WorldWideScience

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,

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

    Science.gov (United States)

    Lester, Helen; Schmittdiel, Julie; Selby, Joe; Fireman, Bruce; Campbell, Stephen; Lee, Janelle; Whippy, Alan; Madvig, Philip

    2010-05-11

    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. Longitudinal analysis. 35 medical facilities of Kaiser Permanente Northern California, 1997-2007. 2 523 659 adult members of Kaiser Permanente Northern California. Main outcomes measures Yearly assessment of patient level glycaemic control (HbA(1c) financial incentives were attached to screening for diabetic retinopathy (1999-2003), the rate rose from 84.9% to 88.1%. This was followed by four years without incentives when the rate fell year on year to 80.5%. During the two initial years when financial incentives were attached to cervical cancer screening (1999-2000), the screening rate rose slightly, from 77.4% to 78.0%. During the next five years when financial incentives were removed, screening rates fell year on year to 74.3%. Incentives were then reattached for two years (2006-7) and screening rates began to increase. Across the 35 facilities, the removal of incentives was associated with a decrease in performance of about 3% per year on average for screening for diabetic retinopathy and about 1.6% per year for cervical cancer screening. Policy makers and clinicians should be aware that removing facility directed financial incentives from clinical indicators may mean that performance levels decline.

  3. 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...

  4. Life Outcomes and Higher Education: The Need for Longitudinal Research Using a Broad Range of Quality of Life Indicators.

    Science.gov (United States)

    Sheppard-Jones, Kathleen; Kleinert, Harold; Butler, Laura; Whaley, Barry

    2018-02-01

    Higher education is increasingly becoming an option for young adults with intellectual disability (ID). Although initial evaluations of postsecondary education for this population have been promising, a broader "quality of life" framework needs to be adopted in order to truly understand the impact of these programs. Moreover, researchers and program evaluators must collect longitudinal data that follows former students for multiple years and uses multiple measures. We conducted a pilot evaluation of the life outcomes of students who had attended at least two semesters in Kentucky's supported higher education program for students with ID, collecting data on life status and experiences using measures from the National Core Indicators-Adult Consumer Survey. The findings from this pilot study show better outcomes for young adults who participated in a postsecondary education program compared to young adults who did not, but these findings need to be considered in light of several limitations. In many respects, our data provided more new questions than answers. Recommendations for collecting and evaluating broad-based, longitudinal data to gain insight into the potential benefits of postsecondary education for people with intellectual disability are discussed.

  5. Quality indicators in radiotherapy

    International Nuclear Information System (INIS)

    Cionini, Luca; Gardani, Gianstefano; Gabriele, Pietro; Magri, Secondo; Morosini, Pier Luigi; Rosi, Antonella; Viti, Vincenza

    2007-01-01

    Background and purpose: There is a widespread and increasing tendency to develop hospital performance indicators in the field of accreditation/certification systems and quality benchmarking. A study has been undertaken to develop a set of performance indicators for a typical radiotherapy Centre and to evaluate their ability to provide a continuous quality improvement. Materials and methods: A working group consisting of radiation oncologists, medical physicists and radiation technologists under the coordination of experts in health technology assessment has elaborated a set of general indicators able to monitor performances and the quality level of a typical radiotherapy Centre. The work has been carried out through four steps: a preliminary set of indicators was selected; data on these indicators were collected in a number of Italian radiotherapy Centres and medical physics Services; problems in collection and analysis of data were discussed; a final set of indicators was developed. Results: A final set of 13 indicators is here presented. They concern general structural and/or operational features, health physics activities and accuracy and technical complexity of the treatment. Conclusions: The indicators tested in a few Italian Centres of radiotherapy and medical physics Services are now ready to be utilized by a larger community

  6. Air quality indicators

    International Nuclear Information System (INIS)

    Clench-Aas, Jocelyn; Guerreiro, Cristina; Bartonova, Alena

    1999-06-01

    This report proposes and describes in detail several air quality indicators that may be used to describe population exposure. The suggested indicators account for temporal and spatial patterns of pollution and movements of individuals between different micro-environments. The Air Quality Indicator /AQI) should represent both the spatial and temporal aspects of pollution exposure that may have important effects on health. Two indicators are needed, the Population Air Quality Indicator and the Individual Air Quality Indicator. Mean concentrations, 98th percentile and maximum values are the traditional indicators for estimating exposure. the temporal variability of PM-10 and NO 2 , however, is here described by means of: 1) The rate of change of pollution as the difference between two consecutive hourly values and of 2) episodes, described in terms of number, duration and winter episode period, maximum concentration in the episode and integrated episode exposure (episode AOT50/100). The spatial variation of AQIs can be described in several ways, e.g.: 1) Concentrations in neighbouring grid squares can be compared as an indication of spatial variation and 2) point estimates can be compared to grid values for a description of variation within a grid. Both methods are presented here. A test of the representativity of static point estimates for pollution exposure is to compare them to an estimate of air pollution exposure accounting for movements between different locations, obtained using diaries. The ultimate aim of AQIs is to describe the population exposure to ambient pollution. This is done by estimating the number of people exposed using different characteristics of AQIs. The data used to describe these indicators originates from dispersion modelling of short-term air pollution concentrations in Oslo. Two series of data are used. One represents hour-for hour concentrations in the 1 km 2 grid system covering the city of Oslo, winter 1994/95, calculated by the grid

  7. 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.

  8. 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 (phand hygiene 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

  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. Quality Indicators in Radiation Oncology

    International Nuclear Information System (INIS)

    Albert, Jeffrey M.; Das, Prajnan

    2013-01-01

    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

  12. Quality indicators for eye bank.

    Science.gov (United States)

    Acharya, Manisha; Biswas, Saurabh; Das, Animesh; Mathur, Umang; Dave, Abhishek; Singh, Ashok; Dubey, Suneeta

    2018-03-01

    The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016. Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

  13. Quality indicators for eye bank

    Directory of Open Access Journals (Sweden)

    Manisha Acharya

    2018-01-01

    Full Text Available Purpose: The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Methods: Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions – “result quality” and “process quality.” The indicators were measured and tracked as part of quality assurance (QA program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011–2016. Results: Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%, discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. Conclusion: These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

  14. Website quality indicators for consumers.

    Science.gov (United States)

    Griffiths, Kathleen M; Christensen, Helen

    2005-11-15

    The rating tool DISCERN was designed for use by consumers without content expertise to evaluate the quality of health information. There is some evidence that DISCERN may be a valid indicator of evidence-based website quality when applied by health professionals. However, it is not known if the tool is a valid measure of evidence-based quality when used by consumers. Since it is a lengthy instrument requiring training in its use, DISCERN may prove impractical for use by the typical consumer. It is therefore important to explore the validity of other simpler potential indicators of site quality such as Google PageRank. This study aimed to determine (1) whether the instrument DISCERN is a valid indicator of evidence-based Web content quality for consumers without specific mental health training, and (2) whether Google PageRank is an indicator of website content quality as measured by an evidence-based gold standard. This was a cross-sectional survey of depression websites using consumer and health professional raters. The main outcome measures were (1) site characteristics, (2) evidence-based quality of content as measured by evidence-based depression guidelines, (3) DISCERN scores, (4) Google PageRank, and (5) user satisfaction. There was a significant association between evidence-based quality ratings and average DISCERN ratings both for consumers (r = 0.62, P = .001) and health professionals (r = 0.80, P PageRank (r = 0.59, P = .002). However, the correlation between DISCERN scores and user satisfaction was higher than the correlation between Google PageRank and user satisfaction. DISCERN has potential as an indicator of content quality when used either by experts or by consumers. Google PageRank shows some promise as an automatic indicator of quality.

  15. [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.

  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...

  17. Air quality indices : a review

    International Nuclear Information System (INIS)

    Hewings, J.

    2001-10-01

    Pollution Probe presents some background information that will help in the development of a national Air Quality Index (AQI) in Canada. This report examines the issues that should be addressed in revising the national Index of the Quality of Air (IQUA) or creating a new national Air Quality Index. The IQUA was devised in 1976 and provides Canadians with real-time information on the state of community air quality by including major pollutants and their synergies. It is currently being used for air quality management plans and air quality alert systems. At the same time that the IQUA was devised, the United States Environmental Protection Agency (US EPA) produced a parallel air quality index known as the Pollution Standard Index (PSI) which incorporated 5 criteria pollutants (particulate matter, sulphur dioxide, carbon monoxide, nitrogen oxide and ground level ozone) for which national health-based standards were devised. In 1999, the US EPA renamed their index the Air Quality Index (AQI) and made revisions to the primary health-based national ambient air quality standards for ground-level ozone and particulate matter. Separate values for PM2.5 and PM10 were incorporated and mandatory reporting was required for metropolitan areas with populations of 350,000 or more. Similarly, the IQUA has undergone major developments that affect the validity of the index, including: rejection by the Working Group on Air Quality Objectives and Guidelines of the previous maximum desirable and maximum acceptable air quality criteria, recognition that standards for many of the contaminants are outdated, developing more sensitive instrumentation for real-time monitoring of contaminants. This report also describes the use of the national short term Air Quality Index by provincial, territorial and local authorities in Canada. Pollution Probe recommends setting up a mechanism to review and revise IQUA on a regular basis that would incorporate governments, the medical profession, special

  18. [Family physicians attitude towards quality indicator program].

    Science.gov (United States)

    Shani, Michal; Nakar, Sasson; Azuri, Yossi

    2012-10-01

    Quality indicator programs for primary care are implanted throughout the world improving quality in health care. In this study, we have assessed family physicians attitudes towards the quality indicators program in Israel. Questionnaires were distributed to family physicians in various continuing educational programs. The questionnaire addressed demographics, whether the physician dealt with quality indicators, time devoted by the physician to quality indicators, pressure placed on the physician related to quality indicators, and the working environment. A total of 140 questionnaires were distributed and 91 (65%) were completed. The average physician age was 49 years (range 33-65 years]; the average working experience as a family physician was 17.8 years (range 0.5-42); 58 physicians were family medicine specialist (65.9%). Quality indicators were part of the routine work of 94% of the physicians; 72% of the physicians noted the importance of quality indicators; 84% of the physicians noted that quality indicators demand better team work; 76% of the physicians noted that quality indicators have reduced their professional independence. Pressure to deal with quality indicators was noted by 72% of the family physicians. Pressure to deal with quality indicators was related to reduced loyalty to their employer (P = 0.001), reducing their interest to practice family medicine (p programs, without creating a heavy burden on the work of family physicians.

  19. 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...

  20. Biological indicators of radiation quality

    International Nuclear Information System (INIS)

    Bender, M.A.; Wong, R.M.A.

    1982-01-01

    The induction of many biological effects by high linear energy transfer (LET) radiation is strikingly different in one or two respects from the induction by acute low-LET radiation. If the acute low-LET dose-effect curve is of the usual quadratic form, it becomes linear as LET increases. In any case the linear slope increases as LET increases; that is, the relative biological effectiveness (RBE) increases. Both changes might be exploited as biological indicators of whether or not the recent recalculations of dose and of neutron contribution to dose at Hiroshima and Nagasaki seem consistent with the epidemiological observations. The biological end points that have been extensively studied in survivors include acute effects, growth and development after in utero or childhood exposure, genetic and cytogenetic effects in offspring, somatic chromosomal aberrations in survivors, and, of course, cancers, including leukemia. No significant indication among offspring of genetic or cytogenetic effects attributable to parental exposure has been found. Among the remaining end points, only the data on somatic chromosomal aberrations and on cancers appear robust enough to allow one to draw definite inferences by comparing experiences at the two cities

  1. Dimensionality reduction of quality of life indicators

    Directory of Open Access Journals (Sweden)

    Andrea Jindrová

    2012-01-01

    Full Text Available Selecting indicators for assessing the quality of life at the regional level is not unambigous. Currently, there are no precisely defined indicators that would give comprehensive information about the quality of life on a local level. In this paper we focus on the determination (selection of groups of indicators that can be interpreted, on the basis of studied literature, as factors characterizing the quality of life. Furthermore, on the application of methods to reduce the dimensionality of these indicators, from the source of the database CULS KROK, which provides statistics on the regional and districts level. To reduce the number of indicators and the subsequent creation of derived variables that capture the relationships between selected indicators multivariate statistical analysis methods, especially method of principal components and factor analysis were used. This paper also indicates the methodology grant project “Methodological Approaches to assess Subjective Aspects of the life quality in regions of the Czech Republic”.

  2. Formalising medical quality indicators to improve guidelines

    NARCIS (Netherlands)

    Van Gendt, Marjolein; Ten Teije, Annette; Serban, Radu; Van Harmelen, Frank

    2005-01-01

    Medical guidelines can significantly improve quality of medical care and reduce costs. But how do we get sound and well-structured guidelines? This paper investigates the use of quality indicators that are formulated by medical institutions to evaluate medical care. The main research questions are

  3. interRAI home care quality indicators

    NARCIS (Netherlands)

    Morris, J.N.; Fries, B.E.; Frijters, D.H.M.; Hirdes, J.P.; Steel, R.K.

    2013-01-01

    Background: This paper describe the development of interRAI's second-generation home care quality indicators (HC-QIs). They are derived from two of interRAI's widely used community assessments: the Community Health Assessment and the Home Care Assessment. In this work the form in which the quality

  4. Urbanization, housing and environmental quality indicators ...

    African Journals Online (AJOL)

    Urbanization, housing and environmental quality indicators. ... Journal of Agriculture, Forestry and the Social Sciences ... Urbanization ideally should also imply an enhancement of housing quality and other components of human settlements such as power supply, portable water, good roads, proper refuse and sewage ...

  5. Selecting clinical quality indicators for laboratory medicine.

    Science.gov (United States)

    Barth, Julian H

    2012-05-01

    Quality in laboratory medicine is often described as doing the right test at the right time for the right person. Laboratory processes currently operate under the oversight of an accreditation body which gives confidence that the process is good. However, there are aspects of quality that are not measured by these processes. These are largely focused on ensuring that the most clinically appropriate test is performed and interpreted correctly. Clinical quality indicators were selected through a two-phase process. Firstly, a series of focus groups of clinical scientists were held with the aim of developing a list of quality indicators. These were subsequently ranked in order by an expert panel of primary and secondary care physicians. The 10 top indicators included the communication of critical results, comprehensive education to all users and adequate quality assurance for point-of-care testing. Laboratories should ensure their tests are used to national standards, that they have clinical utility, are calibrated to national standards and have long-term stability for chronic disease management. Laboratories should have error logs and demonstrate evidence of measures introduced to reduce chances of similar future errors. Laboratories should make a formal scientific evaluation of analytical quality. This paper describes the process of selection of quality indicators for laboratory medicine that have been validated sequentially by deliverers and users of the service. They now need to be converted into measureable variables related to outcome and validated in practice.

  6. 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

  7. Evaluation of headache service quality indicators

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... of ensuring equal access to the services); and over protocols for reporting serious adverse events. CONCLUSION: This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service quality evaluation was successful. The project is ready to be taken into its next...

  8. Adjustment of nursing home quality indicators

    Directory of Open Access Journals (Sweden)

    Hirdes John P

    2010-04-01

    Full Text Available Abstract Background This manuscript describes a method for adjustment of nursing home quality indicators (QIs defined using the Center for Medicaid & Medicare Services (CMS nursing home resident assessment system, the Minimum Data Set (MDS. QIs are intended to characterize quality of care delivered in a facility. Threats to the validity of the measurement of presumed quality of care include baseline resident health and functional status, pattern of comorbidities, and facility case mix. The goal of obtaining a valid facility-level estimate of true quality of care should include adjustment for resident- and facility-level sources of variability. Methods We present a practical and efficient method to achieve risk adjustment using restriction and indirect and direct standardization. We present information on validity by comparing QIs estimated with the new algorithm to one currently used by CMS. Results More than half of the new QIs achieved a "Moderate" validation level. Conclusions Given the comprehensive approach and the positive findings to date, research using the new quality indicators is warranted to provide further evidence of their validity and utility and to encourage their use in quality improvement activities.

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    The objective of this research study is to identify quality indicators of cesarean deliveries and determine their relationship to neonatal ..... (N=39). P value. Mean. Age. 24.8 + 5.8. 25.6 + 5.9. 0.74. Duration of labor. (hours) ... chains must be improved on a national and local ... emergency obstetric care: A handbook, Geneva,.

  10. Soil enzymes: health and quality indicators

    Directory of Open Access Journals (Sweden)

    Laura E. Cerón Rincón

    2005-01-01

    define sustainability, in other words, the maintenance of their functions inside the limits of an ecosystem. The health and quality indicators are a set of measurements (physical, chemical and biological properties that pretend to establish quality standards for this resource; the enzymatic activity is placed inside this set because of its close relationship with the other properties and because of its sensibleness to the changes due to handling and use. The present review pretends to illustrate how the tracking of the biological catalysis of the soil through uses and alterations that an ecosystem may suffer, may supply information for the understanding of how the processes responsible for the maintenance of functions such as biomass production, pollutant remediation and cycling of nutrients, suffer changes and if these are positive, negative or iterative.

  11. [Indication for mitral valve interventions: Development of a quality indicator for external hospital quality assurance].

    Science.gov (United States)

    Köster, Christina; Schorbach, Lena; Wrede, Stephanie; Meyer, Sven; Kazmaier, Tonia; Szecsenyi, Joachim

    2017-11-01

    The indication for a mitral valve intervention is an important patient-relevant parameter for the assessment of process quality and the comparison of healthcare providers. In this article, we describe the development of a corresponding quality indicator for an external hospital quality assurance (QA) procedure in Germany. An expert panel was set up by the aQua Institute to assist with the development of a QA procedure for mitral valve interventions and the associated quality indicators. In a comprehensive, systematic literature and evidence research, the American and European guidelines were identified as the best evidence available. Especially the more current American guideline formed the basis on which a quality indicator dealing with the correct indication for a mitral valve intervention was developed. The developed quality indicator assesses the proportion of patients for whom an indication for a mitral valve intervention was determined in compliance with guideline recommendations. The indicator differentiates between surgical and catheter-based procedures. To determine whether or not the indication was correct, different medical parameters are included, such as, for example, type of mitral valve defect, etiology of the disease, severity of symptoms, valve morphology (e. g., mitral valve area), valve hemodynamics and comorbidity, which healthcare providers have to document. The documentation for the developed quality indicator is considerable. Nonetheless, its relevance is undeniable because it allows the user to determine whether a surgical or catheter-based mitral valve intervention was necessary and performed according to guideline recommendations. In the first year of its implementation, this indicator should be evaluated for further improvement and simplification of assessment. Copyright © 2017. Published by Elsevier GmbH.

  12. 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

  13. Quality indicators for woodwind reed material

    International Nuclear Information System (INIS)

    Glave, Stefan; Pallon, Jan; Bornman, Chris; Bjoern, Lars Olof; Wallen, Rita; Raastam, Jacob; Kristiansson, Per; Elfman, Mikael; Malmqvist, Klas

    1999-01-01

    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

  14. Readmission of ICU patients: A quality indicator?

    Science.gov (United States)

    Woldhek, Annemarie L; Rijkenberg, Saskia; Bosman, Rob J; van der Voort, Peter H J

    2017-04-01

    Readmission rate is frequently proposed as a quality indicator because it is related to both patient outcome and organizational efficiency. Currently available studies are not clear about modifiable factors as tools to reduce readmission rate. In a 14year retrospective cohort study of 19,750 ICU admissions we identified 1378 readmissions (7%). A multivariate logistic regression analysis for determinants of readmission within 24h, 48h, 72h and any time during hospital admission was performed with adjustment for patients' characteristics and initial admission severity scores. In all models with different time points, patients with older age, a medical and emergency surgery initial admission and patients with higher SOFA score have a higher risk of readmission. Immunodeficiency was a predictor only in the at any time model. Confirmed infection was predicted in all models except the 24h model. Last day noradrenaline treatment was predicted in the 24 and 48h model. Mechanical ventilation on admission independently protected for readmission, which can be explained by the large number of cardiac surgery patients. All multivariate models had a moderate performance with the highest AUC of 0.70. Readmission can be predicted with moderate precision and independent variables associated with readmission are age, severity of disease, type of admission, infection, immunodeficiency and last day noradrenaline use. The latter factor is the only one that can be modified and therefore readmission rate does not meet the criteria to be used as a useful quality indicator. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Indicadores precoces da dislexia de desenvolvimento: um estudo longitudinal || Early indicators of dyslexia: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Anabela Carvalho

    2017-12-01

    Full Text Available A dislexia do desenvolvimento é frequentemente diagnosticada quando os problemas na aprendizagem da leitura já afetaram negativamente outras áreas académicas e até o bem-estar emocional. A pesquisa internacional aponta para a existência de alguns preditores desta perturbação da aprendizagem, permitindo uma intervenção atempada e preventiva. No entanto, as diferenças relativas ao código ortográfico do Português Europeu não nos permitem tirar ilações de estudos realizados noutros contextos linguísticos. Com este problema em mente, desenvolvemos um estudo longitudinal que pretende destacar os preditores da dislexia em crianças portuguesas. A investigação seguiu um plano longitudinal ao longo de três anos e os resultados obtidos junto de uma amostra de 200 crianças permitem identificar a existência de poder preditivo em duas variáveis: no conhecimento que a criança tem do nome das letras e no seu desempenho em tarefas de fluência verbal, mostrando a influência que os fatores relativos às dificuldades na aquisição do princípio alfabético e no acesso ao léxico terão na manifestação posterior de problemas na aquisição da leitura.

  16. Evaluation of diet quality indicators in adults

    Directory of Open Access Journals (Sweden)

    Katarína Fatrcová-Šramková

    2013-11-01

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

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

    African Journals Online (AJOL)

    Sultan

    environmental framework for the promotion of a healthy and comfortable ... (n.d.) consists of six metrics namely: Indoor air quality (IAQ) ..... Quality. Thermal quality measurement in the hospital ...... article/pii/S036013231300142X. Jensen, K.

  18. Quality Indicators for the Total Testing Process.

    Science.gov (United States)

    Plebani, Mario; Sciacovelli, Laura; Aita, Ada

    2017-03-01

    ISO 15189:2012 requires the use of quality indicators (QIs) to monitor and evaluate all steps of the total testing process, but several difficulties dissuade laboratories from effective and continuous use of QIs in routine practice. An International Federation of Clinical Chemistry and Laboratory Medicine working group addressed this problem and implemented a project to develop a model of QIs to be used in clinical laboratories worldwide to monitor and evaluate all steps of the total testing process, and decrease error rates and improve patient services in laboratory testing. All laboratories are invited, at no cost, to enroll in the project and contribute to harmonized management at the international level. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [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.

  20. 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...

  1. Measuring educational quality by means of indicators

    NARCIS (Netherlands)

    Scheerens, Jaap; Scheerens, J; Luyten, H.; van Ravens, J.

    2011-01-01

    In this chapter the input-process-outcomes-context framework, introduced in Chapter 1 is used for categorising and describing input indicators, process indicators, outcome indicators and context indicators. The chapter starts out with a review and further illustration of this framework and follows

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

    African Journals Online (AJOL)

    Uterine rupture and cesarean hysterectomy were associated with an outcome of neonatal death (p<0.001). Infrastructure and personnel limitations are major barriers to the improvement of quality of cesarean deliveries. Future endeavors towards quality improvement must address these deficiencies. (Afr J Reprod Health ...

  3. Quality indicators for hip fracture care, a systematic review.

    Science.gov (United States)

    Voeten, S C; Krijnen, P; Voeten, D M; Hegeman, J H; Wouters, M W J M; Schipper, I B

    2018-05-17

    Quality indicators are used to measure quality of care and enable benchmarking. An overview of all existing hip fracture quality indicators is lacking. The primary aim was to identify quality indicators for hip fracture care reported in literature, hip fracture audits, and guidelines. The secondary aim was to compose a set of methodologically sound quality indicators for the evaluation of hip fracture care in clinical practice. A literature search according to the PRISMA guidelines and an internet search were performed to identify hip fracture quality indicators. The indicators were subdivided into process, structure, and outcome indicators. The methodological quality of the indicators was judged using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. For structure and process indicators, the construct validity was assessed. Sixteen publications, nine audits and five guidelines were included. In total, 97 unique quality indicators were found: 9 structure, 63 process, and 25 outcome indicators. Since detailed methodological information about the indicators was lacking, the AIRE instrument could not be applied. Seven indicators correlated with an outcome measure. A set of nine quality indicators was extracted from the literature, audits, and guidelines. Many quality indicators are described and used. Not all of them correlate with outcomes of care and have been assessed methodologically. As methodological evidence is lacking, we recommend the extracted set of nine indicators to be used as the starting point for further clinical research. Future research should focus on assessing the clinimetric properties of the existing quality indicators.

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    personnel limitations are major barriers to the improvement of quality of cesarean deliveries. Future endeavors towards ..... order to address this problem, medication supply chains must be improved on a national and local level and improved ...

  5. Developing quality indicators for older adults: transfer from the USA to the UK is feasible.

    Science.gov (United States)

    Steel, N; Melzer, D; Shekelle, P G; Wenger, N S; Forsyth, D; McWilliams, B C

    2004-08-01

    Measurement of the quality of health care is essential for quality improvement, and patients are an underused source of data about quality of care. We describe the adaptation of a set of USA quality indicators for use in patient interview surveys in England, to measure the extent to which older patients receive a broad range of effective health care interventions in both primary and secondary care. One hundred and nineteen quality indicators covering 16 clinical areas, based on a set of indicators for the care of vulnerable elderly patients in the USA, were reviewed by a panel of 10 clinical experts in England. A modified version of the RAND/UCLA appropriateness method was used and panel members were supplied with literature reviews summarising the evidence base for each quality indicator. The indicators were sent for comment before the panel meeting to UK charitable organisations for older people. The panel rated 102 of the 119 indicators (86%) as valid for use in England; 17 (14%) were rejected as invalid. All 58 indicators about treatment or continuity and follow up were rated as valid compared with just over half (13 of 24) of the indicators about screening. These 102 indicators are suitable for use in patient interview surveys, including the English Longitudinal Study of Ageing (ELSA). The systematic measurement of quality of care at the population level and identification of gaps in quality is essential for quality improvement. There is potential for transfer of quality indicators between countries, at least for the health care of older people.

  6. Longitudinal Beam measurements at the LHC: The LHC Beam Quality Monitor

    CERN Document Server

    Papotti, G; Follin, F; Wehrle, U

    2011-01-01

    The LHC Beam Quality Monitor is a system that measures individual bunch lengths and positions, similarly to the twin system SPS Beam Quality Monitor, from which it was derived. The pattern verification that the system provides is vital during the injection process to verify the correctness of the injected pattern, while the bunch length measurement is fed back to control the longitudinal emittance blow up performed during the energy ramp and provides a general indication of the health of the RF system. The algorithms used, the hardware implementation and the system integration in the LHC control infrastructure are presented in this paper, along with possible improvements.

  7. Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children.

    Science.gov (United States)

    Bonnemains, Laurent; Stos, Bertrand; Vaugrenard, Thibaud; Marie, Pierre-Yves; Odille, Freddy; Boudjemline, Younes

    2012-03-01

    To examine in a population of post-operative tetralogy of Fallot patients, the correlation between right ventricle (RV) ejection fractions (EF) computed from magnetic resonance imaging (MRI) and three echocardiographic indices of RV function: TAPSE, longitudinal strain and strain rate. Indeed, these patients present a pulmonary regurgitation which is responsible for progressive dilatation of the RV. An echocardiographic assessment of the RV function would be very useful in determining the timing of pulmonary revalvulation for Fallot patients. However, these indices are generally based on the ventricle contraction in the long axis direction which is impaired in this population and does not seem to correlate with the EF. Thirty-five post-operative tetralogy of Fallot patients and 20 patients with normal RVs were included. In both groups, RVEF, assessed by MRI, was compared with the three echocardiographic indices. Longitudinal strain and strain rates were computed both on the free wall and on the whole RV. No correlation was found between the echocardiographic indices and the MRI EF in our Fallot population. The accuracy of those indices as a diagnostic test of an altered RV was low with Younden's indices varying from -0.18 to 0.5 and areas under the Receiver Operating Characterictic (ROC) curves equal to 0.54 for tricuspid annulus plane systolic excursion, 0.59-0.62 for strain and 0.57-0.63 for strain rate. Three conventional echocardiographic indices based on RV longitudinal contraction failed to assess the EF in our population of post-operative tetralogy of Fallot patients.

  8. Measuring quality of care: considering conceptual approaches to quality indicator development and evaluation.

    Science.gov (United States)

    Stelfox, Henry T; Straus, Sharon E

    2013-12-01

    In this article, we describe one approach for developing and evaluating quality indicators. We focus on describing different conceptual approaches to quality indicator development, review one approach for developing quality indicators, outline how to evaluate quality indicators once developed, and discuss quality indicator maintenance. The key steps for developing quality indicators include specifying a clear goal for the indicators; using methodologies to incorporate evidence, expertise, and patient perspectives; and considering contextual factors and logistics of implementation. The Strategic Framework Board and the National Quality Measure Clearinghouse have developed criteria for evaluating quality indicators that complement traditional psychometric evaluations. Optimal strategies for quality indicator maintenance and dissemination have not been determined, but experiences with clinical guideline maintenance may be informative. For quality indicators to effectively guide quality improvement efforts, they must be developed, evaluated, maintained, and implemented using rigorous evidence-informed practices. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Cross-sectional versus sequential quality indicators of risk factor management in patients with type 2 diabetes

    NARCIS (Netherlands)

    Voorham, Jaco; Denig, Petra; Wolffenbuttel, Bruce H. R.; Haaijer-Ruskamp, Flora M.

    Background: The fairness of quality assessment methods is under debate. Quality indicators incorporating the longitudinal nature of care have been advocated but their usefulness in comparison to more commonly used cross-sectional measures is not clear. Aims: To compare cross-sectional and sequential

  10. Predictors of Longitudinal Quality of Life in Juvenile Localized Scleroderma.

    Science.gov (United States)

    Ardalan, Kaveh; Zigler, Christina K; Torok, Kathryn S

    2017-07-01

    Localized scleroderma can negatively affect children's quality of life (QoL), but predictors of impact have not been well described. We sought to identify predictors of QoL impact in juvenile localized scleroderma patients. We analyzed longitudinal data from a single-center cohort of juvenile localized scleroderma patients, using hierarchical generalized linear modeling (HGLM) to identify predictors of QoL impact. HGLM is useful for nested data and allows for evaluation of both time-variant and time-invariant predictors. The number of extracutaneous manifestations (ECMs; e.g., joint contracture and hemifacial atrophy) and female sex predicted negative QoL impact, defined as a Children's Dermatology Life Quality Index score >1 (P = 0.019 for ECMs and P = 0.002 for female sex). As the time since the initial visit increased, the odds of reporting a negative QoL impact decreased (P scleroderma than cutaneous features. Further study is required to determine which ECMs have the most impact on QoL, which factors underlie sex differences in QoL in localized scleroderma, and why increasing the time since the initial visit appears to be protective. An improved understanding of predictors of QoL impact may allow for the identification of patients at risk of poorer outcomes and for the tailoring of treatment and psychosocial support. © 2016, American College of Rheumatology.

  11. European Educational Research Quality Indicators (EERQI): A first prototype framework of intrinsic and extrinsic indicators

    NARCIS (Netherlands)

    Mooij, Ton

    2011-01-01

    Mooij, T. (2011, 15-16 March). European Educational Research Quality Indicators (EERQI): A first prototype framework of intrinsic and extrinsic indicators. Paper presented at the final EERQI conference, Brussels, University Foundation.

  12. [Construction and implementation of two quality indicators in nursing services].

    Science.gov (United States)

    de Moura, Gisela Maria Schebela Souto; Juchem, Beatriz Cavalcanti; Falk, Maria Lucia Rodrigues; de Magalhães, Ana Maria Muller; Suzuki, Lyliam Midori

    2009-03-01

    Indicators monitor the quality of services and improve the attention offered to the patients. Hospital de Clinicas de Porto Alegre, Rio Grande do Sul, Brazil, has been developing strategies to assess its services according to its institutional management policy of quality The present study aims to report the experience at this university hospital with the construction and implementation of quality indicators in its nursing services. In 2006, four indicators were established: incidence of pressure ulcer, with a goal of quality of nursing services, for this is a large hospital.

  13. 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.

  14. An environmental scan of quality indicators in critical care.

    Science.gov (United States)

    Valiani, Sabira; Rigal, Romain; Stelfox, Henry T; Muscedere, John; Martin, Claudio M; Dodek, Peter; Lamontagne, François; Fowler, Robert; Gheshmy, Afshan; Cook, Deborah J; Forster, Alan J; Hébert, Paul C

    2017-06-21

    We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. We convened a panel of experts ( n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks. We also noted the organizations' rationale for selecting these indicators and their reported evidence base. From 28 targeted organizations, we identified 222 quality indicators, 127 of which were unique. Of the 127 indicators, 63 (32.5%) were safety indicators and 61 (31.4%) were effectiveness indicators. The rationale for selecting quality indicators was supported by consensus for 58 (26.1%) of the 222 indicators and by published research evidence for 45 (20.3%); for 119 indicators (53.6%), the rationale was not reported or the reader was referred to other organizations' reports. Of the 127 unique quality indicators, 27 (21.2%) were accompanied by a formal grading of evidence, whereas for 52 (40.9%), no reference to evidence was provided. There are many quality indicators related to critical care that are available in the public domain. However, owing to a paucity of rationale for selection, supporting evidence and results of implementation, it is not clear which indicators should be adopted for use. Copyright 2017, Joule Inc. or its licensors.

  15. Evaluating quality indicators for patients with community-acquired pneumonia.

    Science.gov (United States)

    Rhew, D C; Goetz, M B; Shekelle, P G

    2001-11-01

    Several organizations have published evidence-based quality indicators for community-acquired pneumonia (CAP). However, there is variability in the types of indicators presented between organizations and the level of supporting evidence for each of the indicators. A systematic review of the literature and relevant Internet Web sites was performed to identify quality indicators for CAP that have been proposed or recommended by organizations, and each of the indicators was then critically appraised, using a well-defined set of criteria. The MEDLINE, EMBASE, Best Evidence, and Cochrane Systematic Review databases and Internet Web sites were searched for articles and guidelines published between January 1980 and May 2001 to identify quality indicators for CAP and relevant evidence. Experts in the area of health services research were contacted to identify additional sources. A well-defined set of criteria was applied to evaluate each of the quality indicators. The systematic review of the literature and Internet Web sites yielded 44 CAP-specific quality indicators. The critical appraisal of these indicators yielded 16 indicators that were supported by a study that identified an association between quality of care and the process of care or outcome measure, were applied to enough patients to be able to detect clinically meaningful differences, were clinically and/or economically relevant, were measurable in a clinical practice setting, and were precise in their specifications. Many organizations recommend indicators for CAP. Indicators may serve as measures of clinical performance for clinicians and hospitals, may help in benchmarking, and may ultimately facilitate improvements in quality of care and cost reductions. However, CAP indicators often vary in their meaningfulness, scientific soundness, and interpretability of results. A set of five critical appraisal questions may assist in the evaluation of which quality indicators are most valid.

  16. Internet quality indicators for health professional agencies and associations.

    Science.gov (United States)

    Courtney, Karen L; Alexander, Gregory L; Pack, Beth; Bax, Heather; Adams-Leander, Shelia; Holcomb, Melissa

    2005-01-01

    Building on work within public administration research, five categories of quality indicators are proposed for evaluating World Wide Web (web) sites belonging to state health professional agencies and associations. The five measures include: transparency, transactions, connectivity, personalization and usability. This project describes the construction of each quality indicator index and a calculation of quality scores. This project applies these methods to state Boards of Nursing and nursing association websites.

  17. Measures and Indicators of Vgi Quality: AN Overview

    Science.gov (United States)

    Antoniou, V.; Skopeliti, A.

    2015-08-01

    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.

  18. 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.

  19. A first-approximation urban-air-quality indicator

    Science.gov (United States)

    David M. Paproski; Julian R. Walker

    1977-01-01

    Development of the first-approximation-urban-air-quality indicator was reported by the Economic Council of Canada. The indicator takes account of ambient concentrations of five pollutants: sulfur dioxide, particulate matter, oxides of nitrogen, carbon monoxide, and total oxidants. Epidemiological evidence indicating the potential impact of these pollutants on human...

  20. 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.

  1. 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.

  2. X-ray Computed Tomography Image Quality Indicator (IQI) Development

    Data.gov (United States)

    National Aeronautics and Space Administration — Phase one of the program is to identify suitable x-ray Computed Tomography (CT) Image Quality Indicator (IQI) design(s) that can be used to adequately capture CT...

  3. Canadian environmental sustainability indicators : air quality indicator : data sources methods 2005

    International Nuclear Information System (INIS)

    2006-01-01

    National indicators of freshwater quality, air quality and greenhouse gas emissions were established in 2004 by the Canadian government in recognition that public health and economic well-being are linked to the quality of the environment. These indicators build on a base of an established national monitoring network and are communicated to the public by Environment Canada, Statistics Canada and Health Canada in an effort to provide reliable information on the state of the environment. Each indicator reported in a given year has an associated data sources and methods report to provide technical detail and background information that will help interpret the indicator. This particular report focused on the basic methods and data for the air quality indicator as it was reported in 2005. It approximated public exposure to ground-level ozone, a key component of smog and a harmful pollutant. Since ozone levels are influenced by weather and transboundary flows of pollutants, this report analyzed observed concentrations in relation to where people live. The indicator measures the seasonal average of the highest 8-hour average ground-level ozone concentration for each day. The indicator reflects possible health impacts related to ozone over the entire season. It is population-weighted and assumes that ozone concentrations are constant within a radius of 40 km around each monitoring station. It was noted that future improvements for the air quality indicator will include measures of fine particulate matter and improvements in monitoring methods. 9 refs., 2 tabs., 6 figs

  4. 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.

  5. Indicators for Research Performance in the Humanities? The Scholars’ View on Research Quality and Indicators

    Energy Technology Data Exchange (ETDEWEB)

    Ochsner, M.; Hug, S.E.

    2016-07-01

    In this paper, we present indicators for research quality in the humanities collected in our previous work (Ochsner, Hug, & Daniel, 2012). We focus on how these indicators are accepted by humanities scholars. We also investigate differences between different subgroups of the humanities scholars we surveyed with regard to their preferences for such indicators. We address the theme of the conference (‘peripheries frontiers and beyond’) regarding two notions of (scientometric) periphery: First, we investigate indicators for research quality in the humanities, a field where there is a lack on knowledge on how to assess or even measure research quality, in fact, there is a quite broad consensus that (evaluative) bibliometrics cannot be readily applied in the humanities (Hicks, 2004; Nederhof, 2006). Second, we fully cover three humanities disciplines at Swiss universities and member universities of the League of European Research Universities (LERU). Scholars are a neglected stakeholder when it comes to the design of research assessment procedures or the selection of research indicators. However, they are directly affected, they know best what research quality in their field is and what impact the use of certain indicators could have on their research practices. The paper is structured as follows: first, we present the background for selecting indicators for research quality. This is followed by a description of our analysis methods and the presentation of the results. We finally discuss the results with regard to their use in research evaluation. (Author)

  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 Health 'Kuznets' Curve'? Cross-Sectional and Longitudinal Evidence on Concentration Indices'.

    Science.gov (United States)

    Costa-Font, Joan; Hernandez-Quevedo, Cristina; Sato, Azusa

    2018-01-01

    The distribution of income related health inequalities appears to exhibit changing patterns when both developing countries and developed countries are examined. This paper tests for the existence of a health Kuznets' curve; that is, an inverse U-shape pattern between economic developments (as measured by GDP per capita) and income-related health inequalities (as measured by concentration indices). We draw upon both cross sectional (the World Health Survey) and a long longitudinal (the European Community Household Panel survey) dataset. Our results suggest evidence of a health Kuznets' curve on per capita income. We find a polynomial association where inequalities decline when GDP per capita reaches a magnitude ranging between $26,000 and $38,700. That is, income-related health inequalities rise with GDP per capita, but tail off once a threshold level of economic development has been attained.

  8. Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management.

