality of tributaries located in the upper basin of the river Mureş, taking into account changes in the value of biotic indices. In this sense, have been selected the next five biotic indices: Ephemeroptera Plecoptera Trichoptera index (EPT, Total Invertebrates index (T, Chironomidae index (Ch, EPT / Total invertebrates index (EPT / T, EPT / Chironomidae index (EPT / Ch and % Chironomidae index (% Chironomidae. Considering all these indices, it was found existence of a medium to best quality water in Mureş tributaries from Harghita Mountains and a good quality water which comes from the Maramureş Mountains and Transylvania Plateau.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    of voltages and currents are estimated. Frequency and its rate of change are directly estimated from voltage input signals. In the second algorithm stage the power quality indicators are calculated. The algorithm considers frequency as an unknown model parameter simultaneously estimated with the voltage......The two-stage Newton Type Algorithm for the tracking of the power quality indicators, frequency and rate of frequency changes is presented in the paper. By this definitions for power quality indicators according to the IEEE Standard 1459-2000 were used. In the first algorithm stage the spectra...

  12. Social Indicators Research and Health-Related Quality of Life Research.

    Science.gov (United States)

    Michalos, Alex C.

    2004-01-01

    The aim of this essay is to build a bridge between two intersecting areas of research, social indicators research on the one hand and health-related quality of life research on the other. The first substantive section of the paper introduces key concepts and definitions in the social indicators research tradition, e.g., social indicators,…

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

    Directory of Open Access Journals (Sweden)

    Dyakova Yu. A.

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-11-27

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

  15. Serengeti real estate: density vs. fitness-based indicators of lion habitat quality.

    Science.gov (United States)

    Mosser, Anna; Fryxell, John M; Eberly, Lynn; Packer, Craig

    2009-10-01

    Habitat quality is typically inferred by assuming a direct relationship between consumer density and resource abundance, although it has been suggested that consumer fitness may be a more accurate measure of habitat quality. We examined density vs. fitness-based measures of habitat quality for lions in the Serengeti National Park, Tanzania. A 40-year average of female reproductive success (yearling cubs per female) was best explained by proximity to river confluences, whereas patterns of productivity (yearling cubs per km(2)) and adult female density (individuals per km(2)) were associated with more general measures of habitat quality and areas of shelter in poor habitat. This suggests that density may not accurately distinguish between high-quality 'source' areas and low-quality sites that merely provide refuges for effectively non-reproductive individuals. Our results indicate that density may be a misleading indicator of real estate value, particularly for populations that do not conform to an ideal free distribution.

  16. EVALUATION OF QUALITY INDICATORS RELATED TO QUALITY BREAD WHEAT PROMISING LINES

    Directory of Open Access Journals (Sweden)

    Watson Munyanyi

    2014-01-01

    Full Text Available The bread waste is one of the important socio-economic's issues country now, the urgent need is feeling to improve the wheat quality. Therefore, using the methods of farming and breeding is necessary to improve the quality of this strategic product. As a result, tests of quality's traits in wheat promising lines in Isfahan climate took place. In this study, the choice 17 advanced lines of compare the performances,s experiments, an experiment was conducted for two consecutive cropping (2011-2012 at cultural experiment and research centre in Isfahan located in Kabutar Abad region. Randomized complete block designs with 3 replications were compared with Spring variety (for control. Traits including: 1000 grain weight, hectolitre weight, protein content, Zeleny sedimentation rate, bread volume, grain moisture content, grain hardness, water absorption, falling number, percentage of dry gluten, gluten index, sedimentation rates were SDS.The results of the combined analysis of variance qualitative characteristics,s for two consecutive cropping showed that treatments with compare together and control variety had significant influence in 1% probability.Correlation coefficients of two years showed that the compound test significant positive correlation within grain hardness index and protein content, wet gluten and dry deposition rates of SDS. Also, significant positive correlation with the percentage of protein content of dry gluten. In view of the high correlation with protein content of dry gluten (quantity. However, grain hardness and relatively high correlation with SDS sedimentation as an important measure of protein quality. Therefore, the test results of dry gluten grains can be tough to choose in order to improve the quality of wheat bread may be used.

  17. Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

    2013-01-01

    Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT. Objectives: To investigate Danish general practitioners' (GPs') assessment...... of a set of internationally developed quality indicators and to explore if there is an association between the GPs' assessment of the indicators and their practice characteristics as well as their antibiotic prescription pattern. Methods: A total of 102 Danish GPs were invited to assess the 41 quality...... indicators. The GPs were categorized into two groups according to their assessment of indicators. Data concerning practice characteristics and antibiotic treatment were obtained during a three-week registration of patients with RTIs and were linked to the GPs' assessments of the indicators. Results: A total...

  18. Indices of water quality and metal pollution of Nile River, Egypt

    OpenAIRE

    Abdel-Satar, Amaal M.; Ali, Mohamed H.; Mohamed E. Goher

    2017-01-01

    Nile River is the valued natural and exclusive source of fresh water in Egypt, where the drinking water supply is limited to the river. The water quality of 24 sites between Aswan and Cairo along the Nile was investigated. To evaluate the suitability of water for aquatic life and drinking purposes, the indices of water quality (WQI), heavy metal pollution (HPI) and contamination (Cd) were computed. The water quality variations were mainly related to inorganic nutrients and heavy metals, where...

  19. [Analysis and evaluation of the QUALIFY tool for assessing quality indicators with structured group interviews].

    Science.gov (United States)

    Lüngen, Markus; Rath, Thomas

    2011-01-01

    Quality indicators are used world-wide to monitor the quality of health care. For these indicators to be effective they also have to meet certain quality criteria. The QUALIFY tool is used for assessing the quality criteria themselves against a scientific background. The present paper evaluates the QUALIFY tool and provides an indication of its further development. The evaluation of the QUALIFY tool was carried out using structured group interviews. Participants of the first focus group were involved in both the development of the tool and in its implementation. The second focus group exclusively consisted of QUALIFY users. There was no essential difference in the rating between the two focus groups. Up till now, QUALIFY has been used for the designation of quality indicators for the German Quality Record for Hospitals, for a pre-selection of indicators for the National Disease Management Guidelines, and for a pharmaceutical drug safety project of the Coalition for Patient Safety. Its wider distribution is hampered by the fact that the actual QUALIFY tool is far too complex and requires a lot of resources. Nevertheless, its cost-effectiveness was rated 'adequate' because the application of inappropriate quality indicators can be very expensive. Our ambition should be to define QUALIFY subsystems of various complexity for different purposes and to enforce anchoring of the tool at an international level. QUALIFY, and thus the assessment of quality indicators, has entered virgin territory. Since quality assessment will be gaining relevance the further evaluation and development of these tools is warranted. In this context group interviews could provide an applicable approach to evaluating acceptance and implementation problems.

  20. Audit of cases with uterine rupture: a process indicator of quality of ...

    African Journals Online (AJOL)

    Roland

    Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of ... (MAN), the maternity hospital with the high- ... stances, such as progress and management of lab- our, use of ...

  1. Teaching Quality Management Model for the Training of Innovation Ability and the Multilevel Decomposition Indicators

    Science.gov (United States)

    Lu, Xingjiang; Yao, Chen; Zheng, Jianmin

    2013-01-01

    This paper focuses on the training of undergraduate students' innovation ability. On top of the theoretical framework of the Quality Function Deployment (QFD), we propose a teaching quality management model. Based on this model, we establish a multilevel decomposition indicator system, which integrates innovation ability characterized by four…

  2. Process quality indicators for chronic kidney disease risk management : a systematic literature review

    NARCIS (Netherlands)

    Smits, Kirsten P J; Sidorenkov, Grigory; Bilo, Henk J G; Bouma, Margriet; Navis, Gerjan J; Denig, Petra

    2016-01-01

    BACKGROUND AND OBJECTIVES: Quality indicators (QIs) can be used for measuring the quality of actions of healthcare providers. This systematic review gives an overview of such QIs measuring processes of care for chronic kidney disease (CKD), and identifies the QIs that have content, face, operational

  3. Process quality indicators for chronic kidney disease risk management : a systematic literature review

    NARCIS (Netherlands)

    Smits, Kirsten P. J.; Sidorenkov, Grigory; Bilo, Henk J. G.; Bouma, Margriet; Navis, Gerjan J.; Denig, Petra

    2016-01-01

    Background and objectivesQuality indicators (QIs) can be used for measuring the quality of actions of healthcare providers. This systematic review gives an overview of such QIs measuring processes of care for chronic kidney disease (CKD), and identifies the QIs that have content, face, operational a

  4. Soil quality indicator responses to row crop, grazed pasture, and agroforestry buffer management

    Science.gov (United States)

    Incorporation of trees and establishment of grass buffers within agroecosystems are management practices shown to enhance soil quality. Soil enzyme activities and water stable aggregates (WSA) have been identified as sensitive soil quality indicators to evaluate early responses to soil management. ...

  5. To what extent do structural quality indicators of (nutritional) care influence malnutrition prevalence in nursing homes?

    NARCIS (Netherlands)

    van Nie-Visser, Noemi C.; Meijers, Judith M.; Schols, J.M.G.A.; Lohrmann, Christa; Spreeuwenberg, Marieke; Halfens, Ruud J.

    2015-01-01

    Background & aims Many residents in European healthcare institutions are malnourished, with reported malnutrition prevalence rates of up to 60%. Due to the negative effects of malnutrition it is important to optimize the quality of nutritional care. If structural quality indicators of nutritional

  6. Conductivity as an indicator of surface water quality in the proximity ...

    African Journals Online (AJOL)

    2015-10-05

    Oct 5, 2015 ... Conductivity as an indicator of surface water quality in the ... FeCr smelting did not significantly impact surface water quality, but that surface run-off and/or ..... farming-management/soil-water/salinity/measuring-the-salinity-.

  7. Performance indicators used to assess the quality of primary dental care.

    NARCIS (Netherlands)

    Gonzalez, G.Z.; Klazinga, N.; Asbroek, G. ten; Delnoij, D.M.

    2006-01-01

    An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. OBJECTIVES: To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a hea

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

    Science.gov (United States)

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

    2016-06-01

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

  9. Effects of Maternal Parenting and Mother-Child Relationship Quality on Short-Term Longitudinal Change in Self-Regulation in Early Adolescence

    Science.gov (United States)

    Moilanen, Kristin L.; Rambo-Hernandez, Karen E.

    2017-01-01

    The purpose of the present study was to explore the degree to which short-term longitudinal change in adolescent self-regulation was attributable to maternal parenting and mother-child relationship quality. A total of 821 mother-adolescent dyads provided data in the 1992 and 1994 waves of the Children of the National Longitudinal Survey of…

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

    Science.gov (United States)

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

    2015-02-01

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

  11. Air quality indicators from the Environmental Performance Index: potential use and limitations in South Africa

    Directory of Open Access Journals (Sweden)

    Rebecca M. Garland

    2017-06-01

    Full Text Available In responding to deteriorating air quality, many countries, including South Africa, have implemented national programmes that aim to manage and regulate ambient air quality, and the emissions of air pollutants. One aspect within these management strategies is effective communication to stakeholders, including the general public, with regard to the state and trend of ambient air quality in South Africa. Currently, information on ambient air quality is communicated through ambient mass concentration values, as well as number of exceedances of South African National Ambient Standards. However, these do not directly communicate the potential impact on human health and the ecosystem. To this end, the use of air quality indicators is seen as a potential way to achieve communication to stakeholders in a simplified, yet scientifically defensible manner. Air quality indicators and their source data from the Environmental Performance Index (EPI were interrogated to understand their potential use in South Africa. An assessment of four air quality indicators, together with their source data, showed improvements in air quality over the time period studied, though the input data do have uncertainties. The source data for the PM indicators, which came from a global dataset, underestimated the annual PM2.5 concentrations in the Highveld Priority Area and Vaal Triangle Airshed Priority Area over the time period studied (2009-2014 by ~3.7 times. This highlights a key limitation of national-scale indicators and input data, that while the data used by the EPI are a well-thought out estimate of a country’s air quality profile, they remain a generalised estimate. The assumptions and uncertainty inherent in such an ambitious global-wide attempt make the estimates inaccurate for countries without proper emissions tracking and accounting and few monitoring stations, such as South Africa. Thus, the inputs and resultant indicators should be used with caution until such

  12. Quality assessment of diagnosis and antibiotic treatment of infectious diseases in primary care: a systematic review of quality indicators

    OpenAIRE

    Saust, Laura Trolle; Monrad, Rikke Nygaard; Hansen, Malene Plejdrup; Arpi, Magnus; Bjerrum, Lars

    2016-01-01

    Objective To identify existing quality indicators (QIs) for diagnosis and antibiotic treatment of patients with infectious diseases in primary care. Design A systematic literature search was performed in PubMed and EMBASE. We included studies with a description of the development of QIs for diagnosis and antibiotic use in patients with infectious diseases in primary care. We extracted information about (1) type of infection; (2) target for quality assessment; (3) methodology used for developi...

  13. Quality in cytopathology: an analysis of the internal quality monitoring indicators of the Instituto Nacional de Câncer

    OpenAIRE

    Araujo Jr,Mario Lucio C.; Daniela A. Santana; Lívia B. Almeida; Quintana,Shirley B. S.; Gloria Regina F. Silva; Fonseca,Rachel C. S. P.

    2015-01-01

    Introduction: Quality control programs are required to ensure the effectiveness of Pap smear, which still remain a key strategy for control of cervical cancer worldwide. Objective: This study was based on the retrospective and quantitative analysis of the post-analytical phase indicators from the internal quality monitoring (IQM) program for cytopathology laboratories, such as: positivity rate, atypical squamous cell (ASC)/satisfactory exams ratio, ASC/abnormal test results ratio, ASC/squamou...

  14. Quality indicators for the acute and long-term management of anaphylaxis

    DEFF Research Database (Denmark)

    Dhami, Sangeeta; Sheikh, Aadam; Muraro, Antonella

    2017-01-01

    is challenging. Quality indicators have the potential to support guideline implementation efforts. OBJECTIVE: To identify quality indicators to support the acute and long-term management of anaphylaxis. METHODS: We conducted a systematic review of the literature that involved searching Medline, EMBASE and CINAHL......) and long-term (n = 27) management of anaphylaxis. The majority of indicators were developed through expert consensus with relatively few of these having been formally piloted or tested to demonstrate that they could discriminate between variations in practice and/or that they were sensitive to change....... CONCLUSIONS: There is a need for a comprehensive set of quality indicators for anaphylaxis management. We have however identified some indicators for the acute and long-term management of anaphylaxis that could with relatively little additional work support efforts to translate guideline recommendations...

  15. Validation of quality indicators for end-of-life communication: results of a multicentre survey.

    Science.gov (United States)

    Heyland, Daren K; Dodek, Peter; You, John J; Sinuff, Tasnim; Hiebert, Tim; Tayler, Carolyn; Jiang, Xuran; Simon, Jessica; Downar, James

    2017-07-31

    The lack of validated quality indicators is a major barrier to improving end-of-life communication and decision-making. We sought to show the feasibility of and provide initial validation for a set of quality indicators related to end-of-life communication and decision-making. We administered a questionnaire to patients and their family members in 12 hospitals and asked them about advance care planning and goals-of-care discussions. Responses were used to calculate a quality indicator score. To validate this score, we determined its correlation with the concordance between the patients' expressed wishes and the medical order for life-sustaining treatments recorded in the hospital chart. We compared the correlation with concordance for the advance care planning component score with that for the goal-of-care discussion scores. We enrolled 297 patients and 209 family members. At all sites, both overall quality indicators and individual domain scores were low and there was wide variability around the point estimates. The highest-ranking institution had an overall quality indicator score (95% confidence interval) of 40% (36%-44%) and the lowest had a score of 18% (11%-25%). There was a strong correlation between the overall quality indicator score and the concordance measure (r = 0.72, p = 0.008); the estimated correlation between the advance care planning score and the concordance measure (r = 0.35) was weaker than that between the goal-of-care discussion scores and the concordance measure (r = 0.53). Quality of end-of-life communication and decision-making appears low overall, with considerable variability across hospitals. The proposed quality indicator measure shows feasibility and partial validity. Study registration: ClinicalTrials.gov, no. NCT01362855. © 2017 Canadian Medical Association or its licensors.

  16. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review.

    Directory of Open Access Journals (Sweden)

    Rym Boulkedid

    Full Text Available OBJECTIVE: Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1 to describe reporting of the Delphi method to develop quality indicators, 2 to discuss specific methodological skills for quality indicators selection 3 to give guidance about this practice. METHODOLOGY AND MAIN FINDING: Three electronic data bases were searched over a 30 years period (1978-2009. All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used. Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80 of studies reported response rates for all rounds, 60% (48/80 that feedback was given between rounds, 77% (62/80 the method used to achieve consensus and 57% (48/80 listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63% with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31. In 40/70 (57% studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40 of cases. Among 75 studies describing criteria to select quality indicators, 28 (37% used validity and 17(23% feasibility. CONCLUSION: The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys.

  17. Evaluation of Selected Quality of Life Indicators in Lag “Dol Ná Nitra”

    Directory of Open Access Journals (Sweden)

    Baková Ingrida

    2016-05-01

    Full Text Available The paper focuses on quality of life of inhabitants in Slovak countryside as well as conditions for development of municipalities on possibilities of drawing European funds and the performance of Local Action Groups. Its main objective is to evaluate the effect of the Slovak Rural Development Programme 2007-2013 measures on increasing the quality of life in a selected region and to compare results in municipalities that were part of a public-private partnership and those they did not participate. The paper mainly deals with quality of life indicators defined in the field of employment and quality of employment.

  18. Biological indices for classification of water quality around Mae Moh power plant, Thailand

    Directory of Open Access Journals (Sweden)

    Pongsarun Junshum and Siripen Traichaiyaporn

    2007-12-01

    Full Text Available The algal communities and water quality were monitored at eight sampling sites around Mae Moh power plant during January-December 2003. Three biological indices, viz. algal genus pollution index, saprobic index, and Shannon-Weaver index, were adopted to classify the water quality around the power plant in comparison with the measured physico-chemical water quality. The result shows that the Shannon-Weaver diversity index appears to be much more applicable and interpretable for the classification of water quality around the Mae Moh power plant than the algal genus pollution index and the saprobic index.

  19. Characterization of groundwater quality using water evaluation indices, multivariate statistics and geostatistics in central Bangladesh

    Directory of Open Access Journals (Sweden)

    Md. Bodrud-Doza

    2016-04-01

    Full Text Available This study investigates the groundwater quality in the Faridpur district of central Bangladesh based on preselected 60 sample points. Water evaluation indices and a number of statistical approaches such as multivariate statistics and geostatistics are applied to characterize water quality, which is a major factor for controlling the groundwater quality in term of drinking purposes. The study reveal that EC, TDS, Ca2+, total As and Fe values of groundwater samples exceeded Bangladesh and international standards. Ground water quality index (GWQI exhibited that about 47% of the samples were belonging to good quality water for drinking purposes. The heavy metal pollution index (HPI, degree of contamination (Cd, heavy metal evaluation index (HEI reveal that most of the samples belong to low level of pollution. However, Cd provide better alternative than other indices. Principle component analysis (PCA suggests that groundwater quality is mainly related to geogenic (rock–water interaction and anthropogenic source (agrogenic and domestic sewage in the study area. Subsequently, the findings of cluster analysis (CA and correlation matrix (CM are also consistent with the PCA results. The spatial distributions of groundwater quality parameters are determined by geostatistical modeling. The exponential semivariagram model is validated as the best fitted models for most of the indices values. It is expected that outcomes of the study will provide insights for decision makers taking proper measures for groundwater quality management in central Bangladesh.

  20. Internal medicine resident training and provision of diabetes quality of care indicators.

    Science.gov (United States)

    Devkota, Bishnu P; Ansstas, Michael; Scherrer, Jeffrey F; Salas, Joanne; Budhathoki, Chakra

    2015-04-01

    Existing research is inconsistent on whether clinical experience is associated with improved management of type 2 diabetes mellitus. We sought to determine whether meeting diabetes quality indicators improves as general internal medicine physicians progress from first to last year of residency. We performed a chart abstraction of electronic health records data covering the period from September 2008 to August 2011. In all, 352 patient records were abstracted and linked to year of resident provider. Type 2 diabetes quality indicators included glycated hemoglobin (A1C), low-density lipoprotein, diastolic and systolic blood pressure control, obtaining urine microalbumin or prescription for angiotensin-converting enzyme inhibitor or angiotensin receptor blocker and documented foot and eye examinations. Chi-square tests and logistic regression analysis were used to determine whether year of residency was associated with quality of care indices before and after adjusting for patient age, gender, race, body mass index and cigarette smoking. Urine microalbumin was the most often met indicator (76.9%), and the least often met indicator was documented eye examination (37.4%). Results of adjusted analysis indicated that the odds of A1C, low-density lipoprotein control, obtaining urine microalbumin and documented eye and foot examinations were greater among patients of second- and third-year residents compared with those of first-year residents (odds ratios range, 1.26-5.12). Urine microalbumin was the indicator most often in optimal control and least often met indicators were eye and foot examinations. We observed improvement in quality of diabetes care throughout residency. However, the low prevalence of several quality indicators indicates a need for additional training and quality improvement. Copyright © 2015 Canadian Diabetes Association. All rights reserved.

  1. Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.

    Science.gov (United States)

    Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva

    2015-09-01

    To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.

  2. A Comprehensive Real-Time Indoor Air-Quality Level Indicator

    Directory of Open Access Journals (Sweden)

    Jungho Kang

    2016-09-01

    Full Text Available The growing concern about Indoor Air-Quality has accelerated the development of small, low-cost air-quality monitoring systems. These systems are capable of monitoring various indoor air pollutants in real time, notifying users about the current air-quality status and gathering the information to the central server. However, most Internet of Things (IoT-based air-quality monitoring systems numerically present the sensed value per pollutant, making it difficult for general users to identify how polluted the air is. Therefore, in this paper, we first introduce a tiny air-quality monitoring system that we developed and, based on the system, we also test the applicability of the comprehensive Air-Quality Index (AQI, which is widely used all over the world, in terms of its capacity for a comprehensive indoor air-quality indication. We also develop design considerations for an IoT-based air-quality monitoring system and propose a real-time comprehensive indoor air-quality level indication method, which effectively copes with dynamic changes and is efficient in terms of processing and memory overhead.

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

    Directory of Open Access Journals (Sweden)

    L. V. Massel

    2016-01-01

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

  4. Student Preferences and Performance in Online and Face-to-Face Classes Using Myers-Briggs Indicator: A Longitudinal Quasi-Experimental Study

    OpenAIRE

    Seta Boghikian-Whitby; Yehia Mortagy

    2016-01-01

    This longitudinal, quasi-experimental study investigated students’ cognitive personality type using the Myers-Briggs personality Type Indicator (MBTI) in Internet-based Online and Face-to-Face (F2F) modalities. A total of 1154 students enrolled in 28 Online and 32 F2F sections taught concurrently over a period of fourteen years. The study measured whether the sample is similar to the national average percentage frequency of all 16 different personality types; whether specific personality ty...

