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Sample records for treatment quality program

  1. The Effectiveness of Stress Management Program on Quality of Life among Methadone Maintenance Treatment Members

    Directory of Open Access Journals (Sweden)

    s Zarei

    2014-11-01

    Full Text Available Objective: The aim of present study was to investigate the effectiveness of stress management program on quality of life among methadone maintenance treatment members. Method: In this pre-test, post-test experimental study, 30 individual who referred to Saba MMT center in Pakdasht were randomly divided into experimental group (n=15 participants and control group (n=15 participants. The experimental group was undergone ten 90 minutes sessions of stress management program and the control group didn’t receive any treatment program. Quality of life questionnaire (SF-36 was administered. Result: The results showed that the mean sf-36 score in the experimental group had significant higher increased in comparison of control group. Conclusion: It can be concluded stress management program is effective on increasing of quality of life among methadone maintenance treatment members.

  2. Optimization of radio-therapeutic treatment and the program of quality assurance in ionizing radiation therapy

    International Nuclear Information System (INIS)

    Rosca, A.; Bahnarel, I.; Coretchi, L.

    2015-01-01

    The Program of Quality Assurance (PQA) in Ionizing Radiation Therapy (IRT) addresses the most important problems of assuring the quality of IRT utilization in the treatment of patients with neoplasm. In this context, the IRT value grows considerably, hence the implementation of PQA is of great significance. The study concentrates on a detailed description of the PQA as concerns the activity involving IRT devices applied in the IRT departments (rooms) of public medical/sanitary institutions, science research institutions etc., where IRT is employed using technogenic sources and ionizing radiation generators. For the performing of the study, annual statistics reports about the activity of the IRT, and data of Cancer Registry of the Oncologic Institute of the Republic of Moldova were analyzed. The work also includes an in-depth description of the personnel categories involved in PQA, possible errors in radiotherapy, the responsibilities of the bioengineer in this program, importance of source calibration, the impact of the quality control in PQA, the role of topometric training, the interaction between the medical and technical personnel and the patient. Optimization of IRT is very important and necessary in the Republic of Moldova. PQA incontestably contributes to reducing specialist's errors in planning correct treatment, dictates the need of team work and proper delegation of the responsibilities in co-optation of other professionals, performance of duty of bioengineering, the influence of quality control of profile installations, meaning accurate topographic planning, applying several methods of work, quality assurance program assuming the major importance. (authors)

  3. SU-F-T-169: A Periodic Quality Assurance Program for a Spot-Scanning Proton Treatment Facility

    Energy Technology Data Exchange (ETDEWEB)

    Mundy, D; Tryggestad, E; Beltran, C; Furutani, K; Gilson, G; Ito, S; Johnson, J; Kruse, J; Remmes, N; Tasson, A; Whitaker, T; Herman, M [Mayo Clinic, Rochester, MN (United States)

    2016-06-15

    Purpose: To develop daily and monthly quality assurance (QA) programs in support of a new spot-scanning proton treatment facility using a combination of commercial and custom equipment and software. Emphasis was placed on efficiency and evaluation of key quality parameters. Methods: The daily QA program was developed to test output, spot size and position, proton beam energy, and image guidance using the Sun Nuclear Corporation rf-DQA™3 device and Atlas QA software. The program utilizes standard Atlas linear accelerator tests repurposed for proton measurements and a custom jig for indexing the device to the treatment couch. The monthly QA program was designed to test mechanical performance, image quality, radiation quality, isocenter coincidence, and safety features. Many of these tests are similar to linear accelerator QA counterparts, but many require customized test design and equipment. Coincidence of imaging, laser marker, mechanical, and radiation isocenters, for instance, is verified using a custom film-based device devised and manufactured at our facility. Proton spot size and position as a function of energy are verified using a custom spot pattern incident on film and analysis software developed in-house. More details concerning the equipment and software developed for monthly QA are included in the supporting document. Thresholds for daily and monthly tests were established via perturbation analysis, early experience, and/or proton system specifications and associated acceptance test results. Results: The periodic QA program described here has been in effect for approximately 9 months and has proven efficient and sensitive to sub-clinical variations in treatment delivery characteristics. Conclusion: Tools and professional guidelines for periodic proton system QA are not as well developed as their photon and electron counterparts. The program described here efficiently evaluates key quality parameters and, while specific to the needs of our facility

  4. SU-F-T-169: A Periodic Quality Assurance Program for a Spot-Scanning Proton Treatment Facility

    International Nuclear Information System (INIS)

    Mundy, D; Tryggestad, E; Beltran, C; Furutani, K; Gilson, G; Ito, S; Johnson, J; Kruse, J; Remmes, N; Tasson, A; Whitaker, T; Herman, M

    2016-01-01

    Purpose: To develop daily and monthly quality assurance (QA) programs in support of a new spot-scanning proton treatment facility using a combination of commercial and custom equipment and software. Emphasis was placed on efficiency and evaluation of key quality parameters. Methods: The daily QA program was developed to test output, spot size and position, proton beam energy, and image guidance using the Sun Nuclear Corporation rf-DQA™3 device and Atlas QA software. The program utilizes standard Atlas linear accelerator tests repurposed for proton measurements and a custom jig for indexing the device to the treatment couch. The monthly QA program was designed to test mechanical performance, image quality, radiation quality, isocenter coincidence, and safety features. Many of these tests are similar to linear accelerator QA counterparts, but many require customized test design and equipment. Coincidence of imaging, laser marker, mechanical, and radiation isocenters, for instance, is verified using a custom film-based device devised and manufactured at our facility. Proton spot size and position as a function of energy are verified using a custom spot pattern incident on film and analysis software developed in-house. More details concerning the equipment and software developed for monthly QA are included in the supporting document. Thresholds for daily and monthly tests were established via perturbation analysis, early experience, and/or proton system specifications and associated acceptance test results. Results: The periodic QA program described here has been in effect for approximately 9 months and has proven efficient and sensitive to sub-clinical variations in treatment delivery characteristics. Conclusion: Tools and professional guidelines for periodic proton system QA are not as well developed as their photon and electron counterparts. The program described here efficiently evaluates key quality parameters and, while specific to the needs of our facility

  5. Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program.

    Science.gov (United States)

    Pratt, Keeley J; Lazorick, Suzanne; Lamson, Angela L; Ivanescu, Andrada; Collier, David N

    2013-07-10

    Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL. A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate. Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression. We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth's BMI changes, but also psychosocial changes including QOL.

  6. Water quality modelling and optimisation of wastewater treatment network using mixed integer programming

    CSIR Research Space (South Africa)

    Mahlathi, Christopher

    2016-10-01

    Full Text Available Instream water quality management encompasses field monitoring and utilisation of mathematical models. These models can be coupled with optimisation techniques to determine more efficient water quality management alternatives. Among these activities...

  7. Implementation of a quality assurance program for computerized treatment planning systems according to TRS 430

    International Nuclear Information System (INIS)

    Camargo, Priscilla Roberta Tavares Leite

    2006-01-01

    This work presents the guidelines and necessary tests tom implement a quality assurance program for Eclipse 7.3.10 from Varian at Hospital das Clinicas, Sao Paulo University School of Medicine - Brazil, in accordance with the new IAEA publication TRS 430. The recommended tests for the TRS 430 air mainly classified into acceptance tests, commissioning (dosimetric and non-dosimetric tests), and routine tests. The IAEA document's recommendations are being implemented at the hospital for two Varian linear accelerators - Clinac 600C e Clinac 2100C. The acceptance tests verified 'hardware', integration of network systems, data transfer and 'software' parameters. The results obtained are in a good agreement with the manufacturer's specifications. Measurements of absolute dose in several set-ups were made for the commissioning dosimetric tests. These data were compared to the absolute doses determined by the TPS. The great majority of the tests showed 90% to 80% of the analyzed data in acceptance levels, with a good agreement between the experimental data and the data determined by the TPS. Only settings with asymmetric fields presented significant discords, showing the need for a more detailed inquiry for these settings. The non-dosimetric commissioning tests have also presented excellent results, with virtually all the system tools and general performance in compliance with TRS 430. The acceptance criteria have been applied for a comparison between the values of MUs generated by TPS and the calculated manually ones. The beams have been characterized for Eclipse with data transferred from CadPlan and with data from recommissioning of accelerators, so for these tests it was found a difference of at least 3% for the conformal field shape for the data originated in the beams of recommissioning and at least 4% for the data proceeded from CadPlan. The tolerance level established by TRS 430 for this setting was 3%. (author)

  8. Quality Management Program

    International Nuclear Information System (INIS)

    1991-10-01

    According to section 35.32, ''Quality Management Program,'' of 10 CFR Part 35, ''Medical Use of Byproduct Material,'' applicants or licensees, as applicable, are required to establish a quality management (QM) program. This regulatory guide provides guidance to licensees and applicants for developing policies and procedures for the QM program. This guide does not restrict or limit the licensee from using other guidance that may be equally useful in developing a QM program, e.g., information available from the Joint Commission on Accreditation of Healthcare Organizations or the American College of Radiology. Any information collection activities mentioned in this regulatory guide are contained as requirements in 10 CFR Part 35, which provides the regulatory basis for this guide. This information collection requirements in 10 CFR Part 35 have been cleared under OMB Clearance No. 3150-0010

  9. Quality Assurance Program Description

    Energy Technology Data Exchange (ETDEWEB)

    Halford, Vaughn Edward [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ryder, Ann Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-07-01

    Effective May 1, 2017, led by a new executive leadership team, Sandia began operating within a new organizational structure. National Technology and Engineering Solutions of Sandia (Sandia’s) Quality Assurance Program (QAP) was established to assign responsibilities and authorities, define workflow policies and requirements, and provide for the performance and assessment of work.

  10. Land Application of Wastes: An Educational Program. Treatment Systems, Effluent Qualities, and Costs - Module 4, Objectives, Script, and Booklet.

    Science.gov (United States)

    Clarkson, W. W.; And Others

    This module describes the following conventional treatment systems and evaluates their use as pretreatment steps for land application: preliminary, primary, secondary, disinfection, and advanced waste treatment. Effluent qualities are summarized, a brief discussion of application systems is given, and cost comparisons are discussed in some detail.…

  11. Quality-Assurance Program Plan

    International Nuclear Information System (INIS)

    Kettell, R.A.

    1981-05-01

    This Quality Assurance Program Plan (QAPP) is provided to describe the Quality Assurance Program which is applied to the waste management activities conducted by AESD-Nevada Operations at the E-MAD Facility located in Area 25 of the Nevada Test Site. The AESD-Nevada Operations QAPP provides the necessary systematic and administrative controls to assure activities that affect quality, safety, reliability, and maintainability during design, procurement, fabrication, inspection, shipments, tests, and storage are conducted in accordance with established requirements

  12. Quality assurance program

    International Nuclear Information System (INIS)

    Brooks, G.L.

    The concept of levels of quality assurance as applied to CANDU-type nuclear power plant components, i.e. maintaining an appropriate cost/benefit ratio, is introduced. The design process itself has quality assurance features by virtue of multi-level review. (E.C.B.)

  13. SU-G-201-01: An Automated Treatment Plan Quality Assurance Program for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Y; Tan, J; Jiang, S; Albuquerque, K; Jia, X [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: Plan specific quality assurance (QA) is an important step in high dose rate (HDR) brachytherapy to ensure the integrity of a treatment plan. The conventional approach is to assemble a set of plan screen-captures in a document and have an independent plan-checker to verify it. Not only is this approach cumbersome and time-consuming, using a document also limits the items that can be verified, hindering plan quality and patient safety. We have initiated efforts to develop a web-based HDR brachytherapy QA system called AutoBrachy QA, for comprehensive and efficient QA. This abstract reports a new plugin in this system for the QA of a cylinder HDR brachytherapy treatment. Methods: A cylinder plan QA module was developed using Python. It was plugged into our AutoBrachy QA system. This module extracted information from CT images and treatment plan. Image processing techniques were employed to obtain geometric parameters, e.g. cylinder diameter. A comprehensive set of eight geometrical and eight dosimetric features of the plan were validated against user specified planning parameter, such as prescription value, treatment depth and length, etc. A PDF document was generated, consisting of a summary QA sheet with all the QA results, as well as images showing plan details. Results: The cylinder QA program has been implemented in our clinic. To date, it has been used in 11 patient cases and was able to successfully perform QA tests in all of them. The QA program reduced the average plan QA time from 7 min using conventional manual approach to 0.5 min. Conclusion: Being a new module in our AutoBrachy QA system, an automated treatment plan QA module for cylinder HDR brachytherapy has been successfully developed and clinically implemented. This module improved clinical workflow and plan integrity compared to the conventional manual approach.

  14. [Therapeutic benefit of a registered psychoeducation program on treatment adherence, objective and subjective quality of life: French pilot study for schizophrenia].

    Science.gov (United States)

    Sauvanaud, F; Kebir, O; Vlasie, M; Doste, V; Amado, I; Krebs, M-O

    2017-05-01

    In schizophrenic disorders, supportive psychosocial therapies have been used as adjuncts to pharmacotherapy to help alleviate residual symptoms and to improve social functioning and quality of life. Among these therapies, psychoeducational therapies showed a significant efficacy on improving drug adherence and on reducing relapses. However, according to the French Health Agency, fewer than 10% of psychiatric structures in France offer registered psychoeducation programs. Caregiver apprehension of patients' depressive reactions to the awareness of the disease could underlie the underuse of psychoeducation therapies. Indeed, the psychoeducation programs' impact on objective and subjective quality of life is discussed among the literature. In this context, we conducted a retrospective, monocentric, open-labelled and non-controlled pilot study to measure the impact of a registered psychoeducation program on objective and subjective quality of life of patients suffering from schizophrenia. Secondary objectives included measures of the effects on drug observance and awareness of the disease. We included stabilized patients over the age of eighteen suffering from schizophrenia. Referent psychiatrics were asked to inform the patient of the diagnosis and to prescribe psychoeducation therapy. From 2011 to 2014, we offered three ambulatory programs, each program including fifteen two-hour group sessions. The groups were opened for three to six patients and managed by two caregivers. Themes discussed during the sessions included: schizophrenic disease, treatments, relationships to family, diet, social issues, toxics, relaxation. Objective and subjective quality of life were evaluated one month before and one month after the program using respectively the global assessment functioning (GAF) and the subjective quality of life (SQoL) scales. The Medical Adherence Rating Scale (MARS) and the French IQ8 scale evaluated respectively drug adherence and awareness of the disease. All

  15. Quality Assurance Program. QAP Workbook.

    Science.gov (United States)

    Pelavin Research Inst., Washington, DC.

    The Quality Assurance Program (QAP) workbook is intended to assist institutions of higher education conduct qualitative and quantitative evaluations of their financial aid operations in relation to requirements of Title IV of the Higher Education Act. The workbook provides a structured approach for incorporating a cyclical Title IV QA system into…

  16. Use of the evidence base in substance abuse treatment programs for American Indians and Alaska Natives: pursuing quality in the crucible of practice and policy.

    Science.gov (United States)

    Novins, Douglas K; Aarons, Gregory A; Conti, Sarah G; Dahlke, Dennis; Daw, Raymond; Fickenscher, Alexandra; Fleming, Candace; Love, Craig; Masis, Kathleen; Spicer, Paul

    2011-06-16

    A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Broadening this conversation beyond its primary focus on the use of evidence-based treatments to other

  17. Effects of a yoga program on mood states, quality of life, and toxicity in breast cancer patients receiving conventional treatment: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Raghavendra Mohan Rao

    2017-01-01

    Full Text Available Aims: The aim of this study is to compare the effects of yoga program with supportive therapy counseling on mood states, treatment-related symptoms, toxicity, and quality of life in Stage II and III breast cancer patients on conventional treatment. Methods: Ninety-eight Stage II and III breast cancer patients underwent surgery followed by adjuvant radiotherapy (RT or chemotherapy (CT or both at a cancer center were randomly assigned to receive yoga (n = 45 and supportive therapy counseling (n = 53 over a 24-week period. Intervention consisted of 60-min yoga sessions, daily while the control group was imparted supportive therapy during their hospital visits. Assessments included state-trait anxiety inventory, Beck's depression inventory, symptom checklist, common toxicity criteria, and functional living index-cancer. Assessments were done at baseline, after surgery, before, during, and after RT and six cycles of CT. Results: Both groups had similar baseline scores. There were 29 dropouts 12 (yoga and 17 (controls following surgery. Sixty-nine participants contributed data to the current analysis (33 in yoga, and 36 in controls. An ANCOVA, adjusting for baseline differences, showed a significant decrease for the yoga intervention as compared to the control group during RT ( first result and CT (second result, in (i anxiety state by 4.72 and 7.7 points, (ii depression by 5.74 and 7.25 points, (iii treatment-related symptoms by 2.34 and 2.97 points, (iv severity of symptoms by 6.43 and 8.83 points, (v distress by 7.19 and 13.11 points, and (vi and improved overall quality of life by 23.9 and 31.2 points as compared to controls. Toxicity was significantly less in the yoga group (P = 0.01 during CT. Conclusion: The results suggest a possible use for yoga as a psychotherapeutic intervention in breast cancer patients undergoing conventional treatment.

  18. First external quality assurance program for bloodstream Real-Time PCR monitoring of treatment response in clinical trials of Chagas disease.

    Directory of Open Access Journals (Sweden)

    Juan C Ramírez

    Full Text Available Real-Time PCR (qPCR testing is recommended as both a diagnostic and outcome measurement of etiological treatment in clinical practice and clinical trials of Chagas disease (CD, but no external quality assurance (EQA program provides performance assessment of the assays in use. We implemented an EQA system to evaluate the performance of molecular biology laboratories involved in qPCR based follow-up in clinical trials of CD. An EQA program was devised for three clinical trials of CD: the E1224 (NCT01489228, a pro-drug of ravuconazole; the Sampling Study (NCT01678599, that used benznidazole, both conducted in Bolivia; and the CHAGASAZOL (NCT01162967, that tested posaconazole, conducted in Spain. Four proficiency testing panels containing negative controls and seronegative blood samples spiked with 1, 10 and 100 parasite equivalents (par. eq./mL of four Trypanosoma cruzi stocks, were sent from the Core Lab in Argentina to the participating laboratories located in Bolivia and Spain. Panels were analyzed simultaneously, blinded to sample allocation, at 4-month intervals. In addition, 302 random blood samples from both trials carried out in Bolivia were sent to Core Lab for retesting analysis. The analysis of proficiency testing panels gave 100% of accordance (within laboratory agreement and concordance (between laboratory agreement for all T. cruzi stocks at 100 par. eq./mL; whereas their values ranged from 71 to 100% and from 62 to 100% at 1 and 10 par. eq./mL, respectively, depending on the T. cruzi stock. The results obtained after twelve months of preparation confirmed the stability of blood samples in guanidine-EDTA buffer. No significant differences were found between qPCR results from Bolivian laboratory and Core Lab for retested clinical samples. This EQA program for qPCR analysis of CD patient samples may significantly contribute to ensuring the quality of laboratory data generated in clinical trials and molecular diagnostics laboratories of

  19. First external quality assurance program for bloodstream Real-Time PCR monitoring of treatment response in clinical trials of Chagas disease.

    Science.gov (United States)

    Ramírez, Juan C; Parrado, Rudy; Sulleiro, Elena; de la Barra, Anabelle; Rodríguez, Marcelo; Villarroel, Sandro; Irazu, Lucía; Alonso-Vega, Cristina; Alves, Fabiana; Curto, María A; García, Lineth; Ortiz, Lourdes; Torrico, Faustino; Gascón, Joaquim; Flevaud, Laurence; Molina, Israel; Ribeiro, Isabela; Schijman, Alejandro G

    2017-01-01

    Real-Time PCR (qPCR) testing is recommended as both a diagnostic and outcome measurement of etiological treatment in clinical practice and clinical trials of Chagas disease (CD), but no external quality assurance (EQA) program provides performance assessment of the assays in use. We implemented an EQA system to evaluate the performance of molecular biology laboratories involved in qPCR based follow-up in clinical trials of CD. An EQA program was devised for three clinical trials of CD: the E1224 (NCT01489228), a pro-drug of ravuconazole; the Sampling Study (NCT01678599), that used benznidazole, both conducted in Bolivia; and the CHAGASAZOL (NCT01162967), that tested posaconazole, conducted in Spain. Four proficiency testing panels containing negative controls and seronegative blood samples spiked with 1, 10 and 100 parasite equivalents (par. eq.)/mL of four Trypanosoma cruzi stocks, were sent from the Core Lab in Argentina to the participating laboratories located in Bolivia and Spain. Panels were analyzed simultaneously, blinded to sample allocation, at 4-month intervals. In addition, 302 random blood samples from both trials carried out in Bolivia were sent to Core Lab for retesting analysis. The analysis of proficiency testing panels gave 100% of accordance (within laboratory agreement) and concordance (between laboratory agreement) for all T. cruzi stocks at 100 par. eq./mL; whereas their values ranged from 71 to 100% and from 62 to 100% at 1 and 10 par. eq./mL, respectively, depending on the T. cruzi stock. The results obtained after twelve months of preparation confirmed the stability of blood samples in guanidine-EDTA buffer. No significant differences were found between qPCR results from Bolivian laboratory and Core Lab for retested clinical samples. This EQA program for qPCR analysis of CD patient samples may significantly contribute to ensuring the quality of laboratory data generated in clinical trials and molecular diagnostics laboratories of CD.

  20. External assurance program in radiotherapy dose by TLD: implementation of a quality system and extension to complex treatments

    International Nuclear Information System (INIS)

    Mojsiejczuk, N.; Lohr, J.; Molina, L.; Vallejos, M.; Montaño, G.; Stefanic, A.; Zaretzky, A.

    2011-01-01

    Until now, the Regional Reference Center with secondary patterns for dosimetry ('Centro Regional de Referencia con Patrones Secundarios para Dosimetria' (CRRD)) has done dosimetry verifications with thermoluminescent dosimeters (TLD) in radiotherapy in square and rectangular fields. The objective of this paper is to inform about the first tests done to span new verification conditions in irradiations with multi-leaf collimator using regular and irregular field shapes. On the other hand, it will briefly describe the progress in the implementation of a quality management system adopted by the CRRD, regarding the TLD verification service. (author)

  1. Environmental Restoration Quality Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Colley, J.S.

    1992-08-01

    The Martin Marietta Energy Systems, Inc., Environmental Restoration (ER) Program was initially chartered on October 1, 1989, as a entral Environmental Restoration Division'' to manage the investigation and remediation of inactive sites and facilities that have been declared surplus and have no further programmatic use. The Energy Systems ER Division was established to support the DOE Oak Ridge Field Office (DOE-OR) consolidated ER Program. The DOE-OR Assistant Manager for Environmental Restoration and Waste Management provides program and budget direction to the Energy Systems ER Program for environmental restoration activities at the sites operated by Energy Systems (Oak Ridge K-25 Site, Oak Ridge National Laboratory, Oak Ridge Y-12 Plant, Paducah Gaseous Diffusion Plant, Portsmouth Gaseous Diffusion Plant) and at the off-site locations. The Energy Systems ER Division is specifically charged with assessing these sites for potential contamination and managing the cleanup processes. The Energy Systems Environmental Restoration Division was chartered on October 1, 1989, as a central organization to manage the Remedial Action (RA) Program. The purpose of this document is to ensure that: senior ER management provides planning, organization, direction, control, and support to achieve the organization's objectives; the line organization achieves quality; and overall performance is reviewed and evaluated using a rigorous assessment process.

  2. Total quality management program planning

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, P.T.; Spence, K.

    1994-05-01

    As government funding grows scarce, competition between the national laboratories is increasing dramatically. In this era of tougher competition, there is no for resistance to change. There must instead be a uniform commitment to improving the overall quality of our products (research and technology) and an increased focus on our customers` needs. There has been an ongoing effort to bring the principles of total quality management (TQM) to all Energy Systems employees to help them better prepare for future changes while responding to the pressures on federal budgets. The need exists for instituting a vigorous program of education and training to an understanding of the techniques needed to improve and initiate a change in organizational culture. The TQM facilitator is responsible for educating the work force on the benefits of self-managed work teams, designing a program of instruction for implementation, and thus getting TQM off the ground at the worker and first-line supervisory levels so that the benefits can flow back up. This program plan presents a conceptual model for TQM in the form of a hot air balloon. In this model, there are numerous factors which can individually and collectively impede the progress of TQM within the division and the Laboratory. When these factors are addressed and corrected, the benefits of TQM become more visible. As this occurs, it is hoped that workers and management alike will grasp the ``total quality`` concept as an acceptable agent for change and continual improvement. TQM can then rise to the occasion and take its rightful place as an integral and valid step in the Laboratory`s formula for survival.

  3. Creative musical expression as a catalyst for quality-of-life improvement in inner-city adolescents placed in a court-referred residential treatment program.

    Science.gov (United States)

    Bittman, Barry; Dickson, Larry; Coddington, Kim

    2009-01-01

    Obstacles to effectively rehabilitate inner-city adolescents in staff-secure residential treatment centers should not be underestimated. Effective evidence-based protocols are lacking to help juveniles who are often angry, detached, frustrated, and in direct conflict with their peers. Facing a myriad of issues ranging from youth delinquency offenses to trauma, abuse, drug/alcohol use, peer pressure/gang-related activities, lack of structure in home environments, mental health diagnoses, and cognitive functioning difficulties, these adolescents present extraordinary challenges to an over-stressed juvenile justice system. A randomized controlled crossover study is utilized to comprehensively evaluate the effectiveness of a novel creative musical expression protocol as a catalyst for nonverbal and verbal disclosure leading to improvements in quality of life for inner-city youth in a court-referred residential treatment program. A total of 52 (30 females and 22 males) African-American, Asian, Caucasian, and Puerto Rican subjects ranging in age from 12 to 18 (mean age 14.5) completed the study. Dependent variable measures included the Child and Adolescent Functional Assessment Scale (CAFAS), the Adolescent Psychopathology Scale (APS), the Adolescent Anger Rating Scale (AARS), the Reynolds Adolescent Depression Scale, 2nd edition (RADS 2), and the Adolescent Visual-Analog Recreational Music Making Assessment (A-VARMMA). Statistically significant (experimental vs control) improvements in multiple parameters include school/work role performance, total depression, anhedonia/negative affect, negative self-evaluation, and instrumental anger. In addition, extended impact (experimental vs control) is characterized by statistically significant improvements 6 weeks after completion of the protocol, for school/work role performance, behavior toward others, anhedonia/negative affect, total anger, instrumental anger, anger, and interpersonal problems. The primary limitations of this

  4. Development of a VMAT quality assurance program

    International Nuclear Information System (INIS)

    Silva, Ricardo Goulart da

    2013-01-01

    Modern radiation therapy keeps evolving and the technological changes include new imaging modalities, new patient immobilization devices and new treatment delivery systems. These advances have made it possible to reduce the dose to normal tissue structures and consequently minimize the risk of toxicity and morbidity, while allowing for dose escalation to the tumor volumes, potentially leading to improved locoregional control. Traditional IMRT techniques offer all of these features but the treatment session time is usually long, mainly for the head and neck cases. Currently, the VMAT technique is a reality in reference centers around the world. This technology has improved delivery efficiency over IMRT, decreasing the treatment application time, as this modality introduces extra degrees of freedom in the optimization process. The modulation of the radiation beams is achieved by simultaneous variation of dynamic parameters such as dose rate, gantry speed and leaves speed. The high level of complexity associated to the new treatment trends, inevitably, requires more accuracy and more rigorous quality assurance programs. The commissioning methods reported for the Varian RapidArc system were extended to an Elekta Synergy linear accelerator, using custom files built in the iComCAT software. Specific tests for the machine quality assurance are presented and also the dosimetric validation process applied to the Monaco treatment planning system. The MLC parameters, modeled by the Monte Carlo algorithm, were analyzed and the TG 119 tests were adapted for VMAT planning. In the end, a specific program developed for the VMAT technology for Elekta accelerators is presented. (author)

  5. Quality assurance program for isotopic power systems

    International Nuclear Information System (INIS)

    Hannigan, R.L.; Harnar, R.R.

    1982-12-01

    This report summarizes the Sandia National Laboratories Quality Assurance Program that applies to non-weapon (reimbursable) Radioisotopic Thermoelectric Generators. The program has been implemented over the past 16 years on power supplies used in various space and terrestrial systems. The quality assurance (QA) activity of the program is in support of the Department of Energy, Office of Space Nuclear Projects. Basic elements of the program are described in the report and examples of program decumentation are presented

  6. Code quality issues in student programs

    NARCIS (Netherlands)

    Keuning, H.W.; Heeren, B.J.; Jeuring, J.T.

    2017-01-01

    Because low quality code can cause serious problems in software systems, students learning to program should pay attention to code quality early. Although many studies have investigated mistakes that students make during programming, we do not know much about the quality of their code. This study

  7. Internal Quality Assurance Program for ERBB2 (HER2) Testing Improves the Selection of Breast Cancer Patients for Treatment with Trastuzumab.

    Science.gov (United States)

    Martin, Vittoria; Camponovo, Antonella; Ghisletta, Morena; Bongiovanni, Massimo; Mazzucchelli, Luca

    2012-01-01

    International guidelines for ERBB2 (HER2) testing procedures in breast cancer patients highlight the importance of external quality control. In contrast, internal quality assurance programs have been poorly defined, and their clinical significance has not yet been investigated. We developed a quality assurance scheme by performing HER2 FISH on 724 patients randomly selected out of 1996 patients with breast cancer presenting at our institute. We collected samples monthly for tissue microarray analysis and correlated HER2 gene status with IHC scores. The concordance was excellent (κ = 0.92, P internal assurance program improves patient selection and may lead to the definition of in-house tailored diagnostic algorithms different from those proposed in international guidelines.

  8. Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

    Science.gov (United States)

    Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

    2011-01-01

    Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

  9. Army Programs: Army Finance and Accounting Quality Assurance Program

    National Research Council Canada - National Science Library

    1988-01-01

    This regulation discusses the primary responsibilities of commanders and staff officers at installation and higher levels for execution of the Army Finance and Accounting Quality Assurance (QA) Program...

  10. Nuclear medicine quality assurance program in Argentina

    International Nuclear Information System (INIS)

    Levi de Cabrejas, Mariana; Arashiro, Jorge G.; Giannone, Carlos A.

    1999-01-01

    A two steps program has been implemented: the first one is the quality control of the equipment and the second one the development of standard procedures for clinical studies of patients. A training program for doctors and technicians of the nuclear medicine laboratories was carried out. Workshops on instrumentation and quality assurance in nuclear medicine have been organized in several parts of the country. A joint program of the CNEA and the University of Buenos Aires has trained medical physicists. A method has been established to evaluate the capability of the laboratories to produce high quality images and to follow up the implementation of the quality control program

  11. A Decentralized Group Treatment Program.

    Science.gov (United States)

    Conrow, Douglas C.

    Old style and new style mental hospitals are criticized for not dealing directly with a person's inability to live within his community and relate effectively with significant people. The comprehensive mental health programs, which arose in reaction to the deficits of previous facilities and treatment, are viewed as frequently following a similar,…

  12. Quality assurance program plan for Building 324

    International Nuclear Information System (INIS)

    Tanke, J.M.

    1997-01-01

    This Quality Assurance Program Plan (QAPP) provides an overview of the quality assurance program for Building 324. This plan supersedes the PNNL Nuclear Facilities Quality Management System Description, PNL-NF-QMSD, Revision 2, dated March 1996. The program applies to the facility safety structures, systems, and components and to activities that could affect safety structures, systems, and components. Adherence to the quality assurance program ensures the following: US Department of Energy missions and objectives are effectively accomplished; Products and services are safe, reliable, and meet or exceed the requirements and expectations of the user; Hazards to the public, to Hanford Site and facility workers, and to the environment are minimized. The format of this Quality Assurance Program Plan is structured to parallel that of 10 CFR 83 0.120, Quality Assurance Requirements

  13. [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 work (p = 0.001). It is important that policy makers find the way to leverage the advantages of quality indicator programs, without creating a heavy burden on the work of family physicians.

  14. Quality assurance program for nuclear power plants

    International Nuclear Information System (INIS)

    Gamon, T.H.

    1976-02-01

    The Topical Report presented establishes and provides the basis for the Brown and Root Quality Assurance Program for Nuclear Power Plants from which the Brown and Root Quality Assurance Manual is prepared and implemented. The Quality Assurance Program is implemented by the Brown and Root Power Division during the design, procurement, and construction phases of nuclear power plants. The Brown and Root Quality Assurance Program conforms to the requirements of Nuclear Regulatory Commission Regulation 10 CFR 50, Appendix B; to approved industry standards such as ANSI N45.2 and ''Daughter Standards''; or to equivalent alternatives as indicated in the appropriate sections of the report

  15. Quality assurance program for nuclear power plants

    International Nuclear Information System (INIS)

    Gamon, T.H.

    1976-06-01

    This topical report establishes and provides the basis for the Brown and Root Quality Assurance Program for Nuclear Power Plants from which the Brown and Root Quality Assurance Manual is prepared and implemented. The Quality Assurance Program is implemented by the Brown and Root Power Division during the design, procurement, and construction phases of nuclear power plants. The Brown and Root Quality Assurance Program conforms to the requirements of Nuclear Regulatory Commission Regulation 10 CFR 50, Appendix B; to approved industry standards such as ANSI N45.2 and ''Daughter Standards''; or to equivalent alternatives as indicated in the appropriate sections of this report

  16. Internal Quality Assurance Program for ERBB2 (HER2 Testing Improves the Selection of Breast Cancer Patients for Treatment with Trastuzumab

    Directory of Open Access Journals (Sweden)

    Vittoria Martin

    2012-01-01

    Full Text Available International guidelines for ERBB2 (HER2 testing procedures in breast cancer patients highlight the importance of external quality control. In contrast, internal quality assurance programs have been poorly defined, and their clinical significance has not yet been investigated. We developed a quality assurance scheme by performing HER2 FISH on 724 patients randomly selected out of 1996 patients with breast cancer presenting at our institute. We collected samples monthly for tissue microarray analysis and correlated HER2 gene status with IHC scores. The concordance was excellent (=0.92, <0.0001. HER2 amplification characterized 25% of score 2+ but also 13% of score 1+, thus expanding the number of patients eligible for trastuzumab. Based on these findings, the FISH test is now recommended at our institution for score 1+ and 2+ patients. Adherence to internal assurance program improves patient selection and may lead to the definition of in-house tailored diagnostic algorithms different from those proposed in international guidelines.

  17. 40 CFR 264.271 - Treatment program.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Treatment program. 264.271 Section 264... Treatment § 264.271 Treatment program. (a) An owner or operator subject to this subpart must establish a land treatment program that is designed to ensure that hazardous constituents placed in or on the...

  18. Tritium systems test assembly quality assurance program

    International Nuclear Information System (INIS)

    Kerstiens, F.L.; Wilhelm, R.C.

    1986-07-01

    A quality assurance program should establish the planned and systematic actions necessary to provide adequate confidence that fusion facilities and their subsystems will perform satisfactorily in service. The Tritium Systems Test Assembly (TSTA) Quality Assurance Program has been designed to assure that the designs, tests, data, and interpretive reports developed at TSTA are valid, accurate, and consistent with formally specified procedures and reviews. The quality consideration in all TSTA activities is directed toward the early detection of quality problems, coupled with timely and positive disposition and corrective action

  19. A framework for selecting performance measures for opioid treatment programs.

    Science.gov (United States)

    Pelletier, Luc R; Hoffman, Jeffrey A

    2002-01-01

    As a result of new federal regulations released in early 2001 that move the monitoring and evaluation of opioid treatment programs from a government regulation to an accreditation model, program staff members are now being challenged to develop performance measurement systems that improve care and service. Using measurement selection criteria is the first step in developing a performance measurement system as a component of an overall quality management (QM) strategy. Opioid treatment programs can "leapfrog" the development of such systems by using lessons learned from the healthcare quality industry. This article reviews performance measurement definitions, proposes performance measurement selection criteria, and makes a business case for Internet automation and accessibility. Performance measurement sets that are appropriate for opioid treatment programs are proposed, followed by a discussion on how performance measurement can be used within a comprehensive QM program. It is hoped that through development, adoption, and implementation of such a performance measurement program, treatment for clients and their families will continuously improve.

  20. Mixed Waste Integrated Program Quality Assurance requirements plan

    International Nuclear Information System (INIS)

    1994-01-01

    Mixed Waste Integrated Program (MWIP) is sponsored by the US Department of Energy (DOE), Office of Technology Development, Waste Management Division. The strategic objectives of MWIP are defined in the Mixed Waste Integrated Program Strategic Plan, and expanded upon in the MWIP Program Management Plan. This MWIP Quality Assurance Requirement Plan (QARP) applies to mixed waste treatment technologies involving both hazardous and radioactive constituents. As a DOE organization, MWIP is required to develop, implement, and maintain a written Quality Assurance Program in accordance with DOE Order 4700.1 Project Management System, DOE Order 5700.6C, Quality Assurance, DOE Order 5820.2A Radioactive Waste Management, ASME NQA-1 Quality Assurance Program Requirements for Nuclear Facilities and ANSI/ASQC E4-19xx Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs. The purpose of the MWIP QA program is to establish controls which address the requirements in 5700.6C, with the intent to minimize risks and potential environmental impacts; and to maximize environmental protection, health, safety, reliability, and performance in all program activities. QA program controls are established to assure that each participating organization conducts its activities in a manner consistent with risks posed by those activities

  1. Quality control in screening programs for cervical cancer

    International Nuclear Information System (INIS)

    Sarduy Napoles, Miguel

    2012-01-01

    The malignancy of the cervix is one of the few locations avoidable cancers, if detected before it progresses to the infiltration. The most efficient way of early detection is through a screening program to provide women undertaking a regular and quality Pap smear. If this test results abnormal, the program offers easier access to specialized care, effective treatment, and follow-up. The objective of this article is to present usefulness of methods for quality control used in screening programs for cervical cancer to detect their inadequacies. Here are some factors and conditions that must be considered in each of the steps to take, for a cervical cancer screening program to be successful and to meet the objectives proposed in reducing mortality due to this cause. This document contains some useful indexes calculated to ensure quality throughout the process. There should be the measurement of quality throughout the screening process that allows collecting of reliable data as well as correcting deficiencies

  2. Short-term follow-up of exercise training program and beta-blocker treatment on quality of life in dogs with naturally acquired chronic mitral valve disease.

    Science.gov (United States)

    Marcondes-Santos, M; Mansur, A P; Fragata, F S; Strunz, C M C

    2015-10-01

    This study aimed to evaluate the effects of carvedilol treatment and a regimen of supervised aerobic exercise training on quality of life and other clinical, echocardiographic, and biochemical variables in a group of client-owned dogs with chronic mitral valve disease (CMVD). Ten healthy dogs (control) and 36 CMVD dogs were studied, with the latter group divided into 3 subgroups. In addition to conventional treatment (benazepril, 0.3-0.5 mg/kg once a day, and digoxin, 0.0055 mg/kg twice daily), 13 dogs received exercise training (subgroup I; 10.3 ± 2.1 years), 10 dogs received carvedilol (0.3 mg/kg twice daily) and exercise training (subgroup II; 10.8 ± 1.7 years), and 13 dogs received only carvedilol (subgroup III; 10.9 ± 2.1 years). All drugs were administered orally. Clinical, laboratory, and Doppler echocardiographic variables were evaluated at baseline and after 3 and 6 months. Exercise training was conducted from months 3-6. The mean speed rate during training increased for both subgroups I and II (ANOVA, P>0.001), indicating improvement in physical conditioning at the end of the exercise period. Quality of life and functional class was improved for all subgroups at the end of the study. The N-terminal pro-brain natriuretic peptide (NT-proBNP) level increased in subgroup I from baseline to 3 months, but remained stable after training introduction (from 3 to 6 months). For subgroups II and III, NT-proBNP levels remained stable during the entire study. No difference was observed for the other variables between the three evaluation periods. The combination of carvedilol or exercise training with conventional treatment in CMVD dogs led to improvements in quality of life and functional class. Therefore, light walking in CMVD dogs must be encouraged.

  3. Short-term follow-up of exercise training program and beta-blocker treatment on quality of life in dogs with naturally acquired chronic mitral valve disease

    Directory of Open Access Journals (Sweden)

    M. Marcondes-Santos

    2015-01-01

    Full Text Available This study aimed to evaluate the effects of carvedilol treatment and a regimen of supervised aerobic exercise training on quality of life and other clinical, echocardiographic, and biochemical variables in a group of client-owned dogs with chronic mitral valve disease (CMVD. Ten healthy dogs (control and 36 CMVD dogs were studied, with the latter group divided into 3 subgroups. In addition to conventional treatment (benazepril, 0.3-0.5 mg/kg once a day, and digoxin, 0.0055 mg/kg twice daily, 13 dogs received exercise training (subgroup I; 10.3±2.1 years, 10 dogs received carvedilol (0.3 mg/kg twice daily and exercise training (subgroup II; 10.8±1.7 years, and 13 dogs received only carvedilol (subgroup III; 10.9±2.1 years. All drugs were administered orally. Clinical, laboratory, and Doppler echocardiographic variables were evaluated at baseline and after 3 and 6 months. Exercise training was conducted from months 3-6. The mean speed rate during training increased for both subgroups I and II (ANOVA, P>0.001, indicating improvement in physical conditioning at the end of the exercise period. Quality of life and functional class was improved for all subgroups at the end of the study. The N-terminal pro-brain natriuretic peptide (NT-proBNP level increased in subgroup I from baseline to 3 months, but remained stable after training introduction (from 3 to 6 months. For subgroups II and III, NT-proBNP levels remained stable during the entire study. No difference was observed for the other variables between the three evaluation periods. The combination of carvedilol or exercise training with conventional treatment in CMVD dogs led to improvements in quality of life and functional class. Therefore, light walking in CMVD dogs must be encouraged.

  4. Quality assurance in the nuclear test program

    International Nuclear Information System (INIS)

    Shearer, J.N.

    1979-01-01

    In February 1979 Test Program laid the ground work for a new quality assurance structure. The new approach was based on the findings and recommendations of the Ad Hoc QA Program Review panel, which are summarized in this report. The new structure places the responsibility for quality assurance in the hands of the line organizations, both in the programmatic and functional elements of the LLL matrix

  5. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

    Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

  6. AFRRI TRIGA Reactor water quality monitoring program

    International Nuclear Information System (INIS)

    Moore, Mark; George, Robert; Spence, Harry; Nguyen, John

    1992-01-01

    AFRRI has started a water quality monitoring program to provide base line data for early detection of tank leaks. This program revealed problems with growth of algae and bacteria in the pool as a result of contamination with nitrogenous matter. Steps have been taken to reduce the nitrogen levels and to kill and remove algae and bacteria from the reactor pool. (author)

  7. 1994 Ergonomics Program Quality Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Longbotham, L.; Miller, D.P.

    1995-06-01

    A telephone survey was conducted to evaluate the quality of service provided to the primary customers of the Corporate Ergonomics Group (CEG). One hundred clients who received services between October 1993 and June 1994 were asked questions on their expectations, implementation of ergonomic recommendations, follow-ups, time required, productivity improvements, symptom alleviation, and satisfaction. Suggestions on how processes could be improved were also solicited. In general, recommendations are being implemented, worksite evaluations are going smoothly, and customers are satisfied with the process. The CEG was pleased to learn that half of the people who implemented recommendations experienced improvements in productivity, and four out of five symptomatic customers experienced partial or complete relief. Through analysis of the data and by studying clients` suggestions for process improvement, the CEG has developed a strategy for changing and improving current procedures and practices. These plans can be found in the last section of this report.

  8. Prototype international quality assurance program

    International Nuclear Information System (INIS)

    Broadway, J.A.; Chambless, D.A.; Sapozhnikov, Yu.A.; Kalmykov, S.N.

    1998-01-01

    The international community presently lacks the ability to determine the quality and credibility of environmental measurements that is required to make sound decisions in matters related to international security, public health, and investment-related considerations. The ultimate goal of the work described in this article is to develop a credible information base including measurement capability for determination of environmental contamination and the potential for proliferation of material components of chemical or nuclear weapons. This study compared the accuracy obtained by six Russian and six U.S. laboratories for samples representative of classes of trace metals, dioxing-furans, and radioactive substances. The results obtained in this work indicate that current estimates for laboratory accuracy are likely overly optimistic. The weaknesses discovered by this prototype U.S. - Russia study also exist within the broader international community of laboratories. Further work is proposed to address the urgent need for the international community to improve performance evaluations for analytical measurements. (author)

  9. 21 CFR 1304.24 - Records for maintenance treatment programs and detoxification treatment programs.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Records for maintenance treatment programs and detoxification treatment programs. 1304.24 Section 1304.24 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION... treatment programs and detoxification treatment programs. (a) Each person registered or authorized (by...

  10. A Wilderness Challenge Program as Correctional Treatment.

    Science.gov (United States)

    Harris, Patricia M.; And Others

    1993-01-01

    Considers challenge programs as treatment for adult offenders, focusing on APPEL (Adult Probation Positive Experiential Learning) program. Describes development of such offender programs, discusses how particular activities might be used to increase probationers' receptivity to traditional treatment services, examines reasons for apparent success…

  11. Evaluation of a lifestyle modification program for treatment of overweight and nonmorbid obesity in primary healthcare and its influence on health-related quality of life.

    Science.gov (United States)

    Arrebola, E; Gómez-Candela, C; Fernández-Fernández, C; Loria, V; Muñoz-Pérez, E; Bermejo, L M

    2011-06-01

    The impact of overweight and nonmorbid obesity on health-related quality of life (HRQL) has not been widely researched. The aim of this study was to evaluate the effects of a lifestyle modification program (LMP) focused on diet, exercise, and psychological support on HRQL in overweight and nonmorbidly obese patients treated in a primary healthcare setting. Sixty patients with grade II overweight and nonmorbid grade I-II obesity were included in this open pilot clinical trial; subjects' ages ranged from 18 to 50 years. They were provided with an LMP combining nutrition education, physical activity, and psychological support. Subjects attended group sessions every 2 weeks. The main outcome measures at baseline and 6 months were body composition parameters (body mass index, body fat percentage, and waist circumference) and HRQL using the 1.4 Spanish version of the SF-36 questionnaire. The questionnaire yields an 8-scale profile of physical functioning (PF), role--physical (RP), bodily pain (BP), vitality (VT), social functioning (SF), role--emotional (RE), mental health (MH), and general health (GH) factors. The LMP achieved improvements in SF-36 subscales at the end of the intervention: PF (80.37 ± 18.90 vs 89.40 ± 13.95, P obese patients treated in a primary healthcare center.

  12. 200 Area Liquid Effluent Facilities -- Quality assurance program plan

    International Nuclear Information System (INIS)

    Fernandez, L.

    1995-01-01

    This Quality Assurance Program Plan (QAPP) describes the quality assurance and management controls used by the 200 Area Liquid Effluent Facilities (LEF) to perform its activities in accordance with DOE Order 5700.6C. The 200 Area LEF consists of the following facilities: Effluent Treatment Facility (ETF); Treated Effluent Disposal Facility (TEDF); Liquid Effluent Retention facility (LERF); and Truck Loading Facility -- (Project W291). The intent is to ensure that all activities such as collection of effluents, treatment, concentration of secondary wastes, verification, sampling and disposal of treated effluents and solids related with the LEF operations, conform to established requirements

  13. 42 CFR 422.152 - Quality improvement program.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality improvement... those plans, an ongoing quality improvement program that meets applicable requirements of this section...

  14. Wolf Creek quality trend analysis program

    International Nuclear Information System (INIS)

    Rudolph, W.J. II; Lindsay, W.M.

    1987-01-01

    The Wolf Creek quality trend analysis program has been designed with three primary objectives in mind: (1) to provide a statistically relevant diagnostic and trend identification tool to improve plant availability and reliability; (2) to communicate clearly and concisely need-to-know information to management personnel; and (3) to provide an additional method of obtaining corrective actions to significant quality issues. The analysis methodology uses a relatively sophisticated computer program to continuously evaluate a large data base of current, significant problems. The evaluation process groups similar problems according to their alphanumeric codes and highlights these problems whenever they exceed an established statistical control limit. A root cause analysis is performed by quality department personnel who then combine the various computer-generated graphical summaries into a short, concise trend analysis report. Other essential features of the program include measures for following identified adverse trends and implementing formal corrective actions when necessary. The results of diagnostic and trend analysis graphical summaries are considered important additions to the corrective action program at Wolf Creek. The report provides all levels of management with concise and easily interpreted information concerning quality indicators and trends

  15. An operational health physics quality assurance program

    International Nuclear Information System (INIS)

    Costigan, S.A.; McAtee, J.L. III; Somers, W.M.; Huchton, R.L.

    1996-01-01

    DOE Order 5700.6C, Quality Assurance, stipulates QA requirements for all DOE activities. This order is now codified as 10CFR830.120, Nuclear Safety Management, Quality Assurance Requirements, which is applicable to DOE nuclear facilities. A Quality Assurance Management Plan (QAMP) was developed by the Health Physics Operations Group (ESH-1) at Los Alamos National Laboratory (LANL). The goal of the ESH-1 QAMP is to ensure that operational radiation protection activities meet the criteria outlined in DOE Order 5700.6C, DOE-ER-STD-6001-92 and 10CFR830.120. The ten required elements are QA Program, Personal Training and Qualifications, Quality Improvement, Documents and Records, Work Processes, Design, Procurement, Inspection and Acceptance Testing, Management Assessment and Independent Assessment. The QAMP has been useful for the development of QAMPs at nuclear facilities and has helped ensure uniformity of institutional requirements where Health Physics services are deployed to facilities. To implement a subset of QAMP requirements, a Quality Assurance Self-Evaluation Program (QASE) was established. This program provides a novel self-audit mechanism for the formal identification and correction of non-conforming items related to Operational Health Physics. Additionally, the QASE is a useful management tool for Radiological Control Technician Supervisors and staff and provides a tracking mechanism for ongoing problem areas. Data have been Collected for two calendar years on a number of concerns that fall into four general categories: radiological posting and labeling, instrumentation, monitoring requirements, and radiological documents/records

  16. 40 CFR 65.116 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement program for pumps... PROGRAMS (CONTINUED) CONSOLIDATED FEDERAL AIR RULE Equipment Leaks § 65.116 Quality improvement program for... improvement program starting at performance trials. (d) QIP requirements. The quality improvement program...

  17. Quality assurance programs from laboratories offering radiological protection services

    International Nuclear Information System (INIS)

    Marrero Garcia, M.; Prendes Alonso, M.; Jova Sed, L.; Morales Monzon, J.A.