    Science.gov (United States)

    Sampurno, Fanny; Zheng, Jia; Di Stefano, Lydia; Millar, Jeremy L; Foster, Claire; Fuedea, Ferran; Higano, Celestia; Hulan, Hartwig; Mark, Stephen; Moore, Caroline; Richardson, Alison; Sullivan, Frank; Wenger, Neil S; Wittmann, Daniela; Evans, Sue

    2018-03-01

    We sought to develop a core set of clinical indicators to enable international benchmarking of localized prostate cancer management using data available in the TrueNTH (True North) Global Registry. An international expert panel completed an online survey and participated in a face to face meeting. Participants included 3 urologists, 3 radiation oncologists, 2 psychologists, 1 medical oncologist, 1 nurse and 1 epidemiologist with prostate cancer expertise from a total of 7 countries. Current guidelines on prostate cancer treatment and potential quality indicators were identified from a literature review. These potential indicators were refined and developed through a modified Delphi process during which each panelist independently and repeatedly rated each indicator based on importance (satisfying the indicator demonstrated a provision of high quality care) and feasibility (the likelihood that data used to construct the indicator could be collected at a population level). The main outcome measure was items with panel agreement indicted by a disagreement index less 1, median importance 8.5 or greater and median feasibility 9 or greater. The expert panel endorsed 33 indicators. Seven of these 33 prostate cancer quality indicators assessed care relating to diagnosis, 7 assessed primary treatment, 1 assessed salvage treatment and 18 assessed health outcomes. We developed a set of quality indicators to measure prostate cancer care using numerous international evidence-based clinical guidelines. These indicators will be pilot tested in the TrueNTH Global Registry. Reports comparing indicator performance will subsequently be distributed to groups at participating sites with the purpose of improving the consistency and quality of prostate cancer management on a global basis. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  9. Utility of pollution indices in assessment of soil quality around ...

    African Journals Online (AJOL)

    The quality of soil in the vicinity of Madaka mining sites were investigated in this study using Environmental Pollution Indices. Geological mapping of the study area indicated that the area was dominated by schist and granite. The static water level measurement revealed a westward groundwater flow direction which also ...

  10. [Quality Indicators of Primary Health Care Facilities in Austria].

    Science.gov (United States)

    Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

    2017-07-11

    Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

  11. The longitudinal role of breastfeeding in mothers' and fathers' relationship quality trajectories.

    Science.gov (United States)

    Papp, Lauren M

    2012-08-01

    Guided by a family systems perspective, this study investigated whether breastfeeding plays a role in the quality of the mother-father intimate relationship over the course of child development. Using a prospective, longitudinal design, and data drawn from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n=986 couples), the present study examined the predictive role of breastfeeding in the first 3 years of life (for up to 4 months and for 5 months or longer, relative to never breastfeeding) in maternal and paternal trajectories of intimate relationship quality. The outcome variable of interest was emotional intimacy, rated by mothers and fathers when children were 54 months of age, in grades 1, 3, 5, and 6, and 15 years of age. Multivariate hierarchical linear modeling, which appropriately handled dyadic data and accounted for effects of demographic covariates and earlier relationship quality, indicated that breastfeeding uniquely predicted increases in mothers' (but not fathers') marital quality levels over time. There was no difference in the strength of the positive associations for shorter versus longer breastfeeding duration. The findings suggest that improved intimate relationship quality may be another psychosocial benefit experienced by breastfeeding mothers. The findings underscore the importance of considering breastfeeding in the context of intimate relationships and may be of interest to women weighing the decision to breastfeed, their partners, and healthcare providers.

  12. 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.

  13. Valuation of Biochemical and Microbiological Indicators in Soil Quality Assessment

    OpenAIRE

    Peruzzi, Elisabetta

    2017-01-01

    This thesis research aimed at valuating the suitability of biochemical and microbiological indicators in soil quality and soil health assessment, applying an interdisciplinary approach by means of different methodologies. As the concept of soil quality encompasses both functionality and biological diversity, two cases of study are proposed and each of them aimed at the description of this two aspects. The first case study examined the degree of interference of high soil copper contamination w...

  14. 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

  15. Water quality index and eutrophication indices of Caiabi River, MT

    Directory of Open Access Journals (Sweden)

    Grasiane Andrietti

    2016-03-01

    Full Text Available The objective of this study was to evaluate the water quality of the Caiabi River based upon the water quality index (WQI and the trophic state index (TSI, considering seasonal and spatial variations, with the aim of determining the most appropriate monitoring design for this study site. Sampling for water quality monitoring was conducted at five points on the Caiabi River from July 2012 to June 2013. Quality parameters quantified were as follows: pH, temperature, conductivity, dissolved oxygen, total and thermotolerant coliforms, turbidity, Kjeldahl nitrogen, nitrite, nitrate, total phosphorus, biochemical oxygen demand, series of solids, and chlorophyll a. Sampling procedures and analysis followed the methods recommended by the Standard Methods for the Examination of Water and Wastewater. The WQI results showed that the quality of the Caiabi River water is good. TSI results demonstrated the low risk of eutrophication in the Caiabi River, indicating an ultra-oligotrophic lotic environment. Analysis of variance showed that 10 of the 16 monitored quality parameters presented differences of means between the dry and rainy seasons or among the monitored points or in the interaction between seasons and points. These results indicate that two annual sampling collections at two points may be sufficient to describe the water quality behavior in the basin, as long as the conditions of land use are stable.

  16. Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey.

    Science.gov (United States)

    Aeyels, Daan; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Coeckelberghs, Ellen; Bruyneel, Luk; Vanhaecht, Kris

    2017-12-13

    Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI. First, 34 experts (76% response rate) individually assessed the appropriateness of items to quality improvement on a nine point Likert scale. Twenty-seven key interventions, 16 quality indicators at patient level and 27 quality indicators at STEMI care programme level were selected. Eighteen additional items were suggested. Experts received personal feedback, benchmarking their score with group results (response rate, mean, median and content validity index). Consequently, 32 experts (71% response rate) openly discussed items with an item-content validity index above 75%. By consensus, the expert panel validated a final set of 25 key interventions, 13 quality indicators at patient level and 20 quality indicators at care programme level prior for improvement of in hospital care for STEMI. A structured literature review and multidisciplinary expertise was combined to validate a set of key interventions and quality indicators prior for improvement of care for STEMI. The results allow researchers and hospital staff to evaluate and support quality improvement interventions in a large cohort within the context of a health care system.

  17. The importance of using quality indicators in nursing care

    Directory of Open Access Journals (Sweden)

    Thaizy Valânia Lopes Silveira

    Full Text Available OBJECTIVE: To investigate the opinion of hospital nurses on the use of quality indicators for nursing care. METHOD: Research based on the qualitative approach, conducted with 41 nurses from two charity hospitals in Minas Gerais, from September to October 2013. Interviews with a semi-structured script were used to collect data. The empirical data were organized by means of content analysis. RESULTS: Indicators are important for assessing the provided care, for improving the quality of care, and for defining strategies to achieve goals. CONCLUSIONS: The difficulties encountered when using these indicators revealed the following constituent elements: lack of time, inadequate number of professionals and lack of knowledge on the subject. It was concluded that nurses understand that indicators are instruments that enable evaluations and improvements, but their understanding of how to use these instruments is incomplete and fragmented.

  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. 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

  1. Using Aquatic Insects as Indicators of Water Quality

    Science.gov (United States)

    Dyche, Steven E.

    1977-01-01

    Described is a science field activity that studies the presence of certain aquatic insects, like stoneflies, as indicators of water quality. Equipment, materials, and methods are listed in detail, including suggestions for building certain supplies. Results of previous studies on the Yellowstone River are included. (MA)

  2. 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)

  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

  4. 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 pow...... experiment in Denmark....

  5. Indicators for the automated analysis of drug prescribing quality.

    Science.gov (United States)

    Coste, J; Séné, B; Milstein, C; Bouée, S; Venot, A

    1998-01-01

    Irrational and inconsistent drug prescription has considerable impact on morbidity, mortality, health service utilization, and community burden. However, few studies have addressed the methodology of processing the information contained in these drug orders used to study the quality of drug prescriptions and prescriber behavior. We present a comprehensive set of quantitative indicators for the quality of drug prescriptions which can be derived from a drug order. These indicators were constructed using explicit a priori criteria which were previously validated on the basis of scientific data. Automatic computation is straightforward, using a relational database system, such that large sets of prescriptions can be processed with minimal human effort. We illustrate the feasibility and value of this approach by using a large set of 23,000 prescriptions for several diseases, selected from a nationally representative prescriptions database. Our study may result in direct and wide applications in the epidemiology of medical practice and in quality control procedures.

  6. 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

  7. Quality in the provision of headache care. 2: defining quality and its indicators.

    Science.gov (United States)

    Peters, Michele; Jenkinson, Crispin; Perera, Suraj; Loder, Elizabeth; Jensen, Rigmor; Katsarava, Zaza; Gil Gouveia, Raquel; Broner, Susan; Steiner, Timothy

    2012-08-01

    The objective of this study was to define "quality" of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache care: "Good-quality headache care achieves accurate diagnosis and individualized management, has appropriate referral pathways, educates patients about their headaches and their management, is convenient and comfortable, satisfies patients, is efficient and equitable, assesses outcomes and is safe." Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings.

  8. Social isolation after spinal cord injury: Indicators from the Longitudinal Aging Study.

    Science.gov (United States)

    Newman, Susan D; Li, Chao; Krause, James S

    2016-11-01

    The purpose of this study was to develop and test a conceptual model of social isolation, incorporating social disconnectedness (objective measures) and perceived isolation (subjective appraisals) in an aging sample of participants with spinal cord injury (SCI). The study used cross-sectional data from 768 participants from the most recent administration of the SCI Longitudinal Aging Study, which was initiated in 1973. Measures included the revised version of the Life Situation Questionnaire, items from the Craig Handicap Assessment Reporting Technique, and the Patient Reported Outcomes Measurement Information System. Indicators of social isolation were combined into scales assessing social disconnectedness and perceived isolation. We tested the hypothesized model of social isolation, including both social disconnectedness and perceived isolation, after SCI using structural equation modeling. Results of structural equation modeling indicated good fit between the hypothesized model and data (root-mean-square error of approximation = 0.073, 90% confidence interval [0.070, 0.075]; comparative fit index = 0.949; Tucker Lewis Index = 0.946). Perceived isolation was significantly related with social disconnectedness (standardized coefficient [r] = .610). Several exogenous factors were significantly related to social disconnectedness and perceived isolation. Older participants were more likely to report lower levels of perceived isolation. Time since injury demonstrated an inverse relationship with both social disconnectedness and perceived isolation. Higher level and severity of injury were associated with higher levels of social disconnectedness. Our study establishes a stable model of social isolation to guide future research exploring the effect of social isolation on health after SCI. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  9. Statistical analysis of longitudinal quality of life data with missing measurements

    NARCIS (Netherlands)

    Zwinderman, A. H.

    1992-01-01

    The statistical analysis of longitudinal quality of life data in the presence of missing data is discussed. In cancer trials missing data are generated due to the fact that patients die, drop out, or are censored. These missing data are problematic in the monitoring of the quality of life during the

  10. Quality of Life in and After Spinal Cord Injury Rehabilitation: A Longitudinal Multicenter Study

    Science.gov (United States)

    Kennedy, P.; Elfström, M.L.; Ballert, C.S.

    2014-01-01

    Purpose: To investigate the changes in quality of life (QOL) in persons with spinal cord injury (SCI) and their close persons during the first 2 years post injury. Method: Longitudinal multiple sample multiple wave panel design. Data included 292 patients recruited from Austrian British German Irish and Swiss specialist SCI rehabilitation centers and 55 of their close persons. Questionnaire booklets were administered at 6 weeks 12 weeks 1 year and 2 years after injury to both samples. Results: Study 1 investigated the WHOQOL-BREF domains in individuals with SCI and found differences mostly in the physical domain indicating that QOL increases for persons with SCI from onset. An effect of the culture was observed in the psychological and environmental domains with higher QOL scores in the German-speaking sample. Study 2 compared individuals with SCI to their close persons and found differences in the physical environmental and social domains over time. The scores on the psychological dimension did not significantly differ between the persons with SCI and their close persons over time. Conclusion: QOL measured by the WHOQOL-BREF shows that QOL changes during rehabilitation and after discharge. Apart from the physical dimension the persons with SCI and their close persons seem to experience a similar change in QOL. Further longitudinal research is suggested to clarify the mutual adjustment process of people with SCI and their close persons and to explore cultural differences in QOL between English-and German-speaking countries. PMID:25484566

  11. Estimation of air quality by air pollution indices

    International Nuclear Information System (INIS)

    Liblik, Valdo; Kundel, Helmut

    1999-01-01

    A novel system for estimating the quality of atmospheric air in the over-ground air layer with the help of air pollution indices was developed. The method is based on a comparison of measured or calculated maximum short-term concentrations and average annual concentrations of pollutants with maximum permissible concentrations (with regard to human beings and vegetation). Special air quality estimation scales for residential areas and natural systems are presented. On the basis of the concentration of the substance under study zones of very high, high, rather high, moderate, low and very low air pollution were distinguished in the over-ground layer of the atmosphere. These are projected to land surface for landscape zonation. The application of the system of indices is demonstrated in the analysis of air quality for the towns of Kohtla-Jarve, Johvi and Kivioli (in 1997-1998). A comparative analysis of the air pollution zones distinguished on the basis of emissions and data from bio monitoring yielded satisfactory results. The system of air pollution indices developed enables to process the results of air monitoring in case of pollution fields of complicated composition so that the result for estimating the quality of ambient air in a residential area is easily understood by inhabitants and interpretable with the help of a special scale; analyse temporal changes in the quality of the air in towns, villages and other residential areas and use the results as basis for developing measures for reducing the pollution of ambient air; carry out zonation of large territories on the basis of air pollution levels (spatial air pollution zones are projected on the ground surface) and estimate air quality in places where air monitoring is lacking to forecast the possible effect of air pollution on natural systems (author)

  12. [Indicators of healthcare quality in day surgery (2010-2012)].

    Science.gov (United States)

    Martínez Rodenas, F; Codina Grifell, J; Deulofeu Quintana, P; Garrido Corchón, J; Blasco Casares, F; Gibanel Garanto, X; Cuixart Vilamajó, L; de Haro Licer, J; Vazquez Dorrego, X

    2014-01-01

    Monitoring quality indicators in Ambulatory Surgery centers is fundamental in order to identify problems, correct them and prevent them. Given their large number, it is essential to select the most valid ones. The objectives of the study are the continuous improvement in the quality of healthcare of day-case surgery in our center, by monitoring selective quality parameters, having periodic information on the results and taking corrective measures, as well as achieving a percentage of unplanned transfer and cancellations within quality standards. Prospective, observational and descriptive study of the day-case surgery carried out from January 2010 to December 2012. Unplanned hospital admissions and cancellations on the same day of the operation were selected and monitored, along with their reasons. Hospital admissions were classified as: inappropriate selection, medical-surgical complications, and others. The results were evaluated each year and statistically analysed using χ(2) tests. A total of 8,300 patients underwent day surgery during the 3 years studied. The day-case surgery and outpatient index increased by 5.4 and 6.4%, respectively (P<.01). Unexpected hospital admissions gradually decreased due to the lower number of complications (P<.01). Hospital admissions, due to an extended period of time in locoregional anaesthesia recovery, also decreased (P<.01). There was improved prevention of nausea and vomiting, and of poorly controlled pain. The proportion of afternoon admissions was significantly reduced (P<.01). The cancellations increased in 2011 (P<.01). The monitoring of quality parameters in day-case surgery has been a useful tool in our clinical and quality management. Globally, the unplanned transfer and cancellations have been within the quality standards and many of the indicators analysed have improved. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  13. 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?

  14. UK key performance indicators and quality assurance standards for colonoscopy.

    Science.gov (United States)

    Rees, Colin J; Thomas Gibson, Siwan; Rutter, Matt D; Baragwanath, Phil; Pullan, Rupert; Feeney, Mark; Haslam, Neil

    2016-12-01

    Colonoscopy should be delivered by endoscopists performing high quality procedures. The British Society of Gastroenterology, the UK Joint Advisory Group on GI Endoscopy, and the Association of Coloproctology of Great Britain and Ireland have developed quality assurance measures and key performance indicators for the delivery of colonoscopy within the UK. This document sets minimal standards for delivery of procedures along with aspirational targets that all endoscopists should aim for. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. 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

  16. 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

  17. Survey of quality indicators in commercial dehydrated fruits.

    Science.gov (United States)

    Megías-Pérez, Roberto; Gamboa-Santos, Juliana; Soria, Ana Cristina; Villamiel, Mar; Montilla, Antonia

    2014-05-01

    Physical and chemical quality parameters (dry matter, aw, protein, carbohydrates, vitamin C, 2-furoylmethyl amino acids, rehydration ratio and leaching loss) have been determined in 30 commercial dehydrated fruits (strawberry, blueberry, raspberry, cranberry, cherry, apple, grapefruit, mango, kiwifruit, pineapple, melon, coconut, banana and papaya). For comparison purposes, strawberry samples processed in the laboratory by freeze-drying and by convective drying were used as control samples. Overall quality of dehydrated fruits seemed to be greatly dependent on processing conditions and, in a cluster analysis, samples which were presumably subjected to osmotic dehydration were separated from the rest of fruits. These samples presented the lowest concentration of vitamin C and the highest evolution of Maillard reaction, as evidenced by its high concentration of 2-furoylmethyl amino acids. This is the first study on the usefulness of this combination of chemical and physical indicators to assess the overall quality of commercial dehydrated fruits. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Márcio Flávio Moura de Araújo

    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.

  19. 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.

  20. Biomarker as an Indicator of River Water Quality Degradation

    Directory of Open Access Journals (Sweden)

    Dwina Roosmini

    2006-11-01

    Full Text Available Generally physical and chemical methods are use in river water quality monitoring; currently biomarker is developed as alternative biomonitoring method. The aim of this study is to look at the probability using aquatic species in monitoring river water pollutants exposure. This study was done by using Hyposarcus pardalis as biomarker to analyze river water quality in Upstream Citarum River. Hyposarcus pardalis were taken along the river at five sampling point and look at the Cu and Zn concentration. Results from this study show that there was an indication that river water quality has been degrading along the river from upstream to downstream. Zn concentration in Hyposarcus pardalis were increasing as well as Cu concentration. The increase of Zn concentration in Hyposarcus pardalis indicating that the river was polluted by Zn. Secondary data and observation at sampling location shown that textile was the dominant industry which may contribute the Zn concentration in river as they received the effluent. Cu is use in metal coating process, as well as textile industry metal industries were identified at Majalaya, Bantar Panjang, Dayeuh Kolot and Katapang in Bandung-Indonesia. As a receiving water from many activities along the river, upstream Citarum River water quality become degrading as the increasing of heavy metal Zn and Cu concentration in Hyposarcus pardalis.

  1. 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.

  2. Physical soil quality indicators for monitoring British soils

    Science.gov (United States)

    Corstanje, Ron; Mercer, Theresa G.; Rickson, Jane R.; Deeks, Lynda K.; Newell-Price, Paul; Holman, Ian; Kechavarsi, Cedric; Waine, Toby W.

    2017-09-01

    Soil condition or quality determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs) for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change, e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of their capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs was tested for robustness, spatial and temporal variability, and expected rate of change using statistical analysis and modelling. Seven SQIs were prioritised: soil packing density, soil water retention characteristics, aggregate stability, rate of soil erosion, depth of soil, soil structure (assessed by visual soil evaluation) and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programmes.

  3. Physical soil quality indicators for monitoring British soils

    Directory of Open Access Journals (Sweden)

    R. Corstanje

    2017-09-01

    Full Text Available Soil condition or quality determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change, e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of their capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs was tested for robustness, spatial and temporal variability, and expected rate of change using statistical analysis and modelling. Seven SQIs were prioritised: soil packing density, soil water retention characteristics, aggregate stability, rate of soil erosion, depth of soil, soil structure (assessed by visual soil evaluation and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programmes.

  4. Selection indices for yield and quality traits in sweet corn

    International Nuclear Information System (INIS)

    Asghar, M.J.; Mehdi, S.S.

    2010-01-01

    The efficiency of three selection indices, viz., Smith-Hazel index (SHI), Desired gain index (DGI) and Base Index (BI) was compared for the improvement of an open pollinated sweet corn (Zea mays L. Saccharata) population. The data of genetic studies on various yield and quality traits among S1 families were used to construct these selection indices. Smith-Hazel index was found to be the most efficient in improving the aggregate genotype of yield traits for most of the selection strategies. Base index proved to be more efficient as compared to Smith-Hazel index in the improvement of aggregate genotype for five out of six selection strategies of quality traits. Both smith-hazel and Base indices were found useful for the improvement of sweetness and sweet flavour for all the selection strategies. When selection was confined to eight yield and four quality traits simultaneously, Base index proved to be more efficient as compared to Smith-Hazel index and desired gain index in improving the aggregate genotype for almost all the selection strategies. (author)

  5. Childhood maltreatment and adulthood poor sleep quality: a longitudinal study.

    Science.gov (United States)

    Abajobir, Amanuel A; Kisely, Steve; Williams, Gail; Strathearn, Lane; Najman, Jake M

    2017-08-01

    Available evidence from cross-sectional studies suggests that childhood maltreatment may be associated with a range of sleep disorders. However, these studies have not controlled for potential individual-, familial- and environmental-level confounders. To determine the association between childhood maltreatment and lower sleep quality after adjusting for potential confounders. Data for the present study were obtained from a pre-birth cohort study of 3778 young adults (52.6% female) of the Mater Hospital-University of Queensland Study of Pregnancy follow up at a mean age of 20.6 years. The Mater Hospital-University of Queensland Study of Pregnancy is a prospective Australian pre-birth cohort study of mothers consecutively recruited during their first obstetric clinic visit at Brisbane's Mater Hospital in 1981-1983. Participants completed the Pittsburgh Sleep Quality Index at the 21-year follow up. We linked this dataset to agency-recorded substantiated cases of childhood maltreatment. A series of separate logistic regression models was used to test whether childhood maltreatment predicted lower sleep quality after adjustment for selected confounders. Substantiated physical abuse significantly predicted lower sleep quality in males. Single and multiple forms of childhood maltreatment, including age of maltreatment and number of substantiations, did not predict lower sleep quality in either gender in both crude and adjusted models. Not being married, living in a residential problem area, cigarette smoking and internalising were significantly associated with lower sleep quality in a fully adjusted model for the male-female combined sample. Childhood maltreatment does not appear to predict young adult poor sleep quality, with the exception of physical abuse for males. While childhood maltreatment has been found to predict a range of mental health problems, childhood maltreatment does not appear to predict sleep problems occurring in young adults. Poor sleep quality was

  6. Indicators to support the dynamic evaluation of air quality models

    Science.gov (United States)

    Thunis, P.; Clappier, A.

    2014-12-01

    Air quality models are useful tools for the assessment and forecast of pollutant concentrations in the atmosphere. Most of the evaluation process relies on the “operational phase” or in other words the comparison of model results with available measurements which provides insight on the model capability to reproduce measured concentrations for a given application. But one of the key advantages of air quality models lies in their ability to assess the impact of precursor emission reductions on air quality levels. Models are then used in a dynamic mode (i.e. response to a change in a given model input data) for which evaluation of the model performances becomes a challenge. The objective of this work is to propose common indicators and diagrams to facilitate the understanding of model responses to emission changes when models are to be used for policy support. These indicators are shown to be useful to retrieve information on the magnitude of the locally produced impacts of emission reductions on concentrations with respect to the “external to the domain” contribution but also to identify, distinguish and quantify impacts arising from different factors (different precursors). In addition information about the robustness of the model results is provided. As such these indicators might reveal useful as first screening methodology to identify the feasibility of a given action as well as to prioritize the factors on which to act for an increased efficiency. Finally all indicators are made dimensionless to facilitate the comparison of results obtained with different models, different resolutions, or on different geographical areas.

  7. 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.

  8. Performance indicators: A tool for continuous quality improvement

    Directory of Open Access Journals (Sweden)

    Nidhi M Bhatnagar

    2016-01-01

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

  9. Performance indicators: A tool for continuous quality improvement.

    Science.gov (United States)

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

    2016-01-01

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

  10. Extra-analytical quality indicators and laboratory performances.

    Science.gov (United States)

    Sciacovelli, Laura; Aita, Ada; Plebani, Mario

    2017-07-01

    In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring. Active participation in inter-laboratory comparison provides information on the performance level of one laboratory with respect to that of other participating laboratories. In order to guarantee the use of appropriate QIs and facilitate their implementation, many laboratories have adopted the Model of Quality Indicators (MQI) proposed by Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of IFCC, since 2008, which is the result of international consensus and continuous experimentation, and updating to meet new, constantly emerging needs. Data from participating laboratories are collected monthly and reports describing the statistical results and evaluating laboratory data, utilizing the Six Sigma metric, issued regularly. Although the results demonstrate that the processes need to be improved upon, overall the comparison with data collected in 2014 shows a general stability of quality levels and that an improvement has been achieved over time for some activities. The continuous monitoring of QI data allows identification all possible improvements, thus highlighting the value of participation in the inter-laboratory program proposed by WG-LEPS. The active participation of numerous laboratories will guarantee an ever more significant State-of-the-Art, promote the reduction of errors and improve quality of the TTP, thus guaranteeing patient safety. Copyright © 2017. Published by Elsevier Inc.

  11. A cluster-randomised quality improvement study to improve two inpatient stroke quality indicators.

    Science.gov (United States)

    Williams, Linda; Daggett, Virginia; Slaven, James E; Yu, Zhangsheng; Sager, Danielle; Myers, Jennifer; Plue, Laurie; Woodward-Hagg, Heather; Damush, Teresa M

    2016-04-01

    Quality indicator collection and feedback improves stroke care. We sought to determine whether quality improvement training plus indicator feedback was more effective than indicator feedback alone in improving inpatient stroke indicators. We conducted a cluster-randomised quality improvement trial, randomising hospitals to quality improvement training plus indicator feedback versus indicator feedback alone to improve deep vein thrombosis (DVT) prophylaxis and dysphagia screening. Intervention sites received collaborative-based quality improvement training, external facilitation and indicator feedback. Control sites received only indicator feedback. We compared indicators pre-implementation (pre-I) to active implementation (active-I) and post-implementation (post-I) periods. We constructed mixed-effect logistic models of the two indicators with a random intercept for hospital effect, adjusting for patient, time, intervention and hospital variables. Patients at intervention sites (1147 admissions), had similar race, gender and National Institutes of Health Stroke Scale scores to control sites (1017 admissions). DVT prophylaxis improved more in intervention sites during active-I period (ratio of ORs 4.90, pimproved similarly in both groups during active-I, but control sites improved more in post-I period (ratio of ORs 0.67, p=0.04). In logistic models, the intervention was independently positively associated with DVT performance during active-I period, and negatively associated with dysphagia performance post-I period. Quality improvement training was associated with early DVT improvement, but the effect was not sustained over time and was not seen with dysphagia screening. External quality improvement programmes may quickly boost performance but their effect may vary by indicator and may not sustain over time. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Indicators of image quality and doses in mammography

    International Nuclear Information System (INIS)

    Gaona, E.; Franco E, J.G.; Azorin N, J.; Diaz G, J.A.I.; Arreola, M.

    2007-01-01

    Full text: The purpose of the study was to determine the values of the image quality indicators and their relationship with the dose in mammography of screen-film that they allowed the detection of a bigger number of objects in the images obtained with the mannequin (phantom) authorized of the ACR/FDA. The study was carried out in four mammography services in a period of 12 months. The indicators of the image quality are the half optic density (DOM), contrast (differences of densities), the number of observed objects in the images and the dose for image. The minimum acceptable values by the ACR/FDA are a half optical density of 1.4, contrast of 0.4 and the one numbers minimum of objects observed in the image of the mannequin of mammography of 10 (4 fibers, 3 groups of calcifications and 3 masses), with a maximum dose by image of 3 mGy. The found results are half optical density of 1.9, contrast of 0.56 and the average number of objects observed in the images of 12, with a dose in the interval of 1.6 mGy to 2.4 mGy. The doses were measured by thermoluminescent dosimetry and ionization chamber. Once carried out the analysis of the tendencies of the indicators of image quality and their distributions is found that for a p < 0.05, the bigger number of objects observed in the images is in the interval from 1.8 to 1.9 of DOM. When comparing both mammography system, the system screen-film has a lower variability in the distribution of objects associated to a DOM. (Author)

  13. Early Relationship Quality from Home to School: A Longitudinal Study.

    Science.gov (United States)

    Vondra, Joan I.; Shaw, Daniel S.; Swearingen, Laure; Owens, Elizabeth B.; Cohen, Meredith

    1999-01-01

    Examined role of home social relationships as predictors of social functioning in first years of school. Found that the quality of different family relationships provided relatively independent and complementary information about early social functioning in school, with more limited evidence for compensatory or protective processes at work.…

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

    Science.gov (United States)

    Ewaid, Salam Hussein

    2017-11-01

    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.

  15. Quality Indicators for Quality of Care During Hospitalization for Vulnerable Elder Persons

    National Research Council Canada - National Science Library

    Kleerup, Eric

    2004-01-01

    .... While many of the above conditions, such as congestive heart failure, pressure ulcers, and ischemic heart disease, contain indicators for the quality of hospital care associated with that condition...

  16. Annual report. (Air quality criteria and plants as biological indicators)

    Energy Technology Data Exchange (ETDEWEB)

    1969-01-01

    Studies have been carried out to derive air quality criteria as the basis for establishing emission limits. Experiments have also been carried out on the resistance of plant species which are important to the economy and public health. Among the specific avenues of investigation have been: the determination of phytotoxic hydrogen fluoride concentrations; studies on the resistance behavior of cultivated plants; fluorine enrichment in plant organs as a function of exposure height and wind speed; development and use of biological methods for detecting atmospheric impurities; detection of sulfur dioxide effects on plants; the use of transplanted lichens as air pollution indicators; grass cultures as indicators of fluorine pollution; biological accumulation of fluorine as a function of HF concentration in air; and the determination of lead and zinc levels in plants. 5 figures, 4 tables.

  17. Spectral Slope as an Indicator of Pasture Quality

    Directory of Open Access Journals (Sweden)

    Rachel Lugassi

    2014-12-01

    Full Text Available In this study, we develop a spectral method for assessment of pasture quality based only on the spectral information obtained with a small number of wavelengths. First, differences in spectral behavior were identified across the near infrared–shortwave infrared spectral range that were indicative of changes in chemical properties. Then, slopes across different spectral ranges were calculated and correlated with the changes in crude protein (CP, neutral detergent fiber (NDF and metabolic energy concentration (MEC. Finally, partial least squares (PLS regression analysis was applied to identify the optimal spectral ranges for accurate assessment of CP, NDF and MEC. Six spectral domains and a set of slope criteria for real-time evaluation of pasture quality were suggested. The evaluation of three level categories (low, medium, high for these three parameters showed a success rate of: 73%–96% for CP, 72%–87% for NDF and 60%–85% for MEC. Moreover, only one spectral range, 1748–1764 nm, was needed to provide a good estimation of CP, NDF and MEC. Importantly, five of the six selected spectral regions were not affected by water absorbance. With some modifications, this rationale can be applied to further analyses of pasture quality from airborne sensors.

  18. LONGITUDINAL STUDY OF SEMEN QUALITY AFTER INTERMITTENT EXPOSURE TO AIR POLLUTION

    Science.gov (United States)

    LONGITUDINAL STUDY OF SEMEN QUALITY AFTER INTERMITTENT EXPOSURE TO AIR POLLUTION. J. Rubes*, D. Zudova*, Veterinary Research Institute, Brno, CR, S.G. Selevan*, US EPA/ORD/NCEA, Washington, DC, D.P. Evenson, South Dakota State University, Brookings, SD, and S.D. Perreault, US ...

  19. Variations in Student Perceptions of Service Quality of Higher Education Institutions in Brazil: A Longitudinal Study

    Science.gov (United States)

    Campos, Domingos Fernandes; dos Santos, Guido Salvi; Castro, Felipe Nalon

    2017-01-01

    Purpose: The purpose of this paper is to examine, through a longitudinal study, undergraduate student perceptions of service expectations, priorities and quality of the higher education institution that they attend, using an importance-performance rating matrix. Design/methodology/approach: This research was carried out with students exposed to a…

  20. 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…

  1. Quality Indicators for Evaluating Prehospital Emergency Care: A Scoping Review.

    Science.gov (United States)

    Howard, Ian; Cameron, Peter; Wallis, Lee; Castren, Maaret; Lindstrom, Veronica

    2018-02-01

    Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. Significant progress has been made in this area, largely in the form of the development of evidence-informed quality indicators (QIs) of PEC. Problem Quality indicators represent an increasingly popular component of health care quality and performance measurement. However, little is known about the development of QIs in the PEC environment. The purpose of this study was to assess the development and characteristics of PEC-specific QIs in the literature. A scoping review was conducted through a search of PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA); EMBase (Elsevier; Amsterdam, Netherlands); CINAHL (EBSCO Information Services; Ipswich, Massachusetts USA); Web of Science (Thomson Reuters; New York, New York USA); and the Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom). To increase the sensitivity of the literature, a search of the grey literature and review of select websites was additionally conducted. Articles were selected that proposed at least one PEC QI and whose aim was to discuss, analyze, or promote quality measurement in the PEC environment. The majority of research (n=25 articles) was published within the last decade (68.0%) and largely originated within the USA (68.0%). Delphi and observational methodologies were the most commonly employed for QI development (28.0%). A total of 331 QIs were identified via the article review, with an additional 15 QIs identified via the website review. Of

  2. A THEORETICAL FRAMEWORK FOR QUALITY INDICATORS IN ELEARNING

    Directory of Open Access Journals (Sweden)

    Ciprian CEOBANU

    2009-10-01

    Full Text Available Advances in information and communication technologies, especially in Multimedia, Networking and Software Engineering allow the appearance of a new generation of computer-based training systems. Despite its obvious advantages in terms of reduced costs, simplified training programs and flexibility, e-learning was not always the miracle solution. Conceived as a powerful educational tool, e-learning was destined to change the face of learning but unfortunately, this change wasn’t exactly the intended one. The constant interest in researching and testing the use of Information and Communication Technologies (ICT, eLearning and multimedia in the learning process led to educational imperatives about the indicators that can reveal the level of quality for teaching and management of the course. Modern eLearning solutions now recognize the importance of learning as a social process and offer possibilities for collaboration with other learners, for interaction with the learning content and for guidance from teachers, trainers and tutors. Our aim is to analyze the importance of using ICT in a “learning society”. The present paper focuses on the strong potential that ICT provides, in order to develop the learning possibilities among students. The great challenge is to draw up a quality indicators framework which can represent an instrument for teachers on how to organize their online course – including ways of developing the teaching methods.

  3. Evaluating how variants of floristic quality assessment indicate wetland condition.

    Science.gov (United States)

    Kutcher, Thomas E; Forrester, Graham E

    2018-03-28

    Biological indicators are useful tools for the assessment of ecosystem condition. Multi-metric and multi-taxa indicators may respond to a broader range of disturbances than simpler indicators, but their complexity can make them difficult to interpret, which is critical to indicator utility for ecosystem management. Floristic Quality Assessment (FQA) is an example of a biological assessment approach that has been widely tested for indicating freshwater wetland condition, but less attention has been given to clarifying the factors controlling its response. FQA quantifies the aggregate of vascular plant species tolerance to habitat degradation (conservatism), and model variants have incorporated species richness, abundance, and indigenity (native or non-native). To assess bias, we tested FQA variants in open-canopy freshwater wetlands against three independent reference measures, using practical vegetation sampling methods. FQA variants incorporating species richness did not correlate with our reference measures and were influenced by wetland size and hydrogeomorphic class. In contrast, FQA variants lacking measures of species richness responded linearly to reference measures quantifying individual and aggregate stresses, suggesting a broad response to cumulative degradation. FQA variants incorporating non-native species, and a variant additionally incorporating relative species abundance, improved performance over using only native species. We relate our empirical findings to ecological theory to clarify the functional properties and implications of the FQA variants. Our analysis indicates that (1) aggregate conservatism reliably declines with increased disturbance; (2) species richness has varying relationships with disturbance and increases with site area, confounding FQA response; and (3) non-native species signal human disturbance. We propose that incorporating species abundance can improve FQA site-level relevance with little extra sampling effort. Using our

  4. Work-Team Implementation and Trajectories of Manufacturing Quality: A Longitudinal Field Study

    OpenAIRE

    Rajiv D. Banker; Joy M. Field; Kingshuk K. Sinha

    2001-01-01

    The study examines the sustainability of manufacturing quality improvements following the implementation of work teams on production lines. We posit that the impact on manufacturing quality, measured as the defect rate trajectory, is monotonically nonincreasing over time and may, more specifically, assume the shape of an inverted S-curve. Employing a longitudinal research design, we investigate four work teams over a 28-month period in a field setting. Each team corresponds to one of the four...

  5. 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

  6. Indications for quality assurance in conformal radiotherapy in Italy

    International Nuclear Information System (INIS)

    Banci Buonamici, F.; DE Angelis, C.; Rosi, A.; Tabocchini, M.A.; Iotti, C.; Olmi, P.

    2008-01-01

    Intensity-Modulated Radiation Therapy (IMRT) is an advanced and promising technique of external beam irradiation. IMRT is able to conform the dose distribution to the 3D tumour shape also for complex geometries, preserving surrounding normal tissues and reducing the probability of side effects. IMRT is a time consuming and complex technique and its use demands high level quality assurance. It is, therefore, very important to define conditions for its utilization. Professionals of Radiotherapy Centres, with experience in the IMRT use, have constituted a multidisciplinary working group with the aim of developing indications in this field. Purpose of the present document is to highlight relevant aspects of the technique, but also to underline the high complexity of the technique, whose implementation requires extreme attention of the staff of Radiotherapy Centres involved [it

  7. Associations between quality indicators of internal medicine residency training programs

    Science.gov (United States)

    2011-01-01

    Background Several residency program characteristics have been suggested as measures of program quality, but associations between these measures are unknown. We set out to determine associations between these potential measures of program quality. Methods Survey of internal medicine residency programs that shared an online ambulatory curriculum on hospital type, faculty size, number of trainees, proportion of international medical graduate (IMG) trainees, Internal Medicine In-Training Examination (IM-ITE) scores, three-year American Board of Internal Medicine Certifying Examination (ABIM-CE) first-try pass rates, Residency Review Committee-Internal Medicine (RRC-IM) certification length, program director clinical duties, and use of pharmaceutical funding to support education. Associations assessed using Chi-square, Spearman rank correlation, univariate and multivariable linear regression. Results Fifty one of 67 programs responded (response rate 76.1%), including 29 (56.9%) community teaching and 17 (33.3%) university hospitals, with a mean of 68 trainees and 101 faculty. Forty four percent of trainees were IMGs. The average post-graduate year (PGY)-2 IM-ITE raw score was 63.1, which was 66.8 for PGY3s. Average 3-year ABIM-CE pass rate was 95.8%; average RRC-IM certification was 4.3 years. ABIM-CE results, IM-ITE results, and length of RRC-IM certification were strongly associated with each other (p ITE scores were higher in programs with more IMGs and in programs that accepted pharmaceutical support (p < 0.05). RRC-IM certification was shorter in programs with higher numbers of IMGs. In multivariable analysis, a higher proportion of IMGs was associated with 1.17 years shorter RRC accreditation. Conclusions Associations between quality indicators are complex, but suggest that the presence of IMGs is associated with better performance on standardized tests but decreased duration of RRC-IM certification. PMID:21651768

  8. Quality indicators in a computerized technology information system

    International Nuclear Information System (INIS)

    Mancuso, C.A.; Hyde, R.A.

    1992-01-01

    An environmental technology information system was developed by EG ampersand G Idaho, Inc. at the Idaho National Engineering Laboratory (INEL) for the Department of Energy (DOE). The purpose of the system is to reduce costs and time associated with evaluating potential remedial alternatives for a waste site. The information system is organized to aid in the CERCLA process by describing the implementability, effectiveness, and cost of many remedial technologies. Technology categories included in the information system include: Institutional Controls, Retrieval, Separation, Characterization, Physical/Chemical Treatment, Biological Treatment, Thermal Treatment, Storage, Transportation, Disposal, Migration Control (containment), Support Systems, Waste Minimization, and Remote Operations. Two hundred and sixty processes are summarized in these technology areas. Information on these processes was collected from EPA publications, books, journal articles, conference proceedings, vendors, DOE publications, and technical experts. The purpose of this paper is to familiarize readers with issues associated with the development of information systems. A major issue is the system and software quality, which can be controlled by configuration management. Another major issue is the documentation of data quality indicators in references used to collect data for the system, which can not be controlled but must be planned for in the review process

  9. Recursive estimation of the parts production process quality indicator

    Directory of Open Access Journals (Sweden)

    Filipovich Oleg

    2017-01-01

    Full Text Available Consideration is given to a mathematical representation for manufacturing of batch parts on a metal-cutting machine tool. Linear dimensions of machined parts are assumed to be the major quality indicator, deviation from these dimensions is determined by size setting of machine tool and ensemble of random factors. It is allowed to have absolutely precise pre-setting of machine tool, effects from setup level offsetting due to deformation in process equipment on the specified indicator are disregarded. Consideration is given to factors which affect the tool wear, with two definitions of tool wear being provided. Reasons for development of random error in processing, dependence of measurement results on error as well as distribution laws and some parameters of random values are provided. To evaluate deviation of size setting value in each cycle, it is proposed to apply a recursive algorithm in description of investigated dynamic discrete process in the space state. Kalman filter equations are used in description of process model by means of first-order difference equations. The algorithm of recursive estimation is implemented in the mathematical software Maple. Simulation results which prove effectiveness of algorithm application to investigate the given dynamic system are provided. Variants of algorithm application and opportunities of further research are proposed.