  5. Measurement bias detection with Kronecker product restricted models for multivariate longitudinal data: an illustration with health-related quality of life data from thirteen measurement occasions

    NARCIS (Netherlands)

    M.G.E. Verdam; F.J. Oort

    2014-01-01

    Highlights: - Application of Kronecker product to construct parsimonious structural equation models for multivariate longitudinal data. - A method for the investigation of measurement bias with Kronecker product restricted models. - Application of these methods to health-related quality of life data

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  8. Low-Bandwidth Channel Quality Indication for OFDMA Frequency Domain Packet Scheduling

    DEFF Research Database (Denmark)

    Kolding, Troels E.; Frederiksen, Frank; Pokhariyal, Akhilesh

    2007-01-01

     In this paper, we study methods for lowering the bandwidth needed for the UE to transmit channel quality indication (CQI) for time and frequency domain scheduling (FDPS) in OFDMA. We consider smart compression methods, such as threshold based indication, to only include scheduler...

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  10. Race-Related Stress, Quality of Life Indicators, and Life Satisfaction among Elderly African Americans.

    Science.gov (United States)

    Utsey, Shawn O.; Payne, Yasser A.; Jackson, Ebonique S.; Jones, Antoine M.

    2002-01-01

    Examines the relationships among race-related stress, quality of life indicators, and life satisfaction among elderly African Americans. Results indicated that elderly African American men and women differed significantly with regard to institutional and collective racism-related stress. In addition, institutional racism-related stress was a…

  11. Construction of a novel water quality index and quality indicator for reservoir water quality evaluation: A case study in the Amazon region

    Science.gov (United States)

    Lobato, T. C.; Hauser-Davis, R. A.; Oliveira, T. F.; Silveira, A. M.; Silva, H. A. N.; Tavares, M. R. M.; Saraiva, A. C. F.

    2015-03-01

    A novel Quality Indicator (QI) and Water Quality Index (WQI) were constructed in the present study for the evaluation of the water quality of a Hydroelectric Plant reservoir in the Amazon area, Brazil, taking into account the specific characteristics of the Amazon area. Factor analyses were applied in order to select the relevant parameters to be included in the construction of both indices. Quality curves for each selected parameter were then created and the constructed QI and WQI were then applied to investigate the water quality at the reservoir. The hydrological cycle was shown by the indices to directly affect reservoir water quality, and the WQI was further useful in identifying anthropogenic impacts in the area, since water sampling stations suffering different anthropogenic impacts were categorized differently, with poorer water quality, than stations near the dam and the environmental preservation area, which suffer significantly less anthropogenic impacts, and were categorized as presenting better water quality. The constructed indices are thus helpful in investigating environmental conditions in areas that show well-defined hydrological cycles, in addition to being valuable tools in the detection of anthropogenic impacts. The statistical techniques applied in the construction of these indices may also be used to construct other indices in different geographical areas, taking into account the specificities for each area.

  12. [A measure of the efficiency of primary care in Barcelona (Spain) incorporating quality indicators].

    Science.gov (United States)

    Romano, José; Choi, Álvaro

    2016-01-01

    To demonstrate the impact of the incorporation of quality indicators in assessing the technical efficiency of primary healthcare teams. The processes through which primary healthcare resources have been allocated since the onset of the financial crisis in 2008 have focussed on quantitative rather than qualitative indicators. This study applies data envelopment analysis (DEA) techniques to 58 primary healthcare teams from three different primary healthcare services from the province of Barcelona (Spain). We combine publicly available information from the regional government of Catalonia with data requested from the Catalan Health System Observatory. The analysis compares the results of three models, thereby allowing shifts in the efficiency of primary healthcare teams to be identified in terms of the (lack of) consideration for healthcare quality indicators. Only 16% of the primary healthcare teams were found to be efficient according to the baseline models, which only incorporated input and output quantity indicators. However, once proxies for healthcare quality are included in the analysis, this percentage increases to 58.6%. No meaningful differences in primary healthcare team efficiency were found between public and privately owned centres, between regional primary care services and organisational models, or between rural and urban teams. The results suggest the need to incorporate healthcare quality indicators as outputs when considering criteria for the streamlining of primary healthcare services. Failure to incorporate quality indicators is associated with various primary healthcare concepts. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Personality Effects on Romantic Relationship Quality through Friendship Quality : A Ten-Year Longitudinal Study in Youths

    National Research Council Canada - National Science Library

    Yu, Rongqin; Branje, Susan; Keijsers, Loes; Meeus, Wim H. J

    2014-01-01

    ...) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality in young adulthood, via friendship quality development in adolescence...

  14. Personality Effects on Romantic Relationship Quality through Friendship Quality: A Ten-Year Longitudinal Study in Youths: e102078

    National Research Council Canada - National Science Library

    Rongqin Yu; Susan Branje; Loes Keijsers; Wim H J Meeus

    2014-01-01

    ...) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality in young adulthood, via friendship quality development in adolescence...

  15. Developing Indicators of Service Quality Provided for Cardiovascular Patients Hospitalized in Cardiac Care Unit

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash

    2013-03-01

    Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.

  16. [A set of quality and safety indicators for hospitals of the "Agencia Valenciana de Salud"].

    Science.gov (United States)

    Nebot-Marzal, C M; Mira-Solves, J J; Guilabert-Mora, M; Pérez-Jover, V; Pablo-Comeche, D; Quirós-Morató, T; Cuesta Peredo, D

    2014-01-01

    To prepare a set of quality and safety indicators for Hospitals of the «Agencia Valenciana de Salud». The qualitative technique Metaplan® was applied in order to gather proposals on sustainability and nursing. The catalogue of the «Spanish Society of Quality in Healthcare» was adopted as a starting point for clinical indicators. Using the Delphi technique, 207 professionals were invited to participate in the selecting the most reliable and feasible indicators. Lastly, the resulting proposal was validated with the managers of 12 hospitals, taking into account the variability, objectivity, feasibility, reliability and sensitivity, of the indicators. Participation rates varied between 66.67% and 80.71%. Of the 159 initial indicators, 68 were prioritized and selected (21 economic or management indicators, 22 nursing indicators, and 25 clinical or hospital indicators). Three of them were common to all three categories and two did not match the specified criteria during the validation phase, thus obtaining a final catalogue of 63 indicators. A set of quality and safety indicators for Hospitals was prepared. They are currently being monitored using the hospital information systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  18. [Changes observed in three quality indicators after the implementation of improvement strategies in the respiratory intensive care unit].

    Science.gov (United States)

    Álvarez Maldonado, Pablo; Cueto Robledo, Guillermo; Cicero Sabido, Raúl

    2015-04-01

    To compare the results of quality monitoring after the implementation of improvement strategies in the respiratory intensive care unit (RICU). A prospective, comparative, longitudinal and interventional study was carried out. The RICU of Hospital General de México (Mexico). All patients admitted to the RICU from March 2012 to March 2013. An evidence-based bundle of interventions was implemented in order to reduce the ratios of three quality indicators: non-planned extubation (NPE), reintubation, and ventilator-associated pneumonia (VAP). NPE, reintubation and VAP ratios. A total of 232 patients were admitted, with a mean age of 49.5±17.8years; 119 (50.5%) were woman. The mean Simplified Acute Physiology Score (SAPS-3) was 49.8±17, and the mean Sequential Organ Failure Assessment (SOFA) score was 5.3±4.1. The mortality rate in the RICU was 38.7%. The standardized mortality ratio was 1.50 (95%CI: 1.20-1.84). An improved ratio was observed for reintubation and NPE indicators compared to the ratios of the previous 2011 cohort: 1.6% vs. 7% (P=.02) and 8.1 vs. 17 episodes per 1000 days of mechanical ventilation (P=.04), respectively. A worsened VAP ratio was observed: 18.4 vs. 15.1 episodes per 1000 days of mechanical ventilation (P=.5). Quality improvement is feasible with the identification of areas of opportunity and the implementation of strategies. Nevertheless, the implementation of a bundle of preventive measures in itself does not guarantee improvements. Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  19. Using a summary measure for multiple quality indicators in primary care: the Summary QUality InDex (SQUID

    Directory of Open Access Journals (Sweden)

    Nemeth Lynne S

    2007-04-01

    Full Text Available Abstract Background Assessing the quality of primary care is becoming a priority in national healthcare agendas. Audit and feedback on healthcare quality performance indicators can help improve the quality of care provided. In some instances, fewer numbers of more comprehensive indicators may be preferable. This paper describes the use of the Summary Quality Index (SQUID in tracking quality of care among patients and primary care practices that use an electronic medical record (EMR. All practices are part of the Practice Partner Research Network, representing over 100 ambulatory care practices throughout the United States. Methods The SQUID is comprised of 36 process and outcome measures, all of which are obtained from the EMR. This paper describes algorithms for the SQUID calculations, various statistical properties, and use of the SQUID within the context of a multi-practice quality improvement (QI project. Results At any given time point, the patient-level SQUID reflects the proportion of recommended care received, while the practice-level SQUID reflects the average proportion of recommended care received by that practice's patients. Using quarterly reports, practice- and patient-level SQUIDs are provided routinely to practices within the network. The SQUID is responsive, exhibiting highly significant (p Conclusion The SQUID algorithm is feasible and straightforward, and provides a useful QI tool. Its statistical properties and clear interpretation make it appealing to providers, health plans, and researchers.

  20. A new approach to the identification of Landscape Quality Objectives (LQOs) as a set of indicators.

    Science.gov (United States)

    Sowińska-Świerkosz, Barbara Natalia; Chmielewski, Tadeusz J

    2016-12-15

    The objective of the paper is threefold: (1) to introduce Landscape Quality Objectives (LQOs) as a set of indicators; (2) to present a method of linking social and expert opinion in the process of the formulation of landscape indicators; and (3) to present a methodological framework for the identification of LQOs. The implementation of these goals adopted a six-stage procedure based on the use of landscape units: (1) GIS analysis; (2) classification; (3) social survey; (4) expert value judgement; (5) quality assessment; and (6) guidelines formulation. The essence of the research was the presentation of features that determine landscape quality according to public opinion as a set of indicators. The results showed that 80 such indicators were identified, of both a qualitative (49) and a quantitative character (31). Among the analysed units, 60% (18 objects) featured socially expected (and confirmed by experts) levels of landscape quality, and 20% (6 objects) required overall quality improvement in terms of both public and expert opinion. The adopted procedure provides a new tool for integrating social responsibility into environmental management. The advantage of the presented method is the possibility of its application in the territories of various European countries. It is flexible enough to be based on cartographic studies, landscape research methods, and environmental quality standards existing in a given country. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Longitudinal associations of depressive symptoms and pain with quality of life in patients receiving chronic hemodialysis.

    Science.gov (United States)

    Belayev, Linda Y; Mor, Maria K; Sevick, Mary Ann; Shields, Anne Marie; Rollman, Bruce L; Palevsky, Paul M; Arnold, Robert M; Fine, Michael J; Weisbord, Steven D

    2015-04-01

    Depressive symptoms and pain are common in patients on chronic hemodialysis (HD), yet their associations with quality of life (QOL) are not fully understood. We sought to characterize the longitudinal associations of these symptoms with QOL. As part of a trial comparing two symptom management strategies in patients receiving chronic HD, we assessed depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9), and pain using the Short Form McGill Pain Questionnaire (SF-MPQ) monthly over 24 months. We assessed health-related QOL (HR-QOL) quarterly using the Short Form 12 (SF-12) and global QOL (G-QOL) using a single-item survey. We used random effects linear regression to analyze the independent associations of depressive symptoms and pain, scaled based on 5-point increments in symptom scores, with HR-QOL and G-QOL. Overall, 286 patients completed 1417 PHQ-9 and SF-MPQ symptom assessments, 1361 SF-12 assessments, and 1416 G-QOL assessments. Depressive symptoms were independently and inversely associated with SF-12 physical HR-QOL scores (β = -1.09; 95% confidence interval [CI]: -1.69, -0.50, P < 0.001); SF-12 mental HR-QOL scores (β = -4.52; 95% CI: -5.15, -3.89, P < 0.001); and G-QOL scores (β = -0.64; 95%CI: -0.79, -0.49, P < 0.001). Pain was independently and inversely associated with SF-12 physical HR-QOL scores (β = -0.99; 95% CI: -1.30, -0.68, P < 0.001) and G-QOL scores (β = -0.12; 95%CI: -0.20, -0.05, P = 0.002); but not with SF-12 mental HR-QOL scores (β = -0.16; 95%CI: -0.050, 0.17, P = 0.34). In patients receiving chronic HD, depressive symptoms and to a lesser extent pain, are independently associated with reduced HR-QOL and G-QOL. Interventions to alleviate these symptoms could potentially improve patients' HR-QOL and G-QOL. © 2014 International Society for Hemodialysis.

  2. Quality indicators to compare accredited independent pharmacies and accredited chain pharmacies in Thailand.

    Science.gov (United States)

    Arkaravichien, Wiwat; Wongpratat, Apichaya; Lertsinudom, Sunee

    2016-08-01

    Background Quality indicators determine the quality of actual practice in reference to standard criteria. The Community Pharmacy Association (Thailand), with technical support from the International Pharmaceutical Federation, developed a tool for quality assessment and quality improvement at community pharmacies. This tool has passed validity and reliability tests, but has not yet had feasibility testing. Objective (1) To test whether this quality tool could be used in routine settings. (2) To compare quality scores between accredited independent and accredited chain pharmacies. Setting Accredited independent pharmacies and accredited chain pharmacies in the north eastern region of Thailand. Methods A cross sectional study was conducted in 34 accredited independent pharmacies and accredited chain pharmacies. Quality scores were assessed by observation and by interviewing the responsible pharmacists. Data were collected and analyzed by independent t-test and Mann-Whitney U test as appropriate. Results were plotted by histogram and spider chart. Main outcome measure Domain's assessable scores, possible maximum scores, mean and median of measured scores. Results Domain's assessable scores were close to domain's possible maximum scores. This meant that most indicators could be assessed in most pharmacies. The spider chart revealed that measured scores in the personnel, drug inventory and stocking, and patient satisfaction and health promotion domains of chain pharmacies were significantly higher than those of independent pharmacies (p independent pharmacies and chain pharmacies in the premise and facility or dispensing and patient care domains. Conclusion Quality indicators developed by the Community Pharmacy Association (Thailand) could be used to assess quality of practice in pharmacies in routine settings. It is revealed that the quality scores of chain pharmacies were higher than those of independent pharmacies.

  3. A 2-1-1 research collaboration: participant accrual and service quality indicators.

    Science.gov (United States)

    Eddens, Katherine S; Alcaraz, Kassandra I; Kreuter, Matthew W; Rath, Suchitra; Greer, Regina

    2012-12-01

    In times of crises, 2-1-1 serves as a lifeline in many ways. These crises often cause a spike in call volume that can challenge 2-1-1's ability to meet its service quality standards. For researchers gathering data through 2-1-1s, a sudden increase in call volume might reduce accrual as 2-1-1 has less time to administer study protocols. Research activities imbedded in 2-1-1 systems may affect directly 2-1-1 service quality indicators. Using data from a 2-1-1 research collaboration, this paper examines the impact of crises on call volume to 2-1-1, how call volume affects research participant accrual through 2-1-1, and how research recruitment efforts affect 2-1-1 service quality indicators. t-tests were used to examine the effect of call volume on research participant accrual. Linear and logistic regressions were used to examine the effect of research participant accrual on 2-1-1 service quality indicators. Data were collected June 2010-December 2011; data were analyzed in 2012. Findings from this collaboration suggest that crises causing spikes in call volume adversely affect 2-1-1 service quality indicators as well as accrual of research participants. Administering a brief (2-3 minute) health risk assessment did not affect service quality negatively, but administering a longer (15-18 minute) survey had a modest adverse effect on these indicators. In 2-1-1 research collaborations, both partners need to understand the dynamic relationship among call volume, research accrual, and service quality and adjust expectations accordingly. If research goals include administering a longer survey, increased staffing of 2-1-1 call centers may be needed to avoid compromising service quality. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector.

    Science.gov (United States)

    Croes, R R; Krabbe-Alkemade, Y J F M; Mikkers, M C

    2017-01-03

    There is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be characterized as a system involving managed competition and mandatory healthcare insurance. Information about the quality of care provided by hospitals has been publicly available since 2008. In this paper, we evaluate the relationship between quality scores for three diagnosis groups and the market power indicators of hospitals. We estimate the impact of competition on quality in an environment of liberalized pricing. For this research, we used unique price and production data relating to three diagnosis groups (cataract, adenoid and tonsils, bladder tumor) produced by Dutch hospitals in the period 2008-2011. We also used the quality indicators relating to these diagnosis groups. We reveal a negative relationship between market share and quality score for two of the three diagnosis groups studied, meaning that hospitals in competitive markets have better quality scores than those in concentrated markets. We therefore conclude that more competition is associated with higher quality scores.

  5. Longitudinal beam parameters and quality checks of the LHC beam in the SPS: further results and comparisons

    CERN Document Server

    Papotti, G; Linnecar, T; Shaposhnikova, E; Tückmantel, Joachim; CERN. Geneva. AB Department

    2008-01-01

    Controlled longitudinal emittance blow up is used, along with other measures, to stabilize the nominal LHC beam in the SPS. Two Machine Development studies (MDs) were carried out in 2007 to evaluate the effectiveness of different noise settings for the longitudinal blow up of the beam. The noise settings are affected by both the presence of the 800 MHz RF system and intensity effects which modify the synchrotron frequency distribution inside the bunch. The results for the first MD are reported in Note [1]. This Note reports on the results of the second MD, carried out on 2007-10-17, as well as the comparison between the two in order to analyse the differences between the two occasions. Figures of merit are used that allow rapid evaluation of the quality of the beam as for example stability and bunch length uniformity across batches.

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

    Directory of Open Access Journals (Sweden)

    William Barbosa Vianna

    2009-08-01

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

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

    Directory of Open Access Journals (Sweden)

    A. Morugán-Coronado

    2013-03-01

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

  8. Agricultural management practices and soil quality : measuring, assessing, and comparing laboratory and field test kit indicators of soil quality atributes

    OpenAIRE

    Evanylo, Gregory K.; McGuinn, Robert

    2000-01-01

    Describes some indicators of soil that can be measured with a simple test kit developed by the United States Department of Agriculture - Natural Resource Conservation Service, directions for interpreting these measurements, the effects of soil amendments on soil quality attributes, and comparisons of field kit and laboratory results.

  9. [Validation and adhesion to GESIDA quality indicators in patients with HIV infection].

    Science.gov (United States)

    Riera, Melchor; Esteban, Herminia; Suarez, Ignacio; Palacios, Rosario; Lozano, Fernando; Blanco, Jose R; Valencia, Eulalia; Ocampo, Antonio; Amador, Concha; Frontera, Guillem; vonWichmann-de Miguel, Miguel Angel

    2016-01-01

    The objective of the study is to validate the relevant GESIDA quality indicators for HIV infection, assessing the reliability, feasibility and adherence to them. The reliability was evaluated using the reproducibility of 6 indicators in peer review, with the second observer being an outsider. The feasibility and measurement of the level of adherence to the 22 indicators was conducted with annual fragmented retrospective collection of information from specific databases or the clinical charts of the nine participating hospitals. Reliability was very high, with interobserver agreement levels higher than 95% in 5 of the 6 indicators. The median time to achieve the indicators ranged between 5 and 600minutes, but could be achieved progressively from specific databases, enabling obtaining them automatically. As regards adherence to the indicators related with the initial evaluation of the patients, instructions and suitability of the guidelines for ART, adherence to ART, follow-up in clinics, and achieve an undetectable HIV by PCR at week 48 of the ART. Indicators of quality related to the prevention of opportunistic infections and control of comorbidities, the standards set were not achieved, and significant heterogeneity was observed between hospitals. The GESIDA quality indicators of HIV infection enabled the relevant indicators to be feasibly and reliably measured, and should be collected in all the units that care for patients with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    The two-stage Newton Type Algorithm for the tracking of the power quality indicators, frequency and rate of frequency changes is presented in the paper. By this definitions for power quality indicators according to the IEEE Standard 1459-2000 were used. In the first algorithm stage the spectra of...... spectrum. The proposed algorithm is implemented for the analysis of transient processes during a real islanding experiment on the Rejsby Hede wind farm in Denmark.......The two-stage Newton Type Algorithm for the tracking of the power quality indicators, frequency and rate of frequency changes is presented in the paper. By this definitions for power quality indicators according to the IEEE Standard 1459-2000 were used. In the first algorithm stage the spectra...... of voltages and currents are estimated. Frequency and its rate of change are directly estimated from voltage input signals. In the second algorithm stage the power quality indicators are calculated. The algorithm considers frequency as an unknown model parameter simultaneously estimated with the voltage...

  11. Protocol for a scoping review study to identify and classify patient-centred quality indicators

    Science.gov (United States)

    Jolley, Rachel J; Lorenzetti, Diane L; Manalili, Kimberly; Lu, Mingshan; Santana, Maria J

    2017-01-01

    Introduction The concept of patient-centred care (PCC) is changing the way healthcare is understood, accepted and delivered. The Institute of Medicine has defined PCC as 1 of its 6 aims to improve healthcare quality. However, in Canada, there are currently no nationwide standards in place for measuring and evaluating healthcare from a patient-centred approach. In this paper, we outline our scoping review protocol to systematically review published and unpublished literature specific to patient-centred quality indicators that have been implemented and evaluated across various care settings. Methods and analysis Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. We will search electronic databases (MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Social Work Abstracts, Social Services Abstracts), grey literature sources and the reference lists of key studies to identify studies appropriate for inclusion. 2 reviewers will independently screen all abstracts and full-text studies for inclusion. We will include any study which focuses on quality indicators in the context of PCC. All bibliographic data, study characteristics and indicators will be collected and analysed using a tool developed through an iterative process by the research team. Indicators will be classified according to a predefined conceptual framework and categorised and described using qualitative content analysis. Ethics and dissemination The scoping review will synthesise patient-centred quality indicators and their characteristics as described in the literature. This review will be the first step to formally identify what quality indicators have been used to evaluate PCC across the healthcare continuum, and will be used to inform a stakeholder consensus process exploring the development of a generic set of patient-centred quality indicators applicable to multiple care settings. The

  12. Two-Dimensional Porosity of Crusted Silty Soils: Indicators of Soil Quality in Semiarid Rangelands?

    OpenAIRE

    2011-01-01

    Little is known about the morphological characteristics of pores in soil crusts. The objective was to characterize the 2D-porosity (amount, shape, size and area of pores) of soil crusts to ascertain their potential as indicators of soil quality for natural crusted soils. 2D-porosity was described in thin sections and measured by image analysis of polished resin-impregnated soil blocks. Physical soil crust and incipient biological soil crusts appear to be the lowest-quality soil...

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

    Directory of Open Access Journals (Sweden)

    A. Morugán-Coronado

    2012-12-01

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

  14. Psychosocial work environment and prediction of quality of care indicators in one Canadian health center.

    Science.gov (United States)

    Paquet, Maxime; Courcy, François; Lavoie-Tremblay, Mélanie; Gagnon, Serge; Maillet, Stéphanie

    2013-05-01

    Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay. © Sigma Theta Tau International.