    1998-01-01

    The implementation of an adequate program for quality assurance in institutions servicing radiological protection programs will become an additional tool to achieve security targets included in that program. All scientific and technical services offered by CPHR employ quality assurance systems

  18. Assessing Outpatient Drug Abuse Treatment Programs.

    Science.gov (United States)

    Tims, Frank M.; And Others

    1992-01-01

    Data about outpatient treatment unit follow-up evaluations drawn from selected evaluation items in the recent National Drug Abuse Treatment Survey are reported. Directors and supervisors of 670 units completed surveys describing the follow-up studies. The majority of programs collecting follow-up data used the information for program change. (SLD)

  19. Quality Assurance Program Plan for the Environmental Restoration Program

    International Nuclear Information System (INIS)

    1992-01-01

    The United States Department of Energy (USDOE) has initiated the Environmental Restoration Program (ERP) in an effort to manage, control and remediate existing hazardous, toxic and radioactive wastes generated at the Portsmouth Gaseous Diffusion Plant (PORTS). This ERP Quality Assurance Program Plan (QAPP) is responsive to the PORTS ESH Division QAPP and the ES Environmental Restoration Division (ERD) QAPP. This QAPP establishes the policies, requirements and responsibilities by which an appropriate level of QA shall be implemented within the PORTS-ERP. All PORTS-ERP activities shall be conducted in accordance with the requirements of this document and/or of a project level document which is derivative of this document

  20. Characteristics of Child Sexual Abuse Treatment Programs.

    Science.gov (United States)

    Keller, Robert A.; And Others

    1989-01-01

    This article presents the findings from a nationwide survey of 553 child sexual abuse treatment programs. The survey focused on program context, client, and service characteristics. Most programs were affiliated with a larger agency, focused on treating victims, and relied on a combination of individual, family, dyad, and group therapy approaches.…

  1. National Program of Quality Assurance in Radiotherapy in Cuba

    International Nuclear Information System (INIS)

    Alonso Samper, J. L.; Dominguez Hung, L.; Morales Lopez, J. L.; Alfonso Laguardia, R.; Garcia Yip, F.

    2001-01-01

    It tries on the establishment of a Quality Assurance Nacional System, a Quality Assurance Committee implemented in Cuba, and a Quality Auditory National Program implemented in Cuba to control and assure radiotherapy quality

  2. 7 CFR 58.141 - Alternate quality control program.

    Science.gov (United States)

    2010-01-01

    ... Service 1 Quality Specifications for Raw Milk § 58.141 Alternate quality control program. When a plant has in operation an acceptable quality program, at the producer level, which is approved by the... 7 Agriculture 3 2010-01-01 2010-01-01 false Alternate quality control program. 58.141 Section 58...

  3. Quality assurance applied to an environmental surveillance program

    International Nuclear Information System (INIS)

    Oakes, T.W.; Shank, K.E.; Eldridge, J.S.

    1977-01-01

    A discussion of a quality assurance program applied to environmental surveillance activities is presented. This includes the philosophy and concepts of quality assurance, along with a detailed assessment of the sources of uncertainty in a monitoring program. The role management must play for a successful program is also discussed, and the quality assurance program implemented at Oak Ridge National Laboratory is presented

  4. 40 CFR 63.176 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for pumps... improvement program starting at performance trials. (d) The quality improvement program shall include the...), for each pump in each process unit (or plant site) subject to the quality improvement program. The...

  5. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Molvin, Lior Z. [Stanford Hospital and Clinics, Stanford, CA (United States); Wang, Jia [Stanford University, Environmental Health and Safety, Stanford, CA (United States)

    2014-10-15

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  6. Pediatric CT quality management and improvement program

    International Nuclear Information System (INIS)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik; Molvin, Lior Z.; Wang, Jia

    2014-01-01

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  7. Management practices in substance abuse treatment programs.

    Science.gov (United States)

    McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis

    2009-07-01

    Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.

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

    Science.gov (United States)

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

    2012-01-01

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

  9. Methods of Software Quality Assurance under a Nuclear Quality Assurance Program

    International Nuclear Information System (INIS)

    Kim, Jang Yeol; Lee, Young Jun; Cha, Kyung Ho; Cheon, Se Woo; Lee, Jang Soo; Kwon, Kee Choon

    2005-01-01

    This paper addresses a substantial implementation of a software quality assurance under a nuclear quality assurance program. The relationship of the responsibility between a top-level nuclear quality assurance program such as ASME/NQA-1 and its lower level software quality assurance is described. Software quality assurance activities and software quality assurance procedures during the software development life cycle are also described

  10. Environmental Restoration Quality Program Plan. Environmental Restoration Program

    Energy Technology Data Exchange (ETDEWEB)

    Colley, J.S.

    1992-08-01

    The Martin Marietta Energy Systems, Inc., Environmental Restoration (ER) Program was initially chartered on October 1, 1989, as a ``entral Environmental Restoration Division`` to manage the investigation and remediation of inactive sites and facilities that have been declared surplus and have no further programmatic use. The Energy Systems ER Division was established to support the DOE Oak Ridge Field Office (DOE-OR) consolidated ER Program. The DOE-OR Assistant Manager for Environmental Restoration and Waste Management provides program and budget direction to the Energy Systems ER Program for environmental restoration activities at the sites operated by Energy Systems (Oak Ridge K-25 Site, Oak Ridge National Laboratory, Oak Ridge Y-12 Plant, Paducah Gaseous Diffusion Plant, Portsmouth Gaseous Diffusion Plant) and at the off-site locations. The Energy Systems ER Division is specifically charged with assessing these sites for potential contamination and managing the cleanup processes. The Energy Systems Environmental Restoration Division was chartered on October 1, 1989, as a central organization to manage the Remedial Action (RA) Program. The purpose of this document is to ensure that: senior ER management provides planning, organization, direction, control, and support to achieve the organization`s objectives; the line organization achieves quality; and overall performance is reviewed and evaluated using a rigorous assessment process.

  11. Retention in care, viral suppression, treatment adherence and quality of life in a public antiretroviral therapy program in Addis Ababa, Ethiopia

    NARCIS (Netherlands)

    Mekuria, L.A.

    2016-01-01

    In his thesis, Legese A. Mekuria presents the results of a PhD study which was undertaken in 10 health-care facilities in Addis Ababa, Ethiopia. The overall aim was to estimate retention in HIV care, viral suppression, medication adherence and patients’ health-related quality of life (HRQoL). An

  12. 76 FR 46814 - Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts...

    Science.gov (United States)

    2011-08-03

    ...] Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts (10th... evaluate the effectiveness and efficiency of Quality Improvement Organizations (QIOs) that will enter into... and efficient performance of contract obligations by the Quality Improvement Organizations (QIOs), and...

  13. [Workplace health promotion program quality evaluation questionnaire].

    Science.gov (United States)

    Korzeniowska, Elzbieta; Puchalski, Krzysztof

    2002-01-01

    There are substantial reasons for undertaking the evaluation of workplace health promotion (WHP) programs. The most important ones are: (a) the need to guarantee a competent organization of programs; (b) the feasibility to evaluate WHP programs, which take the form of medical services offered to employers on the health service market; (c) the need to disseminate the idea and support the workplace health promotion lobby; and (d) the use of evaluation as a tool for analyzing WHP promulgation process. The implementation of the scientifically-based evaluation of health promotion programs carried out in regularly functioning enterprises is very limited, hence the increasing interest in procedures of quality assessment already known and accepted by enterprises. This approach is recommended by the World Health Organization (WHO). In the European Union countries, a questionnaire on the workplace health promotion program evaluation is promulgated within the European Network for Workplace Health Promotion. The National Center for Workplace Health Promotion that coordinates the activities of the National Network for Workplace Health Promotion Centers in Poland has developed a Polish version of the questionnaire adopted to local conditions. The author presents the criteria and the most essential solutions that provided the ground for designing the questionnaire to be used by the organizers of WHP programs in enterprises for self-assessment of their own activities. It reflects the views on the strategy of the WHP evaluation presented by the National Center, and contains a simplified procedure that does not involve control groups so difficult to gather under the concept of "health promoting enterprise". The idea of control groups is usually misunderstood and disapproved by the management of enterprises involved in the implementation of WHP programs.

  14. Quality assurance program for molecular medicine laboratories.

    Science.gov (United States)

    Hajia, M; Safadel, N; Samiee, S Mirab; Dahim, P; Anjarani, S; Nafisi, N; Sohrabi, A; Rafiee, M; Sabzavi, F; Entekhabi, B

    2013-01-01

    Molecular diagnostic methods have played and continuing to have a critical role in clinical laboratories in recent years. Therefore, standardization is an evolutionary process that needs to be upgrade with increasing scientific knowledge, improvement of the instruments and techniques. The aim of this study was to design a quality assurance program in order to have similar conditions for all medical laboratories engaging with molecular tests. We had to design a plan for all four elements; required space conditions, equipments, training, and basic guidelines. Necessary guidelines was prepared and confirmed by the launched specific committee at the Health Reference Laboratory. Several workshops were also held for medical laboratories directors and staffs, quality control manager of molecular companies, directors and nominees from universities. Accreditation of equipments and molecular material was followed parallel with rest of program. Now we are going to accredit medical laboratories and to evaluate the success of the program. Accreditation of medical laboratory will be succeeding if its basic elements are provided in advance. Professional practice guidelines, holding training and performing accreditation the molecular materials and equipments ensured us that laboratories are aware of best practices, proper interpretation, limitations of techniques, and technical issues. Now, active external auditing can improve the applied laboratory conditions toward the defined standard level.

  15. USAF Mobility Program Water Treatment System.

    Science.gov (United States)

    also be necessary. Water treatment systems are presented which can be developed to yield potable water from these sources. The proposed systems can be designed to meet the requirements of the Bare Base Mobility Program. (Author)

  16. 40 CFR 63.175 - Quality improvement program for valves.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for valves... alternative quality improvement programs specified in paragraphs (d) and (e) of this section. The decision to... § 63.168 and § 63.175. (1) If the owner or operator elects to continue the quality improvement program...

  17. 40 CFR 63.1035 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Quality improvement program for pumps... owner or operator shall resume the quality improvement program starting at performance trials. (d) QIP requirements. The quality improvement program shall meet the requirements specified in paragraphs (d)(1...

  18. Quality assurance program plan for radionuclide airborne emissions monitoring

    International Nuclear Information System (INIS)

    Boom, R.J.

    1995-12-01

    This Quality Assurance Program Plan identifies quality assurance program requirements and addresses the various Westinghouse Hanford Company organizations and their particular responsibilities in regards to sample and data handling of radiological airborne emissions. This Quality Assurance Program Plan is prepared in accordance with and to written requirements

  19. Minnesota 4-H Youth Program Quality Improvement Model

    Science.gov (United States)

    Herman, Margo; Grant, Samantha

    2015-01-01

    The University of Minnesota Extension Center for Youth Development made an organizational decision in 2011 to invest in a system-wide approach to implement youth program quality into the 4-H program using the Youth Program Quality Assessment (YPQA) tool. This article describes the four key components to the Minnesota Youth Program Quality…

  20. Quality assurance program in diagnostic radiology

    International Nuclear Information System (INIS)

    Yacovenco, Alejandro; Borges, J.C.

    1994-01-01

    Aiming to elaborate a methodology to optimize the performance of the Radiology Service of the Military Police Hospital, in Rio dee Janeiro, some goals were established: improvement of the attendance to patients; improvement of the qualification of technicians; achievement and maintenance of high degrees of quality in each step of the radiological process; improvement of the image quality; optimization of dose per examination and cost reduction. The procedure used to detect faults in the radiological process was the analysis of causes of film losses. Results show a 70% reduction in the film rejection rate. 74% of total identified faults were due to equipment, 11% to films, 10% to patients and 5% to developing. The reduction in the cost of developed film reached 75%. A training course given to the staff of the radiological service fully reached its goals, contributing, with the staff motivation, mostly to the success of the program. This success indicates that, with a serious persistent work, it is possible to offer to patients services within their expectations, even at a public hospital. Such programs should be supported by health authorities, not only due to their technical and economic needs but, mostly, due to their social implications. (author). 10 refs., 11 figs

  1. Sandia National Laboratories, California Air Quality Program annual report.

    Energy Technology Data Exchange (ETDEWEB)

    Gardizi, Leslee P.; Smith, Richard (ERM, Walnut Creek, CA)

    2009-06-01

    The annual program report provides detailed information about all aspects of the SNL/CA Air Quality Program. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. The program report describes the activities undertaken during the past year, and activities planned in future years to implement the Air Quality Program, one of six programs that supports environmental management at SNL/CA.

  2. Multidisciplinary intensive rehabilitation treatment improves sleep quality in Parkinson's disease.

    Science.gov (United States)

    Frazzitta, Giuseppe; Maestri, Roberto; Ferrazzoli, Davide; Riboldazzi, Giulio; Bera, Rossana; Fontanesi, Cecilia; Rossi, Roger P; Pezzoli, Gianni; Ghilardi, Maria F

    2015-01-01

    Sleep disturbances are among the most common non-motor symptoms of Parkinson's disease (PD), greatly interfering with daily activities and diminishing life quality. Pharmacological treatments have not been satisfactory because of side effects and interactions with anti-parkinsonian drugs. While studies have shown that regular exercise improves sleep quality in normal aging, there is no definitive evidence in PD. In a retrospective study, we determined whether an intense physical and multidisciplinary exercise program improves sleep quality in a large group of patients with PD. We analyzed the scores of PD Sleep Scale (PDSS), which was administered twice, 28 days apart, to two groups of patients with PD of comparable age, gender, disease duration and pharmacological treatment. The control group (49 patients) did not receive rehabilitation, The treated group (89 patients) underwent a 28-day multidisciplinary intensive rehabilitation program (three one-hour daily sessions comprising cardiovascular warm-up, relaxation, muscle-stretching, balance and gait training, occupational therapy to improve daily living activities). At enrolment, control and treated groups had similar UPDRS and PDSS scores. At re-test, 28 days later, UPDRS and total PDSS scores improved in the treated (p improvement in PDSS scores for sleep quality, motor symptoms and daytime somnolence. The control group did not show improvement for any item. These results suggest that multidisciplinary intensive rehabilitation treatment may have a positive impact on many aspects of sleep in PD.

  3. Outcome of Minnesota's gambling treatment programs.

    Science.gov (United States)

    Stinchfield, R; Winters, K C

    2001-01-01

    This study measured the outcome of four state-supported outpatient gambling treatment programs in Minnesota. The programs were developed specifically for the treatment of pathological gamblers and offered multiple modalities of treatment including individual, group, education, twelve-step work, family groups, and financial counseling. The therapeutic orientation was eclectic with an emphasis on the twelve steps of Gamblers Anonymous (GA) and a treatment goal of abstinence. The sample included 348 men and 220 women treated between January 1992 and January 1995. A pretest-posttest design was utilized with multidimensional assessments obtained at intake, discharge, six-months, and twelve-months post-discharge. Variables assessed included a range of clinical and outcome variables. At six month follow-up, 28% reported that they had abstained from gambling during the six months following discharge and an additional 20% had gambled less than once per month. Almost half of the sample (48%) showed clinically significant improvement in gambling frequency at six month follow-up. Outcome variables of gambling frequency, SOGS scores, amount of money gambled, number of friends who gamble, psychosocial problems, and number of financial problems, all showed statistically significant improvements from pretreatment to follow-up. The treatment programs yielded outcome results similar to those reported for alcohol and drug abuse treatment programs.

  4. Commercial waste treatment program annual progress report for FY 1983

    Energy Technology Data Exchange (ETDEWEB)

    McElroy, J.L.; Burkholder, H.C. (comps.)

    1984-02-01

    This annual report describes progress during FY 1983 relating to technologies under development by the Commercial Waste Treatment Program, including: development of glass waste form and vitrification equipment for high-level wastes (HLW); waste form development and process selection for transuranic (TRU) wastes; pilot-scale operation of a radioactive liquid-fed ceramic melter (LFCM) system for verifying the reliability of the reference HLW treatment proces technology; evaluation of treatment requirements for spent fuel as a waste form; second-generation waste form development for HLW; and vitrification process control and product quality assurance technologies.

  5. Quality Assurance Program Plan (QAPP) Waste Management Project

    Energy Technology Data Exchange (ETDEWEB)

    VOLKMAN, D.D.

    1999-10-27

    This document is the Quality Assurance Program Plan (QAPP) for Waste Management Federal Services of Hanford, Inc. (WMH), that implements the requirements of the Project Hanford Management Contract (PHMC), HNF-MP-599, Project Hanford Quality Assurance Program Description (QAPD) document, and the Hanford Federal Facility Agreement with Consent Order (Tri-Party Agreement), Sections 6.5 and 7.8. WHM is responsible for the treatment, storage, and disposal of liquid and solid wastes generated at the Hanford Site as well as those wastes received from other US Department of Energy (DOE) and non-DOE sites. WMH operations include the Low-Level Burial Grounds, Central Waste Complex (a mixed-waste storage complex), a nonradioactive dangerous waste storage facility, the Transuranic Storage Facility, T Plant, Waste Receiving and Processing Facility, 200 Area Liquid Effluent Facility, 200 Area Treated Effluent Disposal Facility, the Liquid Effluent Retention Facility, the 242-A Evaporator, 300 Area Treatment Effluent Disposal Facility, the 340 Facility (a radioactive liquid waste handling facility), 222-S Laboratory, the Waste Sampling and Characterization Facility, and the Hanford TRU Waste Program.

  6. USAID program for the prevention and treatment of vaginal fistula.

    Science.gov (United States)

    MacDonald, P; Stanton, M E

    2007-11-01

    The cornerstone of the US Agency for International Development (USAID) fistula program is to support and strengthen local capacity for fistula repair. The USAID program includes support to upgrade facilities, enhance local surgical repair capability, allocate equipment and supplies to operating rooms, implement quality improvement systems, and cover the women's transportation costs to and from the treatment facilities. The program also offers training in clinical and counseling skills; transferring skills South-to-South; and monitoring and evaluating the program's effectiveness. As new fistula cases continually increase the backlog of untreated cases, its efforts are also directed toward the prevention of fistula and the reintegration of treated women into their communities. Furthermore, the program challenges the culture of sexual violence against women that leads to traumatic gynecologic fistulas.

  7. Cuban experience in dosimetry quality audit program in radiotherapy

    International Nuclear Information System (INIS)

    Alonso-Samper, J.L.; Dominguez, L.; Yip, F.G.; Laguardia, R.A.; Morales, J.L.; Larrinaga, E.

    2002-01-01

    Full text: Five years ago we started a National Program of Quality Assurance in Radiotherapy. This program was possible thanks to the cooperation between the Cuban Ministry of Health and the International Atomic Energy Agency (IAEA) in the Projects ARCAL XXX and CUB/6/011. In the framework of these projects a total of ten complete dosimetry set were acquired and a large number of medical physicists were trained. At the same time, the Cuban side signed a contract for nine cobalt units, which have been gradually installed and all of them are running at the moment. During more than 20 years Cuba has taken part in the IAEA/WHO TLD postal dose audit programs and our results have been inside the (+/-)5 % acceptance limit. Cuba also joined the IAEA Coordinated Research Program E2 40 07, to extend at a national level the experience of the TLD based audits, using the capability of our SSDL to measure TLD. At the same time the work of the already existing External Audit Group was consolidated. The National Program of Quality Assurance in Radiotherapy works on base of external on-site visits. The main objective is to avoid any accident and to improve the quality of the RT treatments. Every year each Radiotherapy service is visited by a qualified team of physicists with the objective to check the physical aspects of the quality of the RT treatment, it includes: Documents and Records, safety, mechanical and dosimetric aspects, treatment planning, also we use the fixed depth phantom to simulate and verify several techniques. Although the TLD postal audit results are acceptable, in our QA audits we have detected some problems that may deviate the dose delivery to patients in more than 5%, examples of which are: Not all the clinical plans are redundantly checked by an independent person; Not all the controls (daily, monthly and annual) are performed according to the protocols approved by the National QA Committee. In some cases the controls are not well recorded; Clinical

  8. Food and Nutrition Services Quality Control Management Program.

    Science.gov (United States)

    Wimsatt-Fraim, Teresa S.

    A program was conducted to improve the quality of food service through the training of 44 food and nutrition service employees in a 200-bed hospital. A 12-week quality control program was implemented to address four key areas: food temperatures, food accuracy, food quality, and dietary personnel. Learning strategies, emphasizing critical thinking…

  9. 18 CFR 12.40 - Quality control programs.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Quality control... PROJECT WORKS Other Responsibilities of Applicant or Licensee § 12.40 Quality control programs. (a... meeting any requirements or standards set by the Regional Engineer. If a quality control program is...

  10. Implementation of a laboratory quality assurance program: the Louisville experience.

    Science.gov (United States)

    Metz, Michael J; Abdel-Azim, Tamer; Miller, Cynthia J; Lin, Wei-Shao; ZandiNejad, Amirali; Oliveira, Gustavo M; Morton, Dean

    2014-02-01

    Remakes, or the refabrication of dental prostheses, can occur as a result of inherent inaccuracies in both clinical and laboratory procedures. Because dental schools manage large numbers of predoctoral dental students with limited familiarity and expertise as related to clinical prosthodontic techniques, it is likely these schools will experience an elevated incidence of laboratory remakes and their ramifications. The University of Louisville School of Dentistry, not unlike other dental schools, has experienced remakes associated with both fixed and removable prosthodontic procedures. Limitations in faculty standardization and variable enforcement of established preclinical protocols have been identified as variables associated with the high percentage of remakes documented. The purpose of this study was to introduce the implementation of a new multidepartmental quality assurance program designed to increase consistency and quality in both information provided to commercial dental laboratories and the prostheses returned. The program has shown to be advantageous in terms of cost-effectiveness and treatment outcomes. A statistically significant decrease in remake percentages has been recorded from inception of this program in December 2010 until December 2012. Furthermore, this program has resulted in more consistent communication between the dental school and commercial dental laboratories, among faculty members, and between faculty and students.

  11. INFLUENCE OF TREATMENT ON MAIZE SEED QUALITY

    Directory of Open Access Journals (Sweden)

    Ivica Beraković

    2012-12-01

    Full Text Available Due to the increasing occurrence of major pests ON corn, hybrid seed is necessary to be protected against pests and seed corn should be treated with appropriately insecticides. Choosing better technological solutions and choosing and appropriate insecticide seed treatment for corn can significantly reduce pest attack and thus enhance the production of corn. The aim of this research was to obtain based upon result information on the impact of treatment on quality of maize seed as well as the means to improve the conditions of storage and preservation of semen quality. Investigation and checking if insecticide treated seed adverse phytotoxic effect on plant growth and development in field conditions. The results indicate a significant effect of insecticide seed treatments on germination energy and non standard germination. A very significant influence of treated seed storage was also found on quality seeds. Looking at the impact of the treated hybrid on germination vigor and standard germination, a very significant hybrid impact was found out. The highest quality of the seed semen during the study was noticed with the seed of hybrid “H2”, followed by hybrid “H1”, while the hybrids “H3” and “H4” possessed less. The research shows that hybrids “H2” and “H1” are more suitable for seed treatment with insecticides than “H3” and “H4” hybrids. The field observations and research results obtained indicate a very significant impact of the treated seed on the above ground parts of plants, above ground mass, stem thickness and a very significant impact on plant spacing. The positive effect of treatment with “T1” and “T3” insecticides is visible in all conducted field researches. Plants treated with common fungicides and insecticides “T1” and “T3” had a greater height of the above ground plant parts, a larger mass of the above ground stems, greater stem thickness and better plant density treatments, compared to

  12. Long-term effects of HIV treatment in sub-Saharan Africa: from access to quality

    NARCIS (Netherlands)

    Boender, T.S.

    2016-01-01

    As HIV treatment programs in sub-Saharan Africa mature, there are rising concerns about the long-term sustainability and quality of these programs. Increasing levels of HIV drug resistance have been measured in sub-Saharan Africa, and could jeopardize long-term treatment success. This thesis

  13. TU-AB-BRD-04: Development of Quality Management Program

    International Nuclear Information System (INIS)

    Thomadsen, B.

    2015-01-01

    Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before a failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to

  14. TU-AB-BRD-04: Development of Quality Management Program

    Energy Technology Data Exchange (ETDEWEB)

    Thomadsen, B. [University of Wisconsin (United States)

    2015-06-15

    Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before a failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to

  15. Air quality evaluation of Rhode Island's incident management program

    Science.gov (United States)

    1997-09-01

    The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...

  16. Opportunities to Improve Air Quality through Transportation Pricing Programs

    Science.gov (United States)

    This document is intended to give state and local air quality and transportation planners,elected government officials, and other interested parties background information on transportation pricing programs.

  17. Impact of horizontal approach in vertical program: continuous quality improvement of malaria and tuberculosis diagnostic services at primary-level medical laboratories in the context of HIV care and treatment program in Ethiopia.

    Science.gov (United States)

    Marinucci, Francesco; Manyazewal, Tsegahun; Paterniti, Antonio D; Medina-Moreno, Sandra; Wattleworth, Matthew; Hagembe, Juliana; Redfield, Robert R

    2013-03-01

    The use of standardized tools for continuous quality improvement of laboratory services is crucial to identify service gaps, plan targeted interventions, and prove successes. Laboratory quality improvement tools (LQITs) were developed and applied for 18 months at five health centers and one faith-based hospital laboratories in Southwest Showa Zone in Ethiopia to assess and monitor the quality of malaria and acid-fast bacilli (AFB) microscopy total testing processes. For the six laboratories, baseline malaria microscopy scores were 55%, 42%, 52%, 55%, 54%, and 61%. Similarly, baseline AFB microscopy scores were 49%, 41%, 46%, 58%, 44%, and 70%. On the sixth quarter for the first four laboratories and the fourth quarter for the last two laboratories, malaria microscopy scores were 89%, 88%, 88%, 90%, 88%, and 89%, whereas AFB microscopy scores were 90%, 88%, 89%, 95%, 88%, and 90%. All laboratories scored above 85% for both services at the end of interventions.

  18. Influence of different heat treatment programs on properties of sol ...

    Indian Academy of Sciences (India)

    DTA) experiments, five heat treatment programs were developed. All programs lead to single phase perovskite KNN films with random crystal orientation, but only the programs that included a treatment after each single spin-coating step ...

  19. Transuranic Waste Characterization Quality Assurance Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-30

    This quality assurance plan identifies the data necessary, and techniques designed to attain the required quality, to meet the specific data quality objectives associated with the DOE Waste Isolation Pilot Plant (WIPP). This report specifies sampling, waste testing, and analytical methods for transuranic wastes.

  20. Transuranic Waste Characterization Quality Assurance Program Plan

    International Nuclear Information System (INIS)

    1995-01-01

    This quality assurance plan identifies the data necessary, and techniques designed to attain the required quality, to meet the specific data quality objectives associated with the DOE Waste Isolation Pilot Plant (WIPP). This report specifies sampling, waste testing, and analytical methods for transuranic wastes

  1. Challenges and successes of a multidisciplinary pediatric obesity treatment program.

    Science.gov (United States)

    Walsh, Stephanie M; Palmer, Wendy; Welsh, Jean A; Vos, Miriam B

    2014-12-01

    Despite the well-documented need for multidisciplinary pediatric obesity treatment programs, few programs exist and best practices are not clearly defined. We describe the design and initial quality-related outcomes of the Strong4Life multidisciplinary pediatric obesity treatment program along with some challenges and solutions implemented over the first 2 years. The purpose of this report is to inform others interested in designing similar programs. The Strong4Life Clinic obesity program was designed to provide children with the medical care, as well as the behavior change guidance and support needed to reverse their obesity and/or minimize the related health risks. This low-intensity program is designed to provide approximately 6 hours of care over 12 months from a medical provider, psychologist, registered dietitian nutritionist, exercise physiologist, and nurse. Between August 2011 and February 2014, the Strong4Life clinic served 781 high-risk (mean sex- and age-adjusted body mass index [BMI] percentile 98.8) and racially/ethnically diverse (45% non-Hispanic black and 24% Hispanic) patients. Of the 781 patients seen, 66% returned for at least 1 visit. Nearly all returning Strong4Life patients stabilized or improved their BMI (90% of those who participated 6 months, but longer follow-up and assessment of comorbidities are needed. © 2014 American Society for Parenteral and Enteral Nutrition.

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

    Science.gov (United States)

    Haworth, Jennifer Grant; Conrad, Clifton F.

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

  3. Quality assurance program plan fuel supply shutdown project

    International Nuclear Information System (INIS)

    Metcalf, I.L.

    1998-01-01

    This Quality Assurance Program plan (QAPP) describes how the Fuel Supply Shutdown (FSS) project organization implements the quality assurance requirements of HNF-MP-599, Project Hanford Quality Assurance Program Description (QAPD) and the B and W Hanford Company Quality Assurance Program Plan (QAPP), FSP-MP-004. The QAPP applies to facility structures, systems, and components and to activities (e.g., design, procurement, testing, operations, maintenance, etc.) that could affect structures, systems, and components. This QAPP also provides a roadmap of applicable Project Hanford Policies and Procedures (PHPP) which may be utilized by the FSS project organization to implement the requirements of this QAPP

  4. Quality planning and executive force of program files in quality management

    International Nuclear Information System (INIS)

    Sun Danyu

    2008-01-01

    This paper discussed the quality planning in quality management. In the quality planning, the quality objectives, the quality liabilities and the procedures shall be developed, grading supervise shall be exercised, quality assurance program shall be established, and requirements on resource and documents shall be defined. At the same time, we shall also intensify and enhance the execute force of program documentation, supervise and inspect the implementation result, establish detailed check indicators, and bring up the requirement on how to improve the quality of products. (author)

  5. Quality assurance program plan for radionuclide airborne emissions monitoring

    International Nuclear Information System (INIS)

    Boom, R.J.

    1995-03-01

    This Quality Assurance Program Plan identifies quality assurance program requirements and addresses the various Westinghouse Hanford Company organizations and their particular responsibilities in regards to sample and data handling of airborne emissions. The Hanford Site radioactive airborne emissions requirements are defined in National Emissions Standards for Hazardous Air Pollutants (NESHAP), Code of Federal Regulations, Title 40, Part 61, Subpart H (EPA 1991a). Reporting of the emissions to the US Department of Energy is performed in compliance with requirements of US Department of Energy, Richland Operations Office Order 5400.1, General Environmental Protection Program (DOE-RL 1988). This Quality Assurance Program Plan is prepared in accordance with and to the requirements of QAMS-004/80, Guidelines and Specifications for Preparing Quality Assurance Program Plans (EPA 1983). Title 40 CFR Part 61, Appendix B, Method 114, Quality Assurance Methods (EPA 1991b) specifies the quality assurance requirements and that a program plan should be prepared to meet the requirements of this regulation. This Quality Assurance Program Plan identifies NESHAP responsibilities and how the Westinghouse Hanford Company Environmental, Safety, Health, and Quality Assurance Division will verify that the methods are properly implemented

  6. The Marshall Islands radioassay quality assurance program. An overview

    International Nuclear Information System (INIS)

    Hamilton, T.F.; Robison, W.L.; Kehl, S.; Stoker, A.C.; Conrado, C.L.

    2000-01-01

    An extensive quality assurance program to provide high quality data and assessments in support of the Marshall Islands Dose Assessment and Radioecology Program has been developed the Lawrence Livermore National Laboratory. Quality assurance objectives begin with the premise of providing integrated and cost-effective program support (to meet wide-ranging programmatic needs, scientific peer review, and build public confidence) and continue through from design and implementation of large-scale field programs, sampling and sample preparation, radiometric and chemical analyses, documentation of quality assurance/quality control practices, exposure assessments, and dose/risk assessments until publication. The basic structure of the radioassay quality assurance/quality control program can be divided into four essential elements: (1) sample and data integrity control, (2) instrument validation and calibration, (3) method performance testing, validation, development and documentation, and (4) periodic peer review and on-site assessments. While the quality assurance objectives are tailored towards a single research program and the evaluation of major exposure pathways/critical radionuclides pertinent to the Marshall Islands, quality assurance practices that are consistent with proposed criteria designed for laboratory accreditation were attempted to be developed. (author)

  7. The Cost of Quality Out-of-School-Time Programs

    Science.gov (United States)

    Grossman, Jean Baldwin; Lind, Christianne; Hayes, Cheryl; McMaken, Jennifer; Gersick, Andrew

    2009-01-01

    Funders and program planners want to know: What does it cost to operate a high-quality after-school or summer program? This study answers that question, discovering that there is no "right" number. Cost varies substantially, depending on the characteristics of the participants, the goals of the program, who operates it and where it is located.…

  8. Teaching Quality Object-Oriented Programming

    Science.gov (United States)

    Feldman, Yishai A.

    2005-01-01

    Computer science students need to learn how to write high-quality software. An important methodology for achieving quality is design-by-contract, in which code is developed together with its specification, which is given as class invariants and method pre- and postconditions. This paper describes practical experience in teaching design-by-contract…

  9. PREDICTION OF MEAT PRODUCT QUALITY BY THE MATHEMATICAL PROGRAMMING METHODS

    Directory of Open Access Journals (Sweden)

    A. B. Lisitsyn

    2016-01-01

    Full Text Available Abstract Use of the prediction technologies is one of the directions of the research work carried out both in Russia and abroad. Meat processing is accompanied by the complex physico-chemical, biochemical and mechanical processes. To predict the behavior of meat raw material during the technological processing, a complex of physico-technological and structural-mechanical indicators, which objectively reflects its quality, is used. Among these indicators are pH value, water binding and fat holding capacities, water activity, adhesiveness, viscosity, plasticity and so on. The paper demonstrates the influence of animal proteins (beef and pork on the physico-chemical and functional properties before and after thermal treatment of minced meat made from meat raw material with different content of the connective and fat tissues. On the basis of the experimental data, the model (stochastic dependence parameters linking the quantitative resultant and factor variables were obtained using the regression analysis, and the degree of the correlation with the experimental data was assessed. The maximum allowable levels of meat raw material replacement with animal proteins (beef and pork were established by the methods of mathematical programming. Use of the information technologies will significantly reduce the costs of the experimental search and substantiation of the optimal level of replacement of meat raw material with animal proteins (beef, pork, and will also allow establishing a relationship of product quality indicators with quantity and quality of minced meat ingredients.

  10. Continuous quality improvement program for hip and knee replacement.

    Science.gov (United States)

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

    2015-01-01

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

  11. Lake Tahoe Water Quality Improvement Programs

    Science.gov (United States)

    Information on the Lake Tahoe watershed, EPA's protection efforts, water quality issues, effects of climate, change, Lake Tahoe Total Maximum Daily Load (TMDL), EPA-sponsored projects, and list of partner agencies.

  12. Quality assurance program on diagnostic radiology

    International Nuclear Information System (INIS)

    Yacovenco, Alejandro; Borges, Jose Carlos; Mota, Helvecio Correa

    1995-01-01

    Aiming to elaborate a methodology to optimize the performance of the Radiology Service of the Military Police Hospital, in Rio de Janeiro, some goals were established: improvement of the attendance to patients; improvement of the qualification of technicians; achievement and maintenance of high degrees of quality in each step of the radiological process; improvement of the image quality; optimization of dose per examination and cost reduction. (author). 8 refs., 3 figs

  13. Process monitoring using a Quality and Technical Surveillance Program

    International Nuclear Information System (INIS)

    Rafferty, C.A.

    1995-01-01

    The purpose of process monitoring using a Quality and Technical Surveillance Program was to help ensure manufactured clad vents sets fully met technical and quality requirements established by the manufacturer and the customer, and that line and program management were immediately alerted if any aspect of the manufacturing activities drifted out of acceptable limits. The Quality and Technical Surveillance Program provided a planned, scheduled approach to monitor key processes and documentation illuminated potential problem areas early enough to permit timely corrective actions to reverse negative trends that, if left uncorrected, could have resulted in deficient hardware. Significant schedule and cost impacts were eliminated

  14. National Water-Quality Assessment Program: Island of Oahu, Hawaii

    Science.gov (United States)

    Anthony, Stephen S.

    1998-01-01

    During the past 25 years, our Nation has sought to improve its water quality; however, many water-quality issues remain unresolved. To address the need for consistent and scientifically sound information for managing the Nation's water resources, the U.S. Geological Survey began a full-scale National Water-Quality Assessment (NAWQA) Program in 1991. This program is unique compared with other national water-quality assessment studies in that it integrates the monitoring of the quality of surface and ground waters with the study of aquatic ecosystems. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers, (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality. Assessing the quality of water in every location of the Nation would not be practical; therefore, NAWQA Program studies are conducted within a set of areas called study units. These study units represent the diverse geography, water resources, and land and water uses of the Nation. The island of Oahu, Hawaii, is one such study unit designed to supplement water-quality information collected in other study units across the Nation while addressing issues relevant to the island of Oahu.

  15. Nutrition Program Quality Assurance through a Formalized Process of On-Site Program Review

    Science.gov (United States)

    Paddock, Joan Doyle; Dollahite, Jamie

    2012-01-01

    A protocol for a systematic onsite review of the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education was developed to support quality programming and ensure compliance with state guidelines and federal regulations. Onsite review of local nutrition program operations is one strategy to meet this…

  16. Overview of the EPA quality system for environmental programs

    International Nuclear Information System (INIS)

    Johnson, G.L.

    1993-01-01

    Formalized quality assurance program requirements for the U.S. Environmental Protection Agency (EPA) have been established for more than a decade. During this period, the environmental issues and concerns addressed by the EPA have changed. Many issues, such as ozone depletion and global climate warming, have become international concerns among the world environmental community. Other issues, such as hazardous waste cleanup and clean air, remain a focus of national environmental concerns. As the environmental issues of the 1980's evolved, the traditional quality assurance (QA) program was transformed through the use of quality management principles into a Quality System to help managers meet the needs of the 1990's and beyond

  17. Water quality modelling and optimisation of wastewater treatment ...

    African Journals Online (AJOL)

    2016-10-04

    Oct 4, 2016 ... Using this model, it was demonstrated that water quality standards can be met at all monitoring points at a minimum cost by simultaneously optimising treatment levels at each treatment plant. Keywords: instream water quality, mixed integer optimisation, wastewater treatment levels, Streeter-Phelps.

  18. Perceived Autonomy Support in the NIMH RAISE Early Treatment Program.

    Science.gov (United States)

    Browne, Julia; Penn, David L; Bauer, Daniel J; Meyer-Kalos, Piper; Mueser, Kim T; Robinson, Delbert G; Addington, Jean; Schooler, Nina R; Glynn, Shirley M; Gingerich, Susan; Marcy, Patricia; Kane, John M

    2017-09-01

    This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

  19. 78 FR 44575 - Sickle Cell Disease Treatment Demonstration Program

    Science.gov (United States)

    2013-07-24

    ... Extension: Sickle Cell Disease Treatment Demonstration Program (U1E) Awards to Three Currently Funded... the Sickle Cell Disease Treatment Demonstration Program. Three of these awards will end on August 31.... Justification: The Sickle Cell Disease Treatment Demonstration Program provides grants to evaluate the use of...

  20. Program Director Participation in a Leadership and Management Skills Fellowship and Characteristics of Program Quality.

    Science.gov (United States)

    Carek, Peter J; Mims, Lisa D; Conry, Colleen M; Maxwell, Lisa; Greenwood, Vicki; Pugno, Perry A

    2015-01-01

    The association between a residency program director completing a leadership and management skills fellowship and characteristics of quality and innovation of his/her residency program has not been studied. Therefore, the aim of this study is to examine the association between a residency program director's completion of a specific fellowship addressing these skills (National Institute for Program Director Development or NIPDD) and characteristics of quality and innovation of the program they direct. Using information from the American Academy of Family Physicians (AAFP), National Resident Matching Program (NRMP) and FREIDA® program characteristics were obtained. Descriptive statistics were used to summarize the data. The relationship between programs with a NIPDD graduate as director and program quality measures and indicators of innovation was analyzed using both chi square and logistic regression. Initial analyses showed significant associations between the NIPDD graduate status of a program director and regional location, mean years of program director tenure, and the program's 5-year aggregate ABFM board pass rate from 2007--2011. After grouping the programs into tertiles, the regression model showed significant positive associations with programs offering international experiences and being a NIPDD graduate. Program director participation in a fellowship addressing leadership and management skills (ie, NIPDD) was found to be associated with higher pass rates of new graduates on a Board certification examination and predictive of programs being in the upper tertile of programs in terms of Board pass rates.

  1. National Irrigation Water Quality Program Data-Synthesis Data Base

    National Research Council Canada - National Science Library

    Seiler, Ralph L; Skorupa, Joseph P

    2001-01-01

    Under the National Irrigation Water Quality Program (NIWQP) of the U.S. Department of the Interior, researchers investigated contamination caused by irrigation drainage in 26 areas in the Western United States from 1986 to 1993...

  2. SWMM 5 REDEVELOPMENT QUALITY ASSURANCE PROGRAM

    Science.gov (United States)

    EPA recently released a new version of the Storm Water Management Model (SWMM) that combines a new interface with a completely re-written computational engine. The SWMM redevelopment project proceeded under a Quality Assurance Project Plan (QAPP) that describes methods and proced...

  3. Implications of Continuous Quality Improvement for Program Evaluation and Evaluators.

    Science.gov (United States)

    Mark, Melvin M.; Pines, Edward

    1995-01-01

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

  4. External quality control program: Experience in the department of ...

    African Journals Online (AJOL)

    Objective: To share experiences and lessons learned from 2002 National External Quality Assessment Schemes for Leukocyte Immunophenotyping (UK NEQAS) and College of American Pathologists (CAP) proficiency testing (PT) panels received and tested as part of External Quality Control Program Setting: Department ...

  5. Family and Community Perceptions of Quality in Juvenile Justice Programs

    Science.gov (United States)

    Selber, Katherine; Streeter, Calvin

    2004-01-01

    The conceptualization and empirical assessment of service quality in juvenile justice remains limited. There are few reports on programmatic attempts to assess satisfaction in juvenile justice programs or attempts to include what constitutes quality of service from multiple customer perspectives. This article describes a potential model, the Gap…

  6. Quality assurance program description for shipping packages of radioactive material

    International Nuclear Information System (INIS)

    1978-01-01

    This quality assurance plan describes the quality assurance program at the Pacific Northwest Laboratory (PNL), for shipping packages of radioactive material. The purpose of this report is to describe how PNL will comply with the Code of Federal Regulations, Title 10, Part 71, Appendix E. In compliance with the instructions from the Nuclear Regulatory Commission (NRC), the 18 criteria from Appendix E are covered

  7. Quality Assurance Program Plan for radionuclide airborne emissions monitoring

    International Nuclear Information System (INIS)

    Vance, L.M.

    1993-07-01

    This Quality Assurance Program Plan (QAPP) describes the quality assurance requirements and responsibilities for radioactive airborne emissions measurements activities from regulated stacks are controlled at the Hanford Site. Detailed monitoring requirements apply to stacks exceeding 1% of the standard of 10 mrem annual effective dose equivalent to the maximally exposed individual from operations of the Hanford Site

  8. Quality Assurance Program Plan for radionuclide airborne emissions monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Vance, L.M.

    1993-07-01

    This Quality Assurance Program Plan (QAPP) describes the quality assurance requirements and responsibilities for radioactive airborne emissions measurements activities from regulated stacks are controlled at the Hanford Site. Detailed monitoring requirements apply to stacks exceeding 1% of the standard of 10 mrem annual effective dose equivalent to the maximally exposed individual from operations of the Hanford Site.

  9. Department of Energy hazardous waste remedial actions program: Quality assurance program

    International Nuclear Information System (INIS)

    Horne, T.E.

    1988-01-01

    This paper describes the Quality Assurance Program developed for the Hazardous Waste Remedial Actions Program Support Contractor Office (HAZWRAP SCO). Key topics discussed include an overview of the HAZWRAP SCO mission and organization, the basic quality assurance program requirements and the requirements for the control of quality for the Department of Energy and Work for Others hazardous waste management programs, and the role of ensuring quality through the project team concept for the management of remedial response actions. The paper focuses on planning for quality assurance for this remedial waste management process from preliminary assessments of remedial sites to feasibility studies. Some observations concerning the control of quality during the implementation of remedial actions are presented. (2 refs.)

  10. Evaluation of a quality control program in radiodiagnosis

    International Nuclear Information System (INIS)

    Yacovenco, Alejandro; Infantosi, A.F.C.; Tauhata, L.

    1996-01-01

    A quality assurance program, implemented at the Radiologic Service of the Hospital of the Military Police in Rio de Janeiro, Brazil, is evaluated. The results show a reduction around of 70% in the number of rejected films and 75% in the costs. A return to the former conditions is reported as after the discontinuation of the program

  11. 10 CFR 830.121 - Quality Assurance Program (QAP).

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Quality Assurance Program (QAP). 830.121 Section 830.121... Assurance Program (QAP). (a) Contractors conducting activities, including providing items or services, that... must: (1) Submit a QAP to DOE for approval and regard the QAP as approved 90 days after submittal...

  12. A quality audit program for external beam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-12-31

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

  13. A quality audit program for external beam radiotherapy

    International Nuclear Information System (INIS)

    Hanson, W.F.; Stovall, M.

    1993-01-01

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

  14. Integer programming for improving radiotherapy treatment efficiency.

    Science.gov (United States)

    Lv, Ming; Li, Yi; Kou, Bo; Zhou, Zhili

    2017-01-01

    Patients received by radiotherapy departments are diverse and may be diagnosed with different cancers. Therefore, they need different radiotherapy treatment plans and thus have different needs for medical resources. This research aims to explore the best method of scheduling the admission of patients receiving radiotherapy so as to reduce patient loss and maximize the usage efficiency of service resources. A mix integer programming (MIP) model integrated with special features of radiotherapy is constructed. The data used here is based on the historical data collected and we propose an exact method to solve the MIP model. Compared with the traditional First Come First Served (FCFS) method, the new method has boosted patient admission as well as the usage of linear accelerators (LINAC) and beds. The integer programming model can be used to describe the complex problem of scheduling radio-receiving patients, to identify the bottleneck resources that hinder patient admission, and to obtain the optimal LINAC-bed radio under the current data conditions. Different management strategies can be implemented by adjusting the settings of the MIP model. The computational results can serve as a reference for the policy-makers in decision making.

  15. Integer programming for improving radiotherapy treatment efficiency

    Science.gov (United States)

    Lv, Ming; Kou, Bo; Zhou, Zhili

    2017-01-01

    Background and purpose Patients received by radiotherapy departments are diverse and may be diagnosed with different cancers. Therefore, they need different radiotherapy treatment plans and thus have different needs for medical resources. This research aims to explore the best method of scheduling the admission of patients receiving radiotherapy so as to reduce patient loss and maximize the usage efficiency of service resources. Materials and methods A mix integer programming (MIP) model integrated with special features of radiotherapy is constructed. The data used here is based on the historical data collected and we propose an exact method to solve the MIP model. Results Compared with the traditional First Come First Served (FCFS) method, the new method has boosted patient admission as well as the usage of linear accelerators (LINAC) and beds. Conclusions The integer programming model can be used to describe the complex problem of scheduling radio-receiving patients, to identify the bottleneck resources that hinder patient admission, and to obtain the optimal LINAC-bed radio under the current data conditions. Different management strategies can be implemented by adjusting the settings of the MIP model. The computational results can serve as a reference for the policy-makers in decision making. PMID:28700726

  16. Overall quality assurance program requirements for nuclear power plants

    International Nuclear Information System (INIS)

    1992-09-01

    This standard contains the requirements for the owner's overall quality assurance program for a nuclear power plant. This program encompasses all phases of a nuclear power plant life cycle, including site evaluation, design, procurement, manufacturing, construction and installation, commissioning, operation, and decommissioning. It covers the activities associated with specifying, directing, and administering the work to be done during these phases, and the evaluation and integrated of the activities and programs of participants

  17. UMTRA technical assistance contractor quality assurance program plan

    International Nuclear Information System (INIS)

    1994-10-01

    This Quality Assurance Program Plan (QAPP) provides the primary requirements for the integration of quality functions into all Technical Assistance Contractor (TAC) Project organization activities. The QAPP is the written directive authorized by the TAc Program Manager to accomplish this task and to implement procedures that provide the controls and sound management practices needed to ensure TAC contractual obligations are met. The QA program is designed to use monitoring, audit, and surveillance functions as management tools to ensure that all Project organization functions are executed in a manner that will protect public health and safety, promote the success of the Project, and meet or exceed contract requirements

  18. Three steps to a more successful quality assurance program

    International Nuclear Information System (INIS)

    Ferriss, W.E.

    1975-01-01

    The three steps that will be presented are by no means a cure-all for the variety of problems and challenges that a Quality Assurance (QA) Department is faced with in its role in the design and construction of a nuclear power plant. However, these steps are considered to be three of the most important ones in the realization of an effective and efficient QA program. Step 1. Awareness. With the multitude of people involved in activities that effect the resultant Quality of Design, Procurement, and Construction of a nuclear power plant, a concerted effort has been put forth at Bechtel to promote 'Quality Awareness'. This effort has resulted in presentations to thousands of engineers, buyers, superintendents, supervisors and many others to make them more aware of their role in the Quality program. These presentations cover the Quality criteria, organizations, manuals, and implementation responsibilities that constitute the Company Quality program. In addition to the above, many specialized courses covering inspection techniques, communications, auditing, problem solving, etc. have been given to the people involved in the Generic Quality Assurance functions. Step 2. Attitude. Nuclear Power Quality requirements are quite stringent and have presented additional requirements to engineers, buyers, and superintendents who have previously designed and constructed fossil fuel power plants. Logically there was a resistance to these new requirements and a number of attitudes had to be changed. The most effective way that we have found to accomplish this is through communications from top management expressing their support of the Quality Program. Step 3. Objective and economical compliance. With the increased awareness and a more positive attitude toward Quality requirements, Bechtel has been able to devote considerable effort on finding effective methods to comply with Quality requirements in the most economical way. The complete presentation will include several examples of

  19. Family Income, Parent Education, and Perceived Constraints as Predictors of Observed Program Quality and Parent Rated Program Quality

    Science.gov (United States)

    Torquati, Julia C.; Raikes, Helen H.; Huddleston-Casas, Catherine A.; Bovaird, James A.; Harris, Beatrice A.

    2011-01-01

    Observed child care quality and parent perceptions of child care quality received by children in poor (below Federal Poverty Line, FPL), low-income (between FPL and 200% of FPL), and non-low-income families were examined. Observations were completed in 359 center- and home-based child care programs in four Midwestern states and surveys were…

  20. Communication and quality of life outcomes from an interprofessional intensive, comprehensive, aphasia program (ICAP).