  10. An assessment of Lot Quality Assurance Sampling to evaluate malaria outcome indicators: extending malaria indicator surveys.

    Science.gov (United States)

    Biedron, Caitlin; Pagano, Marcello; Hedt, Bethany L; Kilian, Albert; Ratcliffe, Amy; Mabunda, Samuel; Valadez, Joseph J

    2010-02-01

    Large investments and increased global prioritization of malaria prevention and treatment have resulted in greater emphasis on programme monitoring and evaluation (M&E) in many countries. Many countries currently use large multistage cluster sample surveys to monitor malaria outcome indicators on a regional and national level. However, these surveys often mask local-level variability important to programme management. Lot Quality Assurance Sampling (LQAS) has played a valuable role for local-level programme M&E. If incorporated into these larger surveys, it would provide a comprehensive M&E plan at little, if any, extra cost. The Mozambique Ministry of Health conducted a Malaria Indicator Survey (MIS) in June and July 2007. We applied LQAS classification rules to the 345 sampled enumeration areas to demonstrate identifying high- and low-performing areas with respect to two malaria program indicators-'household possession of any bednet' and 'household possession of any insecticide-treated bednet (ITN)'. As shown by the MIS, no province in Mozambique achieved the 70% coverage target for household possession of bednets or ITNs. By applying LQAS classification rules to the data, we identify 266 of the 345 enumeration areas as having bednet coverage severely below the 70% target. An additional 73 were identified with low ITN coverage. This article demonstrates the feasibility of integrating LQAS into multistage cluster sampling surveys and using these results to support a comprehensive national, regional and local programme M&E system. Furthermore, in the recommendations we outlined how to integrate the Large Country-LQAS design into macro-surveys while still obtaining results available through current sampling practices.

  11. 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.

  12. 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

  13. [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.

  14. 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

    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......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...... during first-line compared to relapsed treatment regimens. The background of these findings should be in focus in future studies, and HRQoL measurements should be integrated in maintenance studies....

  15. 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…

  16. 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…

  17. Longitudinal change in quality of life following hospitalisation for acute exacerbations of COPD

    Science.gov (United States)

    Steer, John; Gibson, G John; Bourke, Stephen C

    2015-01-01

    Background Current guidelines for management of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (COPD) recommend that clinical decisions, including escalation to assisted ventilation, be informed by an estimate of the patients’ likely postdischarge quality of life. There is little evidence to inform predictions of outcome in terms of quality of life, psychological well-being and functional status. Undue nihilism might lead to denial of potentially life-saving therapy, while undue optimism might prolong suffering when alternative palliation would be more appropriate. This study aimed to detail longitudinal changes in quality of life following hospitalisation for acute exacerbations of COPD. Methods We prospectively recruited two cohorts (exacerbations requiring assisted ventilation during admission and exacerbations not ventilated). Admission clinical data, and mortality and readmission details were collected. Quality of life, psychological well-being and functional status were formally assessed over the subsequent 12 months. Time-adjusted mean change in quality of life was examined. Results 183 patients (82 ventilated; 101 not ventilated) were recruited. On average, overall quality of life improved by a clinically important amount in those not ventilated and did not decline in ventilated patients. Both groups showed clinically important improvements in respiratory symptoms and an individual's sense of control over their condition, despite the tendency for functional status to decline. Conclusions On average, postdischarge quality of life improved in non-ventilated and did not decline in ventilated patients. Certain quality of life domains (ie, symptoms and mastery) improved significantly. Better understanding of longitudinal change in postdischarge quality of life should help to inform decision-making. PMID:25628892

  18. From student to graduate: longitudinal changes in the qualities of nurses.

    Science.gov (United States)

    Cowin, Leanne S; Johnson, Maree

    2015-12-01

    To examine the development of perceived qualities of nursing from student to graduate nurse over time. Researchers continue to explore student nurse and new graduate nurse attrition, particularly in the light of a looming crisis in nursing recruitment and retention. Qualities of nurses represent the job fit of nursing from student to graduate years. A prospective longitudinal design with a convenience sample was used for this study. Data were collected annually from 2009-2012 through the completion of a short on-line survey. The sample size of undergraduate nurses in year 1 was 676, with 527 in year 2, 339 in year 3 and 190 in year 4. Only 136 participants completed the survey each year forming the complete data set for analysis. Most qualities of nursing differed significantly across time with the qualities of Caring, Empathetic, Knowledge and Respectful demonstrating strong changes. Most declines in scores occurred on graduation. Caring, the central tenet of nursing increased during the student years and declined slightly on graduation. This unique longitudinal study of Australian nurses suggests that the clinical experience and theoretical grounding provided in our University programs, has resulted in an increasing cumulative effect in the third year supporting most qualities of nurses/nursing understood in year 1, that is, the career fit to perceptions, has been achieved. The decline in the 1(st) year of graduation, where the concept of workplace misfit is occurring, is where further nurse graduate support is urgently required. © 2015 John Wiley & Sons Ltd.

  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 ...

  20. 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 ...

  1. 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....

  2. 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. PMID:25232964

  3. Social support and health-related quality of life in women with breast cancer: a longitudinal study.

    Science.gov (United States)

    Leung, Janni; Pachana, Nancy A; McLaughlin, Deirdre

    2014-09-01

    A breast cancer diagnosis is a distressing event that impacts on physical and psychological functioning. This study examined the longitudinal relationships among a diagnosis of breast cancer, social support, and health-related quality of life (HRQOL). Participants were 412 women from the 1946-1951 birth cohort of the Australian Longitudinal Study on Women's Health who self-reported a new diagnosis of breast cancer between 1998 and 2007. The three surveys of longitudinal data analyzed included data 3 years before diagnosis, at diagnosis (baseline), and 3 years after diagnosis (follow-up). Social support was measured using the 19-item Medical Outcomes Study Social Support Survey; HRQOL was measured using the Medical Outcomes Study 36-item Short-Form Health Survey. Compared with pre-diagnosis HRQOL, women newly diagnosed with breast cancer reported significantly poorer HRQOL in subscales related to pain, physical functioning, and health and vitality. At 3-year follow-up, HRQOL had improved in most domains to levels consistent with pre-diagnosis. Levels of social support remained stable across time. The structural equation model showed that social support was positively predictive of better physical and mental HRQOL at 3-year follow-up. Longitudinal analyses indicate that social support appears to be an important predictor of HRQOL in women diagnosed with breast cancer. In particular, positive emotional and informational support that may normally be provided by a partner is important in maintaining HRQOL. Identification of those lacking social support, especially patients without partners, will enable them to be guided to appropriate support networks and programs. Copyright © 2014 John Wiley & Sons, Ltd.

  4. 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).

  5. 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.)

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

    International Nuclear Information System (INIS)

    Martin, David D.; Heckmann, Conrad; Neuhof, Julia; Ranke, Michael B.; Binder, Gerhard; Jenni, Oskar G.

    2012-01-01

    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 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.)

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

    Science.gov (United States)

    2012-01-01

    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. PMID:22742447

  8. 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.

  9. Quality Indicators for In-Hospital Pharmaceutical Care of Dutch Elderly Patients Development and Validation of an ACOVE-Based Quality Indicator Set

    NARCIS (Netherlands)

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

    2011-01-01

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

  10. Performance Indicators For Quality In Surgical And Laboratory ...

    African Journals Online (AJOL)

    Methodology: Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. Results: In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 ...

  11. Evaluation Criteria and Indicators of Quality for Internet Resources.

    Science.gov (United States)

    Wilkinson, Gene L.; And Others

    1997-01-01

    Most Web site rating systems overemphasize technological "bells and whistles." The University of Georgia's information quality criteria address site access and usability; resource identification and documentation; author identification; authority of author; information structure and design; relevance and scope, validity, and accuracy and…

  12. The Discussion of Subjective Quality of Working Life Indicators

    Czech Academy of Sciences Publication Activity Database

    Vinopal, Jiří

    2012-01-01

    Roč. 44, č. 3 (2012), s. 385-401 ISSN 0049-1225 Institutional support: RVO:68378025 Keywords : Job Satisfaction * Quality of Working Life * Work Satisfaction Subject RIV: AO - Sociology, Demography Impact factor: 0.240, year: 2012 http://www.sav.sk/journals/uploads/06251222Vinopal%203-2012.pdf

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

    NARCIS (Netherlands)

    Campbell, S.M.; Kontopantelis, E.; Hannon, K.; Burke, M.; Barber, A.; Lester, H.E.

    2011-01-01

    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

  14. Quality indicators in laboratory medicine: a fundamental tool for quality and patient safety.

    Science.gov (United States)

    Plebani, Mario; Sciacovelli, Laura; Marinova, Mariela; Marcuccitti, Jessica; Chiozza, Maria Laura

    2013-09-01

    The identification of reliable quality indicators (QIs) is a crucial step in enabling users to quantify the quality of laboratory services. The current lack of attention to extra-laboratory factors is in stark contrast with the body of evidence pointing to the multitude of errors that continue to occur in the pre- and post-analytical phases. Different QIs and terminologies are currently used and, therefore, there is the need to harmonize proposed QIs. A model of quality indicators (MQI) has been consensually developed by a group of clinical laboratories according to a project launched by a working group of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). The model includes 57 QIs related to key processes (35 pre-, 7 intra- and 15 post-analytical phases) and 3 to support processes. The developed MQI and the data collected provide evidence of the feasibility of the project to harmonize currently available QIs, but further efforts should be done to involve more clinical laboratories and to collect a more consistent amount of data. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. Measurement of Health Care Quality in Atopic Dermatitis - Development and Application of a Set of Quality Indicators.

    Science.gov (United States)

    Steinke, S; Beikert, F C; Langenbruch, A; Fölster-Holst, R; Ring, J; Schmitt, J; Werfel, T; Hintzen, S; Franzke, N; Augustin, M

    2018-05-15

    Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. 1) Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. 2) Application of the indicators to a cross-sectional study and creation of a global process quality index. An expert committee consisting of 10 members of the German guideline group on atopic dermatitis condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1,678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 (no quality achieved) to 100 (full quality achieved)) displaying the quality of health care. In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcome indicators as the median SCORAD (SCORing Atopic Dermatitis; rp =0.08), Dermatology Life Quality Index (DLQI; rp = 0.256), and Patient Benefit Index (PBI; rp = -0.151). Process quality of AD care is moderate to good. The health care process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness, and feasibility of the proposed quality indicators for AD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. Quality of life of elderly individuals receiving literacy training: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Bruna Rodrigues dos Santos

    2015-04-01

    Full Text Available Because of population aging in Brazil, educational programs directed to young and adult individuals now have to absorb a large number of 60 year old or older individuals. Objectives: Identify the relationships among the variables quality of life, time attending the program, depressive symptoms, and cognitive status; and longitudinally compare the scores concerning the quality of life of these individuals. Method: Descriptive, correlational, comparative, longitudinal and quantitative study. The participants were elderly individuals who attended literacy training provided in a Brazilian city from 2012 to 2014. The instruments to collect data included sociodemographic characterization, the WHOQOL-bref, WHOQOL-old, the Geriatric Depression Scale (GDS, and the Mini Mental State Examination. Results: The participants were predominantly young-elderly women, with low incomes. Scores obtained on the GDS were related with the domains: Physical (p<0.05; Environment (p<0.01; Autonomy (p<0.01, Past, Present and Future Activities (p<0.05, Intimacy (p<0.01; and Social Relationships (p<0.01. The scores concerning cognition were related to the Autonomy domain (p<0.01. The physical domain of quality of life presented significant worsening in 2013 when compared to 2012 (M1=70.23; M2=61.20;M3=62.40. These results cannot be generalized because they concern only elderly individuals receiving literacy training provided in a midsized city in the interior of São Paulo, Brazil.

  17. Quality-of-care indicators for non-small cell lung cancer.

    Science.gov (United States)

    Tanvetyanon, Tawee

    2009-10-01

    Quality-of-care indicators are measurable elements of practice performance that can be used to assess the quality or change in quality of the care provided. To date, the literature on quality-of-care indicators for non-small cell lung cancer (NSCLC) has not been reviewed. A search was performed to identify articles reporting on quality-of-care indicators specific for NSCLC published from January 2003 to May 2009 (using MEDLINE and American Society of Clinical Oncology abstract databases). Web sites of major quality care organizations were also searched. The identified indicators were then classified by their aspect of care provision (structure-of-care, process-of-care, or outcome-of-care indicator). For structure-of-care quality indicators, the most cited indicators were related to the quality of lung surgery. These included being National Cancer Institute-designated cancer centers or high-volume hospitals. For process-of-care quality indicators, the most common indicators were the receipt of surgery for early-stage NSCLC and the administration of chemotherapy for advanced-stage NSCLC. For outcome-of-care quality indicators, the most cited indicators were related to postoperative morbidity or mortality after lung surgery. Several quality-of-care indicators for NSCLC are available. Process-of-care indicators are the most studied. The use of these indicators to measure practice performance holds the promise of improving outcomes of patients with NSCLC.

  18. Body dissatisfaction in women's artistic gymnastics: A longitudinal study of psychosocial indicators.

    Science.gov (United States)

    Neves, Clara Mockdece; Filgueiras Meireles, Juliana Fernandes; Berbert de Carvalho, Pedro Henrique; Schubring, Astrid; Barker-Ruchti, Natalie; Caputo Ferreira, Maria Elisa

    2017-09-01

    Body dissatisfaction is prevalent in women's artistic gymnastics (WAG). Cross-sectional research points to social and individual risk factors, however it does not account for potential changes in body dissatisfaction during an athletic season. This study aimed to determine how gymnasts' body dissatisfaction, risk factors for eating disorders, media internalisation, perfectionism and mood state change during pre-competition, competition and post-competition seasons and to identify how these psychosocial indicators impact on body dissatisfaction during the athletic year. The sample consisted of 20 Brazilian elite women's artistic gymnasts aged 10-16 years. Data were obtained from a 9-month study using: Body Shape Questionnaire (BSQ); Eating Attitude Test-26; Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3); Multidimensional Perfectionism Scale (MPS); Brunel Mood Scale (BRUMS) and triceps and subscapular skinfolds. Body dissatisfaction was higher during the competition season and disordered eating, perfectionism and vigour values were higher in the pre-competition season. Disordered eating has been found as the strongest predictor of body dissatisfaction during all seasons, and mood state partly contributed to body dissatisfaction in the competitive season. Stakeholders should understand that body dissatisfaction and the prevalence of disordered eating may change over time.

  19. Active and intelligent packaging: The indication of quality and safety.

    Science.gov (United States)

    Janjarasskul, Theeranun; Suppakul, Panuwat

    2018-03-24

    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.

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

    Science.gov (United States)

    Martin, Claudio M.; Project, The Quality Improvement in Critical Care

    2016-01-01

    Background. Caring for critically ill patients is complex and resource intensive. An approach to monitor and compare the function of different intensive care units (ICUs) is needed to optimize outcomes for patients and the health system as a whole. Objective. To develop and implement quality indicators for comparing ICU characteristics and performance within and between ICUs and regions over time. Methods. Canadian jurisdictions with established ICU clinical databases were invited to participate in an iterative series of face-to-face meetings, teleconferences, and web conferences. Eighteen adult intensive care units across 14 hospitals and 5 provinces participated in the process. Results. Six domains of ICU function were identified: safe, timely, efficient, effective, patient/family satisfaction, and staff work life. Detailed operational definitions were developed for 22 quality indicators. The feasibility was demonstrated with the collection of 3.5 years of data. Statistical process control charts and graphs of composite measures were used for data display and comparisons. Medical and nursing leaders as well as administrators found the system to be an improvement over prior methods. Conclusions. Our process resulted in the selection and development of 22 indicators representing 6 domains of ICU function. We have demonstrated the feasibility of such a reporting system. This type of reporting system will demonstrate variation between units and jurisdictions to help identify and prioritize improvement efforts. PMID:27493476

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

    OpenAIRE

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

    2017-01-01

    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, saf...

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

    Science.gov (United States)

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

    2016-02-01

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

  3. A longitudinal study of quality of life of earthquake survivors in L'Aquila, Italy.

    Science.gov (United States)

    Valenti, Marco; Masedu, Francesco; Mazza, Monica; Tiberti, Sergio; Di Giovanni, Chiara; Calvarese, Anna; Pirro, Roberta; Sconci, Vittorio

    2013-12-07

    People's well-being after loss resulting from an earthquake is a concern in countries prone to natural disasters. Most studies on post-earthquake subjective quality of life (QOL) have focused on the effects of psychological impairment and post-traumatic stress disorder (PTSD) on the psychological dimension of QOL. However, there is a need for studies focusing on QOL in populations not affected by PTSD or psychological impairment. The aim of this study was to estimate QOL changes over an 18-month period in an adult population sample after the L'Aquila 2009 earthquake. The study was designed as a longitudinal survey with four repeated measurements performed at six monthly intervals. The setting was the general population of an urban environment after a disruptive earthquake. Participants included 397 healthy adult subjects. Exclusion criteria were comorbidities such as physical, psychological, psychiatric or neurodegenerative diseases at the beginning of the study. The primary outcome measure was QOL, as assessed by the WHOQOL-BREF instrument. A generalised estimating equation model was run for each WHOQOL-BREF domain. Overall, QOL scores were observed to be significantly higher 18 months after the earthquake in all WHOQOL-BREF domains. The model detected an average increase in the physical QOL scores (from 66.6 ± 5.2 to 69.3 ± 4.7), indicating a better overall physical QOL for men. Psychological domain scores (from 64.9 ± 5.1 to 71.5 ± 6.5) were observed to be worse in men than in women. Levels at the WHOQOL domain for psychological health increased from the second assessment onwards in women, indicating higher resiliency. Men averaged higher scores than women in terms of social relationships and the environmental domain. Regarding the physical, psychological and social domains of QOL, scores in the elderly group (age > 60) were observed to be similar to each other regardless of the significant covariates used. WHOQOL-BREF scores of the psychological domain

  4. Use of Quality Models and Indicators for Evaluating Test Quality in an ESP Course

    Directory of Open Access Journals (Sweden)

    IEVA RUDZINSKA

    2013-12-01

    Full Text Available Qualitative methods of assessment play a decisive role in education in general and in language learning in particular. The necessity to perform a qualitative assessment comes from both increased student competition in higher education institutions (HEIs, and hence higher demands for fair assessment, and a growing public awareness on higher education issues, and therefore the need to account for a wider circle of stakeholders, including society as a whole. The aim of the present paper is to study the regulations and laws pertaining to the issue of assessment in Latvian HEIs, as well as to carry out literature sources analysis about assessment in language testing, seeking to select criteria characterizing the quality of English for Specific Purposes (ESP tests and to apply the model of evaluating the quality of a language test on an example of a test in sport English, developed in a Latvian higher education institution. An analysis of the regulations and laws about assessment in higher education and literature sources about tests in language courses has enabled the development of a test quality model, consisting of seven intrinsic quality criteria: clarity, adequacy, deep approach, attractiveness, originality/similarity, orientation towards student learning result/process, test scoring objectivity/subjectivity. Quality criteria comprise eleven indicators. The reliability of the given model is evaluated by means of the whole model, its criteria and indicator Cronbach’s alphas and point-biserial (item-total correlations or discrimination indexes DI. The test was taken by 63 participants, all of them 2nd year full time students attending a Latvian higher education institution. A statistical data analysis was performed with SPSS 17.0. The results show that, although test adequacy and clarity is sufficiently high, attractiveness and deep approach should be improved. Also the reliability of one version of the test is higher than that of the other one

  5. 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.

  6. [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.

  7. CHEMICAL WATER QUALITY INDICATORS IN BASIN FOREST PARCZEW

    Directory of Open Access Journals (Sweden)

    Antoni Grzywna

    2014-10-01

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

  8. Assessment of the quality of life in maxillectomy patients: A longitudinal study.

    Science.gov (United States)

    Kumar, Pradeep; Alvi, Habib Ahmad; Rao, Jitendra; Singh, Balendra Pratap; Jurel, Sunit Kumar; Kumar, Lakshya; Aggarwal, Himanshi

    2013-02-01

    To longitudinally assess the quality of life in maxillectomy patients rehabilitated with obturator prosthesis. Thirty-six subjects were enrolled in the span of 16 months, out of which six were dropouts. Subjects (age group 20-60 years) with maxillary defects, irrespective of the cause, planned for definite obturator prosthesis, were recruited. The Hindi version of European Organization for Research and Treatment of Cancer, Head and Neck version 1 of Quality of Life Questionnaire was used before surgical intervention and one month after definitive obturator. Questionnaire includes 35 questions related to the patient's physical health, well being, psychological status, social relation and environmental conditions. The data were processed with statistical package for social science (SPSS). Probability level of Pmaxillectomy defects.

  9. A hard day's night : a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue

    NARCIS (Netherlands)

    De Lange, Annet H.; Kompier, Michiel A. J.; Taris, Toon W.; Geurts, Sabine A. E.; Beckers, Debby G. J.; Houtman, Irene L. D.; Bongers, Paulien M.

    This prospective four-wave study examined (i) the causal direction of the longitudinal relations among job demands, job control, sleep quality and fatigue; and (ii) the effects of stability and change in demand-control history on the development of sleep quality and fatigue. Based on results of a

  10. A hard day's night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue

    NARCIS (Netherlands)

    Lange, A.H. de; Kompier, M.A.J.; Taris, T.W.; Geurts, S.A.E.; Beckers, D.G.J.; Houtman, I.L.D.; Bongers, P.M.

    2009-01-01

    This prospective four-wave study examined (i) the causal direction of the longitudinal relations among job demands, job control, sleep quality and fatigue; and (ii) the effects of stability and change in demand-control history on the development of sleep quality and fatigue. Based on results of a

  11. A hard day's night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue

    NARCIS (Netherlands)

    de Lange, A.H.; Kompier, M.A.J.; Taris, T.W.; Geurts, S.A.E.; Beckers, D.G.J.; Houtman, I.L.H.; Bongers, P.M.

    2009-01-01

    Summary This prospective four-wave study examined (i) the causal direction of the longitudinal relations among job demands, job control, sleep quality and fatigue; and (ii) the effects of stability and change in demand-control history on the development of sleep quality and fatigue. Based on results

  12. A hard day's night: A longitudinal study on the relationships among job demands and job control, sleep quality and fatigue

    NARCIS (Netherlands)

    Lange, A.H.de; Kompier, M.A.J.; Taris, T.W.; Geurts, S.A.E.; Beckers, D.G.J.; Houtman, I.L.D.; Bongers, P.M.

    2009-01-01

    This prospective four-wave study examined (i) the causal direction of the longitudinal relations among job demands, job control, sleep quality and fatigue; and (ii) the effects of stability and change in demand-control history on the development of sleep quality and fatigue. Based on results of a

  13. 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

  14. Longitudinal Pediatric Palliative Care: Quality of Life & Spiritual Struggle (FACE): design and methods.

    Science.gov (United States)

    Dallas, Ronald H; Wilkins, Megan L; Wang, Jichuan; Garcia, Ana; Lyon, Maureen E

    2012-09-01

    As life expectancy increases for adolescents ever diagnosed with AIDS due to treatment advances, the optimum timing of advance care planning is unclear. Left unprepared for end-of-life (EOL) decisions, families may encounter miscommunication and disagreements, resulting in families being charged with neglect, court battles and even legislative intervention. Advanced care planning (ACP) is a valuable tool rarely used with adolescents. The Longitudinal Pediatric Palliative Care: Quality of Life & Spiritual Struggle study is a two-arm, randomized controlled trial assessing the effectiveness of a disease specific FAmily CEntered (FACE) advanced care planning intervention model among adolescents diagnosed with AIDS, aimed at relieving psychological, spiritual, and physical suffering, while maximizing quality of life through facilitated conversations about ACP. Participants will include 130 eligible dyads (adolescent and family decision-maker) from four urban cities in the United States, randomized to either the FACE intervention or a Healthy Living Control. Three 60-minute sessions will be conducted at weekly intervals. The dyads will be assessed at baseline as well as 3-, 6-, 12-, and 18-month post-intervention. The primary outcome measures will be in congruence with EOL treatment preferences, decisional conflict, and quality of communication. The mediating and moderating effects of threat appraisal, HAART adherence, and spiritual struggle on the relationships among FACE and quality of life and hospitalization/dialysis use will also be assessed. This study will be the first longitudinal study of an AIDS-specific model of ACP with adolescents. If successful, this intervention could quickly translate into clinical practice. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. From Computer-interpretable Guidelines to Computer-interpretable Quality Indicators: A Case for an Ontology.

    Science.gov (United States)

    White, Pam; Roudsari, Abdul

    2014-01-01

    In the United Kingdom's National Health Service, quality indicators are generally measured electronically by using queries and data extraction, resulting in overlap and duplication of query components. Electronic measurement of health care quality indicators could be improved through an ontology intended to reduce duplication of effort during healthcare quality monitoring. While much research has been published on ontologies for computer-interpretable guidelines, quality indicators have lagged behind. We aimed to determine progress on the use of ontologies to facilitate computer-interpretable healthcare quality indicators. We assessed potential for improvements to computer-interpretable healthcare quality indicators in England. We concluded that an ontology for a large, diverse set of healthcare quality indicators could benefit the NHS and reduce workload, with potential lessons for other countries.

  16. Image quality indicators for radiography and recommendations for their use - 1966

    Energy Technology Data Exchange (ETDEWEB)

    1976-01-01

    This Standard covers dimensional requirements, materials, construction and marking of wire type and step/hole type image quality indicators for assessing quality of radiographs on materials from 3 mm to 250 mm thick. Standard models of each type; use of image quality indicators (with obtainable sensitivity values) and charts for calculations. (Metric)

  17. 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

  18. Mixing layer height as an indicator for urban air quality?

    Directory of Open Access Journals (Sweden)

    A. Geiß

    2017-08-01

    Full Text Available The mixing layer height (MLH is a measure for the vertical turbulent exchange within the boundary layer, which is one of the controlling factors for the dilution of pollutants emitted near the ground. Based on continuous MLH measurements with a Vaisala CL51 ceilometer and measurements from an air quality network, the relationship between MLH and near-surface pollutant concentrations has been investigated. In this context the uncertainty of the MLH retrievals and the representativeness of ground-based in situ measurements are crucial. We have investigated this topic by using data from the BAERLIN2014 campaign in Berlin, Germany, conducted from June to August 2014. To derive the MLH, three versions of the proprietary software BL-VIEW and a novel approach COBOLT were compared. It was found that the overall agreement is reasonable if mean diurnal cycles are considered. The main advantage of COBOLT is the continuous detection of the MLH with a temporal resolution of 10 min and a lower number of cases when the residual layer is misinterpreted as mixing layer. We have calculated correlations between MLH as derived from the different retrievals and concentrations of pollutants (PM10, O3 and NOx for different locations in the metropolitan area of Berlin. It was found that the correlations with PM10 are quite different for different sites without showing a clear pattern, whereas the correlation with NOx seems to depend on the vicinity of emission sources in main roads. In the case of ozone as a secondary pollutant, a clear correlation was found. We conclude that the effects of the heterogeneity of the emission sources, chemical processing and mixing during transport exceed the differences due to different MLH retrievals. Moreover, it seems to be unrealistic to find correlations between MLH and near-surface pollutant concentrations representative for a city like Berlin (flat terrain, in particular when traffic emissions are dominant. Nevertheless it is

  19. 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

  20. 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.

  1. Clinical pharmacology quality assurance program: models for longitudinal analysis of antiretroviral proficiency testing for international laboratories.

    Science.gov (United States)

    DiFrancesco, Robin; Rosenkranz, Susan L; Taylor, Charlene R; Pande, Poonam G; Siminski, Suzanne M; Jenny, Richard W; Morse, Gene D

    2013-10-01

    Among National Institutes of Health HIV Research Networks conducting multicenter trials, samples from protocols that span several years are analyzed at multiple clinical pharmacology laboratories (CPLs) for multiple antiretrovirals. Drug assay data are, in turn, entered into study-specific data sets that are used for pharmacokinetic analyses, merged to conduct cross-protocol pharmacokinetic analysis, and integrated with pharmacogenomics research to investigate pharmacokinetic-pharmacogenetic associations. The CPLs participate in a semiannual proficiency testing (PT) program implemented by the Clinical Pharmacology Quality Assurance program. Using results from multiple PT rounds, longitudinal analyses of recovery are reflective of accuracy and precision within/across laboratories. The objectives of this longitudinal analysis of PT across multiple CPLs were to develop and test statistical models that longitudinally: (1) assess the precision and accuracy of concentrations reported by individual CPLs and (2) determine factors associated with round-specific and long-term assay accuracy, precision, and bias using a new regression model. A measure of absolute recovery is explored as a simultaneous measure of accuracy and precision. Overall, the analysis outcomes assured 97% accuracy (±20% of the final target concentration of all (21) drug concentration results reported for clinical trial samples by multiple CPLs). Using the Clinical Laboratory Improvement Act acceptance of meeting criteria for ≥2/3 consecutive rounds, all 10 laboratories that participated in 3 or more rounds per analyte maintained Clinical Laboratory Improvement Act proficiency. Significant associations were present between magnitude of error and CPL (Kruskal-Wallis P Kruskal-Wallis P < 0.001).

  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. Identifying models of delivery, care domains and quality indicators relevant to palliative day services: a scoping review protocol.

    Science.gov (United States)

    O'Connor, Seán R; Dempster, Martin; McCorry, Noleen K

    2017-05-16

    With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services. Electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials) will be searched for evidence using consensus development methods; randomised or quasi-randomised controlled trials; mixed methods; and prospective, longitudinal or retrospective case-control studies to develop or test quality indicators for evaluating palliative care within non-residential settings, including day hospices and community or primary care settings. At least two researchers will independently conduct all searches, study selection and data abstraction procedures. Meta-analyses and statistical methods of synthesis are not planned as part of the review. Results will be reported using numerical counts, including number of indicators in each care domain and by using qualitative approach to describe important indicator characteristics. A conceptual model will also be developed to summarise the impact of different aspects of quality in a palliative day service context. Methodological quality relating to indicator development will be assessed using the Appraisal of Indicators through Research and Evaluation (AIRE) tool. Overall strength of evidence will be assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Final decisions on quality assessment will be made via consensus between review authors. Identifying, developing and implementing evidence-based quality indicators is critical to the evaluation and

  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. Biological indices of soil quality: an ecosystem case study of their use

    Science.gov (United States)

    Jennifer D. Knoepp; David C. Coleman; D.A. Crossley; James S. Clark

    2000-01-01

    Soil quality indices can help ensure that site productivity and soil function are maintained. Biological indices yield evidence of how a soil functions and interacts with the plants, animals, and climate that comprise an ecosystem. Soil scientists can identify and quantify both chemical and biological soil-quality indicators for ecosystems with a single main function,...

  6. Evaluating the scientific basis of quality indicators in colorectal cancer care: A systematic review

    NARCIS (Netherlands)

    Keikes, Lotte; Koopman, Miriam; Tanis, Pieter J.; Lemmens, Valery E. P. P.; Punt, Cornelis J. A.; van Oijen, Martijn G. H.

    2017-01-01

    In colorectal cancer care, many indicators for assessment and improvement of quality of care are being used. These quality indicators serve as national and international benchmarks to compare health care on hospital and patient level. However, the scientific basis of these indicators is often

  7. Evaluating the scientific basis of quality indicators in colorectal cancer care : A systematic review

    NARCIS (Netherlands)

    Keikes, Lotte; Koopman, Miriam; Tanis, Pieter J.; Lemmens, Valery E.P.P.; Punt, Cornelis J.A.; van Oijen, Martijn G.H.

    2017-01-01

    Aim In colorectal cancer care, many indicators for assessment and improvement of quality of care are being used. These quality indicators serve as national and international benchmarks to compare health care on hospital and patient level. However, the scientific basis of these indicators is often

  8. Quality of life among prostate cancer patients: A prospective longitudinal population-based study

    International Nuclear Information System (INIS)

    Schaake, Wouter; Groot, Martijn de; Krijnen, Wim P.; Langendijk, Johannes A.; Bergh, Alfons C.M. van den

    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, treated with radiotherapy. The EORTC QLQ-C30 was used to assess QoL before radiotherapy and six months, one year, two years and three years after completion of radiotherapy. Mixed model analyses were used to investigate longitudinal changes in QoL. QoL of prostate cancer patients was compared to that of a normative cohort using a multivariate analysis of covariance. Results: A significant decline in QoL was observed after radiotherapy (p < 0.001). The addition of hormonal therapy to radiotherapy was associated with a lower level of role functioning. Patients with coronary heart disease and or chronic obstructive pulmonary disease or asthma had a significantly worse course in QoL. Although statistically significant, all differences were classified as small or trivial. Conclusion: Prostate cancer patients experience a small worsening of QoL as compared with baseline and as compared with a normal reference population. As co-morbidity modulates patients’ post-treatment QoL, a proper assessment of co-morbidity should be included in future longitudinal analyses on QoL

  9. Substance abuse and quality of life among severely mentally ill consumers: a longitudinal modelling analysis.

    Science.gov (United States)

    Urbanoski, Karen A; Cairney, John; Adlaf, Edward; Rush, Brian

    2007-10-01

    Evidence suggests that substance abuse negatively affects both psychiatric symptom severity and quality of life (QOL) in people with severe mental illness (SMI). However, these relationships have not been examined simultaneously, nor have they been characterized over time. Thus, it is difficult to appreciate the extent to which substance abuse exerts an enduring effect on psychiatric symptoms and distress and/or QOL in this population. The purpose of this study is to test a conceptual model linking these factors together. Subjects were participants in a longitudinal evaluation of community mental healthcare in Ontario (n = 133). Comprehensive consumer assessments were conducted at treatment entry, and at 9 and 18 months. Subjects were receiving intensive case management or assertive community treatment throughout the 18-month study period. Structural equation modelling was used to examine the concurrent and longitudinal relationships between substance abuse, symptoms and distress, and QOL. The prevalence of substance abuse was 55.0%. The SEM analysis suggested that substance abuse at baseline was associated with elevated symptomatology and distress and lower QOL, and that these effects endured after 18 months of treatment. Psychiatric symptoms and distress mediated the negative relationship between substance abuse and QOL. The mediating role played by symptom and distress levels in the relationship between substance abuse and QOL suggests the importance of closely monitoring changes in these factors among SMI patients with substance problems. Tracking symptom severity and distress levels over time will allow service providers to intervene and potentially improve the QOL of individuals with SMI.

  10. Treatment factors affecting longitudinal quality of life in new onset pediatric epilepsy.

    Science.gov (United States)

    Modi, Avani C; Ingerski, Lisa M; Rausch, Joseph R; Glauser, Tracy A

    2011-05-01

    Recognizing the importance of patient-reported outcomes, this longitudinal, prospective study examined: Changes in health-related quality of life (HRQOL) over seven months following antiepileptic drug (AED) initiation and the relationship of seizures, AED side-effects, and AED type to HRQOL. Parents of 124 children with newly diagnosed epilepsy completed measures of HRQOL and side-effects at each clinic visit. Treatment information was also collected. HRQOL remained stable over time; however, seizures and AED side-effects significantly affected multiple HRQOL domains. Higher seizure activity was associated with decreased Physical HRQOL. Side-effects were negatively associated with all HRQOL domains. Children taking carbamazepine who experienced higher side-effects early in therapy demonstrated declining emotional functioning compared to children experiencing no/some side-effects. AED side-effects, AED type, and seizure frequency were associated with longitudinal HRQOL in children with newly-diagnosed epilepsy. Routine assessment of AED side-effects and HRQOL may be useful for clinical decision making.

  11. Development of indicators of the quality of radiotherapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Danielson, Brita; Brundage, Michael; Pearcey, Robert; Bass, Brenda; Pickles, Tom; Bahary, Jean-Paul; Foley, Kimberley; Mackillop, William

    2011-01-01

    Purpose: To develop a set of indicators of the quality of radiotherapy (RT) for localized prostate cancer. Methods and materials: Following a comprehensive review of the literature to identify candidate quality indicators, we utilized a modified Delphi technique to develop a set of indicators of the quality of RT for localized prostate cancer. The first Delphi round consisted of an online survey in which radiation oncologists were asked to rate the importance of the candidate quality indicators. The second round was a face-to-face meeting of a smaller group of radiation oncologists to discuss, rate, and rank a final set of quality indicators. Results: The literature review identified 57 candidate quality indicators. After the two rounds of the Delphi process, a final set of 25 indicators was agreed upon. The set includes quality indicators covering all aspects of prostate cancer radical RT management: pre-treatment assessment, external beam RT, brachytherapy, androgen deprivation therapy, and follow-up. Conclusions: This new set of quality indicators is more comprehensive than others described in the literature, and can be applied to patterns of care studies that assess the quality of RT for prostate cancer. The process used to develop this set of indicators can be readily adapted for use in other contexts.

  12. 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

  13. Environmental Indicator Principium with Case References to Agricultural Soil, Water, and Air Quality and Model-Derived Indicators.

    Science.gov (United States)

    Zhang, T Q; Zheng, Z M; Lal, R; Lin, Z Q; Sharpley, A N; Shober, A L; Smith, D; Tan, C S; Van Cappellen, P

    2018-03-01

    Environmental indicators are powerful tools for tracking environmental changes, measuring environmental performance, and informing policymakers. Many diverse environmental indicators, including agricultural environmental indicators, are currently in use or being developed. This special collection of technical papers expands on the peer-reviewed literature on environmental indicators and their application to important current issues in the following areas: (i) model-derived indicators to indicate phosphorus losses from arable land to surface runoff and subsurface drainage, (ii) glutathione-ascorbate cycle-related antioxidants as early-warning bioindicators of polybrominated diphenyl ether toxicity in mangroves, and (iii) assessing the effectiveness of using organic matrix biobeds to limit herbicide dissipation from agricultural fields, thereby controlling on-farm point-source pollution. This introductory review also provides an overview of environmental indicators, mainly for agriculture, with examples related to the quality of the agricultural soil-water-air continuum and the application of model-derived indicators. Current knowledge gaps and future lines of investigation are also discussed. It appears that environmental indicators, particularly those for agriculture, work efficiently at the field, catchment, and local scales and serve as valuable metrics of system functioning and response; however, these indicators need to be refined or further developed to comprehensively meet community expectations in terms of providing a consistent picture of relevant issues and/or allowing comparisons to be made nationally or internationally. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  14. The Global Streamflow Indices and Metadata Archive (GSIM – Part 2: Quality control, time-series indices and homogeneity assessment

    Directory of Open Access Journals (Sweden)

    L. Gudmundsson

    2018-04-01

    Full Text Available This is Part 2 of a two-paper series presenting the Global Streamflow Indices and Metadata Archive (GSIM, which is a collection of daily streamflow observations at more than 30 000 stations around the world. While Part 1 (Do et al., 2018a describes the data collection process as well as the generation of auxiliary catchment data (e.g. catchment boundary, land cover, mean climate, Part 2 introduces a set of quality controlled time-series indices representing (i the water balance, (ii the seasonal cycle, (iii low flows and (iv floods. To this end we first consider the quality of individual daily records using a combination of quality flags from data providers and automated screening methods. Subsequently, streamflow time-series indices are computed for yearly, seasonal and monthly resolution. The paper provides a generalized assessment of the homogeneity of all generated streamflow time-series indices, which can be used to select time series that are suitable for a specific task. The newly generated global set of streamflow time-series indices is made freely available with an digital object identifier at https://doi.pangaea.de/10.1594/PANGAEA.887470 and is expected to foster global freshwater research, by acting as a ground truth for model validation or as a basis for assessing the role of human impacts on the terrestrial water cycle. It is hoped that a renewed interest in streamflow data at the global scale will foster efforts in the systematic assessment of data quality and provide momentum to overcome administrative barriers that lead to inconsistencies in global collections of relevant hydrological observations.