  15. Improving outcomes using German Inpatient Quality Indicators in conjunction with peer review procedures.

    Science.gov (United States)

    Mansky, Thomas; Völzke, Tatjana; Nimptsch, Ulrike

    2015-01-01

    Some hospital comparisons seem to generate confusion because different methods of outcome comparisons lead to different results in hospital rankings. This article questions the concept of overall comparisons of hospitals, which are multiproduct enterprises and may have specialties that provide good results in some areas despite having worse outcomes in others. Therefore, the authors argue for a disease specific view of outcome measurement. The concept of the German Inpatient Quality Indicators is explained. These indicators cover volume, mortality, and other information by a disease specific approach, which includes information for potential patients as well as specific feedback to the physicians responsible for the respective specialty. This article focuses on the feedback to the hospitals and explains how these indicators can be used for improvement in conjunction with a peer review process. The indicators provide information to the hospitals regarding their relative position because German reference values are available for all indicators. Thus, the indicators can serve as a trigger instrument for identifying possible quality problems. Based on these indications, peer review can be used to analyze the treatment processes and to eventually verify weaknesses and define actions for improvement. The first studies indicate that the use of this approach within hospital quality management can largely improve hospital outcomes in hospitals with subpar results compared to the German average.

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

    Science.gov (United States)

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

    2014-04-30

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

  17. The intake of saturated fat and dietary fibre: a possible indicator of diet quality

    DEFF Research Database (Denmark)

    Biltoft-Jensen, Anja Pia; Fagt, Sisse; Groth, Margit Velsing

    2008-01-01

    The aim of the present study was to assess if a simple dietary quality index (SDQI) is a useful indicator for nutritional quality in the Danish diet. Data from the Danish National Dietary Survey 2000-2 for adults (n 3151; age 18-75 years) were used to construct an SDQI based on the intake......-dense foods, for example, salty snacks, confectionery, and beverages, for example, soft drinks and alcohol. The SDQI is a simple and useful tool to characterise the diet quality of Danish adults....

  18. Quality Indicators of Cardiovascular Disease Prevention for Primary Care in Slovenia

    Directory of Open Access Journals (Sweden)

    Davorina Petek

    2012-10-01

    Results: Most of validated indicators belonged to the health-care management of people with established cardiovascular disease. Fewer numbers of indicators were validated for primary prevention, mostly on life style recording and advice. Only very few indicators on outcome measures (level of risk factors were validated. No indicators of patients’ involvement or new risk factors, such as socioeconomic circumstances, got consensus. Conclusion: Slovenia validated more indicators than the international study, especially indicators of primary prevention. The experts did not achieve consensus on indicators of patients’ perspective, despite the paradigm of family medicine that the patient is in the centre of care. Validated indicators can now be tested for systematic quality assessment of cardiovascular prevention in the country.

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

    Science.gov (United States)

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

    2015-10-01

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

  20. Application of water quality indices and analysis of the surface water quality monitoring network in semiarid North-Central Chile.

    Science.gov (United States)

    Espejo, Lesly; Kretschmer, Nicole; Oyarzún, Jorge; Meza, Francisco; Núñez, Jorge; Maturana, Hugo; Soto, Guido; Oyarzo, Paula; Garrido, Marcela; Suckel, Felipe; Amezaga, Jaime; Oyarzún, Ricardo

    2012-09-01

    Surface water quality has increasing importance worldwide and is particularly relevant in the semiarid North-Central Chile, where agriculture and mining activities are imposing heavy pressure on limited water resources. The current study presents the application of a water quality index in four watersheds of the 29°-33°S realm for the period 1999-2008, based on the Canadian Council of Ministers for the Environment approach and the Chilean regulation for irrigation water quality. In addition, two modifications to the index are tested and a comprehensive characterization of the existing monitoring network is performed through cluster analysis. The basins studied show fairly good water quality in the overall, specially the Limarí basin. On the other hand, the lower index values were obtained for the headwaters of Elqui, associated with the El Indio mining district. The first modification of the indicator (i.e., to consider parameters differentially according to their effect on human health or the environment) did not produce major differences with respect to the original index, given the generally good water quality. The second modification (i.e., to consider as threshold values the more restrictive figures derived from a set of regulations) yielded important differences in the indicator values. Finally, an adequate characterization of the monitoring network was obtained. The results presented spatial coherence and the information can be used as a basis for the optimization of the monitoring network if required.

  1. Quality management: where is the evidence? Developing an indicator-based approach in Kenya.

    Science.gov (United States)

    Prytherch, Helen; Nafula, Maureen; Kandie, Charles; Brodowski, Marc; Marx, Irmgard; Kubaj, Sandy; Omogi, Irene; Zurkuhlen, Alexia; Herrler, Claudia; Goetz, Katja; Szecsenyi, Joachim; Marx, Michael

    2017-02-01

    The 2030 Sustainable Development Agenda emphasizes the importance of quality of care in the drive to achieve universal health coverage. Despite recent progress, challenges in service delivery, efficiency and resource utilization in the health sector remain. The Ministry of Health Department of Standards and Regulations sought to operationalize the Kenya Quality Assurance Model for Health. To this end, the European Practice Assessment (EPA) was adapted to the area of Reproductive and Maternal and Neonatal Health. The adaptation process made use of a ten step-modified RAND Corporation/University of California Los Angeles (UCLA) Appropriateness Method. The steps included a scoping workshop, definition of five critical domains of quality in the Kenyan context ('People, Management, Clinical Care, Quality & Safety, Interface between inpatients and outpatients care'), a review of policy documents, management and clinical guidelines, grey and scientific literature to identify indicators in use in the Kenyan health system and an expert panel process to rate their feasibility and validity. The resulting 278 indicators, clustered across the five domains, were broken-down into 29 dimensions and assigned measure specifications. A set of data collection tools were developed to furnish the indicators and piloted at two health facilities. They were subsequently finalized for use in 30 health facilities in 3 counties. The integrative and indicator-based aspects of the EPA process could be readily adapted to facilitate the operationalization of a practical quality assurance approach in Kenya.

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

    Science.gov (United States)

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

    2001-11-01

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

  3. Analysis of flexible aircraft longitudinal dynamics and handling qualities. Volume 2: Data

    Science.gov (United States)

    Waszak, M. R.; Schmidt, D. K.

    1985-01-01

    Two analysis methods are applied to a family of flexible aircraft in order to investigate how and when structural (especially dynamic aeroelastic) effects affect the dynamic characteristics of aircraft. The first type of analysis is an open loop modal analysis technique. This method considers the effect of modal residue magnitudes on determining vehicle handling qualities. The second method is a pilot in the loop analysis procedure that considers several closed loop system characteristics. Both analyses indicated that dynamic aeroelastic effects caused a degradation in vehicle tracking performance, based on the evaluation of some simulation results. Volume 2 consists of the presentation of the state variable models of the flexible aircraft configurations used in the analysis applications mode shape plots for the structural modes, numerical results from the modal analysis frequency response plots from the pilot in the loop analysis and a listing of the modal analysis computer program.

  4. Quality indicators for the analysis of communication in an online course

    Directory of Open Access Journals (Sweden)

    Antonella Pezzotti

    2012-08-01

    Full Text Available This study describes the development and validation of quality indicators for analyzing forums interactions in an online course in biology teaching. The aim is to evaluate the quality of communication so as to strengthen the tutor’s role and help students learn fundamental biology concepts while enhancing their collaboration competencies. The indicators are used to analyze cognitive, metacognitive and relational aspects, drawing on a content analysis methodology. The model appears to have a wide range of possible applications in other online courses.

  5. [Quality management in a clinical research facility: Evaluation of changes in quality in-house figures and the appraisal of in-house quality indicators].

    Science.gov (United States)

    Aden, Bile; Allekotte, Silke; Mösges, Ralph

    2016-12-01

    For long-term maintenance and improvement of quality within a clinical research institute, the implementation and certification of a quality management system is suitable. Due to the implemented quality management system according to the still valid DIN EN ISO 9001:2008 desired quality objectives are achieved effectively. The evaluation of quality scores and the appraisal of in-house quality indicators make an important contribution in this regard. In order to achieve this and draw quality assurance conclusions, quality indicators as sensible and sensitive as possible are developed. For this, own key objectives, the retrospective evaluation of quality scores, a prospective follow-up and also discussions establish the basis. In the in-house clinical research institute the measures introduced by the quality management led to higher efficiency in work processes, improved staff skills, higher customer satisfaction and overall to more successful outcomes in relation to the self-defined key objectives. Copyright © 2016. Published by Elsevier GmbH.

  6. Longitudinal Changes in Drug Use Severity and Physical Health-Related Quality of Life among Untreated Stimulant Users

    OpenAIRE

    BORDERS, TYRONE F.; Booth, Brenda M.; Falck, Russel S.; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G.

    2009-01-01

    The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8™ Health Survey and drug, alcohol, and psychi...

  7. Personality Effects on Romantic Relationship Quality through Friendship Quality : A Ten-Year Longitudinal Study in Youths

    NARCIS (Netherlands)

    Yu, Rongqin; Branje, Susan; Keijsers, Loes; Meeus, Wim H. J.

    2014-01-01

    This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality

  8. Personality effects on romantic relationship quality through friendship quality : A ten-year longitudinal study in youths

    NARCIS (Netherlands)

    Branje, S.T.J.; Keijsers, L.; Meeus, W.H.J.

    2014-01-01

    This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality

  9. Personality Effects on Romantic Relationship Quality through Friendship Quality : A Ten-Year Longitudinal Study in Youths

    NARCIS (Netherlands)

    Yu, Rongqin; Branje, Susan; Keijsers, Loes; Meeus, Wim H. J.

    2014-01-01

    This study examined whether individuals with different personality types (i.e., overcontrollers, undercontrollers, resilients) had different friendship quality development throughout adolescence. It also investigated whether personality types were indirectly related to romantic relationship quality

  10. APPRAISAL OF THE QUALITY OF FABRICS MADE OF COMBED WOOL YARNS THROUGH SYNTHETIC INDICES

    Directory of Open Access Journals (Sweden)

    HRISTIAN Liliana

    2015-05-01

    Full Text Available In order to assess the quality level, it is necessary to determine a series of indices, then to establish the reference elements on whose basis to formulate the findings and the conclusions, thus highlighting the optimum variants of fabrics. In this work have been determined the values of synthetic durability indices, setting the basis for a ranking of studied fabric variants in terms of surface characteristics. The highest weight in this work belongs to the measurement applied to an important number of quality characteristics, representative for the appraisal of durability functions specific to fabric surfaces. The selection of the representative characteristics: breaking strength, Pr (daN; mass loss due to friction stress, Δm (%; thickness diminution due to friction stress, Sg (%, breaking strain work, Ws (daN/m, fabric strength per denier, τt (cN/tex and wrinkle recovering angle α (o, on whose basis the durability indices were calculated, have been determined through standardized means and methods. The expertise method has been applied to assess the significance degree of the characteristics which express the analyzed products functions. Quality index is the relative expression of a certain characteristic, obtained by referring it to a reference value (norm, standard or pattern. The index can be converted in marks, namely by convention the qualificative/mark «0» represents an inadequate product/non-quality, while the qualificative/mark «1» represents the high qualificative/mark level. In terms of complexity, quality indices can be simple, synthetic and global. The work sets the accent on the appraisal of quality level of the analyzed textile surface by means of synthetic indices.

  11. The Resident Assessment Instrument-Minimum Data Set 2.0 quality indicators: a systematic review

    Directory of Open Access Journals (Sweden)

    Squires Janet E

    2010-06-01

    Full Text Available Abstract Background The Resident Assessment Instrument-Minimum Data Set (RAI-MDS 2.0 is designed to collect the minimum amount of data to guide care planning and monitoring for residents in long-term care settings. These data have been used to compute indicators of care quality. Use of the quality indicators to inform quality improvement initiatives is contingent upon the validity and reliability of the indicators. The purpose of this review was to systematically examine published and grey research reports in order to assess the state of the science regarding the validity and reliability of the RAI-MDS 2.0 Quality Indicators (QIs. Methods We systematically reviewed the evidence for the validity and reliability of the RAI-MDS 2.0 QIs. A comprehensive literature search identified relevant original research published, in English, prior to December 2008. Fourteen articles and one report examining the validity and/or reliability of the RAI-MDS 2.0 QIs were included. Results The studies fell into two broad categories, those that examined individual quality indicators and those that examined multiple indicators. All studies were conducted in the United States and included from one to a total of 209 facilities. The number of residents included in the studies ranged from 109 to 5758. One study conducted under research conditions examined 38 chronic care QIs, of which strong evidence for the validity of 12 of the QIs was found. In response to these findings, the 12 QIs were recommended for public reporting purposes. However, a number of observational studies (n = 13, conducted in "real world" conditions, have tested the validity and/or reliability of individual QIs, with mixed results. Ten QIs have been studied in this manner, including falls, depression, depression without treatment, urinary incontinence, urinary tract infections, weight loss, bedfast, restraint, pressure ulcer, and pain. These studies have revealed the potential for systematic bias in

  12. 30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

    Directory of Open Access Journals (Sweden)

    Sahar Hassani

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

  13. 30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

    Science.gov (United States)

    Hassani, Sahar; Lindman, Anja Schou; Kristoffersen, Doris Tove; Tomic, Oliver; Helgeland, Jon

    2015-01-01

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

  14. Integrating resource, social, and managerial indicators of quality into carrying capacity decision-making

    Science.gov (United States)

    Newman, P.; Marion, J.; Cahill, K.

    2001-01-01

    In park and wilderness management, integrating social and resource indicators is essential to meet park mandates that require the protection of both experiential and resource conditions. This paper will address the challenges we face in integrating social and resource data and outline a study in progress in Yosemite National Park. This study will develop and apply a management model that integrates resource, social and managerial indicators of quality into carrying capacity decisionmaking.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  16. Quality indicators for acute myocardial infarction: A position paper of the Acute Cardiovascular Care Association.

    Science.gov (United States)

    Schiele, Francois; Gale, Chris P; Bonnefoy, Eric; Capuano, Frederic; Claeys, Marc J; Danchin, Nicolas; Fox, Keith Aa; Huber, Kurt; Iakobishvili, Zaza; Lettino, Maddalena; Quinn, Tom; Rubini Gimenez, Maria; Bøtker, Hans E; Swahn, Eva; Timmis, Adam; Tubaro, Marco; Vrints, Christiaan; Walker, David; Zahger, Doron; Zeymer, Uwe; Bueno, Hector

    2017-02-01

    Evaluation of quality of care is an integral part of modern healthcare, and has become an indispensable tool for health authorities, the public, the press and patients. However, measuring quality of care is difficult, because it is a multifactorial and multidimensional concept that cannot be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons for the choice for each measure.

  17. Composite indicator to evaluate quality of municipal management of primary health care.

    Science.gov (United States)

    Scaratti, Dirceu; Calvo, Maria Cristina Marino

    2012-06-01

    To develop a composite indicator to evaluate the quality of municipal management of primary health care. The evaluation model focuses on aspects of health system management. Fifty-five performance indicators were used and classified according to the criteria of relevance, effectiveness, efficacy and efficiency. The measures were aggregated through an additive data envelopment analysis model for measures of value, merit and quality. Data was utilized from 36 municipalities in Santa Catarina State (Southern Brazil), with populations between 10 thousand and 50 thousand residents in 2006. The results are presented as monotonic measures over the interval [0, 1] (score = 1: efficient; other values: inefficient). Five municipalities had a score of 1 in the quality of management for actions promoting access, while eight municipalities received a score of 1 in the quality of management of actions for service provision; the other municipalities were classified as inefficient (score management in primary health care can be evaluated with a composite indicator, constructed through linear programming techniques, which simultaneously considers the criteria of relevance, effectiveness, efficacy and efficiency and expresses them as measures of value, merit and quality.

  18. The Dynamic Interplay among Maternal Empathy, Quality of Mother-Adolescent Relationship, and Adolescent Antisocial Behaviors: New Insights from a Six-Wave Longitudinal Multi-Informant Study.

    Directory of Open Access Journals (Sweden)

    Elisabetta Crocetti

    Full Text Available Adolescents' behavior is often a matter of concern, given their increased likelihood of enacting antisocial behaviors, which cause disruptions in the social order and are potentially harmful for the adolescents themselves and for the people around them. In this six-wave longitudinal study we sought to examine the interplay among maternal empathy, multiple indicators of mother-adolescent relationship quality (i.e., balanced relatedness, conflict, and support, and adolescent antisocial behaviors rated both by adolescents and their mothers. Participants for the current study were 497 Dutch adolescents (56.9% males followed from age 13 to 18, and their mothers. A series of cross-lagged panel models revealed reciprocal associations between maternal empathy and mother-adolescent relationship quality and between mother-adolescent relationship quality and adolescent antisocial behaviors. Interestingly, we also found some indirect effects of adolescent antisocial behaviors on maternal empathy mediated by mother-adolescent relationship quality. Overall, this study further highlights a process of reciprocal influences within mother-adolescent dyads.

  19. The Dynamic Interplay among Maternal Empathy, Quality of Mother-Adolescent Relationship, and Adolescent Antisocial Behaviors: New Insights from a Six-Wave Longitudinal Multi-Informant Study

    Science.gov (United States)

    Crocetti, Elisabetta; Moscatelli, Silvia; Van der Graaff, Jolien; Keijsers, Loes; van Lier, Pol; Koot, Hans M.; Rubini, Monica; Meeus, Wim; Branje, Susan

    2016-01-01

    Adolescents’ behavior is often a matter of concern, given their increased likelihood of enacting antisocial behaviors, which cause disruptions in the social order and are potentially harmful for the adolescents themselves and for the people around them. In this six-wave longitudinal study we sought to examine the interplay among maternal empathy, multiple indicators of mother-adolescent relationship quality (i.e., balanced relatedness, conflict, and support), and adolescent antisocial behaviors rated both by adolescents and their mothers. Participants for the current study were 497 Dutch adolescents (56.9% males) followed from age 13 to 18, and their mothers. A series of cross-lagged panel models revealed reciprocal associations between maternal empathy and mother-adolescent relationship quality and between mother-adolescent relationship quality and adolescent antisocial behaviors. Interestingly, we also found some indirect effects of adolescent antisocial behaviors on maternal empathy mediated by mother-adolescent relationship quality. Overall, this study further highlights a process of reciprocal influences within mother-adolescent dyads. PMID:26990191

  20. The Dynamic Interplay among Maternal Empathy, Quality of Mother-Adolescent Relationship, and Adolescent Antisocial Behaviors: New Insights from a Six-Wave Longitudinal Multi-Informant Study.

    Science.gov (United States)

    Crocetti, Elisabetta; Moscatelli, Silvia; Van der Graaff, Jolien; Keijsers, Loes; van Lier, Pol; Koot, Hans M; Rubini, Monica; Meeus, Wim; Branje, Susan

    2016-01-01

    Adolescents' behavior is often a matter of concern, given their increased likelihood of enacting antisocial behaviors, which cause disruptions in the social order and are potentially harmful for the adolescents themselves and for the people around them. In this six-wave longitudinal study we sought to examine the interplay among maternal empathy, multiple indicators of mother-adolescent relationship quality (i.e., balanced relatedness, conflict, and support), and adolescent antisocial behaviors rated both by adolescents and their mothers. Participants for the current study were 497 Dutch adolescents (56.9% males) followed from age 13 to 18, and their mothers. A series of cross-lagged panel models revealed reciprocal associations between maternal empathy and mother-adolescent relationship quality and between mother-adolescent relationship quality and adolescent antisocial behaviors. Interestingly, we also found some indirect effects of adolescent antisocial behaviors on maternal empathy mediated by mother-adolescent relationship quality. Overall, this study further highlights a process of reciprocal influences within mother-adolescent dyads.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

    Background: Landmark clinical trials have led to optimal treatment recommendations for patients with diabetes. Whether optimal treatment is actually delivered in practice is even more important than the efficacy of the drugs tested in trials. To this end, treatment quality indicators have been devel

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

    Science.gov (United States)

    Kasner, Melanie; Reid, Greg; MacDonald, Cathy

    2012-01-01

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

  4. Indicators of quality use of medicines in South-East Asian countries : a systematic review

    NARCIS (Netherlands)

    Nguyen, H. T.; Wirtz, V. J.; Haaijer-Ruskamp, F. M.; Taxis, K.

    2012-01-01

    Objectives To identify indicators of quality use of medicines used in South-East Asian region. Methods A systematic review was conducted searching MEDLINE, Embase and The International Network for Rational Use of Drugs (INRUD) and The World Health Organization (WHO) website. Original studies or repo

  5. Indicators of quality use of medicines in South-East Asian countries : a systematic review

    NARCIS (Netherlands)

    Nguyen, H. T.; Wirtz, V. J.; Haaijer-Ruskamp, F. M.; Taxis, K.

    2012-01-01

    Objectives To identify indicators of quality use of medicines used in South-East Asian region. Methods A systematic review was conducted searching MEDLINE, Embase and The International Network for Rational Use of Drugs (INRUD) and The World Health Organization (WHO) website. Original studies or

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

    Science.gov (United States)

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

    2013-01-01

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

  7. Assessment of water quality based on diatom indices in a small ...

    African Journals Online (AJOL)

    2016-04-02

    Apr 2, 2016 ... for water quality changes over short time scales. Diatoms have .... A CyberScan Series 600 portable ... estuary section of the river were sampled from Sites E1 to E3 ..... the indices were developed or were planktonic forms (e.g..

  8. Productivity as an Indication of Quality in Higher Education: The Views of Employed Graduates in Greece

    Science.gov (United States)

    Eliophotou Menon, Maria

    2016-01-01

    The paper investigates the views of Greek university graduates on the link between higher education and productivity in order to determine the extent to which productivity can be considered to be an indication of quality in higher education. It also investigates the perceived effect of the type and content of higher education on productivity;…

  9. Air quality indicators from the Environmental Performance Index: potential use and limitations in South Africa

    CSIR Research Space (South Africa)

    Garland, Rebecca M

    2017-05-01

    Full Text Available values, as well as number of exceedances of South African National Ambient Standards. However, these do not directly communicate the potential impact on human health and the ecosystem. To this end, the use of air quality indicators is seen as a potential...

  10. Aggregation of ecological indicators for mapping aquatic nature quality : overview of existing methods and case studies

    NARCIS (Netherlands)

    Knotters, M.; Lahr, J.; Oosten-Siedlecka, van A.M.; Verdonschot, P.F.M.

    2010-01-01

    Indicators for aquatic nature quality are calculated using ecological monitoring data from individual sampling stations. For reporting purposes, these results need to be aggregated and scaled up to higher levels (catchment area, country). This report provides an overview of different existing spatia

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

    Science.gov (United States)

    Tereshchuk, T O

    2015-01-01

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

  12. Conclusions and future use of fecal indicator bacteria for monitoring water quality and protecting human health

    Science.gov (United States)

    Sadowsky, Michael J.; Whitman, Richard L.

    2011-01-01

    A summary of the focus and the recurring theme of the book is presented in this chapter. It includes the use of faecal bacteria as an indicator of faecal pollution and water quality, ubiquity of faecal bacteria, and sources and movement of faecal bacteria in the environment.

  13. Farm-scale variation of soil quality indices and association with edaphic properties

    Science.gov (United States)

    Soil organisms are indicators of dynamic soil quality because their community structure and population density are sensitive to management changes. However, edaphic properties can also affect soil organisms and high spatial variability can confound their utility for soil evaluation. In the present...