    Science.gov (United States)

    Hoover, Elizabeth L; Caplan, David N; Waters, Gloria S; Carney, Anne

    2017-03-01

    Intensive Comprehensive Aphasia Programs (ICAPs) have developed in response to a growing need for treatments which produce changes in language function in people with aphasia, especially in the chronic phase of recovery. ICAPs are growing in number and several papers have presented preliminary results of their use, but little data exist about their efficacy or effectiveness. This paper explores the communication effects of an ICAP program that incorporated evidenced-based individual and group treatment in an interprofessional program. Twenty-seven individuals with chronic aphasia were provided with 30 h of interprofessional treatment a week for a four-week period in both individual and group formats. A delayed treatment, within-participant research protocol was used. Language measures were taken at two intervals pre- and two intervals post treatment. Functional, narrative, and quality of life measures were taken once pre and once post treatment. Significant change was observed on targeted language functions post treatment. Significant treatment effects were also observed on functional and quality of life measures as well as on all impairment-based language measures for the group. The results provide evidence of linguistic and quality of life change in individuals with chronic aphasia who were treated in an interprofessional ICAP.

  1. Impact of Aspect-Oriented Programming on the Quality of Novices’ Programs: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Marija Katic

    2013-06-01

    Full Text Available Aspect-oriented programming has been introduced in order to increase the modularity of object-oriented programs and is claimed to improve software quality. Although there are various researches on this claim, the question to what extent aspect-oriented programming improves the quality of programs depending on a developer’s experience still remains. The purpose of this study is to investigate whether aspect-oriented programming used by novice programmers improves the quality of programs, in terms of software flexibility and readability (consequently reusability and maintainability as well. As a part of an undergraduate course in programming paradigms and languages, a systematic comparison between students’ object-oriented and aspect-oriented solutions of the same problem was driven. In order to drive this comparison we have established the basis for the development of the new quality assessment model consisting of software metrics for an objective evaluation and student survey for subjective evaluation. The results show that the use of aspect-oriented programming lead to novices’ programs that are easier to change and read (flexible and readable compared to object-oriented programs. What is more, administered survey showed that students perceive their programs as more flexible and readable.

  2. Computer program CDCID: an automated quality control program using CDC update

    International Nuclear Information System (INIS)

    Singer, G.L.; Aguilar, F.

    1984-04-01

    A computer program, CDCID, has been developed in coordination with a quality control program to provide a highly automated method of documenting changes to computer codes at EG and G Idaho, Inc. The method uses the standard CDC UPDATE program in such a manner that updates and their associated documentation are easily made and retrieved in various formats. The method allows each card image of a source program to point to the document which describes it, who created the card, and when it was created. The method described is applicable to the quality control of computer programs in general. The computer program described is executable only on CDC computing systems, but the program could be modified and applied to any computing system with an adequate updating program

  3. Image Quality Improvement after Implementation of a CT Accreditation Program

    International Nuclear Information System (INIS)

    Kim, You Sung; Jung, Seung Eun; Choi, Byung Gil; Shin, Yu Ri; Hwang, Seong Su; Ku, Young Mi; Lim, Yeon Soo; Lee, Jae Mun

    2010-01-01

    The purpose of this study was to evaluate any improvement in the quality of abdominal CTs after the utilization of the nationally based accreditation program. Approval was obtained from the Institutional Review Board, and informed consent was waived. We retrospectively analyzed 1,011 outside abdominal CTs, from 2003 to 2007. We evaluated images using a fill-up sheet form of the national accreditation program, and subjectively by grading for the overall CT image quality. CT scans were divided into two categories according to time periods; before and after the implementation of the accreditation program. We compared CT scans between two periods according to parameters pertaining to the evaluation of images. We determined whether there was a correlation between the results of a subjective assessment of the image quality and the evaluation scores of the clinical image. The following parameters were significantly different after the implementation of the accreditation program: identifying data, display parameters, scan length, spatial and contrast resolution, window width and level, optimal contrast enhancement, slice thickness, and total score. The remaining parameters were not significantly different between scans obtained from the two different periods: scan parameters, film quality, and artifacts. After performing the CT accreditation program, the quality of the outside abdominal CTs show marked improvement, especially for the parameters related to the scanning protocol

  4. Quality of serum creatinine measurement in light of EQA programs.

    Science.gov (United States)

    Friedecky, Bedrich; Kratochvila, Josef; Budina, Marek; Jabor, Antonin

    2007-01-01

    The aim of our study was to identify the role of External Quality Assessment (EQA) programs in improving the quality of serum creatinine measurement and glomerular filtration rate (GFR) estimation. Comparison of results achieved during EQA with National Kidney Disease Education Program and College of American Pathologists guidelines identified an urgent need for an improvement in measurement quality. We compared actual results for serum creatinine measurement within the Czech Republic EQA with the requirements of EC Directive 98/79. We used the results for 2005-2006 EQA programs. There were seven surveys involved with two samples each, and a 2006 questionnaire on the post-analytical phase survey. Bias depended strongly on the creatinine concentration. However, this dependence varied for different in vitro diagnostic manufacturers, although they should all follow the same directive. We chose biological variation as the significance rate for bias and a resulting overall error of 6.9%. The proportion of results with total error EQA programs in improving the quality of creatinine measurement results and GFR calculation should be in monitoring the quality of IVD products, enabling users to adapt their use of these products accordingly. EQA programs can also educate on performing GFR estimation in a unified way. Highly commutable control materials with certified creatinine values or, alternatively, lyophilized materials with sufficient commutability proved by comparison with native frozen human sera, should become an important EQA tool.

  5. Environmental Restoration Program quality system requirements for the Hanford Site

    International Nuclear Information System (INIS)

    Cote, R.F.

    1993-11-01

    This document defines the quality system requirements for the US Department of Energy, Richland Operations Office, Environmental Restoration Program at the Hanford Site. The Quality System Requirements (OSR) for the Hanford Site integrates quality assurance requirements from the US Department of Energy Orders, the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement), and applicable industry standards into a single source document for the development of quality systems applicable to the Environmental Restoration Program activities. This document, based on fifteen criteria and divided intro three parts, provides user organizations with the flexibility to incorporate only those criteria and parts applicable to their specific scopes of work. The requirements of this document shall be applied to activities that affect quality based on a graded approach that takes into consideration the risk inherent in, as well as the importance of, specific items, services, and activities in terms of meeting ER Program objectives and customer expectations. The individual quality systems developed in accordance with this document are intended to provide an integrated management control system that assures the conduct of ER Program activities in a manner that protects human health and the environment

  6. Water Quality: Water Education for Teachers. A 4-H School Enrichment Program.

    Science.gov (United States)

    Powell, G. Morgan; Kling, Emily B.

    This looseleaf notebook is a teacher resource package that is designed for enrichment program use. It contains five units dealing with water quality: (1) The Water Cycle; (2) Our Water Supply; (3) Waste/Water Treatment; (4) Water Conservation; (5) Water Pollution. The units provide background information, experiments, stories, poems, plays, and…

  7. Assessment and Treatment of Co-occurring Eating Disorders in Privately Funded Addiction Treatment Programs

    Science.gov (United States)

    Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M.

    2011-01-01

    Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percent reported admitting cases of low severity. Twenty-one percent of programs attempt to treat eating disorders. These results highlight the need for education of addiction treatment professionals in assessment, referral and treatment of eating disorders. PMID:21477048

  8. The quality assurance program at K ampersand S

    International Nuclear Information System (INIS)

    Slowey, T.W.

    1993-01-01

    K ampersand S operates the largest and one of the most comprehensive Accredited Dosimetry Calibration Laboratories (ADCLs) in the American Association of Physicists in Medicine (AAPM) secondary laboratory system. It offers calibrations covering energies from Grenz-Ray (0.03-mm Al) to cesium-137 and cobalt-60, brachytherapy source and well chamber calibrations for low-activity sources, and, recently, high-dose-rate iridium-192. The present Quality Assurance (QA) program at K ampersand S began with the AAPM Guidelines for Accreditation (Task Group No. 22 and No. 3, 1989) and grew over the past 10 years to include all aspects of providing a private, self-supporting calibration service from a free-standing independent facility. Some aspects of the QA program were prompted by the requirements of the nuclear power industry while other parts were from national consensus standards or the experiences of staff. Redundancy and teamwork are the most important characteristics of this QA program. K ampersand S has participated in a National Institute of Standards and Technology (NIST) measurement quality assurance (MQA) program since 1982, and, in recent years, an ADCL intralaboratory intercomparison was conducted by Task Group 3 of the Radiation Therapy Committee of the AAPM. One measure of the credibility of a QA program is consistent performance on the MQA program and the ADCL intercomparisons over the past 10 years. An equally important measure of the ability of a program to assure quality results is the frequency of reported errors

  9. National waste terminal storage program. Supplementary quality-assurance requirements

    International Nuclear Information System (INIS)

    Garland, D.L.

    1980-01-01

    The basic Quality Assurance Program Requirements standard for the National Waste Terminal Storage Program has been developed primarily for nuclear reactors and other fairly well established nuclear facilities. In the case of waste isolation, however, there are many ongoing investigations for which quality assurance practices and requirements have not been well defined. This paper points out these problems which require supplementary requirements. Briefly these are: (1) the language barrier, that is geologists and scientists are not familiar with quality assurance (QA) terminology; (2) earth sciences deal with materials that cannot be characterized as easily as metals or other materials that are reasonably homogeneous; (3) development and control of mathematical models and associated computer programs; (4) research and development

  10. Quality assurance program document for 75 mW radioisotope thermoelectric generator program

    International Nuclear Information System (INIS)

    Gregory, B.M.

    1977-09-01

    The General Atomic Company Quality Assurance Document (QAPD) for the 75 mW Radioisotope Thermoelectric Generator (RTG) Program serves the following purposes: (1) identifies the QA Manual and special requirements for the Quality Assurance Program for the design, fabrication assembly, testing, and delivery of the 5 75-mW RTG's and the 2 75-mW Electrical Thermoelectric Generators (ETG) Test Units in accordance with the contractural requirements; (2) describes the operating agreements and relationships between GA and other participants on quality assurance matters on the program; (3) identifies the equipment and activities subject to the Quality Assurance Program and defines GA's scope of supply and documentation requirements for retention and delivery to the Customer; (4) identifies the personnel in key positions, assigned the responsibility for defining, approving, and implementing the QA program; (5) provides a document in which special quality assurance requirements or procedures may be described or identified for implementation during the program; and provides a controlled and identified document to which the customer may refer in signifying their approval of the quality assurance program that will be implemented by GA for the items within the scope of supply

  11. Quality of life issues relating to endocrine treatment options

    DEFF Research Database (Denmark)

    Iversen, P

    1999-01-01

    treatments for prostate cancer, such as castration, combined androgen blockade and non-steroidal antiandrogen monotherapy, have shown similar results in terms of time to progression and survival. The main difference between these treatments is their impact on patients' quality of life. Instruments...... for measuring health-related quality of life should assess both overall and disease-specific quality of life. Data from two large studies of bicalutamide monotherapy show that this non-steroidal antiandrogen is associated with significant health-related quality of life advantages in the treatment of patients...... with locally advanced (M0) disease compared with castration, suggesting that this treatment may benefit patients with early disease. Bicalutamide was favoured in 8 out of 9 evaluable quality of life dimensions, and this was statistically significant for sexual interest and physical capacity. Endocrine...

  12. Improvement of sheep skin quality after treatment with diazinon ...

    African Journals Online (AJOL)

    Lice and keds count of the trial sheep was carried out before and after treatment with diazinon. After the treatment, the parasite count ... to demonstrate the effect of diazinon treatment on both the parasites that cause cockle and the skin quality, so that ... It is a fat-tailed hair breed. Coat colours are mostly uniformly brown or ...

  13. [Quality of food: perceptions of 'Bolsa Familia' program participants].

    Science.gov (United States)

    Uchimura, Kátia Yumi; Bosi, Maria Lúcia Magalhães; Lima, Flávia Emília Leite de; Dobrykopf, Vanessa França

    2012-03-01

    This study deals with perceptions of beneficiaries of the 'Bolsa Familia' Program, in Curitiba, southern Brazil, about their feeding habits. To understand the perceptions of participants of the 'Bolsa Família' Program on the quality of their food. A qualitative study based on the critical-interpretive tradition, which used individual interviews as a technique for gathering empirical data from the informants. The study included 38 individuals, members of families included in the program. The discursive content was recorded on digital media and, thereafter, transcribed and analyzed. After categorization, three main themes emerged: a description of food, quality of food, and feelings and experiences of individuals enrolled in the program. the acknowledgement of social vulnerability and consequent feeding habit insecurity to which such groups are subject was the main finding, as well as feelings of resignation.

  14. SSCL magnet systems quality program implementation for laboratory and industry

    International Nuclear Information System (INIS)

    Warner, D.G.; Bever, D.L.

    1992-01-01

    The development and delivery of reliable and producible magnets for the Superconducting Super Collider Laboratory (SSCL) require the teamwork of a large and diverse workforce composed of personnel with backgrounds in laboratory research, defense, and energy. The SSCL Magnet Quality Program is being implemented with focus on three definitive objectives: (1) communication of requirements, (2) teamwork, and (3) verification. Examination of the SSCL Magnet Systems Division's (MSD) current and planned approach to implementation of the SSCL Magnet Quality Program utilizing these objectives is discussed

  15. Costs and water quality effects of wastewater treatment plant centralization

    Energy Technology Data Exchange (ETDEWEB)

    Macal, C.M.; Broomfield, B.J.

    1980-01-01

    The costs and water quality impacts of two regional configurations of municipal wastewater treatment plants in Northeastern Illinois are compared. In one configuration, several small treatment plants are consolidated into a smaller number of regional facilities. In the other, the smaller plants continue to operate. Costs for modifying the plants to obtain various levels of pollutant removal are estimated using a simulation model that considers the type of equipment existing at the plants and the costs of modifying that equipment to obtain a range of effluent levels for various pollutants. A dynamic water-quality/hydrology simulation model is used to determine the water quality effects of the various treatment technologies and pollutant levels. Cost and water quality data are combined and the cost-effectiveness of the two treatment configurations is compared. The regionalized treatment-plant configuration is found to be the more cost-effective.

  16. Understanding the "How" of Quality Improvement: Lessons from the Rhode Island Program Quality Intervention

    Science.gov (United States)

    Devaney, Elizabeth; Smith, Charles; Wong, Kenneth

    2012-01-01

    Over the past 10 years, afterschool and youth development programming has moved from providing childcare for working parents to being an integral component of the learning day, supporting the academic, social, and emotional development of young people. An important part of that transition has been a growing emphasis on improving program quality.…

  17. Balancing compliance and cost when implementing a Quality Assurance program

    International Nuclear Information System (INIS)

    Pickering, S.Y.

    1997-12-01

    When implementing a Quality Assurance (QA) program, compliance and cost must be balanced. A QA program must be developed that hits the mark in terms of adequate control and documentation, but does not unnecessarily expand resources. As the Waste Isolation Pilot Plant (WIPP) has moved towards certification, Sandia National Laboratories has learned much about balancing compliance and costs. Some of these lessons are summarized here

  18. High ca-hardness treatment program of secondary cooling system in HANARO

    International Nuclear Information System (INIS)

    Park, Y. C.; Woo, J. S.; Ryu, J. S.; Cho, Y. K.; Jeon, B. J.

    2002-01-01

    The secondary cooling water in HANARO had been treated with a low ca-hardness treatment program. The program has now been altered to a high ca-hardness treatment program to reduce the consumption of service water and the maintenance cost. After the alteration of the water treatment method, the water quality of the secondary cooling system is maintained below the limit of water quality control as same as before the alteration. This means indirectly that the secondary cooling system is not much affected by the water quality. To confirm this fact, it is necessary to analyze the effects of corrosion, scale, sludgy and slime that the water qualities are directly interfered with the secondary cooling system. We analyzed the deteriorating effects with a water monitoring equipment connected to the secondary cooling system to measure the monitoring parameters every 6 months. As a result, it is confirmed through this examination that the effects are maintained below the control limits and the high ca-hardness treatment program is applicable to treatment of the water quality of the secondary cooling system in HANARO

  19. UMTRA technical assistance contractor Quality Assurance Program Plan

    International Nuclear Information System (INIS)

    Pehrson, P.

    1993-01-01

    This Quality Assurance Program Plan (QAPP) provides the primary requirements for the integration of quality functions into all Technical Assistance Contractor (TAC) Project organization activities. The QAPP is the written directive authorized by the TAC Program Manager to accomplish this task and to implement procedures that provide the controls and sound management practices needed to ensure TAC contractual obligations are met. The QA program is designed to use monitoring, audit, and surveillance functions as management tools to ensure that all Project organization functions are executed in a manner that will protect public health and safety, promote the success of the Project, and meet or exceed contract requirements. The key to ensuring compliance with this directive is a two-step professional approach: utilize the quality system in all areas of activity, and generate a personal commitment from all personnel to provide quality service. The quality staff will be experienced, trained professionals capable of providing maximum flexibility to Project goal attainment. Such flexibility will enable the staff to be more cost effective and to further improve communication and coordination. To provide control details, this QAPP will be supplemented by approved standard operating procedures that provide requirements for performing the various TAC quality-related activities. These procedures shall describe applicable design input and document control activities and documentation

  20. Quality programs for waste management research and development

    International Nuclear Information System (INIS)

    Hood, F.C.

    1990-01-01

    This paper deals with the application of total quality management principles to waste management research and development activities at PNL. The PNL Quality Program has evolved with expanding expectations for 'error-free' performance from the client and the public sector; it describes the management controls needed to achieve desired levels of product quality and to verify they are reached. It includes the definition of work requirements, performance objectives, roles and responsibilities, performance indicators and measurement, performance feedback mechanisms, and process improvement methodologies. (orig.)

  1. On the quality of treatment planning systems in radiation therapy.

    Science.gov (United States)

    Panten, T; Höss, A; Bohsung, J; Becker, G; Sroka-Pérez, G

    1998-10-01

    To assist in the design of quality assurance activities of 3D treatment planning systems (TPSs), a postal survey has been carried out, addressing TPS users on quality characteristics and their relative importance in clinical routine planning. The approach as described in ISO/IEC 9126 has been used to analyze TPS quality. Both TPS quality characteristics and how these may be used to establish a quality model are included. A questionnaire on ranking of these TPS quality characteristics has been sent out to the German DEGRO members in February 1997. By the end of July 1997, 90 individual assessments (of 45 physicists, 35 physicians, and 10 radiographers) had been collected. On an importance scale from 1 (very important) to 6 (unimportant), weight factors of 1.71 (portability), 2.84 (maintainability), 3.18 (efficiency), 3.85 (usability), 4.52 (functionality) and 4.90 (reliability) have been determined from the data. From user satisfaction data also obtained from the questionnaire responses, baseline quality indices could be established from the quality model for the RTPs Cadplan, TMS Helax, and Voxelplan. The responses highlight the need for TPS quality assurance at the same time along the lines of safety-related, research-oriented, and interactive end-user software systems in radiotherapy treatment planning. Quality assurance activities must take this into account. Their effect can be monitored by using quality indices as derivable from the established quality model.

  2. Quality assurance in mammography and the DQM program

    International Nuclear Information System (INIS)

    Rimondi, O.; Giambaccini, M.; Marziani, M.

    1991-01-01

    The aim of the optimization program for mammography (DQM) in Italy is to achieve the best compromise between image quality and dose to patient. 272 centers agreed to the second phase of the program, from February 1987 to January 1990. Exposure, half-value layer (HVL) and focal spot size were measured according to the same methods employed in the first phase of the DQM program (1985), while image quality was evaluated by means of a new performance phantom. The average exposure was 0.96 R (2.48x10 -4 C/Kg); in 173 (64.3%) centers exposure was 5 R (12.9x10 -4 C/Kg). In every center the average whole-breast dose to a reference organ (5cm thick, composed of 50% fat +50% water) was calculated on the basis of entrance exposure, HVL, and focus-skin distance; in 63.2% of the centers doses <0.15 cGy were employed. The results allowed dose and image quality to be correlated in order to divide the centers (using a film-screen system) into groups with a different efficiency level: in 101 centers dose and image quality were good, in 64 centers too high a dose was employed, 66 centers image quality was poor, and in 38 centers dose was too high and image quality was poor. It must be stressed that the DQM program can play its role only if each center carries out its Quality Assurance activity after the methods recommended by the World Health Organization

  3. Electronic laboratory quality assurance program: A method of enhancing the prosthodontic curriculum and addressing accreditation standards.

    Science.gov (United States)

    Moghadam, Marjan; Jahangiri, Leila

    2015-08-01

    An electronic quality assurance (eQA) program was developed to replace a paper-based system and to address standards introduced by the Commission on Dental Accreditation (CODA) and to improve educational outcomes. This eQA program provides feedback to predoctoral dental students on prosthodontic laboratory steps at New York University College of Dentistry. The purpose of this study was to compare the eQA program of performing laboratory quality assurance with the former paper-based format. Fourth-year predoctoral dental students (n=334) who experienced both the paper-based and the electronic version of the quality assurance program were surveyed about their experiences. Additionally, data extracted from the eQA program were analyzed to identify areas of weakness in the curriculum. The study findings revealed that 73.8% of the students preferred the eQA program to the paper-based version. The average number of treatments that did not pass quality assurance standards was 119.5 per month. This indicated a 6.34% laboratory failure rate. Further analysis of these data revealed that 62.1% of the errors were related to fixed prosthodontic treatment, 27.9% to partial removable dental prostheses, and 10% to complete removable dental prostheses in the first 18 months of program implementation. The eQA program was favored by dental students who have experienced both electronic and paper-based versions of the system. Error type analysis can yield the ability to create customized faculty standardization sessions and refine the didactic and clinical teaching of the predoctoral students. This program was also able to link patient care activity with the student's laboratory activities, thus addressing the latest requirements of the CODA regarding the competence of graduates in evaluating laboratory work related to their patient care. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  4. The development of quality assurance program for cyberknife

    International Nuclear Information System (INIS)

    Jang, Ji Sun; Lee, Dong Han; Kang, Young Nam

    2006-01-01

    Standardization quality assurance (QA)program of Cyberknife for suitable circumstances in Korea has not been established. In this research, we investigated the development of QA program for Cyberknife and evaluation of the feasibility under applications. Considering the feature of constitution for systems and the therapeutic methodology of Cyberknife, the list of quality control (QC) was established and divided dependent on the each period of operations. And then all these developed QC lists were categorized into three groups such as basic QC, delivery specific QC, and patient specific QC based on the each purpose of QA. In order to verify the validity of the established QA program, this QC lists was applied to two Cyberknife centers. The acceptable tolerance was based on the undertaking inspection list from the Cyberknife manufacturer and the QC results during last three years of two Cyberknife centers in Korea. The acquired measurement results were evaluated for the analysis of the current QA status and the verification of the propriety for the developed QA program. The current QA status of two Cyberknife centers was evaluated from the accuracy of all measurements in relation with application of the established QA program. Each measurement result was verified having a good agreement within the acceptable tolerance limit of the developed QA program. It is considered that the developed QA program in this research could be established the standardization of QC methods for Cyberknife and confirmed the accuracy and stability for the image-guided stereotactic radiotherapy

  5. Program of TLD audits for quality control in radiotherapy

    International Nuclear Information System (INIS)

    Alvarez, P.; Feld, D.; Gomez, C.; Kessler, C.; Montano, R.G.; Lindner, C.; Peretti, M.; Saravi, M.; Miguez, V.; Paidon, S.; Raslawski, E.

    1998-01-01

    Full text: It is known that a high precision in radiotherapy is essential to ensure a successful radiation treatment. To reach this goal it is necessary to detect and minimise many errors, which can be done through a periodic program of quality control, not only internal checks but also participating in external audits that attempt to control the absorbed dose delivered and detect any source of error, coming from the machine itself or from human mistakes. Under the frame of the International Quality Assurance Network for Dosimetry in Radiotherapy proposed by the International Atomic Energy Agency, a National External Audit Group (EAG) has been created in our country, composed by the Secondary Standard Dosimetry Laboratory (SSDL), 2 Medical Physics and 1 Medical Radiotherapist. The SSDL and one of the Medical Physics belong to the National Atomic Energy Agency, meanwhile the rest of the group belong to the National Pediatric Hospital P rof. J.P.Garrahan . This EAG performs external audits to Radiation Therapy Centres with a thermoluminescence system, which is checked periodically by the IAEA. The audits are performed to the 60 Co γ-ray and high energy X-ray beams that are being used for medical application in the whole country. The SSDL is the responsible of the thermoluminescence measurements; deviation of the absorbed dose determined by the TLD system from the one informed by the Responsible of the Center within the interval ± 5% are considered acceptable while deviations out of this interval require the intervention of the Medical Physic Group and the Radiotherapist in order to determine the cause of the discrepancies. In 1997, 4 audits performed in reference conditions were carried out 68 60 Co units participated in the audits, 61 of them with deviation within the acceptable interval in their first participation, meanwhile 1 got this deviation in repeated audits, after the follow up performed by the Medical Physic Group. Regarding high energy X-ray beams

  6. Effect of surface treatment of tailings on effluent quality

    International Nuclear Information System (INIS)

    Murray, D.R.; Okuhara, D.

    1980-01-01

    Lysimeters containing 125 tons of mine tailings were used to determine the impact of gravel, sawdust, and vegetation as surface treatments on the quality and quantity of effluent produced from sulfide-containing uranium mill tailings. Over a 5-yr period, treatments did not alter the effluent quality to a level acceptable to regulatory requirements. The concentration of iron, copper, lead, aluminum, and sulfate increased with the rise of acidity during this period. However, the rate and extent of changes did vary with the treatment. The role of surface treatment in long-term waste abandonment must be investigated further

  7. Evaluating Quality in Associate Degree Culinary Arts Programs

    Science.gov (United States)

    Hertzman, Jean; Ackerman, Robert

    2010-01-01

    Purpose: The purpose of this study is to determine which categories and indicators of quality are best suited to evaluating associate degree culinary arts programs (ADCAP). Design/methodology/approach: The researchers surveyed a national sample of culinary educators and industry chefs in the USA. The instrument asked the participants to rate the…

  8. Effects of different irrigation programs on yield and quality ...

    African Journals Online (AJOL)

    This study was carried out to determine the effects of different irrigation programs on yield and quality parameters of eggplant under greenhouse conditions, using Class A pan evaporation calculations and different plant-pan coefficients. Irrigation water was applied through drip irrigation method twice a week during the ...

  9. Quality Assurance Plans under the Renewable Fuel Standard Program

    Science.gov (United States)

    Quality Assurance Plan or (QAP) is a voluntary program where independent third-parties may audit and verify that RINs have been properly generated and are valid for compliance purposes. RINs verified under a QAP may be purchased by regulated parties.

  10. The Rockford School of Medicine Undergraduate Quality Assurance Program

    Science.gov (United States)

    Barr, Daniel; And Others

    1976-01-01

    An undergraduate program of ambulatory care quality assurance is described which has been operational at the Rockford School of Medicine for three years. Focus is on involving students in peer review and related audit activities. Results of preliminary evaluation are reported and generalizations offered. (JT)

  11. Analytical chemistry measurements quality control program using computer applications

    International Nuclear Information System (INIS)

    Clark, J.P.; Huff, G.A.

    1978-01-01

    An Analytical Chemistry Measurements Quality Control Program assures the reliability of analytical measurements performed at the Barnwell Nuclear Fuel Plant. The program includes training, methods quality control, replicate samples and measurements, mass measurements, interlaboratory sample exchanges, and standards preparation. This program has been designed to meet the requirements of 10CFR70.57. Portions of the program have been automated by using a PDP 11/35 computer system to provide features which are not readily available in manual systems. These include such items as realtime measurement control, computer calculated bias and precision estimates, various surveillance applications, and evaluation of measurement system variables. The efficiency of the computer system has been demonstrated in gathering and assimilating the results of over 1100 quality control samples during a recent cold chemical checkout campaign. These data were used to determine equations for predicting measurements reliability estimates; to evaluate measurement performance of the analysts, equipment, and measurement period; and to provide directions for chemistry methods modifications and additional training requirements. A procedure of replicate sampling and measuring provides random error estimates. The analytical chemistry measurement quality control activities during the campaign represented about 10% of the total analytical chemistry effort

  12. ENCOURAGING THE USE OF WETLANDS IN WATER QUALITY TRADING PROGRAMS

    Science.gov (United States)

    The interest in water quality trading (WQT) has grown in recent years because of its potential to meet nutrient reduction goals at lower costs. However, one problem identified by researchers in most WQT programs has been few actual trades, usually associated with low numbers of ...

  13. Quality Special Education Programs: The Role of Transformational Leadership

    Science.gov (United States)

    Clinton, Demi

    2013-01-01

    The purpose of this quantitative study was to determine whether or not a relationship existed between principals who demonstrate transformational leadership traits and six different quality practices in their special education program. Effective principals must know and understand special education laws, practices, and current issues, but evidence…

  14. Quality Assurance Program description, Defense Waste Processing Facility (DWPF)

    International Nuclear Information System (INIS)

    Maslar, S.R.

    1992-01-01

    This document describes the Westinghouse Savannah River Company's (WSRC) Quality Assurance Program for Defense Waste Processing at the Savannah River Site (SRS). WSRC is the operating contractor for the US Department of Energy (DOE) at the SRS. The following objectives are achieved through developing and implementing the Quality Assurance Program: (1) Ensure that the attainment of quality (in accomplishing defense high-level waste processing objectives at the SRS) is at a level commensurate with the government's responsibility for protecting public health and safety, the environment, the public investment, and for efficiently and effectively using national resources. (2) Ensure that high-level waste from qualification and production activities conform to requirements defined by OCRWM. These activities include production processes, equipment, and services; and products that are planned, designed, procured, fabricated, installed, tested, operated, maintained, modified, or produced

  15. Quality programs for waste management research and development

    International Nuclear Information System (INIS)

    Hood, F.C.

    1990-06-01

    The Pacific Northwest Laboratory (PNL) is a US Department of Energy (DOE) multi-program national laboratory. PNL develops waste management processes and techniques as well as providing management services for characterization and remediation of radioactive and/or hazardous waste sites for the DOE. This paper deals with the application of total quality management principles to waste management research and development activities at PNL. The PNL Quality Program has evolved with expanding expectations for ''error-free'' performance from the client and the public sector; it describes the management controls needed to achieve desired levels of product quality and to verify they are reached. It includes the definition of work requirements, performance objectives, roles and responsibilities, performance indicators and measurement, performance feedback mechanisms, and process improvement methodologies. 6 refs

  16. National water-quality assessment program : the Albemarle- Pamlico drainage

    Science.gov (United States)

    Lloyd, O.B.; Barnes, C.R.; Woodside, M.D.

    1991-01-01

    In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. Long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water quality information that will be useful to policy makers and managers at the national, State, and local levels. Study-unit investigations constitute a major component of the NAWQA program, forming the principal building blocks on which national-level assessment activities are based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Albemarle-Pamlico drainage was among the first 20 NAWQA study units selected for study under the full-scale implementation plan. The Albemarle-Pamlico drainage study will examine the physical, chemical, and biological aspects of water quality issues in a coordinated investigation of surface water and ground water in the Albemarle-Pamlico drainage basin. The quantity and quality of discharge from the Albemarle-Pamlico drainage basin contribute to some water quality problems in the biologically sensitive waters of Albemarle and Pamlico Sounds. A retrospective analysis of existing water quality data will precede a 3-year period of intensive data-collection and analysis activities. The data resulting from this study and the improved understanding of important processes and issues in the upstream part of the study unit will enhance understanding of the quality of

  17. Water quality modelling and optimisation of wastewater treatment ...

    African Journals Online (AJOL)

    Instream water quality management encompasses field monitoring and utilisation of mathematical models. These models can be coupled with optimisation techniques to determine more efficient water quality management alternatives. Among these activities, wastewater treatment plays a crucial role. In this work, a ...

  18. Development and evaluation of the Sleep Treatment and Education Program for Students (STEPS).

    Science.gov (United States)

    Brown, Franklin C; Buboltz, Walter C; Soper, Barlow

    2006-01-01

    University students report significantly worse sleep quality than the general population. Sleep problems are related to increased health concerns, irritability, depression, fatigue, and attention and concentration difficulties, along with poor academic performance. Clinical research indicates that psychoeducational interventions are among the most effective methods for improving sleep quality in the general population. Similar studies for university students are lacking. In this study, the authors describe the development of the Sleep Treatment and Education Program for Students (STEPS) and evaluate its effectiveness with a double blind, experimental design. Students in the treatment group reported significantly improved sleep quality and sleep hygiene behaviors at 6 weeks posttreatment.

  19. Quality assurance program plan for the Reactor Research Experiment Programs (RREP)

    International Nuclear Information System (INIS)

    Pipher, D.G.

    1982-05-01

    This document describes the Quality Assurance Program plans which will be applied to tasks on Reactor Research Experiments performed on Sandia National Laboratories' reactors. The program provides for individual project or experiment quality plan development and allows for reasonable plan flexibility and maximum plan visibility. Various controls and requirements in this program plan are considered mandatory on all features which are identified as important to public health and safety (Level I). It is the intent of this document that the Quality Assurance program comprise those elements which will provide adequate assurance that all components, equipment, and systems of the experiments will perform as designed, and hence prevent delays and costs due to rejections or failures

  20. Overview of the National Water-Quality Assessment Program

    Science.gov (United States)

    Leahy, P.P.; Thompson, T.H.

    1994-01-01

    The Nation's water resources are the basis for life and our economic vitality. These resources support a complex web of human activities and fishery and wildlife needs that depend upon clean water. Demands for good-quality water for drinking, recreation, farming, and industry are rising, and as a result, the American public is concerned about the condition and sustainability of our water resources. The American public is asking: Is it safe to swim in and drink water from our rivers or lakes? Can we eat the fish that come from them? Is our ground water polluted? Is water quality degrading with time, and if so, why? Has all the money we've spent to clean up our waters, done any good? The U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program was designed to provide information that will help answer these questions. NAWQA is designed to assess historical, current, and future water-quality conditions in representative river basins and aquifers nationwide. One of the primary objectives of the program is to describe relations between natural factors, human activities, and water-quality conditions and to define those factors that most affect water quality in different parts of the Nation. The linkage of water quality to environmental processes is of fundamental importance to water-resource managers, planners, and policy makers. It provides a strong and unbiased basis for better decisionmaking by those responsible for making decisions that affect our water resources, including the United States Congress, Federal, State, and local agencies, environmental groups, and industry. Information from the NAWQA Program also will be useful for guiding research, monitoring, and regulatory activities in cost effective ways.

  1. Quality assurance of a conformal treatment technique

    Energy Technology Data Exchange (ETDEWEB)

    Kroes, A.P.G.; Bruinvis, I.A.D.; Lanson, J.H.; Uiterwaal, G.J. [Nederlands Kanker Inst. `Antoni van Leeuwenhoekhuis`, Amsterdam (Netherlands)

    1995-12-01

    For a parotid gland irradiation technique with a pair of oblique wedged photon beams the target coverage near the surface was investigated. The planning target volume extends to 5 millimetres under the skin; a minimum target dose of 95% is required when the dose at the centre is set to 100%. The treatment technique was simulated on a water phantom with a beam of 45 degree gantry angle, 55 degree wedge, 8 x 10 cm{sup 2} field size and the isocentre at 2 cm depth. Beam energies of 4, 6 and 8 MV were used. The dose distributions were measured in two orthogonal planes through the isocentre perpendicular to the water surface with p-type silicon diodes along lines through the isocentre every 45 degrees. Dose distributions were calculated in these planes with our 3-D planning system (U-Mplan, University of Michigan planning system), with model parameters are fitted to depth dose curves and profiles of open and wedged normally incident beams. The location of the 95% isodose was determined in five points near the surface. For 4, 6 and 8 MV the depths of the 95% isodose were 6.0, 10.3 and 11.0 mm, respectively. The depths of the 95% points of single normally incident open fields were 6.0, 9.0 and 11.5 mm, respectively. The treatment planning system (TPS) calculated the 95% isodose for the parotid technique at 5.5, 7.3 and 11.5 mm depths, for 4, 6 and 8 MV, respectively. Thus for 6 MV the 95% was 3 mm deeper than calculated by the TPS; 2 mm were caused by the inaccuracy of the open field depth dose curve fit in the build-up region. The depth near the surface of the 95% isodose for this treatment technique can be estimated from single open field depth dose curves with acceptable accuracy. This result is not obvious because the effects of the wedge and oblique incidence on the dose distribution are also involved. The TPS performed well for the 4 and 8 MV beams, but for treatments with 6 MV target under dosage could have remained undetected. (Abstract Truncated)

  2. Optimizing basin-scale coupled water quantity and water quality management with stochastic dynamic programming

    DEFF Research Database (Denmark)

    Davidsen, Claus; Liu, Suxia; Mo, Xingguo

    2015-01-01

    Few studies address water quality in hydro-economic models, which often focus primarily on optimal allocation of water quantities. Water quality and water quantity are closely coupled, and optimal management with focus solely on either quantity or quality may cause large costs in terms of the oth......-er component. In this study, we couple water quality and water quantity in a joint hydro-economic catchment-scale optimization problem. Stochastic dynamic programming (SDP) is used to minimize the basin-wide total costs arising from water allocation, water curtailment and water treatment. The simple water...... concentrations. Inelastic water demands, fixed water allocation curtailment costs and fixed wastewater treatment costs (before and after use) are estimated for the water users (agriculture, industry and domestic). If the BOD concentration exceeds a given user pollution thresh-old, the user will need to pay...

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

    Science.gov (United States)

    Bowe, Sarah N

    2016-02-01

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

  4. Substance abuse treatment programs' data management capacity: an exploratory study.

    Science.gov (United States)

    Wisdom, Jennifer P; Ford, James H; Wise, Meg; Mackey, Deirdre; Green, Carla A

    2011-04-01

    Despite treatment improvement and performance management imperatives, little research describes the data management capacity of substance abuse treatment programs, and useful metrics are not available to gauge capacity. This exploratory study evaluates clinical and administrative data management at eight substance abuse treatment programs in four US states to identify factors for developing an appropriate metric. Findings indicate that programs tend to manage data inefficiently and have few protocols guiding information management. Barriers to better data management included lack of integrated information technology (IT) systems; limited funding, time, and staff for developing and implementing IT-related changes; and divergent staff skills in and attitudes toward IT. This snapshot of substance abuse treatment programs' data management capabilities suggests a need for a metric to examine data management capability in these settings. Infusion of expertise, training, and funding are needed to improve substance abuse treatment programs' IT-related systems and data management processes.

  5. Quality Assurance Program Plan for the Waste Isolation Pilot Plant Experimental-Waste Characterization Program

    International Nuclear Information System (INIS)

    1991-01-01

    This Quality Assurance Program Plan (QAPP) identifies the quality of data necessary to meet the specific objectives associated with the Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP) Experimental-Waste Characterization Program (the Program). This experimental-waste characterization program is only one part of the WIPP Test Phase, both in the short- and long-term, to quantify and evaluate the characteristics and behavior of transuranic (TRU) wastes in the repository environment. Other parts include the bin-scale and alcove tests, drum-scale tests, and laboratory experiments. In simplified terms, the purpose of the Program is to provide chemical, physical, and radiochemical data describing the characteristics of the wastes that will be emplaced in the WIPP, while the remaining WIPP Test Phase is directed at examining the behavior of these wastes in the repository environment. 50 refs., 35 figs., 33 tabs

  6. Treatment of the mentally ill chemical abuser: description of the Hutchings Day Treatment Program.

    Science.gov (United States)

    Carey, K B

    1989-01-01

    Drug and alcohol abuse represents a major obstacle to the successful rehabilitation of psychiatrically-disabled persons. Prevalence estimates for current chemical abuse among individuals in psychiatric treatment range from 24% to 49%. Although specialized treatment programs for mentally ill chemical abusers (MICAs) have recently been developed, few of these innovative programs are described in the literature. This paper presents main features of the MICA Day Treatment Program at the Richard H. Hutchings Psychiatric Center, including staffing, schedule, maintenance of a drug-free treatment environment, and therapeutic programming. Recommendations are offered for treatment providers who are developing their own services for MICAs.

  7. Service Quality in Alcohol Treatment: A Qualitative Study

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2010-01-01

    The objective of the study was to qualitatively evaluate the managerial and organisational issues associated with service quality in a privately funded alcohol treatment centre in the UK. Two different groups of participants at a private treatment clinic were interviewed. The first group comprised 25 of its patients. The second group comprised 15…

  8. Establishing High-Quality Prostate Brachytherapy Using a Phantom Simulator Training Program

    International Nuclear Information System (INIS)

    Thaker, Nikhil G.; Kudchadker, Rajat J.; Swanson, David A.; Albert, Jeffrey M.; Mahmood, Usama; Pugh, Thomas J.; Boehling, Nicholas S.; Bruno, Teresa L.; Prestidge, Bradley R.; Crook, Juanita M.; Cox, Brett W.; Potters, Louis; Moran, Brian J.; Keyes, Mira; Kuban, Deborah A.; Frank, Steven J.

    2014-01-01

    Purpose: To design and implement a unique training program that uses a phantom-based simulator to teach the process of prostate brachytherapy (PB) quality assurance and improve the quality of education. Methods and Materials: Trainees in our simulator program were practicing radiation oncologists, radiation oncology residents, and fellows of the American Brachytherapy Society. The program emphasized 6 core areas of quality assurance: patient selection, simulation, treatment planning, implant technique, treatment evaluation, and outcome assessment. Using the Iodine 125 ( 125 I) preoperative treatment planning technique, trainees implanted their ultrasound phantoms with dummy seeds (ie, seeds with no activity). Pre- and postimplant dosimetric parameters were compared and correlated using regression analysis. Results: Thirty-one trainees successfully completed the simulator program during the period under study. The mean phantom prostate size, number of seeds used, and total activity were generally consistent between trainees. All trainees met the V100 >95% objective both before and after implantation. Regardless of the initial volume of the prostate phantom, trainees' ability to cover the target volume with at least 100% of the dose (V100) was not compromised (R=0.99 pre- and postimplant). However, the V150 had lower concordance (R=0.37) and may better reflect heterogeneity control of the implant process. Conclusions: Analysis of implants from this phantom-based simulator shows a high degree of consistency between trainees and uniformly high-quality implants with respect to parameters used in clinical practice. This training program provides a valuable educational opportunity that improves the quality of PB training and likely accelerates the learning curve inherent in PB. Prostate phantom implantation can be a valuable first step in the acquisition of the required skills to safely perform PB

  9. Does orthodontic treatment affect patients' quality of life?

    Science.gov (United States)

    Kiyak, H Asuman

    2008-08-01

    The oral-facial region is usually an area of significant concern for the individual because it draws the most attention from other people in interpersonal interactions and is the primary source of vocal, physical, and emotional communication. As a result, patients who seek orthodontic treatment are concerned with improving their appearance and social acceptance, often more than they are with improving their oral function or health. Enhancing these aspects of quality of life is an important motive for undergoing orthodontic treatment. Regardless of age, patients' and their parents' or caregivers' expectations about improvements in oral function, esthetics, social acceptance, and body image are important for both general dentists and orthodontists to consider when advising patients about these procedures and during the treatment process. This review of research on the impact of conventional and surgical orthodontics on quality of life examines the association between oral health-related quality of life and severity and type of malocclusion, as well as the impact of treatment and patient characteristics on quality of life. The article will emphasize the importance of clinicians' having a clear understanding, before initiating treatment, of their patients' quality of life and their expectations about improvements in specific domains of quality of life.

  10. System for the quality assurance of personnel training programs

    International Nuclear Information System (INIS)

    Rjona, Orison; Venegas, Maria del C.; Rodriguez, Lazaro; Lopez, Miguel A.; Armenteros, Ana L.

    1999-01-01

    In this work are described the fundamental possibilities and characteristics of a software that allows to carry out the management and automatic evaluation of all data gotten during jobs analysis and design, development, implementation and evaluation of personnel training programs of nuclear and radioactive installations and risk industries. The system that is introduced, GESAT, proportion a tool of centralized managerial control of training data and the obtaining of the quality objectives of each installation in the training of their personnel. GESAT includes all phases of SAT method (Systematic Approach to Training). It constitutes the necessary practical support for the elaboration, implementation and evaluation of training programs, allowing the establishment of restrictions and controls and avoiding inconsistencies in the process. It offers the possibility of automatic evaluation that identify fundamental deficiencies in the planning and implementation of training programs. This evaluation facilitates the systematic feed back and the continuous improvement of the training programs.(author)

  11. Service quality in alcohol treatment: a research note.

    Science.gov (United States)

    Resnick, Sheilagh M; Griffiths, Mark D

    2011-01-01

    The purpose of this paper is to evaluate service quality in a UK privately funded alcohol treatment clinic. Data were gathered via interviews with two groups of participants using the SERVQUAL questionnaire. The first group comprised 32 patients and the second 15 clinic staff. The SERVQUAL instrument measures service quality expectations and perceptions across five service dimensions and identifies gaps between service expectations and perceptions of what was delivered. Patients' service quality expectations were exceeded on four of five dimensions. However, staff members felt services fell below expectations on four of five dimensions with the "reliability" service dimension emerging as the common service element falling below expectations for both participant groups. It was concluded that achieving consistent service delivery and increasing empathy between staff and patients improves overall service quality perceptions. The paper relies on self-report methods from a relatively small number of individuals. There have been limited research studies measuring alcohol treatment service quality in the private sector.

  12. Quality assurance in cancer management. Impact of quality standards on treatment accuracy: The experience of the EORTC

    International Nuclear Information System (INIS)

    Bernier, J.

    1997-01-01

    There is thus a need to ensure that the same quality of treatment is offered to all cancer patients in Europe. A research of this kind must be aimed at identifying which steps in the complex treatment processes are more error prove, which of those can most effectively be corrected, and which procedures could be taken over by countries, or individual centers to monitor themselves the quality of their treatment procedures. To achieve this goals, the EORTC Radiotherapy Co-operative Group has put a major effort in the development of two Quality Assurance programs: the Physics Audit program (PAQ) and in the Assurance of Protocol Compliance Program (APCP). In the PAO, a first survey conducted in 1986, on the radiotherapy infrastructure in European Centers participating in clinical trials showed that 20% of the centers encountered difficulties to comply with the EORTC requirements due to imbalance in staff or equipment. Besides radiotherapy infrastructure, the beam output was checked in 50 centers: a major problem was detected in 30% of the checked electron beams. Dosimetric recommendations were sent out to all radio-oncology departments active in the EORTC and a mailed measurement procedure was developed for the verification of the beam output in photon beams. The EORTC Radiotherapy Group has demonstrated that multicenter QA programs permit, through the pooling of a large number of data, auditing by specialists of implemented Quality Standards both in radiation physics and in clinical oncology, contributing to the basis for the development of harmonized quality procedures and standards in the therapeutic management of cancer. This type of QA program should also foster the interaction between several medical disciplines and promote the application of Quality Standards in community level hospitals. Current efforts are also put forth to develop common research instruments, such as the processing of database and MRI or CT-scan images through teleconferencing and the set up

  13. [Quality management in diabetology by the PC software program DIQUAL].

    Science.gov (United States)

    Köhler, S; Use, G; Schumann, M; Müller, U A

    2000-06-01

    Today, effective therapies for patients with diabetes mellitus. However, these therapeutic strategies are often not or incorrectly applied. Following these discrepancies for health care providers, it is mandatory to document the efficacy of diabetes treatment. However, it is hard to prove the outcome of diabetes care because of unsuitable documentation, missing parameters and different definitions of quality indicators. The computer programme DIQUAL was developed to improve the diabetes management on the diabetes ward, the diabetes out-patient department and for the documentation of outcome quality. DIQUAL is a patient database and offers structured data collecting and administration, text processing, referring letters, application and list functions, internal and external quality control, as well as cohort or cross-section analysis, data export function for nation wide data collection, system internal plausibility check and extension modules for scientific studies. On the basis of DIQUAL, the first nation wide comparison of outcome quality in the routine treatment of type 1 diabetes was possible. In 1998, we analysed the original data of 1789 patients from 32 district and university hospitals on the basis of the therapeutic goals. HbA1C decreased 1.8% and the incidence of severe hypoglycaemia was lowered to the half. There was a substantial improvement of processes in the health care institutions and the quality of information transmission to the general practitioners. This system of measurement and improvement of quality is also suitable for other areas in health care and medicine.

  14. Quality of life and communication in orthognathic treatment.

    Science.gov (United States)

    Catt, Susan L; Ahmad, Sofia; Collyer, Jeremy; Hardwick, Lauren; Shah, Nahush; Winchester, Lindsay

    2018-04-11

    The primary aim was to determine what, if any, relationships exist between communication and quality of life in patients receiving orthognathic treatment since this has not been explored. A secondary aim was to compare the Quality of Life (QoL) of a pre-treatment sample with those at 2 years post-surgery. A cross-sectional questionnaire method was used. Outpatient clinics providing orthognathic treatment at four UK hospital sites. Two separate samples of pre-treatment (n = 73) and 2-year post-surgery (n = 78) patients participated in the study. At clinic appointments, all eligible patients were invited to complete the Orthognathic Quality of Life Questionnaire (OQLQ), a previously validated condition-specific quality of life measure. At the same time, participants at the 2-year post-surgery stage also completed a second short questionnaire, the Communication Assessment Tool-Team (CAT-T), where they rated the quality of communication they had received during treatment. One hundred and fifty-one complete responses were received. The average age was 24.5 years (S.D. 9.77) and the majority (67%) were female in both groups. Statistically significant associations were found between QoL and quality of communication in the treated sample. Findings also showed a comparatively poorer QoL for the pre-treatment participants. This reduced QoL was more pronounced in females than males for all aspects except dentofacial appearance. There was an improvement in QoL for patients at 2 years post-surgery compared to pre-treatment. There is an association between QoL and quality of communication as reported by participants at 2 years post-surgery. These novel findings are similar to outcomes in other patient settings such as oncology, but further investigation is required to establish the direction of cause and effect.

  15. ERD UMTRA Project quality assurance program plan, Revision 7

    International Nuclear Information System (INIS)

    1995-09-01

    This document is the revised Quality Assurance Program Plan (QAPP) dated September, 1995 for the Environmental Restoration Division (ERD) Uranium Mill Tailings Remedial Action Project (UMTRA). Quality Assurance requirements for the ERD UMTRA Project are based on the criteria outlined in DOE Order 5700.6C or applicable sections of 10 CFR 830.120. QA requirements contained in this QAPP shall apply to all personnel, processes, and activities, including planning, scheduling, and cost control, performed by the ERD UMTRA Project and its contractors

  16. Plutonium stabilization and handling quality assurance program plan

    International Nuclear Information System (INIS)

    Weiss, E.V.