  15. The Global Streamflow Indices and Metadata Archive (GSIM) - Part 2: Quality control, time-series indices and homogeneity assessment

    Science.gov (United States)

    Gudmundsson, Lukas; Do, Hong Xuan; Leonard, Michael; Westra, Seth

    2018-04-01

    This is Part 2 of a two-paper series presenting the Global Streamflow Indices and Metadata Archive (GSIM), which is a collection of daily streamflow observations at more than 30 000 stations around the world. While Part 1 (Do et al., 2018a) describes the data collection process as well as the generation of auxiliary catchment data (e.g. catchment boundary, land cover, mean climate), Part 2 introduces a set of quality controlled time-series indices representing (i) the water balance, (ii) the seasonal cycle, (iii) low flows and (iv) floods. To this end we first consider the quality of individual daily records using a combination of quality flags from data providers and automated screening methods. Subsequently, streamflow time-series indices are computed for yearly, seasonal and monthly resolution. The paper provides a generalized assessment of the homogeneity of all generated streamflow time-series indices, which can be used to select time series that are suitable for a specific task. The newly generated global set of streamflow time-series indices is made freely available with an digital object identifier at https://doi.pangaea.de/10.1594/PANGAEA.887470" target="_blank">https://doi.pangaea.de/10.1594/PANGAEA.887470 and is expected to foster global freshwater research, by acting as a ground truth for model validation or as a basis for assessing the role of human impacts on the terrestrial water cycle. It is hoped that a renewed interest in streamflow data at the global scale will foster efforts in the systematic assessment of data quality and provide momentum to overcome administrative barriers that lead to inconsistencies in global collections of relevant hydrological observations.

  16. Assessment of emergency general surgery care based on formally developed quality indicators.

    Science.gov (United States)

    Ingraham, Angela; Nathens, Avery; Peitzman, Andrew; Bode, Allison; Dorlac, Gina; Dorlac, Warren; Miller, Preston; Sadeghi, Mahsa; Wasserman, Deena D; Bilimoria, Karl

    2017-08-01

    Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators. Through 2 rankings, an expert panel ranked potential quality indicators for validity. We then examined historic compliance with select quality indicators after 4 nonelective procedures (cholecystectomy, appendectomy, colectomy, small bowel resection) at 4 academic centers. Of 25 indicators rated as valid, 13 addressed patient-level quality and 12 addressed hospital-level quality. Adherence with 18 indicators was assessed. Compliance with performing a cholecystectomy for acute cholecystitis within 72 hours of symptom onset ranged from 45% to 76%. Compliance with surgery start times within 3 hours from the decision to operate for uncontained perforated viscus ranged from 20% to 100%. Compliance with exploration of patients with small bowel obstructions with ischemia/impending perforation within 3 hours of the decision to operate was 0% to 88%. For 3 quality indicators (auditing 30-day unplanned readmissions/operations for patients previously managed nonoperatively, monitoring time to source control for intra-abdominal infections, and having protocols for bypass/transfer), none of the hospitals were compliant. Developing indicators for providers to assess their performance provides a foundation for specific initiatives. Adherence to quality indicators may improve the quality of emergency general surgery care provided for which current outcomes are potentially modifiable. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. 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

  18. 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...

  19. European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery.

    Science.gov (United States)

    Querleu, Denis; Planchamp, François; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

    2016-09-01

    The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). Quality indicators were based on scientific evidence and/or expert consensus. A 4-step evaluation process included a systematic literature search for the identification of potential QIs and the documentation of scientific evidence, physical meetings of an ad hoc multidisciplinarity International Development Group, an internal validation of the targets and scoring system, and an external review process involving physicians and patients. Ten structural, process, or outcome indicators were selected. Quality indicators 1 to 3 are related to achievement of complete cytoreduction, caseload in the center, training, and experience of the surgeon. Quality indicators 4 to 6 are related to the overall management, including active participation to clinical research, decision-making process within a structured multidisciplinary team, and preoperative workup. Quality indicator 7 addresses the high value of adequate perioperative management. Quality indicators 8 to 10 highlight the need of recording pertinent information relevant to improvement of quality. An ESGO-approved template for the operative report has been designed. Quality indicators were described using a structured format specifying what the indicator is measuring, measurability specifications, and targets. Each QI was associated with a score, and an assessment form was built. The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give

  20. 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.

  1. 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. Copyright 2006 APA, all rights reserved).

  2. First Dutch Consensus of Pain Quality Indicators for Pain Treatment Facilities.

    Science.gov (United States)

    de Meij, Nelleke; van Grotel, Marloes; Patijn, Jacob; van der Weijden, Trudy; van Kleef, Maarten

    2016-01-01

    There is a general consensus about the need to define and improve the quality of pain treatment facilities. Although guidelines and recommendations to improve the quality of pain practice management have been launched, provision of appropriate pain treatment is inconsistent and the quality of facilities varies widely. The aim of the study was to develop an expert-agreed list of quality indicators applicable to pain treatment facilities. The list was also intended to be used as the basis for a set of criteria for registered status of pain treatment facilities. The University Pain Center Maastricht at the Department of Anesthesiology and Pain Management of the Maastricht University Medical Center conducted a 3-round Delphi study in collaboration with the Board of the Pain Section of the Dutch Society of Anesthesiologists (NVA). Twenty-five quality indicators were selected as relevant to 2 types of pain treatment facilities, pain clinics and pain centers. The final expert-agreed list consisted of 22 quality indicators covering 7 quality domains: supervision, availability of care, staffing level and patient load, quality policy, multidisciplinarity, regionalization, and research and education. This set of quality indicators may facilitate organizational evaluation and improve insight into service quality from the perspectives of patients, pain specialists, and other healthcare professionals. Recommendations for improvements to the current set of quality indicators are made. In 2014 the process of registering pain treatment facilities in the Netherlands started; facilities can register as a pain clinic or pain center. © 2015 World Institute of Pain.

  3. 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.

  4. Impaired bone formation in ovariectomized mice reduces implant integration as indicated by longitudinal in vivo micro-computed tomography.

    Science.gov (United States)

    Li, Zihui; Kuhn, Gisela; Schirmer, Michael; Müller, Ralph; Ruffoni, Davide

    2017-01-01

    Although osteoporotic bone, with low bone mass and deteriorated bone architecture, provides a less favorable mechanical environment than healthy bone for implant fixation, there is no general agreement on the impact of osteoporosis on peri-implant bone (re)modeling, which is ultimately responsible for the long term stability of the bone-implant system. Here, we inserted an implant in a mouse model mimicking estrogen deficiency-induced bone loss and we monitored with longitudinal in vivo micro-computed tomography the spatio-temporal changes in bone (re)modeling and architecture, considering the separate contributions of trabecular, endocortical and periosteal surfaces. Specifically, 12 week-old C57BL/6J mice underwent OVX/SHM surgery; 9 weeks after we inserted special metal-ceramics implants into the 6th caudal vertebra and we measured bone response with in vivo micro-CT weekly for the following 6 weeks. Our results indicated that ovariectomized mice showed a reduced ability to increase the thickness of the cortical shell close to the implant because of impaired peri-implant bone formation, especially at the periosteal surface. Moreover, we observed that healthy mice had a significantly higher loss of trabecular bone far from the implant than estrogen depleted animals. Such behavior suggests that, in healthy mice, the substantial increase in peri-implant bone formation which rapidly thickened the cortex to secure the implant may raise bone resorption elsewhere and, specifically, in the trabecular network of the same bone but far from the implant. Considering the already deteriorated bone structure of estrogen depleted mice, further bone loss seemed to be hindered. The obtained knowledge on the dynamic response of diseased bone following implant insertion should provide useful guidelines to develop advanced treatments for osteoporotic fracture fixation based on local and selective manipulation of bone turnover in the peri-implant region.

  5. Impaired bone formation in ovariectomized mice reduces implant integration as indicated by longitudinal in vivo micro-computed tomography.

    Directory of Open Access Journals (Sweden)

    Zihui Li

    Full Text Available Although osteoporotic bone, with low bone mass and deteriorated bone architecture, provides a less favorable mechanical environment than healthy bone for implant fixation, there is no general agreement on the impact of osteoporosis on peri-implant bone (remodeling, which is ultimately responsible for the long term stability of the bone-implant system. Here, we inserted an implant in a mouse model mimicking estrogen deficiency-induced bone loss and we monitored with longitudinal in vivo micro-computed tomography the spatio-temporal changes in bone (remodeling and architecture, considering the separate contributions of trabecular, endocortical and periosteal surfaces. Specifically, 12 week-old C57BL/6J mice underwent OVX/SHM surgery; 9 weeks after we inserted special metal-ceramics implants into the 6th caudal vertebra and we measured bone response with in vivo micro-CT weekly for the following 6 weeks. Our results indicated that ovariectomized mice showed a reduced ability to increase the thickness of the cortical shell close to the implant because of impaired peri-implant bone formation, especially at the periosteal surface. Moreover, we observed that healthy mice had a significantly higher loss of trabecular bone far from the implant than estrogen depleted animals. Such behavior suggests that, in healthy mice, the substantial increase in peri-implant bone formation which rapidly thickened the cortex to secure the implant may raise bone resorption elsewhere and, specifically, in the trabecular network of the same bone but far from the implant. Considering the already deteriorated bone structure of estrogen depleted mice, further bone loss seemed to be hindered. The obtained knowledge on the dynamic response of diseased bone following implant insertion should provide useful guidelines to develop advanced treatments for osteoporotic fracture fixation based on local and selective manipulation of bone turnover in the peri-implant region.

  6. 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.…

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

    Science.gov (United States)

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

    2016-01-01

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

  8. OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion

    NARCIS (Netherlands)

    Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

    2006-01-01

    PURPOSE: This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health

  9. Implementing quality indicators in intensive care units: exploring barriers to and facilitators of behaviour change

    NARCIS (Netherlands)

    de Vos, M.L.G.; van der Veer, S.N.; Graafmans, W.C.; de Keizer, N.F.; Jager, K.J.; Westert, G.P.; van der Voort, P.H.J.

    2010-01-01

    ABSTRACT: BACKGROUND: Quality indicators are increasingly used in healthcare but there are various barriers hindering their routine use. To promote the use of quality indicators, an exploration of the barriers to and facilitating factors for their implementation among healthcare professionals and

  10. 77 FR 32975 - AHRQ Workgroups on ICD-10-CM/PCS Conversion of Quality Indicators (QIs)

    Science.gov (United States)

    2012-06-04

    ... on ICD-10-CM/PCS Conversion of Quality Indicators (QIs) AGENCY: Agency for Healthcare Research and... workgroups, to be convened by AHRQ's contractor, on ICD-10-CM/PCS conversion of the AHRQ Quality Indicators..., please visit the AHRQ Web site at http://www.QUALITYindicators.AHRQ.gov . Specifically, each Workgroup on...

  11. Formalization and Computation of Diabetes Quality Indicators with Patient Data from a Chinese Hospital

    NARCIS (Netherlands)

    Liu, Haitong; ten Teije, Annette; Dentler, Kathrin; Ma, Jingdong; Zhang, Shijing; Riaño, David; Lenz, Richard; Reichert, Manfred

    2017-01-01

    Clinical quality indicators are tools to measure the quality of healthcare and can be classified into structure-related, process-related and outcome-related indicators. The objective of this study is to investigate whether Electronic Medical Record (EMR) data from a Chinese diabetes specialty

  12. Stakeholders' perspectives on quality indicators for diabetes care: a qualitative study.

    Science.gov (United States)

    Markhorst, Joekie; Martirosyan, Liana; Calsbeek, Hiske; Braspenning, Jozé

    2012-01-01

    Transparency in diabetes care requires quality indicators that are of interest to stakeholders in order to optimise their usage. Indicator development is often focused on consensus, and little is known about stakeholders' preferences for information on quality. To explore the preferences of consumers, providers, purchasers and policy makers for different quality domains and indicators in relation to the intended use of quality indicators. Between June and December 2009, 14 semi-structured interviews were held with stakeholders who have a decisive vote in the selection of the national indicator set for diabetes care in the Netherlands. The following subjects were explored: (1) the aims of using information on quality; (2) the interpretation of and preferences for the quality domains of safety, timeliness, effectiveness and patient-centredness in relation to the user aims; and (3) the preferences for structure, process or outcome indicators. Content analysis was used to analyse qualitative data. Stakeholders had similar and different aims according to their roles. The interpretations of quality domains varied greatly between the stakeholders. Besides differences in interpretation, their preferences were similar. Most stakeholders prioritised patient-centredness above the other domains of quality, ranked in order of priority as safety, effectiveness and timeliness, whereas purchasers also prioritised efficiency. All stakeholders preferred to use process indicators or a mix of process and outcome indicators. The preferences of the stakeholders for quality indicators seem to be neither well-refined nor congruent. The implementation of an indicator set can probably be improved if the stakeholders' definitions and preferences for quality domains become more explicit during the selection process for indicators.

  13. Measuring the quality of renal care: things to keep in mind when selecting and using quality indicators

    NARCIS (Netherlands)

    van der Veer, Sabine N.; van Biesen, Wim; Couchoud, Cécile; Tomson, Charles R. V.; Jager, Kitty J.

    2014-01-01

    This educational paper discusses a variety of indicators that can be used to measure the quality of care in renal medicine. Based on what aspect of care they reflect, indicators can be grouped into four main categories: structure, process, surrogate outcome and outcome indicators. Each category has

  14. The Moderating Effects of Pubertal Timing on the Longitudinal Associations between Parent-Child Relationship Quality and Adolescent Substance Use

    Science.gov (United States)

    Shelton, Katherine H.; Van Den Bree, Marianne B. M.

    2010-01-01

    This prospective, longitudinal study investigated the moderating role of pubertal timing on reciprocal links between adolescent appraisals of parent-child relationship quality and girls' (N = 1,335) and boys' (N = 1,203) cigarette and alcohol use across a 12-month period. Reciprocal effects were found between parent-child relations and on-time…

  15. Developing quality indicators for community services: the case of district nursing.

    Science.gov (United States)

    Davies, Philippa; Wye, Lesley; Horrocks, Sue; Salisbury, Chris; Sharp, Debbie

    2011-01-01

    Quality indicators exist for the acute and primary care sectors in the National Health Service (NHS), but until recently little attention has been given to measuring the quality of community services. The innovative project described in this paper attempted to address that gap. To produce a framework for developing quality indicators for Bristol Community Health services. To develop a set of initial indicators for Bristol Community Health services using the proposed framework. After familiarising ourselves with community services and NHS policy, gathering the views of stakeholders and consulting the literature on quality indicators, we designed a framework for indicator development, using the 'test' case of the district nursing service. The long list of possible indicators came from best practice guidelines for wound, diabetes and end of life care, the three conditions most commonly treated by district nurses. To narrow down this list we surveyed and held workshops with district nurses, interviewed service users by telephone and met with commissioners and senior community health managers. The final set of quality indicators for district nurses included 23 organisational and clinical process and outcome indicators and eight patient experience indicators. These indicators are now being piloted, together with two potential tools identified to capture patient reported outcomes. Developing quality indicators for community services is time consuming and resource intensive. A range of skills are needed including clinical expertise, project management and skills in evidence-based medicine. The commitment and involvement of front-line professionals is crucial.

  16. Drinking Patterns Among Older Couples: Longitudinal Associations With Negative Marital Quality.

    Science.gov (United States)

    Birditt, Kira S; Cranford, James A; Manalel, Jasmine A; Antonucci, Toni C

    2018-04-16

    Research with younger couples indicates that alcohol use has powerful effects on marital quality, but less work has examined the effects of drinking among older couples. This study examined whether dyadic patterns of drinking status among older couples are associated with negative marital quality over time. Married participants (N = 4864) from the Health and Retirement Study reported on alcohol consumption (whether they drink alcohol and average amount consumed per week) and negative marital quality (e.g., criticism and demands) across two waves (Wave 1 2006/2008 and Wave 2 2010/2012). Concordant drinking couples reported decreased negative marital quality over time, and these links were significantly greater among wives. Wives who reported drinking alcohol reported decreased negative marital quality over time when husbands also reported drinking and increased negative marital quality over time when husbands reported not drinking. The present findings stress the importance of considering the drinking status rather than the amount of alcohol consumed of both members of the couple when attempting to understand drinking and marital quality among older couples. These findings are particularly salient given the increased drinking among baby boomers and the importance of marital quality for health among older couples.

  17. 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.

  18. A Longitudinal Study of How Quality Mentorship and Research Experience Integrate Underrepresented Minorities into STEM Careers.

    Science.gov (United States)

    Estrada, Mica; Hernandez, Paul R; Schultz, P Wesley

    2018-01-01

    African Americans, Latinos, and Native Americans are historically underrepresented minorities (URMs) among science, technology, engineering, and mathematics (STEM) degree earners. Viewed from a perspective of social influence, this pattern suggests that URMs do not integrate into the STEM academic community at the same rate as non-URM students. Estrada and colleagues recently showed that Kelman's tripartite integration model of social influence (TIMSI) predicted URM persistence into science fields. In this paper, we longitudinally examine the integration of URMs into the STEM community by using growth-curve analyses to measure the development of TIMIS's key variables (science efficacy, identity, and values) from junior year through the postbaccalaureate year. Results showed that quality mentorship and research experience occurring in the junior and senior years were positively related to student science efficacy, identity, and values at that same time period. Longitudinal modeling of TIMSI further shows that, while efficacy is important, and perhaps a necessary predictor of moving toward a STEM career, past experiences of efficacy may not be sufficient for maintaining longer-term persistence. In contrast, science identity and values do continue to be predictive of STEM career pathway persistence up to 4 years after graduation. © 2018 M. Estrada et al. CBE—Life Sciences Education © 2018 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  19. Sexual quality of life, body image distress, and psychosocial outcomes in colorectal cancer: a longitudinal study.

    Science.gov (United States)

    Reese, Jennifer Barsky; Handorf, Elizabeth; Haythornthwaite, Jennifer A

    2018-04-20

    The objectives were to assess changes in sexual QOL and body image distress over time and to examine longitudinal associations between sexual QOL and body image variables with psychosocial outcomes in a sample of colorectal cancer patients. Participants (N = 141) completed a mail-based survey assessing sexual QOL [sexual distress (ISS), treatment impact on sexual function (SFQ), sexual function (FSFI; IIEF)], body image distress (BIS), and psychosocial outcomes [relationship quality (DAS-4), depressive symptoms (CESD-SF), and health-related QOL (HRQOL; FACT-C)]; 88 patients completed 6-month follow-up surveys (62%). Gender and cancer subgroups (male vs. female; rectal vs. colon cancer) were compared and longitudinal models examined associations between sexual QOL and body image variables with psychosocial outcomes over time and by subgroup. Impairments in sexual QOL and body image distress were common. Women and patients with rectal cancer reported worse body image distress compared to men (p = .005) and those with colon cancer (p = .03), respectively; compared to patients with colon cancer, those with rectal cancer reported worse treatment impact (p image distress decreased (p = .02), while sexual QOL was stable (e.g., 58% classified as dysfunctional at both time points, p = .13). For most sexual and body image predictors, worse impairment was associated with worse psychosocial outcomes over time. Several significant gender and cancer subgroup effects were found. Sexual QOL and body image are compromised after colorectal cancer and tend to remain impaired if unaddressed. Sexual concerns should be addressed early to limit broader-reaching psychosocial effects.

  20. Longitudinal variations of laryngeal overpressure and voice-related quality of life in spasmodic dysphonia.

    Science.gov (United States)

    Yeung, Jeffrey C; Fung, Kevin; Davis, Eric; Rai, Sunita K; Day, Adam M B; Dzioba, Agnieszka; Bornbaum, Catherine; Doyle, Philip C

    2015-03-01

    Adductor spasmodic dysphonia (AdSD) is a voice disorder characterized by variable symptom severity and voice disability. Those with the disorder experience a wide spectrum of symptom severity over time, resulting in varied degrees of perceived voice disability. This study investigated the longitudinal variability of AdSD, with a focus on auditory-perceptual judgments of a dimension termed laryngeal overpressure (LO) and patient self-assessments of voice-related quality of life (V-RQOL). Longitudinal, correlational study. Ten adults with AdSD were followed over three time periods. At each, both voice samples and self-ratings of V-RQOL were gathered prior to their scheduled Botox injection. Voice recordings subsequently were perceptually evaluated by eight listeners for LO using a visual analog scale. LO ratings for all-voiced and Rainbow Passage sentence stimuli were found to be highly correlated. However, only the LO ratings obtained from judgments of AV stimuli were found to correlate moderately with self-ratings of voice disability for both the physical functioning and social-emotional subscores, as well as the total V-RQOL score. Based on perceptual judgments, LO appears to provide a reliable means of quantifying the severity of voice abnormalities in AdSD. Variability in self-ratings of the V-RQOL suggest that perceived disability related to AdSD should be actively monitored. Further, auditory-perceptual judgments may provide an accurate index of the potential impact of the disorder on the speaker. Similarly, LO was supported as a simple clinical measure that serves as a reliable index of voice change over time. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Standards of care and quality indicators for multidisciplinary care models for psoriatic arthritis in Spain.

    Science.gov (United States)

    Gratacós, Jordi; Luelmo, Jesús; Rodríguez, Jesús; Notario, Jaume; Marco, Teresa Navío; de la Cueva, Pablo; Busquets, Manel Pujol; Font, Mercè García; Joven, Beatriz; Rivera, Raquel; Vega, Jose Luis Alvarez; Álvarez, Antonio Javier Chaves; Parera, Ricardo Sánchez; Carrascosa, Jose Carlos Ruiz; Martínez, Fernando José Rodríguez; Sánchez, José Pardo; Olmos, Carlos Feced; Pujol, Conrad; Galindez, Eva; Barrio, Silvia Pérez; Arana, Ana Urruticoechea; Hergueta, Mercedes; Coto, Pablo; Queiro, Rubén

    2018-06-01

    To define and give priority to standards of care and quality indicators of multidisciplinary care for patients with psoriatic arthritis (PsA). A systematic literature review on PsA standards of care and quality indicators was performed. An expert panel of rheumatologists and dermatologists who provide multidisciplinary care was established. In a consensus meeting group, the experts discussed and developed the standards of care and quality indicators and graded their priority, agreement and also the feasibility (only for quality indicators) following qualitative methodology and a Delphi process. Afterwards, these results were discussed with 2 focus groups, 1 with patients, another with health managers. A descriptive analysis is presented. We obtained 25 standards of care (9 of structure, 9 of process, 7 of results) and 24 quality indicators (2 of structure, 5 of process, 17 of results). Standards of care include relevant aspects in the multidisciplinary care of PsA patients like an appropriate physical infrastructure and technical equipment, the access to nursing care, labs and imaging techniques, other health professionals and treatments, or the development of care plans. Regarding quality indicators, the definition of multidisciplinary care model objectives and referral criteria, the establishment of responsibilities and coordination among professionals and the active evaluation of patients and data collection were given a high priority. Patients considered all of them as important. This set of standards of care and quality indicators for the multidisciplinary care of patients with PsA should help improve quality of care in these patients.

  2. Longitudinal validity and responsiveness of the Food Allergy Quality of Life Questionnaire - Parent Form in children 0-12 years following positive and negative food challenges

    NARCIS (Netherlands)

    DunnGalvin, A.; Cullinane, C.; Daly, D. A.; Flokstra-de Blok, B. M. J.; Dubois, A. E. J.; Hourihane, J. O'B.

    P>Background There are no published studies of longitudinal health-related quality of life (HRQL) assessments of food-allergic children using a disease-specific measure. Objective This study assessed the longitudinal measurement properties of the Food Allergy Quality of Life Questionnaire - Parent

  3. Analysis of aspects of quality of life in teachers' voice after discharged: longitudinal study.

    Science.gov (United States)

    Ferreira, Josiane Mendes; Campos, Nathália Ferreira; Bassi, Iara Barreto; Santos, Marco Aurélio Rocha; Teixeira, Letícia Caldas; Gama, Ana Cristina Côrtes

    2013-01-01

    To evaluate the long-term effects of voice therapy on the life quality of teachers who were discharged or abandoned the voice therapy for dysphonia. This was a longitudinal study based on analysis of assessments with teachers of municipal schools in Belo Horizonte, who were referred to voice therapy and were discharged or abandoned the speech-language therapy for more than six months. A total of 33 teachers in the discharged group and 20 teachers in the abandoned group were contacted by phone and invited to participate in the study by answering the Voice activity and participation profile, which was forwarded to the researchers and sent via letter. At the moment of the pre speech therapy, the discharged and abandoned groups were homogeneous, except in relation to daily communication parameter. Comparing the discharged group in the pre and post speech-language therapy, it was showed improvements in social communication parameter as well as in the total score. The discharged group presented worsening in self-perception parameter when comparing the average values in the post therapy and current moments, and the group abandoned presented worsening in work, social communication and total score when comparing to the average values in the pre therapy and current moments. The discharged and abandoned groups differ in the present moment in all investigated parameters. Speech-language therapy for dysphonia have long term positive effects on life quality and voice of teachers who were soon discharged from the therapy and in a period of two years on average. Teachers who have abandoned treatment and did not obtain improvement in the voice showed negative impact in life quality and voice in a time of 2 years and 2 months on average.

  4. 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

  5. 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

  6. Combining Archetypes, Ontologies and Formalization Enables Automated Computation of Quality Indicators.

    Science.gov (United States)

    Legaz-García, María Del Carmen; Dentler, Kathrin; Fernández-Breis, Jesualdo Tomás; Cornet, Ronald

    2017-01-01

    ArchMS is a framework that represents clinical information and knowledge using ontologies in OWL, which facilitates semantic interoperability and thereby the exploitation and secondary use of clinical data. However, it does not yet support the automated assessment of quality of care. CLIF is a stepwise method to formalize quality indicators. The method has been implemented in the CLIF tool which supports its users in generating computable queries based on a patient data model which can be based on archetypes. To enable the automated computation of quality indicators using ontologies and archetypes, we tested whether ArchMS and the CLIF tool can be integrated. We successfully automated the process of generating SPARQL queries from quality indicators that have been formalized with CLIF and integrated them into ArchMS. Hence, ontologies and archetypes can be combined for the execution of formalized quality indicators.

  7. 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.

  8. 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...

  9. 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.

  10. 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.

    2013-01-01

    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. PMID:23709286

  11. An Overview of Key Indicators and Evaluation Tools for Assessing Housing Quality: A Literature Review

    Science.gov (United States)

    Sinha, Rajan Chandra; Sarkar, Satyaki; Mandal, Nikhil Ranjan

    2017-09-01

    The issue of the housing quality has been addressed for various stakeholders at different levels. There exist varied opinion about its measurability and possible applications. Thus the study is carried out to have an insight into the concept of housing quality and its relevance in the changing demographics, technological, socio-economic and socio-cultural conditions. This study attempts to summarize the literature that addresses past research concerned with factors related to housing quality, its measurement methodology and critically examines the broad key indicators identified to have impact upon enhancing the housing quality. This work discusses the recent techniques which are extensively used for analysis of housing quality.

  12. 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).

  13. Longitudinal health-related quality of life outcomes and related factors after pediatric SCT.

    Science.gov (United States)

    Barrera, M; Atenafu, E; Hancock, K

    2009-08-01

    Our purpose was to investigate longitudinally health-related quality of life (HRQOL) outcomes and related factors up to 2 years post-pediatric SCT. A total of 99 mothers of patients, aged 1.5-17 years, completed two standardized HRQOL questionnaires, generic and disease specific (DS), about the child, and reported on their own symptoms of depression and family function pre-SCT, 12 and 24 months post-SCT. Clinical (diagnosis, radiation), child (age) and family (maternal depression) information was also obtained. Significant improvement in physical and psychosocial HRQOL from pre-SCT to 1 or 2 years post-SCT was reported. Survivors of ALL were reported to have poorer physical and psychosocial HRQOL than survivors of solid tumors on the DS measure. Maternal depression was negatively associated with physical and psychosocial HRQOL. Maternal education (higher) at pre-SCT predicted improvements in physical domains 2 years post-SCT; mother's age (older) and child's age (younger) also predicted improvements of physical and emotional HRQOL. We conclude that survivors of pediatric SCT improved physical and psychosocial HRQOL by 1 and 2 years post-SCT. Older survivors whose mothers are younger and distressed, with lower education at SCT have compromised HRQOL compared to other survivors. This study has important implications for the care of SCT survivors and their families.

  14. Linking clinical quality indicators to research evidence - a case study in asthma management for children.

    Science.gov (United States)

    Choong, Miew Keen; Tsafnat, Guy; Hibbert, Peter; Runciman, William B; Coiera, Enrico

    2017-07-21

    Clinical quality indicators are used to monitor the performance of healthcare services and should wherever possible be based on research evidence. Little is known however about the extent to which indicators in common use are based on research. The objective of this study is to measure the extent to which clinical quality indicators used in asthma management in children with outcome measurements can be linked to results in randomised controlled clinical trial (RCT) reports. This work is part of a broader research program to trial methods that improve the efficiency and accuracy of indicator development. National-level indicators for asthma management in children were extracted from the National Quality Measures Clearinghouse database and the National Institute for Health and Care Excellence quality standards by two independent appraisers. Outcome measures were extracted from all published English language RCT reports for asthma management in children below the age of 12 published between 2005 and 2014. The two sets were then linked by manually mapping both to a common set of Unified Medical Language System (UMLS) concepts. The analysis identified 39 indicators and 562 full text RCTs dealing with asthma management in children. About 95% (37/39) of the indicators could be linked to RCT outcome measures. It is possible to identify relevant RCT reports for the majority of indicators used to assess the quality of asthma management in childhood. The methods reported here could be automated to more generally support assessment of candidate indicators against the research evidence.

  15. Pork loin quality is not indicative of fresh belly or fresh and cured ham quality.

    Science.gov (United States)

    Arkfeld, E K; Wilson, K B; Overholt, M F; Harsh, B N; Lowell, J E; Hogan, E K; Klehm, B J; Bohrer, B M; Mohrhauser, D A; King, D A; Wheeler, T L; Dilger, A C; Shackelford, S D; Boler, D D

    2016-12-01

    The objective was to characterize the relationship between fresh loin quality with fresh belly or fresh and cured ham quality. Pigs raised in 8 barns representing 2 seasons [cold ( = 4,290) and hot ( = 3,394)] and 2 production focuses [lean ( = 3,627) and quality ( = 4,057)] were used. Carcass characteristics and other meat quality data were collected on 7,684 carcasses. All of the carcasses were evaluated for HCW, LM depth, tenth rib fat depth, leg (ham primal) weight, instrumental color on the gluteus medius and gluteus profundus of the ham face, and subjective loin quality. Instrumental loin color and ultimate pH (≥ 22 h postmortem) were collected on the ventral side of loins along with dimensions and firmness scores of fresh bellies from 50% of the carcasses. Ten percent of the boneless loins and fresh hams were evaluated for slice shear force (SSF) or cured ham characteristics. Correlation coefficients between traits were computed using the CORR procedure of SAS and considered significantly different from 0 at ≤ 0.05. Temperature decline, beginning at 31 min postmortem and concluding at 22 h postmortem, for the longissimus dorsi and semimembranosus muscles were evaluated on 10% of the carcasses. Ultimate loin pH was correlated with dimensional belly characteristics ( ≥ |0.07|; ham instrumental color ( ≥ |0.03|; ≤ 0.05), and semimembranosus ultimate pH ( = 0.33; hams. Instrumental L*on the ventral surface of the loin was related to L* on both muscles of the ham face ( ≤ 0.0001). Even though significant relationships between the loin, belly, and ham were detected, the variability in belly and ham quality explained by variability in loin quality was poor (≤ 22.09%). Compositional differences between the loin and belly may have contributed to those poor relationships. Additionally, differences in temperature declines during chilling between the loin and ham likely contributed to the weak nature of relationships. Equilibration of longissimus dorsi

  16. Long-distance longitudinal prostate MRI quality assurance: from startup to 12 months.

    Science.gov (United States)

    Curci, Nicole E; Gartland, Patrick; Shankar, Prasad R; Montgomery, Jeffrey S; Miller, David C; George, Arvin K; Davenport, Matthew S

    2018-02-22

    To evaluate a 12-month long-distance prostate MRI quality assurance (QA) program. The need for IRB approval was waived for this prospective longitudinal QA effort. One academic institution experienced with prostate MRI [~ 1000 examinations/year (Site 2)] partnered with a private institution 240 miles away that was starting a new prostate MRI program (Site 1). Site 1 performed all examinations (N = 249). Four radiologists at Site 1 created finalized reports, then sent images and reports to Site 2 for review on a rolling basis. One radiologist at Site 2 reviewed findings and exam quality and discussed results by phone (~ 2-10 minutes/MRI). In months 1-6 all examinations were reviewed. In months 7-12 only PI-RADS ≤ 2 and 'difficult' cases were reviewed. Repeatability was assessed with intra-class correlation (ICC). 'Clinically significant cancer' was Gleason ≥ 7. Image quality significantly (p < 0.001) improved after the first three months. Inter-rater agreement also improved in months 3-4 [ICC: 0.849 (95% CI 0.744-0.913)] and 5-6 [ICC: 0.768 (95% CI 0.619-0.864)] compared to months 1-2 [ICC: 0.621 (95% CI 0.436-0.756)]. PI-RADS ≤ 2 examinations were reclassified PI-RADS ≥ 3 in 19% (30/162); of these, 23 had post-MRI histology and 57% (13/23) had clinically significant cancer (5.2% of 249). False-negative examinations [N = 18 (PI-RADS ≤ 2 and Gleason ≥ 7)] were more common at Site 1 during months 1-6 [9% (14/160) vs. 4% (4/89)]. Positive predictive values for PI-RADS ≥ 3 were similar. Remote quality assurance of prostate MRI is feasible and useful, enabling new programs to gain durable skills with minimal risk to patients.

  17. Using the Delphi method to develop nursing-sensitive quality indicators for the NICU.

    Science.gov (United States)

    Chen, Lin; Huang, Li-Hua; Xing, Mei-Yuan; Feng, Zhi-Xian; Shao, Le-Wen; Zhang, Mei-Yun; Shao, Rong-Ya

    2017-02-01

    To develop nursing-sensitive quality indicators consistent with current medical practices in Chinese neonatal intensive care units. The development of nursing-sensitive quality indicators has become a top priority in nursing management. To the best of our knowledge, there has been no objective, scientific and sensitive evaluation of the quality of neonatal intensive care unit nursing in China. A modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of quality care in neonatal intensive care unit nursing. Based on a literature review, we identified 21 indicators of nursing-sensitive quality in the neonatal intensive care unit. Our group of 11 consultants chose 13 indicators to be discussed using the Delphi method. In October and November 2014, 39 neonatal intensive care unit experts in 18 tertiary hospitals spread across six provinces participated in two rounds of Delphi panels. Of the 13 indicators discussed, 11 were identified as indicators of nursing-sensitive quality in the neonatal intensive care unit: rate of nosocomial infections, rate of accidental endotracheal extubation, rate of errors in medication administration, rate of treatment for pain, rate of peripheral venous extravasation, rate of compliance with handwashing techniques, incidence of pressure ulcers, incidence of noise, the bed-to-care ratio, the proportion of nurses with greater than five years neonatal intensive care unit experience and incidence of retinopathy. The 11 neonatal intensive care unit nursing-sensitive indicators identified by the Delphi method integrated with basic Chinese practices provide a basis for nursing management and the monitoring of nursing quality. This study identified nursing-sensitive quality indicators for neonatal intensive care unit care that are suitable for current clinical practice in China. © 2016 John Wiley & Sons Ltd.

  18. [Obsessive compulsive disorder and the internet. An evaluation of Dutch-language websites and quality indicators].

    Science.gov (United States)

    Serdobbel, Y; Pieters, G; Joos, S

    2006-01-01

    The Internet is an important source of information about health matters. The quality of the information about Obsessive Compulsive Disorder (OCD) has not been investigated. Possible indicators of quality are the DISCERN rating tool, Google PageRank and cooperation from health care professionals. To investigate the quality of the information given on Dutch-language websites relating to OCD and to determine whether the quality of the contents is correlated with site characteristics, scores on DISCERN and Google PageRank. We selected 27 Dutch-language websites via Google and Ixquick and investigated the correlation between the quality of the contents measured by 4 parameters and the presence of incorrect information, site characteristics, the DISCERN score and Google PageRank. The quality of the information was generally poor. The only investigated site characteristic that was found to be associated with basic criteria relating to symptoms and diagnosis was the size of the site. The DISCERN score was significantly correlated with the quality of the information. The occurrence of incorrect information was independent of the quality of the content, site characteristics, Google PageRank and DISCERN scores. The quality of Dutch-language websites on the subject of OCD is inadequate. Site characteristics and Google PageRank are not good predictors of the quality of information. The DISCERN rating tool is a potentially valuable indicator of content quality with regard to treatment options.

  19. 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.

  20. Building Quality Foundations: Indicators and Instruments to Measure the Quality of Vocational Education and Training

    Science.gov (United States)

    Coates, Hamish

    2009-01-01

    Vocational education and training plays a major and increasing role in developing the knowledge and skills that underpin Australia's economy and society. It is vital, accordingly, that training outcomes are of high quality. This paper reports work undertaken to develop a new evidence-based and outcomes-focused national approach to monitoring and…

  1. Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy.

    Science.gov (United States)

    Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dube, Catherine; Enns, Robert; Hollingworth, Roger; Macintosh, Donald; Borgaonkar, Mark; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Kuipers, Ernst J

    2012-01-01

    Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. The consensus process identified a clear need for high-quality clinical and outcomes research to support quality improvement in the delivery of endoscopy services. The

  2. Development of Indicators to Assess Quality of Care for Prostate Cancer.

    Science.gov (United States)

    Nag, Nupur; Millar, Jeremy; Davis, Ian D; Costello, Shaun; Duthie, James B; Mark, Stephen; Delprado, Warick; Smith, David; Pryor, David; Galvin, David; Sullivan, Frank; Murphy, Áine C; Roder, David; Elsaleh, Hany; Currow, David; White, Craig; Skala, Marketa; Moretti, Kim L; Walker, Tony; De Ieso, Paolo; Brooks, Andrew; Heathcote, Peter; Frydenberg, Mark; Thavaseelan, Jeffery; Evans, Sue M

    2016-02-20

    The development, monitoring, and reporting of indicator measures that describe standard of care provide the gold standard for assessing quality of care and patient outcomes. Although indicator measures have been reported, little evidence of their use in measuring and benchmarking performance is available. A standard set, defining numerator, denominator, and risk adjustments, will enable global benchmarking of quality of care. To develop a set of indicators to enable assessment and reporting of quality of care for men with localised prostate cancer (PCa). Candidate indicators were identified from the literature. An international panel was invited to participate in a modified Delphi process. Teleconferences were held before and after each voting round to provide instruction and to review results. Panellists were asked to rate each proposed indicator on a Likert scale of 1-9 in a two-round iterative process. Calculations required to report on the endorsed indicators were evaluated and modified to reflect the data capture of the Prostate Cancer Outcomes Registry-Australia and New Zealand (PCOR-ANZ). A total of 97 candidate indicators were identified, of which 12 were endorsed. The set includes indicators covering pre-, intra-, and post-treatment of PCa care, within the limits of the data captured by PCOR-ANZ. The 12 endorsed quality measures enable international benchmarking on the quality of care of men with localised PCa. Reporting on these indicators enhances safety and efficacy of treatment, reduces variation in care, and can improve patient outcomes. PCa has the highest incidence of all cancers in men. Early diagnosis and relatively high survival rates mean issues of quality of care and best possible health outcomes for patients are important. This paper identifies 12 important measurable quality indicators in PCa care. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  3. 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.

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

    NARCIS (Netherlands)

    González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana 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

  5. 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…

  6. Home Care Quality Indicators (HCQIS) Based on the MDS-HC

    Science.gov (United States)

    Hirdes, John P.; Fries, Brant E.; Morris, John N.; Ikegami, Naoki; Zimmerman, David; Dalby, Dawn M.; Aliaga, Pablo; Hammer, Suzanne; Jones, Richard

    2004-01-01

    Purpose: This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services. Design and Methods: Data from 3,041 Canadian and 11,252 U.S. home care clients assessed…

  7. 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. ...

  8. Indices for the assessment of nutritional quality of meals: a systematic review

    NARCIS (Netherlands)

    Gorgulho, B.M.; Pot, G.K.; Sarti, F.M.; Marchioni, D.M.

    2016-01-01

    This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs,

  9. Quality indicators for safe medication preparation and administration: a systematic review

    NARCIS (Netherlands)

    Smeulers, Marian; Verweij, Lotte; Maaskant, Jolanda M.; de Boer, Monica; Krediet, C. T. Paul; Nieveen van Dijkum, Els J. M.; Vermeulen, Hester

    2015-01-01

    One-third of all medication errors causing harm to hospitalized patients occur in the medication preparation and administration phase, which is predominantly a nursing activity. To monitor, evaluate and improve the quality and safety of this process, evidence-based quality indicators can be used.

  10. Development of quality indicators based on a multidisciplinary, evidence-based guideline on pediatric constipation

    NARCIS (Netherlands)

    Stienen, J.J.C.; Tabbers, M.M.; Benninga, M.A.; Harmsen, M.; Ouwens, M.M.T.J.