  14. Key Performance Indicators of Public Universities Based on Quality Assessment Criteria in Thailand

    Science.gov (United States)

    Sukboonyasatit, Kritsana; Thanapaisarn, Chaiwit; Manmar, Lampang

    2011-01-01

    The research objective was to develop public universities' key performance indicators. Qualitative research and interviews were employed with each public university's senior executive and quality assessors. The sample group was selected by the office of the public sector development commission and Thailand's public universities can be separated…

  15. 78 FR 22883 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

    Science.gov (United States)

    2013-04-17

    ....federalregister.gov/articles/2013/01/28/2013-01348/ahrq-standing-workgroup-for-quality-indicator-measure... transparency about the scientific development of the AHRQ QIs. Time-Limited Workgroup Time-limited workgroups... specialized in the relevant statistical methods and applications One or more individuals with expertise...

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  17. Evaluation of physical quality indices of a soil under a seasonal semideciduous forest

    Directory of Open Access Journals (Sweden)

    Thalita Campos Oliveira

    2014-04-01

    Full Text Available The concept of soil quality is currently the subject of great discussion due to the interaction of soil with the environment (soil-plant-atmosphere and practices of human intervention. However, concepts of soil quality relate quality to agricultural productivity, but assessment of soil quality in an agronomic context may be different from its assessment in natural areas. The aim of this study was to assess physical quality indices, the S index, soil aeration capacity (ACt/Pt, and water storage capacity (FC/Pt of the soil from a permanent plot in the Caetetus Ecological Reserve (Galia, São Paulo, Brazil under a seasonal semideciduous forest and compare them with the reference values for soil physical quality found in the literature. Water retention curves were used for that purpose. The S values found were higher than the proposed limit for soil physical quality (0.035. The A and E horizons showed the highest values because their sandy texture leads to a high slope of the water retention curve. The B horizons showed the lowest S values because their natural density leads to a lower slope of the water retention curve. The values found for ACt/Pt and FC/Pt were higher and lower than the idealized limits. The values obtained from these indices under natural vegetation can provide reference values for soils with similar properties that undergo changes due to anthropic activities. All the indices evaluated were effective in differentiating the effects of soil horizons in the natural hydro-physical functioning of the soils under study.

  18. Quality in cytopathology: an analysis of the internal quality monitoring indicators of the Instituto Nacional de Câncer

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    Mario Lucio C. Araujo Jr

    2015-04-01

    Full Text Available Introduction: Quality control programs are required to ensure the effectiveness of Pap smear, which still remain a key strategy for control of cervical cancer worldwide. Objective: This study was based on the retrospective and quantitative analysis of the post-analytical phase indicators from the internal quality monitoring (IQM program for cytopathology laboratories, such as: positivity rate, atypical squamous cell (ASC/satisfactory exams ratio, ASC/abnormal test results ratio, ASC/squamous intraepithelial lesions (SIL ratio, percentage of tests compatible with high-grade squamous intraepithelial lesion (HSIL, and total of false negative. Materials and methods: The information was extracted from the computerized system of the Section for Integrated Technology in Cytopathology (Seção Integrada de Tecnologia em Citopatologia [SITEC], a reference institution for cancer cytopathology, from July 2013 to June 2014. From a total of 156,888 Pap smears, 157,454 were considered satisfactory for indicator analysis and 566 were excluded because they were considered unsatisfactory and/or rejected for analysis. The data was organized in tables using Microsoft Excel 2010 software, and categorized as indicators. Results: The averages for the indicators were: 7.2% for positivity rate, 56.9 for ASC/abnormal test ratio, 4.1 for ASC/satisfactory tests ratio, 1.4 for ASC/SIL ratio, 0.6% percentage for tests compatible with HSIL, and 2.1% for false-negative rate. Conclusion: The results show that an Internal Quality Monitoring Program is essencial to ensure quality for cytopathology laboratories, and a randomized review of at least 10% of the negative exams, as recommended by the Brazilian Ministry of Health/Instituto Nacional de Câncer (INCA, since is an effective method, especially for large laboratories.

  19. Evaluation of quality indicators and disease damage in childhood-onset systemic lupus erythematosus patients.

    Science.gov (United States)

    Harris, Julia G; Maletta, Kristyn I; Kuhn, Evelyn M; Olson, Judyann C

    2017-02-01

    The aim of this study was to describe compliance with select quality indicators and assess organ-specific dysfunction in a childhood-onset systemic lupus erythematosus population by using a validated damage index and to evaluate associations between compliance with quality indicators and disease damage. A retrospective chart review was performed on patients diagnosed with systemic lupus erythematosus prior to age 18 followed at a single center in the USA from 1999 to 2012 (n = 75). Data regarding quality indicators and outcome variables, including the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, were collected. The median disease duration was 3.8 years. The proportion of patients or patient-years in which care complied with the proposed quality measures was 94.4% for hydroxychloroquine use, 84.3% for vitamin D recommendation,75.8% for influenza vaccination (patient-years), 67.2% for meningococcal vaccination, 49.0% for ophthalmologic examination (patient-years), 31.7% for pneumococcal vaccination, and 28.6% for bone mineral density evaluation. Disease damage was present in 41.3% of patients at last follow-up, with an average damage index score of 0.81. Disease damage at last follow-up was associated with minority race/ethnicity (p = 0.008), bone mineral density evaluation (p = 0.035), and vitamin D recommendation (p = 0.018). Adherence to quality indicators in a childhood-onset systemic lupus erythematosus population is varied, and disease damage is prevalent. This study highlights the importance of quality improvement initiatives aimed at optimizing care delivery to reduce disease damage in pediatric lupus patients.

  20. Do treatment quality indicators predict cardiovascular outcomes in patients with diabetes?

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    Grigory Sidorenkov

    Full Text Available BACKGROUND: Landmark clinical trials have led to optimal treatment recommendations for patients with diabetes. Whether optimal treatment is actually delivered in practice is even more important than the efficacy of the drugs tested in trials. To this end, treatment quality indicators have been developed and tested against intermediate outcomes. No studies have tested whether these treatment quality indicators also predict hard patient outcomes. METHODS: A cohort study was conducted using data collected from >10.000 diabetes patients in the Groningen Initiative to Analyze Type 2 Treatment (GIANTT database and Dutch Hospital Data register. Included quality indicators measured glucose-, lipid-, blood pressure- and albuminuria-lowering treatment status and treatment intensification. Hard patient outcome was the composite of cardiovascular events and all-cause death. Associations were tested using Cox regression adjusting for confounding, reporting hazard ratios (HR with 95% confidence intervals. RESULTS: Lipid and albuminuria treatment status, but not blood pressure lowering treatment status, were associated with the composite outcome (HR = 0.77, 0.67-0.88; HR = 0.75, 0.59-0.94. Glucose lowering treatment status was associated with the composite outcome only in patients with an elevated HbA1c level (HR = 0.72, 0.56-0.93. Treatment intensification with glucose-lowering but not with lipid-, blood pressure- and albuminuria-lowering drugs was associated with the outcome (HR = 0.73, 0.60-0.89. CONCLUSION: Treatment quality indicators measuring lipid- and albuminuria-lowering treatment status are valid quality measures, since they predict a lower risk of cardiovascular events and mortality in patients with diabetes. The quality indicators for glucose-lowering treatment should only be used for restricted populations with elevated HbA1c levels. Intriguingly, the tested indicators for blood pressure-lowering treatment did not predict patient

  1. Expanding the uses of AHRQ's prevention quality indicators: validity from the clinician perspective.

    Science.gov (United States)

    Davies, Sheryl; McDonald, Kathryn M; Schmidt, Eric; Schultz, Ellen; Geppert, Jeffrey; Romano, Patrick S

    2011-08-01

    The Agency for Healthcare Research and Quality's prevention quality indicators (PQIs) are used as a metric of area-level access to quality care. Recently, interest has expanded to using the measures at the level of payer or large physician groups, including public reporting or pay-for-performance programs. However, the validity of these expanded applications is unknown. We conducted a novel panel process to establish face validity of the 12 PQIs at 3 denominator levels: geographic area, payer, and large physician groups; and 3 uses: quality improvement, comparative reporting, and pay for performance. Sixty-four clinician panelists were split into Delphi and Nominal Groups. We aimed to capitalize on the reliability of the Delphi method and information sharing in the Nominal group method by applying these techniques simultaneously. We examined panelists' perceived usefulness of the indicators for specific uses using median scores and agreement within and between groups. Panelists showed stronger support of the usefulness of chronic disease indicators at the payer and large physician group levels than for acute disease indicators. Panelists fully supported the usefulness of 2 indicators for comparative reporting (asthma, congestive heart failure) and no indicators for pay-for-performance applications. Panelists expressed serious concerns about the usefulness of all new applications of 3 indicators (angina, perforated appendix, dehydration). Panelists rated age, current comorbidities, earlier hospitalization, and socioeconomic status as the most important risk-adjustment factors. Clinicians supported some expanded uses of the PQIs, but generally expressed reservations. Attention to denominator definitions and risk adjustment are essential for expanded use.

  2. Environmental quality indicators and financial development in Malaysia: unity in diversity.

    Science.gov (United States)

    Alam, Arif; Azam, Muhammad; Abdullah, Alias Bin; Malik, Ihtisham Abdul; Khan, Anwar; Hamzah, Tengku Adeline Adura Tengku; Faridullah; Khan, Muhammad Mushtaq; Zahoor, Hina; Zaman, Khalid

    2015-06-01

    Environmental quality indicators are crucial for responsive and cost-effective policies. The objective of the study is to examine the relationship between environmental quality indicators and financial development in Malaysia. For this purpose, the number of environmental quality indicators has been used, i.e., air pollution measured by carbon dioxide emissions, population density per square kilometer of land area, agricultural production measured by cereal production and livestock production, and energy resources considered by energy use and fossil fuel energy consumption, which placed an impact on the financial development of the country. The study used four main financial indicators, i.e., broad money supply (M2), domestic credit provided by the financial sector (DCFS), domestic credit to the private sector (DCPC), and inflation (CPI), which each financial indicator separately estimated with the environmental quality indicators, over a period of 1975-2013. The study used the generalized method of moments (GMM) technique to minimize the simultaneity from the model. The results show that carbon dioxide emissions exert the positive correlation with the M2, DCFC, and DCPC, while there is a negative correlation with the CPI. However, these results have been evaporated from the GMM estimates, where carbon emissions have no significant relationship with any of the four financial indicators in Malaysia. The GMM results show that population density has a negative relationship with the all four financial indicators; however, in case of M2, this relationship is insignificant to explain their result. Cereal production has a positive relationship with the DCPC, while there is a negative relationship with the CPI. Livestock production exerts the positive relationship with the all four financial indicators; however, this relationship with the CPI has a more elastic relationship, while the remaining relationship is less elastic with the three financial indicators in a country

  3. Assessing soil quality indicator under different land use and soil erosion using multivariate statistical techniques.

    Science.gov (United States)

    Nosrati, Kazem

    2013-04-01

    Soil degradation associated with soil erosion and land use is a critical problem in Iran and there is little or insufficient scientific information in assessing soil quality indicator. In this study, factor analysis (FA) and discriminant analysis (DA) were used to identify the most sensitive indicators of soil quality for evaluating land use and soil erosion within the Hiv catchment in Iran and subsequently compare soil quality assessment using expert opinion based on soil surface factors (SSF) form of Bureau of Land Management (BLM) method. Therefore, 19 soil physical, chemical, and biochemical properties were measured from 56 different sampling sites covering three land use/soil erosion categories (rangeland/surface erosion, orchard/surface erosion, and rangeland/stream bank erosion). FA identified four factors that explained for 82 % of the variation in soil properties. Three factors showed significant differences among the three land use/soil erosion categories. The results indicated that based upon backward-mode DA, dehydrogenase, silt, and manganese allowed more than 80 % of the samples to be correctly assigned to their land use and erosional status. Canonical scores of discriminant functions were significantly correlated to the six soil surface indices derived of BLM method. Stepwise linear regression revealed that soil surface indices: soil movement, surface litter, pedestalling, and sum of SSF were also positively related to the dehydrogenase and silt. This suggests that dehydrogenase and silt are most sensitive to land use and soil erosion.

  4. Using diatom indices for water quality assessment in a subtropical river, China.

    Science.gov (United States)

    Tan, Xiang; Sheldon, Fran; Bunn, Stuart E; Zhang, Quanfa

    2013-06-01

    Diatoms have been regularly used as bioindicators to assess water quality of surface waters. However, diatom-based indices developed for a specific geographic region may not be appropriate elsewhere. We sampled benthic diatom assemblages in the upper Han River, a subtropical river in China, to evaluate applicability of 14 diatom-based indices used worldwide for water quality assessment. A total of 194 taxa from 31 genera were identified in the dry season and 139 taxa from 23 genera in the wet season. During the dry season, significant relationships were found for all but one of the diatom-based indices (Index Diatom Artois-Picardie) with one or more physical and chemical variables including nutrients and ion concentrations in river waters. The Biological Diatom Index (IBD) and diatom-based eutrophication/pollution index (EPI-D) were strongly related to trophic status and ionic content, while Watanabe's Index was related to organic pollution and conductivity. Yet, the diatom indices showed weak relationships with physical and chemical variables during the wet season. It suggests that diatom-based indices developed in Europe can be applied with confidence as bioindicators of water quality in subtropical rivers of China, at least during base-flow conditions.

  5. High Compact, High Quality Single Longitudinal Mode Hundred Picoseconds Laser Based on Stimulated Brillouin Scattering Pulse Compression

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    Zhenxu Bai

    2016-01-01

    Full Text Available A high beam quality hundred picoseconds single-longitudinal-mode (SLM laser is demonstrated based on stimulated Brillouin scattering (SBS pulse compression and aberration compensation. Flash-lamp-pumped Q-switched Nd3+:Y3Al5O12 (Nd:YAG SLM laser with Cr4+:Y3Al5O12 (Cr4+:YAG as a saturable absorber is used as the seed source. By combining master-oscillator-power-amplifier (MOPA, a compact single-cell with FC-770 as working medium is generated as pulse compressor. The 7.8 ns SLM laser is temporally compressed to about 450 ps, and 200 mJ energy is obtained at 1064 nm without optical damage. The energy stability is better than 3% with beam quality factor M2 less than 1.8, which makes this laser system an attractive source for scientific and industrial applications.

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

    Directory of Open Access Journals (Sweden)

    Jeffrey L. Smith

    2011-01-01

    Full Text Available Arable lands are needed for sustainable agricultural systems to support an ever-growing human population. Soil quality needs to be defined to assure that new land brought into crop production is sustainable. To evaluate soil quality, a number of soil attributes will need to be measured, evaluated, and integrated into a soil-quality index using the multivariable indicator kriging (MVIK procedure. This study was conducted to determine the spatial variability and correlation of indicator parameters on a field scale with respect to soil quality and suitability for use with MVIK. The variability of the biological parameters decreased in the order of respiration > enzyme assays and qCO2 > microbial biomass C. The distribution frequency of all parameters except respiration were normal although the spatial distribution across the landscape was highly variable. The biological parameters showed little correlation with each other when all data points were considered; however, when grouped in smaller sections, the correlations were more consistent with observed patterns across the field. To accurately assess soil quality, and arable land use, consideration of spatial and temporal variability, soil conditions, and other controlling factors must be taken into account.

  7. Correlation between biochemical indicators of lead exposure and semen quality in a lead-poisoned firearms instructor

    Energy Technology Data Exchange (ETDEWEB)

    Fisher-Fischbein, J.; Fischbein, A.; Melnick, H.D.; Bardin, C.W.

    1987-02-13

    Lead poisoning is a disease of great public health concern, particularly because of the hazards that lead can pose to children as a result of ingestion of lead-based paint and perhaps as a consequence of the effects of lead pollution of the ambient air. However, lead poisoning is also a common occupational disease among adults. Persons who work as instructors at indoor firing ranges are likewise at high risk for occupational lead poisoning. The typical biochemical features of lead poisoning include inhibition of heme synthesis manifested by elevated levels of erythrocyte protoporphyrin and decreased activity of sigma-aminolevulinic acid dehydratase. Reproductive effects of lead have been reported in both men and women, but these effects rarely present themselves as practical clinical problems in occupational medicine practice. The current Department of Labor standard for occupational exposure to inorganic lead has been promulgated with special emphasis on the protection of the worker from damage to the reproductive system. The authors had the opportunity of measuring biologic indicators of lead exposure and of assessing semen quality in a firearms instructor with lead poisoning and infertility, who was treated and who fathered a child. They report herein the results of these longitudinal observations.

  8. Using Gambusia affinis growth and condition to assess estuarine habitat quality: A comparison of indices

    Science.gov (United States)

    Piazza, Bryan P.; La Peyre, M.K.

    2010-01-01

    Numerous indices have been used to estimate fish growth and condition however, differences in sensitivity and reliability of the methods have hampered efforts to identify appropriate indicators for routine evaluation of habitat quality in the field. We compared common morphometric (length, weight, somatic growth, length-weight condition) and biochemical (RNA:DNA ratio, relative DNA content, energy density) growth indices on the same wild-caught mosquitofish Gambusia affinis to examine their usefulness as indicators of habitat quality. A laboratory experiment was used to quantify growth rates of wild-caught G. affinis under different feeding treatments. Field studies consisted of both a short-term enclosure experiment (10 d) and weekly (7 wk) fish collections to compare growth indices in managed inflow and reference marshes during a winter/spring freshwater pulse event in upper Breton Sound, Louisiana, USA. Marshes flooded by restored freshwater pulses were capable of producing optimum growth (0.001 g DW d-1 DW = dry weight) and energetically valuable habitat (>6000 cal g-1 DW) for trophic transport. Because of differences in timing of response, morphometric and biochemical indices were generally not directly correlated, but there was clear agreement in direction and magnitude of response. The most striking difference in timing was that biochemical indices (RNA:DNA) responded more slowly to treatments than did morphometric growth indices. While gross patterns are comparable between indicators, differences in sensitivity and response time between indicators suggest that choice of indicator needs to be accounted for in interpretation and analysis of effects. ?? Inter-Research 2010, www.int-res.com.

  9. A systematic review of diet quality indices in relation to obesity.

    Science.gov (United States)

    Asghari, Golaleh; Mirmiran, Parvin; Yuzbashian, Emad; Azizi, Fereidoun

    2017-04-01

    Tools, called 'diet/dietary quality indices', evaluate the level of adherence to a specified pattern or a set of recommendations in populations. Yet, there are no review studies providing unanimous comprehensive results of dietary indices on obesity. We reviewed observational studies, focusing on the association of diet quality indices with general obesity or abdominal obesity in adults. We systematically conducted a search in all English language publications available on MEDLINE, ISI Web of Science and Embase between January 1990 and January 2016. Among the wide variety of indices and weight-derived variables, studies with dietary-guideline-based indices and mean changes for weight gain or OR for general obesity and abdominal obesity were selected. From a total of 479 articles, thirty-four studies were selected for the current review, ten of which had prospective designs and twenty-six had cross-sectional designs. Associations of weight status with the original Healthy Eating Index (HEI) and other versions of the HEI including alternative HEI, HEI-2005 and HEI-05 were examined in thirteen studies, with ten studies revealing significant associations. The HEI was a better general obesity predictor in men than in women. Diet scores lacked efficacy in assessing overall diet quality and demonstrated no significant findings in developing countries, in comparison with US populations. In addition, indices based on dietary diversity scores were directly associated with weight gain. Despite the insufficient evidence to draw definitive conclusions about the relation between dietary indices and obesity, HEI was found to be inversely associated with obesity and diversity-based indices were positively associated with obesity.

  10. Process quality indicators for chronic kidney disease risk management: a systematic literature review.

    Science.gov (United States)

    Smits, Kirsten P J; Sidorenkov, Grigory; Bilo, Henk J G; Bouma, Margriet; Navis, Gerjan J; Denig, Petra

    2016-10-01

    Quality indicators (QIs) can be used for measuring the quality of actions of healthcare providers. This systematic review gives an overview of such QIs measuring processes of care for chronic kidney disease (CKD), and identifies the QIs that have content, face, operational and/or predictive validity. PubMed and Embase were searched using a strategy combining the terms "quality of care," "quality indicators" and "chronic kidney disease". Papers were included if they focused on developing, testing or applying QIs for assessing the quality of care in adult patients with CKD not on renal replacement therapy. Two hundred and seventy-three QIs from thirty-one papers were extracted, including QIs on adequate monitoring of kidney function and vascular risk factors, on indicated treatment, drug safety, adherence and referral to a specialist. The QIs that were considered content, face and operational valid focused on monitoring of glomerular filtration rate, albumin-creatinine ratio, lipid levels and blood pressure, the use of non-steroidal anti-inflammatory drugs, nitrofurantoin and biphosphonates in patients with CKD, and QIs on monitoring haemoglobin and treatment with angiotensin-converting-enzyme-inhibitors/angiotensin-receptor-II-blockers in patients with CKD and comorbidities. No QIs were tested for predictive validity. In addition, only two QIs focused on diet and no other QIs focused on lifestyle management. Based on this review, sufficiently validated QIs can be selected for measuring the quality of CKD care. This review provides insight in QIs that need further validation, and in areas of care where QIs are still lacking. © 2016 John Wiley & Sons Ltd.

  11. Rocky-shore communities as indicators of water quality: a case study in the Northwestern Mediterranean.

    Science.gov (United States)

    Pinedo, Susana; García, María; Satta, Maria Paola; de Torres, Mariona; Ballesteros, Enric

    2007-01-01

    The collection of 152 samples from the upper sublittoral zone along the rocky coasts of Catalonia (Northwestern Mediterranean) was carried out in 1999 in order to test the suitability of littoral communities to be used as indicators of water quality in the frame of the European Water Framework Directive. Detrended correspondence analysis were performed to distinguish between different communities and to relate communities composition to water quality. Samples collected in reference sites were included in the analysis. Mediterranean rocky shore communities situated in the upper sublittoral zone can be used as indicators of the water quality: there is a gradient from high to bad status that comprises from dense Cystoseira mediterranea forests to green algae dominated communities. The geographical patterns in the distribution of these communities show that the best areas are situated in the Northern coast, where tourism is the main economic resource of the area, and the worst area is situated close to the metropolitan zone of Barcelona with high population and industrial development. Thus, Mediterranean sublittoral rocky shore communities are useful indicators of water quality and multivariate analysis are a suitable statistical tool for the assessment of the ecological status.