    1998-01-01

    This Quality Assurance Program Plan (QAPP) identifies project quality assurance requirements for all contractors involved in the planning and execution of Hanford Site activities for design, procurement, construction, testing and inspection for Project W-460, Plutonium Stabilization and Handling. The project encompasses procurement and installation of a Stabilization and Packaging System (SPS) to oxidize and package for long term storage remaining plutonium-bearing special nuclear materials currently in inventory at the Plutonium Finishing Plant (PFP), and modification of vault equipment to allow storage of resulting packages of stabilized SNM

  17. Transportation and retention in outpatient drug abuse treatment programs.

    Science.gov (United States)

    Friedmann, P D; Lemon, S C; Stein, M D

    2001-09-01

    To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

  18. Implementation of a quality assurance program for computerized treatment planning systems according to TRS 430; Implantacao de um programa de controle de qualidade para sistemas de planejamento de tratamento computadorizados de acordo com o TRS 430

    Energy Technology Data Exchange (ETDEWEB)

    Camargo, Priscilla Roberta Tavares Leite

    2006-07-01

    This work presents the guidelines and necessary tests tom implement a quality assurance program for Eclipse 7.3.10 from Varian at Hospital das Clinicas, Sao Paulo University School of Medicine - Brazil, in accordance with the new IAEA publication TRS 430. The recommended tests for the TRS 430 air mainly classified into acceptance tests, commissioning (dosimetric and non-dosimetric tests), and routine tests. The IAEA document's recommendations are being implemented at the hospital for two Varian linear accelerators - Clinac 600C e Clinac 2100C. The acceptance tests verified 'hardware', integration of network systems, data transfer and 'software' parameters. The results obtained are in a good agreement with the manufacturer's specifications. Measurements of absolute dose in several set-ups were made for the commissioning dosimetric tests. These data were compared to the absolute doses determined by the TPS. The great majority of the tests showed 90% to 80% of the analyzed data in acceptance levels, with a good agreement between the experimental data and the data determined by the TPS. Only settings with asymmetric fields presented significant discords, showing the need for a more detailed inquiry for these settings. The non-dosimetric commissioning tests have also presented excellent results, with virtually all the system tools and general performance in compliance with TRS 430. The acceptance criteria have been applied for a comparison between the values of MUs generated by TPS and the calculated manually ones. The beams have been characterized for Eclipse with data transferred from CadPlan and with data from recommissioning of accelerators, so for these tests it was found a difference of at least 3% for the conformal field shape for the data originated in the beams of recommissioning and at least 4% for the data proceeded from CadPlan. The tolerance level established by TRS 430 for this setting was 3%. (author)

  19. Children Facing Divorce: A Treatment Program

    Science.gov (United States)

    Magid, Kenneth M.

    1977-01-01

    The children facing divorce program began last year and was built on the talents of an interdisciplinary staff. Included are experts in client-centered counseling, sociometry and psychodrama, Gestalt and TA, behavior modification, and various eclectic approaches to family therapy. (Author)

  20. Quality of Life and Cost Effectiveness of Prostate Cancer Treatment

    Science.gov (United States)

    2008-03-01

    measurement of satisfaction with treatment . AM J Man Care. 1997;3:579-594. 38. Borras JM, Sancez-Hernandez A, Navarro M, et al. Compliance...of Prostate Cancer Treatment PRINCIPAL INVESTIGATOR: Ravishankar Jayadevappa, Ph.D. CONTRACTING ORGANIZATION: University of...and Cost Effectiveness of Prostate Cancer Treatment 5b. GRANT NUMBER W81XWH-04-1-0257 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Ravishankar

  1. Quality assurance program plan for cesium legacy project

    International Nuclear Information System (INIS)

    Tanke, J.M.

    1997-01-01

    This Quality Assurance Program Plan (QAPP) provides information on how the Quality Assurance Program is implemented for the Cesium Legacy Project. It applies to those items and tasks which affect the completion of activities identified in the work breakdown structure of the Project Management Plan (PMP). These activities include all aspects of cask transportation, project related operations within the 324 Building, and waste management as it relates to the specific activities of this project. General facility activities (i.e. 324 Building Operations, Central Waste Complex Operations, etc.) are covered in other appropriate QAPPs. The 324 Building is currently transitioning from being a Pacific Northwest National Laboratory (PNNL) managed facility to a B and W Hanford Company (BWHC) managed facility. During this transition process existing PNNL procedures and documents will be utilized until replaced by BWHC procedures and documents

  2. Quality Assurance Program Plan for SFR Metallic Fuel Data Qualification

    Energy Technology Data Exchange (ETDEWEB)

    Benoit, Timothy [Argonne National Lab. (ANL), Argonne, IL (United States). Nuclear Engineering Division; Hlotke, John Daniel [Argonne National Lab. (ANL), Argonne, IL (United States). Nuclear Engineering Division; Yacout, Abdellatif [Argonne National Lab. (ANL), Argonne, IL (United States). Nuclear Engineering Division

    2017-07-05

    This document contains an evaluation of the applicability of the current Quality Assurance Standards from the American Society of Mechanical Engineers Standard NQA-1 (NQA-1) criteria and identifies and describes the quality assurance process(es) by which attributes of historical, analytical, and other data associated with sodium-cooled fast reactor [SFR] metallic fuel and/or related reactor fuel designs and constituency will be evaluated. This process is being instituted to facilitate validation of data to the extent that such data may be used to support future licensing efforts associated with advanced reactor designs. The initial data to be evaluated under this program were generated during the US Integral Fast Reactor program between 1984-1994, where the data includes, but is not limited to, research and development data and associated documents, test plans and associated protocols, operations and test data, technical reports, and information associated with past United States Nuclear Regulatory Commission reviews of SFR designs.

  3. Quality Program: what influences the opinion of nursing team.

    Science.gov (United States)

    Costa, Fernanda Mazzoni da; Souza, Irene Duarte; Monteiro, Maria Inês; Lopes, Maria Helena Baena de Moraes; Greco, Rosangela Maria

    2016-01-01

    To analyze the major impact variables in the opinion of nursing staff about the Quality Program of a teaching hospital. An exploratory-descriptive study was performed with 72 nursing staff. Data were collected through self-administered questionnaire containing 24 statements about the Quality Program; and the degree of agreement of the participants was expressed in a Likert scale. The collected data were analyzed by factor analysis and Pearson's correlation coefficient. The analysis grouped the statements in six factors. The Pearson's correlation coefficient defined a scale of influence of the variables within each factor, whose variable with the greatest impact in each factor is the priority issue for improving worker opinion about the Quality Program. The priority variables were to believe the Quality Program contributes to the hospital; to understand the program orientations; interest in hospital quality direction; and do not feel exhausted due to the program. These variables must be focused during the implementation and execution of Quality Program, as they have greater impact on improving opinion regarding the Quality Program and thus helping to increase compliance of the nursing staff to the program. Analisar as variáveis de maior impacto na opinião dos trabalhadores de enfermagem sobre um Programa de Qualidade de um hospital de ensino. Estudo exploratório-descritivo, desenvolvido com 72 trabalhadores de enfermagem, com dados coletados por meio de questionário autoaplicável, contendo 24 afirmações com escala Likert sobre o Programa de Qualidade. Para análise dos dados, foram utilizados análise fatorial e coeficiente de correlação de Pearson. A análise agrupou as afirmações em seis fatores. O coeficiente de correlação de Pearson definiu uma escala de influência das variáveis dentro de cada fator, cuja variável de maior impacto em cada fator representa a questão prioritária para a melhoria da opinião do trabalhador sobre o Programa de

  4. Effect of surface treatment of tailings on effluent quality

    International Nuclear Information System (INIS)

    Murray, D.R.

    1980-01-01

    Successful reclamation treatment, in preparation for long range abandonment of mining wastes, involves both surface treatment and water quality control containment of waste solids and liquid contaminants. This paper describes use of lysimeters containing 125 tonnes of tailings to determine the impact of gravel, sawdust, and vegetation as surface treatments on the quality and quantity of effluent produced from sulphide-containing uranium mill tailings. Over a five-year period these treatments were observed and compared with bare tailings where no surface addition was made. The treatments did not alter the effluent quality to a level acceptable to regulatory requirements. Surface treatments did not appear to affect the leaching of Ra-226, NH 4 and NO 3 . The concentration of Fe, SO 4 , Cu, Pb, and Al increased with the rise of acidity as the pH changed from pH 9.5 to pH 2 in four and one-half years. However the rate and extent of changes of some of these parameters vary with the treatment. The experimental results for the observed trends are presented with limited explanation. Original design problems and unexpected delays in tailing reactions have made firm conclusions impossible at this stage. These data, however, provide a base for further investigation and development of explanations and firm conclusions, as to the role of surface treatment in long-term waste abandonment

  5. Importance of quality assurance in establishing nucleoelectric programs - Spanish experience

    International Nuclear Information System (INIS)

    Alvarez Buergo, L. de; Santoma Juncadella, L.

    1977-01-01

    One condition which must be fulfilled in order for a nucleoelectric station to be successfully introduced, in countries being developed, is to define and structure the necessary organizations which will carry out the programs and insure that the stations be reliable, safe and economical. The two basic organizations which should be defined and structured are: a) The Government organization, whose objective is to insure the health and safety of the public, by means of evaluation, revision and control of the projects and their future operation; and b) The Project Management organization, whose objective is to select the site and the prototype of the station to be installed as well as carry out the project in such a way that the stations produce the expected amount of energy at a competitive kwh price and so that the operation does not create undue or unacceptable risks for the public. The importance of the quality assurance on the job is analyzed to achieve the indicated objectives, specific missions are defined and the quality assurance is presented as the link between the binomial National Participation-Quality Demands. The Spanish experience, referring to the application of quality in its present nuclear program with about 6500 Mwe in the construction stage and another 15.000 Mwe in various study and contracting stages, is also analyzed [es

  6. Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data

    Science.gov (United States)

    American Psychologist, 2009

    2009-01-01

    This document provides a set of criteria to be used by psychologists in evaluating quality improvement programs (QIPs) that have been promulgated by health care organizations, government agencies, professional associations, or other entities. These criteria also address the privacy and confidentiality issues evoked by the intended use of patient…

  7. Water Quality: A Field-Based Quality Testing Program for Middle Schools and High Schools.

    Science.gov (United States)

    Massachusetts State Water Resources Authority, Boston.

    This manual contains background information, lesson ideas, procedures, data collection and reporting forms, suggestions for interpreting results, and extension activities to complement a water quality field testing program. Information on testing water temperature, water pH, dissolved oxygen content, biochemical oxygen demand, nitrates, total…

  8. Quality of life issues relating to endocrine treatment options

    DEFF Research Database (Denmark)

    Iversen, P

    1999-01-01

    Recent interest has focused on the use of hormone therapy in prostate cancer for both the management of patients with non-metastatic disease and as a neoadjuvant or adjuvant to curative therapies. This has resulted in patients with fewer symptoms being treated for longer periods of time. Endocrine...... with locally advanced (M0) disease compared with castration, suggesting that this treatment may benefit patients with early disease. Bicalutamide was favoured in 8 out of 9 evaluable quality of life dimensions, and this was statistically significant for sexual interest and physical capacity. Endocrine...... for measuring health-related quality of life should assess both overall and disease-specific quality of life. Data from two large studies of bicalutamide monotherapy show that this non-steroidal antiandrogen is associated with significant health-related quality of life advantages in the treatment of patients...

  9. Nuclear Waste Treatment Program: Annual report for FY 1986

    International Nuclear Information System (INIS)

    Burkholder, H.C.; Brouns, R.A.; Powell, J.A.

    1987-09-01

    To support DOE's attainment of its goals, Nuclear Waste Treatment Program (NWTP) is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting. This annual report describes progress during FY 1986 toward meeting these two objectives. 29 refs., 59 figs., 25 tabs

  10. Nuclear Waste Treatment Program: Annual report for FY 1986

    Energy Technology Data Exchange (ETDEWEB)

    Burkholder, H.C.; Brouns, R.A. (comps.); Powell, J.A. (ed.)

    1987-09-01

    To support DOE's attainment of its goals, Nuclear Waste Treatment Program (NWTP) is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting. This annual report describes progress during FY 1986 toward meeting these two objectives. 29 refs., 59 figs., 25 tabs.

  11. A semi-automated tool for treatment plan-quality evaluation and clinical trial quality assurance

    International Nuclear Information System (INIS)

    Wang, Jiazhou; Chen, Wenzhou; Studenski, Matthew; Cui, Yunfeng; Xiao, Ying; Lee, Andrew J

    2013-01-01

    The goal of this work is to develop a plan-quality evaluation program for clinical routine and multi-institutional clinical trials so that the overall evaluation efficiency is improved. In multi-institutional clinical trials evaluating the plan quality is a time-consuming and labor-intensive process. In this note, we present a semi-automated plan-quality evaluation program which combines MIMVista, Java/MATLAB, and extensible markup language (XML). More specifically, MIMVista is used for data visualization; Java and its powerful function library are implemented for calculating dosimetry parameters; and to improve the clarity of the index definitions, XML is applied. The accuracy and the efficiency of the program were evaluated by comparing the results of the program with the manually recorded results in two RTOG trials. A slight difference of about 0.2% in volume or 0.6 Gy in dose between the semi-automated program and manual recording was observed. According to the criteria of indices, there are minimal differences between the two methods. The evaluation time is reduced from 10–20 min to 2 min by applying the semi-automated plan-quality evaluation program. (note)

  12. A semi-automated tool for treatment plan-quality evaluation and clinical trial quality assurance

    Science.gov (United States)

    Wang, Jiazhou; Chen, Wenzhou; Studenski, Matthew; Cui, Yunfeng; Lee, Andrew J.; Xiao, Ying

    2013-07-01

    The goal of this work is to develop a plan-quality evaluation program for clinical routine and multi-institutional clinical trials so that the overall evaluation efficiency is improved. In multi-institutional clinical trials evaluating the plan quality is a time-consuming and labor-intensive process. In this note, we present a semi-automated plan-quality evaluation program which combines MIMVista, Java/MATLAB, and extensible markup language (XML). More specifically, MIMVista is used for data visualization; Java and its powerful function library are implemented for calculating dosimetry parameters; and to improve the clarity of the index definitions, XML is applied. The accuracy and the efficiency of the program were evaluated by comparing the results of the program with the manually recorded results in two RTOG trials. A slight difference of about 0.2% in volume or 0.6 Gy in dose between the semi-automated program and manual recording was observed. According to the criteria of indices, there are minimal differences between the two methods. The evaluation time is reduced from 10-20 min to 2 min by applying the semi-automated plan-quality evaluation program.

  13. Quality of online information on breast cancer treatment options.

    Science.gov (United States)

    Arif, Nadia; Ghezzi, Pietro

    2018-02-01

    Offering breast cancer patients treatment choice has become a priority as the involvement of patients in the decision-making process is associated with improved physical and psychological outcomes. As the Internet is increasingly being used by patients as a source of medical information, it is important to evaluate the quality of information relating to breast cancer on the Internet. We analysed 200 websites returned by google.co.uk searching "breast cancer treatment options" in terms of their typology and treatment options described. These were related to standard measures of health information quality such as the JAMA score and the presence of quality certifications, as well as readability. We found that health portals were of higher quality whilst commercial and professional websites were of poorer quality in terms of JAMA criteria. Overall, readability was higher than previously reported for other conditions, and Google ranked websites with better readability higher. Most websites discussed surgical and medical treatments. Few websites, with a large proportion being of commercial typology, discussed complementary and alternative medicine. Google ranked professional websites low whilst websites from non-profit organizations were promoted in the ranking. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Implementation of a bowel management program in the treatment of ...

    African Journals Online (AJOL)

    Implementation of a bowel management program in the treatment of incontinence in children for primary healthcare providers. Mahmoud M.A. Elfiky, Mostafa A. Gad, Mohamed M. El Barbary, Sherif N. Kaddah, Gamal H. El Tagy ...

  15. The Humanistic Treatment Philosophy of Innovative Drug Programs

    Science.gov (United States)

    Kolton, Marilyn S.

    1973-01-01

    This article presents a philosophy perceived by young professionals, often members of the counterculture, who completed a series of questions concerning innovative programs with a humanistic orientation to drug treatment. (Author/RK)

  16. Use of Gestalt Therapy Within a Drug Treatment Program.

    Science.gov (United States)

    Sideroff, Stephen I.

    1979-01-01

    Presents a Gestalt therapeutic approach that has shown promise within a drug treatment program. The major issues discussed include the acquisition of self-support, taking responsibility, dealing with anxiety, contact, and the expression of pent-up feelings. (Author)

  17. Pilot treatment program for shoplifting in eating disorders.

    Science.gov (United States)

    Birmingham, C L; Hlynsky, J; Russell, B; Gritzner, S

    2005-12-01

    There are no established treatment programs for shoplifting in eating disorder patients. Our objective was to observe the effect of an established behavioural treatment program in a series of eating disorder patients. Patients with eating disorders who shoplift voluntarily took part in an 8-week behavioral treatment program at the Elizabeth Fry Society of Greater Vancouver, British Columbia. They completed assessments at the first session, last session, and at 1 and 6 months post intervention. Six patients enrolled in the study and three patients completed the treatment program. Only one patient reported a decrease in shoplifting frequency. All subjects reported an increase in self-esteem and ability to control shoplifting impulses. Our findings suggest that behavioral therapy may be effective in treating shoplifting in eating disorders, but that longer sessions and follow-up may be necessary to show benefit. A randomized control trial with longer-term follow-up is needed to determine whether there is a benefit.

  18. [Larynx cancer: quality of life and voice after treatment].

    Science.gov (United States)

    Rossi, Vaneli Colombo; Fernandes, Fernando Laffitte; Ferreira, Maria Augusta Aliperti; Bento, Lucas Ricci; Pereira, Pablo Soares Gomes; Chone, Carlos Takahiro

    2014-01-01

    Treatments for patients with laryngeal cancer often have an impact on physical, social, and psychological functions. To evaluate quality of life and voice in patients treated for advanced laryngeal cancer through surgery or exclusive chemoradiation. Retrospective cohort study with 30 patients free from disease: ten total laryngectomy patients without production of esophageal speech (ES); ten total laryngectomy patients with tracheoesophageal speech (TES), and ten with laryngeal speech. Quality of life was measured by SF-36, Voice-Related Quality of Life (V-RQOL), and Voice Handicap Index (VHI) protocols, applied on the same day. The SF-36 showed that patients who received exclusive chemoradiotherapy had better quality of life than the TES and ES groups. The V-RQOL showed that the voice-related quality of life was lower in the ES group. In the VHI, the ES group showed higher scores for overall, emotional, functional, and organic VHI. Quality of life and voice in patients treated with chemoradiotherapy was better than in patients treated surgically. The type of medical treatment used in patients with laryngeal cancer can bring changes in quality of life and voice. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  19. Larynx cancer: quality of life and voice after treatment

    Directory of Open Access Journals (Sweden)

    Vaneli Colombo Rossi

    2014-10-01

    Full Text Available INTRODUCTION: Treatment for patients with larynx cancer often results in a negative impact on their physical, social and psychological functions. OBJECTIVE: To evaluate quality of life and voice in patients treated for advanced laryngeal cancer as a consequence of surgery or exclusive chemoradiation. METHODS: Retrospective cohort study with 30 patients free of disease: 10 total laryngectomy patients without production of esophageal speech (EVS; 10 Total laryngectomy patients with tracheoesophageal voice (TEV and 10 patients with laryngeal voice. Quality of life was measured by SF-36; Voice-Related Quality of Life (V-RQOL and Voice Handicap Index (VHI protocols, applied on the same day. RESULTS: The SF-36 demonstrated that patients who received chemoradiotherapy exclusively enjoyed a feature better quality of life than the group of TEV and EVS. In V-RQOL it was observed that the quality of life related to voice is lower than in the EVS. In the VHI group EVS presented higher scores for overall VHI, emotional, functional and organic. DISCUSSION: Quality of life and voice in patients treated with chemoradiotherapy was better than in patients treated surgically. CONCLUSION: The type of medical treatment selected in patients with laryngeal cancer can influence changes in quality of life and voice.

  20. The Impulsive Lifestyle Counseling Program for Antisocial Behavior in Outpatient Substance Abuse Treatment.

    Science.gov (United States)

    Thylstrup, Birgitte; Hesse, Morten

    2016-06-01

    Antisocial behavior is associated with low quality of life for the patient and with adverse effects on society and those close to the antisocial patient. However, most patients with antisocial behavior are not seen in treatment settings that focus on their personality but rather in criminal justice settings, substance-abuse treatment, and social welfare settings. This article describes the adaptation and implementation of a highly structured manualized treatment, Impulsive Lifestyle Counseling (ILC), based on the Lifestyle Issues program, a 10-week psychoeducation program studied in prison settings. ILC consists of four sessions over 4 weeks and a booster session 8 weeks later. The goal of treatment is described to patients as "to help people identify their impulsive thoughts and lifestyle leading to problems with drug use, other people, and the police." Two clinical examples and reflections on our experiences with the training and implementation of the ILC program are presented. © The Author(s) 2011.

  1. Incorporation of continuous quality improvement in a hospital dietary department's quality management program.

    Science.gov (United States)

    Letort, N R; Boudreaux, J

    1994-12-01

    What techniques or steps are necessary to overcome obstacles and achieve the incorporation of continuous quality improvement (CQI) methods in existing quality management programs? Education of staff, identification of customers' expectations, and implementation of a plan to administer activities are critical to a positive outcome of CQI efforts. Our article outlines one approach to the transition from quality assurance to CQI using the FOCUS-PDCA technique. We use the example of improving the timeliness of late tray deliveries to demonstrate how to implement the conversion to CQI using the FOCUS-PDCA technique. The dietetics practitioners may apply the sequential steps described in the article to successfully incorporate the CQI concept in most hospital dietary departments' quality management activities.

  2. Improvement in Quality Metrics by the UPMC Enhanced Care Program: A Novel Super-Utilizer Program.

    Science.gov (United States)

    Bryk, Jodie; Fischer, Gary S; Lyons, Anita; Shroff, Swati; Bui, Thuy; Simak, Deborah; Kapoor, Wishwa

    2017-09-25

    The aim was to evaluate pre-post quality of care measures among super-utilizer patients enrolled in the Enhanced Care Program (ECP), a primary care intensive care program. A pre-post analysis of metrics of quality of care for diabetes, hypertension, cancer screenings, and connection to mental health care for participants in the ECP was conducted for patients enrolled in ECP for 6 or more months. Patients enrolled in ECP showed statistically significant improvements in hemoglobin A1c, retinal exams, blood pressure measurements, and screenings for colon cancer, and trends toward improvement in diabetic foot exams and screenings for cervical and breast cancer. There was a significant increase in connecting patients to mental health care. This study shows that super-utilizer patients enrolled in the ECP had significant improvements in quality metrics from those prior to enrollment in ECP.

  3. What is the role of a project or program manager in implementing and maintaining a quality assurance program

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    The task of managing a government-funded program has changed significantly from the days when a program manager managed the funds and depended on reports from a contractor to measure the program's progress. Today's manager of waste management program must be personally involved in every aspect of the program. The successful manager of a waste management program will lead the development of management controls to ensure successful accomplishment of project objectives. This paper describes the responsibilities of the project manager, the quality assurance staff and how they interface to develop and implement a quality assurance program for a waste management program

  4. The RCPA Quality Assurance Program in Dermatopathology: A Retrospective Review.

    Science.gov (United States)

    Peck, Martyn; Beer, Trevor W; Badrick, Tony; Wood, Benjamin A

    2018-03-01

    To review the Royal College of Pathologists of Australasia (RCPA) Quality Assurance Program Dermatopathology module from 2005 to 2016 to assess diagnostic performance, changes over time, and areas of diagnostic difficulty. The computerized records of the RCPA Dermatopathology subspecialist module were reviewed. Cases were categorized into groups including nonneoplastic disorders, neoplasms, and cases with multiple diagnoses. The performance of participants over time in each of these categories and in more specific areas (including melanocytic and adnexal neoplasms) was assessed. Cases which showed high rates of discordant responses were specifically reviewed. One hundred sixteen cases circulated over 10 years were evaluated. The overall concordance rate was 77%, with a major discordance rate of 7%. There was a slightly higher concordance rate for neoplasms compared with nonneoplastic lesions (80% vs. 74%). Specific areas associated with lower concordance rates included classification of adnexal tumors and identification of multiple pathologies. A spindle cell nevus of Reed yielded a 40% discordance rate, with most misclassifications indicating melanoma. The RCPA quality assurance program module has circulated a wide range of common and uncommon cases to participants over the 12 years studied, highlighting a low but important rate of major discordant responses. Melanocytic lesions, hematolymphoid infiltrates, adnexal tumors, and identification of multiple pathologies are identified as areas worthy of particular attention in quality improvement activities.

  5. Quality Assurance Program Plan for the Waste Isolation Pilot Plant Experimental-Waste Characterization Program

    International Nuclear Information System (INIS)

    1991-01-01

    This Quality Assurance Program Plan (QAPP) identifies the quality of data necessary to meet the specific objectives associated with the Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP) Experimental-Waste Characterization Program (the Program). DOE plans to conduct experiments in the WIPP during a Test Phase of approximately 5 years. These experiments will be conducted to reduce the uncertainties associated with the prediction of several processes (e.g., gas generation) that may influence repository performance. The results of the experiments will be used to assess the ability of the WIPP to meet regulatory requirements for the long-term protection of human health and the environment from the disposal of TRU wastes. 37 refs., 25 figs., 18 tabs

  6. Sleep Quality Improves During Treatment With Bryophyllum pinnatum

    Science.gov (United States)

    Hassani, Taziri Al; Müller-Hübenthal, Boris; Pittl, Sandra; Kuck, Angela; Meden, Harald; Eberhard, Jutta; Decker, Michael; Fürer, Karin; von Mandach, Ursula

    2015-01-01

    Hypothesis. Cancer patients frequently suffer from poor sleep quality. Bryophyllum pinnatum is a herbal medication used in anthroposophic medicine, which has been shown to be associated with improvements in sleep quality during pregnancy with only few and minor or moderate side-effects reported. In this study, the sleep quality of cancer patients during treatment with B pinnatum was investigated. Study Design. In this prospective, observational study, cancer patients suffering from sleep problems were treated with B pinnatum (350 mg tablets, corresponding to 50% of leaf pressed juice [Weleda AG, Arlesheim, Switzerland], dosage at physician’s consideration, but most frequently 2 tablets with evening meal and 2 before going to bed). Methods. Sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daily sleepiness (Epworth Sleeping Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) were assessed at the beginning of the treatment and after 3 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded. From the 28 recruited patients, 20 completed both questionnaires and were considered in the present analysis. Data are expressed as mean ± standard deviation. Results. Patients were 61 ± 10.4 years old and the majority were female (17 out of 20). During treatment with B pinnatum, the PSQI decreased from 12.2 ± 3.62 to 9.1 ± 3.61 (P < .01), and ESS changed from 8.4 ± 3.18 to 7.1 ± 3.98 (P < .05). There was no change in FSS. The treatment was well tolerated by the majority of patients, with only 6 patients reporting discomfort that might have been caused by B pinnatum (fatigue n = 3, dry throat n = 1, agitation n = 1, difficult digestion n = 1). No serious adverse drug reactions were detected. Conclusion. B pinnatum may be a suitable treatment for sleep problems of cancer patients. Controlled, randomized clinical trials of the use of B pinnatum in sleep disorders are urgently needed. PMID:25873294

  7. Effectiveness of a quality-improvement program in improving management of primary care practices.

    NARCIS (Netherlands)

    Szecsenyi, J.; Campbell, S.M.; Broge, B.; Laux, G.; Willms, S.; Wensing, M.J.P.; Goetz, K.

    2011-01-01

    BACKGROUND: The European Practice Assessment program provides feedback and outreach visits to primary care practices to facilitate quality improvement in five domains (infrastructure, people, information, finance, and quality and safety). We examined the effectiveness of this program in improving

  8. Use of national surgical quality improvement program data as a catalyst for quality improvement.

    Science.gov (United States)

    Rowell, Katherine S; Turrentine, Florence E; Hutter, Matthew M; Khuri, Shukri F; Henderson, William G

    2007-06-01

    Semiannually, the National Surgical Quality Improvement Program (NSQIP) provides its participating sites with observed-to-expected (O/E) ratios for 30-day postoperative mortality and morbidity. At each reporting period, there is typically a small group of hospitals with statistically significantly high O/E ratios, meaning that their patients have experienced more adverse events than would be expected on the basis of the population characteristics. An important issue is to determine which actions a surgical service should take in the presence of a high O/E ratio. This article reviews case studies of how some of the Department of Veterans Affairs and private-sector NSQIP participating sites used the clinically rich NSQIP database for local quality improvement efforts. Data on postoperative adverse events before and after these local quality improvement efforts are presented. After local quality improvement efforts, wound complication rates were reduced at the Salt Lake City Veterans Affairs medical center by 47%, surgical site infections in patients undergoing intraabdominal surgery were reduced at the University of Virginia by 36%, and urinary tract infections in vascular patients were reduced at the Massachusetts General Hospital by 74%. At some sites participating in the NSQIP, notably the Massachusetts General Hospital and the University of Virginia, the NSQIP has served as the basis for surgical service-wide outcomes research and quality improvement programs. The NSQIP not only provides participating sites with risk-adjusted surgical mortality and morbidity outcomes semiannually, but the clinically rich NSQIP database can also serve as a catalyst for local quality improvement programs to significantly reduce postoperative adverse event rates.

  9. Quality of data computational models and telemedicine treatment effects

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Widya, I.A.; Bults, Richard G.A.; Hermens, Hermanus J.

    2014-01-01

    Clinical decision-support functions of telemedicine systems use patient's monitored clinical data to support treatment of outpatients. However, the quality of monitored clinical data may vary due to performance variations of technological resources inside a deployed telemedicine system. This paper

  10. Gastric cancer : staging, treatment, and surgical quality assurance

    NARCIS (Netherlands)

    Dikken, Johannes Leen

    2012-01-01

    Research described in this thesis focuses on several aspects of gastric cancer care: staging and prognostication, multimodality treatment, and surgical quality assurance. PART I - STAGING AND PROGNOSTICATION Cancer staging is one of the fundamental activities in oncology.6,7 For over 50 years, the

  11. Quality of life among dots (directly observed treatment short course ...

    African Journals Online (AJOL)

    Background: Globally, 8.7 million people suffered with tuberculosis (TB) and 1.4 million deaths were reported in 2011. Tuberculosis may generate residual lesions in the course of its pathology, which impair the functionality and quality of life of the patient even after achieving "cure" or "treatment completion. The present ...

  12. Quality of life of women undergoing treatment for cervical cancer

    Directory of Open Access Journals (Sweden)

    Francieli Ana Dallabrida

    2014-04-01

    Full Text Available This study aimed to evaluate the quality of life of women with cervical cancer. This is a cross-sectional, descriptive study developed with 43 women undergoing oncological treatment assisted at an Oncology High Complexity Center, in the Southern region of Brazil. The instrument used was the European Organization for Research and Treatment of Cancer – Quality of Life Questionnaire Core-30, and the data were analyzed through descriptive statistics. The average age was 54.6 years old. Married women prevailed (53.4%, with incomplete elementary education (72.1% and income from one to two minimum wages (62.8%. Quality of Life was considered very satisfactory. According to the development scales and emotional functioning, the result was from regular to satisfactory. The most frequent symptoms were fatigue, lack of appetite and pain. There is a need of structure of public health policies, for preventing cervical cancer in the most vulnerable population.

  13. Integrated intensive proprioceptive and visuomotor rehabilitation program for treatment of spastic diplegic Children

    Directory of Open Access Journals (Sweden)

    Fathy A. Elshazly

    2016-08-01

    Full Text Available Although so many rehabilitation programs have been addressed for rehabilitation of diplegic children, it still a challenging task to attain a satisfactory functional recovery. The purpose of the study was to investigate the efficacy of an intensive proprioceptive and visuomotor training program in the treatment of diplegic children in term of spatiotemporal gait parameters, postural stability, and quality of life. In a prospective randomized controlled trial, convenient sample of forty ambulant diplegic children were randomly distributed to either control (n=20 or study (n=20 groups; the control group received a traditional rehabilitation program for 1 hour, 5 times/week for 3 successive months, while the study group received the same program with intensive proprioceptive and visuomotor integration. Vicon 3D motion analysis system, Technobody balance system and Pediatric Quality of life Inventory were used to measure spatiotemporal gait parameters, stability indices and quality of life respectively. all parameters were similar in both groups at inception (p˃0.05. Children within both groups showed improvement of gait function, postural stability and quality of life (p˂0.05 and the integrated proprioceptive and visuomotor rehabilitation program achieved better gain (p˂0.05. Integrated proprioceptive and visuomotor rehabilitation might improve gait function, postural stability, and quality of life in diplegic children.

  14. 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

  15. Quality Assurance of ARM Program Climate Research Facility Data

    Energy Technology Data Exchange (ETDEWEB)

    Peppler, RA; Kehoe, KE; Sonntag, KL; Bahrmann, CP; Richardson, SJ; Christensen, SW; McCord, RA; Doty, DJ; Wagener, Richard [BNL; Eagan, RC; Lijegren, JC; Orr, BW; Sisterson, DL; Halter, TD; Keck, NN; Long, CN; Macduff, MC; Mather, JH; Perez, RC; Voyles, JW; Ivey, MD; Moore, ST; Nitschke, DL; Perkins, BD; Turner, DD

    2008-03-01

    This report documents key aspects of the Atmospheric Radiation Measurement (ARM) Climate Research Facility (ACRF) data quality assurance program as it existed in 2008. The performance of ACRF instruments, sites, and data systems is measured in terms of the availability, usability, and accessibility of the data to a user. First, the data must be available to users; that is, the data must be collected by instrument systems, processed, and delivered to a central repository in a timely manner. Second, the data must be usable; that is, the data must be inspected and deemed of sufficient quality for scientific research purposes, and data users must be able to readily tell where there are known problems in the data. Finally, the data must be accessible; that is, data users must be able to easily find, obtain, and work with the data from the central repository. The processes described in this report include instrument deployment and calibration; instrument and facility maintenance; data collection and processing infrastructure; data stream inspection and assessment; the roles of value-added data processing and field campaigns in specifying data quality and haracterizing the basic measurement; data archival, display, and distribution; data stream reprocessing; and engineering and operations management processes and procedures. Future directions in ACRF data quality assurance also are presented.

  16. Quality Assurance of ARM Program Climate Research Facility Data

    International Nuclear Information System (INIS)

    Peppler, R.A.; Kehoe, K.E.; Sonntag, K.L.; Bahramann, C.P.; Richardson, S.J.; Christensen, S.W.; McCord, R.A.; Doty, D.J.; Wagener, R.; Eagan, R.C.; Lijegren, J.C.; Orr, B.W.; Sisterson, D.L.; Halter, T.D.; Keck, N.N.; Long, C.N.; Macduff, M.C.; Mather, J.H.; Perez, R.C.; Voyles, J.W.; Ivey, M.D.; Moore, S.T.; Nitschke, D.L.; Perkins, B.D.; Turner, D.D.

    2008-01-01

    This report documents key aspects of the Atmospheric Radiation Measurement (ARM) Climate Research Facility (ACRF) data quality assurance program as it existed in 2008. The performance of ACRF instruments, sites, and data systems is measured in terms of the availability, usability, and accessibility of the data to a user. First, the data must be available to users; that is, the data must be collected by instrument systems, processed, and delivered to a central repository in a timely manner. Second, the data must be usable; that is, the data must be inspected and deemed of sufficient quality for scientific research purposes, and data users must be able to readily tell where there are known problems in the data. Finally, the data must be accessible; that is, data users must be able to easily find, obtain, and work with the data from the central repository. The processes described in this report include instrument deployment and calibration; instrument and facility maintenance; data collection and processing infrastructure; data stream inspection and assessment; the roles of value-added data processing and field campaigns in specifying data quality and characterizing the basic measurement; data archival, display, and distribution; data stream reprocessing; and engineering and operations management processes and procedures. Future directions in ACRF data quality assurance also are presented

  17. Hampton roads regional Water-Quality Monitoring Program

    Science.gov (United States)

    Porter, Aaron J.; Jastram, John D.

    2016-12-02

    IntroductionHow much nitrogen, phosphorus, and suspended solids are contributed by the highly urbanized areas of the Hampton Roads region in Virginia to Chesapeake Bay? The answer to this complex question has major implications for policy decisions, resource allocations, and efforts aimed at restoring clean waters to Chesapeake Bay and its tributaries. To quantify the amount of nitrogen, phosphorus, and suspended solids delivered to the bay from this region, the U.S. Geological Survey has partnered with the Hampton Roads Sanitation District (HRSD), in cooperation with the Hampton Roads Planning District Commission (HRPDC), to conduct a water-quality monitoring program throughout the Hampton Roads region.

  18. Data Control Program to support the Quality Assurance System

    International Nuclear Information System (INIS)

    Yacobenco, A.; Varella, M.; Figuereido, W.; Passos, V.

    1998-01-01

    In order to give support the Quality Assurance System (QAS) in Odontological Radiology a software called Data Control Program (DCP) was developed. The aim of the DCP was to applied an uniform methodology during the inspections and for control of administrative and financial data. First, the DCP was developed using microsoft. The microcomputer configuration employs a Pentium 200 MHz processor, 64 MB of memory and 3,2 GB of free space in the hard disk. The DCP allows for the simultaneous use of several departments in the company providing the elaboration of safe and reliable system of information management in several areas and a fast and good performance in services

  19. CR mammography: Design and implementation of a quality control program

    Energy Technology Data Exchange (ETDEWEB)

    Moreno-Ramirez, A.; Brandan, M. E.; Villasenor-Navarro, Y.; Galvan, H. A.; Ruiz-Trejo, C. [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, DF 04510 (Mexico); Departamento de Radiodiagnostico, Instituto Nacional de Cancerologia, DF 14080 (Mexico); Instituto de Fisica, Universidad Nacional Autonoma de Mexico, DF 04510 (Mexico)

    2012-10-23

    Despite the recent acquisition of significant quantities of computed radiography CR equipment for mammography, Mexican regulations do not specify the performance requirements for digital systems such as those of CR type. The design of a quality control program QCP specific for CR mammography systems was thus considered relevant. International protocols were taken as reference to define tests, procedures and acceptance criteria. The designed QCP was applied in three CR mammography facilities. Important deficiencies in spatial resolution, noise, image receptor homogeneity, artifacts and breast thickness compensation were detected.

  20. Harvested rainwater quality before and after treatment in six ...

    Science.gov (United States)

    Rainwater harvesting (RWH) is an alternative method of providing water for indoor domestic use, but the water quality after treatment and distribution at individual residences is not well documented. In this study, water quality parameters were measured at the cistern and indoor cold-water taps of six residential RWH systems that use various treatment processes. Potential human pathogens (Mycobacterium avium, Mycobacterium intracellulare, Aspergillus flavus, Aspergillus fumigatus, and Aspergillus niger) were found frequently in cisterns and in treated rainwater delivered at the tap; Legionella pneumophila was not detected as frequently, but it persisted in a system after its first detection. The observed decreases in bacterial concentrations from the cistern to the tap after filtration/ ultraviolet (UV) treatment and distribution were less than expected; this suggests deficiencies in the effectiveness of the filtration/UV processes employed and/or degradation in water quality in the distribution system due to the absence of a disinfectant residual. Determination of the disinfection efficiency occuring in home treatment processes. Molecular analysis of rainwater before and after treatment. First study to include the monitoring of opportunistic fungal pathogens.

  1. Maintaining quality control in a nontraditional nuclear technology degree program

    International Nuclear Information System (INIS)

    DeSain, G.W.

    1989-01-01

    Regents College, created by the Board of Regents of the University of The State on New York in 1971, has been offering, since January 1985, AS and BS degrees in nuclear technology. The impetus for establishing the nuclear technology degrees came from nuclear utility management and had to do with the US Nuclear Regulatory Commission proposed rule regarding degreed operators on shift. There are a variety of ways to earn credits in Regents College degree programs: (1) college courses taken for degree-level credit from regionally accredited colleges; (2) courses sponsored by business, industry, or government that have been evaluated and recommended for credit by the New York National or American Council on Education (ACE's) Program on Noncollegiate Sponsored Instruction (PONSI); (3) military education that has been evaluated by ACE PONSI; (4) approved college-proficiency examinations; and (5) special assessment: an individualized examination of college-level knowledge gained from experience or independent study. Nuclear technology students primarily use college course work, evaluated military education, and proficiency examinations to complete degree programs. However, an increasing number of utilities are having training programs PONSI evaluated, resulting in an increased use of these courses in the nuclear technology degrees. Quality control is a function of several factors described in the paper

  2. An In-Depth Survey of the Screening and Assessment Practices of Highly Regarded Adolescent Substance Abuse Treatment Programs

    Science.gov (United States)

    Gans, Jeremy; Falco, Mathea; Schackman, Bruce R.; Winters, Ken C.

    2010-01-01

    Aims: To examine the quality of screening and assessment practices at some of the most highly regarded adolescent substance use treatment programs in the United States. Methods: Between March and September 2005, telephone surveys were administered to directors of highly regarded programs. Several different publications and databases were then used…

  3. Quality and productivity improvement program (PPKP) from alumni perspective

    Science.gov (United States)

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

    Defining the quality of the university education system is not easy. Institutions of higher education, through curriculum are hoped to provide the knowledge, wisdom and personality of students. It is questionable of how far Quality and Productivity Improvement Program (PPKP) are capable to ensure the courses offered relevant and effective in preparing the students for job market. The effectiveness of a university to undertake responsibilities and the impact given to students even after they graduate can be a measure of education quality at university. So, the quality of education can be enhanced and improved from time to time. In general, this study is aims to determine the effectiveness of PPKP's education system from the perspective of their alumni as well as their satisfaction and the importance level based on how PPKP be able to meet their needs. In overall, summary of open-ended questions from the questionnaire, Importance-Performance analysis and correlation analysis were conducted for this study. Based on result, it appears that there are still some deficiencies that can be improve, particularly in terms of teaching skills and PPKP's relationships with external organizations to enable knowledge be channel effectively. Importance-Performance analysis highlights some topics or courses that should be offered by PPKP based on their importance in industrial practice. Summary of the results of correlation analysis was found that women are more positive and not too demanding compared to men. In addition, it is found that the responsibilities and workload of the older generations, higher income and a high level of experience demands them to use and practice what they have learned during their studies at PPKP. Results of this study are hoped could be used to improve the quality of education system at PPKP.

  4. [Effects of aerobic exercise program and relaxation techniques on anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia: a randomized controlled trial].

    Science.gov (United States)

    Arcos-Carmona, Isabel María; Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo Adolfo; Gutiérrez-Rubio, Ana Belén; Ramos-González, Elena; Moreno-Lorenzo, Carmen

    2011-10-08

    Fibromyalgia is considered as a combination of physical, psychological and social disabilities. The purpose of the present study was to determine the benefits of aerobic exercise program and progressive relaxation techniques on anxiety, quality of sleep, depression and quality of life in patients with fibromyalgia. An experimental study was performed with a placebo control group. Fifty-six fibromyalgia patients were randomly assigned to intervention (aerobic exercises+progressive relaxation techniques) and placebo (sham treatment with disconnected magnet therapy device) groups. Outcome measures were anxiety (STAI- State Trait Anxiety Inventory), quality of sleep (Pittsburgh sleep quality index), depression (Beck depression inventory) and quality of life (questionnaire SF-36). Measures were performed at baseline and after 10-weeks treatment. After 10 weeks of treatment, the intervention group showed significant reduction (panxiety and quality of life. The combination of aerobic exercise program and progressive relaxation techniques contribute to improve night rest, trait anxiety and quality of life in patients with fibromyalgia. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  5. Standards of Practice: Quality Assurance Guidelines for Percutaneous Treatments of Intervertebral Discs

    International Nuclear Information System (INIS)

    Kelekis, Alexis D.; Filippiadis, Dimitris K.; Martin, Jean-Baptiste; Brountzos, Elias

    2010-01-01

    Percutaneous treatments are used in the therapy of small- to medium-sized hernias of intervertebral discs to reduce the intradiscal pressure in the nucleus and theoretically create space for the herniated fragment to implode inward, thus reducing pain and improving mobility and quality of life. These techniques involve the percutaneous removal of the nucleus pulposus by using a variety of chemical, thermal, or mechanical techniques and consist of removal of all or part of nucleus pulposus to induce more rapid healing of the abnormal lumbar disc. These guidelines are written to be used in quality improvement programs for assessing fluoroscopy- and/or computed tomography-guided percutaneous intervertebral disc ablative techniques.

  6. Recommendations for quality assurance programs in nuclear medicine facilities. Radiation recommendations series

    International Nuclear Information System (INIS)

    Segal, P.; Hamilton, D.R.

    1984-10-01

    The publication provides the elements that should be considered by nuclear medicine facilities to improve their existing programs or develop new quality assurance programs. The important administrative aspects of quality assurance programs are stressed. Each facility is encouraged to adopt those elements of the recommended program that are appropriate to its individual needs and resources

  7. Extending cluster lot quality assurance sampling designs for surveillance programs.

    Science.gov (United States)

    Hund, Lauren; Pagano, Marcello

    2014-07-20

    Lot quality assurance sampling (LQAS) has a long history of applications in industrial quality control. LQAS is frequently used for rapid surveillance in global health settings, with areas classified as poor or acceptable performance on the basis of the binary classification of an indicator. Historically, LQAS surveys have relied on simple random samples from the population; however, implementing two-stage cluster designs for surveillance sampling is often more cost-effective than simple random sampling. By applying survey sampling results to the binary classification procedure, we develop a simple and flexible nonparametric procedure to incorporate clustering effects into the LQAS sample design to appropriately inflate the sample size, accommodating finite numbers of clusters in the population when relevant. We use this framework to then discuss principled selection of survey design parameters in longitudinal surveillance programs. We apply this framework to design surveys to detect rises in malnutrition prevalence in nutrition surveillance programs in Kenya and South Sudan, accounting for clustering within villages. By combining historical information with data from previous surveys, we design surveys to detect spikes in the childhood malnutrition rate. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Developing High-Quality Cancer Rehabilitation Programs: A Timely Need.

    Science.gov (United States)

    Alfano, Catherine M; Cheville, Andrea L; Mustian, Karen

    2016-01-01

    The number of survivors of cancer in the United States, already 14.5 million, is growing with improved cancer treatment and aging of the population. Two-thirds of cancer survivors will be older than age 65 and are likely to enter cancer treatment already deconditioned and with multiple comorbidities. Survivors of cancer face numerous adverse consequences of cancer treatment that add to or exacerbate the effects of existing comorbidities and increase risk of functional decline. Many of these problems are amenable to rehabilitation interventions, but referral to cancer rehabilitation professionals is not a standard part of care. We present an expanded prospective model of surveillance, cancer rehabilitation assessment, and referral efforts using a multidisciplinary team approach. In this model, cancer rehabilitation begins at the time of cancer diagnosis and continues through and beyond cancer treatment. Physical impairments and psychosocial symptoms are assessed and treated, and lifestyle and exercise interventions are provided to optimize functioning, health, and quality of life. We present a stepped-care framework to guide decisions on when, how, and where to refer survivors to cancer rehabilitation specialists depending on safety requirements and needs. This model has the potential to result in early identification of symptoms and impairments, appropriate referral and timely treatment, and, in turn, will better address and minimize both acute and long-term cancer morbidity.

  9. What Works after School? The Relationship between After-School Program Quality, Program Attendance, and Academic Outcomes

    Science.gov (United States)

    Leos-Urbel, Jacob

    2015-01-01

    This article examines the relationship between after-school program quality, program attendance, and academic outcomes for a sample of low-income after-school program participants. Regression and hierarchical linear modeling analyses use a unique longitudinal data set including 29 after-school programs that served 5,108 students in Grades 4 to 8…

  10. Establishment of quality system program for the manufacture of nuclear grade steels

    International Nuclear Information System (INIS)

    Saito, Toru

    1978-01-01

    Recently, the pressure vessels employed in the fields of nuclear power generation, petroleum refining, and chemical industry tend to be large size and high performance, therefore thick steel plates and forgings of high quality are demanded, and the establishment and maintenance of strict quality assurance system for material production are required. In Mizushima Works, Kawasaki Steel Corp., the installations for large forgings and thick plates were constructed from 1969 to 1976, and the researches on the development of production techniques were forwarded in parallel. A Quality System Certificate (Material) has been granted to Mizushima Works on March 11, 1977, by the American Society of Mechanical Engineers for the manufacture of steel plates and forgings of nuclear grade. The quality system manual as the basis of quality assurance activities, the organization for quality assurance, its responsibility and authority, the discrimination of materials, the control of manufacturing processes, the qualification of workers in charge of nondestructive test, welding, heat treatment and others, the management of tests and inspections, the management of products with faults and repairing measures, and internal supervisory system are explained. The wide use of computers is novel in the field of quality system program. (Kako, I.)

  11. A research-oriented treatment planning program system

    International Nuclear Information System (INIS)

    Kalet, I.J.; Jacky, J.P.

    1982-01-01

    The function of a treatment planning program is to graphically simulate radiation dose distributions from proposed radiation therapy treatments. While many such programs are available which provide this much-needed service, none addresses the question of how to intercompare calculation and display techniques. This paper describes a program system designed for support of research efforts, particularly development and testing of new calculation algorithms. The system emphasizes a modular flexible structure, enabling programs to be developed somewhat as interchangeable parts. Thus multiple variants of a calculation algorithm can be compared without undue software overhead or additional data management. Unusual features of the system include extensive use of command procedures, logical names and a structured language (PASCAL). These features are described along with other implementation details. Obstacles, limitations and future applications are also discussed. (Auth.)

  12. National Biobank of Korea: Quality control Programs of Collected-human Biospecimens

    Science.gov (United States)

    Lee, Jae-Eun; Kim, Ji-Hyun; Hong, Eun-Jung; Yoo, Hye Sook; Nam, Hye-Young; Park, Ok

    2012-01-01

    Personalized medicine is emerging as a main paradigm for risk prediction, pre-diagnosis, and effective prevention and treatment of disease. A large number of human biospecimens and their clinical data are essential resources for the success of personalized medicine as well as other biomedical research. The National Biobank of Korea (NBK) has collected well-annotated and high quality human biospecimens, and distributes them to the Korean biomedical scientists, through the Korea Biobank Project (KBP). The ultimate goal of NBK activities is to promote biomedical research and public health. As of December- 2011, the NBK has collected various human biospecimens from 525,416 participants including 325,952 Korean populations and 199,464 patients. The purpose of this paper is to introduce the KBP and quality control programs for collection of human biospecimens with high quality of NBK. PMID:24159512

  13. Treatment Regret and Quality of Life Following Radical Prostatectomy

    Science.gov (United States)

    Gilts, Chelsea D.; Cohen, Lorenzo; Pettaway, Curtis A.; Parker, Patricia A.