    2011-01-01

    Several clinical guidelines for childhood functional constipation have been developed, but none of them is accompanied by a set of quality indicators. It is important to gain insight into the quality of care in daily practice in order to improve the implementation of clinical guidelines. This can be

  11. How Well Does Your IEP Measure Up?: Quality Indicators for Effective Service Delivery.

    Science.gov (United States)

    Twachtman-Cullen, Diane; Twachtman-Reilly, Jennifer

    This book is intended to offer guidance in writing individualized education programs (IEPs) that deliver high-quality, need-based educational programming for students with autism spectrum disorders. Following an introductory historical overview of special education law, the remaining chapters in part 1 address the quality indicators for each of…

  12. European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery

    NARCIS (Netherlands)

    Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

    Objectives The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit

  13. Dashboard report on performance on select quality indicators to cancer care providers.

    Science.gov (United States)

    Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats

    2016-01-01

    Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.

  14. The dissolved organic matter as a potential soil quality indicator in arable soils of Hungary.

    Science.gov (United States)

    Filep, Tibor; Draskovits, Eszter; Szabó, József; Koós, Sándor; László, Péter; Szalai, Zoltán

    2015-07-01

    Although several authors have suggested that the labile fraction of soils could be a potential soil quality indicator, the possibilities and limitations of using the dissolved organic matter (DOM) fraction for this purpose have not yet been investigated. The objective of this study was to evaluate the hypothesis that DOM is an adequate indicator of soil quality. To test this, the soil quality indices (SQI) of 190 arable soils from a Hungarian dataset were estimated, and these values were compared to DOM parameters (DOC and SUVA254). A clear difference in soil quality was found between the soil types, with low soil quality for arenosols (average SQI 0.5) and significantly higher values for gleysols, vertisols, regosols, solonetzes and chernozems. The SQI-DOC relationship could be described by non-linear regression, while a linear connection was observed between SQI and SUVA. The regression equations obtained for the dataset showed only one relatively weak significant correlation between the variables, for DOC (R (2) = 0.157(***); n = 190), while non-significant relationships were found for the DOC and SUVA254 values. However, an envelope curve operated with the datasets showed the robust potential of DOC to indicate soil quality changes, with a high R (2) value for the envelope curve regression equation. The limitations to using the DOM fraction of soils as a quality indicator are due to the contradictory processes which take place in soils in many cases.

  15. Effects of Grazing and Fire Frequency on Floristic Quality and its Relationship to Indicators of Soil Quality in Tallgrass Prairie

    Science.gov (United States)

    Manning, George C.; Baer, Sara G.; Blair, John M.

    2017-12-01

    Fire and grazing are widely used to manage grasslands for conservation purposes, but few studies have evaluated the effects of these drivers on the conservation value of plant communities measured by the floristic quality index (FQI). Further, the influence of fire and grazing on soil properties and functions are difficult for land managers and restoration practitioners to assess. The objectives of this study were to: (1) quantify the independent and interactive effects of grazing and fire frequency on floristic quality in native tallgrass prairie to provide potential benchmarks for community assessment, and (2) to explore whether floristic quality can serve as an indicator of soil structure and function for more holistic ecosystem assessments. A factorial combination of fire frequencies (1-2, 4, and 20 years return intervals) and grazing (by bison or ungrazed) treatments were sampled for plant species composition, and for several indicators of soil quality in lowland tallgrass prairie. Floristic quality, diversity, and richness were higher in grazed than ungrazed prairie over all fire frequencies ( P total N, and soil bulk density were also higher in grazed prairie soil over all fire frequencies ( P total organic C, and total soil N were positively correlated with FQI ( P quality and soil N pools are more strongly influenced by grazing than fire and that floristic quality can be an indicator of total soil C and N stocks in never cultivated lowland prairie.

  16. Continuous monitoring and feedback of quality of recovery indicators for anaesthetists: a qualitative investigation of reported effects on professional behaviour.

    Science.gov (United States)

    D'Lima, D; Arnold, G; Brett, S J; Bottle, A; Smith, A; Benn, J

    2017-07-01

    Research suggests that providing clinicians with feedback on their performance can result in professional behaviour change and improved clinical outcomes. Departments would benefit from understanding which characteristics of feedback support effective quality monitoring, professional behaviour change and service improvement. This study aimed to report the experience of anaesthetists participating in a long-term initiative to provide comprehensive personalized feedback to consultants on patient-reported quality of recovery indicators in a large London teaching hospital. Semi-structured interviews were conducted with 13 consultant anaesthetists, six surgical nursing leads, the theatre manager and the clinical coordinator for recovery. Transcripts were qualitatively analysed for themes linked to the perceived value of the initiative, its acceptability and its effects upon professional practice. Analysis of qualitative data from participant interviews suggested that effective quality indicators must address areas that are within the control of the anaesthetist. Graphical data presentation, both longitudinal (personal variation over time) and comparative (peer-group distributions), was found to be preferable to summary statistics and provided useful and complementary perspectives for improvement. Developing trust in the reliability and credibility of the data through co-development of data reports with clinical input into areas such as case-mix adjustment was important for engagement. Making feedback specifically relevant to the recipient supported professional learning within a supportive and open collaborative environment. This study investigated the requirements for effective feedback on quality of anaesthetic care for anaesthetists, highlighting the mechanisms by which feedback may translate into improvements in practice at the individual and peer-group level. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia

  17. Indices for the assessment of nutritional quality of meals: a systematic review.

    Science.gov (United States)

    Gorgulho, B M; Pot, G K; Sarti, F M; Marchioni, D M

    2016-06-01

    This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs, SciELO, Scopus, Cochrane, Embase and Google Scholar. The literature search resulted in seven different meal quality indices. Each article was analysed in order to identify the following items: authors, country, year, study design, population characteristics, type of meal evaluated, dietary assessment method, characteristics evaluated (nutrients or food items), score range, index components, nutritional references, correlations performed, validation and relationship with an outcome (if existing). Two studies developed instruments to assess the quality of breakfast, three analysed lunch, one evaluated dinner and one was applied to all types of meals and snacks. All meal quality indices reviewed were based on the evaluation of presence or absence of food groups and relative contributions of nutrients, according to food-based guidelines or nutrient references, adapting the daily dietary recommendations to one specific meal. Most of the indices included three items as components for meal quality assessment: (I) total fat or some specific type of fat, (II) fruits and vegetables and (III) cereals or whole grains. This systematic review indicates aspects that need further research, particularly the numerous approaches to assessing meals considering different foods and nutrients, and the need for validation studies of meal indices.

  18. Evidence-based practice: a quality indicator analysis of peer-tutoring in adapted physical education.

    Science.gov (United States)

    Kalef, Laura; Reid, Greg; Macdonald, Cathy

    2013-09-01

    The purpose of the research was to conduct a quality indicator analysis of studies investigating peer-tutoring for students with a disability in adapted physical education. An electronic search was conducted among English journals published from 1960 to November 2012. Databases included ERIC, PsycINFO, and SPORTDiscus. Fifteen research studies employing group-experimental (Gersten et al., 2005) or single-subject designs (Horner et al., 2005) met inclusion criteria. Each study was assessed for the presence and clarity of quality indicators. Group designs met an average of 62.5% essential and 69% desirable indicators. An average of 80% of indicators was present for single-subject designs. Results suggest claims of peer-tutoring being an evidence-based practice are premature. Recommendations for clarifying and applying the quality indicators are offered. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Saust, Laura Trolle; Bjerrum, Lars; Arpi, Magnus

    2017-01-01

    Objective: To develop quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections, tailored to the Danish general practice setting. Design: A RAND/UCLA Appropriateness Method was used. Setting: General practice. Subjects: A panel of nine experts, mainly...... general practitioners, was asked to rate the relevance of 64 quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections based on guidelines. Subsequently, a face-to-face meeting was held to resolve misinterpretations and to achieve consensus. Main outcome measures...... indicators focusing on the diagnostic process and 19 indicators focusing on the decision about antibiotic treatment and choice of antibiotics, respectively. Conclusion: These newly developed quality indicators may be used to strengthen Danish general practitioners’ focus on their management of patients...

  20. 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

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

    Science.gov (United States)

    Boulkedid, Rym; Abdoul, Hendy; Loustau, Marine; Sibony, Olivier; Alberti, Corinne

    2011-01-01

    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. 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. 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.

  2. 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.

  3. Trending Longitudinal Agreement between Parent and Child Perceptions of Quality of Life for Pediatric Palliative Care Patients

    Directory of Open Access Journals (Sweden)

    Meaghann S. Weaver

    2017-08-01

    Full Text Available Pediatric palliative care studies often rely on proxy-reported instead of direct child-reported quality of life metrics. The purpose of this study was to longitudinally evaluate quality of life for pediatric patients receiving palliative care consultations and to compare patient-reported quality of life with parent perception of the child’s quality of life across wellness domains. The 23-item PedsQL™ V4.0 Measurement Model was utilized for ten child and parent dyads at time of initial palliative care consultation, Month 6, and Month 12 to assess for physical, emotional, social, and cognitive dimensions of quality of life as reported independently by the child and by the parent for the child. Findings were analyzed using Bland–Altman plots to compare observed differences to limits of agreement. This study revealed overall consistency between parent- and child-reported quality of life across domains. Physical health was noted to be in closest agreement. At the time of initial palliative care consult, children collectively scored their social quality of life higher than parental perception of the child’s social quality of life; whereas, emotional and cognitive quality of life domains were scored lower by children than by the parental report. At the one year survey time point, the physical, emotional, and social domains trended toward more positive patient perception than proxy perception with congruence between quality of life scores for the cognitive domain. Findings reveal the importance of eliciting a child report in addition to a parent report when measuring and longitudinally trending perceptions on quality of life.

  4. Monitoring of performance management using Quality Assurance Indicators and ISO requirement

    Directory of Open Access Journals (Sweden)

    Dargahi H

    2007-06-01

    Full Text Available Background: Quality assurance is a prevention-oriented system that can be used to improve the quality of care, increase productivity and monitor the performance management in clinical laboratories. ISO 9001: 2000 requirements are a collection of management and technical systems designed to implement quality assurance and monitor performance management in organizations. Methods: A checklist was prepared to monitor the preanalytical, analytical and postanalytical stages of laboratory performance management in 16 areas and all laboratory activities in 14 of the clinical laboratories of the Tehran University of Medical Sciences (TUMS hospitals. Collected data were stored and statistically analyzed using SPSS software. Results: The best performance, in which 77.73% of quality assurance indicators were observed, was found in Sina Hospital. However, only 57.56% of these indicators were fulfilled at Farabi Hospital, with the lowest-level performance among the clinical laboratories of TUMS hospitals. The highest level of compliance with quality assurance indicators was in the hematology departments and for facility demands in management areas. Overall, quality assurance indicators were appropriately followed in only 7% of the clinical laboratories. Conclusion: The average quality assurance observation rate in the clinical laboratories studied was 67.22%, which is insufficient and must be remedied with stricter enforcement of the ISO 9001: 2000 regulations.

  5. 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.

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

    DEFF Research Database (Denmark)

    Maraldo, Kristine; Schmelz, Rüdiger; Larsen, Thomas

    2015-01-01

    One objective in organic farming is to sustain the quality of the soil resource. Because enchytraeids are an important soil faunal component, they stand as bioindicators of soil quality. We tested this candidature in a field experiment on loamy sand soil with 1- and 4-year old grass-clover leys...... interactions among soil physical, chemical and biological properties suggest that enchytraeid abundance is not a feasible stand-alone indicator of management impacts on soil quality in temporary grass-clover leys but may candidate as one of several biological key parameters in more comprehensive soil quality...

  7. Indices of quality surface water bodies in the planning of water resources

    Directory of Open Access Journals (Sweden)

    Rodríguez-Miranda, Juan Pablo

    2016-12-01

    Full Text Available This paper considers a review of the literature major and significant methods of quality indices of water applied in surface water bodies, used and proposed for assessing the significance of parameters of water quality in the assessment of surface water currents and they are usually used in making decisions for intervention and strategic prevention measures for those responsible for the conservation and preservation of watersheds where these water bodies belong. An exploratory methodology was applied to realize the conceptualization of each water quality index. As a result, it is observed that there are several important methods for determining the water quality index applied in surface water bodies.

  8. 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.

  9. Evaluation of multiple water quality indices for drinking and irrigation purposes for the Karoon river, Iran.

    Science.gov (United States)

    Aminiyan, Milad Mirzaei; Aitkenhead-Peterson, Jacqueline; Aminiyan, Farzad Mirzaei

    2018-06-16

    The main purpose of this study was to evaluate the water quality of the Karoon river, which is a main river in Iran country. For this purpose, hydrochemical analyses of a database that maintained by the Water Resources Authority of Khuzestan Province, Iran's Ministry of Energy, were carried out. These data were compared with the maximum permissible limit values recommended by World Health Organization and Food and Agriculture Organization water standards for drinking and agricultural purposes, respectively. Also in this regard, multiple indices of water quality were utilized. However, not all indices gave similar rankings for water quality. According to the USSL diagram and Kelly ratio, Karoon's water quality is not suitable for irrigation purposes due to high salinity and moderate alkalinity. However, the results of the magnesium hazard analysis suggested that water quality for irrigation is acceptable. A Piper diagram illustrated that the most dominant water types during the 15 years of the study were Na-Cl and Na-SO 4 . The mineral saturation index also indicated that Na-Cl is the dominant water type. The water quality for drinking purpose was evaluated using a Schoeller diagram and water quality index (WQI). According to the computed WQI ranging from 111.9 to 194.0, the Karoon's water in the Khuzestan plain can be categorized as "poor water" for drinking purposes. Based on hydrochemical characteristics, years 2000-2007 and 2008-2014 were categorized into two clusters illustrating a decline in water quality between the two time periods.

  10. Key team physical and technical performance indicators indicative of team quality in the soccer Chinese super league.

    Science.gov (United States)

    Yang, Gai; Leicht, Anthony S; Lago, Carlos; Gómez, Miguel-Ángel

    2018-01-01

    The aim of this study was to identify the key physical and technical performance variables related to team quality in the Chinese Super League (CSL). Teams' performance variables were collected from 240 matches and analysed via analysis of variance between end-of-season-ranked groups and multinomial logistic regression. Significant physical performance differences between groups were identified for sprinting (top-ranked group vs. upper-middle-ranked group) and total distance covered without possession (upper and upper-middle-ranked groups and lower-ranked group). For technical performance, teams in the top-ranked group exhibited a significantly greater amount of possession in opponent's half, number of entry passes in the final 1/3 of the field and the Penalty Area, and 50-50 challenges than lower-ranked teams. Finally, time of possession increased the probability of a win compared with a draw. The current study identified key performance indicators that differentiated end-season team quality within the CSL.

  11. Longitudinal changes in quantitative and qualitative indicators of word and story recall in young-old and old-old adults.

    Science.gov (United States)

    Small, B J; Dixon, R A; Hultsch, D F; Hertzog, C

    1999-03-01

    The present study examined longitudinal changes in quantitative and qualitative measures of episodic memory. The sample, taken from the Victoria Longitudinal Study, consisted of 158 young-old adults (initially 55 to 70 years old) and 84 old-old adults (initially 71 to 86 years old) who were tested three times over six years. Average word and text recall, as well as five indicators of qualitative aspects of word recall (e.g., number of categories recalled) and one indicator of structure of text recall (i.e., levels of information) were used. For word recall, although both age groups exhibited negative longitudinal changes in quantitative performance, overall qualitative performance was generally stable. Two qualitative indicators (number of categories and intrusions) showed modest decline and one (organization at recall) showed improvement. Results for overall text recall showed significant performance increments for the young-old group, whereas the old-old group exhibited slight declines in overall performance. Analyses of qualitative measures showed stable structure of hierarchical recall, with the old-old being impaired at all levels of detail in the stories. Overall results suggest that some underlying structural characteristics of word and text recall may be maintained into late life even when significant overall decline is observed.

  12. Usability Evaluation and Implementation of a Health Information Technology Dashboard of Evidence-Based Quality Indicators.

    Science.gov (United States)

    Schall, Mark Christopher; Cullen, Laura; Pennathur, Priyadarshini; Chen, Howard; Burrell, Keith; Matthews, Grace

    2017-06-01

    Health information technology dashboards that integrate evidence-based quality indicators can efficiently and accurately display patient risk information to promote early intervention and improve overall quality of patient care. We describe the process of developing, evaluating, and implementing a dashboard designed to promote quality care through display of evidence-based quality indicators within an electronic health record. Clinician feedback was sought throughout the process. Usability evaluations were provided by three nurse pairs and one physician from medical-surgical areas. Task completion times, error rates, and ratings of system usability were collected to compare the use of quality indicators displayed on the dashboard to the indicators displayed in a conventional electronic health record across eight experimental scenarios. Participants rated the dashboard as "highly usable" following System Usability Scale (mean, 87.5 [SD, 9.6]) and Poststudy System Usability Questionnaire (mean, 1.7 [SD, 0.5]) criteria. Use of the dashboard led to reduced task completion times and error rates in comparison to the conventional electronic health record for quality indicator-related tasks. Clinician responses to the dashboard display capabilities were positive, and a multifaceted implementation plan has been used. Results suggest application of the dashboard in the care environment may lead to improved patient care.

  13. Effects of Grazing and Fire Frequency on Floristic Quality and its Relationship to Indicators of Soil Quality in Tallgrass Prairie.

    Science.gov (United States)

    Manning, George C; Baer, Sara G; Blair, John M

    2017-12-01

    Fire and grazing are widely used to manage grasslands for conservation purposes, but few studies have evaluated the effects of these drivers on the conservation value of plant communities measured by the floristic quality index (FQI). Further, the influence of fire and grazing on soil properties and functions are difficult for land managers and restoration practitioners to assess. The objectives of this study were to: (1) quantify the independent and interactive effects of grazing and fire frequency on floristic quality in native tallgrass prairie to provide potential benchmarks for community assessment, and (2) to explore whether floristic quality can serve as an indicator of soil structure and function for more holistic ecosystem assessments. A factorial combination of fire frequencies (1-2, 4, and 20 years return intervals) and grazing (by bison or ungrazed) treatments were sampled for plant species composition, and for several indicators of soil quality in lowland tallgrass prairie. Floristic quality, diversity, and richness were higher in grazed than ungrazed prairie over all fire frequencies (P soil bulk density were also higher in grazed prairie soil over all fire frequencies (P soil N were positively correlated with FQI (P soil N pools are more strongly influenced by grazing than fire and that floristic quality can be an indicator of total soil C and N stocks in never cultivated lowland prairie.

  14. Postpartum haemorrhage in midwifery care in the Netherlands: validation of quality indicators for midwifery guidelines.

    Science.gov (United States)

    Smit, Marrit; Chan, Kar-Li L; Middeldorp, Johanna M; van Roosmalen, Jos

    2014-12-07

    Postpartum haemorrhage (PPH) is still one of the major causes of severe maternal morbidity and mortality worldwide. Currently, no guideline for PPH occurring in primary midwifery care in the Netherlands is available. A set of 25 quality indicators for prevention and management of PPH in primary care has been developed by an expert panel consisting of midwives, obstetricians, ambulance personal and representatives of the Royal Dutch College of Midwives (KNOV) and the Dutch Society of Obstetrics and Gynecology (NVOG). This study aims to assess the performance of these quality indicators as an assessment tool for midwifery care and suitability for incorporation in a professional midwifery guideline. From April 2008 to April 2010, midwives reported cases of PPH. Cases were assessed using the 25 earlier developed quality indicators. Quality criteria on applicability, feasibility, adherence to the indicator, and the indicator's potential to monitor improvement were assessed. 98 cases of PPH were reported during the study period, of which 94 were analysed. Eleven indicators were found to be applicable and feasible. Five of these indicators showed improvement potential: routine administration of uterotonics, quantifying blood loss by weighing, timely referral to secondary care in homebirth and treatment of PPH using catherisation, uterine massage and oxytocin and the use of oxygen. Eleven out of 25 indicators were found to be suitable as an assessment tool for midwifery care of PPH and are therefore suitable for incorporation in a professional midwifery guideline. Larger studies are necessary to confirm these results.

  15. Dynamic Database for Quality Indicators Comparison in Education. Working Paper N. 04/2010

    Science.gov (United States)

    Poliandri, Donatella; Cardone, Michele; Muzzioli, Paola; Romiti, Sara

    2010-01-01

    The purpose of this study is to explore aspects and indicators most commonly used to assess the quality of education systems in different countries through the comparison of 12 national publications describing the state of the educational system. To compare indicators the CIPP model was chosen. This model is organized in four main parts: Context,…

  16. Quality indicators for the assessment and management of pain in the emergency department: a systematic review.

    Science.gov (United States)

    Stang, Antonia Schirmer; Hartling, Lisa; Fera, Cassandra; Johnson, David; Ali, Samina

    2014-01-01

    Evidence indicates that pain is undertreated in the emergency department (ED). The first step in improving the pain experience for ED patients is to accurately and systematically assess the actual care being provided. Identifying gaps in the assessment and treatment of pain and improving patient outcomes requires relevant, evidence-based performance measures. To systematically review the literature and identify quality indicators specific to the assessment and management of pain in the ED. Four major bibliographical databases were searched from January 1980 to December 2010, and relevant journals and conference proceedings were manually searched. Original research that described the development or collection of data on one or more quality indicators relevant to the assessment or management of pain in the ED was included. The search identified 18,078 citations. Twenty-three articles were included: 15 observational (cohort) studies; three before-after studies; three audits; one quality indicator development study; and one survey. Methodological quality was moderate, with weaknesses in the reporting of study design and methodology. Twenty unique indicators were identified, with the majority (16 of 20) measuring care processes. Overall, 91% (21 of 23) of the studies reported indicators for the assessment or management of presenting pain, as opposed to procedural pain. Three of the studies included children; however, none of the indicators were developed specifically for a pediatric population. Gaps in the existing literature include a lack of measures reflecting procedural pain, patient outcomes and the pediatric population. Future efforts should focus on developing indicators specific to these key areas.

  17. PP095. Guideline-based development of quality indicators for hypertensive diseases in pregnancy

    DEFF Research Database (Denmark)

    Luitjes, S.H.E.; Wouters, M; Franx, A.

    2012-01-01

    for care improvement.RESULTS: A representative set of 14 quality indicators was selected from 48 initial guideline recommendations. Indicators concerned both professional performance and organisation of care for patients with hypertension in pregnancy.CONCLUSION: This study describes the systematic...

  18. Quality improvement of interdisciplinary rounds by leadership training based on essential quality indicators of the Interdisciplinary Rounds Assessment Scale.

    Science.gov (United States)

    Ten Have, Elsbeth C M; Nap, Raoul E; Tulleken, Jaap E

    2013-10-01

    The implementation of interdisciplinary teams in the intensive care unit (ICU) has focused attention on leadership behavior. Daily interdisciplinary rounds (IDRs) in ICUs integrate leadership behavior and interdisciplinary teamwork. The purpose of this intervention study was to measure the effect of leadership training on the quality of IDRs in the ICU. A nonrandomized intervention study was conducted in four ICUs for adults. The intervention was a 1-day training session in a simulation environment and workplace-based feedback sessions. Measurement included 28 videotaped IDRs (total, 297 patient presentations) that were assessed with 10 essential quality indicators of the validated IDR Assessment Scale. Participants were 19 intensivists who previously had no formal training in leading IDRs. They were subdivided by cluster sampling into a control group (ten experienced intensivists) and intervention group (nine intensive care fellows). Mann-Whitney U test was used to compare results between control and intervention groups. Baseline measurements of control and intervention groups revealed two indicators that differed significantly. The frequency of yes ratings for the intervention group significantly increased for seven of the ten indicators from before to after intervention. The frequency of yes ratings after training was significantly greater in the intervention than control groups for eight of the ten essential quality indicators. The leadership training improved the quality of the IDRs performed in the ICUs. This may improve quality and safety of patient care.

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

    Science.gov (United States)

    Engels, Yvonne; Campbell, Stephen; Dautzenberg, Maaike; van den Hombergh, Pieter; Brinkmann, Henrik; Szécsényi, Joachim; Falcoff, Hector; Seuntjens, Luc; Kuenzi, Beat; Grol, Richard

    2005-04-01

    To develop a framework for general practice management made up of quality indicators shared by six European countries. Two-round postal Delphi questionnaire in the setting of general practice in Belgium, France, Germany, The Netherlands, Switzerland and the United Kingdom. Six national expert panels, each consisting of 10 members, primarily primary care practitioners and experts in the field of quality in primary care participated in the study. The main outcome measures were: (a) a European framework with indicators for the organization of primary care; and (b) ratings of the face validity of the usefulness of the indicators by expert panels in six countries. Agreement was reached about a definition of practice management across five domains (infrastructure, staff, information, finance, and quality and safety), and a common set of indicators for the organization of general practice. The panellist response rate was 95%. Sixty-two indicators (37%) were rated face valid by all six panels. Examples include out of hours service, accessibility, the content of doctors' bags and staff involvement in quality improvement. No indicators were rated invalid by all six panels. It proved to be possible to develop a European set of indicators for assessing the quality of practice management, despite the differences in health care systems and cultures in the six different countries. These indicators will now be used in a quality assessment procedure of practice management in nine European countries. While organizational indicators are part of the new GMS contract in the UK, this research shows that many practice management issues within primary care are also of relevance in other European countries.

  20. 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.

  1. 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.

  2. [Assessing the balance of quality indicator sets of external quality assurance according to SGB V section 136].

    Science.gov (United States)

    Doebler, Klaus; Geraedts, Max

    2017-12-20

    The value and usefulness of the results of indicator-based performance measurement in healthcare for different purposes do not only depend on the methodological quality of the individual indicators but also on the composition of the indicator sets. So far, the balance of the currently used indicator sets of the German mandatory national performance measurement system for hospitals has not been systematically analyzed. Due to the lack of a methodological gold standard for the assessment of balance and orientation of indicator sets we adapted the OECD concept of quality dimensions and defined four categories: 1) "Achieving primary goals of treatment", 2) "Avoiding adverse events", 3) "Indication" and 4) "Patient-centeredness". We defined rules for the assignment to the categories and analyzed the distribution of the 239 indicators from 29 medical areas in relation to these categories. 63 indicators (26.4 %) were assigned to the category "Achieving primary goals of treatment", 153 (64.0 %) to the category "Avoiding adverse events", 18 (7.5 %) to the category "Indication", one indicator (0.4 %) to the category "Patient-centeredness". Four indicators (1.7 %) addressed documentation quality. 12 of the 29 indicator sets only covered one OECD quality dimension by at least one indicator. The current indicator sets seem to be unbalanced with a strong focus on the category "Avoiding adverse events". As regards the goal of monitoring the compliance with minimal safety standards and performing improvement interventions, the direction of the indicator sets seems to be appropriate. With respect to other goals, such as for example the identification of "excellence", further development efforts are required. One relevant reason for the dominant focus on the category "Avoiding adverse events" seems to be that data sources for a follow-up and for the inclusion of the patient perspective have not been available until recently. There is a strong demand for the consequent use of

  3. [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.

  4. Flight Test and Handling Qualities Analysis of a Longitudinal Flight Control System Using Multiobjective Techniques

    National Research Council Canada - National Science Library

    Anderson, John

    1998-01-01

    ...) and AFIT MXTOOLS toolboxes were used to produce the optimal, multiobjective designs. These designs were implemented for flight test on the Calspan VSS I Learjet, simulating the unstable longitudinal dynamics of an F-16 type aircraft...

  5. Social Modulation or Hormonal Causation? Linkages of Testosterone with Sexual Activity and Relationship Quality in a Nationally Representative Longitudinal Sample of Older Adults.

    Science.gov (United States)

    Das, Aniruddha; Sawin, Nicole

    2016-11-01

    This study used population-representative longitudinal data from the 2005-2006 and 2010-2011 waves of the National Social Life, Health and Aging Project-a probability sample of US adults aged 57-85 at baseline (N = 650 women and 620 men)-to examine the causal direction in linkages of endogenous testosterone (T) with sexual activity and relationship quality. For both genders, our autoregressive effects indicated a large amount of temporal stability, not just in individual-level attributes (T, masturbation) but also dyadic ones (partnered sex, relationship quality)-indicating that a need for more nuanced theories of relational processes. Cross-lagged results suggested gender-specific effects-generally more consistent with sexual or relational modulation of T than with hormonal causation. Specifically, men's findings indicated their T might be elevated by their sexual (masturbatory) activity but not vice versa, although androgen levels did lower men's subsequent relationship quality. Women's T, in contrast, was negatively influenced not just by their higher relationship quality but also by their more frequent partnered sex-perhaps reflecting a changing function of sexual activity in late life.

  6. Review article: what makes a good healthcare quality indicator? A systematic review and validation study.

    Science.gov (United States)

    Jones, Peter; Shepherd, Michael; Wells, Susan; Le Fevre, James; Ameratunga, Shanthi

    2014-04-01

    Indicators measuring aspects of performance to assess quality of care are often chosen arbitrarily. The present study aimed to determine what should be considered when selecting healthcare quality indicators, particularly focusing on the application to emergency medicine. Structured searches of electronic databases were supplemented by website searches of quality of care and benchmarking organisations, citation searches and discussions with experts. Candidate attributes of 'good' healthcare indicators were extracted independently by two authors. The validity of each attribute was independently assessed by 16 experts in quality of care and emergency medicine. Valid and reliable attributes were included in a critical appraisal tool for healthcare quality indicators, which was piloted by emergency medicine specialists. Twenty-three attributes were identified, and all were rated moderate to extremely important by an expert panel. The reliability was high: alpha = 0.98. Twelve existing tools explicitly stated a median (range) of 14 (8-17) attributes. A critical appraisal tool incorporating all the attributes was developed. This was piloted by four emergency medicine specialists who were asked to appraise and rank a set of six candidate indicators. Although using the tool took more time than implicit gestalt decision making: median (interquartile range) 190 (43-352) min versus 17.5 (3-34) min, their rankings changed after using the tool. To inform the appraisal of quality improvement indicators for emergency medicine, a comprehensive list of indicator attributes was identified, validated, developed into a tool and piloted. Although expert consensus is still required, this tool provides an explicit basis for discussions around indicator selection. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  7. Identifying individual changes in performance with composite quality indicators while accounting for regression to the mean.

    Science.gov (United States)

    Gajewski, Byron J; Dunton, Nancy

    2013-04-01

    Almost a decade ago Morton and Torgerson indicated that perceived medical benefits could be due to "regression to the mean." Despite this caution, the regression to the mean "effects on the identification of changes in institutional performance do not seem to have been considered previously in any depth" (Jones and Spiegelhalter). As a response, Jones and Spiegelhalter provide a methodology to adjust for regression to the mean when modeling recent changes in institutional performance for one-variable quality indicators. Therefore, in our view, Jones and Spiegelhalter provide a breakthrough methodology for performance measures. At the same time, in the interests of parsimony, it is useful to aggregate individual quality indicators into a composite score. Our question is, can we develop and demonstrate a methodology that extends the "regression to the mean" literature to allow for composite quality indicators? Using a latent variable modeling approach, we extend the methodology to the composite indicator case. We demonstrate the approach on 4 indicators collected by the National Database of Nursing Quality Indicators. A simulation study further demonstrates its "proof of concept."

  8. 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…

  9. [Evaluation method with radiographic image quality indicator for internal defects of dental casting metallic restoration].

    Science.gov (United States)

    Li, Y; Zheng, G; Lin, H

    2014-12-18

    To develop a new kind of dental radiographic image quality indicator (IQI) for internal quality of casting metallic restoration to influence on its usage life. Radiographic image quality indicator method was used to evaluate the depth of the defects region and internal quality of 127 casting metallic restoration and the accuracy was compared with that of conventional callipers method. In the 127 cases of casting metallic restoration, 9 were found the thickness less than 0.7 mm and the thinnest thickness only 0.2 mm in 26 casting metallic crowns or bridges' occlusal defects region. The data measured by image quality indicator were consistent with those measured by conventional gauging. Two metal inner crowns were found the thickness less than 0.3 mm in 56 porcelain crowns or bridges. The thickness of casting removable partial denture was more than 1.0 mm, but thinner regions were not found. It was found that in a titanium partial denture, the X-ray image of clasp was not uniform and there were internal porosity defects in the clasp. Special dental image quality indicator can solve the visual error problems caused by different observing backgrounds and estimate the depth of the defects region in the casting.

  10. 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.

  11. [Development of quality of care indicators to support chronic disease management].

    Science.gov (United States)

    Beaulieu, Marie-dominique; Pomey, Marie-pascale; Del Grande, Claudio; Côté, Brigitte; Tremblay, Éric; Ghorbel, Monia; Hua, Phuong

    2015-01-01

    This article presents the results of a project conducted by the Institut national d'excellence en santé et en services sociaux of Québec to develop quality of care indicators for the management of six chronic illnesses. Indicators were identified through literature searches and analysis of clinical practice guidelines (CPGs). Interdisciplinary expert panels assessed their validity and the strength of the evidence on which they were based. Representatives of patients (N = 19) and professionals (N = 29) were consulted on their relevance and acceptability. Indicators were categorized according to the Chronic Care Model (CCM). A total of 164 indicators were developed, 126 specific to the illnesses under study and 38 on processes and outcomes generic to the CCM. There was convergence between patients and professionals on the relevance of a majority of indicators. Professionals expressed concerns on the indicators measured by means of patient surveys that they considered to be too subjective. The importance given to CPGs as the main source of indicators resulted in a great number of indicators of the technical quality ofcare. Using the CCM contributed to a broader perspective of quality. The consultation process identified some of the concerns of professionals about indicator measurement, thusguidingfuture implementation initiatives.

  12. [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.

  13. 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.

  14. [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.

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

    Science.gov (United States)

    Arkaravichien, Wiwat; Wongpratat, Apichaya; Lertsinudom, Sunee

    2016-08-01

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

  16. 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

    2018-01-01

    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.

  17. Sickness absence and psychosocial job quality: an analysis from a longitudinal survey of working Australians, 2005-2012.

    Science.gov (United States)

    Milner, Allison; Butterworth, Peter; Bentley, Rebecca; Kavanagh, Anne M; LaMontagne, Anthony D

    2015-05-15

    Sickness absence is associated with adverse health, organizational, and societal outcomes. Using data from a longitudinal cohort study of working Australians (the Household, Income and Labour Dynamics in Australia (HILDA) Survey), we examined the relationship between changes in individuals' overall psychosocial job quality and variation in sickness absence. The outcome variables were paid sickness absence (yes/no) and number of days of paid sickness absence in the past year (2005-2012). The main exposure variable was psychosocial job quality, measured using a psychosocial job quality index (levels of job control, demands and complexity, insecurity, and perceptions of unfair pay). Analysis was conducted using longitudinal fixed-effects logistic regression models and negative binomial regression models. There was a dose-response relationship between the number of psychosocial job stressors reported by an individual and the odds of paid sickness absence (1 adversity: odds ratio (OR) = 1.26, 95% confidence interval (CI): 1.09, 1.45 (P = 0.002); 2 adversities: OR = 1.28, 95% CI: 1.09, 1.51 (P = 0.002); ≥3 adversities: OR = 1.58, 95% CI: 1.29, 1.94 (P job quality. These results suggest that workplace interventions aiming to improve the quality of work could help reduce sickness absence. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. A Critical Assessment of the Quality and Validity of Composite Indicators of Innovation

    Energy Technology Data Exchange (ETDEWEB)

    Vértesy, D.

    2016-07-01

    While it is generally accepted that monitoring innovation system performance requires a set of indicators, there is a constant debate on whether and how composite indices can be used to summarize them. This paper enters this discussion by assessing the validity and quality of the most commonly used composite indicators of innovation. In our framework, the validity of an index relates to the link between component indicators or aggregates and to the aspect(s) of national systems of innovation they seek to measure, while the quality of an indicator relates to its statistical properties. To better understand validity, we discuss how the evolution of the national system of innovation concept and its use in policy has shifted demand from an advocacy to more analytical functions of composite indicators of innovation.We next examine selected composite indicators of innovation (the WIPO-INSEAD’s Global Innovation Indicator, the Summary Innovation Index and Innovation Output Indicator of the European Commission and the Fraunhofer Innovation Index) in different contexts of external and internal validity and conduct global sensitivity analyses on them. Our policy-relevant findings highlight the need for analytically stronger composites of a more limited set of indicators.We also found significant quality differences across the indices, as some included components which explain little or none of the variance in composite scores, and were more sensitive to modeling choices. The indices studied differed in how validly they represented various innovation system functions and types of innovation, and showed information relevant for a broader or a more limited set of stakeholders. We argue that further development of innovation indicators should put more emphasis on identifying tradeoffs within innovation policy, and unintended consequences of innovative activities. (Author)

  19. Evaluation of the EIA system performance in Greece, using quality indicators

    International Nuclear Information System (INIS)

    Androulidakis, Ioannis; Karakassis, Ioannis

    2006-01-01

    Greece was among the last countries in the European Union to adopt the EU Directives on Environmental Impact Assessment, upgrading the previously existing legislative framework. The aim of the present paper was to appraise the quality of a randomly selected sample of EISs using non-obligatory but quality-related indicators and to evaluate the overall quality of these studies produced in Greece during the last decade (1993-2003). It was found that the majority of these EISs performed rather poorly in respect of most indicators used and there was little evidence of improvement with time. It is concluded that the authorities in charge still have little experience in coping with the increasing bulk of project submissions and are primarily interested in conformity with formal requirements rather than in reliable predictions and in overall quality of the EIA procedure

  20. Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

    Science.gov (United States)

    Foebel, Andrea D; van Hout, Hein P; van der Roest, Henriëtte G; Topinkova, Eva; Garms-Homolova, Vjenka; Frijters, Dinnus; Finne-Soveri, Harriet; Jónsson, Pálmi V; Hirdes, John P; Bernabei, Roberto; Onder, Graziano

    2015-11-14

    Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

  1. Chemical, biochemical and microbiological indicators to assess soil quality in temperate agro-ecosystems

    OpenAIRE

    Giacometti, Caterina

    2013-01-01

    Soil is a critically important component of the earth’s biosphere. Developing agricultural production systems able to conserve soil quality is essential to guarantee the current and future capacity of soil to provide goods and services. This study investigates the potential of microbial and biochemical parameters to be used as early and sensitive soil quality indicators. Their ability to differentiate plots under contrasting fertilization regimes is evaluated based also on their sensitivi...

  2. Using Latent Semantic Analysis to Identify Quality in Use (QU) Indicators from User Reviews

    OpenAIRE

    Syn, Wendy Tan Wei; How, Bong Chih; Atoum, Issa

    2015-01-01

    The paper describes a novel approach to categorize users' reviews according to the three Quality in Use (QU) indicators defined in ISO: effectiveness, efficiency and freedom from risk. With the tremendous amount of reviews published each day, there is a need to automatically summarize user reviews to inform us if any of the software able to meet requirement of a company according to the quality requirements. We implemented the method of Latent Semantic Analysis (LSA) and its subspace to predi...

  3. Is the Readmission Rate a Valid Quality Indicator? A Review of the Evidence

    Science.gov (United States)

    Fischer, Claudia; Lingsma, Hester F.; Marang-van de Mheen, Perla J.; Kringos, Dionne S.; Klazinga, Niek S.; Steyerberg, Ewout W.

    2014-01-01

    Introduction Hospital readmission rates are increasingly used for both quality improvement and cost control. However, the validity of readmission rates as a measure of quality of hospital care is not evident. We aimed to give an overview of the different methodological aspects in the definition and measurement of readmission rates that need to be considered when interpreting readmission rates as a reflection of quality of care. Methods We conducted a systematic literature review, using the bibliographic databases Embase, Medline OvidSP, Web-of-Science, Cochrane central and PubMed for the period of January 2001 to May 2013. Results The search resulted in 102 included papers. We found that definition of the context in which readmissions are used as a quality indicator is crucial. This context includes the patient group and the specific aspects of care of which the quality is aimed to be assessed. Methodological flaws like unreliable data and insufficient case-mix correction may confound the comparison of readmission rates between hospitals. Another problem occurs when the basic distinction between planned and unplanned readmissions cannot be made. Finally, the multi-faceted nature of quality of care and the correlation between readmissions and other outcomes limit the indicator's validity. Conclusions Although readmission rates are a promising quality indicator, several methodological concerns identified in this study need to be addressed, especially when the indicator is intended for accountability or pay for performance. We recommend investing resources in accurate data registration, improved indicator description, and bundling outcome measures to provide a more complete picture of hospital care. PMID:25379675

  4. 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.

  5. Is the readmission rate a valid quality indicator? A review of the evidence.

    Directory of Open Access Journals (Sweden)

    Claudia Fischer

    Full Text Available Hospital readmission rates are increasingly used for both quality improvement and cost control. However, the validity of readmission rates as a measure of quality of hospital care is not evident. We aimed to give an overview of the different methodological aspects in the definition and measurement of readmission rates that need to be considered when interpreting readmission rates as a reflection of quality of care.We conducted a systematic literature review, using the bibliographic databases Embase, Medline OvidSP, Web-of-Science, Cochrane central and PubMed for the period of January 2001 to May 2013.The search resulted in 102 included papers. We found that definition of the context in which readmissions are used as a quality indicator is crucial. This context includes the patient group and the specific aspects of care of which the quality is aimed to be assessed. Methodological flaws like unreliable data and insufficient case-mix correction may confound the comparison of readmission rates between hospitals. Another problem occurs when the basic distinction between planned and unplanned readmissions cannot be made. Finally, the multi-faceted nature of quality of care and the correlation between readmissions and other outcomes limit the indicator's validity.Although readmission rates are a promising quality indicator, several methodological concerns identified in this study need to be addressed, especially when the indicator is intended for accountability or pay for performance. We recommend investing resources in accurate data registration, improved indicator description, and bundling outcome measures to provide a more complete picture of hospital care.