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

    Directory of Open Access Journals (Sweden)

    Linda Pieri

    2011-12-01

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

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

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    Jonathan Van Beek

    2015-08-01

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

  14. Quality indicators for musculoskeletal injury management in the emergency department: a systematic review.

    Science.gov (United States)

    Strudwick, Kirsten; Nelson, Mark; Martin-Khan, Melinda; Bourke, Michael; Bell, Anthony; Russell, Trevor

    2015-02-01

    There is increasing importance placed on quality of health care for musculoskeletal injuries in emergency departments (EDs). This systematic review aimed to identify existing musculoskeletal quality indicators (QIs) developed for ED use and to critically evaluate their methodological quality. MEDLINE, EMBASE, CINAHL, and the gray literature, including relevant organizational websites, were searched in 2013. English-language articles were included that described the development of at least one QI related to the ED care of musculoskeletal injuries. Data extraction of each included article was conducted. A quality assessment was then performed by rating each relevant QI against the Appraisal of Indicators through Research and Evaluation (AIRE) Instrument. QIs with similar definitions were grouped together and categorized according to the health care quality frameworks of Donabedian and the Institute of Medicine. The search revealed 1,805 potentially relevant articles, of which 15 were finally included in the review. The number of relevant QIs per article ranged from one to 11, resulting in a total of 71 QIs overall. Pain (n = 17) and fracture management (n = 13) QIs were predominant. Ten QIs scored at least 50% across all AIRE Instrument domains, and these related to pain management and appropriate imaging of the spine. Methodological quality of the development of most QIs is poor. Recommendations for a core set of QIs that address the complete spectrum of musculoskeletal injury management in emergency medicine is not possible, and more work is needed. Currently, QIs with highest methodological quality are in the areas of pain management and medical imaging. © 2015 by the Society for Academic Emergency Medicine.

  15. CRITERIA AND QUALITY INDICATORS OF INFORMATION AND COMMUNICATION TECHNOLOGIES OF LEARNING

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    Oleg M. Spirin

    2013-03-01

    Full Text Available In the article the concept of information and communication technology and information and communication technology of learning is specified. It is grounded an external and internal criteria of information and communication technologies of learning quality assessment based on experience of information and communication technology quality assessment of the methodical system of informatics teachers vocational training. There are considered the external indexes – design, structural, organizational, communicative and gnostic criteria, and internal – differentiation, individualization, intensification of teaching process and effectiveness of educational activity. There are presented the approaches to assess the indicators for determination of criteria demonstration degree.

  16. Turbidity as an Indicator of Water Quality in Diverse Watersheds of the Upper Pecos River Basin

    Directory of Open Access Journals (Sweden)

    Gregory M. Huey

    2010-06-01

    Full Text Available Microbial concentrations, total suspended solids (TSS and turbidity vary with stream hydrology and land use. Turbidity, TSS, and microbial concentrations, loads and yields from four watersheds were assessed: an unburned montane forest, a catastrophically burned montane forest, urban land use and rangeland prairie. Concentrations and loads for most water quality variables were greatest during storm events. Turbidity was an effective indicator of TSS, E. coli and Enterococci spp. The greatest threat to public health from microbial contamination occurs during storm runoff events. Efforts to manage surface runoff and erosion would likely improve water quality of the upper Pecos River basin in New Mexico, USA.

  17. [Health information on the Internet and trust marks as quality indicators: vaccines case study].

    Science.gov (United States)

    Mayer, Miguel Angel; Leis, Angela; Sanz, Ferran

    2009-10-01

    To find out the prevalence of quality trust marks present in websites and to analyse the quality of these websites displaying trust marks compared with those that do not display them, in order to put forward these trust marks as a quality indicator. Cross-sectional study. Internet. Websites on vaccines. Using "vacunas OR vaccines" as key words, the features of 40 web pages were analysed. These web pages were selected from the page results of two search engines, Google and Yahoo! Based on a total of 9 criteria, the average score of criteria fulfilled was 7 (95% CI 3.96-10.04) points for the web pages offered by Yahoo! and 7.3 (95% CI 3.86-10.74) offered by Google. Amongst web pages offered by Yahoo!, there were three with clearly inaccurate information, while there were four in the pages offered by Google. Trust marks were displayed in 20% and 30% medical web pages, respectively, and their presence reached statistical significance (P=0.033) when fulfilling the quality criteria compared with web pages where trust marks were not displayed. A wide variety of web pages was obtained by search engines and a large number of them with useless information. Although the websites analysed had a good quality, between 15% and 20% showed inaccurate information. Websites where trust marks were displayed had more quality than those that did not display one and none of them were included amongst those where inaccurate information was found.

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

    Directory of Open Access Journals (Sweden)

    Leandro Campos Pinto

    2013-12-01

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

  19. Study of water quality using benthic biological indicators in rural and urban streams

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    Sandro Morais Pimenta

    2016-03-01

    Full Text Available Methods other than physical-chemical and geochemical analyses can be used to assess water quality in surface drainage. This study used intolerant, tolerant and resistant benthic species as bioindicators of changes in water quality of two streams, taking in account particle size of sediments and volatile solids. Eight points were sampled in the stream Bandeirinha and four points in the stream Josefa Gomes in January and September 2013 in the municipality of Formosa-GO. The two streams were chosen in order to study two different environments. The study used the diversity indexes of Shannon (H, Equitability (E and Bray-Curtis Similarity and the grouping analysis method UPGMA (Unweighted Pair Group Method with Arithmetic Mean. The results of particle size and volatile solids study of Bandeirinha stream located in rural areas showed bioindicator species intolerant of changes in water quality. The stream Josefa Gomes, completely inserted in an urban environment, showed alteration identified by tolerant and resistant species. The results demonstrate differences in water quality in the rural and urban environments and the relationship of bioindicators with sediments. The study aids the interpretation of changes in the water quality of the two drainages areas. Analysis of water quality based upon benthic biological indicators associated with physical-chemical and geochemical analyses of water and sediments provide a better interpretation of the results.

  20. The association of cancer survival with four socioeconomic indicators: a longitudinal study of the older population of England and Wales 1981–2000

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    Young Harriet

    2007-01-01

    Full Text Available Abstract Background Many studies have found socioeconomic differentials in cancer survival. Previous studies have generally demonstrated poorer cancer survival with decreasing socioeconomic status but mostly used only ecological measures of status and analytical methods estimating simple survival. This study investigate socio-economic differentials in cancer survival using four indicators of socioeconomic status; three individual and one ecological. It uses a relative survival method which gives a measure of excess mortality due to cancer. Methods This study uses prospective record linkage data from The Office for National Statistics Longitudinal Study for England and Wales. The participants are Longitudinal Study members, recorded at census in 1971 and 1981 and with a primary malignant cancer diagnosed at age 45 or above, between 1981 and 1997, with follow-up until end 2000. The outcome measure is relative survival/excess mortality, compared with age and sex adjusted survival of the general population. Relative survival and Poisson regression analyses are presented, giving models of relative excess mortality, adjusted for covariates. Results Different socioeconomic indicators detect survival differentials of varying magnitude and definition. For all cancers combined, the four indicators show similar effects. For individual cancers there are differences between indicators. Where there is an association, all indicators show poorer survival with lower socioeconomic status. Conclusion Cancer survival differs markedly by socio-economic status. The commonly used ecological measure, the Carstairs Index, is adequate at demonstrating socioeconomic differentials in survival for combined cancers and some individual cancers. A combination of car access and housing tenure is more sensitive than the ecological Carstairs measure at detecting socioeconomic effects on survival – confirming Carstairs effects where they occur but additionally identifying

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

    Science.gov (United States)

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

    2012-01-01

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

  2. Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    Massimo GIUSTI; Giulia MELLE; Monica FENOCCHIO; Lorenzo MORTARA; Francesca CECOLI; Valeria CAORSI; Diego FERONE; Francesco MINUTO; Elda RASORE

    2011-01-01

    Differentiated thyroid carcinoma (DTC) generally has a favorable outcome. Thyroid disease, treatments,stress, and comorbidity can compromise health-related quality of life (QoL) and indirectly weigh upon the outcome.From 2004 to 2008, we evaluated QoL longitudinally in 128 DTC subjects. During scheduled examinations, subjects were asked to undergo a semi-structured psychiatric interview and five rated inventories. The same examination was conducted in 219 subjects after surgery for benign thyroid pathology. Low scores represent a better QoL. DTC and control subjects were similar in terms of age, male/female ratio, concomitant psychopharmacological treatments, and frequency of psychiatric diseases. In DTC subjects, Billewicz scale (BS) scores showed an increasing trend over time,especially among females. The ad hoc thyroid questionnaire (TQ) scores were similar in both groups and did not change over time, but at the end of the study ad hoc TQ and BS were significantly related. Ad hoc TQ scores were also related to age on entry to the study. In both male and female DTC subjects, Hamilton's tests for anxiety (HAM-A), but not for depression (HAM-D), showed an improving trend. At the end of the study, HAM-A and HAM-D scores were comparable to those of the control group. HAM-A and HAM-D were both positively correlated with the stage of cancer and the time between diagnosis and treatment. Only HAM-D correlated with age on entry to the study. Kellner symptom questionnaire (KSQ) item scores were higher in DTC subjects than in controls. The change over time in the items including anxiety, somatization, depression, and hostility was significant. Somatization and hostility were more significantly reduced in DTC females than in DTC males. Hostility scores were significantly lower in DTC subjects than in controls at the end of the study. Somatization and depression were significantly related to staging on diagnosis and age on entry to the study. Our study confirms a wide

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

    Directory of Open Access Journals (Sweden)

    Edward Kelley

    2005-12-01

    Full Text Available

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

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

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

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

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    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

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

  5. Land Use Effects on Soil Quality Indicators: A Case Study of Abo-Wonsho Southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Awdenegest Moges

    2013-01-01

    Full Text Available Soil quality assessment is valuable for evaluating agroecosystem sustainability, soil degradation, and identifying sustainable land management practices. This study compared soil quality within culturally protected forest areas and adjacent grassland, grazing land, and farmland in Abo-Wonsho, Southern Ethiopia. A total of 40 soil samples (4 land uses × 5 replications × 2 soil depth layers: 0 to 10 cm and 10 to 20 cm were collected for analysis. Soil textural fractions (i.e., sand, silt, and clay percentage varied with land use and soil depths even though the textural class across all land use types was sandy loam. Bulk density, soil organic carbon (SOC, and available potassium (K varied significantly: , , and , respectively, with land use and soil depth, but other indicators showed no significant difference. We conclude soil quality can be protected and maintained by improving existing land use practices within both agricultural and modern forest management areas.

  6. Are Front of Pack Claims Indicators of Nutrition Quality? Evidence from 2 Product Categories.

    Science.gov (United States)

    Schaefer, Debra; Hooker, Neal H; Stanton, John L

    2016-01-01

    American grocery shoppers face an array of front of pack (FOP) nutrition and health claims when making food selections. Such systems have been categorized as summary or nutrient specific. Either type should help consumers make judgments about the nutrition quality of a product. This research tests if the type or quantity of FOP claims are indeed good indicators of objective nutrition quality. Claim and nutrition information from more than 2200 breakfast cereals and prepared meals launched between 2006 and 2010 were analyzed using binary and multinomial logistic regression models. Results suggest that no type or number of front of pack claims could distinguish "healthy" foods. However, some types and frequencies of FOP claims were significant predictors of higher or lower levels of certain key nutrients. Given the complex and crowded label environment in which these FOP claims reside, one may be concerned that such cues are not closely related to objective measures of nutrition quality. © 2015 Institute of Food Technologists®

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

    Directory of Open Access Journals (Sweden)

    Pavlova Iu.A.

    2012-03-01

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

  8. The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands

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    Robbert J. J. Gobbens

    2014-01-01

    Full Text Available Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI, fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%. Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N=264, 52.3% response rate. ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed, the LAPAQ (physical activity, a hand grip strength test, the SFQ (fatigue, and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability.

  9. The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands.

    Science.gov (United States)

    Gobbens, Robbert J J; van Assen, Marcel A L M

    2014-01-01

    Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N = 264, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability.

  10. Making air quality indices comparable--assessment of 10 years of air pollutant levels in western Europe.

    Science.gov (United States)

    Lokys, Hanna Leona; Junk, Jürgen; Krein, Andreas

    2015-01-01

    To address the incomparability of the large number of existing air quality indices, we propose a new normalization method that is suited to directly compare air quality indices based on the common European World Health Organization (WHO) air quality guidelines for NO2, O3, and PM10. Using this method, we compared three air quality indices based on the European guidelines, related them to another air quality index based on the relative risk concept, and used them to assess the air quality and its trends in northwest central Europe. The average air quality in the area of investigation is below the recommended European guidelines. The majority of index values exceeding this threshold are caused by PM10, which is also, in most cases, responsible for the degrading trends in air quality. Eleven out of 29 stations tested showed significant trends, of which eight indicated trends towards better air quality.

  11. A quality monitoring program for red blood cell components: in vitro quality indicators before and after implementation of semiautomated processing.

    Science.gov (United States)

    Acker, Jason P; Hansen, Adele L; Kurach, Jayme D R; Turner, Tracey R; Croteau, Ioana; Jenkins, Craig

    2014-10-01

    Canadian Blood Services has been conducting quality monitoring of red blood cell (RBC) components since 2005, a period spanning the implementation of semiautomated component production. The aim was to compare the quality of RBC components produced before and after this production method change. Data from 572 RBC units were analyzed, categorized by production method: Method 1, RBC units produced by manual production methods; Method 2, RBC units produced by semiautomated production and the buffy coat method; and Method 3, RBC units produced by semiautomated production and the whole blood filtration method. RBC units were assessed using an extensive panel of in vitro tests, encompassing regulated quality control criteria such as hematocrit (Hct), hemolysis, and hemoglobin (Hb) levels, as well as adenosine triphosphate, 2,3-diphosphoglycerate, extracellular K(+) and Na(+) levels, methemoglobin, p50, RBC indices, and morphology. Throughout the study, all RBC units met mandated Canadian Standards Association guidelines for Hb and Hct, and most (>99%) met hemolysis requirements. However, there were significant differences among RBC units produced using different methods. Hb content was significantly lower in RBC units produced by Method 2 (51.5 ± 5.6 g/unit; p < 0.001). At expiry, hemolysis was lowest in Method 2-produced RBC units (p < 0.05) and extracellular K(+) levels were lowest in units produced by Method 1 (p < 0.001). While overall quality was similar before and after the production method change, the observed differences, although small, indicate a lack of equivalency across RBC products manufactured by different methods. © 2014 AABB.

  12. Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance

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    Badia BISBIS

    2016-06-01

    Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care  indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from  Nador, 2% from Bouarfa, 4% from  Taourirt and 2% from Jerrada. One might question about  the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential  problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    PURPOSE: To establish a quality indicator that could be used in optimizing treatment for rhegmatogenous retinal detachment (RRD). METHODS: The Danish National Patient Registry was used to identify surgery conducted in Denmark for RRD in the period 01 January 2001-31 December 2009. Cases were...... identified by diagnosis and surgical codes. RESULTS: A total of 6522 cases were operated for a primary RRD in the study period, and 22% (1434 patients) were reoperated for a redetachment. A Cox regression analysis showed that the risk of redetachment was equal to or less than detachment on the fellow eye 1...... year after primary surgery with techniques not using silicone oil. The same was true 1.5 years after surgery for techniques using silicone oil. Based on this, we established a quality indicator defining failure as the need for operation for redetachment within 1 year from initial surgery when using...

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

    Directory of Open Access Journals (Sweden)

    Aweke M. Gelaw

    2015-02-01

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

  15. Charcot–Marie–Tooth disease, psychiatric indicators and quality of life: a systematic review

    Science.gov (United States)

    Cordeiro, Joana L.C.; Marques, Wilson; Hallak, Jaime E.C.; Osório, Flávia L.

    2014-01-01

    This study is aimed to conduct a systematic literature review regarding the associations between psychiatric symptoms, functional impairments, and quality of life in patients with CMT (Charcot–Marie–Tooth). The PUBMED, PsycInfo, SCIELO, and LILACS electronic databases were used, and the following search terms were employed: CMT, HMSN (hereditary motor and sensory neuropathy), mental disorder, quality of life, psychiatry, psychiatric, and psychological without the use of time-limit filters. According to the adopted inclusion criteria, 20 studies were included and appraised. These studies indicated that patients with CMT exhibited an increased trend toward depressive symptoms compared with the general population. In addition, CMT patients were exposed to a higher risk of reduced quality of life and significant sleep impairment. Considering the comorbidity of CMT with other psychiatric disorders, the heterogeneity of the instruments used to evaluate the psychiatric symptoms compromised the ability to compare the studies examined. Our results indicate a need for a systematic evaluation of these conditions to minimize the impairments and decreased quality of life caused by CMT. PMID:24654889

  16. The use of benthic metabolic processes as indicators for environmental quality assessment in coastal lagoons

    Directory of Open Access Journals (Sweden)

    E. Arévalo

    2013-11-01

    Full Text Available The review highlights the various methods used for assessing environmental quality in Mediterranean coastal lagoons, with emphasis on benthic parameters and processes. The application of indices based on benthic macrofauna, extensively used in coastal areas, may fail in discerning between natural and anthropogenic pressures over naturally stressed coastal lagoons. Sediment can play an important regulatory role over the overlying water composition through the storage capacity for organic matter and pollutants, regeneration of nutrients or its buffering capacity. Descriptive classical measurements like sedimentary organic matter, Chlorophyll α and nutrient content are commonly included in monitoring efforts. However, other more complex indicators like primary production, sediment-water solute fluxes, solute sorption dynamics or microbial reaction rate determinations, have not been fully implemented for environmental quality assessment in coastal lagoons. These could offer crucial information on current and projected anthropogenic influence on ecosystem functioning. Irruption of novel techniques in benthic biogeochemistry like Excitation-Emission-Matrix (EEM fluorescence for the study of dissolved organic matter dynamics shows high potential in combination with biological quality elements and other metabolic measurements for the evaluation of the environmental quality in coastal lagoons.

  17. SEASONAL CHANGES IN SELECTED INDICATORS OF WATER QUALITY OF THE ŁYDYNIA RIVER

    Directory of Open Access Journals (Sweden)

    Marek Gugała

    2016-01-01

    Full Text Available The objective of the research was to compare seasonal changes in selected indicators of water quality of the Łydynia river against Regulation of the Minister of Environment of 9 November 2011 on classification method for waterbody of surface waters and environmental quality standards for priority substances (Dz. U. [Journal of Laws] 2011, No. 257, item 1545. Water samples were taken in Ciechanów in the spring and autumn from 2009 to 2011. Water pH, specific conductance and calcium ion (Ca2+ and magnesium ion (Mg2+ concentrations were determined as part of physical and chemical analysis. The study results were compared with the limit values of water quality indicators established in annex no. 1 for the aforementioned regulation. The water quality of the Łydynia river was found to be class I water (class I being the highest purity class. Additionally, colour and turbidity (the parameters not included in the aforementioned regulation were determined in water samples.

  18. Re-evaluation of peroxide value as an indicator of the quality of edible oils.

    Science.gov (United States)

    Shiozawa, Satoshi; Tanaka, Masaharu; Ohno, Katsutoshi; Nagao, Yasuhiro; Yamada, Toshihiro

    2007-06-01

    The oxidation of oils has important effects on the quality of oily foods, such as instant noodles. In particular, the generation of aldehydes, which accompanies the oxidation of oils, is one of the first factors to reduce food quality. We examined various indicators of oil quality during temperature-accelerated storage and found that peroxide value (POV) was highly correlated with the total concentration of major odorants. Moreover, the correlation of POV with the total concentration of five unsaturated aldehydes (t-2-heptenal, t-2-octenal, t-2-decenal, t-2-undecenal and t,t-2,4-decadienal) that show strong cytotoxicity was greater than the correlation of POV with the total concentration of major odorants. The maximum allowable concentration of the five aldehydes was calculated based on the 'no observed adverse-effect level' of the aldehyde that showed the highest cytotoxicity, t,t-2,4-decadienal, along with the human daily oil intake. We showed that it is useful to utilize POV as an indicator to control food quality and safety.

  19. Quality indicators for trace gas concentrations determined from earthlimb emission spectra

    Science.gov (United States)

    Uplinger, W. G.; Kumer, J. B.

    1986-01-01

    Different techniques which can be used to indicate the quality of the mixing ratios retrieved from spectral radiance measurements made by the CLAES instrument for 11 different atmospheric gases are discussed. A key to retrieval from noisy data is the Singular Value Decomposition (SVD), which is described. The use of the SVD with simulated data and radiance measurements from a balloon floating at 30 km is discussed.

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

    Directory of Open Access Journals (Sweden)

    Claudia Pileggi

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

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

    OpenAIRE

    BONDARI, D.; Bondari, Simona; Gheonea, Ioana; ANDRONACHE, ANDREEA

    2014-01-01

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

  2. The use of benthic metabolic processes as indicators for environmental quality assessment in coastal lagoons

    OpenAIRE

    E. Arévalo; J. S. P. Ibánhez; Papaspyrou, S; A. Nicolaidou

    2013-01-01

    The review highlights the various methods used for assessing environmental quality in Mediterranean coastal lagoons, with emphasis on benthic parameters and processes. The application of indices based on benthic macrofauna, extensively used in coastal areas, may fail in discerning between natural and anthropogenic pressures over naturally stressed coastal lagoons. Sediment can play an important regulatory role over the overlying water composition through the storage capacity for organic matte...

  3. The relationship between different diet quality indices and severity of airflow obstruction among COPD patients.

    Science.gov (United States)

    Yazdanpanah, Leila; Paknahad, Zamzam; Moosavi, Ali Javad; Maracy, Mohammad Reza; Zaker, Mohammad Masoud

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. Smoking is the number one cause of COPD; however, genetic, environmental and dietary factors contribute to the etiology of this disease. In this study, we assessed the association between three diet quality indices -the Healthy Eating Index-2005 (HEI-2005), the Healthy Eating Index-2010 (HEI-2010), and Mediterranean Diet Score (MED)- and the severity of disease in COPD patients. This cross-sectional study was performed at Rasul-e-Akram Hospital in Tehran on 121 COPD patients with the mean age of (SD) of 66.1(10.9) years. A pulmonary specialist diagnosed all participants based on a spirometry test. They were categorized into four groups (1, 2, 3, 4 stages of disease). Three diet quality indices, spirometry test and determination of disease severity were performed for all the participants. ANCOVA and Kruskal-Wallis test were used to assess the relationship between dietary quality indices and severity of the disease. The relationship between HEI-2010, HEI-2005, MED score, their components and lung function was assessed using a multiple linear regression analysis. All analyses were done using SPSS 18. Reduction of the Healthy Eating Index-2010 and MED score were observed along with the increase in disease severity, but they were not significant. The relationship between the three diet quality indices and lung function showed a significant association between MED score and Forced expiratory volume in one second (FEV1), The Forced Vital Capacity (FVC) (β=2.9, 95% CI (1.1, 4.8), p=0.002), (β=2.8, 95% CI (0.9, 4.8), p=0.007), respectively. Mediterranean dietary pattern and obtaining a better score on HEI-2010 diet were associated with a better lung function test.

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

    OpenAIRE

    Ana Stranjancevic; Iva Bulatovic

    2015-01-01

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

  5. Implementation of quality of care indicators for third-level public hospitals in Mexico

    Directory of Open Access Journals (Sweden)

    Pedro Jesús Saturno-Hernández

    2017-05-01

    Full Text Available Objective. To select, pilot test and implement a set of indi­cators for tertiary public hospitals. Materials and meth­ods. Quali-quantitative study in four stages: identification of indicators used internationally; selection and prioritization by utility, feasibility and reliability; exploration of the quality of sources of information in six hospitals; pilot feasibility and reliability, and follow-up measurement. Results. From 143 indicators, 64 were selected and eight were prioritized. The scan revealed sources of information deficient. In the pilot, three indicators were feasible with reliability limited. Has conducted workshops to improve records and sources of information; nine hospitals reported measurements of a quarter. Conclusions. Eight priority indicators could not be measured immediately due to limitations in the data sources for its construction. It is necessary to improve mechanisms of registration and processing of data in this group of hospital.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    on patients' lives, particularly whether primary prophylaxis implantation may impact adversely on patient-centered outcomes such as quality of life (QoL) and distress. We examined the evidence for a role of ICD indication on these patient-centered outcomes. A literature search was conducted on PubMed and Web......-426 patients across studies, five of seven articles used a prospective design, and follow-up ranged from 2-12 months. No study reported an effect for indication on patient-centered outcomes. There is no evidence to suggest that patients receiving an ICD for primary prophylaxis have subsequent poorer Qo...