    2013-01-01

    Purpose Negative physical functioning outcomes including incontinence and erectile dysfunction are relatively common following radical prostatectomy (RP) and are associated with treatment regret and compromised quality of life (QOL). The role that treatment regret may have in influencing the association between prostate-specific QOL (i.e., sexual, urinary, bowl functioning) and general QOL following RP has not been examined. Method This study examined the associations of treatment regret, general QOL (SF-36 Physical (PCS) and Mental Health (MCS) composite scores) and prostate-specific QOL (PCQOL sexual, urinary, bowl functioning, and cancer worry subscales) in 95 men who underwent RP for prostate cancer. Results Multiple regression analyses indicated that poorer sexual and urinary functioning was associated with poorer MCS. Additionally, men with lower sexual and urinary functioning reported greater treatment regret. Treatment regret was also associated with lower MCS. Finally, treatment regret partially mediated the effects of both sexual and urinary functioning on MCS. Conclusions These findings suggest that regardless of a patient’s prostate-specific QOL, reducing treatment regret may improve mental health following RP. Though there are limited options to alter patients’ sexual or urinary functioning following RP, treatment regret may be a modifiable contributor to post-surgical adjustment and QOL. PMID:23907238

  14. The Impact of Product Quality, Service Quality, and Customer Loyalty Program perception on Retail Customer Attitude

    Directory of Open Access Journals (Sweden)

    Ricko Achmadi Putra

    2017-09-01

    Full Text Available This journal examines the relationship between perception of product quality, perception of service quality, perception of Customer Loyalty Program on retail customer behavior, and sales volumes of cement products. This study examines three different cement brands, namely cement XYZ with the largest market share, cement PQR which is the main competitor, as well as cement ABC, a newcomer cement brand which is strong enough to enter the Indonesian cement market. The research is focused on the building material retailers with 100 respondents. The data collection will be done by survey through direct interview by using questionnaires. The analysis of this research uses descriptive analysis, analysis by ANOVA and also inferential analysis by using Structural Equation Model (SEM. The results of this study indicate that from the factors that influence the attitudes of retail customers of the three variables tested, only one dominant factor which influences the attitude of retail customers, which is the perception of the product quality. The results of this research also show that the perception of product quality also affects sale volume significantly, the greater the perception of the quality of cement products, the greater the volume of sales generated by the retail customer.

  15. Long Term Resource Monitoring Program Water Quality Component Review

    National Research Council Canada - National Science Library

    Soballe, David M; Houser, Jeffrey N

    2006-01-01

    ...) adequacy and suitability of the water quality procedures manual, (4) adequacy and efficiency of procedures for quality assurance and quality control in data collection and laboratory analyses, (5...

  16. Autism Program Quality Indicators: A Self-Review and Quality Improvement Guide for Schools and Programs Serving Students with Autism Spectrum Disorders.

    Science.gov (United States)

    Crimmins, Daniel B.; Durand, V. Mark; Theurer-Kaufman, Karin; Everett, Jessica

    This publication provides Autism Program Quality Indicators (APQI), intended as a self-review and quality improvement guide for schools and programs serving students with autism spectrum disorders. The APQI were developed by the New York Autism Network at the request of the New York State Education Department. The APQI promote the goal that all…

  17. Mechanical and dosimetric quality control for computer controlled radiotherapy treatment equipment.

    Science.gov (United States)

    Thompson, A V; Lam, K L; Balter, J M; McShan, D L; Martel, M K; Weaver, T A; Fraass, B A; Ten Haken, R K

    1995-05-01

    Modern computer controlled radiotherapy treatment equipment offers the possibility of delivering complex, multiple field treatments with minimal operator intervention, thus making multiple field conformal therapy practical. Conventional quality control programs are inadequate for this new technology, so new quality control procedures are needed. A reasonably fast, sensitive, and complete daily quality control program has been developed in our clinic that includes nearly automated mechanical as well as dosimetric tests. Automated delivery of these quality control fields is performed by the control system of the MM50 racetrack microtron, directed by the CCRS sequence processor [D. L. McShan and B. A. Fraass, Proceedings of the XIth International Conference on the use of computers in Radiation Therapy, 20-24 March 1994, Manchester, U.K. (North Western Medical Physics Department, Manchester, U.K., 1994), pp. 210-211], which controls the treatment process. The mechanical tests involve multiple irradiations of a single film to check the accuracy and reproducibility of the computer controlled setup of gantry and collimator angles, table orientation, collimator jaws, and multileaf collimator shape. The dosimetric tests, which involve multiple irradiations of an array of ionization chambers in a commercial dose detector (Keithly model 90100 Tracker System) rigidly attached to the head of the treatment gantry, check the output and symmetry of the treatment unit as a function of gantry and collimator angle and other parameters. For each of the dosimetric tests, readings from the five ionization chambers are automatically read out, stored, and analyzed by the computer, along with the geometric parameters of the treatment unit for that beam.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Boron neutron capture therapy: Brain Tumor Treatment Evaluation Program

    International Nuclear Information System (INIS)

    Griebenow, M.L.; Dorn, R.V. III; Gavin, P.R.; Spickard, J.H.

    1988-01-01

    The United States (US) Department of Energy (DOE) recently initiated a focused, multidisciplined program to evaluate Boron Neutron Capture Therapy (BNCT) for the treatment of brain tumors. The program, centered at the DOE/endash/Idaho National Engineering Laboratory (INEL), will develop the analytical, diagnostic and treatment tools, and the database required for BNCT technical assessment. The integrated technology will be evaluated in a spontaneously-occurring canine brain-tumor model. Successful animal studies are expected to lead to human clinical trials within four to five years. 2 refs., 3 figs

  19. An institutional review board-based clinical research quality assurance program.

    Science.gov (United States)

    Lad, Pramod M; Dahl, Rebecca

    2013-01-01

    Despite the acknowledged importance of quality assurance in the clinical research process, the problem of how such a program should be implemented at the level of an academic teaching hospital or a similar institution has not been addressed in the literature. Despite the fact that quality assurance is expected in programs which certify and accredit Institutional Review Boards (IRBs), very little is known about the role of the IRB in programs of clinical research quality assurance. In this article we consider the definition of clinical research quality assurance, and describe a program designed to achieve it. The key elements of such a program are education at the site level, which has both mandatory and voluntary components, and an auditing and monitoring program, which reinforces the education on quality assurance. The role of the IRB in achieving the program goals and the organizational placement of the quality assurance program within the IRB structure and function are important items of discussion.

  20. Current status of quality assurance of treatment planning systems

    International Nuclear Information System (INIS)

    Mijnheer, B.J.

    1997-01-01

    A review is given of the current status of quality assurance of treatment planning systems. At this moment only one comprehensive report is available. In order to review national activities a questionnaire has been distributed amongst national societies of medical physicists. From the 23 responding countries, 8 indicated that only limited efforts are underway, 8 answered that a working group is evaluating their specific national requirements while in 5 countries a document is drafted. The highlights of these reports have been summarized. (author)

  1. Egg shell treatment methods effect on commercial eggs quality

    Directory of Open Access Journals (Sweden)

    Dayane Santos de Almeida

    2015-01-01

    Full Text Available ABSTRACT:The objective was to evaluate commercial eggs quality after being subjected to a cleaning process and immersion in whey protein concentrate (WPC as a function of storage time. The experimental design was completely randomized in a factorial 4x7, being four methods of treating shell (not cleaned and not coated with WPC, not cleaned and coated with WPC, cleaned and not coated with WPC, cleaned and coated with WPC and seven periods of storage (1, 7, 14, 21, 28, 35 and 42 days for a total of 28 treatments, with five replicates of four eggs each. Quality parameters evaluated were weight loss of eggs (%, specific gravity (g/cm3, haugh units (HU, yolk index (YI and potential hydrogen (pH albumen. The storage period increase, regardless of the shell treatment method, causing weight loss in eggs, reductions in specific gravity in the Haugh units, yolk index and increase in the albumen pH. The cleaning method makes egg's internal quality worse during storage. Coverage of whey protein concentrate is a viable alternative for commercial eggs conservation stored at room temperature in order to minimize quality loss during storage, including eggs that need to go through the cleaning process.

  2. Lack of grading agreement among international hemostasis external quality assessment programs

    OpenAIRE

    Olson, John D.; Jennings, Ian; Meijer, Piet; Bon, Chantal; Bonar, Roslyn; Favaloro, Emmanuel J.; Higgins, Russell A.; Keeney, Michael; Mammen, Joy; Marlar, Richard A.; Meley, Roland; Nair, Sukesh C.; Nichols, William L.; Raby, Anne; Reverter, Joan C.

    2018-01-01

    Laboratory quality programs rely on internal quality control and external quality assessment (EQA). EQA programs provide unknown specimens for the laboratory to test. The laboratory's result is compared with other (peer) laboratories performing the same test. EQA programs assign target values using a variety of methods statistical tools and performance assessment of ‘pass’ or ‘fail’ is made. EQA provider members of the international organization, external quality assurance in thrombosis and h...

  3. An evaluation of the American Indian Air Quality Training Program

    Science.gov (United States)

    Quartaroli, Marylynn

    During centuries of geographic, economic, and cultural domination, the federal government held the responsibility for the management of environmental issues on tribal lands. Today, tribes are reasserting their sovereignty in many ways, including the development of their own environmental programs. Tribal agencies desperately search for tribal members who are qualified to make decisions for the benefit of the tribes from both Western scientific and traditional cultural viewpoints. To meet this need, the American Indian Air Quality Training Program (AIAQTP) offers technical and regulatory training courses that are both scientifically up-to-date and culturally responsive to this community. This study is an evaluation of these courses. To supplement data from existing program documents and databases, I also observed five courses, sent follow-up questionnaires, and interviewed lead instructors and course participants to develop an understanding of their perceptions of the training received. Computer analysis of this quantitative and qualitative data revealed patterns and themes; an external reviewer also independently analyzed the data set. The training courses offered by AIAQTP were judged to have merit and value by the course instructors, the participants, the external evaluator, and me. Designed to be both culturally responsive and technically rigorous, these courses provided relevant and useful information and skills to the tribal environmental professionals in attendance, meeting the demands of their jobs. Although not all training needs or expectations were met, the study participants indicated their intentions to continue their education and training in air quality and other environmental media. A significant benefit of attendance at AIAQTP training courses was the development of a network of tribal professionals across the nation that acts as a support system for the implementation and continuation of changes in the professional practice for the trainees and

  4. Southern California Bight 2003 Regional Monitoring Program: V. water quality

    Science.gov (United States)

    Nezlin, Nikolay P.; DiGiacomo, Paul M.; Weisberg, Stephen B.; Diehl, Dario W.; Warrick, Jonathan A.; Mengel, Michael J.; Jones, Burton H.; Reifel, Kristen M.; Johnson, Scott C.; Ohlmann, J. Carter; Washburn, Libe; Terrill, Eric J.

    2007-01-01

    More than $30 million is expended annually on environmental monitoring in the Southern California Bight (SCB), yet only 5% of the Bight is monitored on an ongoing basis. Therefore, environmental managers in the SCB decided to expand their monitoring program and, starting in 1994, decided to conduct periodic regional assessments of ecosystem condition and assess the overall health of the SCB. Sixty-five different organizations collaborated in 2003 to create the third SCB Regional Monitoring Program (Bight '03). Bight '03 was designed to be integrated regional monitoring program that encompasses regulatory, academic, and non-governmental agencies. Bight '03 had three components: Coastal Ecology, Shoreline Microbiology, and Water Quality. This report addresses the purpose, approach, findings, and recommendations from the Water Quality component, which focused on contamination-laden stormwater runoff, in particularly its variability in time and space as well as its short-term ecological impacts. Specifically, the Bight '03 Water Quality component had three primary goals, the first of which was to described the temporal evolution of stormwater plumes produced by the major southern California rivers. Specifically, the study was intended to determine how far offshore the plumes extended, how rapidly they advected, how long before the plumes dispersed and how these properties differed among storms and river systems. The second goal was to describe how the physical properties (e.g., turbidity, temperature, salinity) of the plume related to biogeochemical and ecological properties that are of more direct concern to the water quality management community. Accomplished primarily through ship-based sampling of water quality parameters, this second goal was to describe how far offshore, and for how ;long after the storm, elevated bacterial concentrations, toxicity, and nutrients could be detected. Similar to the fist goal, the study also addressed how these answers differed

  5. Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

    Science.gov (United States)

    Fields, Dail; Roman, Paul M; Blum, Terry C

    2012-06-01

    To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.

  6. Development of Geometrical Quality Control Real-time Analysis Program using an Electronic Portal Imaging

    International Nuclear Information System (INIS)

    Lee, Sang Rok; Jung, Kyung Yong; Jang, Min Sun; Lee, Byung Gu; Kwon, Young Ho

    2012-01-01

    To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. When conducting a geometrical quality control using an electronic portal imaging

  7. Quality assurance program for prototype stereotactic system developed for neptun 10 Pc linac

    International Nuclear Information System (INIS)

    Khoshbin Khoshnazar, A.R.; Bahreyni Toossi, M.T.; Hashemiyan, A.R.; Bahreyni Toossi, M.T.; Salek, R.

    2005-01-01

    A prototype stereotactic radiosurgery set was designed and constructed for a Neptun 10 Pc linac that is currently being used at Imam Reza hospital in Mashad. Materials and Methods: A complete quality assurance program was designed and performed for the constructed system including isocentric accuracy test, localization accuracy test, dose delivery accuracy test and leakage radiation test. Target simulator, control alignment device and plexiglass phantom which were parts of the developed hardware were used to fulfill quality assurance program. Results: The average isocentric shift resulted from the gantry rotation and couch turning were respectively obtained to be 1.4 and 2 mm. The average localization error in the three coordinates was found to be 2.2 mm. The total treatment uncertainty due to all of the probable errors in the system was equal to 4.32 mm. The dose delivery accuracy test was carried out, the result indicated a 3.7% difference between the given and measured dose. Conclusion: The quality assurance tests showed consistent performance of the constructed system within the accepted limits; however, some inconsistency might exist in certain cases. The safety of stereotactic radiosurgery system method is increased when the overall uncertainty is minimized nd the treatment of the lesions adjacent to critical organs is avoided

  8. Atraumatic Restorative Treatment (ART) in pediatric dentistry residency programs: a survey of program directors.

    Science.gov (United States)

    Kateeb, Elham; Warren, John; Damiano, Peter; Momany, Elizabeth; Kanellis, Michael; Weber-Gasparoni, Karin; Ansley, Tim

    2013-01-01

    The purpose of this study was to investigate the extent of clinical training on atraumatic restorative treatment (ART) among pediatric dentistry residency programs and assess program directors' attitudes toward ART. All U.S. Pediatric Dentistry residency programs' directors were asked to complete a web-based survey. Sixty-one of the 76 directors (80 percent) completed the survey, with no significant response bias. Eighty-nine percent of the responding programs provided clinical instruction on ART. Of these, 30 percent provided ART training often/very often. ART was used mostly in single-surface cavities (43 percent) and as an interim treatment in primary teeth (57 percent). Factors associated with ART clinical training included not placing amalgams in primary teeth (Ppediatric dentistry residency programs in the United States. Residency directors' attitudes were highly predictive of the amount of clinical training provided, suggesting that directors need to be better informed about the use of ART.

  9. Quality Assurance Program Plan Waste Management Federal Services of Hanford, Inc

    International Nuclear Information System (INIS)

    VOLKMAN, D.D.

    1999-01-01

    This document is the Quality Assurance Program Plan (QAPP) for Waste Management Federal Services of Hanford, Inc. (WMH), that implements the requirements of the Project Hanford Management Contract (PHMC), HNF-MP-599, Project Hanford Quality Assurance Program Description (QAPD) document, and the Hanford Federal Facility Agreement with Consent Order (Tri-Party Agreement), Sections 6.5 and 7.8. WHM is responsible for the treatment, storage, and disposal of liquid and solid wastes generated at the Hanford Site as well as those wastes received from other US Department of Energy (DOE) and non-DOE sites. WMH operations include the Low-Level Burial Grounds, Central Waste Complex (a mixed-waste storage complex), a nonradioactive dangerous waste storage facility, the Transuranic Storage Facility, T Plant, Waste Receiving and Processing Facility, 200 Area Liquid Effluent Facility, 200 Area Treated Effluent Disposal Facility, the Liquid Effluent Retention Facility, the 242-A Evaporator, 300 Area Treatment Effluent Disposal Facility, the 340 Facility (a radioactive liquid waste handling facility), 222-S Laboratory, the Waste Sampling and Characterization Facility, and the Hanford TRU Waste Program

  10. The use of yoga in specialized VA PTSD treatment programs.

    Science.gov (United States)

    Libby, Daniel J; Reddy, Felice; Pilver, Corey E; Desai, Rani A

    2012-01-01

    Posttraumatic stress disorder (PTSD) is a chronic, debilitating anxiety disorder that is highly prevalent among U.S. military veterans. Yoga, defined to include physical postures (asana) and mindfulness and meditation, is being increasingly used as an adjunctive treatment for PTSD and other psychological disorders. No research or administrative data have detailed the use of these services in Department of Veterans Affairs' (VA) 170 PTSD treatment programs. One hundred twenty-five program coordinators or designated staff completed an 81-item survey of their program's use of complementary and alternative medicine modalities in the past year. This report describes data from a subset of 30 questions used to assess the prevalence, nature, and context of the use of yoga, mindfulness, and meditation other than mindfulness practices. Results revealed that these practices are widely offered in VA specialized PTSD treatment programs and that there is great variability in the context and nature of how they are delivered. Understanding how yoga is used by these programs may inform ongoing efforts to define and distinguish yoga therapy as a respected therapeutic discipline and to create patient-centered care models that mindfully fulfill the unmet needs of individuals with mental health issues, including veterans with PTSD.

  11. Treatment Services Received in the CASAWORKS for Families Program

    Science.gov (United States)

    Mckay, James R.; Gutman, Marjorie; Mclellan, A. Thomas; Lynch, Kevin G.; Ketterlinus, Robert

    2003-01-01

    This article presents information on treatment services received by women participating in an initial multistate evaluation of CASAWORKS families. Results indicated most women received services to address medical, employment, basic needs, alcohol and drug, family, and psychiatric problems during the first six months of the program. The clients…

  12. Dropout of a multidisciplinary treatment program for women with fibromyalgia

    Directory of Open Access Journals (Sweden)

    Tatiana Rehder Gonçalves

    2010-03-01

    Full Text Available Objective: To evaluate the dropout of a multidisciplinary treatment program in fibromyalgia (FM. Methods: An observational study conducted during the period of April 2000 to December 2005, including 133 women with fibromyalgia, participating in a multidisciplinary treatment program. Those who had left the treatment for two weeks or more were classified as inactive and contacted by telephone to record the reasons for their noncompliance, which were divided into four groups: 1 Family; 2 Occupations; 3 Medical; 4 Other Reasons. Results: When collecting data, 92 (69.4% women were considered inactive. There was no significant difference between noncompliance before and after six months of treatment. Of the total number of inactive women, 54 (40.8% participants left for medical reasons, 30 (22.6% for other reasons, 26 (19.4% for family reasons and 23 (17.2% due to occupation. There was no statistical difference between the motives of dropout according to the length of stay in the program (p> 0.05. Conclusion: We conclude that the multidisciplinary program for women with fibromyalgia had high levels of noncompliance, half of them occurred in the first six months. Among the main reasons reported for dropout, the medical reasons were more frequent.

  13. Influence of different heat treatment programs on properties of sol ...

    Indian Academy of Sciences (India)

    Influence of different heat treatment programs on properties of sol–gel synthesized (Na0·5K0·5)NbO3 (KNN) thin films. S WIEGAND. ∗. , S FLEGE, O BAAKE and W ENSINGER. Department of Materials and Geosciences, Materials Analysis Group, Technische Universität Darmstadt, Petersenstrasse. 23, 64287 Darmstadt ...

  14. Biospecimen quality program in the biobank of the Norwegian Institute of Public Health

    Directory of Open Access Journals (Sweden)

    Liv Paltiel

    2012-04-01

    Full Text Available Background: The biological material collected, processed and stored in biobanks are important research tools and it is important to minimize preanalytical variations to provide researchers with high quality biological material that will give reproducible results. Methods: To minimize the preanalytical variations caused by sample collection, processing and storage, we have established a biospecimen quality program. It consists of quality assurance aspects as well as quality control programs to measure adherence to protocols and sample integrity. The quality control program includes measurements and evaluation of the DNA quality and quantity before storage, i.e. concentration, purity, fragmentation and PCR success, and long term storage programs for plasma, urine and RNA. Conclusions: The Biobank at the Norwegian Institute of Public Health has established a biospecimen quality program that ensures high quality specimens and provides the documentation required to use the biomaterial in a best possible way.

  15. Program characteristics for successful treatment of adolescent drug abuse.

    Science.gov (United States)

    Friedman, A S; Glickman, N W

    1986-11-01

    The relationship to treatment outcome, as measured by reduction in drug use, of specific characteristics and elements of 30 drug-free outpatient programs for adolescents is reported. Admission and discharge data were obtained from National Institute on Drug Abuse-Client Oriented Data Acquisition Process on 5789 adolescents in the 30 programs. A partial cross-validation study was conducted by analyzing separately for two annual client subsamples. The program, not the individual clients, was the unit of analysis. While controlling for differences between programs on their client populations, multiple regression analysis indicated that the following characteristics of programs were found to predict the outcome criterion variable, to a statistically significant degree: treat a large number of adolescent clients; have a special school for school dropouts; have a relatively large budget; employ counselors or therapists who have at least 2 years' experience in working with adolescent drug abusers; provide special services such as vocational counseling, recreational services, and birth control services; use such therapy methods as crisis intervention, gestalt therapy, music/art therapy, and group confrontation; and be perceived by the clients as allowing and encouraging free expression and spontaneous action by clients. There was a high degree of replication of these findings across the two annual subsamples of clients; and the amount of variance in the treatment outcome criterion variable accounted for by the above-listed program characteristics was quite impressive.

  16. A Stochastic Programming Model for Fuel Treatment Management

    Directory of Open Access Journals (Sweden)

    Mohannad Kabli

    2015-06-01

    Full Text Available This work considers a two-stage stochastic integer programming (SIP approach for optimizing fuel treatment planning under uncertainty in weather and fire occurrence for rural forests. Given a set of areas for potentially performing fuel treatment, the problem is to decide the best treatment option for each area under uncertainty in future weather and fire occurrence. A two-stage SIP model is devised whose objective is to minimize the here-and-now cost of fuel treatment in the first-stage, plus the expected future costs due to uncertain impact from potential fires in the second-stage calculated as ecosystem services losses. The model considers four fuel treatment options: no treatment, mechanical thinning, prescribed fire, and grazing. Several constraints such as budgetary and labor constraints are included in the model and a standard fire behavior model is used to estimate some of the parameters of the model such as fuel levels at the beginning of the fire season. The SIP model was applied to data for a study area in East Texas with 15 treatment areas under different weather scenarios. The results of the study show, for example, that unless the expected ecosystem services values for an area outweigh fuel treatment costs, no treatment is the best choice for the area. Thus the valuation of the area together with the probability of fire occurrence and behavior strongly drive fuel treatment choices.

  17. 77 FR 33253 - Regulatory Guide 8.33, Quality Management Program

    Science.gov (United States)

    2012-06-05

    ... NUCLEAR REGULATORY COMMISSION [NRC-2012-0126] Regulatory Guide 8.33, Quality Management Program... Regulatory Commission (NRC or Commission) is withdrawing Regulatory Guide (RG) 8.33, ``Quality Management... Quality Management Program was deleted from the regulations as part of an overall revision in 2002 of the...

  18. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and... management, quality assurance, and medication therapy management programs (MTMPs). (a) General rule. Each... utilization management program, quality assurance measures and systems, and an MTMP as described in paragraphs...

  19. Quality assurance program plan for low-level waste at the WSCF Laboratory

    International Nuclear Information System (INIS)

    Morrison, J.A.

    1994-01-01

    The purpose of this document is to provide guidance for the implementation of the Quality Assurance Program Plan (QAPP) for the management of low-level waste at the Waste Sampling and Characterization Facility (WSCF) Laboratory Complex as required by WHC-CM-4-2, Quality Assurance Manual, which is based on Quality Assurance Program Requirements for Nuclear Facilities, NQA-1 (ASME)

  20. Nevada Nuclear Waste Storage Investigations Quality-Assurance Program Plan: management and overview

    International Nuclear Information System (INIS)

    1981-10-01

    This Quality Assurance Program Plan (QAPP) defines the quality assurance program in effect for those activities of the Nevada Nuclear Waste Storage (NNWSI) that are directly controlled by: DOE/NV, the Technical Overview Contractor, and the Quality Assurance Overview Contractor. It is intended as a supplement to the NNWSI-QAP

  1. On the quality of treatment planning systems in radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Panten, T.; Sroka-Perez, G. [Radiologische Klinik der Univ. Heidelberg, Heidelberg (Germany). Abt. fuer Klinische Radiologie; Hoess, A. [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Abt. Medizinische Physik; Bohsung, J. [Humboldt-Universitaet, Berlin (Germany). Abt. fuer Strahlentherapie; Becker, G. [Radiologische Universitaetsklinik, Tuebingen (Germany). Abt. fuer Strahlentherapie

    1998-10-01

    Purpose: To assist in the design of quality assurance activities of 3D treatment planning systems (TPSs), a postal survey has been carried out, addressing TPS users on quality characteristics and their relative importance in clinical routine planning. Material and methods: The approach as described in ISO/IEC 9126 has been used to analyze TPS quality. Both TPS quality characteristics and how these may be used to establish a quality model are included. A questionnaire on ranking of these TPS quality characteristics has been sent out to the German DEGRO members in February 1997. Results: By the end of July 1997, 90 individual assessments (of 45 physicists, 35 physicians, and 10 radiographers) had been collected. On an importance scale from 1 (very important) to 6 (unimportant), weight factors of 1.71 (portability), 2.84 (maintainability), 3.18 (efficiency), 3.85 (usability), 4.52 (functionality) and 4.90 (reliability) have been determined from the data. From user satisfaction data also obtained from the questionnaire responses, baseline quality indices could be established from the quality model for the RTPs Cadplan, TMS Helax, and Voxelplan. Conclusion: The responses highlight the need for TPS quality assurance at the same time along the lines of safety-related, research-oriented, and interactive end-user software systems in radiotherapy treatment planning. Quality assurance activities must take this into account. Their effect can be monitored by using quality indices as derivable from the established quality model. (orig.) [Deutsch] Ziel: Um die Planung von Qualitaetssicherungsmassnahmen an 3D-Bestrahlungsplanungssystemen (BPS) zu unterstuetzen, wurde eine postalische Umfrage unter BPS-Anwendern bezueglich der Qualitaetsmerkmale und deren relativer Wichtigkeit durchgefuehrt. Material und Methoden: Zur Analyse der Qualitaet von BPS wurde die Herangehensweise nach ISO/IEC 9126 benutzt, die sowohl die BPS-Qualitaetsmerkmale als auch ein Verfahren zu deren Verknuepfung

  2. Mathematical model for HIV spreads control program with ART treatment

    Science.gov (United States)

    Maimunah; Aldila, Dipo

    2018-03-01

    In this article, using a deterministic approach in a seven-dimensional nonlinear ordinary differential equation, we establish a mathematical model for the spread of HIV with an ART treatment intervention. In a simplified model, when no ART treatment is implemented, disease-free and the endemic equilibrium points were established analytically along with the basic reproduction number. The local stability criteria of disease-free equilibrium and the existing criteria of endemic equilibrium were analyzed. We find that endemic equilibrium exists when the basic reproduction number is larger than one. From the sensitivity analysis of the basic reproduction number of the complete model (with ART treatment), we find that the increased number of infected humans who follow the ART treatment program will reduce the basic reproduction number. We simulate this result also in the numerical experiment of the autonomous system to show how treatment intervention impacts the reduction of the infected population during the intervention time period.

  3. Preliminary Results of the Louisiana Sex Offender Treatment Program

    Directory of Open Access Journals (Sweden)

    Lee A. Underwood

    2015-12-01

    Full Text Available The purpose of this study was to offer preliminary support for the Louisiana Sex Offender Treatment Program (LSOTP in addressing the needs of juvenile sex offenders. Research objectives were (1 to offer statistical evidence for reductions in anxiety, depression, cognitive distortion and negative attitudes towards women comparing a group of 21 adolescents, 12 of whom received services as usual and nine of whom participated in the LSOTP. A controlled experimental evaluation design was utilized. The juvenile sex offenders were randomly assigned to the experimental group for 12 weeks receiving treatment services and a control group receiving care “as usual” in a residential group care program. Participants in the experimental group experienced statistically significant decreases in cognitive distortions related specifically to rape and molestation.The results of this study offer preliminary support of the LSOTP as a best practices alternative to other treatment modalities.

  4. 77 FR 59931 - Single Source Program Expansion Supplement Award to Nurse Education, Practice, Quality and...

    Science.gov (United States)

    2012-10-01

    ... Program Expansion Supplement Award to Nurse Education, Practice, Quality and Retention (NEPQR) Program... Expansion Supplement Award to Nurse Education, Practice, Quality and Retention (NEPQR) Program Grantee... award to develop strategies to surmount the barriers to gaining nursing academic credit for military...

  5. "Quality Handling" a training program to reduce fear and stress in farm animals

    NARCIS (Netherlands)

    Boivin, X.; Ruis, M.A.W.

    2011-01-01

    Research programs such as the European Welfare Quality® program, have attempted to improve animal welfare by developing training programs for improving stockperson behaviour towards the animals. The authors will illustrate different approches in this paper, with a special focus on the Quality

  6. More than attendance: the importance of after-school program quality.

    Science.gov (United States)

    Hirsch, Barton J; Mekinda, Megan A; Stawicki, Julieann

    2010-06-01

    A central theme of the articles featured in this issue is the need to improve the quality of after-school programs. In this commentary, we discuss why student engagement, program characteristics and implementation, staff training, and citywide policy are key considerations in the effort to define and achieve high quality programs for youth.

  7. Treatment plan complexity metrics for predicting IMRT pre-treatment quality assurance results.

    Science.gov (United States)

    Crowe, S B; Kairn, T; Kenny, J; Knight, R T; Hill, B; Langton, C M; Trapp, J V

    2014-09-01

    The planning of IMRT treatments requires a compromise between dose conformity (complexity) and deliverability. This study investigates established and novel treatment complexity metrics for 122 IMRT beams from prostate treatment plans. The Treatment and Dose Assessor software was used to extract the necessary data from exported treatment plan files and calculate the metrics. For most of the metrics, there was strong overlap between the calculated values for plans that passed and failed their quality assurance (QA) tests. However, statistically significant variation between plans that passed and failed QA measurements was found for the established modulation index and for a novel metric describing the proportion of small apertures in each beam. The 'small aperture score' provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA, with a low false negative rate.

  8. Risk management program for the 283-W water treatment facility

    International Nuclear Information System (INIS)

    Green, W.E.

    1999-01-01

    This Risk Management (RM) Program covers the 283-W Water Treatment Facility (283W Facility), located in the 200 West Area of the Hanford Site. A RM Program is necessary for this facility because it stores chlorine, a listed substance, in excess of or has the potential to exceed the threshold quantities defined in Title 40 of the Code of Federal Regulations (CFR) Part 68 (EPA, 1998). The RM Program contains data that will be used to prepare a RM Plan, which is required by 40 CFR 68. The RM Plan is a summary of the RM Program information, contained within this document, and will be submitted to the U.S. Environmental Protection Agency (EPA) ultimately for distribution to the public. The RM Plan will be prepared and submitted separately from this document

  9. Effect of irradiation as quarantine treatment on citrus fruit quality

    International Nuclear Information System (INIS)

    Betancurt, Pablo; Montalban, Antonio; Arcia, Patricia; Borthagaray, Maria D.; Curutchet, Ana; Pica, Leticia; Soria, Alejandra; Abreu, Anibal V.; Ares, M. Ines

    2009-01-01

    Gamma radiations have been used to improve sanitation treatments without significant effects on fresh fruit quality. The objective of this work was to evaluate the fruit quality characteristics of citrus variety Valencia (Valencia Late), main variety produced and exported in Uruguay. All samples were stored at 3-5 deg C, 80% RH, for 20 and 40 days. Irradiation doses used were 0,35 kGy min. and 0,80 kGy max. (doses that also eliminate the fruit fly). Irradiation experiments were conducted using irradiation equipment from Atomic Center (CAE), year 1968, Co60 source, 800.000 Ci. The effects of irradiation on sensory qualities and physical characteristics were studied. The attributes evaluated were visual appearance (1- 4 hedonic scale, expert), overall acceptance (1-9 hedonic scale, consumers), texture (TAB Stevens, speed: 2m/s, distance: 2mm), yield of juice and colour (Hunter values). In general, no significant changes in these parameters were observed after irradiation. Quality was not significantly affected by doses usually applied to decrease the viability of pathogen that cause citrus Scab. This is an important contribution for the protocols that would allow citrus fruit exportation. (author)

  10. Development of a quality assurance program for ionizing radiation secondary calibration laboratories

    International Nuclear Information System (INIS)

    Heaton, H.T. II; Taylor, A.R. Jr.

    1993-01-01

    For calibration laboratories, routine calibrations of instruments meeting stated accuracy goals are important. One method of achieving the accuracy goals is to establish and follow a quality assurance program designed to monitor all aspects of the calibration program and to provide the appropriate feedback mechanism if adjustments are needed. In the United States there are a number of organizations with laboratory accreditation programs. All existing accreditation programs require that the laboratory implement a quality assurance program with essentially the same elements in all of these programs. Collectively, these elements have been designated as a Measurement Quality Assurance (MQA) program. This paper will briefly discuss the interrelationship of the elements of an MQA program. Using the Center for Devices and Radiological Health (CDRH) X-ray Calibration Laboratory (XCL) as an example, it will focus on setting up a quality control program for the equipment in a Secondary Calibration Laboratory

  11. Protocol for the quality control systems of electronic portal imaging used in verification of radiotherapy treatment

    International Nuclear Information System (INIS)

    Silvestre, Ileana; Alfonso, Rodolfo; Garcia, Fernando

    2009-01-01

    Following the approach of quality control of radiotherapy equipment, conceived in the IAEA TECDOC-1151, we analyzed the different tests must be to an EPID to guarantee levels of accuracy required in the administration of radiation treatments, including the study of the impact of different parameters, geometric and dosimetric imaging, involved in the process. Established the types and frequency of checks, as well as procedures for their implementation, the allowable tolerances set of values records and forms for recording . Was carried out assessment protocol in various services based on amorphous silicon EPID for its applicability and scope. Was designed and validated in clinical practice protocol for EPID quality control, demonstrating its applicability with a minimum of material and human resources. It We concluded that with proper and systematic quality control program, tests including dosimetry, the EPID can provide valuable information about physico-beam dosimetry, and ensure adequate accuracy geometric in the patient's location. (author)

  12. Quality of life of patients after oncological treatment

    International Nuclear Information System (INIS)

    Vasilkova, L.

    2015-01-01

    Quality of life is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. It is conditionally multidimensional and multi-factor conditional. Usually, in medicine we monitor the impact of the disease on the physical and mental state of the patient’s subjective point of view. The quality of life of cancer patients affects psychological and somatic symptoms, e. g. depression, anxiety, changes in the perception of their own body image and self-esteem, decreased libido, pain, anger, fear from the future and from relapse, gastrointestinal upset, lymphedema, stoma, fatigue, insomnia. Important role have also failures of cognitive functions arising as a result of treatment toxicity. (author)

  13. Effects of the Programmed Nutrition Beef Program on meat quality characteristics.

    Science.gov (United States)

    Phelps, K J; Drouillard, J S; Jennings, J S; Depenbusch, B E; Van Bibber-Krueger, C L; Miller, K A; Vaughn, M A; Burnett, D D; Ebarb, S M; Houser, T A; Johnson, S E; Gonzalez, J M

    2014-04-01

    The objective of this study was to examine the effects of alternative finishing strategies on beef steak color and cooked meat characteristics. Beef steers (n = 64 pens; 8 steers/pen) were allocated to a randomized complete block design with a 2 × 2 factorial treatment arrangement and initial body weight serving as the blocking factor. Factor 1 consisted of dietary treatment with cattle either being fed a conventional feedlot diet (CON) or a diet that included Programmed Nutrition Beef Program supplements. Cattle in the Programmed Nutrition (PN) treatments were fed in two-stages: 1) the basal diet with Programmed Nutrition Beef Receiver from d 1 to 20 and the basal diet with Programmed Nutrition Beef Finisher from d 21 to harvest. Factor 2 consisted of the inclusion (EGP+) or absence (EGP-) of an exogenous growth promoting program. Steers in the EGP+ treatments were implanted initially with Component E-S, reimplanted with Component TE-IS, and fed 400 mg · d(-1) · steer(-1) of ractopamine hydrochloride for the final 28 d before harvest. Steers were harvested on d 175 of feeding and 1 strip loin was removed from 2 carcasses selected at random from each pen for transport to Kansas State University. After 14 d of aging, loins were fabricated into 2.54-cm thick steaks for objective and trained sensory panel measurement of cooked meat characteristics and objective color measurements during 7 d retail display. There were no interactions (P > 0.10) between feeding strategy and exogenous growth promotants for all objective measures of color and cooked meat characteristics. Throughout the display period, PN steaks were darker (P = 0.02) than CON steaks, but surface percentages of oxymyoglobin and metmyoglobin and metmyoglobin reducing ability were unaffected by feeding strategy (P > 0.10). Loins and steaks from PN cattle possessed decreased moisture loss during aging and cooking (P strategies presented in this study can favorably impact water-holding capacity without

  14. Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs.

    Science.gov (United States)

    Bray, Jeremy W; Mallonee, Erin; Dowd, William; Aldridge, Arnie; Cowell, Alexander J; Vendetti, Janice

    2014-01-01

    This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT) services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist) and service delivery setting (emergency department, hospital inpatient, outpatient). Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service provision for some settings and implementation models.

  15. SELECTION OF CHEMICAL TREATMENT PROGRAM FOR OILY WASTEWATER

    Directory of Open Access Journals (Sweden)

    Miguel Díaz

    2017-04-01

    Full Text Available When selecting a chemical treatment program for wastewater to achieve an effective flocculation and coagulation is crucial to understand how individual colloids interact. The coagulation process requires a rapid mixing while flocculation process needs a slow mixing. The behavior of colloids in water is strongly influenced by the electrokinetic charge, where each colloidal particle carries its own charge, which in its nature is usually negative. Polymers, which are long chains of high molecular weight and high charge, when added to water begin to form longer chains, allowing removing numerous particles of suspended matter. A study of physico-chemical treatment by addition of coagulant and flocculant was carried out in order to determine a chemical program for oily wastewater coming from the gravity separation process in a crude oil refinery. The tests were carried out in a Jar Test equipment, where commercial products: aluminum polychloride (PAC, aluminum sulfate and Sintec D50 were evaluated with five different flocculants. The selected chemical program was evaluated with fluids at three temperatures to know its sensitivity to this parameter and the mixing energy in the coagulation and flocculation. The chemical program and operational characteristics for physico-chemical treatment with PAC were determined, obtaining a removal of more than 93% for suspended matter and 96% for total hydrocarbons for the selected coagulant / flocculant combination.

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

    Science.gov (United States)

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

    2013-01-01

    Molecular pathology is an integral part of daily diagnostic pathology and used for classification of tumors, for prediction of prognosis and response to therapy, and to support treatment decisions. For these reasons, analyses in molecular pathology must be highly reliable and hence external quality assessment (EQA) programs are called for. Several EQA programs exist to which laboratories can subscribe, but they vary in scope, number of subscribers, and execution. The guideline presented in this paper has been developed with the purpose to harmonize EQA in molecular pathology. It presents recommendations on how an EQA program should be organized, provides criteria for a reference laboratory, proposes requirements for EQA test samples, and defines the number of samples needed for an EQA program. Furthermore, a system for scoring of the results is proposed as well as measures to be taken for poorly performing laboratories. Proposals are made regarding the content requirements of an EQA report and how its results should be communicated. Finally, the need for an EQA database and a participant manual are elaborated. It is the intention of this guideline to improve EQA for molecular pathology in order to provide more reliable molecular analyses as well as optimal information regarding patient selection for treatment.

  17. Quality assurance of HDR prostate plans: Program implementation at a community hospital

    International Nuclear Information System (INIS)

    Rush, Jennifer B.; Thomas, Michael D.

    2005-01-01

    Adenocarcinoma of the prostate is currently the most commonly diagnosed cancer in men in the United States, and the second leading cause of cancer mortality. The utilization of radiation therapy is regarded as the definitive local therapy of choice for intermediate- and high-risk disease, in which there is increased risk for extracapsular extension, seminal vesicle invasion, or regional node involvement. High-dose-rate (HDR) brachytherapy is a logical treatment modality to deliver the boost dose to an external beam radiation therapy (EBRT) treatment to increase local control rates. From a treatment perspective, the utilization of a complicated treatment delivery system, the compressed time frame in which the procedure is performed, and the small number of large dose fractions make the implementation of a comprehensive quality assurance (QA) program imperative. One aspect of this program is the QA of the HDR treatment plan. Review of regulatory and medical physics professional publications shows that substantial general guidance is available. We provide some insight to the implementation of an HDR prostate plan program at a community hospital. One aspect addressed is the utilization of the low-dose-rate (LDR) planning system and the use of existing ultrasound image sets to familiarize the radiation therapy team with respect to acceptable HDR implant geometries. Additionally, the use of the LDR treatment planning system provided a means to prospectively determine the relationship between the treated isodose volume and the product of activity and time for the department's planning protocol prior to the first HDR implant. For the first 12 HDR prostate implants, the root-mean-square (RMS) deviation was 3.05% between the predicted product of activity and time vs. the actual plan values. Retrospective re-evaluation of the actual implant data reduced the RMS deviation to 2.36%

  18. Experiences of burnout among drug counselors in a large opioid treatment program: A qualitative investigation.

    Science.gov (United States)

    Beitel, Mark; Oberleitner, Lindsay; Muthulingam, Dharushana; Oberleitner, David; Madden, Lynn M; Marcus, Ruthanne; Eller, Anthony; Bono, Madeline H; Barry, Declan T

    2018-03-09

    Little is known about possible experiences of burnout among drug counselors in opioid treatment programs that are scaling up capacity to address the current opioid treatment gap. Participants in this quality improvement study were 31 drug counselors employed by large opioid treatment programs whose treatment capacities were expanding. Experiences of burnout and approaches for managing and/or preventing burnout were examined using individual semi-structured interviews, which were audiotaped, transcribed, and systematically coded by a multidisciplinary team using grounded theory. Rates of reported burnout (in response to an open-ended question) were lower than expected, with approximately 26% of participants reporting burnout. Counselor descriptions of burnout included cognitive, affective, behavioral, and physiological symptoms; and job-related demands were identified as a frequent cause. Participants described both self-initiated (e.g., engaging in pleasurable activities, exercising, taking breaks during workday) and system-supported strategies for managing or preventing burnout (e.g., availing of supervision and paid time off). Counselors provided recommendations for system-level changes to attenuate counselor risk of burnout (e.g., increased staff-wide encounters, improved communication, accessible paid time off, and increased clinical supervision). Findings suggest that drug counselor burnout is not inevitable, even in opioid treatment program settings whose treatment capacities are expanding. Organizations might benefit from routinely assessing counselor feedback about burnout and implementing feasible recommendations to attenuate burnout and promote work engagement.

  19. Human Milk-Treatment and Quality of Banked Human Milk.

    Science.gov (United States)

    Picaud, Jean-Charles; Buffin, Rachel

    2017-03-01

    The aim of human milk banks is to deliver safe and high quality donor human milk. Treatment of human milk has to destroy most microorganisms while preserving immunological and nutrient components, which is obtained when using low time low temperature pasteurization. However it destroys bile-simulated lipase, reduces lactoferrin, lysozyme, immunoglobulins, and bactericidal capacity of human milk. New methods are under investigation such as high temperature short time pasteurization, high pressure processing, or ultraviolet irradiation. They have been tested in experimental conditions and there are promising results, but they have to be tested in real conditions in human milk bank. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Quality of life issues relating to endocrine treatment options

    DEFF Research Database (Denmark)

    Iversen, P

    1999-01-01

    Recent interest has focused on the use of hormone therapy in prostate cancer for both the management of patients with non-metastatic disease and as a neoadjuvant or adjuvant to curative therapies. This has resulted in patients with fewer symptoms being treated for longer periods of time. Endocrine...... with locally advanced (M0) disease compared with castration, suggesting that this treatment may benefit patients with early disease. Bicalutamide was favoured in 8 out of 9 evaluable quality of life dimensions, and this was statistically significant for sexual interest and physical capacity. Endocrine...

  1. Effects of a partnership support program for couples undergoing fertility treatment.

    Science.gov (United States)

    Asazawa, Kyoko

    2015-10-01

    The study's purpose was to examine the effects of providing a partnership support program. It was designed to improve Japanese couples' partnership, maintain quality of life, decrease psychological distress, and improve marital relationship satisfaction while they underwent infertility treatment that included the possibility of using assisted reproductive technology. This quasi-experimental study with a two-group pretest-post-test design used purposive sampling and non-random assignment of 318 consenting Japanese patients from previous phases of assisted reproductive technology fertility treatment who were patients from a fertility clinic in Tokyo, Japan. The intervention group of 152 patients (76 couples) participated in the partnership support program. The comparison group of 166 patients (83 couples) received usual care. Recruitment was age matched. The program provided information and used a participatory-interactive approach to enhance understanding and cooperation in couples undergoing fertility treatment. The main outcome measures were: "partnership", FertiQoL, Quality Marriage Index, and "psychological distress". There were 311 participants (intervention group n = 148; comparison group, n = 163). The intervention group showed significant improvement in the couples' partnerships and a significant decrease in women's psychological distress using subgroup analysis. The partnership support program provided effective improvement in partnership for the couples, and reduced psychological distress for the women; however, it had less impact for the men. The program was not effective in improving couples' overall quality of life (QOL); however, it was effective in improving the "mind-body" aspects of the QOL subscale. © 2015 The Author. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

  2. Self-care behaviour, treatment satisfaction and quality of life in people on intensive insulin treatment.

    Science.gov (United States)

    Gurkova, Elena; Ziakova, Katarina

    2014-06-01

    The aim of this cross-sectional study was to identify self-care behaviours and their relationships with treatment satisfaction and quality of life in people attending a structured educational programme for patients on intensive insulin therapy. A sample of 104 people with diabetes (62 with type-1; 42 with type 2) was recruited from the National Institute of Endocrinology and Diabetology in Ľubochňa over six months. The majority of respondents were women (62.5%); had multiple daily injections of insulin (73%); diabetic late complications (68%) and had not previously participated in the structured educational programmes in the specialized diabetes centre (64.4%). Self-management behaviour data were collected by means of structured interviews with patients as well as during clinic visits. For measuring quality of life, the Audit Diabetes Dependent Quality of Life questionnaire and for measuring satisfaction with their treatment regimen, the Diabetes Treatment Satisfaction Questionnaire status version was used. General satisfaction with the treatment was significantly higher in people with diabetes, who implemented regular self-monitoring of the concentration of glucose in plasma (SMPG). We also demonstrated low adherence in the frequency of SMPG. 17% of respondents in our study performed daily SMPG. However, 52% respondents reported adaptation of insulin dosage in relation to factors such as carbohydrate intake, glycaemia values or degree of physical activity. Differences in quality of life due to performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations as well as carbohydrate counting were not significant. Performing the regular self-monitoring of glycaemia was associated only with higher treatment satisfaction. No significant improvement in quality of life was seen in people performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations or carbohydrate counting.

  3. The Effectiveness of Promoting Iranians’ Marital Quality Training Program in Marital Quality Among Couples Referring to Health Centers

    Directory of Open Access Journals (Sweden)

    Yadoll Khorramabadi

    2016-08-01

    Full Text Available The increase of dissatisfaction in marriage and its adverse effects on physical and mental health of couples and children make it necessary to improve marital interaction and implement enrichment programs. This research aimed to investigate the effectiveness of PIMQ (Promoting Iranians’ Marital Quality training program in marital quality. A researcher-made program called PIMQ designed based on cultural beliefs, value system, religious orientation, literacy level, and social character of couples was used in this research. This program was implemented on 30 couples who were randomly placed in two experimental and control groups. The marital quality scale was administered to each group before educational sessions. The PIMQ program was implemented for the experimental group in eight sessions of one hour while the second group received no intervention. The sessions were held once a week. Immediately after the completion of educational sessions, the marital quality scale was applied on both groups. A month after the completion of sessions, the follow-up was performed. The results of covariance analysis showed that PIMQ training program could increase marital quality in the experimental group and the increase remained significant at one month follow-up. Based on the research hypotheses, PIMQ training program increased marital quality in the posttest and follow-up.

  4. Quality assurance FY 1995 site support program plan WBS 6.7.2.5

    Energy Technology Data Exchange (ETDEWEB)

    Dell, L.D.

    1994-09-01

    This report is a summary of the quality assurance plan and program for the Westinghouse Hanford Company. The quality assurance plan verifies that the appropriate quality assurance programs and controls are applied to activities that affect quality related to work in: waste management; environmental activities (restoration, remediation, and monitoring); implementation of environmental, state, local, and federal regulations; tri-party agreement activities; facility operation and deactivation/transition to shutdown; new facility construction and operation.

  5. Quality assurance FY 1995 site support program plan WBS 6.7.2.5

    International Nuclear Information System (INIS)

    Dell, L.D.

    1994-09-01

    This report is a summary of the quality assurance plan and program for the Westinghouse Hanford Company. The quality assurance plan verifies that the appropriate quality assurance programs and controls are applied to activities that affect quality related to work in: waste management; environmental activities (restoration, remediation, and monitoring); implementation of environmental, state, local, and federal regulations; tri-party agreement activities; facility operation and deactivation/transition to shutdown; new facility construction and operation

  6. Self–Evaluation of Distance Learning Study Program as a Part of Internal Quality Assurance

    Directory of Open Access Journals (Sweden)

    Radojka Krneta

    2012-02-01

    Full Text Available This paper features quality assurance of specific distance learning master study program through self-evaluation. This unique program involving e-learning as the program content, as well as delivery method, is presented in the paper from the aspects of its quality assurance. Student evaluation of this study program as a part of the internal quality assurance is performed at the end of every school year in the aim of its quality assurance. Results and conclusions of self-evaluation conducted in this school year by known SEVAQ+ evaluation tool are presented here.