  6. Development of the information model for consumer assessment of key quality indicators by goods labelling

    Science.gov (United States)

    Koshkina, S.; Ostrinskaya, L.

    2018-04-01

    An information model for “key” quality indicators of goods has been developed. This model is based on the assessment of f standardization existing state and the product labeling quality. According to the authors’ opinion, the proposed “key” indicators are the most significant for purchasing decision making. Customers will be able to use this model through their mobile technical devices. The developed model allows to decompose existing processes in data flows and to reveal the levels of possible architectural solutions. In-depth analysis of the presented information model decomposition levels will allow determining the stages of its improvement and to reveal additional indicators of the goods quality that are of interest to customers in the further research. Examining the architectural solutions for the customer’s information environment functioning when integrating existing databases will allow us to determine the boundaries of the model flexibility and customizability.

  7. STUDY ON WATER QUALITY INDICATORS AT TAIA TREATMENT PLANT HUNDEDOARA COUNTY

    Directory of Open Access Journals (Sweden)

    Ramona Violeta CAZALBAŞU

    2017-05-01

    Full Text Available Water is consumed in its natural form or in a processed one. It is a well-known fact that enterprises, institutions, energy and agriculture consume it as processed water whereas the population consumes it as drinking water or wastewater. This paper presents the study of water quality indicators from the treatment plant Taia in Hunedoara County. The following quality indicators were determined: turbidity, hardness, alkalinity, chlorine oxide and organic substances. The determined quality indicators revealed that they fall within the limits set by legislation, with some exceptions. In each step of purification of organic substances there has been a continual reduction, this being carried out both biologically because of the biomass deposited on sand grains in the filter bed as well as especially during the oxidation step with active chlorine

  8. 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)

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

    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

  9. Data Quality Indicators Composition and Calculus: Engineering and Information Systems Approaches

    Directory of Open Access Journals (Sweden)

    Leon REZNIK

    2015-02-01

    Full Text Available Big Data phenomenon is a result of novel technological developments in sensor, computer and communication technologies. Nowadays more and more data are produced by nanoscale photonic, optoelectronic and electronic devices. However, their quality characteristics could be very low. The paper proposes new methods of the data management with huge data amounts that is based on associating of data quality indicators with each data entity. To achieve this goal, one needs to define the composition of the data quality indicators and to develop their integration calculus. As data quality evaluation involves multi-disciplinary research, various metrics have been investigated. The paper describes two major approaches in assigning the data quality indicators and developing their integration calculus. The information systems approach employs traditional high-level metrics like data accuracy, consistency and completeness. The engineering approach utilizes signal characteristics processed with the probability based calculus. The data quality metrics composition and calculus are discussed. The tools developed to automate the metrics selection and calculus procedures are presented. The user- friendly interface examples are provided.

  10. 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 of diet......-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....

  11. Radon concentration as an indicator of the indoor air quality: development of an efficient measurement method

    International Nuclear Information System (INIS)

    Roessler, F.A.

    2015-01-01

    Document available in abstract form only. Full text of publication follows: Energy conservation regulation could lead to a reduction of the air exchange rate and also a degradation of the indoor air quality. Present methods for the estimating the indoor air quality can only be implemented with limitations. This paper presents a method that allows the estimation of the indoor air quality under normal conditions by using natural radon as an indicator. With mathematical models, the progression of the air exchange rate is estimated by using the radon concentration. Furthermore, the progression of individual air pollutants is estimated. Through series of experiments in a measurement chamber, the modelling could be verified. (author)

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

    Science.gov (United States)

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

    2015-10-01

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

  13. Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators.

    Science.gov (United States)

    Portrait, France R M; van der Galiën, Onno; Van den Berg, Bernard

    2016-04-01

    The Dutch healthcare system is in transition towards managed competition. In theory, a system of managed competition involves incentives for quality and efficiency of provided care. This is mainly because health insurers contract on behalf of their clients with healthcare providers on, potentially, quality and costs. The paper develops a strategy to comprehensively analyse available multidimensional data on quality and costs to assess and report on the relative performance of healthcare providers within managed competition. We had access to individual information on 2409 clients of 19 Dutch diabetes care groups on a broad range of (outcome and process related) quality and cost indicators. We carried out a cost-consequences analysis and corrected for differences in case mix to reduce incentives for risk selection by healthcare providers. There is substantial heterogeneity between diabetes care groups' performances as measured using multidimensional indicators on quality and costs. Better quality diabetes care can be achieved with lower or higher costs. Routine monitoring using multidimensional data on quality and costs merged at the individual level would allow a systematic and comprehensive analysis of healthcare providers' performances within managed competition. Copyright © 2015 John Wiley & Sons, Ltd.

  14. 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.

  15. The macro-invertebrates and their value like indicators of the water quality

    International Nuclear Information System (INIS)

    Roldan Perez, Gabriel

    1999-01-01

    An analysis of the water pollution problems is presented and some of the more used methods for assessment of its damage degree through bio indicators are discussed. There are biological methods for assessment of water quality widely used in developed countries. Because the aquatic fauna existing there is different from the one here, those methods cannot be applied in the tropics before knowing what kinds of organisms live here and what ecological requirements they have. The adoption of a method for assessment of water quality in tropical mountains ecosystems is proposed, using macro invertebrates as bio indicators

  16. Quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections in general practice

    DEFF Research Database (Denmark)

    Saust, Laura Trolle; Bjerrum, Lars; Arpi, Magnus

    2017-01-01

    Objective: To develop quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections, tailored to the Danish general practice setting. Design: A RAND/UCLA Appropriateness Method was used. Setting: General practice. Subjects: A panel of nine experts, mainly...... general practitioners, was asked to rate the relevance of 64 quality indicators for the diagnosis and antibiotic treatment of acute respiratory tract infections based on guidelines. Subsequently, a face-to-face meeting was held to resolve misinterpretations and to achieve consensus. Main outcome measures...

  17. Individual quality of life in patients undergoing radiotherapy. A longitudinal survey

    International Nuclear Information System (INIS)

    Wenskus, Julia Katharina

    2015-01-01

    The way that Quality of Life (QoL) is perceived has crucially changed over the last few decades. As a consequence of demographic change and ongoing technical progress, QoL gained in importance and became established as a major outcome parameter in clinical trials. Scientists in the field of QoL differentiate between three categories: health-related, global and individual QoL. For the assessment of individual QoL, Becker et al. (2014) and Merk (2011) developed and validated an easily applicable and economical questionnaire; the SEIQoL-Q. The purpose of our study was to modify the SEIQoL-Q based on Merk's approach (2011) and apply the revised version in a longitudinal survey of different patient populations in the Clinic for Radiotherapy of the University Hospital of Freiburg. Apart from that, other crucial factors, which might affect the evaluation of one's QoL, were gathered by use of a newly established questionnaire. 132 patients undergoing radiotherapy and having been diagnosed with breast cancer (BC), prostate cancer (PC), bone metastasis (BM) or a benign disease (B) were included in our study. The participants were interviewed at four definitive times in their treatment (1. before the radiotherapy had started, 2. after 50 % of the total radiation dose had been given, 3. at the end of the therapy, 4. during the aftercare). A total of 419 interviews were carried out. While the highest possible score was 100, the average individual QoL was 60.48 (BC: 56.55; PC: 64.13; BM: 59.27; B: 58.85). Significant differences of the individual QoL were revealed between the diagnosis groups (BC vs. PC, PC vs. B, PC vs. BM), the age (< 66 years: 55.39; = 66 years: 62.27) and the gender (women: 57.11; men: 62.88). Additionally, the expectations and the mood influenced the assessment of the individual QoL. Furthermore, it could be shown that there were correlations between the individual QoL and personality, depressive tendencies, ego strength, optimism, self-concept, faith and

  18. Longitudinal Trends in Anxiety, Depression, and Quality of Life During Different Intermittent Periods of Adjuvant Breast Cancer Chemotherapy.

    Science.gov (United States)

    Zhang, Jiayuan; Zhou, Yuqiu; Feng, Ziwei; Xu, Yong; Zeng, Guangchun

    Chemotherapy (CT) is an important adjuvant treatment that has been widely used for breast cancer (BC) patients. However, no research has focused on trends in emotions and quality of life (QOL) during intermittent periods between CT sessions that are critical for recovery. The aim of this study was to investigate longitudinal trends in anxiety, depression, and QOL during the different intermittent periods between adjuvant CT for BC. A longitudinal study design was adopted. Eighty-eight women undergoing CT for BC were selected using a purposive sampling method, and they completed the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Functional Assessment of Cancer Therapy-Breast (FACT-B) at 5 points. A repeated-measures analysis-of-variance model was used to compare anxiety, depression, and QOL at different time points. The results showed a significant difference in SAS (F = 187.78, P fashion.

  19. 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.

  20. Instrument Psychometrics: Parental Satisfaction and Quality Indicators of Perinatal Palliative Care.

    Science.gov (United States)

    Wool, Charlotte

    2015-10-01

    Despite a life-limiting fetal diagnosis, prenatal attachment often occurs in varying degrees resulting in role identification by an individual as a parent. Parents recognize quality care and report their satisfaction when interfacing with health care providers. The aim was to test an instrument measuring parental satisfaction and quality indicators with parents electing to continue a pregnancy after learning of a life-limiting fetal diagnosis. A cross sectional survey design gathered data using a computer-mediated platform. Subjects were parents (n=405) who opted to continue a pregnancy affected by a life-limiting diagnosis. Factor analysis using principal component analysis with Varimax rotation was used to validate the instrument, evaluate components, and summarize the explained variance achieved among quality indicator items. The Prenatal Scale was reduced to 37 items with a three-component solution explaining 66.19% of the variance and internal consistency reliability of 0.98. The Intrapartum Scale included 37 items with a four-component solution explaining 66.93% of the variance and a Cronbach α of 0.977. The Postnatal Scale was reduced to 44 items with a six-component solution explaining 67.48% of the variance. Internal consistency reliability was 0.975. The Parental Satisfaction and Quality Indicators of Perinatal Palliative Care Instrument is a valid and reliable measure for parent-reported quality care and satisfaction. Use of this instrument will enable clinicians and researchers to measure quality indicators and parental satisfaction. The instrument is useful for assessing, analyzing, and reporting data on quality for care delivered during the prenatal, intrapartum, and postnatal periods.

  1. Development of sustainable water treatment technology using scientifically based calculated indexes of source water quality indicators

    Directory of Open Access Journals (Sweden)

    А. С. Трякина

    2017-10-01

    Full Text Available The article describes selection process of sustainable technological process flow chart for water treatment procedure developed on scientifically based calculated indexes of quality indicators for water supplied to water treatment facilities. In accordance with the previously calculated values of the indicators of the source water quality, the main purification facilities are selected. A more sustainable flow chart for the modern water quality of the Seversky Donets-Donbass channel is a two-stage filtering with contact prefilters and high-rate filters. The article proposes a set of measures to reduce such an indicator of water quality as permanganate oxidation. The most suitable for these purposes is sorption purification using granular activated carbon for water filtering. The increased water hardness is also quite topical. The method of ion exchange on sodium cation filters was chosen to reduce the water hardness. We also evaluated the reagents for decontamination of water. As a result, sodium hypochlorite is selected for treatment of water, which has several advantages over chlorine and retains the necessary aftereffect, unlike ozone. A technological flow chart with two-stage purification on contact prefilters and two-layer high-rate filters (granular activated carbon - quartz sand with disinfection of sodium hypochlorite and softening of a part of water on sodium-cation exchangers filters is proposed. This technological flow chart of purification with any fluctuations in the quality of the source water is able to provide purified water that meets the requirements of the current sanitary-hygienic standards. In accordance with the developed flow chart, guidelines and activities for the reconstruction of the existing Makeevka Filtering Station were identified. The recommended flow chart uses more compact and less costly facilities, as well as additional measures to reduce those water quality indicators, the values of which previously were in

  2. Suitability of three indicators measuring the quality of coordination within hospitals

    Directory of Open Access Journals (Sweden)

    Loirat Philippe

    2010-04-01

    Full Text Available Abstract Background Coordination within hospitals is a major attribute of medical care and influences quality of care. This study tested the validity of 3 indicators covering two key aspects of coordination: the transfer of written information between professionals (medical record content, radiology exam order and the holding of multidisciplinary team meetings during treatment planning. Methods The study was supervised by the French health authorities (COMPAQH project. Data for the three indicators were collected in a panel of 30 to 60 volunteer hospitals by 6 Clinical Research Assistants. The metrological qualities of the indicators were assessed: (i Feasibility was assessed using a grid of 19 potential problems, (ii Inter-observer reliability was given by the kappa coefficient ( and internal consistency by Cronbach's alpha test, (iii Discriminatory power was given by an analysis of inter-hospital variability using the Gini coefficient as a measure of dispersion. Results Overall, 19281 data items were collected and analyzed. All three indicators presented acceptable feasibility and reliability (, 0.59 to 0.97 and showed wide differences among hospitals (Gini, 0.08 to 0.11, indicating that they are suitable for making comparisons among hospitals. Conclusion This set of 3 indicators provides a proxy measurement of coordination. Further research on the indicators is needed to find out how they can generate a learning process. The medical record indicator has been included in the French national accreditation procedure for healthcare organisations. The two other indicators are currently being assessed for inclusion.

  3. Quality of care indicators for the rehabilitation of children with traumatic brain injury.

    Science.gov (United States)

    Rivara, Frederick P; Ennis, Stephanie K; Mangione-Smith, Rita; MacKenzie, Ellen J; Jaffe, Kenneth M

    2012-03-01

    To develop measurement tools for assessing compliance with identifiable processes of inpatient care for children with traumatic brain injury (TBI) that are reliable, valid, and amenable to implementation. Literature review and expert panel using the RAND/UCLA Appropriateness Method and a Delphi technique. Not applicable. Children with TBI. Not applicable. Quality of care indicators. A total of 119 indicators were developed across the domains of general management; family-centered care; cognitive-communication, speech, language, and swallowing impairments; gross and fine motor skill impairments; neuropsychologic, social, and behavioral impairments; school reentry; and community integration. There was a high degree of agreement on these indicators as valid and feasible quality measures for children with TBI. These indicators are an important step toward building a better base of evidence about the effectiveness and efficiency of the components of acute inpatient rehabilitation for pediatric patients with TBI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. An empirical comparison of key statistical attributes among potential ICU quality indicators.

    Science.gov (United States)

    Brown, Sydney E S; Ratcliffe, Sarah J; Halpern, Scott D

    2014-08-01

    Good quality indicators should have face validity, relevance to patients, and be able to be measured reliably. Beyond these general requirements, good quality indicators should also have certain statistical properties, including sufficient variability to identify poor performers, relative insensitivity to severity adjustment, and the ability to capture what providers do rather than patients' characteristics. We assessed the performance of candidate indicators of ICU quality on these criteria. Indicators included ICU readmission, mortality, several length of stay outcomes, and the processes of venous-thromboembolism and stress ulcer prophylaxis provision. Retrospective cohort study. One hundred thirty-eight U.S. ICUs from 2001-2008 in the Project IMPACT database. Two hundred sixty-eight thousand eight hundred twenty-four patients discharged from U.S. ICUs. None. We assessed indicators' (1) variability across ICU-years; (2) degree of influence by patient vs. ICU and hospital characteristics using the Omega statistic; (3) sensitivity to severity adjustment by comparing the area under the receiver operating characteristic curve (AUC) between models including vs. excluding patient variables, and (4) correlation between risk adjusted quality indicators using a Spearman correlation. Large ranges of among-ICU variability were noted for all quality indicators, particularly for prolonged length of stay (4.7-71.3%) and the proportion of patients discharged home (30.6-82.0%), and ICU and hospital characteristics outweighed patient characteristics for stress ulcer prophylaxis (ω, 0.43; 95% CI, 0.34-0.54), venous thromboembolism prophylaxis (ω, 0.57; 95% CI, 0.53-0.61), and ICU readmissions (ω, 0.69; 95% CI, 0.52-0.90). Mortality measures were the most sensitive to severity adjustment (area under the receiver operating characteristic curve % difference, 29.6%); process measures were the least sensitive (area under the receiver operating characteristic curve % differences

  5. ASSESSMENT OF LAND QUALITY USING ECOPEDOLOGICAL INDICATORS - JEBEL AREA, TIMIŞ COUNTY, ROMANIA

    Directory of Open Access Journals (Sweden)

    Costina Roxana URUIOC

    2012-01-01

    Full Text Available The studied area is placed in North-East Jebel locality. Based on the physical and chemical characteristics and soil morphology profile, the following types of soil were identified: typical preluvosol, typical and gleyic eutricambosols, luvic solonet, gleysol, gleyic vertisol and gleyic-stagnic vertisol. The assessment of land quality (fertility was determined by bonitation. For the notes of bonitation calculation, the following ecopedological indicatories have been used: annual medium temperature, annual medium precipitations, depth of the underground water, texture in Ap horizon, gleization, pseudogleization, salinization, edafic volume, porosity, soil reaction (pH, humus reserve and content of CaCO3. The way that these indicators influence the notes of bonitation is different from a type of soil to another and the use of land. Thus, for grassland, typical preluvosol, the note of bonitate is 81 and it’s included in class II of quality (favorability, luvic solonet with 63 points in class IV of quality, typical eutricambosols with 58 points and vertisol with 57 points, in class V of quality, gleysol with 32 points and gleyic eutricambosol with 36 points, in class VII of quality. In case of using the land for growing maize, we have the following: typical preluvosol with 90 points which is in class II of quality, typical eutricambosol with 54 points and gleyic vertisol with 60 points, in class V of quality, luvic solonet with 49 points in class VI of quality, gleyic-stagnic vertisol with 35 points, in class VII of quality, gleysol with 24 points and gleyic eutricambosol with 29 points, in class VIII of quality. The notes of bonitation calculation, including them in the favorability classes, showed up that lands from Jebel area are good and very good quality, exception those that develop on gleysol and gleyic eutricambosols soils.

  6. Performance Assesment of Bauchi Polytechnics and Technical Colleges Using Quality Assurance Indicators in Nigeria Qualification Framework

    Directory of Open Access Journals (Sweden)

    Idris Adamu

    2016-07-01

    Full Text Available Technical and Vocational Education emphases skill acquisition, Quality Assurance in vocational education is concept that is concerned with high performance involved activities with vocational education such as teaching, learning, infrastructures, student’s behavior and entire academic process. Good quality education is very necessary in the total development of staff and students which ensures proper development, job prospects and the realization of academic goals and objects. Enhanced and sustained to ensure accountability and improve performance. Higher educational institutions in Nigeria continue to experience carelessly attitude about the use of Quality Assurance to understand the risk they are exposed to poor standard. To address these issues, the study embarked upon to determine the level of performance and difference usability of Quality Assurance in Polytechnics and Technical Colleges in Bauchi state. Quantitative method technique was employed using survey questionnaires, 60 staff both senior and junior within these institutions were selected and a questionnaire distributed for their responses. The data were analysed using SPSS software. The result reveals that Federal Polytechnic Bauchi and State Polytechnic Bauchi has high level of Performance about Quality Assurance indicators while College of Education Azare has medium level of Performance. College of education Azare has highest mean rank of 29.87 and percentage of 31.8% obtained from the output result indicated that it has high usability to Quality Assurance, followed by Federal Polytechnic Bauchi with medium usability then State Polytechnic Bauchi has low usability to Quality Assurance. The study concluded by Quality Assurance Unit be made aware to each institution staff to enable recognize the benefits of it. Federal government should give more funding and employ staff to cater the need of Quality Assurance Unit in every institution so that it will help the students to develop

  7. Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study.

    Science.gov (United States)

    Gijsbers, H J H; Lauret, G J; van Hofwegen, A; van Dockum, T A; Teijink, J A W; Hendriks, H J M

    2016-06-01

    The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a validation round was performed. Twenty-six experts were recruited to participate in this study. Twenty-four experts completed two Delphi-rounds. A third round was conducted inviting 1200 qualified and registered physiotherapists of the Dutch integrated care network 'Claudicationet' to validate a draft set of quality indicators. Out of 83 potential QIs in the Dutch physiotherapy guideline on 'Intermittent claudication', consensus among the experts selected nine indicators. All nine quality indicators were validated by 300 physiotherapists. A final set of nine indicators was derived from (1) a Dutch evidence-based physiotherapy guideline, (2) an expert Delphi procedure and (3) a validation by 300 physiotherapists. This set of indicators should be validated in clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  8. Monitoring bacterial indicators of water quality in a tidally influenced delta: A Sisyphean pursuit.

    Science.gov (United States)

    Partyka, Melissa L; Bond, Ronald F; Chase, Jennifer A; Atwill, Edward R

    2017-02-01

    The Sacramento-San Joaquin Delta Estuary (Delta) is the confluence of two major watersheds draining the Western Sierra Nevada mountains into the Central Valley of California, ultimately terminating into San Francisco Bay. We sampled 88 sites once a month for two years (2006-2008) over 87 separate sampling events for a total of 1740 samples. Water samples were analyzed for fecal indicator bacteria (Escherichia coli, enterococci and fecal coliforms), and 53 other physiochemical, land use, and environmental characteristics. The purpose of the study was to create a baseline of microbial water quality in the Delta and to identify various factors (climatic, land use, tidal, etc.) that were associated with elevated concentrations of indicator bacteria. Fecal indicator bacteria generally had weak to modest relationships to environmental conditions; the strength and direction of which varied for each microbial indicator, drainage region, and across seasons. Measured and unmeasured, site-specific effects accounted for large portions of variance in model predictions (ρ=0.086 to 0.255), indicating that spatial autocorrelation was a major component of water quality outcomes. The effects of tidal cycling and lack of connectivity between waterways and surrounding landscapes likely contributed to the lack of association between local land uses and microbial outcomes, though weak associations may also be indicative of mismatched spatiotemporal scales. The complex nature of this system necessitates continued monitoring and regular updates to statistical models designed to predict microbial water quality. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. [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.

  10. 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.

  11. DNA Source Selection for Downstream Applications Based on DNA Quality Indicators Analysis

    Science.gov (United States)

    Lucena-Aguilar, Gema; Sánchez-López, Ana María; Barberán-Aceituno, Cristina; Carrillo-Ávila, José Antonio; López-Guerrero, José Antonio

    2016-01-01

    High-quality human DNA samples and associated information of individuals are necessary for biomedical research. Biobanks act as a support infrastructure for the scientific community by providing a large number of high-quality biological samples for specific downstream applications. For this purpose, biobank methods for sample preparation must ensure the usefulness and long-term functionality of the products obtained. Quality indicators are the tool to measure these parameters, the purity and integrity determination being those specifically used for DNA. This study analyzes the quality indicators in DNA samples derived from 118 frozen human tissues in optimal cutting temperature (OCT) reactive, 68 formalin-fixed paraffin-embedded (FFPE) tissues, 119 frozen blood samples, and 26 saliva samples. The results obtained for DNA quality are discussed in association with the usefulness for downstream applications and availability of the DNA source in the target study. In brief, if any material is valid, blood is the most approachable option of prospective collection of samples providing high-quality DNA. However, if diseased tissue is a requisite or samples are available, the recommended source of DNA would be frozen tissue. These conclusions will determine the best source of DNA, according to the planned downstream application. Furthermore our results support the conclusion that a complete procedure of DNA quantification and qualification is necessary to guarantee the appropriate management of the samples, avoiding low confidence results, high costs, and a waste of samples. PMID:27158753

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

    DEFF Research Database (Denmark)

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

    Objective: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice.  Material and methods: A modified 2-round Delphi study was conducted from April to July 2008. A panel of 27 experts (13 countries) comprising mainly general...

  13. Postpartum haemorrhage in midwifery care in the Netherlands: validation of quality indicators for midwifery guidelines

    NARCIS (Netherlands)

    Smit, M.; Chan, K.L.L.; Middeldorp, J.M.; van Roosmalen, J.

    2014-01-01

    Background: Postpartum haemorrhage (PPH) is still one of the major causes of severe maternal morbidity and mortality worldwide. Currently, no guideline for PPH occurring in primary midwifery care in the Netherlands is available. A set of 25 quality indicators for prevention and management of PPH in

  14. Assessment of water quality based on diatom indices in a small ...

    African Journals Online (AJOL)

    2016-04-02

    Apr 2, 2016 ... single metric which is used to indicate the degree of impact. (Taylor et al. ... comparison of diatom-based water quality results, and are an additional reason for ...... establishing a framework for Community action in the field of.

  15. Novel indicators of recreational water quality and swimming-associated illness

    Science.gov (United States)

    In the United States and elsewhere, recreational water quality is monitored for fecal indicator bacteria to help prevent swimming-associated illnesses. Standard methods to measure these bacteria take at least 24 hours to obtain results. Molecular approaches such as quantitative p...

  16. Quality of life before and after lung transplantation in patients with emphysema versus other indications

    NARCIS (Netherlands)

    TenVergert, EM; Vermeulen, KM; van Enckevort, PJ

    2001-01-01

    Whether lung transplantation improves Health-related Quality of Life in patients with emphysema and other end-stage lung diseases before and after lung transplantation was examined. Between 1992 and 1999, 23 patients with emphysema and 19 patients with other indications completed self-administered

  17. Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study

    NARCIS (Netherlands)

    Gijsbers, H. J. H.; Lauret, G. J.; van Hofwegen, A.; van Dockum, T. A.; Teijink, J. A. W.; Hendriks, H. J. M.

    2016-01-01

    The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a

  18. Audit of cases with uterine rupture: A process indicator of quality of ...

    African Journals Online (AJOL)

    Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of obstetric care. Records of UR cases at a referral maternity in Luanda were studied retrospectively (n=43) and prospectively (n=67) including basic obstetric information, maternal and foetal outcome, ...

  19. 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…

  20. 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;…

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  2. The Minimum Data Set Depression Quality Indicator: Does It Reflect Differences in Care Processes?

    Science.gov (United States)

    Simmons, S.F.; Cadogan, M.P.; Cabrera, G.R.; Al-Samarrai, N.R.; Jorge, J.S.; Levy-Storms, L.; Osterweil, D.; Schnelle, J.F.

    2004-01-01

    Purpose. The objective of this work was to determine if nursing homes that score differently on prevalence of depression, according to the Minimum Data Set (MDS) quality indicator, also provide different processes of care related to depression. Design and Methods. A cross-sectional study with 396 long-term residents in 14 skilled nursing…

  3. 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…

  4. 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,

  5. Comparison of indicators assessing the quality of drug prescribing for asthma

    NARCIS (Netherlands)

    Veninga, C.C.M.; Denig, P.; Pont, L.G.; Haaijer-Ruskamp, F.M.

    Objective. To compare different indicators for assessing the quality of drug prescribing and establish their agreement in identifying doctors who may not adhere to treatment guidelines. Data Sources/Study Setting. Data from 181 general practitioners (GPs) from The Netherlands. The case of asthma is

  6. Do treatment quality indicators predict cardiovascular outcomes in patients with diabetes?

    Directory of Open Access Journals (Sweden)

    Grigory Sidorenkov

    Full Text Available BACKGROUND: Landmark clinical trials have led to optimal treatment recommendations for patients with diabetes. Whether optimal treatment is actually delivered in practice is even more important than the efficacy of the drugs tested in trials. To this end, treatment quality indicators have been developed and tested against intermediate outcomes. No studies have tested whether these treatment quality indicators also predict hard patient outcomes. METHODS: A cohort study was conducted using data collected from >10.000 diabetes patients in the Groningen Initiative to Analyze Type 2 Treatment (GIANTT database and Dutch Hospital Data register. Included quality indicators measured glucose-, lipid-, blood pressure- and albuminuria-lowering treatment status and treatment intensification. Hard patient outcome was the composite of cardiovascular events and all-cause death. Associations were tested using Cox regression adjusting for confounding, reporting hazard ratios (HR with 95% confidence intervals. RESULTS: Lipid and albuminuria treatment status, but not blood pressure lowering treatment status, were associated with the composite outcome (HR = 0.77, 0.67-0.88; HR = 0.75, 0.59-0.94. Glucose lowering treatment status was associated with the composite outcome only in patients with an elevated HbA1c level (HR = 0.72, 0.56-0.93. Treatment intensification with glucose-lowering but not with lipid-, blood pressure- and albuminuria-lowering drugs was associated with the outcome (HR = 0.73, 0.60-0.89. CONCLUSION: Treatment quality indicators measuring lipid- and albuminuria-lowering treatment status are valid quality measures, since they predict a lower risk of cardiovascular events and mortality in patients with diabetes. The quality indicators for glucose-lowering treatment should only be used for restricted populations with elevated HbA1c levels. Intriguingly, the tested indicators for blood pressure-lowering treatment did not predict patient

  7. Longitudinal associations between sibling relationship quality, parental differential treatment, and children's adjustment.

    Science.gov (United States)

    Richmond, Melissa K; Stocker, Clare M; Rienks, Shauna L

    2005-12-01

    This study examined associations between changes in sibling relationships and changes in parental differential treatment and corresponding changes in children's adjustment. One hundred thirty-three families were assessed at 3 time points. Parents rated children's externalizing problems, and children reported on sibling relationship quality, parental differential treatment, and depressive symptoms. On average, older siblings were 10, 12, and 16 years old, and younger siblings were 8, 10, and 14 years old at Waves 1, 2, and 3, respectively. Results from hierarchical linear modeling indicated that as sibling relationships improved over time, children's depressive symptoms decreased over time. In addition, as children were less favored over their siblings over time, children's externalizing problems increased over time. Findings highlight the developmental interplay between the sibling context and children's adjustment. Copyright 2006 APA, all rights reserved).

  8. 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.

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

    Science.gov (United States)

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

    2014-09-01

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

  10. Longitudinal Associations between Sibling Relationship Qualities and Risky Behavior across Adolescence

    Science.gov (United States)

    Solmeyer, Anna R.; McHale, Susan M.; Crouter, Ann C.

    2014-01-01

    This study examined the associations between sibling intimacy and conflict and youths' reports of risky behavior in a sample of adolescents ages 11-20. Participants were mothers, fathers, and sibling dyads in 393 families who were interviewed annually for 3, 4, or 5 years. Multivariate multilevel models tested longitudinal links between sibling…

  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 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. The use of citation indicators to identify and support high-quality research in Poland.

    Science.gov (United States)

    Pilc, Andrzej

    2008-01-01

    In large, mostly English-speaking countries, where the "critical mass" of scientists working in different subfields of science is achieved, the peer review system may be sufficient to assess the quality of scientific research. However, in smaller countries, outside the Anglo-American circle, it is important to introduce different systems to identify research of high quality. In Poland, a parametric system for assessing the quality of research has been introduced. It was largely based on the impact factor of scientific journals. While the use of this indicator to assess research quality is highly questionable, the implementation of the system in the Polish reality is even worse. Therefore it is important to change and improve the system currently used by the Ministry of Science and Higher Education to both evaluate and, more importantly, finance science in Poland. Here, a system based on three factors, i.e. the impact factor, the institutional h-index, and the institutional number of citations, is proposed. The scientific quality of institutions in Division VI: Medical Sciences of the Polish Academy of Sciences were evaluated and the results were compared with the existing system. Moreover, a method to identify high-quality researchers and institutions at the national level based on the quantity of highly cited papers is shown. Additionally, an attempt to identify the highest quality Polish research on an international level is proposed. This is based on the number of individual citations, the individual h-index, the number of publications, and the priority of the discovery.

  13. Experiences from the evaluation of two global quality indicators in a radiology service

    International Nuclear Information System (INIS)

    Hernandez Lopez, L. Y.; Valdes Arce, Y.; Fleitas Estevez, I.

    2013-01-01

    The main objective in radiology is to obtain images of good quality for certain diagnosis, without unnecessarily irradiating the patient. This paper shows the results of the reject films and clinical image quality evaluations in the radiology service of the Hospital 'Abel Santamaria Cuadrado', Pinar del Rio, Cuba. Data were collected during March and September of 2012. Reject films analysis was done for conventional and mammography studies. Clinical image quality evaluated following the European Guidelines on Quality Criteria. The results show that reject films rate decreased from 6% on March to 1.3% on September, after applying corrective actions; while chests studies have the highest reject rate. The mean causes for rejections were maladjustments in the collimation system, equipment faults, sub exposure and overexposure. For mammography studies the initial reject rate was 29.3% and decreased to 5.9% on September. Mean causes for rejection were related to faults in the automatic processor and the mammography x-ray unit. Image quality also improved: only 48.3% of chest images and 10% of mammography images were considered to be acceptable for diagnosis at the first moment; while these percentages increased to 68.3% and 70% for chest and mammography studies, respectively in the September's evaluation. The study demonstrated that the frequently evaluation of the quality's indicators allows to identify the main causes of the image's detriment to propose corrective actions. Still in situations of insufficient resources it is possible to improve quality with simple interventions on the main faults detected. (Author)

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Use of the long-term quality of life assessment in the decision to indicate surgery in patients with chronic rhinosinusitis.

    Science.gov (United States)

    Marambaia, Pablo Pinillos; Lima, Manuela Garcia; Macario, Hélder; Gomes, Amaury de Machado; Gomes, Leonado Marques; Marambaia, Melina Pinillos; Santos, Otávio Marambaia Dos

    2018-04-22

    Quality-of-life questionnaires have been used to support decision-making in patients with chronic rhinosinusitis in the past decade. The choice of treatment in practice, however, also considers the patient's decision. To assess the long-term quality of life of patients with chronic rhinosinusitis who decided to avoid surgery. This is a prospective longitudinal study with a group of patients with chronic rhinosinusitis, with and without indication for surgery, with application of the questionnaire SNOT-22 in two periods: between 2011 and 2012 and between June and August 2016, via email. Data were collected from 42 patients, of which 13 presented indications for surgery and 29 were not indicated for surgery. The average quality of life score was 42.1 (±16.4) in the group with an indication for surgery and 40.6 (±23.4) in the group without this indication, p=0.84. All the patients were assessed by a single doctor with blinding in relation to the initial score. No differences were detected between the groups. The impact of the chronic rhinosinusitis was reduced even among the patients with the indication for surgery. Both groups scored over 40. This study can help predict the impact of the chronic rhinosinusitis over time and better adjust expectations with non-surgical treatment. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  17. Longitudinal assessments of quality of life and late toxicities before and after definitive chemoradiation for esophageal cancer

    International Nuclear Information System (INIS)

    Yamashita, Hideomi; Omori, Mami; Okuma, Kae; Kobayashi, Reiko; Igaki, Hiroshi; Nakagawa, Keiichi

    2014-01-01

    Definitive chemoradiotherapy is often considered for locally advanced esophageal cancer. We studied the effect of chemoradiotherapy treatment on patients' quality of life and late toxicities. Patients undergoing definitive 5-fluorouracil and cis-diammine-glycolatoplatinum (nedaplatin) therapy concurrent with radiotherapy for esophageal cancer without operation adaptation completed standardized quality-of-life questionnaires before and after chemoradiotherapy and at regular times up to -5 years. We analyzed differences in a generic quality-of-life score questionnaire (Functional Assessment of Cancer Therapy-Esophageal scoring) over time by using a linear mixed-effects model. Longitudinal changes before the start of treatment were able to be evaluated in a total of 80 patients. The quality-of-life score before treatment was worse in patients with advanced stages than those with early stages. The quality-of-life score deteriorated once at the time of 2 or 3 months after starting chemoradiotherapy compared with pre-chemoradiotherapy and recovered and rose higher at 4 or 5 months than before starting chemoradiotherapy. After that, the recovery of quality of life was maintained up to the observation end. The score of physical functioning such as fatigue, nausea/vomiting, pain and dyspnea deteriorated at the time of 2 or 3 months after starting chemoradiotherapy compared with before chemoradiotherapy (80, 86, 94 and 89%). The quality-of-life score deteriorates once from before treatment due to acute complications by chemoradiotherapy, but recovers at 4 or 5 months and becomes better than before treatment. (author)

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

    Science.gov (United States)

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

    2013-12-01

    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). Guideline recommendations were rated for their relevance by an expert panel, transformed into potential indicators and incorporated into a questionnaire, the Quality Indicators for Physiotherapy in Hip and Knee Osteoarthritis (QIP-HKOA). Adherence with each indicator was rated on a Likert scale (0 = never to 4 = always). The QIP-HKOA was administered to groups of expert (n = 51) and general (n = 134) physiotherapists (PTs) to test its discriminative power. Reliability was tested in a subgroup of 118 PTs by computing the intraclass correlation coefficient (ICC). QIP-HKOA items were included if they were considered to be related to the cornerstones of physiotherapy in hip and knee OA (exercises and education), had discriminative power and/or if they were followed by physiotherapy care; six indicators had discriminative power and/or were followed by physiotherapy guideline on hip and knee OA was found to be reliable and discriminated between expert and general PTs. Its ability to measure improvement in the quality of the process of physiotherapy care needs to be further examined. Copyright © 2012 John Wiley & Sons, Ltd.

  19. 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.

  20. The association of cancer survival with four socioeconomic indicators: a longitudinal study of the older population of England and Wales 1981–2000

    Directory of Open Access Journals (Sweden)

    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. 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.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Amaal M. Abdel-Satar

    2017-03-01

    Full Text Available 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, the sites affected by intensive load of urban, agricultural and industrial wastewater showed serious deterioration of water quality compared with other sites. The anthropogenic impact sites showed high HPI and Cd values and associated with high risks, where, most of the studied metals often exceeded the drinking water and aquatic life limits. The aquatic WQI indicated that the Nile water quality deteriorated and extended from poor to marginal, while drinking WQI varied from marginal to good. Accordingly, the river becoming unfit for aquatic life and the situation is getting worse by decreases in the water budget from the Nile in Egypt by building of the Grand Ethiopian Renaissance Dam, where the dilution strength of the Nile system will reduce.

  4. Evaluating Urban Quality: Indicators and Assessment Tools for Smart Sustainable Cities

    Directory of Open Access Journals (Sweden)

    Chiara Garau

    2018-02-01

    Full Text Available The analysis of urban sustainability is key to urban planning, and its usefulness extends to smart cities. Analyses of urban quality typically focus on applying methodologies that evaluate quality objectives at environmental, urban, and building levels. Research has shown that a system of indicators can be useful for developing qualitative and quantitative descriptors of urban environments. The first step in this study was to formulate a methodology to measure the quality of urban life based on investigative checklists and objective and subjective indicators, aggregated to develop an index to evaluate a city’s level of smart urban quality. The second step was to apply this methodology to evaluate the city of Cagliari (Italy at the neighbourhood scale, which is considered by literature the most suitable as a self-sufficient spatial unit for showing redevelopment results. In addition to sharing its research findings, this study aims to verify whether the methodology can be applied to similar urban contexts. The main outcomes of this research pertain to opportunities to numerically measure both objective and subjective aspects that affect urban quality. In this way, the most critical areas to be requalified have been highlighted in order to prepare policies congruent with the local context.

  5. SOCIO-CULTURAL AND MEDICAL INDICATORS OF THE SCHOOLCHILDREN'S QUALITY OF LIFE

    Directory of Open Access Journals (Sweden)

    Slobodanka Bašić

    2003-01-01

    Full Text Available An estimate of life quality is based upon medical, psychological and social indicators. It increasingly engages the attention of doctors of medicine, sociologists and psychologists.The aim of this research is to headlight some more relevant socio-cultural parametres in order to determine the quality of life of schoolchildren, that is, to determine whether the crisis in which our society has found itself has produced such socio-cultural conditions that could have induced changes in the children's quality of life and, if they have, to what extent the crisis has been reflected upon their health. The research has comprised 398 schoolchildren and their parents, three elementary schools from Nish and one in Sokobanja.The research of the socio-cultural and medical indicators of their quality of life has shown that the parent's education and ther material position have had an important influence upon the children's life quality.Since there has been no significant presence of any disease recorded in the observed children's sample, it can be concluded that the socio-cultural features have affected the children's life but they have not any significant impact upon their health.

  6. Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators.