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

    OpenAIRE

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mariel GULLIAN-KLANIAN

    2016-01-01

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

  9. A Longitudinal Study of Learning Style Preferences on the Myers-Briggs Type Indicator and Learning Style Inventory

    Science.gov (United States)

    Salter, Daniel W.; Evans, Nancy J.; Forney, Deanna S.

    2006-01-01

    The stability of learning style preferences, as measured by the Myers-Briggs Type Indicator (MBTI) and Learning Style Inventory (LSI), was examined using a configural frequency analysis of differences. Thirteen cohorts (222 graduate students) completed the instruments 3 times during their programs. Implications for use of learning style measures…

  10. Soil quality indicators response to application of hydrophilic polymers to a soil from a sulfide mine.

    Science.gov (United States)

    de Varennes, A; Qu, G; Cordovil, C; Gonçalves, P

    2011-09-15

    In soils impacted by mining activities a vegetal cover is required to protect the site from the erosive forces of water and wind. The success of this objective depends on plant establishment and canopy closure. Polyacryalate polymers aid the growth of crops and indigenous plants in soils from sulfide mines. Soil characteristics change as a consequence of polymer application, but indicators that pinpoint these changes have not been identified yet. Our objectives were to (1) identify the sensitive indicators of changes in soil quality following polymer application, (2) relate these with assessment based on plant growth and soil cover. A mine soil was left unamended or received a characterized polyacrylate, a polyacrylate removed from diapers, or shredded diapers. Biomass of Spergularia purpurea was measured and proportion of soil cover evaluated. Soil enzymes, microbial activity, and respiration were analyzed. Availability of potentially toxic trace elements was estimated by their concentration in shoots. Factor analysis identified three factors that accounted for 94% of the variation in parameters, and the scores separated the four treatments. The indicators with greatest communality were correlated with plant growth and soil cover. The best soil quality indicators were As and Zn in shoots, protease, β-glucosidase, and fructose-induced respiration. It seems that the most important indicators to be used to assess the restoration of sulfide mine soils are those related with bioavailability of trace elements and soil enzymatic activities.

  11. Study on Quality Indicator System of Rhythmic Gymnasts in Analytic Hierarchy Process

    Science.gov (United States)

    Luo, Lin

    2017-08-01

    The rhythmic gymnastics (RG) is a sport item with the direct aim of winning as well as a good ornamental value. The scientific selection by the rhythmic gymnasts is necessary for the success, and also the beginning for the scientific training of the gymnasts in their special training stage. According to RG characteristics and the physical characteristics of the gymnasts, also in combination with the investigations & interviews to the coaches who have years of training experience in RG, the experts & scholars on RG study & teaching in universities, and by referring to relevant documents, this paper established the quality indicator system in analytic hierarchy process (AHP). We summarized and selected several indicators obviously influencing the RG training and divided them into the three types of factors: physical factors, flexibility & strength factors, and speed & dexterity factors, according to which 12 specific indicators, their weights and comprehensive evaluation coefficients. Based on these indicators, we established the quality indicator system of the gymnasts, and developed corresponding software system, providing scientific theoretical basis & practical application basis for the selection & evaluation of the gymnasts.

  12. The effects of instant messaging on the quality of adolescents’ existing friendships: a longitudinal study

    NARCIS (Netherlands)

    Valkenburg, P.M.; Peter, J.

    2009-01-01

    Recent studies suggest that instant messaging (IM) is positively related to the quality of adolescents’ existing friendships. However, most of these studies were based on cross-sectional correlational data. In addition, most studies have focused on direct effects of IM on the quality of friendships

  13. Soil phosphorus forms as quality indicators of soils under different vegetation covers.

    Science.gov (United States)

    Turrión, María-Belén; López, Olga; Lafuente, Francisco; Mulas, Rafael; Ruipérez, César; Puyo, Alberto

    2007-05-25

    The type of vegetation cover determines the physicochemical and biological properties of the soil over which they are developing. The objective of this study was to determine the effect of different vegetation covers on the forms of soil phosphorus, in order to know which of these forms can be used as a soil quality indicator. The experimental area was located on the acidic plateau at the North of Palencia (North Spain), where an area was selected vegetation covers very close to each other: pine (Pinus sylvestris), oak (Quercus pyrenaica), and three different shrub species (Arctostaphylos uva-ursi, Erica australis and Halimium alyssoides). The Ah horizon was sampled and pH, total organic C (C(org)), total N (N), cationic exchange capacity (CEC), sum of bases (S) and P forms by a sequential fractionation were analysed. Results showed that oak and A. uva-ursi improve the considered soil parameters (pH, C(org)/N ratio, CEC, and S) and provide soils of better quality. Inorganic soil P forms were influenced in greater extent by the vegetation cover than were P organic forms. Labile inorganic P forms could be used as indicators of soil quality. The organic P forms were less sensitive than inorganic ones to the indicated improvements.

  14. Nursing students' evaluation of quality indicators during learning in clinical practice.

    Science.gov (United States)

    Jansson, Inger; Ene, Kerstin W

    2016-09-01

    A supportive clinical learning environment is important for nursing students' learning. In this study, a contract between a county and a university involving a preceptor model of clinical education for nursing students is described. The aim of this study was to describe nursing students' clinical education based on quality indicators and to describe the students' experiences of what facilitated or hindered the learning process during their clinical practice. During autumn 2012 and spring 2013, 269 student evaluations with quantitative and qualitative answers were filled out anonymously. Quantitative data from the questionnaires concerning the quality indicators: Administration/information, Assessments/examinations and Reflection were processed to generate descriptive statistics that revealed gaps in what the preceptor model demands and what the students reported. The answers from the qualitative questions concerning the quality indicator Learning were analysed using content analysis. Four categories emerged: Independence and responsibility, continuity of learning, time, and the competence and attitudes of the staff. The study underlines that reflection, continuity, communication and feedback were important for the students' learning process, whereas heavy workload among staff and being supervised by many different preceptors were experienced as stressful and hindering by students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Amino acid quality indices of the leaves ofClerodendrum volubile

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

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

    Science.gov (United States)

    Scott, I; Youlden, D; Coory, M

    2004-01-01

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

  17. [Assessment of quality indicators in pediatric poisoning in an emergency service].

    Science.gov (United States)

    Giménez Roca, C; Martínez Sánchez, L; Calzada Baños, Y; Trenchs Sainz de la Maza, V; Quintilla Martínez, J M; Luaces Cubells, C

    2014-01-01

    Assessment of quality indicators allows clinicians to evaluate clinical assistance with a standard, to detect deficiencies and to improve medical assistance. Patients who came to emergency services of a tertiary level hospital for suspicion of poisoning from January 2011 to June 2012 were assessed using 20 quality indicators of pediatric poisoning. Data collection was performed by retrospective review of clinical reports. A total of 393 patients were admitted for suspicion of poisoning (0.3% of all admissions).The standard was reached in 11 indicators and not reached in 6: administration of activated charcoal within 2hours of poison ingestion (standard=90%, result=83.5%); attention within the first 15minutes of arriving in the emergency service (standard=90%, result=60.4%); start of gastrointestinal decontamination within 20minutes of arrival in emergency services (standard=90%, result=29.7%); performing of electrocardiogram on the patients poisoned with cardiotoxic substances (standard=95%, result=87%); judicial communication of cases of poisoning that could conceal a crime (standard=95%, result=31.3%), and collection of the minimal set of information of poisoned patients (standard=90%, result=1.9%). Three indicators could not be evaluated as a consequence of the limited number of cases where they could be applied (<5). The main deficiencies are related to delay in assistance, collection of information and completion of judicial reports. Giving these patients priority, designing a checklist to collect the main points of their management, and creating obligatory fields for data in computerized medical records, are the main actions available to achieve pediatric poisoning quality indicators in this emergency service. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Analysis of the longitudinal handling qualities and pilot-induced-oscillation tendencies of the High-Angle-of-Attack Research Vehicle (HARV)

    Science.gov (United States)

    Hess, Ronald A.

    1994-01-01

    The NASA High-Angle-of Attack Research Vehicle (HARV), a modified F-18 aircraft, experienced handling qualities problems in recent flight tests at NASA Dryden Research Center. Foremost in these problems was the tendency of the pilot-aircraft system to exhibit a potentially dangerous phenomenon known as a pilot-induced oscillation (PIO). When they occur, PIO's can severely restrict performance, sharply dimish mission capabilities, and can even result in aircraft loss. A pilot/vehicle analysis was undertaken with the goal of reducing these PIO tendencies and improving the overall vehicle handling qualities with as few changes as possible to the existing feedback/feedforward flight control laws. Utilizing a pair of analytical pilot models developed by the author, a pilot/vehicle analysis of the existing longitudinal flight control system was undertaken. The analysis included prediction of overall handling qualities levels and PIO susceptability. The analysis indicated that improvement in the flight control system was warranted and led to the formulation of a simple control stick command shaping filter. Analysis of the pilot/vehicle system with the shaping filter indicated significant improvements in handling qualities and PIO tendencies could be achieved. A non-real time simulation of the modified control system was undertaken with a realistic, nonlinear model of the current HARV. Special emphasis was placed upon those details of the command filter implementation which could effect safety of flight. The modified system is currently awaiting evaluation in the real-time, pilot-in-the-loop, Dual-Maneuvering-Simulator (DMS) facility at Langley.

  19. Developing quality indicators for the appropriateness of resuscitation in prehospital atraumatic cardiac arrest.

    Science.gov (United States)

    Grudzen, Corita R; Liddicoat, Rebecca; Hoffman, Jerome R; Koenig, William; Lorenz, Karl A; Asch, Steven M

    2007-01-01

    The vast majority of out-of-hospital cardiac arrest victims do not survive or suffer severe neurological impairment. We sought to develop a set of straightforward clinical indicators that paramedics could use to better match resuscitation attempts to those most likely to benefit. In partnership with the Los Angeles County Emergency Medical Services, we used the RAND/UCLA appropriateness method of quantifying expert opinion regarding the risks and benefits of medical procedures. We presented available scientific evidence related to potential indicators of the quality of resuscitative care to stakeholder-nominated experts. Forty-one candidate indicators incorporated key variables, including initial rhythm, patient preferences, presence of witnesses, and place of arrest. Nine panelists, including palliative care and emergency medical specialists, rated the appropriateness of paramedic use of each indicator by using a 1-9 scale. An indicator was considered appropriate if the potential benefits outweighed the potential harm to the patient or their family. Indicators were retained if median score was >/=7. The expert panel voted to retain 28 quality indicators. Three addressed signs of irreversible death (e.g., dependent lividity), 8 addressed patient preferences (e.g., inquiring about DNR status), and the remainder addressed combinations of initial rhythm and other prognostic signs (e.g., "If initial rhythm is asystole and patient is known by apparent surrogate decision maker to have a terminal illness, then forgo resuscitation."). Our experts recommended a series of much more liberal criteria for forgoing resuscitation than is currently practiced. This includes ascertaining and honoring patient preferences, either through written documents or family members, and combinations of clinical criteria that predict poor neurological outcome, such as asystole, terminal illness, age greater than 70, and response time greater than 15 minutes. These quality indicators expand on

  20. Longitudinal changes in drug use severity and physical health-related quality of life among untreated stimulant users.

    Science.gov (United States)

    Borders, Tyrone F; Booth, Brenda M; Falck, Russel S; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G

    2009-11-01

    The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8 Health Survey and drug, alcohol, and psychiatric severity were all assessed with the Addiction Severity Index (ASI). Random coefficient regression analyses were conducted to test for longitudinal associations between the independent variables and SF-8 PCS scores. Reductions in drug use severity over time were accompanied by only minor improvements in SF-8 PCS scores, underscoring the potential long-term harm of illicit drug use on physical health. Greater psychiatric severity was strongly associated with lower SF-8 PCS scores, suggesting that clinical attention to mental health issues could potentially lead to improvements in perceived physical health as well as among stimulant users.

  1. Longitudinal evaluation of the impact of dental caries treatment on oral health-related quality of life among schoolchildren.

    Science.gov (United States)

    de Paula, Janice S; Sarracini, Karin L M; Meneghim, Marcelo C; Pereira, Antônio C; Ortega, Edwin M M; Martins, Natália S; Mialhe, Fábio L

    2015-06-01

    This study aimed to evaluate the impact of dental caries treatment on oral health-related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ8-10 ) instrument. Brazilian schoolchildren, 8-10 yr of age, were randomly selected and assigned to two groups--dental caries treatment (DCT) and caries-free (CF)--according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥ 0]. The CPQ8-10 instrument was administered at baseline and at 4 wk of follow-up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ8-10 scores were observed between the baseline and follow-up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8-10 scores. Responsiveness of the CPQ8-10 instrument (magnitude of change in CPQ8-10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ8-10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.

  2. A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol

    Directory of Open Access Journals (Sweden)

    Weggelaar Anne-Marie

    2011-10-01

    Full Text Available Abstract Background although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. Methods/design in-depth multi-level (macro, meso and micro-system analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes and quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient complaints and claims. Discussion the protocol is based on the premise that

  3. A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol

    Science.gov (United States)

    2011-01-01

    Background although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER) study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. Methods/design in-depth multi-level (macro, meso and micro-system) analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient complaints and claims). Discussion the protocol is based on the premise that future research, policy

  4. An objective framework to test the quality of candidate indicators of good environmental status

    Directory of Open Access Journals (Sweden)

    Ana M Queiros

    2016-05-01

    Full Text Available Large efforts are on-going within the EU to prepare the Marine Strategy Framework Directive’s (MSFD assessment of the environmental status of the European seas. This assessment will only be as good as the indicators chosen to monitor the eleven descriptors of good environmental status (GEnS. An objective and transparent framework to determine whether chosen indicators actually support the aims of this policy is, however, not yet in place. Such frameworks are needed to ensure that the limited resources available to this assessment optimize the likelihood of achieving GEnS within collaborating states. Here, we developed a hypothesis-based protocol to evaluate whether candidate indicators meet quality criteria explicit to the MSFD, which the assessment community aspires to. Eight quality criteria are distilled from existing initiatives, and a testing and scoring protocol for each of them is presented. We exemplify its application in three worked examples, covering indicators for three GEnS descriptors (1, 5 and 6, various habitat components (seaweeds, seagrasses, benthic macrofauna and plankton, and assessment regions (Danish, Lithuanian and UK waters. We argue that this framework provides a necessary, transparent and standardized structure to support the comparison of candidate indicators, and the decision-making process leading to indicator selection. Its application could help identify potential limitations in currently available candidate metrics and, in such cases, help focus the development of more adequate indicators. Use of such standardized approaches will facilitate the sharing of knowledge gained across the MSFD parties despite context-specificity across assessment regions, and support the evidence-based management of European seas.

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

    Directory of Open Access Journals (Sweden)

    Esperanza Gil-Jiménez

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

  6. Macroinvetebrate Assemblages as Indicators of Water Quality of the West Seti River, Bajhang, Nepal

    Directory of Open Access Journals (Sweden)

    Mohana Matangulu

    2017-08-01

    Full Text Available Water quality of the West Seti River, a tributary of the Karnali in West Nepal was assessed using macroinvertebrates as bioindicators. The main objective of the study was to assess the ecological water quality of the West Seti River and to generate a baseline data on macroinvertebrate assemblages. The sampling was conducted during December 2015 and a total of 11 sampling sites were selected from the West Seti River and its tributaries. Qualitative samples of macroinvertebrates were collected from different habitats. Selected physico-chemical parameters such as pH and temperature were estimated on-site. Dissolved oxygen (DO was estimated by Winkler’s method. The macroinvertebrate samples were enumerated and identified up to Family level following standard literature. Chi-square test was performed to see whether macroinvertebrate taxa varied significantly along the altitudinal gradient and between the West Seti River and its tributaries. An ecological assessment tool Nepalese Biotic Score/ Average Score Per Taxon (NEPBIOS/ASPT was applied to assess the water quality of the sampling sites. The pH value ranged from 7.9 to 8.7 indicating the alkaline nature of the river. A total of 1666 individuals belonging to 34 Families and 7 Orders of macro-invertebrates were observed. The highest diversity of the macroinvertebrate taxa was observed at site T5 with nineteen Families whereas the lowest taxa diversity was observed at R3 with only five Families. The variation in macroinvertebrate assemblages between the sub-tropical and temperate zones; and the West Seti River and its tributaries were not significant. NEPBIOS/ASPT revealed a score of Water Quality Class of III-IV at Site R3 indicating that the site was polluted. This site was characterized by the abundance of red Chironomids which are considered as the indicators of organic pollution.International Journal of EnvironmentVolume-6, Issue-3, Jun-Aug 2017, page: 25-45

  7. Quality management indicators for tissue banks: an operative model from the period of 2002-2007.

    Science.gov (United States)

    Saldías, M; Alvarez, I; Pérez Campos, H; Sánchez, G; Acosta, M

    2009-10-01

    The purpose of this study was to determine a specific indicator model to evaluate the Quality Management System (QMS) in Tissue Banks (TB) for deceased and/or live donors. Quantitative Indicators for Quality Management are considered for deceased donors as the origin of therapeutic tissues. A glossary of definitions was established (also applicable for tissues from live donors): Deceased Therapeutic Real Donors (DTRD), donors that were processed and at least 1 tissue was harvested for a therapeutic purpose; Deceased Effective Donors (DED), DTRD in which 1 or more tissues were validated, stored, and/or grafted; Processed Tissues (PT), number of tissues harvested from a DTRD, which were processed and counted as final product units; Validated Tissues (VT), number of tissues as final product units, which fulfilled quality criteria to be grafted; Grafted Tissues (GT), number of transplanted tissues for therapeutic purposes; and Grafted Patients (GP), number of patients who were grafted with validated tissues. MANAGEMENT QUANTITATIVE INDICATORS: Deceased donors were considered from 2002 to 2007. The total number of tissues was 15,363: Productivity Index (PI), PI = DED/DTRD; Processing Quality Rate (PQR), PQR = VT/PT%; Productivity Efficiency per Donor (PED), PED = VT/DED; Grafted Tissues Coefficient (GTC), GTC = GT/VT; and Grafted Patients Index per Donor (GID), GID = GP/DED. Results were as follows: PI = 0.80; PQR = 76%; PED = 30.99; GTC = 0.93; and GID = 4. In our study, 80% of DTRD produced VT (PI = 0.80), which represented 76% of PT (average, 31 final products per donor). Also, 93% of the VT were grafted with 5 patients grafted per donor. Defined variables resulted in useful tools to evaluate QMS in a TB.

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

    Directory of Open Access Journals (Sweden)

    Uhrin Peter

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Diane Banks

    2011-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Ali Pourali

    2014-04-01

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

  11. Indicators for Evaluating the Performance and Quality of Care of Ambulatory Care Nurses.

    Science.gov (United States)

    Rapin, Joachim; D'Amour, Danielle; Dubois, Carl-Ardy

    2015-01-01

    The quality and safety of nursing care vary from one service to another. We have only very limited information on the quality and safety of nursing care in outpatient settings, an expanding area of practice. Our aim in this study was to make available, from the scientific literature, indicators potentially sensitive to nursing that can be used to evaluate the performance of nursing care in outpatient settings and to integrate those indicators into the theoretical framework of Dubois et al. (2013). We conducted a scoping review in three databases (CINAHL, MEDLINE, and EMBASE) and the bibliographies of selected articles. From a total of 116 articles, we selected 22. The results of our study not only enable that framework to be extended to ambulatory nursing care but also enhance it with the addition of five new indicators. Our work offers nurses and managers in ambulatory nursing units indicators potentially sensitive to nursing that can be used to evaluate performance. For researchers, it presents the current state of knowledge on this construct and a framework with theoretical foundations for future research in ambulatory settings. This work opens an unexplored field for further research.

  12. A longitudinal study of emotional adjustment, quality of life and adaptive function in attenuated MPS II

    Directory of Open Access Journals (Sweden)

    Elsa G. Shapiro

    2016-06-01

    Conclusions: Attenuated MPS II patients have increasing somatic disease burden and poor physical quality of life as they develop as well as decreasing self-esteem and sense of adequacy. Psychosocial quality of life, adaptive skills, and attention improve. Recognition of and intervention around these issues will be beneficial to MPS II attenuated patients who have the resources to use such assistance to improve their long-term outcomes.

  13. Requirements and Application Guide for the Use of Quality Indicators in Medical Care: Results of a Systematic Review.

    Science.gov (United States)

    Rode, S; Ries, V; Petzold, T; Buch, U; Untersweg, F; Fischer, B

    2016-09-01

    Background: Quality indicators are employed in the assessment of quality of medical care. Valid measurement and reporting of quality are essential for maintenance and enhancement of high-quality medical care. The aim of this study was to identify the requirements for quality indicators and their successful implementation in routine care. Method: A systematic literature search conducted in Medline using MESH keywords resulted in 573 hits. A complementary hand search additionally identified 153 papers, so that in all 726 abstracts were screened. In conformity with the PRISMA Statement, 83 papers were finally included in this review. Results: Quality criteria are described in 48 publications and requirements for the application of quality indicators in medical care are given in 41 publications. Validity (n=19), feasibility (n=16), reliability (n=15), and interpretability of the quality indicator (n=14) are the most frequently named quality criteria, followed by relevance (n=10), sensitivity (n=8) and risk adjustment (n=6). The most common requirements for the application of quality indicators are integration of quality indicators in the given healthcare setting (n=15) and ability to derive potential improvement (n=11), data validity (n=8), data availability (n=7) as well as acceptance of the measurement in the given setting (n=6). Conclusion: Plausible quality measurements help improve healthcare structures and processes and provide patients and professionals with valid statements on the quality of care. The original articles examined focus primarily on the validity of quality indicators. A consensus on methodological criteria for the development, implementation and application of quality indicators is required. Furthermore, the practical applicability of quality criteria should be tested empirically. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Methodology for analyzing environmental quality indicators in a dynamic operating room environment.