  7. Development of quality assurance program for production of sealed radiation source

    CERN Document Server

    Nam, J H; Cho, W K; Han, H S; Hong, S B; Kim, K H; Kim, S D; Lee, Y G; Lim, N J

    2001-01-01

    The quality assurance program for production of sealed radiation sources has been developed to increase the efficiency and safety of production work and to meet the demand of the customers. The quality assurance program are applied to the entire work scope of the production of sealed radiation sources. Every workers related to the production of sealed radiation sources will be required to follow this quality assurance program. It is expected that the sealed radiation source products produced according to this quality assurance program can meet the regulatory requirements, customer's demand and have good competitiveness in the domestic and world markets.

  8. Quality

    International Nuclear Information System (INIS)

    Burnett, N.; Jeffries, J.; Mach, J.; Robson, M.; Pajot, D.; Harrigan, J.; Lebsack, T.; Mullen, D.; Rat, F.; Theys, P.

    1993-01-01

    What is quality? How do you achieve it? How do you keep it once you have got it. The answer for industry at large is the three-step hierarchy of quality control, quality assurance and Total quality Management. An overview is given of the history of quality movement, illustrated with examples from Schlumberger operations, as well as the oil industry's approach to quality. An introduction of the Schlumberger's quality-associated ClientLink program is presented. 15 figs., 4 ills., 16 refs

  9. Quality control of antibiotics before the implementation of an STD program in Northern Myanmar.

    Science.gov (United States)

    Prazuck, Thierry; Falconi, Isabelle; Morineau, Guy; Bricard-Pacaud, Véronique; Lecomte, Antoine; Ballereau, Francoise

    2002-11-01

    The ready availability of poor-quality drugs in developing countries leads to treatment failure and, consequently, excess mortality and morbidity. Moreover, the widespread availability of substandard drugs plays a key role in increasing the resistance to antimicrobial drugs.GOAL As a prerequisite to the establishment of a sexually transmitted disease (STD) control program, this study aimed to evaluate the quality of antibiotics recommended for treatment of STDs that were locally available in the capital of a province of Northern Myanmar. In addition to the hospital pharmacy, we selected at random 5 of the 41 drug sellers and 5 of the 40 general practitioners who sell antibiotics in the city of Myitkyina. Twenty-one marketing products corresponding to nine different antibiotics used for STD treatment were purchased (benzathine benzylpenicillin, benzylpenicillin, ceftriaxone, chlortetracycline, ciprofloxacin, clotrimazole, co-trimoxazole, doxycycline, and erythromycin). Drugs were sent to France, where they were analyzed according to the WHO guidelines. Drugs were considered to be standard if their dosage remained in the 10% range of the expected value. Among the 21 different specialty products, only three displayed the official "registered" label. Three drugs were expired and the expiration date was not available for six others. One product did not contain the active drug declared (chlortetracycline; Lombisin, Unicorn, China) and did not show any in vitro activity against bacteria. Seven of 21 products (33%) did not contain the stated dosage (1, more than stated dosage; 6, less than stated dosage). The highest deficit observed was 48% in two products (co-trimoxazole, Yong Fong, Myanmar; benzylpenicillin, China [city and manufacturer unknown]). The dosage was not available for five drugs. As a result, only 8 of 21 products (38%) did not contain the stated dosage of active drug. These findings suggest that public health policies based on national treatment guidelines

  10. Evaluation of a brief treatment program of cognitive behavior therapy for insomnia in older adults.

    Science.gov (United States)

    Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J

    2014-01-01

    To evaluate the efficacy of a brief 4-w group-administered treatment program of cognitive behavior therapy for insomnia (CBT-I) for older adults with sleep maintenance insomnia. Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pretreatment, posttreatment, and 3-mo follow-up. Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. One-hundred eighteen adults with sleep maintenance insomnia (mean age = 63.76 y, standard deviation = 6.45 y, male = 55). A 4-w, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education, and cognitive restructuring. Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, and confidence in and beliefs about sleep. The brief group-administered CBT-I program produced improvements in the timing and quality of sleep including later bedtimes, earlier out-of-bed times, reduced wake after sleep onset, and improved sleep efficiency. Participants also reported a reduction of the Insomnia Severity Index, Flinders Fatigue Scale, Epworth Sleepiness Scale, Daytime Feeling and Functioning Scale, Sleep Anticipatory Anxiety Questionnaire, the Dysfunctional Beliefs and Attitudes Scale, and increased Sleep Self-Efficacy Scale. The treatment program used in the current study has demonstrated potential for a brief, inexpensive, and effective treatment of sleep maintenance insomnia in the older adult population.

  11. National Irrigation Water Quality Program data-synthesis data base

    Science.gov (United States)

    Seiler, Ralph L.; Skorupa, Joseph P.

    2001-01-01

    Under the National Irrigation Water Quality Program (NIWQP) of the U.S. Department of the Interior, researchers investigated contamination caused by irrigation drainage in 26 areas in the Western United States from 1986 to 1993. From 1992 to 1995, a comprehensive relational data base was built to organize data collected during the 26-area investigations. The data base provided the basis for analysis and synthesis of these data to identify common features of contaminated areas and hence dominant biologic, geologic, climatic, chemical, and physiographic factors that have resulted in contamination of water and biota in irrigated areas in the Western United States. Included in the data base are geologic, hydrologic, climatological, chemical, and cultural data that describe the 26 study areas in 14 Western States. The data base contains information on 1,264 sites from which water and bottom sediment were collected. It also contains chemical data from 6,903 analyses of surface water, 914 analyses of ground water, 707 analyses of inorganic constituents in bottom sediments, 223 analyses of organochlorine pesticides in bottom sediments, 8,217 analyses of inorganic constituents in biota, and 1,088 analyses for organic constituents in biota. The data base is available to the public and can be obtained at the NIWQP homepage http://www.usbr.gov/niwqp as dBase III tables for personal-computer systems or as American Standard Code for Information Exchange structured query language (SQL) command and data files for SQL data bases.

  12. Media advertising effects on consumer perception of orthodontic treatment quality.

    Science.gov (United States)

    Edwards, Daenya T; Shroff, Bhavna; Lindauer, Steven J; Fowler, Chad E; Tufekci, Eser

    2008-09-01

    To determine the effect of media advertising on consumer perception of orthodontic treatment quality. A survey instrument was designed to evaluate factors influencing consumer selection of an orthodontist and consumer perception of different forms of media advertising (radio, television, newspaper, magazine, direct mail, and billboard) by orthodontic practices. The surveys were distributed by eight orthodontic offices in and around the Richmond, Virginia area. The survey return rate was 97%. Respondents most often cited dentist and patient referrals as how they learned of the orthodontic practices they visited (50% to 57%). A caring attitude and good practitioner reputation were the top reasons influencing actual selection of an orthodontist (53% and 49%, respectively). Of respondents, 14% to 24% felt that advertising orthodontists would offer a lower quality of care than nonadvertising orthodontists. Newspaper, magazine, and direct mail advertisements were viewed more favorably than radio, television, and billboard advertisements. Chi-square analyses revealed few statistically significant differences in perception between different income and education groups. The majority of patients do not perceive advertising to reflect poorly on the quality of orthodontic care. However, patients with different income and education levels perceive media advertising differently.

  13. Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs

    Directory of Open Access Journals (Sweden)

    Bray JW

    2014-07-01

    Full Text Available Jeremy W Bray,1 Erin Mallonee,2 William Dowd,2 Arnie Aldridge,2 Alexander J Cowell,2 Janice Vendetti31Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, NC, USA; 2RTI International, Research Triangle Park, NC, USA; 3Department of Community Medicine and Health Care, School of Medicine, UCONN Health, Farmington, CT, USAAbstract: This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist and service delivery setting (emergency department, hospital inpatient, outpatient. Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service

  14. The effectiveness of patient navigation programs for adult cancer patients undergoing treatment: a systematic review.

    Science.gov (United States)

    Tho, Poh Chi; Ang, Emily

    2016-02-01

    Advancements in technology and medical treatment have made cancer care treatment more complex. With the current trend of sub-specialization in health care, cancer patients commonly receive care from multiple specialists and have wider treatment options. In view of this, there is a need to coordinate care and integrate information to enhance care and quality of outcomes for patients. Since the successful implementation of programs for increasing the survival rate of breast cancer patients at Harlem Hospital Center, New York, USA, patient navigation programs have been widely introduced in healthcare settings. Some literature has identified nurses as a primary candidate in assuming the role of a navigator. However, there is a need to further explore the effectiveness of patient navigation programs for their effectiveness in improving quality of life, and patient satisfaction and outcomes during the commencement of cancer treatment. The objective of this review was to synthesize the best available evidence on the effectiveness of patient navigation programs in adult cancer patients undergoing treatments such as radiotherapy and/or chemotherapy. This review considered studies that included adults aged 18 years and over, diagnosed with any type of cancer and undergoing treatment in an acute care hospital setting, including inpatient and outpatient/ambulatory care.This review considered studies that evaluated nurse-led patient navigation programs versus no patient navigation program or non-structured care coordination.A patient navigation program includes patient education, psychosocial support, and care coordination.This review considered randomized controlled trials and quasi-experimental studies.The review focused on the effects of patient navigator program clinical/patient outcomes. The review included studies on patient wellbeing and clinical outcomes, but excluded studies that had examined the impact of these programs on efficiency-related outcomes, such as length

  15. A quality assurance program for environmental data operations involving waste management processes

    International Nuclear Information System (INIS)

    Johnson, G.L.; Blacker, S.M.

    1990-01-01

    This paper describes the 'core' elements needed in an effective Quality Program for environmental data operations involving nuclear, mixed, or non-nuclear wastes. For each core element, this paper examines the minimum components needed for an effective Quality Program for EDOs, and compares approaches to Quality Programs currently required by the U.S. DOE and the U.S. EPA. The comparison suggests how the Quality Program requirements used at DOE, and defined by NQA-1 and its supplements, and those used by EPA through its QAMS program guidance, may provide a basis for developing a harmonized Quality Program for EDOs involving any waste management processes, nuclear, non-nuclear, or mixed. (orig./DG)

  16. Head Start Program Quality: Examination of Classroom Quality and Parent Involvement in Predicting Children's Vocabulary, Literacy, and Mathematics Achievement Trajectories

    Science.gov (United States)

    Wen, Xiaoli; Bulotsky-Shearer, Rebecca J.; Hahs-Vaughn, Debbie L.; Korfmacher, Jon

    2012-01-01

    Guided by a developmental-ecological framework and Head Start's two-generational approach, this study examined two dimensions of Head Start program quality, classroom quality and parent involvement and their unique and interactive contribution to children's vocabulary, literacy, and mathematics skills growth from the beginning of Head Start…

  17. Multicenter Collaborative Quality Assurance Program for the Province of Ontario, Canada: First-Year Results

    International Nuclear Information System (INIS)

    Létourneau, Daniel; McNiven, Andrea; Jaffray, David A.

    2013-01-01

    Purpose: The objective of this work was to develop a collaborative quality assurance (CQA) program to assess the performance of intensity modulated radiation therapy (IMRT) planning and delivery across the province of Ontario, Canada. Methods and Materials: The CQA program was designed to be a comprehensive end-to-end test that can be completed on multiple planning and delivery platforms. The first year of the program included a head-and-neck (H and N) planning exercise and on-site visit to acquire dosimetric measurements to assess planning and delivery performance. A single dosimeter was used at each institution, and the planned to measured dose agreement was evaluated for both the H and N plan and a standard plan (linear-accelerator specific) that was created to enable a direct comparison between centers with similar infrastructure. Results: CQA program feasibility was demonstrated through participation of all 13 radiation therapy centers in the province. Planning and delivery was completed on a variety of infrastructure (treatment planning systems and linear accelerators). The planning exercise was completed using both static gantry and rotational IMRT, and planned-to-delivered dose agreement (pass rates) for 3%/3-mm gamma evaluation were greater than 90% (92.6%-99.6%). Conclusions: All centers had acceptable results, but variation in planned to delivered dose agreement for the same planning and delivery platform was noted. The upper end of the range will provide an achievable target for other centers through continued quality improvement, aided by feedback provided by the program through the use of standard plans and simple test fields

  18. Quality Assurance Program Plan (QAPP) Waste Management Project

    Energy Technology Data Exchange (ETDEWEB)

    HORHOTA, M.J.

    2000-12-21

    The Waste Management Project (WMP) is committed to excellence in our work and to delivering quality products and services to our customers, protecting our employees and the public and to being good stewards of the environment. We will continually strive to understand customer requirements, perform services, and activities that meet or exceed customer expectations, and be cost-effective in our performance. The WMP maintains an environment that fosters continuous improvement in our processes, performance, safety and quality. The achievement of quality will require the total commitment of all WMP employees to our ethic that Quality, Health and Safety, and Regulatory Compliance must come before profits. The successful implementation of this policy and ethic requires a formal, documented management quality system to ensure quality standards are established and achieved in all activities. The following principles are the foundation of our quality system. Senior management will take full ownership of the quality system and will create an environment that ensures quality objectives are met, standards are clearly established, and performance is measured and evaluated. Line management will be responsible for quality system implementation. Each organization will adhere to all quality system requirements that apply to their function. Every employee will be responsible for their work quality, to work safely and for complying with the policies, procedures and instructions applicable to their activities. Quality will be addressed and verified during all phases of our work scope from proposal development through closeout including contracts or projects. Continuous quality improvement will be an ongoing process. Our quality ethic and these quality principles constantly guide our actions. We will meet our own quality expectations and exceed those of our customers with vigilance, commitment, teamwork, and persistence.

  19. Waste Management Project Quality Assurance Program Plan (QAPP)

    International Nuclear Information System (INIS)

    HORHOTA, M.J.

    2000-01-01

    The Waste Management Project (WMP) is committed to excellence in our work and to delivering quality products and services to our customers, protecting our employees and the public and to being good stewards of the environment. We will continually strive to understand customer requirements, perform services, and activities that meet or exceed customer expectations, and be cost-effective in our performance. The WMP maintains an environment that fosters continuous improvement in our processes, performance, safety and quality. The achievement of quality will require the total commitment of all WMP employees to our ethic that Quality, Health and Safety, and Regulatory Compliance must come before profits. The successful implementation of this policy and ethic requires a formal, documented management quality system to ensure quality standards are established and achieved in all activities. The following principles are the foundation of our quality system. Senior management will take full ownership of the quality system and will create an environment that ensures quality objectives are met, standards are clearly established, and performance is measured and evaluated. Line management will be responsible for quality system implementation. Each organization will adhere to all quality system requirements that apply to their function. Every employee will be responsible for their work quality, to work safely and for complying with the policies, procedures and instructions applicable to their activities. Quality will be addressed and verified during all phases of our work scope from proposal development through closeout including contracts or projects. Continuous quality improvement will be an ongoing process. Our quality ethic and these quality principles constantly guide our actions. We will meet our own quality expectations and exceed those of our customers with vigilance, commitment, teamwork, and persistence

  20. Posttreatment attrition and its predictors, attrition bias, and treatment efficacy of the anxiety online programs.

    Science.gov (United States)

    Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

    2014-10-14

    in age. Predicted probabilities resulting from these attrition variables displayed no significant attrition bias using Heckman's method and thus allowing for the use of completer analysis. Six treatment outcome measures (Kessler-6 total score, number of diagnosed disorders, self-confidence in managing mental health issues, quality of life, and the corresponding pre- and posttreatment severity for each program-specific anxiety disorder and for major depressive episode) were used to assess the efficacy of the 5 anxiety treatment programs. Repeated measures MANOVA revealed a significant multivariate time effect for all treatment outcome measures for each treatment program. Follow-up repeated measures ANOVAs revealed significant improvements on all 6 treatment outcome measures for GAD and PTSD, 5 treatment outcome measures were significant for SAD and PD/A, and 4 treatment outcome measures were significant for OCD. Results identified predictors of posttreatment assessment completers and provided further support for the efficacy of self-help online treatment programs for the 5 anxiety disorders. Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).

  1. Evaluation of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program.

    Science.gov (United States)

    Sheils, Catherine R; Dahlke, Allison R; Kreutzer, Lindsey; Bilimoria, Karl Y; Yang, Anthony D

    2016-11-01

    The American College of Surgeons National Surgical Quality Improvement Program is well recognized in surgical quality measurement and is used widely in research. Recent calls to make it a platform for national public reporting and pay-for-performance initiatives highlight the importance of understanding which types of hospitals elect to participate in the program. Our objective was to compare characteristics of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program to characteristics of nonparticipating US hospitals. The 2013 American Hospital Association and Centers for Medicare & Medicaid Services Healthcare Cost Report Information System datasets were used to compare characteristics and operating margins of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program to those of nonparticipating hospitals. Of 3,872 general medical and surgical hospitals performing inpatient surgery in the United States, 475 (12.3%) participated in the American College of Surgeons National Surgical Quality Improvement Program. Participating hospitals performed 29.0% of all operations in the United States. Compared with nonparticipating hospitals, American College of Surgeons National Surgical Quality Improvement Program hospitals had a higher mean annual inpatient surgical case volume (6,426 vs 1,874; P quality-related accreditations (P Quality Improvement Program had established surgical quality improvement collaboratives. The American College of Surgeons National Surgical Quality Improvement Program hospitals are large teaching hospitals with more quality-related accreditations and financial resources. These findings should be considered when reviewing research studies using the American College of Surgeons National Surgical Quality Improvement Program data, and the findings reinforce that efforts are needed to facilitate participation in surgical quality improvement by all

  2. Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment

    Directory of Open Access Journals (Sweden)

    Mihanović M

    2015-03-01

    Full Text Available Mate Mihanović,1,2 Branka Restek-Petrović,1,2 Anamarija Bogović,1 Ena Ivezić,1 Davor Bodor,1 Ivan Požgain3 1Psychiatric Hospital “Sveti Ivan”, Zagreb, 2Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 3Department of Psychiatry, University Hospital Center Osijek, Osijek, Croatia Background: The Sveti Ivan Psychiatric Hospital in Zagreb, Croatia, offers foster home care treatment that includes pharmacotherapy, group psychodynamic psychotherapy, family therapy, and work and occupational therapy. The aim of this study is to compare the health-related quality of life of patients with schizophrenia treated in foster home care with that of patients in standard outpatient treatment. Methods: The sample consisted of 44 patients with schizophrenia who, upon discharge from the hospital, were included in foster home care treatment and a comparative group of 50 patients who returned to their families and continued receiving outpatient treatment. All patients completed the Short Form 36 Health Survey Questionnaire on the day they completed hospital treatment, 6 months later, and 1 year after they participated in the study. The research also included data on the number of hospitalizations for both groups of patients. Results: Though directly upon discharge from the hospital, patients who entered foster home care treatment assessed their health-related quality of life as poorer than patients who returned to their families, their assessments significantly improved over time. After 6 months of treatment, these patients even achieved better results in several dimensions than did patients in the outpatient program, and they also had fewer hospitalizations. These effects remained the same at the follow-up 1 year after the inclusion in the study. Conclusion: Notwithstanding the limitations of this study, it can be concluded that treatment in foster home care is associated with an improvement in the quality of life of patients

  3. Modeling hospital infrastructure by optimizing quality, accessibility and efficiency via a mixed integer programming model.

    Science.gov (United States)

    Ikkersheim, David; Tanke, Marit; van Schooten, Gwendy; de Bresser, Niels; Fleuren, Hein

    2013-06-16

    The majority of curative health care is organized in hospitals. As in most other countries, the current 94 hospital locations in the Netherlands offer almost all treatments, ranging from rather basic to very complex care. Recent studies show that concentration of care can lead to substantial quality improvements for complex conditions and that dispersion of care for chronic conditions may increase quality of care. In previous studies on allocation of hospital infrastructure, the allocation is usually only based on accessibility and/or efficiency of hospital care. In this paper, we explore the possibilities to include a quality function in the objective function, to give global directions to how the 'optimal' hospital infrastructure would be in the Dutch context. To create optimal societal value we have used a mathematical mixed integer programming (MIP) model that balances quality, efficiency and accessibility of care for 30 ICD-9 diagnosis groups. Typical aspects that are taken into account are the volume-outcome relationship, the maximum accepted travel times for diagnosis groups that may need emergency treatment and the minimum use of facilities. The optimal number of hospital locations per diagnosis group varies from 12-14 locations for diagnosis groups which have a strong volume-outcome relationship, such as neoplasms, to 150 locations for chronic diagnosis groups such as diabetes and chronic obstructive pulmonary disease (COPD). In conclusion, our study shows a new approach for allocating hospital infrastructure over a country or certain region that includes quality of care in relation to volume per provider that can be used in various countries or regions. In addition, our model shows that within the Dutch context chronic care may be too concentrated and complex and/or acute care may be too dispersed. Our approach can relatively easily be adopted towards other countries or regions and is very suitable to perform a 'what-if' analysis.

  4. Neuro-linguistic programming and application in treatment of phobias.

    Science.gov (United States)

    Karunaratne, Mahishika

    2010-11-01

    Phobias are a prevalent and often debilitating mental health problem all over the world. This article aims to explore what is known about the use of Neuro-linguistic Programming (NLP) as a treatment for this condition. Whilst there is abundant experiential evidence from NLP practitioners attesting to the efficacy of this method as a treatment for phobias, experimental research in this area is somewhat limited. This paper reviews evidence available in literature produced in the UK and US and reveals that NLP is a successful treatment for phobias as well as being particularly efficient due to the relatively brief time period it takes to effect an improvement. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Effectiveness of a psycho-educational program for improving quality of life of fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    Montesano Adrián

    2008-01-01

    Full Text Available Abstract Background Most fibromyalgia patients are seen in primary care (PC. However, the effectiveness of the treatments prescribed by general practitioners is usually minimal. The main objective of the present research is to assess the efficacy of structured psycho-educational intervention, combined with relaxation, developed to improve the quality of life of patients suffering fibromyalgia (FM. The second objective is to assess the cost-effectiveness of this multimodal intervention. Method/Design Design. Randomized controlled trial with a 12-month follow-up involving two groups, one of which is the intervention group that includes patients receiving a psychoeducational program and the other the control group consisting of patients treated for FM in the usual way. Setting. Three urban PC centers in the province of Barcelona (Spain. Sample. The total sample comprises 218 patients (over 18 years of age suffering FM, selected from a database (Rheumatology service-Viladecans Hospital of patients with this illness. Only those patients introduced in the database between the years 2005 and 2007 were included in the selection. Selected patients will be asked for written informed consent to participate in the study. Intervention. Multi-component program including information about the illness, counselling about physical exercise and training in autogenic relaxation. The intervention consists of nine 2-hour sessions delivered during a two-month period. The pharmacological treatment prescribed by the physician was maintained in both groups. Main variables. Sociodemographic characteristics, quality of life, use and cost of healthcare and social services. Measures. Quality of life is to be measured with the FIQ and the EuroQol-5D, and the use of healthcare services with an adapted version of the Client Service Receipt Inventory (CSRI. These variables will be measured before the beginning of the program (baseline and 1, 2, 6 and 12 months later. Discussion

  6. Quality Assurance of Joint Degree Programs from the Perspective of Quality Assurance Agencies: Experience in East Asia

    Science.gov (United States)

    Hou, Yung-Chi; Ince, Martin; Tsai, Sandy; Wang, Wayne; Hung, Vicky; Lin Jiang, Chung; Chen, Karen Hui-Jung

    2016-01-01

    Joint degree programs have gained popularity in East Asia, due to the growth of transnational higher education in the region since 2000. However, the external quality assurance (QA) and accreditation of joint degree programs is a challenge for QA agencies, as it normally involves the engagement of several institutions and multiple national…

  7. CSF biomarker variability in the Alzheimer's Association quality control program.

    Science.gov (United States)

    Mattsson, Niklas; Andreasson, Ulf; Persson, Staffan; Carrillo, Maria C; Collins, Steven; Chalbot, Sonia; Cutler, Neal; Dufour-Rainfray, Diane; Fagan, Anne M; Heegaard, Niels H H; Robin Hsiung, Ging-Yuek; Hyman, Bradley; Iqbal, Khalid; Kaeser, Stephan A; Käser, Stephan A; Lachno, D Richard; Lleó, Alberto; Lewczuk, Piotr; Molinuevo, José L; Parchi, Piero; Regeniter, Axel; Rissman, Robert A; Rissman, Robert; Rosenmann, Hanna; Sancesario, Giuseppe; Schröder, Johannes; Shaw, Leslie M; Teunissen, Charlotte E; Trojanowski, John Q; Vanderstichele, Hugo; Vandijck, Manu; Verbeek, Marcel M; Zetterberg, Henrik; Blennow, Kaj

    2013-05-01

    The cerebrospinal fluid (CSF) biomarkers amyloid beta 1-42, total tau, and phosphorylated tau are used increasingly for Alzheimer's disease (AD) research and patient management. However, there are large variations in biomarker measurements among and within laboratories. Data from the first nine rounds of the Alzheimer's Association quality control program was used to define the extent and sources of analytical variability. In each round, three CSF samples prepared at the Clinical Neurochemistry Laboratory (Mölndal, Sweden) were analyzed by single-analyte enzyme-linked immunosorbent assay (ELISA), a multiplexing xMAP assay, or an immunoassay with electrochemoluminescence detection. A total of 84 laboratories participated. Coefficients of variation (CVs) between laboratories were around 20% to 30%; within-run CVs, less than 5% to 10%; and longitudinal within-laboratory CVs, 5% to 19%. Interestingly, longitudinal within-laboratory CV differed between biomarkers at individual laboratories, suggesting that a component of it was assay dependent. Variability between kit lots and between laboratories both had a major influence on amyloid beta 1-42 measurements, but for total tau and phosphorylated tau, between-kit lot effects were much less than between-laboratory effects. Despite the measurement variability, the between-laboratory consistency in classification of samples (using prehoc-derived cutoffs for AD) was high (>90% in 15 of 18 samples for ELISA and in 12 of 18 samples for xMAP). The overall variability remains too high to allow assignment of universal biomarker cutoff values for a specific intended use. Each laboratory must ensure longitudinal stability in its measurements and use internally qualified cutoff levels. Further standardization of laboratory procedures and improvement of kit performance will likely increase the usefulness of CSF AD biomarkers for researchers and clinicians. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All

  8. Re-evaluation of Montana's air quality program.

    Science.gov (United States)

    2013-08-01

    This project examined the Montana DOTs current methods for determining projects for the Montana Air and Congestion Initiative (MACI) program, and made recommendations to improve and implement this program. A major project objective was to keep the...

  9. Outcome of Congenitally Hypothyroid Screening Program in Isfahan: Iran From Prevention to Treatment

    Directory of Open Access Journals (Sweden)

    Mahin Hashemipour

    2010-01-01

    Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9  13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

  10. Empowering breeding programs with new approaches to overcome constraints for selecting superior quality traits of rice

    NARCIS (Netherlands)

    Calingacion, M.N.

    2015-01-01

    Empowering breeding programs with new approaches to overcome constraints for selecting superior quality traits of rice

    Mariafe N. Calingacion

    Most rice breeding programs have focused on improving agronomic traits such as yield, while enhancing grain quality traits

  11. Empowering breeding programs with new approaches to overcome constraints for selecting superior quality traits of rice

    NARCIS (Netherlands)

    Calingacion, M.N.

    2015-01-01

    Empowering breeding programs with new approaches to overcome constraints for selecting superior quality traits of rice Mariafe N. Calingacion Most rice breeding programs have focused on improving agronomic traits such as yield, while enhancing grain quality traits such as flavour

  12. Quality Management of Body Donation Program at the University of Padova

    Science.gov (United States)

    Porzionato, Andrea; Macchi, Veronica; Stecco, Carla; Mazzi, Anna; Rambaldo, Anna; Sarasin, Gloria; Parenti, Anna; Scipioni, Antonio; De Caro, Raffaele

    2012-01-01

    Quality management improvement has become a recent focus of attention in medical education. The program for the donation of bodies and body parts (Body Donation Program) at the University of Padova has recently been subjected to a global quality management standard, the ISO 9001:2008 certification. The aim of the present work is to show how the…

  13. 7 CFR 58.149 - Alternate quality control programs for dairy products.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Alternate quality control programs for dairy products... for dairy products. (a) When a plant has in operation an acceptable quality control program which is... (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS...

  14. [Effects of an Interdisciplinary Care Program on Improving the Return-to-Treatment Rate Among Cancer Patients].

    Science.gov (United States)

    Chen, Mei-Chun; Chen, Wan-Yu; Tsui, Wan-Yu; Chang, Guey-Ling; Hong, Ming-Ying

    2018-04-01

    The return-to-treatment rate is an important indicator of treatment outcome and care effectiveness in cancer patients. The return-to-treatment rates for patients at National Taiwan University Hospital (NTUH) in 2011 and 2012 were 38.5% and 33.3%, respectively. In order to improve the quality of care that is provided to patients, we reviewed NTUH's current clinical case management protocols for handling patients who refused treatment and then identified and resolved the potential problems in these protocols. To raise the return-to-treatment rate above 45% by 2013. We developed four new interventions to improve the return-to-treatment rate. Firstly, we assembled a quality care team that monitored the rates of patient return to treatment on a monthly basis and reminded case managers to follow up with patients regularly. Secondly, we introduced new protocols for case managers that facilitated the ongoing analysis of the reasons that patients elect not to return to treatment. Thirdly, we delivered regular education programs for case managers addressing good quality and quantity care for cancer patients. Finally, we developed an interdisciplinary liaison care program for patients. After implementing these four interventions, the return-to-treatment rate improved to 48% in 2013. This improvement project demonstrated that integrating an interdisciplinary team, assembling a quality care team, implementing new protocols to help cancer patients who refuse to commence / continue treatment, providing regular education to clinical case managers, and enacting an interdisciplinary care program were all helpful to improving the effectiveness of cancer care services and the return-to-treatment rate of cancer patients.

  15. Hanford Waste Vitrification Plant quality assurance program description: Overview and applications

    International Nuclear Information System (INIS)

    Caplinger, W.H.

    1990-12-01

    This document describes the Hanford Waste Vitrification Plant Project Quality Assurance Program. This program is being implemented to ensure the acceptability of high-level radioactive canistered waste forms produced by the Hanford Waste Vitrification Plant for disposal in a licensed federal repository. The Hanford Waste Vitrification Plant Quality Assurance Program is comprised of this Quality Assurance Program Description as well as the associated contractors' quality assurance programs. The objective of this Quality Assurance Program Description is to provide the Hanford Waste Vitrification Plant Project participants with guidance and direction for program implementation while satisfying the US Department of Energy Office of Civilian Radioactive Waste Management needs in repository licensing activities with regard to canistered waste forms. To accomplish this objective, this description will be prepared in three parts: Part 1 - Overview and applications document; Part 2 - Development and qualification of the canistered waste form; Part 3 - Production of canistered waste forms. Part 1 describes the background, strategy, application, and content of the Hanford Waste Vitrification Plant Quality Assurance Program. This Quality Assurance Program Description, when complete, is designed to provide a level of confidence in the integrity of the canistered waste forms. 8 refs

  16. Selenide isotope generator for the Galileo mission. Quality assurance program plan

    Energy Technology Data Exchange (ETDEWEB)

    1978-08-01

    This Quality Program Plan has been prepared to describe the quality activities associated with the development, production, test and delivery of hardware for the Selenide Isotope Generator Program. The objective of the Quality Program Plan is to establish and maintain an effective and economical quality assurance system to assure that end items are in accordance with contractural specifications. Section I.9 of Appendix A (Statement of Work) states: The Contractor shall prepare, implement and maintain a Quality Assurance program in accordance with a DOE approved Quality Assurance Program Plan which, for purposes of this contract, the parties agree represent a modified compliance with the latest requirements of the latest NRA-1 in effect at the time of the contract issuance. NRA-1 sets forth general requirements for quality assurance programs covering a wide variety of nuclear systems and is sufficiently expansive in scope to outline the quality activities of a broad range of contractural efforts. This Quality Assurance Program Plan, including the individual Quality Directives (Quality Procedures referenced in various Quality Directives provide only historical foundations of Quality Policy and as such are not relevant to the specifics of this plan.) attached in Appendix I, defines the quality activities that are to be accomplished under the current contractural work effort. The extent to which this Plan provides activity to accomplish the major intent of each section of NRA-1 is summarized in Table 1. NRA-1 however, provides only the skeletal foundation for the plan and it should not be construed that sections or portions not explicitly quoted are implied. The Plan will function as an independent and self-supportative document.

  17. Quality Assurance Program Plan for the radiological survey activities program --- Uranium Mill Tailings Remedial Action Project

    International Nuclear Information System (INIS)

    Knott, R.R.; Little, C.A.

    1991-08-01

    The Pollutant Assessments Group (PAG) at the Grand Junction Office (GJO), Colorado, of Oak Ridge National Laboratory (ORNL) is responsible for surveying designated sites in the vicinity of 24 inactive mill sites involved in the Department of Energy's (DOE) Uranium Mill Tailings Remedial Action Project (UMTRAP). The purpose of these surveys is to provide a recommendation to DOE whether to include or exclude these sites from UMTRAP based on whether the on-site residual radioactive material (if any) originated from the former mill sites, and radiation levels on-site are in excess of appropriate Environmental Protection Agency (EPA) criteria. This report describes the Quality Assurance Plan (QAP) for the PAG in conducting all activities related to UMTRAP. All quality assurance provisions given by the DOE, DOE/UMTRA and ORNL organizations are integrated into this plan. Specifically, this report identifies the policies and procedures followed in accomplishing the PAG/UMTRA QA program, identifies those organizational units involved in the implementation of these procedures, and outlines the respective responsibilities of those groups. 11 refs., 6 figs., 3 tabs

  18. Evaluation and recommendations on U.C. Lawrence Livermore Labortory Quality Assurance Program

    International Nuclear Information System (INIS)

    Carpenter, F.D.; Horner, M.H.

    1978-01-01

    A study was conducted of the University of California's Lawrence Livermore Laboratory Quality Assurance Program, which focused on training needs and recommendations tailored to the various on-going programs. Specific attention was directed to an assessment of the quality status for the MFTF facility and the capabilities of assigned quality project engineers. Conclusions and recommendations are presented which not only address the purpose of this study, but extend into other areas to provide insight and needs for a total cost effective application of a quality assurance program

  19. QUALITY ASSURANCE IN SECONDARY EDUCATION PROGRAME OF BANGLADESH OPEN UNIVERSITY: Present Status and Challenges

    Directory of Open Access Journals (Sweden)

    Zobaida AKHTER

    2008-04-01

    Full Text Available In the present day in national and international perspectives, quality is the top of most agendas. Quality of education has significant impact and invaluable contribution to the area of development. Recently, the SSC & HSC program of BOU have earned recognition of equivalency with the formal education sector, which has naturally raised the question of quality assurance of these programs By applying the quantitative method, the study has assessed the present status of the quality of SSC & HSC program of BOU and also put some recommendations to meet the challenges for further development.

  20. Implementation of a lung radiosurgery program: technical considerations and quality assurance in an Australian institution

    International Nuclear Information System (INIS)

    Siva, Shankar; MacManus, Michael; Ball, David; Chesson, Brent; Aarons, Yolanda; Clements, Natalie; Kron, Tomas

    2012-01-01

    The Peter MacCallum Cancer Centre has established a stereotactic lung radiosurgery program for the treatment of isolated lung metastases. The aim of this study was to critically assess the technical feasibility of performing stereotactic lung radiosurgery in an Australian institution. A single 26-Gy fraction of radiotherapy was delivered to patients with positron emission tomography (PET) staged solitary lung metastases. Motion management was addressed using four-dimensional computed tomographic simulation, and cone beam CT (CBCT) online soft-tissue matching. Treatments were with multiple coplanar and non-coplanar asymmetric beams. Patients were immobilised in a dedicated stereotactic body cradle. Quality assurance (QA) of treatment plans with both ion chamber and film measurements was performed accounting for patient-specific respiratory motion. Between February 2010 and February 2011, nine patients received stereotactic lung radiosurgery. One grade 1 toxicity and one grade 2 toxicity were recorded after treatment. The mean planning target volume was 22.6 cc. A median of eight beams were delivered per treatment plan (range 7–10) with a median of two non-coplanar beams (range 0–6). At treatment plan QA, the difference between planned and delivered dose was ≤1.76% in all static and dynamic ion chamber recordings. A mid-treatment CBCT was performed at a median time of 21 min, with the mean displacement discrepancy from initial set-up being 0.4 mm (range 0–2 mm). Stereotactic radiosurgery to the lung was both feasible and tolerable at our institution. Intrafractional immobilisation within 2 mm was reproducible. Excellent concordance between planned and delivered treatments was achieved in the phantom QA.

  1. Web-based treatment program using intensive therapeutic contact for patients with eating disorders: before-after study.

    Science.gov (United States)

    ter Huurne, Elke D; Postel, Marloes G; de Haan, Hein A; Drossaert, Constance H C; DeJong, Cor A J

    2013-02-04

    Although eating disorders are common in the Netherlands, only a few patients are treated by mental health care professionals. To reach and treat more patients with eating disorders, Tactus Addiction Treatment developed a web-based treatment program with asynchronous and intensive personalized communication between the patient and the therapist. This pilot study evaluated the web-based treatment program using intensive therapeutic contact in a population of 165 patients with an eating disorder. In a pre-post design with 6-week and 6-month follow-ups, eating disorder psychopathology, body dissatisfaction, Body Mass Index, physical and mental health, and quality of life were measured. The participant's satisfaction with the web-based treatment program was also studied. Attrition data were collected, and participants were classified as noncompleters if they did not complete all 10 assignments of the web-based treatment program. Differences in baseline characteristics between completers and noncompleters were studied, as well as reasons for noncompletion. Furthermore, differences in treatment effectiveness, treatment adherence, and baseline characteristics between participants of the three major eating disorder diagnostic groups EDNOS (n=115), BN purging (n=24), and BN nonpurging (n=24) were measured. Of the 165 participants who started the web-based treatment program, 89 participants (54%) completed all of the program assignments (completers) and 76 participants (46%) ended the program prematurely (noncompleters). Severe body dissatisfaction and physical and mental health problems seemed to have a negative impact on the completion of the web-based treatment program. Among the participants who completed the treatment program, significant improvements were found in eating disorder psychopathology (F=54.6, df = 68, Pphysical and mental health also significantly improved, and almost all of these positive effects were sustained up to 6 months after the participants had

  2. Challenges to providing quality substance abuse treatment services for American Indian and Alaska native communities: perspectives of staff from 18 treatment centers

    Science.gov (United States)

    2014-01-01

    Background Substance abuse continues to exact a significant toll, despite promising advancements in treatment, and American Indian and Alaska Native (AI/AN) communities remain disproportionately impacted. Understanding the challenges to providing quality substance abuse treatment to AI/AN communities could ultimately result in more effective treatment interventions, but no multi-site studies have examined this important issue. Methods This qualitative study examined the challenges of providing substance abuse treatment services for American Indian and Alaska Native (AI/AN) communities. We conducted key informant interviews and focus groups at 18 substance abuse treatment programs serving AI/AN communities. Seventy-six service participants (21 individuals in clinical administrative positions and 55 front-line clinicians) participated in the project. Interview transcripts were coded to identify key themes. Results We found that the challenges of bringing effective substance abuse treatment to AI/AN communities fell into three broad categories: challenges associated with providing clinical services, those associated with the infrastructure of treatment settings, and those associated with the greater service/treatment system. These sets of challenges interact to form a highly complex set of conditions for the delivery of these services. Conclusions Our findings suggest that substance abuse treatment services for AI/AN communities require more integrated, individualized, comprehensive, and longer-term approaches to care. Our three categories of challenges provide a useful framework for eliciting challenges to providing quality substance abuse treatment in other substance abuse treatment settings. PMID:24938281

  3. Mastering improvement science skills in the new era of quality and safety: the Veterans Affairs National Quality Scholars Program.

    Science.gov (United States)

    Estrada, Carlos A; Dolansky, Mary A; Singh, Mamta K; Oliver, Brant J; Callaway-Lane, Carol; Splaine, Mark; Gilman, Stuart; Patrician, Patricia A

    2012-04-01

    Healthcare professionals need a new skill set to ensure the success of quality improvement in healthcare. The Department of Veterans Affairs (VA) initiated the VA National Quality Scholars fellowship in 1998; its mission is to improve the quality of care, ensure safety, accelerate healthcare re-design, and advance the improvement science by educating the next generation of leaders in quality and safety. We describe the critical need for leadership in quality and safety and interprofessional education, illustrate the curriculum, provide lessons learned by fellows, summarize key lessons learned from the implementation of an interprofessional education approach, and present most recent accomplishments. Narrative review. As of 2011, 106 program alumni are embedded in the health care delivery system across the United States. Since 2009, when nurse fellows joined the program, of the first nine graduating interdisciplinary fellows, the tailored curriculum has resulted in five advanced academic degrees, 42 projects, 29 teaching activities, 44 presentations, 36 publications, six grants funded or submitted, and two awards. The VA National Quality Scholars program continues to nurture and develop leaders for the new millennium focusing on interprofessional education. The nations' health care systems need strong interdisciplinary leaders in advanced quality improvement science who are dedicated to improving the overall quality of health and health care. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

  4. Consumers as staff in assertive community treatment programs.

    Science.gov (United States)

    Dixon, L; Hackman, A; Lehman, A

    1997-11-01

    The last decade has witnessed the increasing importance of consumers as providers of mental health services. Assertive Community Treatment (ACT) teams and ACT variants, with their emphasis on rehabilitation and support in the client's natural environment, have hosted consumer-professional collaborations. The authors discuss one such program in which an ACT program for homeless mentally ill adults employed consumer advocates (CAs). Consumer advocates were found to have a service profile similar to other staff. Further, there is suggestive evidence that the employment of CAs created a more positive attitude toward persons with mental illness. Issues of role definition, boundaries, support with supervision and the importance of CAs' experiences with mental illness are discussed.

  5. Quality of life in institutionalized elderly undergoing an active aging program

    OpenAIRE

    Magalhães, Carlos Pires; Rebelo, Flávia Marisa Ramalho; Anes, Eugénia

    2016-01-01

    Living with quality is a growing concern of the old population. There is an increasing institutionalization of the elderly, and it is in this context that active aging programs assume relevance, allowing the elderly the contact with experiences that allow them to age with quality of life, by maintaining their autonomy and promoting their physical, mental and emotional well-being. This study aims to assess the quality of life of institutionalized elderly undergoing to an active aging program. ...

  6. Establishment of a national program for quality control of nuclear medicine instrumentation.

    Science.gov (United States)

    Coca Perez, Marco A; Torres Aroche, Leonel A; Bejerano, Gladys López; Mayor, Roberto Fraxedas; Corona, Consuelo Varela; López, Adlin

    2008-12-01

    Monitoring the quality of instrumentation used in nuclear medicine is mandatory to guarantee the clinical efficacy of medical practice. A national program for the quality control of nuclear medicine instruments was established in Cuba and was certified and approved by the regulatory authorities. The program, which establishes official regulations and audit services, sets up educational activities, distributes technical documentation, and maintains a national phantom bank, constitutes a valuable and useful tool to guarantee the quality of nuclear medicine instrumentation.

  7. Quality assurance program requirements (design and construction). Task RS 002-5. Revision 3

    International Nuclear Information System (INIS)

    1985-08-01

    This regulatory guide describes a method acceptable to the NRC staff for complying with regard to establishing and implementing the requisite quality assurance program for the design and construction of nuclear power plants. Guidance for the establishment and execution of quality assurance programs during operation and decommissioning of nuclear power plants have been or will be addressed in separate regulatory guides. Similarly, quality assurance provisions concerning fuel cycle facilities have been or will be addressed in separate regulatory guides

  8. Quality Assurance for Postgraduate Programs: Design of a Model Applied on a University in Chile

    Science.gov (United States)

    Careaga Butter, Marcelo; Meyer Aguilera, Eduardo; Badilla Quintana, María Graciela; Jiménez Pérez, Laura; Sepúlveda Valenzuela, Eileen

    2017-01-01

    The quality of Education in Chile is a controversial topic that has been in the public debate in the last several years. To ensure quality in graduate programs, accreditation is compulsory. The current article presents a model to improve the process of self-regulation. The main objective was to design a Model of Quality Assurance for Postgraduate…

  9. A Review of Paradigms for Evaluating the Quality of Online Education Programs

    Science.gov (United States)

    Shelton, Kaye

    2011-01-01

    As the demands for public accountability increase for higher education, institutions must demonstrate quality within programs and processes, including those provided through online education. While quality may be elusive to specifically quantify, there have been several recommendations for identifying and defining quality online education that…

  10. 10 CFR 63.144 - Quality assurance program change.

    Science.gov (United States)

    2010-01-01

    ... clearly denote the position function, supplemented as necessary by descriptive text, rather than specific..., and responsibilities, or alternatively, the use of descriptive text; (4) The elimination of quality...

  11. The EBR-II spent fuel treatment program

    International Nuclear Information System (INIS)

    Lineberry, M.J.; McFarlane, H.F.

    1995-01-01

    Argonne National Laboratory has refurbished and equipped an existing hot cell facility for demonstrating a high-temperature electrometallurgical process for treating spent nuclear fuel from the Experimental Breeder Reactor-11. Two waste forms will be produced and qualified for geologic disposal of the fission and activation products. Relatively pure uranium will be separated for storage. Following additional development, transuranium elements will be blended into one of the high-level waste streams. The spent fuel treatment program will help assess the viability of electrometallurgical technology as a spent fuel management option

  12. Effect of hot water treatments on quality of highbush blueberries.

    Science.gov (United States)

    Fan, L; Forney, C F; Song, J; Doucette, C; Jordan, M A; McRae, K B; Walker, B A

    2008-08-01

    Highbush blueberries, cv 'Burlington', were treated with 22, 45, 50, or 60 degrees C water for 15 or 30 s along with an untreated control. Fruit were then stored for 0, 1, 2, or 4 wk at 0 degrees C and 2 or 9 d at 20 degrees C prior to evaluation of microbial population and fruit quality. After 4 wk of storage, the hot water treatment at 60 degrees C resulted in 92% marketable berries, followed by 90% at 50 degrees C, 88% at 45 degrees C, and 83% at 22 degrees C compared with 76% in untreated controls. Decay incidence was reduced to 0.6%, 1.2%, 1.4%, or 2.8% with 60, 50, 45, or 22 degrees C water treatments, respectively, compared with 5.1% in controls following 4 wk at 0 degrees C and 2 d at 20 degrees C. After an additional 7 d at 20 degrees C, decay in fruit treated at 60 degrees C for 15 or 30 s remained at 1.8% and 0.4%, respectively, compared to 37.4% in controls. Weight loss of berries treated with hot water was 0.4% against 3.8% in controls, and shriveled and split berries were also reduced compared to controls (Ppathogens causing decay of Burlington blueberries during storage. Hot water treatments also immediately induced an increase in ethanol and reduced fruit titratable acidity and soluble solids content, but had no significant effect on fruit firmness, pH, or most flavor volatile concentrations.

  13. Application of quality assurance program to safety related aging equipment or components

    International Nuclear Information System (INIS)

    Papaiya, N.C.

    1990-01-01

    This paper addresses how quality assurance programs and their criteria are applied to safety related and aging equipment or components used in commercial nuclear plant applications. The QA Programs referred to are 10CFR50 Appendix B and EPRI NP-5652. The QA programs as applicable are applied to equipment/component aging qualification, preventive maintenance, surveillance testing and procurement engineering. The intent of this paper is not the technical issues, methods and research of aging. The paper addresses QA program's application to age-related equipment or components in safety related applications. Quality Assurance Program 10CFR50 Appendix B applies to all safety related aging components or equipment related to the qualification program and associated preventive maintenance and surveillance testing programs. Quality Assurance involvement with procurement engineering for age-related commercial grade items supports EPRI NP-5652 and assures that the dedicated OGI is equal to the item purchased as a basic component to 10CFR50 Appendix B requirements

  14. Changes in quality of care and quality of life of outpatients with advanced cancer after a regional palliative care intervention program.

    Science.gov (United States)

    Yamagishi, Akemi; Sato, Kazuki; Miyashita, Mitsunori; Shima, Yasuo; Kizawa, Yoshiyuki; Umeda, Megumi; Kinoshita, Hiroya; Shirahige, Yutaka; Akiyama, Miki; Yamaguchi, Takuhiro; Morita, Tatsuya

    2014-10-01

    A recent mixed-methods study to evaluate the effects of a comprehensive regional palliative care program, the Japan Outreach Palliative Care Trial of the Integrated Model study, achieved broad positive outcomes at a regional level. This is a secondary analysis of patient outcomes. The primary aims were to explore: 1) the changes in domains of patient-reported quality of care and quality of life after interventions, and 2) the changes in quality of care and quality of life of patients with different characteristics (i.e., performance status, age, and anticancer treatment). A region-representative sample of metastatic/locally advanced cancer patients in outpatient settings participated in questionnaire surveys before and after regional intervention. Responses were obtained from 859 of 1880 and 857 of 2123 in the pre- and postintervention surveys, respectively. All subdomain scores of the quality of care, except for help with decision making, significantly improved in the postintervention survey. The percentages of the patients who reported that improvement was necessary decreased from 13% to 5.0%. Although there were no or only a marginally significant difference in total and subdomain scores of quality of life between preintervention and postintervention surveys, the subgroups of patients with a poor performance status and those receiving no anticancer treatment achieved a significant improvement in the quality of life. Although average changes in patient-reported outcomes were relatively small in the total sample of patients, the intervention seemed to provide tangible benefits for the patients with poor general conditions. A future regional intervention trial should include patient outcomes in those with a poor general condition to evaluate the net effects of the program. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  15. Final Test Results of Quality Assurance Classes Using the Instructional Concepts Program (ICP).

    Science.gov (United States)

    Monteiro, Mike; Bailey, Jerry

    As part of the Quality Assurance procedures, a final test was administered to a sample of the classes participating in the 1970-71 Instructional Concepts Program (ICP). The posttest was designed to measure end-of-program performance on each of the six program outcomes: Color, Shape, Size, Position, Amount, and Pre-Mathematics. This report…

  16. Quality and best practices in early childhood programs: perceptions ...

    African Journals Online (AJOL)

    Definitions of quality in early childhood education (ECE) has predominantly adopted a developmental perspective, where quality care is that which promotes optimal child outcomes in all domains of development. This study investigates Developmentally Appropriate Practice (DAP), an approach designed to promote young ...

  17. A stochastic dynamic programming model for stream water quality ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    1. Introduction. River water quality management problems are characterized by various uncertainties at differ- ... model to achieve the maximum economic benefits without violating water quality standards. This model ..... for aquatic life, for example, would be a useful application of the methodology presented in the paper.