    Science.gov (United States)

    Meijers, Judith M M; Halfens, Ruud J G; van Bokhorst-de van der Schueren, Marian A E; Dassen, Theo; Schols, Jos M G A

    2009-05-01

    In most health care organizations there is still insufficient awareness for recognizing and treating malnourished patients. To gain more insight into nutritional care policies in Dutch health care organizations, this study investigated screening, treatment, and other quality indicators of nutritional care. In 2007 a cross-sectional multicenter study was performed that included 20 255 patients (hospitals, n = 6021; nursing homes, n = 11 902; home care, n = 2332). A standardized questionnaire was used to study nutritional screening and treatment at the patient level and quality indicators at institutional and ward levels (e.g., malnutrition guidelines/protocols, nutritional education, and weighing policy). Nutritional screening was performed more often in nursing homes (60.2%) than in hospitals (40.3%) and home care (13.9%, P hospitals, and home care. At ward level nursing homes focused more on the quality of nutritional care than did hospitals and home care, especially with respect to controlling the use of nutritional guidelines (54.6%, P malnutrition is still a considerable problem in one of every five patients in all participating health care settings. It furthermore demonstrates that recognizing and treating malnutrition continues to be problematic. To target the problem of malnutrition adequately, more awareness is needed of the importance of nutritional screening, appropriate treatment, and other nutritional quality indicators.

  7. Comparing Effects of Forestland conversion to Tea Farming on Soil Quality Indices

    Science.gov (United States)

    Gholoubi, A.; Emami, H.; Alizadeh, A.; Jones, S. B.

    2017-12-01

    The effect of land use type on soil function within an ecosystem can be assessed and monitored using soil quality indices. The research examined effects of land use change from natural forest to tea farming (with the same physiography and parent materials) on soil properties in different regions of the Guilan province, northern Iran. Two universally-accepted methods of soil quality evaluation were used to understand soil conditions in these two land uses. Thirty-six soil samples (0 -30 cm) were randomly collected from six sites with 3 replications. The soil quality of forestland and tea farms was determined using the cumulative rating (CR) index and the Cornell Comprehensive Assessment of Soil Health (CASH) scoring functions. Effects of Land use change on soil quality or health were significant (P tea farm soils. forestland use affected most soil properties and thus their scores in both evaluation methods. Soil organic carbon and pH were the most important indicators reduced by land use change at all locations. There were significant correlations between these indicators and other soil chemical, physical and biological factors affected by changing forestland use.

  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. Psychometric analysis of the TRANSIT quality indicators for cardiovascular disease prevention in primary care.

    Science.gov (United States)

    Khanji, Cynthia; Bareil, Céline; Hudon, Eveline; Goudreau, Johanne; Duhamel, Fabie; Lussier, Marie-Thérèse; Perreault, Sylvie; Lalonde, Gilles; Turcotte, Alain; Berbiche, Djamal; Martin, Élisabeth; Lévesque, Lise; Gagnon, Marie-Mireille; Lalonde, Lyne

    2017-12-01

    To assess a selection of psychometric properties of the TRANSIT indicators. Using medical records, indicators were documented retrospectively during the 14 months preceding the end of the TRANSIT study. Primary care in Quebec, Canada. Indicators were documented in a random subsample (n = 123 patients) of the TRANSIT study population (n = 759). For every patient, the mean compliance to all indicators of a category (subscale score) and to the complete set of indicators (overall scale score) were established. To evaluate test-retest and inter-rater reliabilities, indicators were applied twice, two months apart, by the same evaluator and independently by different evaluators, respectively. To evaluate convergent validity, correlations between TRANSIT indicators, Burge et al. indicators and Institut national d'excellence en santé et en services sociaux (INESSS) indicators were examined. Test-retest reliability, inter-rater reliability, and convergent validity. Test-retest reliability, as measured by intraclass correlation coefficients (ICCs) was equal to 0.99 (0.99-0.99) for the overall scale score while inter-rater reliability was equal to 0.95 (0.93-0.97) for the overall scale score. Convergent validity, as measured by Pearson's correlation coefficients, was equal to 0.77 (P TRANSIT indicators were compared to Burge et al. indicators and to 0.82 (P TRANSIT indicators were compared to INESSS indicators. Reliability was excellent except for eleven indicators while convergent validity was strong except for domains related to the management of CVD risk factors. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. Study the Soil Quality Changes Indicators Using Nemoro and Integrated Quality Index Models in Some Khuzestan’s Soils

    Directory of Open Access Journals (Sweden)

    F. Ramezani

    2016-09-01

    Full Text Available Introduction: Aspects of the physical, chemical and biological are considered. Land degradation for soil quality, or improve soil quality assessment is important.This study was conducted to evaluate soil quality indicators using quantitative models in some lands of Khuzestan province (Iran.Such studies, which are carried out to create a balance between the biological production and the maintenance and improvement of land resource quality, provide a framework for land degradation control and also for identification of sustainable management. Such studies, which are carried out to create a balance between the biological production and the maintenance and improvement of land resource quality, provide a framework for land degradation control and also for identification of sustainable management. Materials and Methods: In order to evaluate the effect of crop management and cultivation on soil quality, Select several Khuzestan region and Samples were taken from the surrounding cultivated land. Physiochemical characteristics of soil samples from a depth of0-30 cm such as soil texture, bulk density (Db, mean weight diameter of wet aggregates (MWD, relative field capacity (RFC, air capacity (FA,plant available water capacity (AWC, saturated hydraulic conductivity (Ks, organic carbon (OC,electrical conductivity (EC, pH, soluble cations (Mg, Ca, Na,sodium absorption ratio (SAR, exchange sodium percent (ESP and cation exchange capacity were determined (CEC. The soil quality was evaluated by integrated quality index (IQI and Nemero quality index (NQI in two data sets of soil properties including MDS and TDS. In these models, a set of characteristics that affect the quality of the soil in the form of a mathematical model incorporating and to propose a numerical quantity this number serve as general indicator of soil quality, Reflect the characteristics of the target. Results and Discussion: The results showed that there was significant correlation between

  12. The effect of propofol-remifentanil anesthesia on selected seizure quality indices in electroconvulsive therapy.

    Science.gov (United States)

    Dinwiddie, Stephen H; Glick, David B; Goldman, Morris B

    2012-07-01

    Use of a short-acting opiate to potentiate anesthetic induction agents has been shown to increase seizure duration in electroconvulsive therapy (ECT), but little is known of the effect of this combination on indices of seizure quality. To determine whether anesthetic modality affects commonly provided indices of seizure quality. Twenty-five subjects were given propofol 2 mg/kg body weight for their first ECT session, at which time seizure threshold was titrated. Subjects thereafter alternated between that anesthetic regimen or propofol 0.5 mg/kg plus remifentanil 1 mcg/kg. Linear mixed models with random subject effect, adjusting for electrode placement, electrical charge, and number of treatments, were fit to estimate effect of anesthesia on seizure duration and several standard seizure quality indices (average seizure energy, time to peak electroencephalography (EEG) power, maximum sustained power, interhemispheric coherence, early and midictal EEG amplitude, and maximum sustained interhemispheric EEG coherence). Propofol-remifentanil anesthesia significantly lengthened seizure duration and was associated with longer time to reach maximal EEG power and coherence as well as maximal degree of interhemispheric EEG coherence. No effect was seen on early ictal amplitude or average seizure energy index. Propofol-remifentanil anesthesia prolongs seizure duration and has a significant effect on some, but not all, measures of seizure quality. This effect may be of some benefit in cases where adequate seizures are otherwise difficult to elicit. Varying anesthetic technique may allow more precise investigation of the relationships between and relative impacts of commonly used seizure quality indices on clinical outcomes and ECT-related cognitive side effects. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. The role of team climate in improving the quality of chronic care delivery: a longitudinal study among professionals working with chronically ill adolescents in transitional care programmes.

    Science.gov (United States)

    Cramm, Jane M; Strating, Mathilde M H; Nieboer, Anna P

    2014-05-22

    This study aimed to (1) evaluate the effectiveness of implementing transition programmes in improving the quality of chronic care delivery and (2) identify the predictive role of (changes in) team climate on the quality of chronic care delivery over time. This longitudinal study was undertaken with professionals working in hospitals and rehabilitation units that participated in the transition programme 'On Your Own Feet Ahead!' in the Netherlands. A total of 145/180 respondents (80.6%) filled in the questionnaire at the beginning of the programme (T1), and 101/173 respondents (58.4%) did so 1 year later at the end of the programme (T2). A total of 90 (52%) respondents filled in the questionnaire at both time points. Two-tailed, paired t tests were used to investigate improvements over time and multilevel analyses to investigate the predictive role of (changes in) team climate on the quality of chronic care delivery. Transition programme. Quality of chronic care delivery measured with the Assessment of Chronic Illness Care Short version (ACIC-S). The overall ACIC-S score at T1 was 5.90, indicating basic or intermediate support for chronic care delivery. The mean ACIC-S score at T2 significantly improved to 6.70, indicating advanced support for chronic care. After adjusting for the quality of chronic care delivery at T1 and significant respondents' characteristics, multilevel regression analyses showed that team climate at T1 (pteam climate (pteam climate to enhance the quality of chronic care delivery to chronically ill adolescents. 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.

  14. CRITERIA AND QUALITY INDICATORS OF INFORMATION AND COMMUNICATION TECHNOLOGIES OF LEARNING

    Directory of Open Access Journals (Sweden)

    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.

  15. [The respect of the right to freedom of movement, an indicator of good quality patient management].

    Science.gov (United States)

    Pothain, Alexandre

    Freedom of movement is at the centre of contradictory challenges for the different people working in psychiatry, faced with a society demanding social regulation and safety, and the desire of institutions to provide high quality care. This freedom, and more globally the respect of patients' civil rights, are an indicator of the expected quality of care. Taking these rights into consideration does not mean neglecting safety, but attempts to put it into perspective. This article presents the clinical case of a patient. Copyright © 2017. Published by Elsevier Masson SAS.

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

    OpenAIRE

    GULLIAN-KLANIAN,Mariel; SÁNCHEZ-SOLÍS,María José; TERRATS-PRECIAT,Montserrat; DELGADILLO-DÍAZ,Mariana; ARANDA,Javier

    2016-01-01

    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 h...

  17. 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.

  18. 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 quality control, but also for revealing inter-laboratory qualitycontrol capability differences.

  19. Quality indicators in the treatment of patients with depression, bipolar disorder or schizophrenia. Consensus study.

    Science.gov (United States)

    Bernardo, Miquel; de Dios, Consuelo; Pérez, Víctor; Ignacio, Emilio; Serrano, Manuel; Vieta, Eduard; Mira, José Joaquín; Guilabert, Mercedes; Roca, Miquel

    To define a set of indicators for mental health care, monitoring quality assurance in schizophrenia, depression and bipolar disorders in Spain. Qualitative research. Consensus-based study involving 6 psychiatrists on the steering committee and a panel of 43 psychiatrists working in several health services in Spain. An initial proposal of 44 indicators for depression, 42 for schizophrenia and 58 for bipolar disorder was elaborated after reviewing the literature. This proposal was analysed by experts using the Delphi technique. The valuation of these indicators in successive rounds allowed those with less degree of consensus to be discarded. Feasibility, sensitivity and clinical relevance were considered. The study was carried out between July 2015 and March 2016. Seventy indicators were defined by consensus: 17 for major depression, 16 for schizophrenia, 17 for bipolar disorder and 20 common to all three pathologies. These indicators included measures related to adequacy, patient safety, exacerbation, mechanical restraint, suicidal behaviour, psychoeducation, adherence, mortality and physical health. This set of indicators allows quality monitoring in the treatment of patients with schizophrenia, depression or bipolar disorder. Mental health care authorities and professionals can use this proposal for developing a balanced scorecard adjusted to their priorities and welfare objectives. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Classifying indicators of quality: a collaboration between Dutch and English regulators.

    Science.gov (United States)

    Mears, Alex; Vesseur, Jan; Hamblin, Richard; Long, Paul; Den Ouden, Lya

    2011-12-01

    Many approaches to measuring quality in healthcare exist, generally employing indicators or metrics. While there are important differences, most of these approaches share three key areas of measurement: safety, effectiveness and patient experience. The European Partnership for Supervisory Organisations in Health Services and Social Care (EPSO) exists as a working group and discussion forum for European regulators. This group undertook to identify a common framework within which European approaches to indicators could be compared. A framework was developed to classify indicators, using four sets of criteria: conceptualization of quality, Donabedian definition (structure, process, outcome), data type (derivable, collectable from routine sources, special collections, samples) and data use (judgement (singular or part of framework) benchmarking, risk assessment). Indicators from English and Dutch hospital measurement programmes were put into the framework, showing areas of agreement and levels of comparability. In the first instance, results are only illustrative. The EPSO has been a powerful driver for undertaking cross-European research, and this project is the first of many to take advantage of the access to international expertize. It has shown that through development of a framework that deconstructs national indicators, commonalities can be identified. Future work will attempt to incorporate other nations' indicators, and attempt cross-national comparison.

  1. Psychosocial Quality-of-Life, Lifestyle and Adiposity: A Longitudinal Study in Pre-schoolers (Ballabeina Study).

    Science.gov (United States)

    Michels, Nathalie; Susi, Kriemler; Marques-Vidal, Pedro M; Nydegger, Andreas; Puder, Jardena J

    2016-06-01

    In obesity prevention, understanding psychosocial influences in early life is pivotal. Reviews reported contradictory results and a lack of longitudinal studies focusing on underlying lifestyle factors. This study tested whether psychosocial Quality-Of-Life (QOL) was associated with pre-schoolers' lifestyle and adiposity changes over one school year and whether lifestyle moderated the latter. It was hypothesised that QOL might not impact adiposity in everybody but that this might depend on preceding lifestyle. Longitudinal data from 291 Swiss pre-schoolers (initially 3.9-6.3 years) was available. The following measures were used in longitudinal regressions: psychosocial QOL by PedsQL, adiposity (BMI z-score, waist, fat%), diet (food frequency), sedentary time and accelerometer-based activity. Concerning lifestyle, low psychosocial QOL was only related to unfavourable changes in diet (less fruit β = 0.21 and more fat intake β = -0.28) and lower physical activity (β = 0.21). Longitudinal QOL-adiposity relations appeared only after moderation by lifestyle factors (beta-range 0.13-0.67). Low psychosocial QOL was associated with increased adiposity in children with an unhealthy diet intake or high sedentary time. By contrast, low psychosocial QOL was associated with decreasing adiposity in high fruit consumers or more physically active pre-schoolers. Results emphasise the need for testing moderation in the QOL-adiposity relation. An unhealthy diet can be a vulnerability factor and high physical activity a protective factor in QOL-related adiposity. Consequently, QOL and lifestyle should be targeted concurrently in multi-factorial obesity prevention. The environment should be an 'activity encouraging, healthy food zone' that minimises opportunities for stress-induced eating. In addition, appropriate stress coping skills should be acquired.

  2. The Relationship between Costs and Quality in Veterans Health Administration Community Living Centers: An Analysis Using Longitudinal Data.

    Science.gov (United States)

    Burgess, James F; Shwartz, Michael; Stolzmann, Kelly; Sullivan, Jennifer L

    2018-05-18

    To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool. We used a generalized estimating equation model with facilities included as fixed effects to examine the relationship between total cost and quality after controlling for resident days and severity. The model included linear and squared terms for all independent variables and interactions with resident days. With the exception of RCC, all other variables had a statistically significant relationship with total costs. For most poorer performing smaller facilities (lower size quartile), improvements in quality were associated with higher costs. For most larger facilities, improvements in quality were associated with lower costs. The relationship between cost and quality depends on facility size and current level of performance. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    was achieved in both Delphi rounds. A total of 41 of the proposed 59 quality indicators attained consensus. None of the quality indicators focusing on the diagnostic process achieved consensus. Consensus was attained for 14 quality indicators focusing on the decision regarding antibiotic treatment and for 27...... quality indicators focusing on the choice of antibiotics. CONCLUSION: This study resulted in a final set of 41 quality indicators concerning respiratory tract infections in general practice. These quality indicators may be used to strengthen general practitioners' focus on their management of patients......OBJECTIVE: To develop a set of quality indicators focusing on the diagnosis and treatment of respiratory tract infections in general practice. DESIGN: A modified 2-round Delphi study. SETTING: General practice. SUBJECTS: A panel of 27 experts (13 countries) comprising mainly general practitioners...

  4. 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.

  5. 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

  6. Measuring the quality of renal care: things to keep in mind when selecting and using quality indicators.

    Science.gov (United States)

    van der Veer, Sabine N; van Biesen, Wim; Couchoud, Cécile; Tomson, Charles R V; Jager, Kitty J

    2014-08-01

    This educational paper discusses a variety of indicators that can be used to measure the quality of care in renal medicine. Based on what aspect of care they reflect, indicators can be grouped into four main categories: structure, process, surrogate outcome and outcome indicators. Each category has its own advantages and disadvantages, and we give some pointers on how to balance these pros and cons while taking into account the aim of the measurement initiative. Especially within initiatives that link payment or reputation to indicator measurement, this balancing should be done with utmost care to avoid potential, unintended consequences. Furthermore, we suggest consideration of (i) a causal chain-i.e. subsequent aspects of care connected by evidence-based links-as a starting point for composing a performance indicator set and (ii) adequate case-mix adjustment, not only of (surrogate) outcomes, but also of process indicators in order to obtain fair comparisons between facilities and within facilities over time. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  7. The Psychometric Properties and the Development of the Indicators of Quality Nursing Work Environments in Taiwan.

    Science.gov (United States)

    Lin, Chiou-Fen; Lu, Meei-Shiow; Huang, Hsiu-Ying

    2016-03-01

    The nursing shortage in medical institutions in Taiwan averaged 9% in 2012, considerably higher than the 5% indicated in the literature. As a result, many hospitals have been forced to close wards or reduce beds. Despite the acute need, the percentage of registered nurses who are employed as nurses in Taiwan (60.4%) is considerably lower than those in Canada or the United States. This low rate may be because of the poor working environment for nurses in Taiwan. This study aimed to develop a set of nursing work environment quality indicators for Taiwan and to test the reliability and validity of the resulting survey tool. Multiple methods were used in this study. In Phase 1, we organized an expert panel, reviewed the literature, and conducted seven rounds of expert panel discussion and six focus group discussions with nursing directors. The goal was to draft indicators representing a quality nursing work environment to fit current conditions in Taiwan. In Phase 2, we conducted an expert review for content validity, held three public hearings, and conducted a survey. Four hundred twenty-seven questionnaires were sent out, with 381 returned. The goal was to test the content validity, construct validity, and internal consistency reliability. The study produced a set of indicators of a quality nursing work environment with eight dimensions and 65 items. The content validity index for importance and suitability dimensions were 1.0, whereas the internal consistency was 0.91. The eight dimensions were safe practice environment (16 items), quality and quantity of staff (four items), salary and welfare (seven items), professional specialization and teamwork (seven items), work simplification (five items), informatics (five items), career development (nine items), and support and caring (12 items). The overall load for the indicators was 77.57%. The developed indicators may be used to evaluate the quality of nursing work environments. Furthermore, the indicators may be used

  8. Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme: a longitudinal observational study.

    Science.gov (United States)

    Kontopantelis, Evangelos; Reeves, David; Valderas, Jose M; Campbell, Stephen; Doran, Tim

    2013-01-01

    The UK's Quality and Outcomes Framework (QOF) was introduced in 2004/5, linking remuneration for general practices to recorded quality of care for chronic conditions, including diabetes mellitus. We assessed the effect of the incentives on recorded quality of care for diabetes patients and its variation by patient and practice characteristics. Using the General Practice Research Database we selected a stratified sample of 148 English general practices in England, contributing data from 2000/1 to 2006/7, and obtained a random sample of 653,500 patients in which 23,920 diabetes patients identified. We quantified annually recorded quality of care at the patient-level, as measured by the 17 QOF diabetes indicators, in a composite score and analysed it longitudinally using an Interrupted Time Series design. Recorded quality of care improved for all subgroups in the pre-incentive period. In the first year of the incentives, composite quality improved over-and-above this pre-incentive trend by 14.2% (13.7-14.6%). By the third year the improvement above trend was smaller, but still statistically significant, at 7.3% (6.7-8.0%). After 3 years of the incentives, recorded levels of care varied significantly for patient gender, age, years of previous care, number of co-morbid conditions and practice diabetes prevalence. The introduction of financial incentives was associated with improvements in the recorded quality of diabetes care in the first year. These improvements included some measures of disease control, but most captured only documentation of recommended aspects of clinical assessment, not patient management or outcomes of care. Improvements in subsequent years were more modest. Variation in care between population groups diminished under the incentives, but remained substantial in some cases.

  9. Water quality in Atlantic rainforest mountain rivers (South America): quality indices assessment, nutrients distribution, and consumption effect.

    Science.gov (United States)

    Avigliano, Esteban; Schenone, Nahuel

    2016-08-01

    The South American Atlantic rainforest is a one-of-a-kind ecosystem considered as a biodiversity hotspot; however, in the last decades, it was intensively reduced to 7 % of its original surface. Water resources and water quality are one of the main goods and services this system provides to people. For monitoring and management recommendations, the present study is focused on (1) determining the nutrient content (nitrate, nitrite, ammonium, and phosphate) and physiochemical parameters (temperature, pH, electrical conductivity, turbidity, dissolved oxygen, and total dissolved solids) in surface water from 24 rainforest mountain rivers in Argentina, (2) analyzing the human health risk, (3) assessing the environmental distribution of the determined pollutants, and (4) analyzing water quality indices (WQIobj and WQImin). In addition, for total coliform bacteria, a dataset was used from literature. Turbidity, total dissolved solids, and nitrite (NO2 (-)) exceeded the guideline value recommended by national or international guidelines in several sampling stations. The spatial distribution pattern was analyzed by Principal Component Analysis and Factor Analysis (PCA/FA) showing well-defined groups of rivers. Both WQI showed good adjustment (R (2) = 0.89) and rated water quality as good or excellent in all sampling sites (WQI > 71). Therefore, this study suggests the use of the WQImin for monitoring water quality in the region and also the water treatment of coliform, total dissolved solids, and turbidity.

  10. Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance

    Directory of Open Access Journals (Sweden)

    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 Folke

    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. Arts in Higher Education: an evaluation of Fine Arts research activity in Spain through quality indicators

    Directory of Open Access Journals (Sweden)

    Raquel Caerols Mateo

    2017-11-01

    Full Text Available The long-standing conflict between research evaluation standards and the fine arts dates from the transformation of the former schools of fine arts into bachelor’s degree programs. The origin of the conflict is epistemological in nature and has consequences at both the academic and curricular level. The quality indicators for evaluating professors are the central issue of this problem still to be solved. Although current systems of evaluation cover both the production of scientific publications as part of traditional research and the artistic creation itself, academics in the fine arts note that deficiencies exist in the assessment of both these aspects.The focus of this paper is primarily on the study of the main national and international databases in the arts, in order to assess their validity as quality indicators for the scholarly output of academics.

  15. Evaluation of Preanalytical Quality Indicators by Six Sigma and Pareto`s Principle.

    Science.gov (United States)

    Kulkarni, Sweta; Ramesh, R; Srinivasan, A R; Silvia, C R Wilma Delphine

    2018-01-01

    Preanalytical steps are the major sources of error in clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in preanalytical area as these processes are done outside the laboratory. Sigma value depicts the performance of laboratory and its quality measures. Hence in the present study six sigma and Pareto principle was applied to preanalytical quality indicators to evaluate the clinical biochemistry laboratory performance. This observational study was carried out for a period of 1 year from November 2015-2016. A total of 1,44,208 samples and 54,265 test requisition forms were screened for preanalytical errors like missing patient information, sample collection details in forms and hemolysed, lipemic, inappropriate, insufficient samples and total number of errors were calculated and converted into defects per million and sigma scale. Pareto`s chart was drawn using total number of errors and cumulative percentage. In 75% test requisition forms diagnosis was not mentioned and sigma value of 0.9 was obtained and for other errors like sample receiving time, stat and type of sample sigma values were 2.9, 2.6, and 2.8 respectively. For insufficient sample and improper ratio of blood to anticoagulant sigma value was 4.3. Pareto`s chart depicts out of 80% of errors in requisition forms, 20% is contributed by missing information like diagnosis. The development of quality indicators, application of six sigma and Pareto`s principle are quality measures by which not only preanalytical, the total testing process can be improved.

  16. Quality indicators on the use of antimicrobials in critically ill patients.

    Science.gov (United States)

    Vera, P; Palomar, M; Álvarez-Lerma, F

    2014-12-01

    Quality indicators have been applied to many areas of health care in recent years, including intensive care. However, they have not been specifically developed and validated for antimicrobial use in critically ill patients. Antimicrobials play a key role in intensive care units not only in the prognosis of each individual patient, but also in the development of resistance and changes in the flora in this setting. Evaluating the use of these agents is complex in the intensive care unit, however, because the indications vary greatly and antimicrobial treatment is often changed during admission. We designed and developed specific quality indicators regarding the use of antimicrobials in critically ill patients admitted to the intensive care unit. These indicators are proposed as a tool for application in intensive care units to detect problems in the use of antimicrobials. Future trials are needed, however, to validate these indicators in a large population over time. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  17. 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.

  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. Indicators of childhood quality of education in relation to cognitive function in older adulthood.

    Science.gov (United States)

    Crowe, Michael; Clay, Olivio J; Martin, Roy C; Howard, Virginia J; Wadley, Virginia G; Sawyer, Patricia; Allman, Richard M

    2013-02-01

    The association between years of education and cognitive function in older adults has been studied extensively, but the role of quality of education is unknown. We examined indicators of childhood educational quality as predictors of cognitive performance and decline in later life. Participants included 433 older adults (52% African American) who reported living in Alabama during childhood and completed in-home assessments of cognitive function at baseline and 4 years later. Reports of residence during school years were matched to county-level data from the 1935 Alabama Department of Education report for school funding (per student), student-teacher ratio, and school year length. A composite measure of global cognitive function was utilized in analyses. Multilevel mixed effects models accounted for clustering of educational data within counties in examining the association between cognitive function and the educational quality indices. Higher student-teacher ratio was associated with worse cognitive function and greater school year length was associated with better cognitive function. These associations remained statistically significant in models adjusted for education level, age, race, gender, income, reading ability, vascular risk factors, and health behaviors. The observed associations were stronger in those with lower levels of education (≤12 years), but none of the education quality measures were related to 4-year change in cognitive function. Educational factors other than years of schooling may influence cognitive performance in later life. Understanding the role of education in cognitive aging has substantial implications for prevention efforts as well as accurate identification of older adults with cognitive impairment.

  20. Comparison of Three Diet Quality Indices for Patients with Chronic Kidney Disease.

    Science.gov (United States)

    Rouhani, Mohammad Hossein; Mortazavi Najafabadi, Mojgan; Moeinzadeh, Firouzeh; Esmaillzadeh, Ahmad; Feizi, Awat; Azadbakht, Leila

    2017-08-01

    Patients with chronic kidney disease (CKD) have specific dietary needs due to recommended dietary restrictions. However, there is no specific index for evaluating the quality of diet in patients with CKD.   OBJECTIVE: To define and compare three specific diet quality indices in patients with CKD. Two hundred twenty-one subjects with CKD were selected for this cross-sectional study. The patients' Dietary intake was assessed with a validated food frequency questionnaire. Total protein intake per body weight (TP/BW), animal protein intake per body weight (AP/BW) and animal protein to vegetable protein ratio (AP/VP) were defined as diet quality indices. Renal function was measured by blood urea nitrogen (BUN) and serum creatinine (Cr). Patients in the highest tertile of TP/BW and tertile of AP/BW consumed more amounts of nutrients which should be limited in CKD (i.e., sodium, potassium and phosphorus). Subjects in the last tertile of AP/BW had higher BUN and Cr. A marginally significant increased risk of higher stage of CKD across the tertiles of AP/BW was observed after adjusting for potential confounders (OR = 2.20, 95% CI: 1.06, 4.56; P = 0.08). The results showed that AP/BW is a good diet quality index and is marginally associated with being in higher stages of CKD.

  1. 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.

  2. 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...

  3. Indicators of soil quality in the implantation of no-till system with winter crops.

    OpenAIRE

    NOGUEIRA, M. A.; TELLES, T. S.; FAGOTTI, D. dos S. L.; BRITO, O. R.; PRETE, C. E. C.; GUIMARÃES, M. de F.

    2014-01-01

    We assessed the effect of different winter crops on indicators of soil quality related to C and N cycling and C fractions in a Rhodic Kandiudult under no-till system at implantation, during two growing seasons, in Londrina PR Brazil. The experimental design was randomized blocks with split-plot in time arrangement, with four replications. The parcels were the winter crops: multicropping of cover crops with black oat (Avena strigosa), hairy vetch (Vicia villosa) and fodder radish (Raphanus sat...

  4. Evaluation of headache service quality indicators: pilot implementation in two specialist-care centres.

    Science.gov (United States)

    Katsarava, Zaza; Gouveia, Raquel Gil; Jensen, Rigmor; Gaul, Charly; Schramm, Sara; Schoppe, Anja; Steiner, Timothy J

    2015-01-01

    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. We tested the quality indicators in the tertiary headache centres of the University of Duisburg-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. The questionnaires were easily understood by both HCPs and patients and were not unduly time-consuming. The results from the two headache centres were comparable despite their differences in structure, staffing and language. These findings met the purpose of the study. Diagnoses were made according to ICHD criteria and critically evaluated during follow-up. However, diagnostic diaries and instruments assessing burden and response to treatment were not always in place or routinely utilised. Triage systems adjusted waiting times to urgency of need. Treatment plans included pathways to other specialities. Patients felt welcomed, reassured and educated, and were mostly satisfied. Discussion points arose over inclusion of psychological therapies in treatment plans; over recording of outcomes; over indicators of efficiency and equitability (protocols to limit wastage of resources, systems to measure input costs and means of ensuring equal access to the services); and over protocols for reporting serious adverse events. This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service

  5. Faecal nitrogen: a potential indicator of red and roe deer diet quality in forest habitats

    Czech Academy of Sciences Publication Activity Database

    Kamler, Jiří; Homolka, Miloslav

    2005-01-01

    Roč. 54, 1-2 (2005), s. 89-98 ISSN 0139-7893 R&D Projects: GA ČR(CZ) GA206/99/D053; GA AV ČR(CZ) IBS6093003 Institutional research plan: CEZ:AV0Z60930519 Keywords : free-living ungulates * faecal indicators * diet quality Subject RIV: EG - Zoology Impact factor: 0.585, year: 2005 http://www.ivb.cz/folia/54/1-2/89-98.pdf

  6. Brief Report: Longitudinal Improvements in the Quality of Joint Attention in Preschool Children with Autism

    Science.gov (United States)

    Lawton, Kathy; Kasari, Connie

    2012-01-01

    Children with autism exhibit deficits in their quantity and quality of joint attention. Early autism intervention studies rarely document improvement in joint attention quality. The purpose of this study was to determine whether there was a change in joint attention quality for preschoolers with autism who were randomized to a joint attention…

  7. Anogenital distance: A longitudinal evaluation of its variants and indices in boys and girls of Sonora, Mexico.

    Science.gov (United States)

    Loreto-Gómez, Carmen; Farías, Paulina; Moreno-Macías, Hortensia; Romano-Riquer, S P; Riojas-Rodríguez, Horacio

    2017-10-01

    There is no consensus on which anogenital distance (AGD) variant to use and how to adjust it by body size in humans. This study quantitatively evaluated AGD variants and body size adjustments to determine which would be the best choice. AGD variants, height, and weight were measured on five occasions during the first year of life of 307 infants. The ratio of anoscrotal distance (ASD) in boys and anofourchette distance (AFD) in girls increased from 1.9 at birth to 2.3 at 12 months of age. Each AGD variant was divided by each body size variable to generate different indices. Such indices were standardized to make them comparable when analyzing their performance through mixed models. ASD and AFD adjusted by height generated precise (p<0.05) AGD indices: 0.4-0.5 and 0.2, respectively. Results suggest that the best body size adjustment for all AGD variants in the first year of life is height. Copyright © 2017 Elsevier Inc. All rights reserved.

  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. Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China.

    Science.gov (United States)

    Fei, Yang; Kang, Fengfeng; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Wang, Zhiguo; Chen, Wenxiang

    2016-08-01

    The aim of the study was to promote the establishment and implementation of quality indicators (QIs) in clinical laboratories, catch up with the state of art, and provide preliminary quality specifications for established QIs. Clinical laboratories from different provinces in China were included in this QIs survey in 2015. All participants were asked to collect data related to QIs and complete QIs questionnaires. Defect percentages and sigma values were calculated for each QI. The 25th percentile, median, and the 75th percentile of defect percentages and TATs were calculated as optimum, desirable and minimum quality specifications. While 25th, median, and 75th of sigma values were calculated as minimum, desirable and optimum quality specifications, respectively. Five thousand seven hundred and fifty-three clinical laboratories from 28 provinces in China participated in this survey. Median defect percentages of pre-examination QIs varied largely from 0.01% (incorrect sample container) to 0.57% (blood culture contamination) with sigma values varied from 4.0σ to 5.1σ. Median defect percentages of examination phase QIs were all really high. The most common problem in examination phase was test uncovered by inter-laboratory comparison (86.67%). Defect percentages of critical values notification and timely critical values notification were all 0.00% (6.0σ). While the median of defect percentages of incorrect laboratory reports was only 0.01% (5.4σ). Improvements are needed in all phases of total testing process (TTP) in laboratories in China, especially in examination phase. More attention should be paid when microbiology specimens are collected and results are reported. Quality specifications can provide directions for laboratories to make effort for.

  10. A longitudinal study of quality of life and functional status in total hip and total knee replacement patients.

    Science.gov (United States)

    Mandzuk, Lynda L; McMillan, Diana E; Bohm, Eric R

    2015-05-01

    Primary total hip and primary total knee surgeries are commonly performed to improve patients' quality of life and functional status. This longitudinal retrospective study (N = 851) examined self-reported quality of life and functional status over the preoperative and postoperative periods: 12 months prior to surgery, one month prior to surgery and 12 months following surgery. A linear mixed effects model was used to analyze the changes in quality of life and functional status over the sampling period. Patients in the convenience sample reported improvements in quality of life and functional status utilizing the SF-12 and Oxford Hip and Oxford Knee, although differences were noted by procedure and gender. Total hip patients tended to demonstrate greater improvement than total knee patients and males reported higher levels of physical and mental quality of life as well as functional status when compared to females. Of particular note was that mental health scores were consistently lower in both total hip and total knee replacement patients across the perioperative period and up to one year postoperative. This study identifies an opportunity for health care providers to proactively address the mental health of total hip and total knee replacement patients throughout their joint replacement trajectory. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. A hard day's night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue.

    Science.gov (United States)

    de Lange, Annet H; Kompier, Michiel A J; Taris, Toon W; Geurts, Sabine A E; Beckers, Debby G J; Houtman, Irene L D; Bongers, Paulien M

    2009-09-01

    This prospective four-wave study examined (i) the causal direction of the longitudinal relations among job demands, job control, sleep quality and fatigue; and (ii) the effects of stability and change in demand-control history on the development of sleep quality and fatigue. Based on results of a four-wave complete panel study among 1163 Dutch employees, we found significant effects of job demands and job control on sleep quality and fatigue across a 1-year time lag, supporting the strain hypothesis (Demand-Control model; Karasek and Theorell, Basic Books, New York, 1990). No reversed or reciprocal causal patterns were detected. Furthermore, our results revealed that cumulative exposure to a high-strain work environment (characterized by high job demands and low job control) was associated with elevated levels of sleep-related complaints. Cumulative exposure to a low-strain work environment (i.e. low job demands and high job control) was associated with the highest sleep quality and lowest level of fatigue. Our results revealed further that changes in exposure history were related to changes in reported sleep quality and fatigue across time. As expected, a transition from a non-high-strain towards a high-strain job was associated with a significant increase in sleep-related complaints; conversely, a transition towards a non-high-strain job was not related to an improvement in sleep-related problems.

  12. Impact on quality of life in teachers after educational actions for prevention of voice disorders: a longitudinal study.

    Science.gov (United States)

    Pizolato, Raquel Aparecida; Rehder, Maria Inês Beltrati Cornacchioni; Meneghim, Marcelo de Castro; Ambrosano, Glaucia Maria Bovi; Mialhe, Fábio Luiz; Pereira, Antonio Carlos

    2013-02-27

    Voice problems are more common in teachers due to intensive voice use during routine at work. There is evidence that occupational disphonia prevention programs are important in improving the quality voice and consequently the quality of subjects' lives. To investigate the impact of educational voice interventions for teachers on quality of life and voice. A longitudinal interventional study involving 70 teachers randomly selected from 11 public schools, 30 to receive educational intervention with vocal training exercises and vocal hygiene habits (experimental group) and 40 to receive guidance on vocal hygiene habits (control group control). Before the process of educational activities, the Voice-Related Quality of Life instrument (V-RQOL) was applied, and 3 months after conclusion of the activities, the subjects were interviewed again, using the same instrument. For data analysis, Prox MIXED were applied, with a level of significance α Educational actions for vocal health had a positive impact on the quality of life of the participants, and the incorporation of permanent educational actions at institutional level is suggested.

  13. Statistical quality control charts for liver transplant process indicators: evaluation of a single-center experience.

    Science.gov (United States)

    Varona, M A; Soriano, A; Aguirre-Jaime, A; Barrera, M A; Medina, M L; Bañon, N; Mendez, S; Lopez, E; Portero, J; Dominguez, D; Gonzalez, A

    2012-01-01

    Liver transplantation, the best option for many end-stage liver diseases, is indicated in more candidates than the donor availability. In this situation, this demanding treatment must achieve excellence, accessibility and patient satisfaction to be ethical, scientific, and efficient. The current consensus of quality measurements promoted by the Sociedad Española de Trasplante Hepático (SETH) seeks to depict criteria, indicators, and standards for liver transplantation in Spain. According to this recommendation, the Canary Islands liver program has studied its experience. We separated the 411 cadaveric transplants performed in the last 15 years into 2 groups: The first 100 and the other 311. The 8 criteria of SETH 2010 were correctly fulfilled. In most indicators, the outcomes were favorable, with an actuarial survivals at 1, 3, 5, and 10 years of 84%, 79%, 76%, and 65%, respectively; excellent results in retransplant rates (early 0.56% and long-term 5.9%), primary nonfunction rate (0.43%), waiting list mortality (13.34%), and patient satisfaction (91.5%). On the other hand, some indicators of mortality were worse as perioperative, postoperative, and early mortality with normal graft function and reoperation rate. After the analyses of the series with statistical quality control charts, we observed an improvement in all indicators, even in the apparently worst, early mortality with normal graft functions in a stable program. Such results helped us to discover specific areas to improve the program. The application of the quality measurement, as SETH consensus recommends, has shown in our study that despite being a consuming time process, it is a useful tool. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. An objective framework to test the quality of candidate indicators of good environmental status

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    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.

  15. A shallow-diving seabird predator as an indicator of prey availability in southern California waters: A longitudinal study

    Science.gov (United States)

    Horn, M. H.; Whitcombe, C. D.

    2015-06-01

    We tested the hypothesis that the Elegant Tern (Thalasseus elegans), a plunge-diving predator, is an indicator of changes in the prey community in southern California coastal waters. Shannon diversity (H‧) of the tern's diet determined from dropped fish collected variously at the three nesting sites for 18 years over a 21-year interval (1993-2013) showed no significant change in diet diversity. Based on a species-accumulation curve, total diet species represented about 70% of an extrapolated asymptotic richness. Abundance patterns of five prey species making up > 75% of prey numbers for all years were compared with abundance patterns of the same species in independent surveys obtained from zooplankton tows, bottom trawls and power-plant entrapments. Three of the five species - northern anchovy, kelp pipefish and California lizardfish - showed significant, positive correlations between diet and survey abundances. Even though the tern's diet has been dominated by anchovy and pipefish, its diet is still broad, with prey taxa representing > 75% of the 42 species groups making up the California shelf fish fauna. Altogether, our results support the hypothesis that the Elegant Tern, with its flexible diet, is a qualitative indicator, a sentinel, of changes in the prey communities in southern California coastal waters.

  16. [Quality of care indicators for benign prostatic hyperplasia. A qualitative study].