    Science.gov (United States)

    Gormley, Thomas; Markel, Troy A; Jones, Howard W; Wagner, Jennifer; Greeley, Damon; Clarke, James H; Abkowitz, Mark; Ostojic, John

    2017-04-01

    Sufficient quantities of quality air and controlled, unidirectional flow are important elements in providing a safe building environment for operating rooms. To make dynamic assessments of an operating room environment, a validated method of testing the multiple factors influencing the air quality in health care settings needed to be constructed. These include the following: temperature, humidity, particle load, number of microbial contaminants, pressurization, air velocity, and air distribution. The team developed the name environmental quality indicators (EQIs) to describe the overall air quality based on the actual measurements of these properties taken during the mock surgical procedures. These indicators were measured at 3 different hospitals during mock surgical procedures to simulate actual operating room conditions. EQIs included microbial assessments at the operating table and the back instrument table and real-time analysis of particle counts at 9 different defined locations in the operating suites. Air velocities were measured at the face of the supply diffusers, at the sterile field, at the back table, and at a return grille. The testing protocol provided consistent and comparable measurements of air quality indicators between institutions. At 20 air changes per hour (ACH), and an average temperature of 66.3°F, the median of the microbial contaminants for the 3 operating room sites ranged from 3-22 colony forming units (CFU)/m(3) at the sterile field and 5-27 CFU/m(3) at the back table. At 20 ACH, the median levels of the 0.5-µm particles at the 3 sites were 85,079, 85,325, and 912,232 in particles per cubic meter, with a predictable increase in particle load in the non-high-efficiency particulate air-filtered operating room site. Using a comparison with cleanroom standards, the microbial and particle counts in all 3 operating rooms were equivalent to International Organization for Standardization classifications 7 and 8 during the mock surgical

  15. A longitudinal investigation of the role of quantity and quality of child-directed speech in vocabulary development.

    Science.gov (United States)

    Rowe, Meredith L

    2012-01-01

    Quantity and quality of caregiver input was examined longitudinally in a sample of 50 parent-child dyads to determine which aspects of input contribute most to children's vocabulary skill across early development. Measures of input gleaned from parent-child interactions at child ages 18, 30, and 42months were examined in relation to children's vocabulary skill on a standardized measure 1year later (e.g., 30, 42, and 54months). Results show that controlling for socioeconomic status, input quantity, and children's previous vocabulary skill; using a diverse and sophisticated vocabulary with toddlers; and using decontextualized language (e.g., narrative) with preschoolers explains additional variation in later vocabulary ability. The differential effects of various aspects of the communicative environment at several points in early vocabulary development are discussed.

  16. Quality indicators for diagnosis and treatment of respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Plejdrup, Malene; Bjerrum, Lars; Gahrn-Hansen, Bente

    indicators were considered. The experts were asked to rate the relevance of 59 quality indicators with regard to reducing antimicrobial resistance and improving patient health. Consensus for a quality indicator was reached if ≥ 75 % of experts scored the item ≥ 5 on a 7-point Likert scale, ranging from 1...

  17. Are performance indicators used for hospital quality management: a qualitative interview study amongst health professionals and quality managers in The Netherlands.

    NARCIS (Netherlands)

    Botje, D.; Asbroek, G. ten; Plochg, T.; Anema, H.; Kringos, D.S.; Fischer, C.; Wagner, C.; Klazinga, N.S.

    2016-01-01

    Background: Hospitals are under increasing pressure to share indicator-based performance information. These indicators can also serve as a means to promote quality improvement and boost hospital performance. Our aim was to explore hospitals’ use of performance indicators for internal quality

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  19. 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.

  20. VARIABILITY OF VALUES OF PHYSICOCHEMICAL WATER QUALITY INDICES ALONG THE LENGTH OF THE IWONICZANKA STREAM

    Directory of Open Access Journals (Sweden)

    Andrzej Bogdał

    2015-11-01

    Full Text Available The paper aims at presentation of the effect of changes in the catchment area management on the value of water quality physicochemical indices along the length of the Iwoniczanka stream, which flows through Iwonicz-Zdrój, one of the oldest health resorts in Poland. Analyses of 14 water quality indices were conducted from November 2013 to May 2014 in five measurement points: two situated in the upper course of the stream – in forest areas, two located in the area of Iwonicz-Zdrój town, and one below the rural built-up area. On the basis of the conducted data analysis it was found that the mean values of pH, electrolytic conductivity, sulphates, calcium, total iron and manganese were increasing with the course of flowing water, as evidenced by the water enrichment in substances which had their sources in built-up areas. On average, the highest values of biogenic indices and chlorides but the lowest values of oxygen indices were registered immediately below the location of drain collector from the closed sewage treatment plant, which resulted in pollution of the analysed stream bed with the substances previously drained from the treatment plant. Water flowing through the forest areas had the maximum ecological potential in the built-up areas and due to phosphate concentrations it was classified to class II and then, due to self-purification, returned to the physicochemical parameters appropriate for class I water. The conducted hydro-chemical tests confirmed a significant negative effect of built-up areas on the quality of the flowing waters.

  1. Evaluation-of soil enzyme activities as soil quality indicators in sludge-amended soils.

    Science.gov (United States)

    Dindar, Efsun; Şağban, Fatma Olcay Topaç; Başkaya, Hüseyin Savaş

    2015-07-01

    Soil enzymatic activities are commonly used as biomarkers of soil quality. Several organic and inorganic compounds found in municipal wastewater sludges can possibly be used as fertilizers. Monitoring and evaluating the quality of sludge amended soils with enzyme activities accepted as a beneficial practice with respect to sustainable soil management. In the present study, variation of some enzyme activities (Alkaline phosphatase, dehydrogenase, urease and beta-glucosidase activities) in soils amended with municipal wastewater sludge at different application rates (50, 100 and 200 t ha(-1) dry sludge) was evaluated. Air dried sludge samples were applied to soil pots and sludge-soil mixtures were incubated during a period of three months at 28 degrees C. The results of the study showed that municipal wastewater sludge amendment apparently increased urease, dehydrogenase, alkaline phosphatase and P-glucosidase activities in soil by 48-70%, 14-47%, 33-66% and 9-14%, respectively. The maximum activity was generally observed in sludge amended soil with dose of 200 t ha(-1). Urease activity appeared to be a better indicator of soil enhancement with wastewater sludge, as its activity was more strongly increased by sludge amendment. Accordingly, urease activity is suggested to be soil quality indicator best suited for measuring existing conditions and potential changes in sludge-amended soil.

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

    Directory of Open Access Journals (Sweden)

    Kappers EF

    2013-11-01

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

  3. Effects of logging activities on ecological water quality indicators in the Berasau River, Johor, Malaysia.

    Science.gov (United States)

    Nor Zaiha, A; Mohd Ismid, M S; Salmiati; Shahrul Azri, M S

    2015-08-01

    Influence of deforestation on biodiversity of aquatic organisms was investigated in a stream in the Ulu Sedili Forest Reserve. The stream was monitored five (5) times from December 2011 until December 2012 with 2-month intervals. Sampling of benthic communities was carried out using rectangular dip net while water quality study using a YSI ProPlus meter and the rest were done in the laboratory. Physicochemical parameters and water quality index (WQI) calculation showed no significant difference among the investigated events. WQI classified the Berasau River between Class II (good) to III (moderate) of river water quality. In total, 603 individuals representing 25 taxa that were recorded with Decapods from genus Macrobrabchium were widely distributed. Several intolerant taxa, especially Ephemeroptera and Odonata, were also observed in this river. According to Pearson's correlation analysis, the richness and diversity indices were generally influenced by water quality parameters represented by WQI (P < 0.01). In conclusion, logging activities have strong attributes for variation in benthic macroinvertebrate assemblage.

  4. Performance indicators for quality in surgical and laboratory services at Muhimbili National Hospital (MNH) in Tanzania.

    Science.gov (United States)

    Mbembati, Naboth A; Mwangu, Mugwira; Muhondwa, Eustace P Y; Leshabari, Melkizedek M

    2008-04-01

    Muhimbili National Hospital (MNH), a teaching and national referral hospital, is undergoing major reforms to improve the quality of health care. We performed a retrospective descriptive study using a set of performance indicators for the surgical and laboratory services of MNH in years 2001 and 2002, to help monitor and evaluate the impact of reforms on the quality of health care during and after the reform process. Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 (23.5%) operations were postponed. In the year 2002, 4301 non-emergency operations were planned, 3046 were performed and 1255 (29%) were postponed. The most common reasons for operation postponement were "time-barred", interference by emergency operations, no show of patients and inoperable anaesthetic machines. Equipment problems and supply and staff shortages together accounted for one quarter of postponements. In the laboratory, a lack of equipment prevented some tests, but quality assurance was performed for most tests. Current surgical services at MNH are inadequate; operating theatres require modern, functioning equipment and adequate supplies of consumables to provide satisfactory care.

  5. Intercorrelation between immunological biomarkers and job stress indicators among female nurses: A nine-month longitudinal study

    Directory of Open Access Journals (Sweden)

    Hyung-Suk eYoon

    2014-10-01

    Full Text Available Some immunological biomarkers have been reported to be associated with job stress. This study was conducted to explore an intercorrelation between the psychological components of job stress and various immunological biomarkers among female nurses. To assess monthly and weekly job stress, 41 nurses had repeatedly completed the questionnaires such as the GJSQ, the POMS and the CES-D. Using flow cytometry and radioimmunoassay, the number of white blood cells, lymphocytic proliferation to mitogens, and toxoid were measured. Moreover, the levels of hydrocortisol, IL-b, INF-r, and TNF-a and salivary IgA were eveluated by enzyme-linked immunosorbent assay. When the Pearson correlation coefficients between job stress and immunological biomarkers were estimated after adjusting for age and smoking status, Clashes: conflict at work was significantly related to the number of CD4 cells (r = 0.36, p-value < 0.05, CD4 to CD8 ratio (0.35; < 0.05, response to concanavalin A (0.42; < 0.05, and phytohemagglutinin (0.35; < 0.05. Additionally, the level of hydrocortisol was significantly related to seven psychosocial measures; i.e., role conflict (-0.47; < 0.01, role ambiguity (-0.39; < 0.05, clashes at work (-0.38; < 0.05, control & influence at work (0.53; < 0.01, task control (0.55; < 0.001, resources at work (0.35; < 0.05, and skill underutilization (0.43; < 0.05. The results indicate that 1 the psychological job stress is associated with the levels of some immunological biomarkers in nurses; and 2 especially, hydrocortisol shows a remarkable relationship with diverse job stress indicators.

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

    Directory of Open Access Journals (Sweden)

    Dagmar Willamowius Vituri

    2014-04-01

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

  7. Development of a new quality fair access best value performance indicator (BVPI) for recycling services.

    Science.gov (United States)

    Harder, M K; Stantzos, N; Woodard, R; Read, A

    2008-01-01

    Recycling schemes are being used worldwide to reduce the impact of municipal waste. Those using public funds are usually obliged to set performance indicators by which the standards of such schemes can be measured. In the UK, a set of statutory Best Value Performance Indicators (BVPI) must be reported annually, such as the Quality of Fair Access, which monitors the public's access to recycling facilities within 1000 m (known as BVPI 91). This work shows that BVPI 91, and performance indicators like it, quantify only very basic recycling services. A much more sensitive performance indicator is developed in this paper, labelled as the Maximum Practicable Recycling Rate Provision (MPRRP) achievable by a local authority. It indicates the percentage of local waste that could be reasonably recycled using the services provided, calculated on the basis of the average composition of the local waste, the local population coverage for collection of any materials, and nationally provided information stating how much of each material stream is generally suitable (practical) for recycling. Evidence for the usefulness of this new quantity is presented. Although this paper refers a particular performance indicator in the UK, its findings are applicable to all urban areas worldwide needing to monitor recycling service. Furthermore, the MPRRP could be used for planning purposes, and for determining the level of performance of an existing service, by comparing its predicted recycling rate to that actually obtained. Further work is now being carried out on this.

  8. Quality of life and sense of coherence in young people and adults with uncomplicated epilepsy: A longitudinal study.

    Science.gov (United States)

    Persenius, Mona; Rystedt, Ingrid; Wilde-Larsson, Bodil; Bååth, Carina

    2015-06-01

    The aim of the study was, in a ten-year follow-up, to describe and explore potential changes in quality of life and sense of coherence in relation to gender differences among persons with epilepsy in the transition from adolescence to adulthood. A longitudinal study of sense of coherence (SOC) and quality of life with repeated measurement design (1999, 2004, and 2009) was conducted in a population of persons (n = 69) who were aged 13-22 years in 1999 and 23-33 years in 2009. The Quality-of-Life Index (QLI) and the Sense of Coherence (SOC) scale were used. There was a significant decrease (p ≤ 0.001) in seizures compared with the 2004 results, mainly among the women (p = 0.003). When comparing the total QLI scores, no significant differences were found between the three data collections and there were no differences in total scores between men and women. There was a decrease in the SOC total score over the 10-year period study. Total SOC was significantly higher among those being 30-33 years old compared to those being 23-29 years old (p = 0.014) and among those having a driving license (p = 0.029) compared to those not having a driving license. Both quality of life and sense of coherence are important for maintaining health and well-being. Promoting health and well-being requires effective high-quality multidisciplinary person-centered care. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Stamenković S.M.

    2013-01-01

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

  11. An effective system to measure and report quality indicators in acute medical units.

    Science.gov (United States)

    Atkinson, J; Barton, L; Harrison, A; Roper, N

    2012-01-01

    The Society for Acute Medicine has developed a number of clinical quality indicators by which all UK Acute Medicine Units can bench mark their activity. These will help to ensure high quality care for patients, inform the continuing development of acute medical services and demonstrate the positive impact of this new specialty. Prospective collection of these data may be a challenge for many busy units. This paper describes a local solution developed in house in a North East hospital. It demonstrates how the data collected can be analysed to assess the effect of changes in consultant presence on the unit and also time taken for patients to be seen by a doctor. The limitations of the system and potential for future development are considered.

  12. Are performance indicators used for hospital quality management: a qualitative interview study amongst health professionals and quality managers in The Netherlands

    OpenAIRE

    Botje, D; Asbroek, G. ten; Plochg, T; Anema, H.; Kringos, D.S.; C. Fischer; Wagner, C.; Klazinga, N. S.

    2016-01-01

    Background: Hospitals are under increasing pressure to share indicator-based performance information. These indicators can also serve as a means to promote quality improvement and boost hospital performance. Our aim was to explore hospitals’ use of performance indicators for internal quality management activities. Methods: We conducted a qualitative interview study among 72 health professionals and quality managers in 14 acute care hospitals in The Netherlands. Concentrating on orthopaedic an...

  13. Effects of nephrectomy on respiratory function and quality of life of living donors: a longitudinal study

    Science.gov (United States)

    Moraes, Karen; Paisani, Denise M.; Pacheco, Nathália C. T.; Chiavegato, Luciana D.

    2015-01-01

    BACKGROUND: A living donor transplant improves the survival and quality of life of a transplant patient. However, the impact of transplantation on postoperative lung function and respiratory muscular strength in kidney donors remains unknown. OBJECTIVE: To evaluate pulmonary function, respiratory muscle strength, quality of life and the incidence of postoperative pulmonary complications (PPCs) in kidney donors undergoing nephrectomy. METHOD: This prospective cohort enrolled 110 consecutive kidney donors undergoing nephrectomy. Subjects underwent pulmonary function (using spirometry) and respiratory muscular strength (using manovacuometry) assessments on the day prior to surgery and 1, 2, 3 and 5 days postoperatively. Quality of life (measured by the SF-36) was evaluated preoperatively and 30 days postoperatively. PPCs were assessed daily by a blinded assessor. RESULTS: Donors exhibited a decrease of 27% in forced vital capacity, 58% in maximum inspiratory capacity and 51% in maximum expiratory pressure on the 1stpostoperative day (p<0.001) but this improved over days 2, 3 and 5 but had not returned to preoperative levels. Patient quality of life was still impaired at 30 days with regards to functional capacity, physical role, pain, vitality and social functioning (p<0.05) but these parameters improved slowly. None of the patients developed PPCs. CONCLUSION: Kidney donors submitted to nephrectomy exhibited a reduction in pulmonary function, respiratory muscular strength and quality of life, most of which were improving toward pre-surgical levels. PMID:26443973

  14. Sleep quality and duration are related to microvascular function: the Amsterdam Growth and Health Longitudinal Study.

    Science.gov (United States)

    Bonsen, Thomas; Wijnstok, Nienke J; Hoekstra, Trynke; Eringa, Etto C; Serné, Erik H; Smulders, Yvo M; Twisk, Jos W R

    2015-04-01

    Sleep and sleep disorders are related to cardiovascular disease, and microvascular function is an early cardiovascular disease marker. Therefore, the relationship of sleep (measured in sleep quality and duration) with microvascular function was examined in healthy adults. Sleep quality was assessed with the validated Sleep Wake Experience List (SWEL) questionnaire. Duration of sleep was self-reported in an additional question. Microvascular function was measured using nailfold capillaroscopy. Linear regression analyses were used to examine the relationship between sleep and microvascular function. Potential confounders included physical activity, smoking, blood pressure, body mass index and several biochemical parameters. Analyses were performed in 259 participants (116 men). For women reporting insufficient (sleep duration, microvascular function (post-ischaemic capillary recruitment) was significantly lower (b = -11.17; P = 0.04) compared to women reporting sufficient sleep duration. There was no relationship between sleep quality and microvascular function in females. In males, a trend towards lower capillary recruitment was found in those reporting a combination of poor sleep quality and insufficient duration (b = -7.54; P = 0.09), compared to those reporting good sleep quality as well as sufficient duration. This study suggests an association between sleep and microvascular function. Which aspects of sleep exactly affect microvascular function, and if indeed the association is different between males and females in other samples, needs further research.

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

    Directory of Open Access Journals (Sweden)

    Armstrong David

    2006-11-01

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

  16. Key Performance Indicators in the Evaluation of the Quality of Radiation Safety Programs.

    Science.gov (United States)

    Schultz, Cheryl Culver; Shaffer, Sheila; Fink-Bennett, Darlene; Winokur, Kay

    2016-08-01

    Beaumont is a multiple hospital health care system with a centralized radiation safety department. The health system operates under a broad scope Nuclear Regulatory Commission license but also maintains several other limited use NRC licenses in off-site facilities and clinics. The hospital-based program is expansive including diagnostic radiology and nuclear medicine (molecular imaging), interventional radiology, a comprehensive cardiovascular program, multiple forms of radiation therapy (low dose rate brachytherapy, high dose rate brachytherapy, external beam radiotherapy, and gamma knife), and the Research Institute (including basic bench top, human and animal). Each year, in the annual report, data is analyzed and then tracked and trended. While any summary report will, by nature, include items such as the number of pieces of equipment, inspections performed, staff monitored and educated and other similar parameters, not all include an objective review of the quality and effectiveness of the program. Through objective numerical data Beaumont adopted seven key performance indicators. The assertion made is that key performance indicators can be used to establish benchmarks for evaluation and comparison of the effectiveness and quality of radiation safety programs. Based on over a decade of data collection, and adoption of key performance indicators, this paper demonstrates one way to establish objective benchmarking for radiation safety programs in the health care environment.

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Juan Esteban Baridón

    2014-12-01

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

  19. Do daily ward interviews improve measurement of hospital quality and safety indicators? A prospective observational study.

    Science.gov (United States)

    Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Mitchell, Deb; O'Brien, Lisa; May, Kerry; Ghaly, Marcelle; Ho, Melissa; Haines, Terry P

    2016-10-01

    The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under-reporting of hospital quality and safety indicators in incident reporting systems. A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub-acute and acute medical assessment unit. An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% (n = 72), pressure injuries by 21.7% (n = 48) and rapid response medical team calls by 12.7% (n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday (P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday (P = 0.01). Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under-reported in incident reporting systems, with variability in under-reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety

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

    Directory of Open Access Journals (Sweden)

    Tahira, Muzammil

    2014-12-01

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

  1. High quality ZnO layers with adjustable refractive indices for integrated optics applications

    OpenAIRE

    Heideman, R.G.; Lambeck, P.V.; Gardeniers, J.G.E.

    1995-01-01

    Thin ( 1 μm) crystalline ZnO films with a good optical quality and good (0002) texture are grown under two considerably different process parameter sets using a r.f. planar magnetron sputtering unit. The optical parameters of the two corresponding ZnO layers are distinctly different: high refractive index ( 2.0 at λ = 632.8 nm) ZnO films resembling the single crystal form, and ZnO films with considerably lower (typical difference 0.05) refractive indices. The refractive index of the latter Zn...

  2. Assessment of physical and chemical indicators of sandy soil quality for sustainable crop production

    Science.gov (United States)

    Lipiec, Jerzy; Usowicz, Boguslaw

    2017-04-01

    Sandy soils are used in agriculture in many regions of the world. The share of sandy soils in Poland is about 55%. The aim of this study was to assess spatial variability of soil physical and chemical properties affecting soil quality and crop yields in the scale of field (40 x 600 m) during three years of different weather conditions. The experimental field was located on the post glacial and acidified sandy deposits of low productivity (Szaniawy, Podlasie Region, Poland). Physical soil quality indicators included: content of sand, silt, clay and water, bulk density and those chemical: organic carbon, cation exchange capacity, acidity (pH). Measurements of the most soil properties were done at spring and summer each year in topsoil and subsoil layer in 150 points. Crop yields were evaluated in places close to measuring points of the soil properties. Basic statistics including mean, standard deviation, skewness, kurtosis minimal, maximal and correlations between the soil properties and crop yields were calculated. Analysis of spatial dependence and distribution for each property was performed using geostatistical methods. Mathematical functions were fitted to the experimentally derived semivariograms that were used for mapping the soil properties and crop yield by kriging. The results showed that the largest variations had clay content (CV 67%) and the lowest: sand content (5%). The crop yield was most negatively correlated with sand content and most positively with soil water content and cation exchange capacity. In general the exponential semivariogram models fairly good matched to empirical data. The range of semivariogram models of the measured indicators varied from 14 m to 250 m indicate high and moderate spatial variability. The values of the nugget-to-sill+nugget ratios showed that most of the soil properties and crop yields exhibited strong and moderate spatial dependency. The kriging maps allowed identification of low yielding sub-field areas that

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

    Science.gov (United States)

    Gort, Marjan; Broekhuis, Manda; Regts, Gerdien

    2013-11-01

    A crucial issue in healthcare is how multidisciplinary teams can use indicators for quality improvement. Such teams have increasingly become the core component in both care delivery and in many quality improvement methods. This study aims to investigate the relationships between (1) team factors and the way multidisciplinary teams use indicators for quality improvement, and (2) both team and process factors and the intended results. An in-depth, multiple-case study was conducted in the Netherlands in 2008 involving four breast cancer teams using six structure, process and outcome indicators. The results indicated that the process of using indicators involves several stages and activities. Two teams applied a more intensive, active and interactive approach as they passed through these stages. These teams were perceived to have achieved good results through indicator use compared to the other two teams who applied a simple control approach. All teams experienced some difficulty in integrating the new formal control structure, i.e. measuring and managing performance, in their operational task, and in using their 'new' managerial task to decide as a team what and how to improve. Our findings indicate the presence of a network of relationships between team factors, the controllability and actionability of indicators, the indicator-use process, and the intended results. Copyright © 2013. Published by Elsevier Ltd.

  4. Quality of life among prostate cancer patients : A prospective longitudinal population-based study

    NARCIS (Netherlands)

    Schaake, Wouter; de Groot, Martijn; Krijnen, Wim P.; Langendijk, Johannes A.; van den Bergh, Alfons C. M.

    2013-01-01

    Purpose: To investigate the course of quality of life (QoL) among prostate cancer patients treated with external beam radiotherapy and to compare the results with QoL of a normal age-matched reference population. Patients and methods: The study population was composed of 227 prostate cancer patients

  5. 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…

  6. Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal Analysis

    Science.gov (United States)

    Kim, Hongsoo; Harrington, Charlene; Greene, William H.