  18. A stochastic dynamic programming model for stream water quality ...

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Keywords. Fuzzy decision; stochastic optimization; water quality; streamflow. 1. Introduction. River water quality management problems are characterized by various uncertainties at differ- ent stages of decision making to arrive at optimal allocation of the assimilative capacity of the river system. The two types of uncertainties ...

  19. Nuclear waste treatment program: Annual report for FY 1987

    Energy Technology Data Exchange (ETDEWEB)

    Brouns, R.A.; Powell, J.A. (comps.)

    1988-09-01

    Two of the US Department of Energy's (DOE) nuclear waste management-related goals are to ensure that waste management is not an obstacle to the further development of light-water reactors and the closure of the nuclear fuel cycle and to fulfill its institutional responsibility for providing safe storage and disposal of existing and future nuclear wastes. As part of its approach to achieving these goals, the Office of Remedial Action and Waste Technology of DOE established what is now called the Nuclear Waste Treatment Program (NWTP) at the Pacific Northwest Laboratory during the second half of FY 1982. To support DOE's attainment of its goals, the NWTP is to provide technology necessary for the design and operation of nuclear waste treatment facilities by commercial enterprises as part of a licensed waste management system and problem-specific treatment approaches, waste form and treatment process adaptations, equipment designs, and trouble-shooting assistance, as required to treat existing wastes. This annual report describes progress during FY 1987 towards meeting these two objectives. 24 refs., 59 figs., 24 tabs.

  20. Sleep and quality of life in urban poverty: the effect of a slum housing upgrading program.

    Science.gov (United States)

    Simonelli, Guido; Leanza, Yvan; Boilard, Alexandra; Hyland, Martín; Augustinavicius, Jura L; Cardinali, Daniel P; Vallières, Annie; Pérez-Chada, Daniel; Vigo, Daniel E

    2013-11-01

    To evaluate the effect of a housing transition on sleep quality and quality of life in slum dwellers, participating in a slum housing upgrading program. Observational before-and-after study with a convergent-parallel mixed method design. Five slums located in the metropolitan area of Buenos Aires, Argentina. A total of 150 slum dwellers benefited by a housing program of the nonprofit organization TECHO (spanish word for "roof"). Participants moved from their very low-quality house to a basic prefabricated 18 m(2) modular house provided by TECHO. The Pittsburgh Sleep Quality Index (PSQI) and World Health Organization Quality of Life brief scale (WHOQOL-BREF) were administered before and after housing upgrading. Data about housing conditions, income, education, sleeping conditions, and cardiovascular risk were also collected. Semistructured interviews were used to expand and nuance quantitative data obtained from a poorly educated sample. Results showed that sleep quality significantly increased after the housing program (z = -6.57, P quality of life (z = -6.85, P importance of serenity for improving quality of life. A minimal improvement in the quality of basic housing can significantly increase sleep quality and quality of life among slum dwellers. Understanding sleep and daily life conditions in informal urban settlements could help to define what kind of low-cost intervention may improve sleep quality, quality of life, and reduce existent sleep disparity.

  1. A Comprehensive, High-Quality Orthopedic Intern Surgical Skills Program.

    Science.gov (United States)

    Ford, Samuel E; Patt, Joshua C; Scannell, Brian P

    2016-01-01

    To design and implement a month-long, low-cost, comprehensive surgical skills curriculum built to address the needs of orthopedic surgery interns with high satisfaction among both interns and faculty. The study design was retrospective and descriptive. The study was conducted at tertiary care referral center with a medium sized orthopedic residency surgery program (5 residents/year). Totally 5 orthopedic surgery residents and 16 orthopedic surgery faculty participated. A general mission was established-to orient the resident to the postgraduate year 1 and prepare them for success in residency. The basic tenets of the American Board of Orthopaedic Surgeons surgical skills program framework were built. Curricular additions included anatomic study, surgical approaches, joint-specific physical examination, radiographic interpretation, preoperative planning, reduction techniques, basic emergency and operating room procedures, cadaveric procedure practice, and introduction to arthroplasty. The program was held in August during protected time for intern participants. In total, 16 orthopedic surgeons instructed 85% of the educational sessions. One faculty member did most of the preparation and organization to facilitate the program. The program ran for a cumulative 89 hours, including 14.5 hours working with cadaveric specimens. The program cost a total of $8100. The average module received a 4.15 rating on a 5-point scale, with 4 representing "good" and 5 representing "excellent." The program was appropriately timed and addressed topics relevant to the intern without sacrificing clinical experience or burdening inpatient services with interns' absence. The program received high satisfaction ratings from both the interns as well as the faculty. Additionally, the program fostered early relationships between interns and faculty-an unforeseen benefit. In the future, our program plans to better integrate validated learning metrics and improve instruction pertaining to both

  2. Quality of nuchal translucency measurements correlates with broader aspects of program rigor and culture of excellence.

    Science.gov (United States)

    Evans, Mark I; Krantz, David A; Hallahan, Terrence; Sherwin, John; Britt, David W

    2013-01-01

    To determine if nuchal translucency (NT) quality correlates with the extent to which clinics vary in rigor and quality control. We correlated NT performance quality (bias and precision) of 246,000 patients with two alternative measures of clinic culture - % of cases for whom nasal bone (NB) measurements were performed and % of requisitions correctly filled for race-ethnicity and weight. When requisition errors occurred in 5% (33%), the curve lowered to 0.93 MoM (p 90%, MoM was 0.99 compared to those quality exists independent of individual variation in NT quality, and two divergent indices of program rigor are associated with NT quality. Quality control must be program wide, and to effect continued improvement in the quality of NT results across time, the cultures of clinics must become a target for intervention. Copyright © 2013 S. Karger AG, Basel.

  3. Assessing Quality of Program Environments for Children and Youth with Autism: Autism Program Environment Rating Scale (APERS).

    Science.gov (United States)

    Odom, Samuel L; Cox, Ann; Sideris, John; Hume, Kara A; Hedges, Susan; Kucharczyk, Suzanne; Shaw, Evelyn; Boyd, Brian A; Reszka, Stephanie; Neitzel, Jennifer

    2018-03-01

    The purpose of this study was to examine the psychometric properties of the Autism Program Environment Rating Scale (APERS), an instrument designed to assess quality of program environments for students with autism spectrum disorder. Data sets from two samples of public school programs that provided services to children and youth with autism spectrum disorder were utilized. Cronbach alpha analyses indicated high coefficients of internal consistency for the total APERS and moderate levels for item domains for the first data set, which was replicated with the second data set. A factor analysis of the first data set indicated that all domain scores loaded on one main factor, in alignment with the conceptual model, with this finding being replicated in the second data set. Also, the APERS was sensitive to changes resulting from a professional development program designed to promote program quality.

  4. Constructed Wetland Treatment Systems For Water Quality Improvement

    International Nuclear Information System (INIS)

    Nelson, E.

    2010-01-01

    The Savannah River National Laboratory implemented a constructed wetland treatment system (CWTS) in 2000 to treat industrial discharge and stormwater from the Laboratory area. The industrial discharge volume is 3,030 m 3 per day with elevated toxicity and metals (copper, zinc and mercury). The CWTS was identified as the best treatment option based on performance, capital and continuing cost, and schedule. A key factor for this natural system approach was the long-term binding capacity of heavy metals (especially copper, lead, and zinc) in the organic matter and sediments. The design required that the wetland treat the average daily discharge volume and be able to handle 83,280 m 3 of stormwater runoff in a 24 hour period. The design allowed all water flow within the system to be driven entirely by gravity. The CWTS for A-01 outfall is composed of eight one-acre wetland cells connected in pairs and planted with giant bulrush to provide continuous organic matter input to the system. The retention basin was designed to hold stormwater flow and to allow controlled discharge to the wetland. The system became operational in October of 2000 and is the first wetland treatment system permitted by South Carolina DHEC for removal of metals. Because of the exceptional performance of the A-01 CWTS, the same strategy was used to improve water quality of the H-02 outfall that receives discharge and stormwater from the Tritium Area of SRS. The primary contaminants in this outfall were also copper and zinc. The design for this second system required that the wetland treat the average discharge volume of 415 m 3 per day, and be able to handle 9,690 m 3 of stormwater runoff in a 24 hour period. This allowed the building of a system much smaller than the A-01 CWTS. The system became operational in July 2007. Metal removal has been excellent since water flow through the treatment systems began, and performance improved with the maturation of the vegetation during the first season of

  5. CONSTRUCTED WETLAND TREATMENT SYSTEMS FOR WATER QUALITY IMPROVEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, E.

    2010-07-19

    The Savannah River National Laboratory implemented a constructed wetland treatment system (CWTS) in 2000 to treat industrial discharge and stormwater from the Laboratory area. The industrial discharge volume is 3,030 m{sup 3} per day with elevated toxicity and metals (copper, zinc and mercury). The CWTS was identified as the best treatment option based on performance, capital and continuing cost, and schedule. A key factor for this natural system approach was the long-term binding capacity of heavy metals (especially copper, lead, and zinc) in the organic matter and sediments. The design required that the wetland treat the average daily discharge volume and be able to handle 83,280 m{sup 3} of stormwater runoff in a 24 hour period. The design allowed all water flow within the system to be driven entirely by gravity. The CWTS for A-01 outfall is composed of eight one-acre wetland cells connected in pairs and planted with giant bulrush to provide continuous organic matter input to the system. The retention basin was designed to hold stormwater flow and to allow controlled discharge to the wetland. The system became operational in October of 2000 and is the first wetland treatment system permitted by South Carolina DHEC for removal of metals. Because of the exceptional performance of the A-01 CWTS, the same strategy was used to improve water quality of the H-02 outfall that receives discharge and stormwater from the Tritium Area of SRS. The primary contaminants in this outfall were also copper and zinc. The design for this second system required that the wetland treat the average discharge volume of 415 m{sup 3} per day, and be able to handle 9,690 m{sup 3} of stormwater runoff in a 24 hour period. This allowed the building of a system much smaller than the A-01 CWTS. The system became operational in July 2007. Metal removal has been excellent since water flow through the treatment systems began, and performance improved with the maturation of the vegetation during

  6. An Overview of Quality Programs that Support Transition-Aged Youth

    Directory of Open Access Journals (Sweden)

    Christopher M. Kalinyak

    2016-12-01

    Full Text Available This article provides a concise overview of several programs that deliver services to transition-aged youth, ages 14–29. Included are family support, the Assisting Unaccompanied Children and Youth program, the Substance Abuse and Mental Health Services Administration services, the wraparound approach, intensive home-based treatment, multisystemic therapy, foster care, independent living, mentoring, the Steps to Success program, the Jump on Board for Success program, the Options program, the Positive Action program, the Transition to Success model, and the Transition to Independence Program. Primary focus is placed upon the usefulness of each of the programs in facilitating successful outcomes for transition-aged youth.

  7. Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients.

    Science.gov (United States)

    Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm Thomas

    2017-07-01

    Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre-quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post-quality improvement program as well as the difference between the validation cohort and the post-quality improvement program, respectively. As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre-quality improvement program baseline cohort, and $4,896,758 versus the pre-quality improvement program in the

  8. Relevant aspects of a quality assurance program applied to a nuclear power plant operation

    International Nuclear Information System (INIS)

    Fernandez, J.C.

    1987-01-01

    The purpose of this work was to enumerate the most relevant subjects to be taken into account for the elaboration of a Quality Assurance Program aimed to regulate a nuclear power plant operation. At first, it was necessary to point out the relevance that implies the presence of a group of personnel, experienced in quality assurance with enough knowledge on the technical and organizing aspects of the plant. Other aspect to be taken into account was the contemplation of the international requirements, through the International Atomic Energy Agency and of the national requirements that each country had set up by the corresponding regulating agencies. These organizations pointed out the minimum rules that must be followed for the adequate and efficient execution of a program. The Quality Assurance Manual and the program and work procedures constituted the Quality Assurance Program which must be checked as regards its fulfillment by auditors and quality assurance supervisions. (Author)

  9. Protocols for collection of streamflow, water-quality, streambed-sediment, periphyton, macroinvertebrate, fish, and habitat data to describe stream quality for the Hydrobiological Monitoring Program, Equus Beds Aquifer Storage and Recovery Program, city of Wichita, Kansas

    Science.gov (United States)

    Stone, Mandy L.; Rasmussen, Teresa J.; Bennett, Trudy J.; Poulton, Barry C.; Ziegler, Andrew C.

    2012-01-01

    The city of Wichita, Kansas uses the Equus Beds aquifer, one of two sources, for municipal water supply. To meet future water needs, plans for artificial recharge of the aquifer have been implemented in several phases. Phase I of the Equus Beds Aquifer Storage and Recovery (ASR) Program began with injection of water from the Little Arkansas River into the aquifer for storage and subsequent recovery in 2006. Construction of a river intake structure and surface-water treatment plant began as implementation of Phase II of the Equus Beds ASR Program in 2010. An important aspect of the ASR Program is the monitoring of water quality and the effects of recharge activities on stream conditions. Physical, chemical, and biological data provide the basis for an integrated assessment of stream quality. This report describes protocols for collecting streamflow, water-quality, streambed-sediment, periphyton, macroinvertebrate, fish, and habitat data as part of the city of Wichita's hydrobiological monitoring program (HBMP). Following consistent and reliable methods for data collection and processing is imperative for the long-term success of the monitoring program.

  10. Change in Adverse Events After Enrollment in the National Surgical Quality Improvement Program: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Joshua Montroy

    Full Text Available The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery.A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR and 95% confidence intervals (CI.Eleven articles reporting on 35 health care institutions were included. Nine (82% of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72-0.91, deep (pRR 0.82; 95% CI0.64-1.05 and organ space (pRR 1.15; 95% CI 0.96-1.37 infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39-0.77; deep pRR 0.61, 95% CI 0.50-0.75, and organ space pRR 0.60, 95% CI 0.50-0.71. Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program.These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities.

  11. Developing a quality and safety curriculum for fellows: lessons learned from a neonatology fellowship program.

    Science.gov (United States)

    Gupta, Munish; Ringer, Steve; Tess, Anjala; Hansen, Anne; Zupancic, John

    2014-01-01

    Formal training in health care quality and safety has become an important component of medical education at all levels, and quality and safety are core concepts within the practice-based learning and system-based practice medical education competencies. Residency and fellowship programs are rapidly attempting to incorporate quality and safety curriculum into their training programs but have encountered numerous challenges and barriers. Many program directors have questioned the feasibility and utility of quality and safety education during this stage of training. In 2010, we adopted a quality and safety educational module in our neonatal fellowship program that sought to provide a robust and practical introduction to quality improvement and patient safety through a combination of didactic and experiential activities. Our module has been successfully integrated into the fellowship program's curriculum and has been beneficial to trainees, faculty, and our clinical services, and our experience suggests that fellowship may be particularly well suited to incorporation of quality and safety training. We describe our module and share tools and lessons learned during our experience; we believe these resources will be useful to other fellowship programs seeking to improve the quality and safety education of their trainees. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  12. Quality assurance requirements and description for the Civilian Radioactive Waste Management Program

    International Nuclear Information System (INIS)

    1992-01-01

    The Quality Assurance Requirements and Description (QARD) is the principal quality assurance document for the Civilian Radioactive Waste Management Program (Program). It establishes the minimum requirements for the Quality Assurance Program. The QARD contains regulatory requirements and program commitments necessary for the development of an effective quality assurance program. Quality assurance implementing documents must be based on, and consistent with, QARD requirements. The QARD applies to the following: (1) acceptance of spent nuclear fuel and high-level radioactive waste; (2) transport of spent nuclear fuel and high-level radioactive waste; (3) the Monitored Retrievable Storage (MRS) facility through application for an operating license; (4) Mined Geologic Disposal System (MGDS), including the site characterization activities (exploratory studies facility (ESF) and surface based testing), through application for an operating license; (5) the high-level-waste form from production through acceptance. Section 2.0 defines in greater detail criteria for determining work subject to QARD requirements. The QARD is organized into sections, supplements, appendices, and a glossary. The sections contain requirements that are common to all Program elements. The supplements contain requirements for specialized activities. The appendices contain requirements that are specific to an individual Program element. The glossary establishes a common vocabulary for the Quality Assurance Program

  13. Safety, reliability, maintainability and quality provisions for the Space Shuttle program

    Science.gov (United States)

    1990-01-01

    This publication establishes common safety, reliability, maintainability and quality provisions for the Space Shuttle Program. NASA Centers shall use this publication both as the basis for negotiating safety, reliability, maintainability and quality requirements with Shuttle Program contractors and as the guideline for conduct of program safety, reliability, maintainability and quality activities at the Centers. Centers shall assure that applicable provisions of the publication are imposed in lower tier contracts. Centers shall give due regard to other Space Shuttle Program planning in order to provide an integrated total Space Shuttle Program activity. In the implementation of safety, reliability, maintainability and quality activities, consideration shall be given to hardware complexity, supplier experience, state of hardware development, unit cost, and hardware use. The approach and methods for contractor implementation shall be described in the contractors safety, reliability, maintainability and quality plans. This publication incorporates provisions of NASA documents: NHB 1700.1 'NASA Safety Manual, Vol. 1'; NHB 5300.4(IA), 'Reliability Program Provisions for Aeronautical and Space System Contractors'; and NHB 5300.4(1B), 'Quality Program Provisions for Aeronautical and Space System Contractors'. It has been tailored from the above documents based on experience in other programs. It is intended that this publication be reviewed and revised, as appropriate, to reflect new experience and to assure continuing viability.

  14. Interpretation of PAMZ air quality data and assessment of the PAMZ air quality monitoring program January 2000 to December 2001

    International Nuclear Information System (INIS)

    2002-01-01

    Since December 1999, passive monitors have been in use to support the Air Quality Monitoring Program begun that year. It currently includes 33 passive stations throughout the zone, which measure nitrogen dioxide, sulphur dioxide and ozone. There are also four continuous monitoring stations, two stations operated by Parkland Airshed Management Zone (PAMZ) (Caroline and portable), one operated by Alberta Environment at Red Deer, as well as one station operated by West Central Airshed Society at Hightower Ridge. In 2000 and 2001, the portable station was operated at seven locations within the zone. There were four objectives to this study: (1) provide a summary of the PAMZ air quality monitoring data for the period January 2000 to December 2001, (2) provide an interpretation of that data with regard to emission sources and PAMZ's high priority issues, (3) provide an assessment of the PAMZ Air Quality Monitoring Program performance with respect to the primary objective of the program, and (4) make recommendations on improving or expanding the Air Quality Program. It was found that the ambient concentrations of the different compounds and parameters were below the guidelines established by the Alberta Ambient Air Quality Guidelines (AAAQG) and Canada-wide Standards, with some exceptions which were listed. Ozone concentrations proved to be higher in the Foothills, rather than in an east-west pattern, and lower in the vicinity of transportation corridors (Highway 2). Nitrogen dioxide concentrations were also high in the transportation corridor. The eastern half of the zone was exposed to higher concentrations of sulphur dioxide due to the more dense population and the presence of industries and major highways. Most of the terms of reference of the Technical Working Group appear to be met by the PAMZ Air Quality Monitoring Program. Some recommendations were included in the report, such as the addition of a fifth continuous Air Quality Monitoring station that is portable

  15. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  16. Cost and quality planning for large NASA programs

    Science.gov (United States)

    Rone, Kyle Y.

    1990-01-01

    The Software Cost and Quality Engineering methodology developed over the last two decades at IBM Federal Sector Div. is used to plan the NASA Space Station Data Management System (DMS). An ongoing project to capture this methodology, which is built on a foundation of experiences and lessons learned, has resulted in the development of a PC-based tool that integrates cost and quality forecasting methodologies and data in a consistent manner. This tool, Software Cost and Quality Engineering Starter Set (SCQESS), is being used to assist in the DMS costing exercises. At the same time, DMS planning serves as a forcing function and provides a platform for the continuing, iterative development, calibration, and validation and verification of SCQESS. The data that forms the cost and quality engineering data base is derived from more than 17 years of development of NASA Space Shuttle software, ranging from low criticality, low complexity support tools to highly complex and highly critical onboard software.

  17. What is the radiotherapy quality control program (PQRT) of the National Cancer Institute - Rio de Janeiro/Brazil?

    International Nuclear Information System (INIS)

    Campos de Araujo, A.M.; Viegas, C.C.B.; Salomon de Souza, R.

    2004-01-01

    The National Cancer Institute (INCA) Quality Program in Radiotherapy (PQRT) started in 1999 as a 3 years pilot program with only 33 participant institutions. Due to its positive results, it has been integrated to the permanent INCA programs and its activities extended to all the radiotherapy services where patients from the National Health System (SUS) are treated. They are about 150 services (90% of all the available Brazilian radiotherapy services). The PQRT activities objective is to allow that radiotherapeutic treatments can be carried out just like planned, according to international quality and safety standards. The PQRT main activities are: on-site quality control audits, postal TLD audits in reference and non-reference conditions, training and development of research projects. The on-site quality control audits have already evaluated 75 teletherapy units (37 Co-60 and 38 linear accelerators), performing dosimetric, electrical, mechanical and safety tests. The Postal TLD audits used, till 2002, for the 33 participants, the International Atomic Energy Agency (IAEA) system for reference conditions. Five audits have been performed with this simple system. Since 2003, the PQRT postal TLD audit program is using its own system, developed for reference and non-reference conditions. This new system has been already applied to 58 beams (18 Co-60 and 40 linacs). In total, in reference conditions, PQRT has performed 400 audits in reference conditions (190 Co-60 and 210 linacs). Eighteen courses attended to the participants, covering their main practical problems. In parallel, some research studies have been carried out

  18. Total Quality Management (TQM) (The National Shipbuilding Research Program)

    Science.gov (United States)

    1989-09-01

    statistical methods to improve shipyard processes. The Quality Control (QC) Story process provides all improvement efforts throughout the shipyard a...methodologies and concepts: Quality Improvement Continuous Process Improvement Critical Processes Statistical Methods QC Story Plan-Do-Check-Act Focus on...process improvement and the use of the QC Story, the PDCA Cycle and statistical methods . The People Side is focused on TQM leadership, respect for

  19. Water quality and treatment of river bank filtrate

    Directory of Open Access Journals (Sweden)

    W. W. J. M. de Vet

    2010-06-01

    Full Text Available In drinking water production, river bank filtration has the advantages of dampening peak concentrations of many dissolved components, substantially removing many micropollutants and removing, virtually completely, the pathogens and suspended solids. The production aquifer is not only fed by the river bank infiltrate but also by water percolating through covering layers. In the polder areas, these top layers consist of peat and deposits from river sediments and sea intrusions.

    This paper discusses the origin and fate of macro components in river bank filtrate, based on extensive full-scale measurements in well fields and treatment systems of the Drinking Water Company Oasen in the Netherlands. First, it clarifies and illustrates redox reactions and the mixing of river bank filtrate and PW as the dominant processes determining the raw water quality for drinking water production. Next, full-scale results are elaborated on to evaluate trickling filtration as an efficient and proven one-step process to remove methane, iron, ammonium and manganese. The interaction of methane and manganese removal with nitrification in these systems is further analyzed. Methane is mostly stripped during trickling filtration and its removal hardly interferes with nitrification. Under specific conditions, microbial manganese removal may play a dominant role.

  20. Peer Evaluation of Master Programs: Closing the Quality Circle of the CDIO Approach?

    DEFF Research Database (Denmark)

    Hussmann, Peter Munkebo; Bisi, Anita; Malmqvist, Johan

    2012-01-01

    peer evaluations of educational programs to enable their further development and close the quality circle. In addition, the project will contribute to the consolidation of the N5T alliance by facilitating contacts between faculty members and providing them with an in-depth knowledge of the study...... programs within their field at another N5T institution. The article describes the quality enhancement tool in detail, its contribution to the development of the involved programs, and how international peer evaluation can contribute to closing the quality circle. Finally, it assesses the value...

  1. Synchronic interval Gaussian mixed-integer programming for air quality management.

    Science.gov (United States)

    Cheng, Guanhui; Huang, Guohe Gordon; Dong, Cong

    2015-12-15

    To reveal the synchronism of interval uncertainties, the tradeoff between system optimality and security, the discreteness of facility-expansion options, the uncertainty of pollutant dispersion processes, and the seasonality of wind features in air quality management (AQM) systems, a synchronic interval Gaussian mixed-integer programming (SIGMIP) approach is proposed in this study. A robust interval Gaussian dispersion model is developed for approaching the pollutant dispersion process under interval uncertainties and seasonal variations. The reflection of synchronic effects of interval uncertainties in the programming objective is enabled through introducing interval functions. The proposition of constraint violation degrees helps quantify the tradeoff between system optimality and constraint violation under interval uncertainties. The overall optimality of system profits of an SIGMIP model is achieved based on the definition of an integrally optimal solution. Integer variables in the SIGMIP model are resolved by the existing cutting-plane method. Combining these efforts leads to an effective algorithm for the SIGMIP model. An application to an AQM problem in a region in Shandong Province, China, reveals that the proposed SIGMIP model can facilitate identifying the desired scheme for AQM. The enhancement of the robustness of optimization exercises may be helpful for increasing the reliability of suggested schemes for AQM under these complexities. The interrelated tradeoffs among control measures, emission sources, flow processes, receptors, influencing factors, and economic and environmental goals are effectively balanced. Interests of many stakeholders are reasonably coordinated. The harmony between economic development and air quality control is enabled. Results also indicate that the constraint violation degree is effective at reflecting the compromise relationship between constraint-violation risks and system optimality under interval uncertainties. This can

  2. Treatment outcomes for methamphetamine users receiving outpatient counselling from the Stimulant Treatment Program in Australia.

    Science.gov (United States)

    McKetin, Rebecca; Dunlop, Adrian J; Holland, Rohan M; Sutherland, Rachel A; Baker, Amanda L; Salmon, Allison M; Hudson, Susan L

    2013-01-01

    The purpose of this study was to document treatment outcomes for methamphetamine users receiving outpatient counselling from the Stimulant Treatment Program (STP) in Australia. Clients attending the STP for methamphetamine use (n = 105) were assessed on entry to the service and at 3 (n = 86) and 6 months (n = 83) after starting treatment. At each interview methamphetamine use (days of use, severity of dependence), other drug use and health and social functioning (HIV risk behaviour, crime, disability, psychotic symptoms and hostility) were assessed for the past month. Participants received a median of six counselling sessions (interquartile range 1-11) over a period of 89 days (interquartile range 41-148 days). Past month methamphetamine use fell from 79% at treatment entry to 53% at the 3-month follow-up (P methamphetamine were more common among younger participants, those who had no history of drug treatment and those without concurrent heroin use. Methamphetamine users entering the STP showed reductions in methamphetamine use and improvements in their mental health after treatment. Improved treatment responses are needed to address polydrug use and other harms within in this population. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  3. Long Term Resource Monitoring Program Water Quality Component Review

    National Research Council Canada - National Science Library

    Soballe, David M; Houser, Jeffrey N

    2006-01-01

    ...) communications and data access. The review was conducted by a panel of five external experts who reviewed program documents and then met at the Upper Midwest Environmental Sciences Center from 3-7 June 2002...

  4. Quality Assurance Plan for Transportation Management Division Transportation Training Programs

    International Nuclear Information System (INIS)

    1994-10-01

    The U.S. Department of Transportation (DOT) implemented new rules requiring minimum levels of training for certain key individuals who handle, package, transport, or otherwise prepare hazardous materials for transportation. In response to these rules, the U.S. Department of Energy (DOE), Transportation Management Division (TMD), has developed a transportation safety training program. This program supplies designed instructional methodology and course materials to provide basic levels of DOT training to personnel for whom training has become mandatory. In addition, this program provides advanced hazardous waste and radioactive material packaging and transportation training to help personnel achieve proficiency and/or certification as hazardous waste and radioactive material shippers. This training program does not include site-specific or task-specific training beyond DOT requirements

  5. Qualification of quality assurance program audit personnel for nuclear power plants - August 1980

    Energy Technology Data Exchange (ETDEWEB)

    1981-01-01

    Appendix B, Quality Assurance Criteria for Nuclear Power Plants and Fuel Reprocessing Plants, to 10 CFR Part 50, Domestic Licensing of Production and Utilization Facilities, establishes overall quality assurance requirements for the design, construction, and operation of safety-related structures, and components of nuclear power plants. Criterion XVIII, Audits, of Appendix B establishes requirements for conducting audits of the quality assurance program. This guide describes a method acceptable to the NRC staff for complying with the Commission's regulations with regard to qualification of quality assurance program audit personnel for nuclear power plants.

  6. Qualification of quality assurance program audit personnel for nuclear power plants - August 1980

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    Appendix B, Quality Assurance Criteria for Nuclear Power Plants and Fuel Reprocessing Plants, to 10 CFR Part 50, Domestic Licensing of Production and Utilization Facilities, establishes overall quality assurance requirements for the design, construction, and operation of safety-related structures, and components of nuclear power plants. Criterion XVIII, Audits, of Appendix B establishes requirements for conducting audits of the quality assurance program. This guide describes a method acceptable to the NRC staff for complying with the Commission's regulations with regard to qualification of quality assurance program audit personnel for nuclear power plants

  7. The data quality analyzer: a quality control program for seismic data

    Science.gov (United States)

    Ringler, Adam; Hagerty, M.T.; Holland, James F.; Gonzales, A.; Gee, Lind S.; Edwards, J.D.; Wilson, David; Baker, Adam

    2015-01-01

    The U.S. Geological Survey's Albuquerque Seismological Laboratory (ASL) has several initiatives underway to enhance and track the quality of data produced from ASL seismic stations and to improve communication about data problems to the user community. The Data Quality Analyzer (DQA) is one such development and is designed to characterize seismic station data quality in a quantitative and automated manner.

  8. LLL's Quality Assurance Program and the design of specific systems: Tritium Handling Facility

    International Nuclear Information System (INIS)

    Dow, J.P.

    1975-01-01

    Lawrence Livermore Laboratory operates a Tritium Handling Facility for several programs. Besides the tritium work for the weapons program, basic research is conducted on all phases of tritium. Additional work is being conducted for the laser fusion program and the controlled thermonuclear program. The Quality Assurance Program for the tritium facility and how it is being implemented on specific tritium handling systems are described. The program is intended to prevent or mitigate the consequences of accidents by rigidly controlling the design, fabrication, procurement, construction and operation of safety-related critical structures, systems, and components of such facilities. (CH)

  9. Office of Civilian Radioactive Waste Management ensuring quality assurance in the waste management program

    International Nuclear Information System (INIS)

    Kehew, W.J.; Barrett, L.H.

    1991-01-01

    This paper focuses on the Quality Assurance (QA) program of the U.S. Department of Energy's (DOE) Office of Civilian Radioactive Waste Management (OCRWM). It describes the objectives and philosophy of quality assurance and the plans and activities that OCRWM is undertaking to implement a fully qualified QA program prior to beginning new site characterization activities in Nevada. This paper outlines OCRWM's plan to implement and use a well-designed and effective QA program throughout all elements of the program. (author) 1 fig., 5 refs

  10. Quality assurance in diagnostic radiology: a guide for state program implementation

    International Nuclear Information System (INIS)

    1981-01-01

    Efforts to reduce unnecessary radiation exposure in the healing arts and minimize health care costs have been stressed by Federal agencies, professional societies and individual States for the past several years. A method to achieve this goal was developed in the early 1970's and tested extensively since then. This method is referred to as 'Quality Assurance,' (Q.A.). Realizing the potential benefits of implementing quality assurance in diagnostic x-ray facilities, the Conference of Radiation Control Program Directors' Executive Board authorized the formation of a task force in 1976 to study various aspects of Q.A. The specific changes given the task force were: To define the areas that use diagnostic x-ray which require quality assurance and to describe the basic factors to be included in quality assurance programs. To examine current diagnostic x-ray quality assurance programs in Federal agencies and serve as a focal point for State input into these programs. To report to the Conference on quality assurance programs and techniques that could be utilized by the State radiation programs. This document is designed to educate State program personnel in the concepts of Q.A. and to encourage them to assist medical diagnostic x-ray facilities in implementing Q.A

  11. Implementing the AECL decommissioning quality assurance program at the Chalk River and Whiteshell Laboratories

    International Nuclear Information System (INIS)

    Colotelo, C.A.; Attas, E.M.; Stephens, M.E.

    2006-01-01

    This paper describes the approach and progress in developing, implementing and maintaining a quality assurance (QA) program for decommissioning at the nuclear facilities managed by Atomic Energy of Canada Limited (AECL). Decommissioning activities conducted by AECL are varied in nature, so the QA program must provide adequate flexibility, while maintaining consistency with accepted quality standards. Well-written documentation adhering to the applicable decommissioning standards is a key factor. Manager commitment and input during the writing of the documentation are also important to ensure relevance of the QA program and effectiveness of implementation. Training in the use of the quality assurance plan and procedures is vital to the understanding of the QA program. Beyond the training aspect there is a need for the quality assurance program to be supported by a QA subject expert who is able to advise the group in implementing the Quality Program with consistency over the range of decommissioning work activities and to provide continual assessment of the quality assurance program for efficiency and effectiveness, with a concomitant continuous improvement process. (author)

  12. Implementation of quality control program in radiodiagnostic services

    International Nuclear Information System (INIS)

    Herrera S, A.; Roas Z, N.

    1995-01-01

    This monograph is the first version of the implementation of the quality control programme in radiology diagnostic services. Here all information related to diagnostic quality to better radiation protection to patients and personnel was collected. The programme was implemented on the X-ray equipment at three hospitals (named hospital A, hospital B and hospital C) and included the evaluation of technical parameters such as kilovolts, exposition time, filtration, fields. In addition, dark room, chassis and image intensifiers were also evaluated. The procedures to carry out the quality control and the manner in which the observations, conclusions and recommendations should be formulated are based on documents issued by the International Commission on Radiological Protection (I.C.R.P.), International Atomic Energy Agency (I.A.E.A.) and World Health Organization (W.H.O.)

  13. 42 CFR 2.34 - Disclosures to prevent multiple enrollments in detoxification and maintenance treatment programs.

    Science.gov (United States)

    2010-10-01

    ... detoxification and maintenance treatment programs. 2.34 Section 2.34 Public Health PUBLIC HEALTH SERVICE... detoxification and maintenance treatment programs. (a) Definitions. For purposes of this section: Central... information about individuals applying for maintenance treatment or detoxification treatment for the purpose...

  14. An Italian external quality assessment (EQA) program on urinary sediment.

    Science.gov (United States)

    Fogazzi, Giovanni B; Secchiero, Sandra; Consonni, Dario; Sciacovelli, Laura; Zardo, Lorena; Garigali, Giuseppe; Verdesca, Simona; Messa, Piergiorgio; Plebani, Mario

    2010-06-03

    EQA programs on urinary sediment are rare. We describe an EQA Italian program which started in 2001 and involves today more than 300 laboratories. The program, which started with a questionnaire about the methodological aspects on urinary sediment, includes today four surveys per year. These ask the participants the identification and clinical associations of urinary sediment particles shown by colour images (surveys 1 and 3) and the diagnosis of clinical cases presented by both images and a short clinical history (surveys 2 and 4). The results of each survey are then scored and commented. Questionnaire (participants = 287): most methodological aspects were not dealt with properly. cells, lipids, casts and some contaminants were poorly known. However, when 27 particles were presented for the second time and 16 particles for the third time, the correct identification rate for most of them increased significantly. Clinical associations (No presented = 16): a correct answer was indicated by > or = 84% of participants for all particles but one. Clinical cases (No presented=4): lowest correct identification for urine contamination from genital secretion (77.3%), highest for ureteric stone (94.4%). Our program shows that EQA programs are both useful and needed. Copyright 2010 Elsevier B.V. All rights reserved.

  15. Use of quality management methods in the transition from efficacious prevention programs to effective prevention services.

    Science.gov (United States)

    Daniels, Vicki-Smith; Sandler, Irwin; Wolchik, Sharlene

    2008-06-01

    This paper applies concepts and methods developed in management to translate efficacious prevention programs into effective prevention services. The paper describes Quality Function Deployment (QFD) as a method for structured planning and development that connects the needs and wants of the consumer with the design of the product or service. The paper describes basic tools used in quality management, and discusses how they might be applied to prepare a prevention program for implementation by community agencies. Prevention programs are conceptualized as having multiple consumers (i.e., stakeholders), including the participants who receive the service, the service providers, the organizations that deliver the program, and the researchers who evaluate the programs. As an illustration of one step in the application of QFD to translate efficacious prevention programs into effective prevention services, analysis of the needs and preferences of Family Courts for the implementation of an the New Beginnings Program is presented.

  16. Jail drug and alcohol treatment program reduces recidivism in nonviolent offenders: a longitudinal study of Monroe County, New York's, Jail Treatment Drug and Alcohol Program.

    Science.gov (United States)

    Turley, Alan; Thornton, Tim; Johnson, Craig; Azzolino, Sue

    2004-12-01

    Substance abuse treatment has become the new fashion for reducing recidivism among inmates. But the question is, does this work? Various studies have been done tracking the same cohort of inmates over time to assess the validity of treatment. This study assesses one treatment program's success over 5 years to determine if drug and alcohol treatment reduces recidivism among nonviolent, short-term (sentence of less than a year) inmates. Monroe County's drug treatment program demonstrates that for 1 year after receiving the treatment, three different cohorts of nonviolent, short-term inmates (1995, 1998, and 2000) were found to be substantially less likely to be recidivists than control group inmates.

  17. Nationwide Quality of Hospice Care: Findings From the Centers for Medicare & Medicaid Services Hospice Quality Reporting Program.

    Science.gov (United States)

    Zheng, Nan Tracy; Li, Qinghua; Hanson, Laura C; Wessell, Kathryn L; Chong, Natalie; Sherif, Noha; Broyles, Ila H; Frank, Jennifer; Kirk, M Alexis; Schwartz, Carol R; Levitt, Alan F; Rokoske, Franziska

    2018-02-01

    With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high-quality care and have the information they need when selecting a hospice. Toward these goals, Centers for Medicare & Medicaid Services has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014. This article presents a first look at the national hospice HIS quality data. We calculated seven quality measures using the HIS data. These measures are endorsed by the National Quality Forum and focus on important care processes hospice providers are required to perform at admission, including discussion of patient preferences regarding life-sustaining treatments, care for spiritual and existential concerns, and symptom management (pain, opioid-induced constipation, and dyspnea). Our sample included 1,218,786 hospice patients discharged from 3922 hospices from October 1, 2014 to September 30, 2015. More than 90% of patients received screenings and assessments captured by six of the seven quality measures. The only exception was pain assessment, for which the national mean score was 78.2%. A small number of hospices (156, 4.0%) had perfect scores for all seven quality measures. Most hospices conduct critical assessments and discuss treatment preferences with patients at admission, although few hospices have perfect scores. Copyright © 2017. Published by Elsevier Inc.

  18. Quality assurance program plan for FRG sealed isotopic heat sources project (C-229)

    International Nuclear Information System (INIS)

    Tanke, J.M.

    1997-01-01

    This QAPP implements the Quality Assurance Program Plan for the FRG Sealed Isotopic Heat Sources Project (C-229). The heat source will be relocated from the 324 Building and placed in interim storage at the Central Waste Complex (CWC)

  19. 77 FR 3386 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Clean Vehicles Program

    Science.gov (United States)

    2012-01-24

    ... Promulgation of Air Quality Implementation Plans; Pennsylvania; Clean Vehicles Program AGENCY: Environmental... vehicles (LEV II). The Clean Air Act (CAA) contains specific authority allowing any state to adopt new... CFR Part 52 Environmental protection, Air pollution control, Incorporation by reference...

  20. Determining the quality of competences assessment programs: A self-evaluation procedure

    NARCIS (Netherlands)

    Baartman, Liesbeth; Prins, Frans; Kirschner, Paul A.; Van der Vleuten, Cees

    2009-01-01

    Baartman, L. K. J., Prins, F. J., Kirschner, P. A., & Van der Vleuten, C. P. M. (2007). Determining the quality of Competence Assessment Programs: A self-evaluation procedure. Studies in Educational Evaluation, 33, 258-281.

  1. Air Quality Flags Program, U.S., 2017, EPA/OAR/OAQPS/OID

    Data.gov (United States)

    U.S. Environmental Protection Agency — This map service contains participants in EPA's Air Quality Flags Program. The map service also includes the current day's AQI forecast for each participant in the...

  2. Quality Control Charts in Large-Scale Assessment Programs

    Science.gov (United States)

    Schafer, William D.; Coverdale, Bradley J.; Luxenberg, Harlan; Jin, Ying

    2011-01-01

    There are relatively few examples of quantitative approaches to quality control in educational assessment and accountability contexts. Among the several techniques that are used in other fields, Shewart charts have been found in a few instances to be applicable in educational settings. This paper describes Shewart charts and gives examples of how…

  3. Evaluating and Enhancing Outcomes Assessment Quality in Higher Education Programs

    Science.gov (United States)

    Wolf, Kenneth; Goodwin, Laura

    2007-01-01

    Accreditation is a mark of distinction indicating that an institution has met high standards set by the profession, and an increasingly important feature of the accreditation process in higher education is "outcomes assessment." This article presents two rubrics for evaluating the quality of an institution's outcomes assessment system. One rubric…

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

    Science.gov (United States)

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

    2011-09-01

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

  5. Quality aspects of ex vivo root canal treatments done by undergraduate dental students using four different endodontic treatment systems.

    Science.gov (United States)

    Jungnickel, Luise; Kruse, Casper; Vaeth, Michael; Kirkevang, Lise-Lotte

    2018-04-01

    To evaluate factors associated with treatment quality of ex vivo root canal treatments performed by undergraduate dental students using different endodontic treatment systems. Four students performed root canal treatment on 80 extracted human teeth using four endodontic treatment systems in designated treatment order following a Latin square design. Lateral seal and length of root canal fillings was radiographically assessed; for lateral seal, a graded visual scale was used. Treatment time was measured separately for access preparation, biomechanical root canal preparation, obturation and for the total procedure. Mishaps were registered. An ANOVA mirroring the Latin square design was performed. Use of machine-driven nickel-titanium systems resulted in overall better quality scores for lateral seal than use of the manual stainless-steel system. Among systems with machine-driven files, scores did not significantly differ. Use of machine-driven instruments resulted in shorter treatment time than manual instrumentation. Machine-driven systems with few files achieved shorter treatment times. With increasing number of treatments, root canal-filling quality increased, treatment time decreased; a learning curve was plotted. No root canal shaping file separated. The use of endodontic treatment systems with machine-driven files led to higher quality lateral seal compared to the manual system. The three contemporary machine-driven systems delivered comparable results regarding quality of root canal fillings; they were safe to use and provided a more efficient workflow than the manual technique. Increasing experience had a positive impact on the quality of root canal fillings while treatment time decreased.

  6. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1994 quality program status report

    International Nuclear Information System (INIS)

    Bolivar, S.L.

    1996-03-01

    This status report is for calendar year 1994. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, a baseline is established that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify adverse trends and to evaluate improvements. This is the fourth annual status report

  7. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1994 quality program status report

    Energy Technology Data Exchange (ETDEWEB)

    Bolivar, S.L.

    1996-03-01

    This status report is for calendar year 1994. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, a baseline is established that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify adverse trends and to evaluate improvements. This is the fourth annual status report.

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

    Science.gov (United States)

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

    2013-08-12

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

  9. Standard guide for establishing a quality assurance program for analytical chemistry laboratories within the nuclear industry

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2006-01-01

    1.1 This guide covers the establishment of a quality assurance (QA) program for analytical chemistry laboratories within the nuclear industry. Reference to key elements of ANSI/ISO/ASQC Q9001, Quality Systems, provides guidance to the functional aspects of analytical laboratory operation. When implemented as recommended, the practices presented in this guide will provide a comprehensive QA program for the laboratory. The practices are grouped by functions, which constitute the basic elements of a laboratory QA program. 1.2 The essential, basic elements of a laboratory QA program appear in the following order: Section Organization 5 Quality Assurance Program 6 Training and Qualification 7 Procedures 8 Laboratory Records 9 Control of Records 10 Control of Procurement 11 Control of Measuring Equipment and Materials 12 Control of Measurements 13 Deficiencies and Corrective Actions 14

  10. Multi-Function Waste Tank Facility Quality Assurance Program Plan, Project W-236A. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Hall, L.R.

    1995-05-30

    This document describes the Quality Assurance (QA) program for the Multi-Function Waste Tank Facility (MWTF) Project. The purpose of this QA program is to control project activities in such a manner as to achieve the mission of the MWTF Project in a safe and reliable manner. The QA program for the MWTF Project is founded on DOE Order 5700.6C, Quality Assurance, and implemented through the use of ASME NQA-1, Quality Assurance Program Requirements for Nuclear Facilities (ASME 1989 with addenda la-1989, lb-1991 and lc-1992). This document describes the program and planned actions which the Westinghouse Hanford Company (WHC) will implement to demonstrate and ensure that the project meets the requirements of DOE Order 5700.6C through the interpretive guidance of ASME NQA-1.

  11. Multi-Function Waste Tank Facility Quality Assurance Program Plan, Project W-236A. Revision 2

    International Nuclear Information System (INIS)

    Hall, L.R.

    1995-01-01

    This document describes the Quality Assurance (QA) program for the Multi-Function Waste Tank Facility (MWTF) Project. The purpose of this QA program is to control project activities in such a manner as to achieve the mission of the MWTF Project in a safe and reliable manner. The QA program for the MWTF Project is founded on DOE Order 5700.6C, Quality Assurance, and implemented through the use of ASME NQA-1, Quality Assurance Program Requirements for Nuclear Facilities (ASME 1989 with addenda la-1989, lb-1991 and lc-1992). This document describes the program and planned actions which the Westinghouse Hanford Company (WHC) will implement to demonstrate and ensure that the project meets the requirements of DOE Order 5700.6C through the interpretive guidance of ASME NQA-1

  12. Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression

    NARCIS (Netherlands)

    Bosch, M.P.C.; Waberg, J.; Noort, M.W.M.L. van den; Staudte, H.; Lim, S.; Egger, J.I.M.

    2016-01-01

    Aim: Treatment non-adherence is a common problem in patients suffering from schizophrenia and depression. This study investigated the possible relationships between symptom severity, quality of sleep, and treatment adherence. Methods: Thirty outpatients with schizophrenia and 58 outpatients with

  13. Audit of an automated checklist for quality control of radiotherapy treatment plans

    International Nuclear Information System (INIS)

    Breen, Stephen L.; Zhang Beibei

    2010-01-01

    Purpose: To assess the effect of adding an automated checklist to the treatment planning process for head and neck intensity-modulated radiotherapy. Methods: Plans produced within our treatment planning system were evaluated at the planners' discretion with an automated checklist of more than twenty planning parameters. Plans were rated as accepted or rejected for treatment, during regular review by radiation oncologists and physicists as part of our quality control program. The rates of errors and their types were characterised prior to the implementation of the checklist and with the checklist. Results: Without the checklist, 5.9% of plans were rejected; the use of the checklist reduced the rejection rate to 3.1%. The checklist was used for 64.7% of plans. Pareto analysis of the causes of rejection showed that the checklist reduced the number of causes of rejections from twelve to seven. Conclusions: The use of an automated checklist has reduced the need for reworking of treatment plans. With the use of the checklist, most rejections were due to errors in prescription or inadequate dose distributions. Use of the checklist by planners must be increased to maximise improvements in planning efficiency.

  14. Healthcare utilization of patients accessing an African national treatment program

    Directory of Open Access Journals (Sweden)

    Wood Robin

    2007-06-01

    Full Text Available Abstract Background The roll-out of antiretroviral therapy (ART in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced. Methods This paper describes healthcare utilization from program entry by treatment-naïve patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count Results 212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO, excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes. Conclusion Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates.

  15. From Errors Treatment to Exceptions Treatment Regarding the Execution Control over Visual Basic Programs

    Directory of Open Access Journals (Sweden)

    Cristina Raluca POPESCU

    2008-01-01

    Full Text Available In order to comply with the quality standards and with the best practices, the execution of the professional programs must be rigorously controlled so that to avoid occurrence of unpredictable situations that might generate anomalies and could lead to computer blockage, forced termination of the execution and data loss. In traditional programming languages, including Visual Basic 6, the concept of error is extremely evolved. It is considered as error any situation in which the program fails to execute correctly, regardless if such anomaly is generated by a software or hardware cause. Nowadays the modern platforms, including VB.NET have introduced a new concept: exception. Unfortunately, perhaps by mistake, exception is assimilated by many IT specialists as an exceptional (extraordinary situation or a rare situation.We agree with the opinion of those IT specialists asserting that error is strictly dependant on the programmer, when he/she fails in correctly generating the application’s structures, whilst exception is a situation not fitting in the usual natural execution or as desired by the programmer or user, without meaning that it occurs more often or more rarely.Designing robust programs implies for such not to terminate abnormally or block, not even upon receiving improper parameters. Two aspects are referred to: the behavior regarding low level errors (caused by the operation system, memory allocation, reading/writing in files or hardware malfunctions and the reaction to the user’s errors, such as providing incorrect input data or incorrect use of operations in respect with their sequences. Notwithstanding what platform is used in designing the programs and regardless the controversy between the specialists, in order for the execution to be terminated under the program’s control, the commands that might generate anomalies and interruptions should be strictly monitored. Implicitly, the execution control

  16. A stochastic dynamic programming model for stream water quality ...

    Indian Academy of Sciences (India)

    This paper deals with development of a seasonal fraction-removal policy model for waste load allocation in streams addressing uncertainties due to randomness and fuzziness. A stochastic dynamic programming (SDP) model is developed to arrive at the steady-state seasonal fraction-removal policy. A fuzzy decision model ...

  17. Measuring Service Quality in Recreational Programs with SERVQUAL.

    Science.gov (United States)

    Bauch, Joel R.

    Many directors of college recreational programs are feeling pressure for increased accountability in the face of shrinking financial resources and increased demand for services. One method of providing that accountability and learning about the strengths and weaknesses of services offered is by assessing the level of client satisfaction. Developed…

  18. Preliminary results of the national program of audit of quality in radiotherapy services in the Republic of Cuba

    International Nuclear Information System (INIS)

    Dominguez Hung, Lourdes; Larrinaga Cortina, Eduardo F.; Morales Lopez, Jorge L.; Garcia Yip, Fernando; Campa Menendez, Raudel

    2001-01-01

    The current state of the radiotherapy in Cuba has allowed to pass to a superior stage, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices as national regulator entity for the control and supervision of the medical devices of the National Health System is the responsible for it implementation. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of 60 Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audit, such as: the installation and unit's security, treatment unit's mechanical and dosimetric aspects and organizational aspects of the institution quality assurance program. Also were carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institution's program of quality assurance and a feedback for the setting about to the PNAC. (author)

  19. Organizational environment and perceptions of teaching quality in seven South Carolina family medicine residency programs.