    Science.gov (United States)

    Navarro-Pérez, Jorge; Peiró, Salvador; Brotons-Muntó, Francisco; López-Alcina, Emilio; Real-Romaguera, Arcadio

    2014-05-01

    To assess quality of care indicators for benign prostatic hyperplasia (BPH), and to evaluate their strengths and weaknesses for incorporation into health information systems. Structured expert meeting, using procedures adapted from the nominal group techniques and the Rand consensus method. Valencian School of Health Studies. Forty panellists (74% doctors, 70% from primary care settings) with experience in the management of BPH from 15 departments of the Valencia Health Agency. Three workshops were held simultaneously (examination and diagnosis, drug therapy, and appropriateness and results), and the 15 quality indicators selected by the coordination group were assessed. Eleven of the 15 indicators scored in the range of high relevance. The 5 best rated were: the use of alpha-blockers + 5-alpha reductase inhibitor from certain severity level, digital rectal examination in the initial assessment, follow-up with the International Prostate Symptoms Score (IPSS), the rate of urgent catheterization in Hospital Accident & Emergency Units, initial assessment with the IPSS and the use of alpha-blockers prior to catheter removal for acute retention of urine. Some of the assessed indicators can be useful for incorporation into health information systems. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  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 (de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Road Traffic Accident Rate as an Indicator of the Quality of Life

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    Artur Igorevich Petrov

    2016-07-01

    Full Text Available The paper considers the issues devoted to assessing the connection between the quality of life and road traffic accident rate in different countries. The hypothesis put forward in the paper is based on the idea that the organization and functioning of the state road traffic safety management system and the outcome characteristics of road traffic accident rate in the road complex are closely related and are derived from the level of development of non-governmental institutions in a particular country. In order to determine how true this hypothesis is, the author carried out statistical studies of the relations between the estimates of the Quality of Life presented for 60 countries in the US News & World Report and the Human Risk indicators estimated for these countries. This indicator proposed by R. Smeed in 1949 for assessing the state of affairs in the field of road safety allows us to evaluate adequately the position of countries in the world ranking of road traffic accident rate. The research aims to establish a regularity that identifies the statistical relationship between the characteristics of the quality of life and human risk (by R. Smeed. The method of construction of correlation-regression models of the processes under consideration is used to achieve this goal. It has been established that there exists a noticeable inverse statistical relationship between the variables of the Quality of Life in different countries (according to the US News & World Report and Human Risk (according to the World Health Organization. The paper discusses reasons for a decline in road traffic accident rate when the quality of life becomes better. The main conclusion of the study lies in the understanding that there exists a strong cause and effect relationship between the level of development of social institutions and the level of transport culture of the population; this relationship is implemented in the form of specific cases of transport

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

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    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

  20. Establishment of a comprehensive indicator to nondestructively analyze watermelon quality at different ripening stages

    Directory of Open Access Journals (Sweden)

    Shuye Qi

    2014-07-01

    Full Text Available Two nondestructive methods based on visible and near-infrared (VIS-NIR spectroscopy and X-ray image have been used for the evaluation of watermelon quality. The prediction performance based on partial least squares (PLS by diffuse transmittance measurement (500–1010 nm was evaluated for chemical quality attributes SSC (Rc = 0.903; RMSEC = 0.572% Brix; Rp = 0.862; RMSEP = 0.717% Brix; RPD = 1.83, lycopene (Rc = 0.845; RMSEC = 0.266 mg/100 gFW; Rp = 0.751; RMSEP = 0.439 mg/100 gFW; RPD = 1.13 and moisture (Rc = 0.917; RMSEC = 0.280%; Rp = 0.937; RMSEP = 0.276%; RPD = 2.79. The X-ray calibration linear equations developed by extracting the appropriate gray threshold were sufficiently precise for volume (R2 = 0.986 and weight (R2 = 0.993. In order to optimize prediction model of watermelon quality in growth period, multivariate multi-block technique factor analysis enabled integration of these traits: chemical information is related to physical information. Applying principle component analysis to extract common factors and varimax with Kaiser normalization to improve explanatory, the comprehensive indicator based on variances was established satisfactorily with Rc = 0.94, RMSEC = 0.244, Rp = 0.93, RMSEP = 0.344 and RPD = 2.00. A comparison of these models indicates that the comprehensive indicator determined only by portable VIS-NIR spectrometer appears as a suitable method for appraising watermelon quality nondestructively on the plant at different ripen stages. This method contributes to infer the picking date of watermelon with higher accuracy and bigger economic benefits than that by experience.

  1. Macroinvetebrate Assemblages as Indicators of Water Quality of the West Seti River, Bajhang, Nepal

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    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

  2. Intercorrelation between immunological biomarkers and job stress indicators among female nurses: A nine-month longitudinal study

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    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.

  3. A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture.

    Science.gov (United States)

    Cramm, Jane M; Strating, Mathilde M H; Bal, Roland; Nieboer, Anna P

    2013-04-01

    Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2-3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2-3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. [An analysis of the effectiveness of external quality assurance programmes using changes in quality indicators of individual hospitals].

    Science.gov (United States)

    Lack, Nicholas; Gerhardinger, Ursula

    2010-01-01

    Judging the effectiveness of external quality assurance programmes by comparing current performance with unadjusted regional or national crude averages is misleading because the influence of the actual size of the populations under consideration as well as the variance of performance between hospitals is underestimated. Not only do these artefacts lead to a general overestimation of changes in regional averages. They also may lead to a ranking confounded by regional size. An assessment at unit level circumvents these difficulties. The differential grading of degree of departure of a unit's performance from national targets available from funnel plots allows, in addition, for the discrimination between effects due to the monitoring institution and achievements attributable to the hospital under surveillance. A central role is played by the scoring system adopted for evaluating incremental changes of performance indicator values in successive years. The following proposal is intended to both assist the assessment of effectiveness of quality assurance programmes and identify areas requiring urgent improvement. Bavarian quality assurance data (BAQ 1995) are used to illustrate the method. Copyright © 2010. Published by Elsevier GmbH.

  5. Can examination of WWW usage statistics and other indirect quality indicators distinguish the relative quality of medical web sites?

    Science.gov (United States)

    Hernández-Borges, A A; Macías-Cervi, P; Gaspar-Guardado, M A; Torres-Alvarez de Arcaya, M L; Ruiz-Rabaza, A; Jiménez-Sosa, A

    1999-01-01

    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. 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. 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. 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 (pquality indicators. On the other hand, the citation analysis on the Web by the quantification of inbound links to medical websites could be an objective and feasible tool in rating great amounts of websites.

  6. VARIABILITY OF VALUES OF PHYSICOCHEMICAL WATER QUALITY INDICES ALONG THE LENGTH OF THE IWONICZANKA STREAM

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    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.

  7. Air Quality Assessment of Faisalabad and Gujranwala Cities of Pakistan: Application of Pollution Indices

    International Nuclear Information System (INIS)

    Faiz, Y.; Waheed, S.; Siddique, N.

    2015-01-01

    Urban air quality of industrial cities of Pakistan, namely Gujranwala and Faisalabad was assessed in terms of pollution level indicators such as pollution load index (PLI), geo-accumulation index (I/sub geo/), pollution index (PI) and integrated pollution index (IPI). It was found that both cities have elevated metal concentration indicating heavy to extreme contamination for most of the sites. Local anthropogenic activities and elevated geo-accumulation indices for different suite of elements were used to indicate possible pollutant sources in these two industrial cities to be traffic derived emissions, suspended soil, road dust, construction materials, fossil fuel and industrial emissions, tanneries, chrome plating units and metal smelters. Comparison of the pollution indices shows that Ba, Br, Ca, Cd, Na, Pb, Sb and Zn have mean PLI, I/sub geo/, PI and IPI for both cities which are in the highly polluted category. Cu, La, Sc, V and Zr have pollution indices corresponding to high or extreme levels in Faisalabad only while Cr and Ti are highly polluting only in Gujranwala. In Faisalabad and Gujranwala it was found that 91.43% and 85.29% respectively of the PI data occurs in high level of pollution implying that to some extent Faisalabad is more polluted as compared to Gujranwala. (author)

  8. 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.

  9. Evaluating laboratory key performance using quality indicators in Alexandria University Hospital Clinical Chemistry Laboratories.

    Science.gov (United States)

    Rizk, Mostafa M; Zaki, Adel; Hossam, Nermine; Aboul-Ela, Yasmin

    2014-12-01

    The performance of clinical laboratories plays a fundamental role in the quality and effectiveness of healthcare. To evaluate the laboratory performance in Alexandria University Hospital Clinical Laboratories using key quality indicators and to compare the performance before and after an improvement plan based on ISO 15189 standards. The study was carried out on inpatient samples for a period of 7 months that was divided into three phases: phase I included data collection for evaluation of the existing process before improvement (March-May 2012); an intermediate phase, which included corrective, preventive action, quality initiative and steps for improvement (June 2012); and phase II, which included data collection for evaluation of the process after improvement (July 2012-September 2012). In terms of the preanalytical indicators, incomplete request forms in phase I showed that the total number of received requests were 31 944, with a percentage of defected request of 33.66%; whereas in phase II, there was a significant reduction in all defected request items (Plaboratories.

  10. 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.

  11. Relationship between the properties of raw and cooked spaghetti - new indices for pasta quality evaluation

    Science.gov (United States)

    Biernacka, Beata; Dziki, Dariusz; Różyło, Renata; Wójcik, Monika; Miś, Antoni; Romankiewicz, Daria; Krzysiak, Zbigniew

    2018-04-01

    The quality of pasta can be evaluated by measuring the characteristics which encompass the most important quality parameters, such as colour, cooking properties and texture. The aim of the study was to suggest new indices which can be used to evaluate the quality of pasta. For the tests, 15 samples of spaghetti (produced from either semolina or common wheat flour) were used. The bending test was performed for the determination of the strength properties of raw pasta, while the pasta colour parameters were evaluated via the Commission Internationale de l'Eclairage system. The pasta cooking test included the evaluation of optimum cooking time, weight increase index and cooking loss. The samples of cooked spaghetti were cut, and the parameters describing pasta texture were determined. Statistical analysis showed significant correlations (α = 0.05) between colour parameters (lightness and redness) and pasta ash content (R = -0.90 and 0.84, respectively). The mechanical properties of raw pasta correlated positively with pasta density. The strongest correlation was found between pasta density and flexural strength. The destruction force for raw spaghetti during the bending test correlated significantly and positively with the cutting force of the cooked pasta. The obtained correlations can be helpful in pasta quality evaluation.

  12. 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.

  13. 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.

  14. Quality of life of the population as an indicator of sustainable development of rural territories

    Directory of Open Access Journals (Sweden)

    Larisa Alexandrovna Tretiakova

    2012-09-01

    Full Text Available The purpose of this study is theoretical justification of socio-economic foundations of sustainable livelihoods in rural areas and development of practical recommendations for evaluating and improving quality of life in rural areas. The subject of this study is a system of socio-economic relations that defines processes and patterns of sustainable livelihoods in rural areas. Methodological basis is a systematic approach and method of dialectical cognition, which examine processes of development of rural territories in relationship and complementarity. The results described in this paper are: the degree of differentiation of rural population under qualitative levels of well-being was studied; the authors’ system of indicators of regional socio-economic development on a basis of detailed hierarchical structure was presented; priority areas for improving standards and quality of life of the rural population were identified. A scope of results was developed and science-based recommendations and suggestions for sustainable development of rural territories based on authors’ methodology for evaluating quality life in rural areas may be subject to legislative and executive authorities in development socio-economic projects and programmes aimed at enhancing rural employment and income were made. The conclusions are: sustainable development of rural territories involves not only increase of efficiency of rural economy, but, above all, increasing and improving the quality of life of the rural population; on a system of complementarities, the evaluation of sustainability of livelihood strategies should take into account the economic, environmental, social and institutional factors

  15. 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

    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

  16. 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

    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

  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, Daan; ten Asbroek, Guus; Plochg, Thomas; Anema, Helen; Kringos, Dionne S.; Fischer, Claudia; Wagner, Cordula; Klazinga, Niek S.

    2016-01-01

    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

  18. Is the quality of donated semen deteriorating? Findings from a 15 year longitudinal analysis of weekly sperm samples.

    Science.gov (United States)

    Haimov-Kochman, Ronit; Har-Nir, Ruth; Ein-Mor, Eliana; Ben-Shoshan, Vered; Greenfield, Caryn; Eldar, Ido; Bdolah, Yuval; Hurwitz, Arye

    2012-06-01

    Studies suggest that global semen quality is declining, but the debate remains open owing to geographic variation. To evaluate temporal trends of sperm parameters - namely concentration, motility and total motile sperm count - in sperm donated during the period 1995-2009. In a retrospective longitudinal cohort study we analyzed the sperm count and motility of 2182 semen samples provided on a weekly basis by 58 young, healthy, fertile, university-educated, paid donors. Despite the lowering of criteria for sperm parameters satisfactory for donation that were implemented in 2004, 38% of applicants for sperm donation are now rejected based on semen quality as compared to a third of applicants 10-15 years ago (P average sperm parameters dropped from a concentration of 106 +/- 25 million spermatozoa/ml with 79% +/- 4.3% motility to 68 +/- 14 million/ ml with 66% +/- 4.5% motile sperm (P sperm count per ejaculate also decreased, from 66.4 +/- 18.2 million to 48.7 +/- 12 million (P sperm donors, only 18% of donors had an acceptable sperm quality, with an average concentration of 87 +/- 12 million spermatozoa/ml, 73% +/- 2.6% motile sperm and total motile sperm count of 53.1 +/- 3.8 million per ejaculate - still significantly lower than 15 years ago (P= 0.01, P= 0.003, P= 0.058 respectively). The rapid deterioration of sperm quality among fertile semen donors is alarming and may lead to cessation of sperm donation programs.

  19. Longitudinal effects of sibling relationship quality on adolescent problem behavior : A cross-ethnic comparison

    NARCIS (Netherlands)

    Buist, K.L.; Paalman, C.H.; Branje, S.T.J.; Dekovic, M.; Reitz, E.; Verhoeven, M.; Meeus, W.H.J.; Koot, H.M.; Hale III, W.W.

    2014-01-01

    The aim of the present study was to examine whether adolescents of Moroccan and Dutch origin differ concerning sibling relationship quality and to examine whether the associations between quality of the sibling relationship and level and change in externalizing and internalizing problem behavior are

  20. Longitudinal effects of sibling relationship quality on adolescent problem behavior: A cross-ethnic comparison

    NARCIS (Netherlands)

    Buist, K.L.; Paalman, C.H.; Branje, S.J.T.; Dekovic, M.; Reitz, E.; Verhoeven, M.; Meeus, W.H.J.; Koot, H.M.; Hale, W.W.

    2014-01-01

    The aim of the present study was to examine whether adolescents of Moroccan and Dutch origin differ concerning sibling relationship quality and to examine whether the associations between quality of the sibling relationship and level and change in externalizing and internalizing problem behavior are

  1. Sleep quality and duration are related to microvascular function: the Amsterdam Growth and Health Longitudinal Study

    NARCIS (Netherlands)

    Bonsen, T.; Wijnstok, N.J.; Hoekstra, T.; Eringa, E.C.; Serne, E.H.; Smulders, Y.M.; Twisk, J.W.R.

    2015-01-01

    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

  2. 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

  3. 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

  4. Flour sodium dodecyl sulfate (SDS)-extractable protein level as a cookie flour quality indicator.

    Science.gov (United States)

    Pareyt, Bram; Bruneel, Charlotte; Brijs, Kristof; Goesaert, Hans; Delcour, Jan A

    2010-01-13

    Flour characteristics of laboratory-milled flour fractions of two wheat cultivars were related to their cookie-baking performance. Cultivar (cv.) Albatros wheat milling yielded fractions with lower damaged starch (DS) and arabinoxylan levels and higher sodium dodecyl sulfate-extractable protein (SDSEP) levels than did cv. Meunier wheat milling. During baking, cv. Albatros flour doughs spread faster and set later than their cv. Meunier counterparts and, hence, resulted in larger cookie diameters. DS levels negatively affected spread rate during both cv. Albatros (R2=0.68) and cv. Meunier (R2=0.51) cookie baking. SDSEP levels also influenced cookie quality. The use of flour heat-treated to reduce its SDSEP levels to different degrees led to reduction of the set time (R2=0.90). It was deduced that larger gluten polymer sizes limit dough spread time during baking and that, apart from DS level, the SDSEP level is an indicator for cookie flour quality.

  5. Evaluating real-time air-quality data as earthquake indicator

    International Nuclear Information System (INIS)

    Hsu, Shih-Chieh; Huang, Yi-Tang; Huang, Jr-Chung; Tu, Jien-Yi; Engling, Guenter; Lin, Chuan-Yao; Lin, Fei-Jan; Huang, Chao-Hao

    2010-01-01

    A catastrophic earthquake, namely the 921-earthquake, occurred with a magnitude of M L = 7.3 in Taiwan on September 21, 1999, causing severe disaster. The evaluation of real-time air-quality data, obtained by the Taiwan Environmental Protection Administration (EPA), revealed a staggering increase in ambient SO 2 concentrations by more than one order of magnitude across the island several hours prior to the earthquake, particularly at background stations. The abrupt increase in SO 2 concentrations likely resulted from seismic-triggered degassing instead of air pollution. An additional case of a large earthquake (M L = 6.8), occurring on March 31, 2002, was examined to confirm our observations of significantly enhanced SO 2 concentrations in ambient air prior to large earthquakes. The coincidence between large earthquakes and increases in trace gases during the pre-quake period (several hours) indicates the potential of employing air-quality monitoring data to forecast catastrophic earthquakes.

  6. [The German program for disease management guidelines: evaluation by use of quality indicators].

    Science.gov (United States)

    Kopp, Ina B; Geraedts, Max; Jäckel, Wilfried H; Altenhofen, Lutz; Thomeczek, Christian; Ollenschläger, Günter

    2007-08-15

    The Program for National Disease Management Guidelines (German DM-CPG Program) in Germany aims at the implementation of best-practice recommendations for prevention, acute care, rehabilitation and chronic care in the setting of disease management programs and integrated health-care systems. Like other guidelines, DM-CPG need to be assessed regarding their influence on structures, processes and outcomes of care. However, quality assessment in integrated health-care systems is challenging. On the one hand, a multitude of potential domains for measurement, actors and perspectives need to be considered. On the other hand, measures need to be identified that assess the function of the diagnostic and therapeutic chain in terms of cooperation and coordination of care. The article reviews methods and use of quality indicators in the context of the German DM-CPG Program.

  7. The efficiency and quality dilemma: What drives South African call centre management performance indicators?

    Directory of Open Access Journals (Sweden)

    Diane Banks

    2011-03-01

    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.

  8. 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.

  9. Evaluation of drinking water quality indices (case study: Bushehr province, Iran

    Directory of Open Access Journals (Sweden)

    Nematollah Jafarzadeh

    2017-05-01

    Full Text Available Background: Internal corrosion and the formation of scale in water distribution pipes are the most important problems for an urban water distribution system. Physical, chemical, or biological factors can lead to these two processes. Internal corrosion and scale formation can impact health, economy, and aesthetics. This study assessed the physicochemical quality parameters and evaluated the potential for corrosion and scale formation in drinking water at the distribution systems of 5 selected cities in Bushehr province (Kangan, Dashtestan, Dashti, Bushehr, and Ganaveh from 2009-2012. Methods: This study was carried out based on laboratory data collected from monthly samplings of tap water in the Water and Wastewater Company of Bushehr province during the years 2009-2012. Internal corrosion and scale formation rates were calculated using the Ryznar, Langelier, Aggressive, and Puckorius indices. Results: The results of the Ryznar, Puckorius, Aggressive and Langelier indices indicated that the drinking water in the 5 selected cities of Bushehr province was corrosive. Moreover, the majority of parameters used to determine water quality exceeded Iran’s national standards. Conclusion: It is concluded that there is problem of water corrosion and scaling in drinking water of distribution systems in selected cities.

  10. Transition from in-hospital ventilation to home ventilation: process description and quality indicators

    Directory of Open Access Journals (Sweden)

    Kastrup, Marc

    2017-12-01

    Full Text Available The current demographic development of our society results in an increasing number of elderly patients with chronic diseases being treated in the intensive care unit. A possible long-term consequence of such a treatment is that patients remain dependent on certain invasive organ support systems, such as long-term ventilator dependency. The main goal of this project is to define the transition process between in-hospital and out of hospital (ambulatory ventilator support. A further goal is to identify evidence-based quality indicators to help define and describe this process.This project describes an ideal sequence of processes (process chain, based on the current evidence from the literature. Besides the process chain, key data and quality indicators were described in detail. Due to the limited project timeline, these indicators were not extensively tested in the clinical environment.The results of this project may serve as a solid basis for proof of feasibility and proof of concept investigations, optimize the transition process of ventilator-dependent patients from a clinical to an ambulatory setting, as well as reduce the rate of emergency re-admissions.

  11. Hydrodynamic modelling of recreational water quality using Escherichia coli as an indicator of microbial contamination

    Science.gov (United States)

    Eregno, Fasil Ejigu; Tryland, Ingun; Tjomsland, Torulv; Kempa, Magdalena; Heistad, Arve

    2018-06-01

    Microbial contamination of recreational beaches is often at its worst after heavy rainfall events due to storm floods that carry fecal matter and other pollutants from the watershed. Similarly, overflows of untreated sewage from combined sewerage systems may discharge directly into coastal water or via rivers and streams. In order to understand the effect of rainfall events, wind-directions and tides on the recreational water quality, GEMSS, an integrated 3D hydrodynamic model was applied to assess the spreading of Escherichia coli (E. coli) at the Sandvika beaches, located in the Oslo fjord. The model was also used to theoretically investigate the effect of discharges from septic tanks from boats on the water quality at local beaches. The model make use of microbial decay rate as the main input representing the survival of microbial pathogens in the ocean, which vary widely depending on the type of pathogen and environmental stress. The predicted beach water quality was validated against observed data after a heavy rainfall event using Nash-Sutcliffe coefficient (E) and the overall result indicated that the model performed quite well and the simulation was in - good agreement with the observed E. coli concentrations for all beaches. The result of this study indicated that: 1) the bathing water quality was poor according to the EU bathing water directive up to two days after the heavy rainfall event depending on the location of the beach site. 2) The discharge from a boat at 300-meter distance to the beaches slightly increased the E. coli levels at the beaches. 3) The spreading of microbial pathogens from its source to the different beaches depended on the wind speed and the wind direction.

  12. 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.

  13. Evaluation of polar organic micropollutants as indicators for wastewater-related coastal water quality impairment

    International Nuclear Information System (INIS)

    Nödler, Karsten; Tsakiri, Maria; Aloupi, Maria; Gatidou, Georgia; Stasinakis, Athanasios S.; Licha, Tobias

    2016-01-01

    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

  14. Consensus on Quality Indicators of Postgraduate Medical E-Learning: Delphi Study

    Science.gov (United States)

    Walsh, Kieran; Westerman, Michiel; Scheele, Fedde

    2018-01-01

    Background The progressive use of e-learning in postgraduate medical education calls for useful quality indicators. Many evaluation tools exist. However, these are diversely used and their empirical foundation is often lacking. Objective We aimed to identify an empirically founded set of quality indicators to set the bar for “good enough” e-learning. Methods We performed a Delphi procedure with a group of 13 international education experts and 10 experienced users of e-learning. The questionnaire started with 57 items. These items were the result of a previous literature review and focus group study performed with experts and users. Consensus was met when a rate of agreement of more than two-thirds was achieved. Results In the first round, the participants accepted 37 items of the 57 as important, reached no consensus on 20, and added 15 new items. In the second round, we added the comments from the first round to the items on which there was no consensus and added the 15 new items. After this round, a total of 72 items were addressed and, of these, 37 items were accepted and 34 were rejected due to lack of consensus. Conclusions This study produced a list of 37 items that can form the basis of an evaluation tool to evaluate postgraduate medical e-learning. This is, to our knowledge, the first time that quality indicators for postgraduate medical e-learning have been defined and validated. The next step is to create and validate an e-learning evaluation tool from these items. PMID:29699970

  15. Microbial Indicators of Soil Quality under Different Land Use Systems in Subtropical Soils

    Science.gov (United States)

    Maharjan, M.

    2016-12-01

    Land-use change from native forest to intensive agricultural systems can negatively impact numerous soil parameters. Understanding the effects of forest ecosystem transformations on markers of long-term soil health is particularly important in rapidly developing regions such as Nepal, where unprecedented levels of agriculturally-driven deforestation have occurred in recent decades. However, the effects of widespread land use changes on soil quality in this region have yet to be properly characterized. Microbial indicators (soil microbial biomass, metabolic quotient and enzymes activities) are particularly suited to assessing the consequences of such ecosystem disturbances, as microbial communities are especially sensitive to environmental change. Thus, the aim of this study was to assess the effect of land use system; i.e. forest, organic and conventional farming, on soil quality in Chitwan, Nepal using markers of microbial community size and activity. Total organic C and N contents were higher in organic farming compared with conventional farming and forest, suggesting higher nutrient retention and soil preservation with organic farming practices compared to conventional. These differences in soil composition were reflected in the health of the soil microbial communities: Organic farm soil exhibited higher microbial biomass C, elevated β-glucosidase and chitinase activities, and a lower metabolic quotient relative to other soils, indicating a larger, more active, and less stressed microbial community, respectively. These results collectively demonstrate that application of organic fertilizers and organic residues positively influence nutrient availability, with subsequent improvements in soil quality and productivity. Furthermore, the sensitivity of microbial indicators to different management practices demonstrated in this study supports their use as effective markers of ecosystem disturbance in subtropical soils.

  16. Consensus on Quality Indicators of Postgraduate Medical E-Learning: Delphi Study.

    Science.gov (United States)

    de Leeuw, Robert Adrianus; Walsh, Kieran; Westerman, Michiel; Scheele, Fedde

    2018-04-26

    The progressive use of e-learning in postgraduate medical education calls for useful quality indicators. Many evaluation tools exist. However, these are diversely used and their empirical foundation is often lacking. We aimed to identify an empirically founded set of quality indicators to set the bar for “good enough” e-learning. We performed a Delphi procedure with a group of 13 international education experts and 10 experienced users of e-learning. The questionnaire started with 57 items. These items were the result of a previous literature review and focus group study performed with experts and users. Consensus was met when a rate of agreement of more than two-thirds was achieved. In the first round, the participants accepted 37 items of the 57 as important, reached no consensus on 20, and added 15 new items. In the second round, we added the comments from the first round to the items on which there was no consensus and added the 15 new items. After this round, a total of 72 items were addressed and, of these, 37 items were accepted and 34 were rejected due to lack of consensus. This study produced a list of 37 items that can form the basis of an evaluation tool to evaluate postgraduate medical e-learning. This is, to our knowledge, the first time that quality indicators for postgraduate medical e-learning have been defined and validated. The next step is to create and validate an e-learning evaluation tool from these items. ©Robert Adrianus de Leeuw, Kieran Walsh, Michiel Westerman, Fedde Scheele. Originally published in JMIR Medical Education (http://mededu.jmir.org), 26.04.2018.

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

    Science.gov (United States)

    2012-01-01

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

  18. 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. © 2015 Eur J Oral Sci.

  19. 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.

  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. 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

  2. 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.

  3. 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

  4. Improving benchmarking by using an explicit framework for the development of composite indicators: an example using pediatric quality of care

    Science.gov (United States)

    2010-01-01

    Background The measurement of healthcare provider performance is becoming more widespread. Physicians have been guarded about performance measurement, in part because the methodology for comparative measurement of care quality is underdeveloped. Comprehensive quality improvement will require comprehensive measurement, implying the aggregation of multiple quality metrics into composite indicators. Objective To present a conceptual framework to develop comprehensive, robust, and transparent composite indicators of pediatric care quality, and to highlight aspects specific to quality measurement in children. Methods We reviewed the scientific literature on composite indicator development, health systems, and quality measurement in the pediatric healthcare setting. Frameworks were selected for explicitness and applicability to a hospital-based measurement system. Results We synthesized various frameworks into a comprehensive model for the development of composite indicators of quality of care. Among its key premises, the model proposes identifying structural, process, and outcome metrics for each of the Institute of Medicine's six domains of quality (safety, effectiveness, efficiency, patient-centeredness, timeliness, and equity) and presents a step-by-step framework for embedding the quality of care measurement model into composite indicator development. Conclusions The framework presented offers researchers an explicit path to composite indicator development. Without a scientifically robust and comprehensive approach to measurement of the quality of healthcare, performance measurement will ultimately fail to achieve its quality improvement goals. PMID:20181129

  5. The association between Act-Belong-Commit indicators and problem drinking among older Irish adults: Findings from a prospective analysis of the Irish Longitudinal Study on Ageing (TILDA).

    Science.gov (United States)

    Santini, Ziggi Ivan; Nielsen, Line; Hinrichsen, Carsten; Tolstrup, Janne S; Vinther, Johan L; Koyanagi, Ai; Donovan, Robert J; Koushede, Vibeke

    2017-11-01

    The Act-Belong-Commit campaign is the world's first comprehensive, population-wide, community-based program to promote mental health. However, its potential for preventing substance use disorders is unknown. Further, a literature gap is evident concerning behavioral modification strategies to prevent such disorders. The aim of this study was to prospectively assess the association between indicators of the Act-Belong-Commit behavioral domains and the development of problem drinking. Data from two waves of the Irish Longitudinal Study on Ageing (TILDA) were analyzed. The sample consisted of 3950 adults aged ≥50years. A validated scale for problem drinking was used. The number of social/recreational activities engaged in was used as an indicator of Act, social network integration as an indicator of Belong, and frequency of participation in these social/recreational activities as an indicator of Commit. Multivariable logistic regression analyses were conducted to assess associations between baseline indicators of Act-Belong-Commit and the development of problem drinking at two-year follow-up. Each increase in the number of social/recreational activities (Act) inversely predicted the onset of problem drinking. Similarly, being well integrated into social networks (Belong) was negatively associated with the development of problem drinking. Finally, frequency of participation in social/recreational activities (Commit) also inversely predicted the onset of problem drinking. These associations were apparent regardless of the presence of baseline common mental disorders. Act-Belong-Commit indicators are shown to be associated with a reduced risk for problem drinking. This lends further support to the Act-Belong-Commit domains and has wide-ranging implications for preventing substance use disorders in the aging community. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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

    DEFF Research Database (Denmark)

    Saunders, Aaron Marc; Kristiansen, Anja; Lund, Marie Braad

    2009-01-01

    doi:10.1016/j.syapm.2008.11.004 The results of this study support the use of fecal Bacteroidales qPCR as a rapid method to complement traditional, culture dependent, water quality indicators in systems where drinking water is supplied without chlorination or other forms of disinfection. A SYBR...... green based, quantitative PCR assay was developed to determine the concentration of fecal Bacteroidales 16S rRNA gene copies. The persistence of a Bacteroides vulgatus pure culture and fecal Bacteroidales from a wastewater inoculum was determined in unchlorinated drinking water at10°C. B. vulgatus 16S r......RNA gene copies persisted throughout the experimental period (200 days) in sterile drinking water but decayed faster in natural drinking water, indicating that the natural microbiota accelerated decay. In a simulated fecal contamination of unchlorinated drinking water, the decay of fecal Bacteroidales 16S...

  7. A potential to monitor nutrients as an indicator of rangeland quality using space borne remote sensing

    International Nuclear Information System (INIS)

    Ramoelo, A; Madonsela, S; Mathieu, R; Van der Korchove, R; Kaszta, Z; Wolf, E; Cho, M A

    2014-01-01

    Global change consisting of land use and climate change could have huge impacts on food security and the health of various ecosystems. Leaf nitrogen (N) is one of the key factors limiting agricultural production and ecosystem functioning. Leaf N can be used as an indicator of rangeland quality which could provide information for the farmers, decision makers, land planners and managers. Leaf N plays a crucial role in understanding the feeding patterns and distribution of wildlife and livestock. Assessment of this vegetation parameter using conventional methods at landscape scale level is time consuming and tedious. Remote sensing provides a synoptic view of the landscape, which engenders an opportunity to assess leaf N over wider rangeland areas from protected to communal areas. Estimation of leaf N has been successful during peak productivity or high biomass and limited studies estimated leaf N in dry season. The objective of this study is to monitor leaf N as an indicator of rangeland quality using WorldView 2 satellite images in the north-eastern part of South Africa. Series of field work to collect samples for leaf N were undertaken in the beginning of May (end of wet season) and July (dry season). Several conventional and red edge based vegetation indices were computed. Simple regression was used to develop prediction model for leaf N. Using bootstrapping, indicator of precision and accuracy were analyzed to select a best model for the combined data sets (May and July). The may model for red edge based simple ratio explained over 90% of leaf N variations. The model developed from the combined data sets with normalized difference vegetation index explained 62% of leaf N variation, and this is a model used to estimate and map leaf N for two seasons. The study demonstrated that leaf N could be monitored using high spatial resolution with the red edge band capability

  8. Studying physician effects on patient outcomes: physician interactional style and performance on quality of care indicators.

    Science.gov (United States)

    Franks, Peter; Jerant, Anthony F; Fiscella, Kevin; Shields, Cleveland G; Tancredi, Daniel J; Epstein, Ronald M

    2006-01-01

    Many prior studies which suggest a relationship between physician interactional style and patient outcomes may have been confounded by relying solely on patient reports, examining very few patients per physician, or not demonstrating evidence of a physician effect on the outcomes. We examined whether physician interactional style, measured both by patient report and objective encounter ratings, is related to performance on quality of care indicators. We also tested for the presence of physician effects on the performance indicators. Using data on 100 US primary care physician (PCP) claims data on 1,21,606 of their managed care patients, survey data on 4746 of their visiting patients, and audiotaped encounters of 2 standardized patients with each physician, we examined the relationships between claims-based quality of care indicators and both survey-derived patient perceptions of their physicians and objective ratings of interactional style in the audiotaped standardized patient encounters. Multi-level models examined whether physician effects (variance components) on care indicators were mediated by patient perceptions or objective ratings of interactional style. We found significant physician effects associated with glycohemoglobin and cholesterol testing. There was also a clinically significant association between better patient perceptions of their physicians and more glycohemoglobin testing. Multi-level analyses revealed, however, that the physician effect on glycohemoglobin testing was not mediated by patient perceived physician interaction style. In conclusion, similar to prior studies, we found evidence of an apparent relationship between patient perceptions of their physician and patient outcomes. However, the apparent relationships found in this study between patient perceptions of their physicians and patient care processes do not reflect physician style, but presumably reflect unmeasured patient confounding. Multi-level modeling may contribute to better

  9. 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

    – Emotional scores were higher when patients had high Rancho Los Amigos Scale scores at admission to early intensive rehabilitation in hospital. These results suggest that the acute and sub-acute periods after brain injury are an extremely difficult time psychologically for many families, and family......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...... the trajectories of HRQoL in 94 Danish family members of patients with severe brain injury at five time points, beginning at the patient's stay in a neuro intensive care unit through one year after injury. The family members’ HRQoL scores significantly and strongly increased over time, and Role Limitations...

  10. Influence of xerostomia on oral health-related quality of life in the elderly: a 5-year longitudinal study.

    Science.gov (United States)

    Enoki, Kaori; Matsuda, Ken-Ich; Ikebe, Kazunori; Murai, Shunsuke; Yoshida, Minoru; Maeda, Yoshinobu; Thomson, William Murray

    2014-06-01

    Xerostomia and tooth loss are major oral health problems in the elderly. The aim of this longitudinal study was to characterize the influence of xerostomia on oral health-related quality of life (OHRQoL) among elderly Japanese people. A total of 99 community-dwelling, independently living individuals aged 60 years and older were interviewed and underwent dental examination at baseline and at a 5-year follow-up. The Oral Health Impact Profile-14 and the Xerostomia Inventory were used to assess OHRQoL and xerostomia severity, respectively. Participants whose xerostomia worsened over the 5-year period had a significantly poorer follow-up OHRQoL. Linear regression models showed that tooth loss and worsening xerostomia were significant predictors of poorer follow-up OHRQoL. Tooth loss and worsening xerostomia result in poorer OHRQoL among older Japanese people. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Cortical reaction as an egg quality indicator in artificial reproduction of pikeperch, Sander lucioperca.

    Science.gov (United States)

    Zarski, Daniel; Krejszeff, Sławomir; Palińska, Katarzyna; Targońska, Katarzyna; Kupren, Krzysztof; Fontaine, Pascal; Kestemont, Patrick; Kucharczyk, Dariusz

    2012-01-01

    The aim of this study was to investigate the process of the cortical reaction in eggs of pikeperch, Sander lucioperca (L.), as well as the application of microscopic assessment of this process in egg quality evaluation. The analysis was carried out with eggs obtained from 10 females by artificial reproduction, in which hormonal stimulation with hCG was applied. Subsequently, each sample of eggs (separately from each female fish) was analysed. The analysis included observation of the cortical reaction and the process of egg swelling, and determination of the effect of temperature (12, 14 and 16°C) and the presence of spermatozoa on the cortical reaction. The results indicate that the cortical reaction in pikeperch eggs is quite violent, resulting in visible deformation of eggs between 3 and 5 min after activation. No effect of temperature or the presence of spermatozoa on the cortical reaction was observed. A strong correlation was recorded for the percentage of egg deformations observed and embryo survival rate. The described method of determination of pikeperch egg quality (based on egg deformation rate between 3 and 5 min after activation) may be highly useful, both in scientific research (where high-quality eggs are required) and in hatchery practice.

  12. 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.

  13. Data on the key performance indicators for quality of service of GSM networks in Nigeria

    Directory of Open Access Journals (Sweden)

    Segun I. Popoola

    2018-02-01

    Full Text Available In this data article, the Key Performance Indicators (KPIs for Quality of Service (QoS of Global System for Mobile Communications (GSM networks in Nigeria are provided and analyzed. The data provided in this paper contain the Call Setup Success Rate (CSSR, Drop Call Rate (DCR, Stand-alone Dedicated Channel (SDCCH congestion, and Traffic Channel (TCH congestion for the four GSM network operators in Nigeria (Airtel, Etisalat, Glo, and MTN. These comprehensive data were obtained from the Nigerian Communications Commission (NCC. Significant differences in each of the KPIs for the four quarters of each year were presented based on Analysis of Variance (ANOVA. The values of the KPIs were plotted against the months of the year for better visualization and understanding of data trends across the four quarters. Multiple comparisons of the mean-quarterly differences of the KPIs were also presented using Tukey's Post Hoc test. Public availability and further interpretation and discussion of these useful information will assist the network providers, Nigerian government, local and international regulatory bodies, policy makers, and other stakeholders in ensuring access of people, machines, and things to high quality telecommunications services. Keywords: Quality of service, GSM networks, Call setup success rate, Drop call rate, Stand-alone dedicated channel congestion, Traffic channel congestion

  14. Direct detection of male quality can facilitate the evolution of female choosiness and indicators of good genes: Evolution across a continuum of indicator mechanisms.

    Science.gov (United States)

    Dhole, Sumit; Stern, Caitlin A; Servedio, Maria R

    2018-04-01

    The evolution of mating displays as indicators of male quality has been the subject of extensive theoretical and empirical research for over four decades. Research has also addressed the evolution of female mate choice favoring such indicators. Yet, much debate still exists about whether displays can evolve through the indirect benefits of female mate choice. Here, we use a population genetic model to investigate how the extent to which females can directly detect male quality influences the evolution of female choosiness and male displays. We use a continuum framework that incorporates indicator mechanisms that are traditionally modeled separately. Counter to intuition, we find that intermediate levels of direct detection of male quality can facilitate, rather than impede, the evolution of female choosiness and male displays in broad regions of this continuum. We examine how this evolution is driven by selective forces on genetic quality and on the display, and find that direct detection of male quality results in stronger indirect selection favoring female choosiness. Our results imply that displays maybe more likely to evolve when female choosiness has already evolved to discriminate perceptible forms of male quality. They also highlight the importance of considering general female choosiness, as well as preference, in studies of "good genes." © 2018 The Author(s). Evolution © 2018 The Society for the Study of Evolution.

  15. Rehabilitation following pediatric traumatic brain injury: variability in adherence to psychosocial quality-of-care indicators.

    Science.gov (United States)

    Ennis, Stephanie K; Jaffe, Kenneth M; Mangione-Smith, Rita; Konodi, Mark A; MacKenzie, Ellen J; Rivara, Frederick P

    2014-01-01

    To examine variations in processes of pediatric inpatient rehabilitation care related to family-centered care, management of neurobehavioral and psychosocial needs, and community reintegration after traumatic brain injury. Nine acute rehabilitation facilities from geographically diverse areas of the United States. A total of 174 children with traumatic brain injury. Retrospective chart review. Adherence to care indicators (the number of times recommended care was delivered or attempted divided by the number of times care was indicated). Across facilities, adherence rates (adjusted for difficulty of delivery) ranged from 33.6% to 73.1% (95% confidence interval, 13.4-53.9, 58.7-87.4) for family-centered processes, 21.3% to 82.5% (95% confidence interval, 6.6-36.1, 67.6-97.4) for neurobehavioral and psychosocial processes, and 22.7% to 80.3% (95% confidence interval, 5.3-40.1, 68.1-92.5) for community integration processes. Within facilities, standard deviations for adherence rates were large (24.3-34.9, family-centered domain; 22.6-34.2, neurobehavioral and psychosocial domain; and 21.6-40.5, community reintegration domain). The current state of acute rehabilitation care for children with traumatic brain injury is variable across different quality-of-care indicators addressing neurobehavioral and psychosocial needs and facilitating community reintegration of the patient and the family. Individual rehabilitation facilities demonstrate inconsistent adherence to different indicators and inconsistent performance across different care domains.

  16. 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.