    2009-01-01

    Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…

  7. Depressive Symptoms and Romantic Relationship Qualities from Adolescence through Emerging Adulthood: A Longitudinal Examination of Influences

    Science.gov (United States)

    Vujeva, Hana M.; Furman, Wyndol

    2011-01-01

    Research has consistently demonstrated the negative consequences of depression on adolescents' functioning in peer and family relationships, but little work has examined how depressive symptoms affect the quality of adolescents' and emerging adults' romantic relationships. Five waves of data on depressive symptoms, romantic relationship conflict,…

  8. A Longitudinal Study of Total Quality Management Processes in Business Colleges.

    Science.gov (United States)

    Vazzana, Gary; Elfrink, John; Bachmann, Duane P.

    2000-01-01

    Surveys of business school deans in 1995 (n=243) and 1998 (n=151) regarding total quality management (TQM) practices revealed increases in mission and strategy development, goal setting, and use of advisory boards and cross-functional teams. Few are using TQM to manage core learning processes. (SK)

  9. Classroom Friends and Very Best Friends: A Short-Term Longitudinal Analysis of Relationship Quality

    Science.gov (United States)

    McChristian, Chrystal L.; Ray, Glen E.; Tidwell, Pamela S.; LoBello, Steven G.

    2012-01-01

    Second-, third-, fifth-, and sixth-grade children evaluated relationship qualities of a self-nominated friend and a self-nominated very best friend over a 6-month school year period. Results demonstrated that 76% of the friend relationships and 50% of the very best friend relationships were maintained over the course of the study. Children in…

  10. A Cybernetic Approach to Assess the Longitudinal Handling Qualities of Aeroelastic Aircraft

    NARCIS (Netherlands)

    Damveld, H.J.

    2009-01-01

    The future demand for larger and lighter civil transport aircraft leads to more flexible aircraft, which bring their own controlling and handling problems. A review of established handling qualities methods showed that they were either unsuitable for aeroelastic aircraft, or had significant

  11. A Longitudinal Study of Total Quality Management Processes in Business Colleges.

    Science.gov (United States)

    Vazzana, Gary; Elfrink, John; Bachmann, Duane P.

    2000-01-01

    Surveys of business school deans in 1995 (n=243) and 1998 (n=151) regarding total quality management (TQM) practices revealed increases in mission and strategy development, goal setting, and use of advisory boards and cross-functional teams. Few are using TQM to manage core learning processes. (SK)

  12. A Longitudinal Sociological Monitoring of Customers' Satisfaction with the Quality of Educational Services

    Science.gov (United States)

    Gaidukova, G. N.

    2014-01-01

    Research data on levels of satisfaction with educational services in a Russian university show room for improvement in such areas as vocational guidance work; range of opportunities in the choice of specialization and optional disciplines; availability of academic and methodological literature; the quality of food services; and amount of practical…

  13. Depressive Symptoms and Romantic Relationship Qualities from Adolescence through Emerging Adulthood: A Longitudinal Examination of Influences

    Science.gov (United States)

    Vujeva, Hana M.; Furman, Wyndol

    2011-01-01

    Research has consistently demonstrated the negative consequences of depression on adolescents' functioning in peer and family relationships, but little work has examined how depressive symptoms affect the quality of adolescents' and emerging adults' romantic relationships. Five waves of data on depressive symptoms, romantic relationship conflict,…

  14. Longitudinal analysis on the development of hospital quality management systems in the Netherlands.

    NARCIS (Netherlands)

    Dückers, M.; Makai, P.; Vos, L.; Groenewegen, P.; Wagner, C.

    2009-01-01

    OBJECTIVE: Many changes have been initiated in the Dutch hospital sector to optimize health-care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment combinations, intensified monitoring of quality and a multi-

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

    Science.gov (United States)

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

    2015-01-01

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

  16. A Longitudinal Sociological Monitoring of Customers' Satisfaction with the Quality of Educational Services

    Science.gov (United States)

    Gaidukova, G. N.

    2014-01-01

    Research data on levels of satisfaction with educational services in a Russian university show room for improvement in such areas as vocational guidance work; range of opportunities in the choice of specialization and optional disciplines; availability of academic and methodological literature; the quality of food services; and amount of practical…

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Science.gov (United States)

    Duriscoe, Dan M.

    2016-09-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Sarma Nandini

    2015-08-01

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

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

    Science.gov (United States)

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

    1999-01-01

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

  2. NHS values, compassion and quality indicators for relationship based person-centred healthcare

    Science.gov (United States)

    Cox, John

    2015-01-01

    The paper by Gilbert et al. should be on the table of every politician and National Health Service (NHS) manager in the run up to the general election, when the NHS is at the hustings. They have raised profound moral dilemmas of the internal and external market in their present form, such as the practicalities of distributive justice and the enhancement of autonomy – to which are added the preservation of personhood, the values of listening, the maintenance of altruism and the origins of compassion. It is asserted that the quality of healthcare is dependent on the quality of the caring relationship between healthcare staff members, and between staff and patients. The nature of Compassionate Resilience is outlined with respect to Health Visitor training – and the contribution of faith communities to public health is also considered. The four Quality Indicators of an enabling environment first proposed by Cox and Gray are summarised, and the need for increased conceptual clarity of these key values recognised. PMID:26029903

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

    Directory of Open Access Journals (Sweden)

    Ana Stranjancevic

    2015-12-01

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

  4. Analysis of Clinical Indicators of Quality in Patients with Endotracheal intubation.

    Science.gov (United States)

    Dash, Sulochana; Balasubramanian, Sreelatha

    2017-06-01

    Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same. This retrospective study was conducted at our institute over a period of 12 months and 709 case records of patients were reviewed. Patients aged 14 years and more belonging to all ASA groups undergoing abdominal surgeries for general and obstetric and gynaecological causes under General Anaesthesia (GA) with endotracheal intubation posted for both elective and emergency surgeries were included in the study. Demographic details including name, age, sex, hospital number, height, weight, body mass index, type of surgery, nature of surgery, duration, American Society of Anaesthesiologists (ASA) physical status were recorded and presence or absence of clinical indicators of quality (presence of cannot intubate cannot ventilate scenario, occurrence of dental injury, episode of non cardiogenic pulmonary oedema, incidents of residual neuromuscular blockade, existence of aspiration pneumonia, unplanned ICU/HDU admissions, interventions for respiratory/ cardiac arrest, occasions of respiratory distress in the recovery period, occurrence of respiratory arrest within 48 hours and re-intubation) were noted and analysed for all 709 patients. Total 709 patients were analysed in our study. We found that incidence of ICU admission was 1.83% and that of respiratory distress which needed intervention were 0.56%. A total of 0.28% patients needed reintubation. Residual neuromuscular blockade was seen in 0.28% patients. We did not find any case of respiratory and cardiac arrest and also there was no Cannot Ventilate and Cannot Intubate (CVCI

  5. Responsiveness, longitudinal- and cross-sectional construct validity of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in Dutch children with asthma

    NARCIS (Netherlands)

    Raat, H; Bueving, H; de Jongste, J; Grol, MH; Juniper, EF; van der Wouden, JC

    2005-01-01

    Objective: Health-related quality of life is an important measure in evaluations of the management of childhood asthma. In this study, we assessed psychometric properties, responsiveness, and longitudinal and cross-sectional construct validity of the Dutch version of the 23-item Pediatric Asthma Qua

  6. Health-related quality of life is associated with physical activity levels among colorectal cancer survivors: a longitudinal, 3-year study of the PROFILES registry

    NARCIS (Netherlands)

    Husson, O.; Mols, F.; Ezendam, N.P.; Schep, G.; Poll-Franse, L.V. van de

    2015-01-01

    PURPOSE: The present study aims to examine the longitudinal relation between physical activity (PA) and health-related quality of life (HRQoL) among colorectal cancer (CRC) survivors. METHODS: Individuals diagnosed with CRC between 2000 and 2009 as registered by the Dutch population-based Eindhoven

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

    Science.gov (United States)

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

    2015-11-01

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

  8. [Anales Españoles de Pediatría 2001. Bibliometric indicators of scientific quality].

    Science.gov (United States)

    González de Dios, J

    2002-08-01

    BACKGROUND. One important objective of Anales Españoles de Pediatría (An Esp Pediatr) is to be included in Journal Citation Reports-Science Citation Index and the main step to achieve this is to increase the scientific quality of this Spanish journal. Bibliometric indicators are important tools used to determine the quality of scientific publications. A bibliometric study of all the original articles published in An Esp Pediatr in 2001 (n 76) was performed; bibliometric indicators were classified into quantitative and qualitative (statistical analyses and level of scientific evidence). The results were compared with the original articles published in the journal from 1994 to June 2000 (n 733) and with the original articles published in Pediatrics in 2001 (n 276). The differences found in An Esp Pediatr between the two study periods were the following in 2001: greater collaboration between epidemiologists and/or biostatisticians in the authorship of articles (19.7 %), increased complexity of statistical analyses (statistical accessibility > 7 in 25 %) and greater use of evidence-based methodological concepts (19.7 %). However, no improvement was found in the scientific evidence (evidence was good in only 1.4 % and average in 25.7 %). Other aspects of interest were a lower number of original articles (due to an increase in other types of articles, such as Letters to the Editor or Special Articles) and a greater percentage of articles on evidence-based medicine or articles using its methodology. The differences in bibliometric indicators of quality found between An Esp Pediatr and Pediatrics continued to be considerable: statistical accessibility, evidence-based methodological concepts and scientific evidence (for example, good evidence was 22 times more frequent in Pediatrics). The scientific quality of An Esp Pediatr improved in 2001 compared with that of previous years, but the differences found between this journal and the gold standard of Pediatrics are still

  9. Analysis of flexible aircraft longitudinal dynamics and handling qualities. Volume 1: Analysis methods

    Science.gov (United States)

    Waszak, M. R.; Schmidt, D. S.

    1985-01-01

    As aircraft become larger and lighter due to design requirements for increased payload and improved fuel efficiency, they will also become more flexible. For highly flexible vehicles, the handling qualities may not be accurately predicted by conventional methods. This study applies two analysis methods to a family of flexible aircraft in order to investigate how and when structural (especially dynamic aeroelastic) effects affect the dynamic characteristics of aircraft. The first type of analysis is an open loop model analysis technique. This method considers the effects of modal residue magnitudes on determining vehicle handling qualities. The second method is a pilot in the loop analysis procedure that considers several closed loop system characteristics. Volume 1 consists of the development and application of the two analysis methods described above.

  10. Development of a Novel Quality Improvement Indicator Based on the Hemolysis Index.

    Science.gov (United States)

    Lee, Eun Jin; Kim, Miyoung; Kim, Han Sung; Park, Min Jeong; Lee, Young Kyung; Kang, Hee Jung

    2016-11-01

    Hemolysis frequently causes preanalytical errors in laboratory measurements. We aimed to develop a quality improvement indicator for evaluating the extent of inappropriate procedures causing hemolysis in clinical samples collected in medical care units. We defined the threshold value of the hemolysis index (H index) causing significant interference with analyte measurement and analyzed the H index values of clinical samples in relation to the threshold. The H index threshold value causing a 10% bias in the measurement of lactate dehydrogenase was found to be 25. The monthly mean H index and monthly frequency of samples with an H index >25 were significantly different among the types of ward (P=0.001, respectively), and significantly decreased after replacement of a laboratory centrifuge lacking temperature control (20.6±0.58 vs 23.30±1.08, P=0.01; 23.4±1.69% vs 32.6±1.78%, P=0.01). The monthly mean H index and the monthly frequency of samples with an H index above a threshold value may be useful quality improvement indicators for detection of inappropriate procedures in the acquisition and handling of blood samples in medical care units.

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

    Science.gov (United States)

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

    2013-09-15

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

  12. Human Capital Questionnaire: Assessment of European nurses' perceptions as indicators of human capital quality.

    Science.gov (United States)

    Yepes-Baldó, Montserrat; Romeo, Marina; Berger, Rita

    2013-06-01

    Healthcare accreditation models generally include indicators related to healthcare employees' perceptions (e.g. satisfaction, career development, and health safety). During the accreditation process, organizations are asked to demonstrate the methods with which assessments are made. However, none of the models provide standardized systems for the assessment of employees. In this study, we analyzed the psychometric properties of an instrument for the assessment of nurses' perceptions as indicators of human capital quality in healthcare organizations. The Human Capital Questionnaire was applied to a sample of 902 nurses in four European countries (Spain, Portugal, Poland, and the UK). Exploratory factor analysis identified six factors: satisfaction with leadership, identification and commitment, satisfaction with participation, staff well-being, career development opportunities, and motivation. The results showed the validity and reliability of the questionnaire, which when applied to healthcare organizations, provide a better understanding of nurses' perceptions, and is a parsimonious instrument for assessment and organizational accreditation. From a practical point of view, improving the quality of human capital, by analyzing nurses and other healthcare employees' perceptions, is related to workforce empowerment.

  13. Macro Invertebrates As Bio Indicators Of Water Quality In Nzovwe Stream In Mbeya Tanzania

    Directory of Open Access Journals (Sweden)

    Fredrick Ojija

    2015-08-01

    Full Text Available This study was carried out to assess the water quality of Nzovwe stream using macroinvertebrates as bioindicators. Biological monitoring working party BMWP scoring system was the index used to assess the ecosystem health of Nzovwe stream. A total of 584 aquatic macroinvertebrates were identified from Nzovwe stream. They belonged to 22 families. The most abundant taxa were Odonata 35.959 Hemiptera 25.514 Coleoptera 18.493 and Diptera 12.842. Whereas the least abundant taxa were Ephemeroptera and Gastropoda each constituting 1.028 of all macroinvertebrates. The most abundant macroinvertebrates were Dragonflies 27.226 Water striders 13.185 and Creeping water bugs 10.274 whereas the least abundant were Giant water bugs 0.514 and Backswimmers 0.514. The BMWP score of Nzovwe stream was 115. Based on this score the water of Nzovwe stream is neither very clean nor significantly altered aquatic environment. Hence the Nzovwe stream is moderately polluted due to non-point source pollution from several sources. Moreover it was found that agricultural activities washing and bathing could alter physico-chemical parameters of the stream and hence changing the abundance of macroinvertebrates as well as the quality of water. This study therefore recommends that the source of pollutants should be controlled and the stream regularly monitored by the relevant authorities. Additionally biological indicators and their indices are suggested to be used in assessing the condition of a stream ecosystem.

  14. [THE USE OF RISK INDICES IN PROCEDURES OF VERIFICATION OF BABY FOOD QUALITY CONFORMANCE].

    Science.gov (United States)

    Buymova, S A; Bubnov, A G

    2016-01-01

    There is considered the possibility of the use of risk indices with regard to their use in certification and validation of conformity assessment and food conformance, including those recommended for children. There were investigated samples of oatmeals, potted meats, liver pate, fruit-vegetable puree. The calculation of risk values was based on original data of quantitative analysis that was performed with the use of thermogravimetric, photometric, titrimetric, and potentiometric methods, as well as methods of gas-liquid chromatography and atomic absorption spectrophotometry. On the base of data of the chemical analysis of the ingredients of a set of food products, including assigned for baby nutrition, all the tested samples were shown to meet the requirements for the controlled regulatory standards on control indices of quality. The calculation of average daily doses of the intake of metal compounds (Cu, Zn, Fe, Na, Ca, Mg) consumed by adult and child's organisms through tested food showed that such doses are allowable since they do not exceed maximum daily dose and average daily requirements. However, some samples were referred to the category of high risk food, because the used method of individual's lifetime risk calculation takes into consideration all possible negative effects (carcinogenic, mutagenic, teratogenic, embryogenic, etc) of the impact of pollutants on the human body. It is shown that in addition to the sanitary and hygienic criteria of food quality, the risks of such food consumption should be taken into consideration by the Technical Regulations and other normative documentations.

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

    Directory of Open Access Journals (Sweden)

    Ajibade, O.M.

    2013-03-01

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

  16. Longitudinal study on Health Related Quality of Life in a cohort of 96 patients with Common Variable Immune Deficiencies

    Directory of Open Access Journals (Sweden)

    Stefano eTabolli

    2014-11-01

    Full Text Available Health Related Quality of Life in Common Variable Immunodeficiency Diseases evaluated by different tools were mainly used to compare different schedules of immunoglobulins administration in cross-sectional or short-term longitudinal studies. We assessed the health related quality of life and psychological status of CVID patients in a longitudinal study over a six years period by a generic, not disease-specific instrument (SF-36, and the risk of depression/anxiety by GHQ-12. At baseline, 96 patients were enrolled. After one year, a second assessment on 92 patients and after six years a third assessment on 66 patients were performed. Eighteen patients died during the study time. Health Related Quality of Life was low, with mental health scales less affected than physical scales. Worsening in SF-36 scales between the first and the third assessment was found for the physical functioning, body pain, general health, social functioning, role-emotional, scales. General Health scale showed a worse score in comparison to patients with other chronic diseases. We showed by GHQ-12 assessment that about one third of patients were at risk of anxiety/depression at all observation times, a figure that reached two third of patients only considering the group of females. Over the 6-years, 11/66 patients worsened their general health condition, passing from GHQ-negative to GHQ-positive, and worsened in SF-36 scales. A decrement of 1-point in each of physical functioning, vitality, social functioning and mental health scales increased the risk of developing anxiety/depression from 3 to 5 per cent. A negative variation of physical functioning increased the risk of psychological distress. In a survival analysis with dichotomized variables, physical functioning scores < 50 were associated with a RR of 4.4 and social functioning scores <37.5 with a RR of 10.0. In our study, the clinical condition and not the different treatment strategies with immunoglobulins had a

  17. Longitudinal Trajectories of Quality of Life and Depression by Housing Tenure Status.

    Science.gov (United States)

    Szabo, Agnes; Allen, Joanne; Alpass, Fiona; Stephens, Christine

    2017-03-22

    A large body of research has demonstrated the positive effects of home ownership on well-being and health outcomes. However, most previous studies have been cross-sectional. The present study aimed to understand the long-term impact of housing tenure on the psychological wellbeing of older people in New Zealand. Data were collected between 2010 and 2014. The 2010 sample (aged from 50-85 years) comprised 2,843 participants (55.4% female). Latent growth curve modeling was used to investigate trajectories of change for home owners and tenants in quality of life and depression symptoms. Analyses also examined the additional impact of demographic and socio-economic variables. Over time, quality of life increased, while depression symptoms decreased, for home owners. For tenants, lower levels of quality of life and higher levels of depression symptoms remained stable. Economic living standard, urban versus rural residence, length of residence, ethnicity, age, and household composition emerged as significant covariates. The psychological benefits of home ownership highlight the importance of secure and sustainable housing. Policies should be designed to ensure access to safe housing solutions for all older people.

  18. Responsiveness of the Eating Disorders Quality of Life Scale (EDQLS in a longitudinal multi-site sample

    Directory of Open Access Journals (Sweden)

    Adair Carol E

    2010-08-01

    Full Text Available Abstract Background In eating disorders (EDs, treatment outcome measurement has traditionally focused on symptom reduction rather than functioning or quality of life (QoL. The Eating Disorders Quality of Life Scale (EDQLS was recently developed to allow for measurement of broader outcomes. We examined responsiveness of the EDQLS in a longitudinal multi-site study. Methods The EDQLS and comparator generic QoL scales were collected in person at baseline, and 3 and 6 months from 130 participants (mean age 25.6 years; range 14-60 in 12 treatment programs in four Canadian provinces. Total score differences across the time points and responsiveness were examined using both anchor- and distribution-based methods. Results 98 (75% and 85 (65% responses were received at 3 and 6 months respectively. No statistically significant differences were found between the baseline sample and those lost to follow-up on any measured characteristic. Mean EDQLS total scores increased from 110 (SD = 24 to 124.5 (SD = 29 at 3 months and 129 (SD = 28 at 6 months, and the difference by time was tested using a general linear model (GLM to account for repeated measurement (p Conclusions The EDQLS is responsive to change in geographically diverse and clinically heterogeneous programs over a relatively short time period in adolescents and adults. It shows promise as an outcome measure for both research and clinical practice.

  19. Contribution of speech and language difficulties to health-related quality-of-life in Australian children: A longitudinal analysis.

    Science.gov (United States)

    Feeney, Rachel; Desha, Laura; Khan, Asaduzzaman; Ziviani, Jenny

    2017-04-01

    The trajectory of health-related quality-of-life (HRQoL) for children aged 4-9 years and its relationship with speech and language difficulties (SaLD) was examined using data from the Longitudinal Study of Australian Children (LSAC). Generalized linear latent and mixed modelling was used to analyse data from three waves of the LSAC across four HRQoL domains (physical, emotional, social and school functioning). Four domains of HRQoL, measured using the Paediatric Quality-of-Life Inventory (PedsQL™), were examined to find the contribution of SaLD while accounting for child-specific factors (e.g. gender, ethnicity, temperament) and family characteristics (social ecological considerations and psychosocial stressors). In multivariable analyses, one measure of SaLD, namely parent concern about receptive language, was negatively associated with all HRQoL domains. Covariates positively associated with all HRQoL domains included child's general health, maternal mental health, parental warmth and primary caregiver's engagement in the labour force. Findings suggest that SaLD are associated with reduced HRQoL. For most LSAC study children, having typical speech/language skills was a protective factor positively associated with HRQoL.

  20. Comparison of the Revised Air Quality Index with the PSI and AQI indices

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Wan-Li; Chen, Yu-Song; Chang, Shiang-Hung [Dept of Environmental Science and Engineering, Tunghai University, Taichung 407 (China); Zhang, Junfeng [Division of Environmental and Occupational Health, University of Medicine and Dentistry of New Jersey, NJ 08854 (United States); Lyons, T.J. [Environmental Science, Murdoch University, Murdoch, WA 6150 (Australia); Pai, Joy-Lynn [Sunway Environmental Technology Co., Ltd., Taipei 104 (China)

    2007-09-01

    Air pollution indices are commonly used to indicate the level of severity of air pollution to the public. The Pollution Standards Index (PSI) was initially established in response to a dramatic increase in the number of people suffering respiratory irritation due to the deteriorating air quality. The PSI was subsequently revised and implemented by the USEPA in 1999, and became known as the Air Quality Index (AQI) that includes data relating to particle suspension, PM{sub 2.5}, and a selective options of either 8-hour or 1-hour ozone concentration during increased O{sub 3} periods. Yet, the costs of launching a network of PM{sub 2.5} monitoring stations are prohibitively high for many countries to implement the AQI from the PSI system in the foreseeable future. Therefore, the purpose of this research is to discuss the optimal method of assessing air quality using the latest developed Revised AQI (RAQI), a system that serves as an alternative to the PSI and AQI systems. The feasibility, effectiveness, and the differences between RAQI, AQI, and PSI in their applications to several air pollution conditions are also studied in this research. The results show that southern Taiwan's suspended particulates have significantly greater impact on PM{sub 2.5}/PM{sub 10} ratios than in central and northern metropolitan areas, and that the ratios are higher in Taiwan as a whole compared to many other countries. We also found that the RAQI shows more significant results compared to the PSI and AQI as it has a wider coverage of the range of pollutant concentration levels. (author)