    Science.gov (United States)

    Probst, J C; Baxley, E G; Schell, B J; Cleghorn, G D; Bogdewic, S P

    1998-08-01

    To explore the relationship between organizational environment and teaching quality in seven family medicine residency programs. In 1995, a questionnaire on organizational environment was administered to the faculties at all seven family medicine residency programs in South Carolina. Eighty-seven percent of the faculty members participated, as did convenience samples of residents, nurses, and administrative staff. The questionnaire measured seven variables: teaching quality, job satisfaction, organizational climate, employees' autonomy, goal attainment, organizational commitment, and job-related stress. Residents, nurses, and administrative staff who were connected to programs at which faculty expressed high levels of job satisfaction assessed teaching quality as higher than did those at other programs. The residents' perceptions of teaching quality were positively correlated with high ratings of organizational climate and job-related stress. The staffs' ratings of goal attainment were also associated with teaching quality. Faculty satisfaction was associated with their reported employee autonomy and goal attainment. The organizational characteristics of family medicine residency programs significantly influence the perceptions of teaching quality: specifically, there perceptions are correlated with the degree to which faculty are satisfied with their work environments. In addition, residents' and staffs' perceptions of teaching quality are associated with their attitudes toward their organizations' environments.

  20. Shelf-life and quality evaluation of clementine following a combined treatment with γ-irradiation

    International Nuclear Information System (INIS)

    Mahrouz, M.; Lacroix, M.; D'Aprano, G.; Oufedjikh, H.; Boubekri, C.

    2004-01-01

    In order to enhance the shelf-life of a late variety of Moroccan Citrus clementina (Nour), ionizing treatments were applied at 0.3 kGy, as well as washing (cold water) and waxing treatments. It has been found that, despite the irradiation treatment, the washing and waxing treatment do not improve the quality of C. clementina, but rather result in peel injury. Finally, sensory evaluation confirmed that irradiation had no detrimental effect on the quality of clementines

  1. Substance abuse treatment engagement, completion and short-term outcomes in the Western Cape province, South Africa: Findings from the Service Quality Measures Initiative.

    Science.gov (United States)

    Myers, Bronwyn; Williams, Petal Petersen; Govender, Rajen; Manderscheid, Ron; Koch, J Randy

    2018-02-21

    Optimizing the effectiveness of substance use disorder (SUD) treatment is critical in low-and middle-income countries (LMICs) with limited opportunities for SUD treatment. This is the first study to identify targets for interventions to improve the quality of SUD treatment in a LMIC. We explored correlates of three indicators of treatment quality (treatment engagement, completion and abstinence at treatment exit) using data from a SUD performance measurement system implemented in the Western Cape Province of South Africa. The sample included data from 1094 adult treatment episodes representing 53% of the treatment episodes in 2016. Using multivariate logistic regression analyses, we modeled socio-demographic, substance use and program correlates of treatment engagement, completion, and abstinence at treatment exit. Overall, 59% of patients completed treatment (48% of patients from outpatient services). Treatment completion was associated with greater likelihood of abstinence at treatment exit. Patients were more likely to complete treatment if they engaged in treatment, were older, and had more severe drug problems (characterized by daily drug use and heroin problems) and attended programs of shorter duration. Residential treatment was associated with greater likelihood of treatment engagement, completion, and abstinence at treatment exit. Improving rates of outpatient treatment completion will enhance the effectiveness of South Africa's SUD treatment system. Interventions that promote engagement in treatment, particularly among younger patients; reduce program length through referral to step-down continuing care; and ensure better matching of drug problem to treatment level and type could improve rates of treatment completion. Copyright © 2018. Published by Elsevier B.V.

  2. PREDICTION OF MEAT PRODUCT QUALITY BY THE MATHEMATICAL PROGRAMMING METHODS

    OpenAIRE

    A. B. Lisitsyn; M. A. Nikitina; A. N. Zakharov; E. B. Sus; V. V. Nasonova; L. I. Lebedeva

    2016-01-01

    Abstract Use of the prediction technologies is one of the directions of the research work carried out both in Russia and abroad. Meat processing is accompanied by the complex physico-chemical, biochemical and mechanical processes. To predict the behavior of meat raw material during the technological processing, a complex of physico-technological and structural-mechanical indicators, which objectively reflects its quality, is used. Among these indicators are pH value, water binding and fat hol...

  3. Emergence Of A Quality Assurance Program For Probiotic Supplemented Foods

    OpenAIRE

    S. Sarkar

    2013-01-01

    In recent year consumer’s inclination towards natural and health-promoting foods have led to projection of probiotics as a new ingredient in functional food market. In absence of any worldwide regulation, probiotic containing foods available in the market are often of poor quality and did not meet the desired level of viable microorganisms, required for exhibiting health benefits. Presently, no globally accepted regulations for probiotic containing foods have been established, resulting in di...

  4. Measuring Performance Excellence: Key Performance Indicators for Institutions Accepted into the Academic Quality Improvement Program (AQIP)

    Science.gov (United States)

    Ballard, Paul J.

    2013-01-01

    Given growing interest in accountability and outcomes, the North Central Association's Higher Learning Commission developed a new path for accreditation, the Academic Quality Improvement Program (AQIP). The goal is to infuse continuous improvement and quality in the culture of higher education, and to blend traditional accreditation with the…

  5. 20 CFR 602.42 - Effect of failure to implement Quality Control program.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Effect of failure to implement Quality... to States § 602.42 Effect of failure to implement Quality Control program. Any State which the... or to comply substantially with any provision specified in this part. See sections 303(a)(1), 303(a...

  6. Evaluating Performance Measurement Systems in Nonprofit Agencies: The Program Accountability Quality Scale (PAQS).

    Science.gov (United States)

    Poole, Dennis L.; Nelson, Joan; Carnahan, Sharon; Chepenik, Nancy G.; Tubiak, Christine

    2000-01-01

    Developed and field tested the Performance Accountability Quality Scale (PAQS) on 191 program performance measurement systems developed by nonprofit agencies in central Florida. Preliminary findings indicate that the PAQS provides a structure for obtaining expert opinions based on a theory-driven model about the quality of proposed measurement…

  7. Community Partnership to Address Snack Quality and Cost in After-School Programs

    Science.gov (United States)

    Beets, Michael W.; Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert G.; Jones, Sonya

    2014-01-01

    Background: Policies call on after-school programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community partnership between ASPs and local grocery stores. Methods: Four large-scale ASPs (serving ~500 children, aged 6-12?years,…

  8. Mammography in public hospitals at Rio de Janeiro: a quality assurance program

    Energy Technology Data Exchange (ETDEWEB)

    Briquet, C.; Coutinho, C.M.C.; Mota, H.C.; Tavares, E. [Instituto de Radioprotecao e Dosimetria/ Commisao Nacional de Energia Nuclear. Av. Salvador Allende, s/n CEP: 22780-160. Rio de Janeiro (Brazil)

    1998-12-31

    This paper presents the preliminary results and the methodology followed by the implementation of a Quality Assurance Program in public hospitals at Rio de Janeiro. We observed that the main problems of image are due to the processing. None facility has a dedicated processor and the processor daily quality control is a concern not yet adopted. (Author)

  9. The Structure and Quality of Social Network Support among Mental Health Consumers of Clubhouse Programs

    Science.gov (United States)

    Pernice-Duca, Francesca M.

    2008-01-01

    This study explored the structure and quality of social network support among a group of adult consumers of community-based mental health programs known as "clubhouses". The structure and quality of social network support was also examined by diagnosis, specifically between consumers living with and without schizophrenia. The study…

  10. Implementation of a quality control program of the equipment of the nuclear medicine services in Chile

    International Nuclear Information System (INIS)

    Astudillo, R.; Diaz, G.; Ferreira, A.; Garcia, M.; Hermosilla, A.; Pacheco, F.; Vasquez, M.; Coca, M.

    2014-08-01

    Now days in Chile there are more of 43 Nuclear Medicine centers; most of them have gamma cameras in order to study physiological process in diagnostic and treatment of patients pathologies. This requires having the equipment in optimal operating condition and it is ensured with quality control programs that are based on a series of tests relating to protocols, such as TECDOC-602 y AAPM No.6. Planar test often applied in gamma cameras including: spatial resolution, spatial linearity, sensitivity and uniformity. SPECT tests consider: tomography uniformity, rotation center tomography resolution and total performance. The tests in dose calibrator are: background measurement, accuracy, precision, linearity and reproducibility. The tests above require the use of radioactive sources and specific simulators patterns or phantom based on international standards such as The National Electrical Manufacturers Association (Nema), International Atomic Energy Agency (IAEA) and The American Association of Medical Physics (AAPM). In this work we carried out several tests of quality control in a Nuclear Medicine Center of Temuco and we propose to implement the applied methodology in others similar Chilean centers. (author)

  11. Taking a quality assurance program from paper to electronic health records: one dental school's experience.

    Science.gov (United States)

    Filker, Phyllis J; Muckey, Erin Joy; Kelner, Steven M; Kodish-Stav, Jodi

    2009-09-01

    The Obama administration is seeking to increase access to and improve the efficiency of the health care system in the United States. One aspect of those efforts is a push towards the utilization of electronic health records (EHRs) by health care providers. Nova Southeastern University College of Dental Medicine (NSU-CDM) opened its doors in 1997 and began its evolution from paper charts to EHRs in 2006. AxiUm, a computer-run patient record and clinical management system, has become an integral part of the college's quality assurance program and its students' clinical education. Since the introduction of axiUm, the school has already noticed an increase in the quality of patient care due to improved oversight of patient management and the ability to more efficiently track treatment outcomes. Over time, the system will enable data collected by students providing care in the clinics to be quantified. Opposition to EHRs tends to stem primarily from the amount of time required for users to gain proficiency in the new technology, as well as from the initial cost to the provider. But there is no better place to begin this learning process regarding the importance and utilization of EHR systems than universities, where health professions students can acquire a comfort level with EHRs in an academic environment that they may then implement in their future practice.

  12. Supporting medical education research quality: the Association of American Medical Colleges' Medical Education Research Certificate program.

    Science.gov (United States)

    Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian

    2011-01-01

    The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.

  13. Assessing Quality in Graduate Programs: An Internal Quality Indicator. AIR Forum 1981 Paper.

    Science.gov (United States)

    DiBiasio, Daniel A.; And Others

    Four approaches to measuring quality in graduate education are reviewed, and the approach used at the graduate school at Ohio State University is assessed. Four approaches found in the literature are: measuring quality by reputation, by scholarly productivity, by correlating reputation and scholarly productivity, and by multiple measures. Ohio…

  14. Signal Quality and Service Quality: A Study of Local and International MBA Programs in Vietnam

    Science.gov (United States)

    Nguyen, Tho D.

    2009-01-01

    Purpose: Although it is well known that firms can use signals to inform consumers about the unobservable aspect of their products or services in a market where asymmetric information exists, research on the relationship between signal quality and service quality is largely ignored. The purpose of this study is to investigate the role of signal…

  15. Quality of life in institutionalized elderly undergoing an active aging program

    OpenAIRE

    Magalhães, Carlos; Anes, Eugénia; Rebelo, Flávia

    2017-01-01

    Introduction: Living with quality is a growing concern of the old population. There is an increasing institutionalization of the elderly, and it is in this context that active aging programs assume relevance, allowing the elderly the contact with experiences that allow them to age with quality of life, by maintaining their autonomy and promoting their physical, mental and emotional well-being. Objective: To evaluate the quality of life (QOL) of institutionalized elderly undergoing to an ac...

  16. Exercise and quality of life during and after treatment for breast cancer: results of two randomized controlled trials.

    Science.gov (United States)

    Cadmus, Lisa A; Salovey, Peter; Yu, Herbert; Chung, Gina; Kasl, Stanislav; Irwin, Melinda L

    2009-04-01

    To determine the effect of exercise on quality of life in (a) a randomized controlled trial of exercise among recently diagnosed breast cancer survivors undergoing adjuvant therapy and (b) a similar trial among post-treatment survivors. Fifty newly diagnosed breast cancer survivors were recruited through a hospital-based tumor registry and randomized to a 6-month, home-based exercise program (n=25) or a usual care group (n=25). In a separate trial, 75 post-treatment survivors were randomized to a 6-month, supervised exercise intervention (n=37) or to usual care (n=38). Participants in both studies completed measures of happiness, depressive symptoms, anxiety, stress, self-esteem, and quality of life at baseline and 6 months. Forty-five participants completed the trial for newly diagnosed survivors and 67 completed the trial for post-treatment survivors. Good adherence was observed in both studies. Baseline quality of life was similar for both studies on most measures. Exercise was not associated with quality of life benefits in the full sample of either study; however exercise was associated with improved social functioning among post-treatment survivors who reported low social functioning at baseline (p<0.05). Exercise did not affect quality of life in either recently diagnosed or post-treatment breast cancer survivors; however this may be due in part to relatively high baseline functioning among participants in both studies. Strategies for future research include limiting enrollment to survivors who report reduced quality of life on screening questionnaires and targeting survivor subgroups known to be at particular risk for quality of life impairment. (c) 2009 John Wiley & Sons, Ltd.

  17. New data base program for quality control of strabismus surgery.

    Science.gov (United States)

    Stärk, N; Stärk, P; Zubcov, A A

    1996-01-01

    The authors report on a newly developed data base program for strabismus patients. All relevant preoperative and postoperative information regarding visual sensory data, motility, squinting angle in nine fields of gaze and head position are easily entered into the data base. The program flows easily through data collection. Its use does not require special computer skills. Depending on monitor size, data for each patient is compressed into three or four screens totaling 120 entry fields, 67 of which refer to preoperative and postoperative squint angle. Entry fields flow in a logical manner. Storing capacity is increased by a factor of up to 40 with 28 drop down fields, totaling 271 available entry fields per patient. To enhance easy access of data, no abbreviations have been used.

  18. Ensuring Quality Leadership. A Program Funded by the GE Fund (Formerly the General Electric Foundation).

    Science.gov (United States)

    Kritek, William J.

    This paper describes the Ensuring Quality Leadership (EQL) program implemented cooperatively by faculty at the University of Wisconsin-Milwaukee School of Education and School of Business Administration, business executives from the Milwaukee area, and principals from Milwaukee's Public Schools (MPS). The program was designed to: (1) provide…

  19. A multidimensional cancer rehabilitation program for cancer survivors - Effectiveness on health-related quality of life

    NARCIS (Netherlands)

    van Weert, E; Hoekstra-Weebers, J; Grol, B; Otter, R; Arendzen, HJ; Postema, K; Sanderman, R; van der Schans, C

    Objective: A multidimensional rehabilitation program for cancer survivors was developed to overcome cancer-related problems and to improve quality of life. The two purposes of the study were to describe the effectiveness of the program and to obtain information about patient preferences for multi or

  20. Los Alamos National Laboratory Yucca Mountain Site Characterization Project: 1991 quality program status report

    International Nuclear Information System (INIS)

    1992-07-01

    This status report summarizes the activities and accomplishments of the Los Alamos National Laboratory (Los Alamos) Yucca Mountain Site Characterization Project's (YMP) quality assurance program for calendar year 1991. The report is divided into three Sections: Program Activities, Verification Activities, and Trend Analysis

  1. Child Care in JOBS Employment and Training Program: What Difference Does Quality Make?

    Science.gov (United States)

    Meyers, Marcia K.

    1993-01-01

    Examined data from Job Opportunities and Basic Skills program. Found that participants increased their use of substitute child care and of licensed day-care homes/centers, after beginning job readiness activities. Child care was found to be highly variable in terms of convenience and program quality. Problems with child care increased…

  2. Quality assurance program covering mixed waste disposal at the Nevada test site

    International Nuclear Information System (INIS)

    O'Neill, L.J.

    1989-01-01

    This paper discusses a quality assurance program that would satisfy the requirements and expectations of the U.S. Department of Energy, the EPA, and the state of Nevada. The author outlines the basic philosophy, concepts, and implementation of the program that would satisfy all three agencies

  3. 32 CFR 199.15 - Quality and utilization review peer review organization program.

    Science.gov (United States)

    2010-07-01

    ... relating to the administration and management of CHAMPUS in that the Peer Review Organization program is... model. The CHAMPUS Quality and Utilization Review Peer Review Organization program, based on specific.... Application of these objectives in the context of hospital services covered by the DRG-based payment system...

  4. Evaluating the Implementation of a Training Program for Improving Quality Service: An Action Research Study

    Science.gov (United States)

    Pierre, Ketly Dieudonne

    2014-01-01

    There is a need to implement a comprehensive training program to build employees' knowledge, skills, and attitudes in order to improve quality service at ABC Restaurant because of a surge in customer complaints. The purpose of this study was to develop a training program that included an employee handbook as a training tool, a handbook designed…

  5. Developing Global Standards Framework and Quality Integrated Models for Cooperative and Work-Integrated Education Programs

    Science.gov (United States)

    Khampirat, Buratin; McRae, Norah

    2016-01-01

    Cooperative and Work-integrated Education (CWIE) programs have been widely accepted as educational programs that can effectively connect what students are learning to the world of work through placements. Because a global quality standards framework could be a very valuable resource and guide to establishing, developing, and accrediting quality…

  6. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1995 quality program status report

    International Nuclear Information System (INIS)

    Bolivar, S.L.

    1996-07-01

    This status report summarizes the activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project's (YMP's) quality assurance program for January 1 to September 30, 1995. The report includes major sections on program activities and trend analysis

  7. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1995 quality program status report

    Energy Technology Data Exchange (ETDEWEB)

    Bolivar, S.L.

    1996-07-01

    This status report summarizes the activities and accomplishments of the Los Alamos National Laboratory Yucca Mountain Site Characterization Project`s (YMP`s) quality assurance program for January 1 to September 30, 1995. The report includes major sections on program activities and trend analysis.

  8. School Age Center Connections: Site-Based Management Strategies for Implementation of Quality Programs.

    Science.gov (United States)

    Willis, Dahna R.

    This paper describes the outcomes of a practicum that initiated site-based-management strategies to support the consistent implementation of a quality school-age child-care program. Implemented at a multisite child-care center, the program sought to enhance staff members' job satisfaction and maximize their opportunities for professional growth…

  9. Who Shall Control Entry to Teacher Education? North Carolina Quality Assurance Program.

    Science.gov (United States)

    Knight, J. Pat

    A Quality Assurance Program (QAP) has been established by North Carolina as a means of assuring competent professional programs for teacher education. The QAP is based on two major premises: (1) Crucial competencies for teacher effectiveness can be identified, verified, and validated; and (2) Teacher education begins at initial entry and…

  10. Automatic treatment planning facilitates fast generation of high-quality treatment plans for esophageal cancer.

    Science.gov (United States)

    Hansen, Christian Rønn; Nielsen, Morten; Bertelsen, Anders Smedegaard; Hazell, Irene; Holtved, Eva; Zukauskaite, Ruta; Bjerregaard, Jon Kroll; Brink, Carsten; Bernchou, Uffe

    2017-11-01

    The quality of radiotherapy planning has improved substantially in the last decade with the introduction of intensity modulated radiotherapy. The purpose of this study was to analyze the plan quality and efficacy of automatically (AU) generated VMAT plans for inoperable esophageal cancer patients. Thirty-two consecutive inoperable patients with esophageal cancer originally treated with manually (MA) generated volumetric modulated arc therapy (VMAT) plans were retrospectively replanned using an auto-planning engine. All plans were optimized with one full 6MV VMAT arc giving 60 Gy to the primary target and 50 Gy to the elective target. The planning techniques were blinded before clinical evaluation by three specialized oncologists. To supplement the clinical evaluation, the optimization time for the AU plan was recorded along with DVH parameters for all plans. Upon clinical evaluation, the AU plan was preferred for 31/32 patients, and for one patient, there was no difference in the plans. In terms of DVH parameters, similar target coverage was obtained between the two planning methods. The mean dose for the spinal cord increased by 1.8 Gy using AU (p = .002), whereas the mean lung dose decreased by 1.9 Gy (p plans were more modulated as seen by the increase of 12% in mean MUs (p = .001). The median optimization time for AU plans was 117 min. The AU plans were in general preferred and showed a lower mean dose to the lungs. The automation of the planning process generated esophageal cancer treatment plans quickly and with high quality.

  11. ReCAP: Feasibility and Effectiveness of a Pilot Program to Facilitate Quality Improvement Learning in Oncology: Experience of the American Society of Clinical Oncology Quality Training Program.

    Science.gov (United States)

    Kamal, Arif H; Quinn, Doris; Gilligan, Timothy D; Davis, Barbara Corning; Dalby, Carole K; Bretsch, Jennifer; McNiff, Kristen K; Jacobson, Joseph O; Kamal, Arif H; Quinn, Doris; Gilligan, Timothy D; Corning Davis, Barbara; Dalby, Carole K; Bretsch, Jennifer; McNiff, Kristen K; Jacobson, Joseph O

    2016-02-01

    Studies have demonstrated that structured training programs can improve health professionals' skills in performing clinical care or research. We sought to develop and test a novel quality training program (QTP) tailored to oncology clinicians. The American Society of Clinical Oncology QTP consisted of three in-person learning sessions and four phases: prework, planning, implementation, and sustain and spread. We measured two primary outcomes: program feasibility and effectiveness. Feasibility was evaluated by recording participation. Effectiveness was measured using the Kirkpatrick model, which evaluates four outcomes: reaction, learning, behavior, and results. We collected qualitative feedback through a focus group of participants and mixed quantitative–qualitative results from a 6-month follow-up evaluation survey. Results are presented using descriptive statistics. We received feedback from of 80% of participants who took part in 92% of in-person program days. QTP deliverables were completed by 100% of teams; none withdrew from the program. Regarding reaction, 100% of respondents expressed interest in actively contributing to future QTP courses. For learning, most teams continued to use the core methodology tools (eg, project charter, aims statements) after the program. Regarding behavior, when asked about intention to serve as a local quality improvement leader, a majority said they “definitely will” serve as: team leader on a specific project (75%), project champion or sponsor (75%), or teacher or trainer for others (64%). In evaluating outcomes, 50% reported applying learned methodology to new projects at their local institution. We demonstrate one of the first feasible and effective training programs to facilitate quality improvement learning for oncology clinicians. Copyright © 2015 by American Society of Clinical Oncology.

  12. Effect of cognitive behavioral stress management program on psychosomatic patients′ quality of life

    Directory of Open Access Journals (Sweden)

    Zahra Ghazavi

    2016-01-01

    Full Text Available Background: Level of stress and its management affects the dimensions of psychosomatic patients′ quality of life (QoL, which is an important psychological issue. The present study aimed to investigate the effect of cognitive behavioral stress management program on psychosomatic patients′ QoL. In cognitive behavioral method, patients discover thought and behavioral mistakes and recover them. The criterion to evaluate the success of the present study was measurement of the patients′ QoL and its notable improvement after intervention. Materials and Methods: This is a before-and-after clinical trial with a control group. The study participants comprised 70 psychosomatic patients referred to subspecial psychiatry clinic in Isfahan who were selected through convenient sampling and allocated to the study and control groups. Quality of Life Questionnaire (SF36 was adopted to collect the data. The questionnaire was completed by the participants in three stages of before-and-after up to a month after intervention. Cognitive behavioral stress management program was administrated in study group for eight straight sessions, two month, and a month after intervention. Along with this, conventional medical treatments were conducted for both the groups. Data were analyzed by ANOVA. The significance level was P < 0.001. Results: There was no significant difference in QoL mean scores between the two groups before intervention (44, 43.1, but mean scores of QoL were significantly higher in intervention G (55.7, 59.1, compared to control (39.8, 35.7, after intervention (P < 0.001 and one month after intervention (P < 0.001. Conclusions: Cognitive behavioral stress management, conducted in the present study, had a notable effect on QoL. Therefore, designing psychological interventions based on cognitive behavioral stress management is suggested as an efficient clinical intervention.

  13. Effect of cognitive behavioral stress management program on psychosomatic patients' quality of life.

    Science.gov (United States)

    Ghazavi, Zahra; Rahimi, Esmat; Yazdani, Mohsen; Afshar, Hamid

    2016-01-01

    Level of stress and its management affects the dimensions of psychosomatic patients' quality of life (QoL), which is an important psychological issue. The present study aimed to investigate the effect of cognitive behavioral stress management program on psychosomatic patients' QoL. In cognitive behavioral method, patients discover thought and behavioral mistakes and recover them. The criterion to evaluate the success of the present study was measurement of the patients' QoL and its notable improvement after intervention. This is a before-and-after clinical trial with a control group. The study participants comprised 70 psychosomatic patients referred to subspecial psychiatry clinic in Isfahan who were selected through convenient sampling and allocated to the study and control groups. Quality of Life Questionnaire (SF36) was adopted to collect the data. The questionnaire was completed by the participants in three stages of before-and-after up to a month after intervention. Cognitive behavioral stress management program was administrated in study group for eight straight sessions, two month, and a month after intervention. Along with this, conventional medical treatments were conducted for both the groups. Data were analyzed by ANOVA. The significance level was P < 0.001. There was no significant difference in QoL mean scores between the two groups before intervention (44, 43.1), but mean scores of QoL were significantly higher in intervention G (55.7, 59.1), compared to control (39.8, 35.7), after intervention ( P < 0.001) and one month after intervention ( P < 0.001). Cognitive behavioral stress management, conducted in the present study, had a notable effect on QoL. Therefore, designing psychological interventions based on cognitive behavioral stress management is suggested as an efficient clinical intervention.

  14. Mixed integer programming improves comprehensibility and plan quality in inverse optimization of prostate HDR brachytherapy.

    Science.gov (United States)

    Gorissen, Bram L; den Hertog, Dick; Hoffmann, Aswin L

    2013-02-21

    Current inverse treatment planning methods that optimize both catheter positions and dwell times in prostate HDR brachytherapy use surrogate linear or quadratic objective functions that have no direct interpretation in terms of dose-volume histogram (DVH) criteria, do not result in an optimum or have long solution times. We decrease the solution time of the existing linear and quadratic dose-based programming models (LP and QP, respectively) to allow optimizing over potential catheter positions using mixed integer programming. An additional average speed-up of 75% can be obtained by stopping the solver at an early stage, without deterioration of the plan quality. For a fixed catheter configuration, the dwell time optimization model LP solves to optimality in less than 15 s, which confirms earlier results. We propose an iterative procedure for QP that allows us to prescribe the target dose as an interval, while retaining independence between the solution time and the number of dose calculation points. This iterative procedure is comparable in speed to the LP model and produces better plans than the non-iterative QP. We formulate a new dose-volume-based model that maximizes V(100%) while satisfying pre-set DVH criteria. This model optimizes both catheter positions and dwell times within a few minutes depending on prostate volume and number of catheters, optimizes dwell times within 35 s and gives better DVH statistics than dose-based models. The solutions suggest that the correlation between the objective value and the clinical plan quality is weak in the existing dose-based models.

  15. Cortical Reorganisation during a 30-Week Tinnitus Treatment Program

    Science.gov (United States)

    McMahon, Catherine M.; Ibrahim, Ronny K.; Mathur, Ankit

    2016-01-01

    Subjective tinnitus is characterised by the conscious perception of a phantom sound. Previous studies have shown that individuals with chronic tinnitus have disrupted sound-evoked cortical tonotopic maps, time-shifted evoked auditory responses, and altered oscillatory cortical activity. The main objectives of this study were to: (i) compare sound-evoked brain responses and cortical tonotopic maps in individuals with bilateral tinnitus and those without tinnitus; and (ii) investigate whether changes in these sound-evoked responses occur with amelioration of the tinnitus percept during a 30-week tinnitus treatment program. Magnetoencephalography (MEG) recordings of 12 bilateral tinnitus participants and 10 control normal-hearing subjects reporting no tinnitus were recorded at baseline, using 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz tones presented monaurally at 70 dBSPL through insert tube phones. For the tinnitus participants, MEG recordings were obtained at 5-, 10-, 20- and 30- week time points during tinnitus treatment. Results for the 500 Hz and 1000 Hz sources (where hearing thresholds were within normal limits for all participants) showed that the tinnitus participants had a significantly larger and more anteriorly located source strengths when compared to the non-tinnitus participants. During the 30-week tinnitus treatment, the participants’ 500 Hz and 1000 Hz source strengths remained higher than the non-tinnitus participants; however, the source locations shifted towards the direction recorded from the non-tinnitus control group. Further, in the left hemisphere, there was a time-shifted association between the trajectory of change of the individual’s objective (source strength and anterior-posterior source location) and subjective measures (using tinnitus reaction questionnaire, TRQ). The differences in source strength between the two groups suggest that individuals with tinnitus have enhanced central gain which is not significantly influenced by the

  16. Cortical Reorganisation during a 30-Week Tinnitus Treatment Program.

    Directory of Open Access Journals (Sweden)

    Catherine M McMahon

    Full Text Available Subjective tinnitus is characterised by the conscious perception of a phantom sound. Previous studies have shown that individuals with chronic tinnitus have disrupted sound-evoked cortical tonotopic maps, time-shifted evoked auditory responses, and altered oscillatory cortical activity. The main objectives of this study were to: (i compare sound-evoked brain responses and cortical tonotopic maps in individuals with bilateral tinnitus and those without tinnitus; and (ii investigate whether changes in these sound-evoked responses occur with amelioration of the tinnitus percept during a 30-week tinnitus treatment program. Magnetoencephalography (MEG recordings of 12 bilateral tinnitus participants and 10 control normal-hearing subjects reporting no tinnitus were recorded at baseline, using 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz tones presented monaurally at 70 dBSPL through insert tube phones. For the tinnitus participants, MEG recordings were obtained at 5-, 10-, 20- and 30- week time points during tinnitus treatment. Results for the 500 Hz and 1000 Hz sources (where hearing thresholds were within normal limits for all participants showed that the tinnitus participants had a significantly larger and more anteriorly located source strengths when compared to the non-tinnitus participants. During the 30-week tinnitus treatment, the participants' 500 Hz and 1000 Hz source strengths remained higher than the non-tinnitus participants; however, the source locations shifted towards the direction recorded from the non-tinnitus control group. Further, in the left hemisphere, there was a time-shifted association between the trajectory of change of the individual's objective (source strength and anterior-posterior source location and subjective measures (using tinnitus reaction questionnaire, TRQ. The differences in source strength between the two groups suggest that individuals with tinnitus have enhanced central gain which is not significantly influenced by

  17. Pain treatment facilities: do we need quantity or quality?

    NARCIS (Netherlands)

    de Meij, N.; Koke, A.; van der Weijden, T.; van Kleef, M.; Patijn, J.

    2014-01-01

    Rationale, aims and objectives: Chronic pain patients referred to a pain treatment facility have no guarantee that they will receive a proper diagnostic procedure or treatment. To obtain information about organizational aspects of pain treatment facilities and the content of their daily pain

  18. Treatment Patterns, Treatment Satisfaction, Severity of Disease Problems, and Quality of Life in Patients with Psoriasis in Three Nordic Countries

    DEFF Research Database (Denmark)

    Ragnarson Tennvall, Gunnel; Hjortsberg, Catharina; Bjarnason, Anton

    2012-01-01

    Biological drugs are expensive, but can reduce symptoms and increase quality of life for patients with psoriasis. The aim of this study was to examine quality of life, disease severity and treatment satisfaction in Danish, Finnish and Swedish patients with psoriasis. Based on 12 months' data from...

  19. John F. Kennedy Space Center, Safety, Reliability, Maintainability and Quality Assurance, Survey and Audit Program

    Science.gov (United States)

    1994-01-01

    This document is the product of the KSC Survey and Audit Working Group composed of civil service and contractor Safety, Reliability, and Quality Assurance (SR&QA) personnel. The program described herein provides standardized terminology, uniformity of survey and audit operations, and emphasizes process assessments rather than a program based solely on compliance. The program establishes minimum training requirements, adopts an auditor certification methodology, and includes survey and audit metrics for the audited organizations as well as the auditing organization.

  20. Program analysis methodology Office of Transportation Technologies: Quality Metrics final report

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2002-03-01

    "Quality Metrics" is the analytical process for measuring and estimating future energy, environmental and economic benefits of US DOE Office of Energy Efficiency and Renewable Energy (EE/RE) programs. This report focuses on the projected benefits of the programs currently supported by the Office of Transportation Technologies (OTT) within EE/RE. For analytical purposes, these various benefits are subdivided in terms of Planning Units which are related to the OTT program structure.

  1. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  2. Review and evaluation of online tobacco dependence treatment training programs for health care practitioners.

    Science.gov (United States)

    Selby, Peter; Goncharenko, Karina; Barker, Megan; Fahim, Myra; Timothy, Valerie; Dragonetti, Rosa; Kemper, Katherine; Herie, Marilyn; Hays, J Taylor

    2015-04-17

    Training health care professionals is associated with increased capacity to deliver evidence-based smoking cessation interventions and increased quit rates among their patients. Online training programs hold promise to provide training but questions remain regarding the quality and usability of available programs. The aim was to assess the quality of English-language online courses in tobacco dependence treatment using a validated instrument. An environmental scan was conducted using the Google search engine to identify available online tobacco dependence treatment courses. The identified courses were then evaluated using the Peer Review Rubric for Online Learning, which was selected based on its ability to evaluate instructional design. It also has clear and concise criteria descriptions to ensure uniformity of evaluations by trained experts. A total of 39 courses were identified, of which 24 unique courses were assessed based on their accessibility and functionality during the period of evaluation. Overall, the course ratings indicated that 17 of 24 courses evaluated failed to meet minimal quality standards and none of the courses evaluated could be ranked as superior. However, many excelled in providing effective navigation, course rationale, and content. Many were weak in the use of instructional design elements, such as teaching effectiveness, learning strategies, instructor's role, and assessment and evaluation. Evaluation results and suggestions for improvement were shared with course administrators. Based on the courses evaluated in this review, course developers are encouraged to employ best practices in instructional design, such as cohesiveness of material, linearity of design, practice exercises, problem solving, and ongoing evaluation to improve existing courses and in the design of new online learning opportunities.

  3. Study of the Nuclear Regulatory Commission quality assurance program

    International Nuclear Information System (INIS)

    Muller, F.W.

    1977-08-01

    Recommendations from a three month study are presented for quality assurance in nuclear power plants as it is practiced in industry and regulated by the NRC. Requested by the NRC, the study was accomplished through on-site visits by Sandia personnel at NRC offices and industry locations and through discussion with relevant technical society groups and interested individuals. The study group recommended changes to improve QA regulation by the NRC, to improve industry application of 10CFR50, Appendix B criteria, and to extend and expand the scope of QA activities by both industry and NRC

  4. Improving the Quality of Services in Residential Treatment Facilities: A Strength-Based Consultative Review Process

    Science.gov (United States)

    Pavkov, Thomas W.; Lourie, Ira S.; Hug, Richard W.; Negash, Sesen

    2010-01-01

    This descriptive case study reports on the positive impact of a consultative review methodology used to conduct quality assurance reviews as part of the Residential Treatment Center Evaluation Project. The study details improvement in the quality of services provided to youth in unmonitored residential treatment facilities. Improvements were…

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

    NARCIS (Netherlands)

    Meij, N. de; Grotel, M. van; Patijn, J.; Weijden, T.T. van der; Kleef, M. van

    2016-01-01

    BACKGROUND: 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

  6. Chromosome microarray proficiency testing and analysis of quality metric data trends through an external quality assessment program for Australasian laboratories.

    Science.gov (United States)

    Wright, D C; Adayapalam, N; Bain, N; Bain, S M; Brown, A; Buzzacott, N; Carey, L; Cross, J; Dun, K; Joy, C; McCarthy, C; Moore, S; Murch, A R; O'Malley, F; Parker, E; Watt, J; Wilkin, H; Fagan, K; Pertile, M D; Peters, G B

    2016-10-01

    Chromosome microarrays are an essential tool for investigation of copy number changes in children with congenital anomalies and intellectual deficit. Attempts to standardise microarray testing have focused on establishing technical and clinical quality criteria, however external quality assessment programs are still needed. We report on a microarray proficiency testing program for Australasian laboratories. Quality metrics evaluated included analytical accuracy, result interpretation, report completeness, and laboratory performance data: sample numbers, success and abnormality rate and reporting times. Between 2009 and 2014 nine samples were dispatched with variable results for analytical accuracy (30-100%), correct interpretation (32-96%), and report completeness (30-92%). Laboratory performance data (2007-2014) showed an overall mean success rate of 99.2% and abnormality rate of 23.6%. Reporting times decreased from >90 days to 102 days to <35 days for abnormal results. Data trends showed a positive correlation with improvement for all these quality metrics, however only 'report completeness' and reporting times reached statistical significance. Whether the overall improvement in laboratory performance was due to participation in this program, or from accumulated laboratory experience over time, is not clear. Either way, the outcome is likely to assist referring clinicians and improve patient care. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  7. Development of a quality-assurance program for the Tritium Systems Test Assembly

    International Nuclear Information System (INIS)

    Minor, R.C.

    1981-01-01

    A quality assurance program was developed for TSTA with the attempt in mind to satisfy the developmental nature of the project. Numerous reviews replace strict guidelines because guidelines are one of the objectives of the project, not a basis for it. The reviews assure adequate technical consideration and avoid unilateral decisions. Other major requirements of the program plan include interfacing with another quality assurance organization, the assignment of responsibilities, and instructions for the preparation of SDD's. Areas of concern are, in general, budget related, and include receiving inspection and acceptance of items. A software program is only now being established

  8. Unwanted facial hair removal with laser treatment improves quality of life of patients.

    Science.gov (United States)

    Maziar, Ali; Farsi, Nader; Mandegarfard, Manijeh; Babakoohi, Shahab; Gorouhi, Farzam; Dowlati, Yahya; Firooz, Alireza

    2010-02-01

    Unwanted facial hair can have adverse psychological effects on women and reduce their quality of life. To assess the effects of unwanted facial hair removal with laser on improving quality of life. In this study, 70 patients treated for unwanted facial hair by laser were assessed by Dermatology Life Quality Index (DLQI) questionnaire on admission and 3 months later after three sessions of laser treatment. The DLQI score before treatment was 9.42 +/- 5.99, which was reduced to 3.12 +/- 3.40 after laser treatment (p facial hair removal with laser can improve the quality of life of patients.

  9. DOE standard: Filter test facility quality program plan

    International Nuclear Information System (INIS)

    1999-02-01

    This standard was developed primarily for application in US Department of Energy programs. It contains specific direction for HEPA filter testing performed at a DOE-accepted HEPA Filter Test Facility (FTF). Beneficial comments (recommendations, additions, deletions) and any pertinent data that may improve this document should be sent to the Office of Nuclear Safety Policy and Standards (EH-31), US Department of Energy, Washington, DC 20585, by letter or by using the self-addressed Document Improvement Proposal form (DOE F 1300.3) appearing at the end of this document

  10. Data Quality Objectives for Tank Farms Waste Compatibility Program

    Energy Technology Data Exchange (ETDEWEB)

    BANNING, D.L.

    1999-07-02

    There are 177 waste storage tanks containing over 210,000 m{sup 3} (55 million gal) of mixed waste at the Hanford Site. The River Protection Project (RPP) has adopted the data quality objective (DQO) process used by the U.S. Environmental Protection Agency (EPA) (EPA 1994a) and implemented by RPP internal procedure (Banning 1999a) to identify the information and data needed to address safety issues. This DQO document is based on several documents that provide the technical basis for inputs and decision/action levels used to develop the decision rules that evaluate the transfer of wastes. A number of these documents are presently in the process of being revised. This document will need to be revised if there are changes to the technical criteria in these supporting documents. This DQO process supports various documents, such as sampling and analysis plans and double-shell tank (DST) waste analysis plans. This document identifies the type, quality, and quantity of data needed to determine whether transfer of supernatant can be performed safely. The requirements in this document are designed to prevent the mixing of incompatible waste as defined in Washington Administrative Code (WAC) 173-303-040. Waste transfers which meet the requirements contained in this document and the Double-Shell Tank Waste Analysis Plan (Mulkey 1998) are considered to be compatible, and prevent the mixing of incompatible waste.

  11. Quality assurance package for routine thermoluminescence dosimetry program

    International Nuclear Information System (INIS)

    Tawil, R.A.; Bencke, G.; Moscovitch, M.

    1988-01-01

    The Quality Assurance Package presented here specifies a set of reader-related hardware diagnostics and calibration procedures and automatically maintains audit trails of generated and derived thermoluminescence data. It specifies acceptable performance criteria for the reader and dosimeter assemblies; tracks and controls Readout Cycle Temperature Profiles; and ensures that the acquired data is verified. The quality of the generated glow curves is tracked by the real-time application of Computerized Glow Curve Deconvolution to reference dosimeters that may be mixed with field dosimeters during readout sessions. This package is supported by a menu-driven software system using vertical auto-selection menus, lotus-style horizontal menus, data entry menus with automatic error checking, and pop-up windows. The menu system is supported by an extensive HELP file; data EDITING is password-protected, and a journal is maintained for each editing session as part of the audit trail. Files for the Raw Data and Derived Dose results are maintained and managed in seven databases. The paper provides an in-depth analysis of each of the procedures, specifies data validation criteria, and presents samples of the reports generated

  12. Three-level approach to quality programs for research, development and production

    International Nuclear Information System (INIS)

    Davis, A.H.; Bussolini, P.L.; Geoffrion, R.R.

    1986-01-01

    A primary mission of the Los Alamos National Laboratory is to develop nuclear weapons systems for the Department of Defense. The activities included in this effort cover a broad spectrum, ranging from pure research to routine production. In order to provide a workable framework for a comprehensive quality assurance program for these varied activities, we have proposed a three-level structure of quality plans, corresponding to a rough classification of the weapons work into three general categories. These categories are: (1) research into materials and processes, and preliminary development; (2) design, development, and fabrication of prototype components; (3) routine production, analysis, or refinement activities. The first category requires a quality program to assure the validity, reliability, and retrievability of the information developed; this is accomplished by a conscientious application of what is generally recognized as good laboratory practice. The second category requires in addition a strong emphasis on design review and inspection. For the third category, a comprehensive quality program is appropriate

  13. Planning and implementation of reliability/quality programs to energy plants

    International Nuclear Information System (INIS)

    Quenon, J.

    1986-01-01

    Quality Assurance principles have long been applied in part to many varied industrial enterprises. The advent of commercial nuclear power brought the evolution of a more comprehensive approach to the applications of quality assurance programs in this industry. However, the application philosophy was almost totally aimed at assuring the safety of the worker and the public. Recently, there has been a strong movement by industries and business in the U.S. and Europe to apply quality assurance in a more general way to assure overall reliability as well as safety. This paper describes an approach to enable management to not only make initial determinations of how to apply the elements of a reliability/quality assurance program, but how to continuously adjust the program to optimize the benefits that can be obtained

  14. Standard guide for establishing a quality assurance program for uranium conversion facilities

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2004-01-01

    1.1 This guide provides guidance and recommended practices for establishing a comprehensive quality assurance program for uranium conversion facilities. 1.2 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate health and safety practices and determine the applicability of regulatory limitations prior to use. 1.3 The basic elements of a quality assurance program appear in the following order: FUNCTION SECTION Organization 5 Quality Assurance Program 6 Design Control 7 Instructions, Procedures & Drawings 8 Document Control 9 Procurement 10 Identification and Traceability 11 Processes 12 Inspection 13 Control of Measuring and Test Equipment 14 Handling, Storage and Shipping 15 Inspection, Test and Operating Status 16 Control of Nonconforming Items 17 Corrective Actions 18 Quality Assurance Records 19 Audits 20 TABLE 1 NQA-1 Basic Requirements Relat...

  15. Telemedicine spirometry training and quality assurance program in primary care centers of a public health system.

    Science.gov (United States)

    Marina Malanda, Nuria; López de Santa María, Elena; Gutiérrez, Asunción; Bayón, Juan Carlos; Garcia, Larraitz; Gáldiz, Juan B

    2014-04-01

    Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (pspirometry tests were assessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; pspirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.

  16. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1993 Quality Program status report

    International Nuclear Information System (INIS)

    Boliver, S.L.

    1995-05-01

    This status report is for calendar year 1993. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory (Los Alamos) Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, we establish a baseline that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify long term trends and to evaluate improvements. This is the third annual status report (Bolivar, 1992; Bolivar, 1994). This report is divided into two primary sections: Program Activities and Trend Analysis. Under Program Activities, programmatic issues occurring in 1993 are discussed. The goals for 1993 are also listed, followed by a discussion of their status. Lastly, goals for 1994 are identified. The Trend Analysis section is a summary of 1993 quarterly trend reports and provides a good overview of the quality assurance issues of the Los Alamos YMP

  17. Los Alamos National Laboratory Yucca Mountain Site Characterization Project 1993 Quality Program status report

    Energy Technology Data Exchange (ETDEWEB)

    Bolivar, S.L.

    1995-05-01

    This status report is for calendar year 1993. It summarizes the annual activities and accomplishments of the Los Alamos National Laboratory (Los Alamos) Yucca Mountain Site Characterization Project (YMP or Project) quality assurance program. By identifying the accomplishments of the quality program, we establish a baseline that will assist in decision making, improve administrative controls and predictability, and allow us to annually identify long term trends and to evaluate improvements. This is the third annual status report (Bolivar, 1992; Bolivar, 1994). This report is divided into two primary sections: Program Activities and Trend Analysis. Under Program Activities, programmatic issues occurring in 1993 are discussed. The goals for 1993 are also listed, followed by a discussion of their status. Lastly, goals for 1994 are identified. The Trend Analysis section is a summary of 1993 quarterly trend reports and provides a good overview of the quality assurance issues of the Los Alamos YMP.

  18. Quality assurance program for surveillance of fast reactor mixed oxide fuel analytical chemistry

    International Nuclear Information System (INIS)

    Rein, J.E.; Zeigler, R.K.; Waterbury, G.R.; McClung, W.E.; Praetorius, P.R.; Delvin, W.L.

    1976-01-01

    An effective quality assurance program for the chemical analysis of nuclear fuel is essential to assure that the fuel will meet the strict chemical specifications required for optimum reactor performance. Such a program has been in operation since 1972 for the fuels manufactured for the Fast Flux Test Facility. This program, through the use of common quality control and calibration standards, has consistently provided high levels of agreement among laboratories in all areas of analysis. The paper presented gives a summary of the chemical specifications for the fuel and source material, an outline of the requirements for laboratory qualifications and the preparation of calibration and quality control materials, general administration details of the plan, and examples where the program has been useful in solving laboratory problems

  19. The effects of chiropractic treatment on patients' quality of life

    OpenAIRE

    2012-01-01

    M.Tech. The purpose of this study is to determine whether chiropractic care has an effect on a patient's quality of life using the endpoints of: "the ability to perform general activities of daily living" (patient's level of disability, and restored function) and their "general emotional state" (energy level, depression, interference from emotional problems and feeling of wellness), also how these endpoints affect quality of life. Two hundred and fifty-three subjects participated in this s...

  20. Quality of computerized tomography exams proposed by a quality certification program

    International Nuclear Information System (INIS)

    Carlos, Marcia Terezinha

    1999-01-01

    Brazilian College of Radiologists (CBR) is concerned about the quality of radiological practices in the country. Actions in direction of accreditation programmes and standardization of the performance in imaging modalities have been implemented. The first accreditation programme was in mammography. In Brazil, computed tomography spread all over the country. Due high radiation dose to the patient and the continuous technological development, an accreditation programme in CT practice is necessary. A pilot programme has been carried out in the area of Rio de Janeiro with the participation of 11 CT facilities with 12 CT units. The background information follows Document EUR 16262 E uropean Guidelines of Quality Criteria for Computed Tomography . Initially practice data were collected through structured interviews using a standardized questionnaire. In regard to the assessment of clinical image quality, two examinations were selected: brain general and abdomen general. Three radiologists specialized in computed tomography evaluated the image quality criteria from a sample of examinations from the participant facilities. Other aspects selected to the assessment of the overall performance are: technical parameters of the examinations; image physical parameters (noise, spatial resolution, sensitivity profile) and radiation dose. Radiation dose and image quality criteria were fulfilled by 7 of 12 brain general examinations analyzed and only 5 of 10 abdomen general examinations analyzed. At the moment, it was not possible to get a conclusion about image quality based on measurements of physical parameters. Other factors affecting overall image quality were: technical limitation of CT units and practitioners are not able to fully handle the technical parameters of the examination. Dose and image quality criteria shall be the basis of an accreditation programme in CT and Brazilian College of Radiology has to use the experience of this work to implement a programme at national

  1. Food assistance programs for children afford mixed dietary quality based on HEI-2010.

    Science.gov (United States)

    Byker, Carmen; Smith, Teresa

    2015-01-01

    Backpack programs across the United States distribute easy-to-prepare foods in a backpack to potentially food-insecure students on Fridays to help reduce weekend hunger. This study used Healthy Eating Index 2010 (HEI-2010) to assess foods provided in Montana backpack programs. Healthy Eating Index 2010 measures compliance with the 2010 Dietary Guidelines and is a tool to assess the diet quality of foods provided in supplemental food assistance programs. We hypothesized that HEI-2010 scores would be of average dietary quality. One randomly selected menu was collected from each Montana backpack program (n = 5) from the 2011-2012 academic year. Each food provided was analyzed for diet quality using HEI-2010 to obtain component and total scores. Descriptive statistics and t tests were calculated to assess whether mean HEI-2010 component scores and total scores differed significantly (P quality of backpack programs may further improve with information sharing between programs about the availability of specific food group items. To better suit children's nutritional needs and increase HEI-2010 scores, researchers, practitioners, and the food industry should identify food options for the backpack program that are easy to prepare, appealing, and affordable. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Plutonium immobilization project development and testing quality assurance program description - February 1999

    International Nuclear Information System (INIS)

    MacLean, L. M.; Ziemba, J.

    1999-01-01

    Lawrence Livermore National Laboratory Immobilization Development and Testing organization (LLNL ID and T) is a Participant in the Plutonium Immobilization Project (PIP). The LLNL D and T has lead responsibilities for form characterization and qualification, ceramic form development, process/equipment development with plutonium, and process systems testing and validation for both conversion and immobilization. This work must be performed in accordance with the graded approach of a Quality Assurance (QA) Program. A QA Program has been developed at LLNL to meet the requirements of the DOE/MD Quality Assurance Requirements. The LLNL QA Program consists of a Quality Assurance Program Description (QAPD) and Quality Implementing Procedures. These documents interface and are a subset of the overall PIP QA Program Documents. The PIP QA Program is described in the PIP ID and T QA Plan, PIP QAPD, and QA Procedures. Other Participant Organizations also must document and describe their PIP compliant QA Programs in a QAPD and implementing procedures. The purpose of this LLNL QAPD is to describe the organization, management processes, QA Controls for Grading, functional responsibilities, levels of authority, and interfaces for those managing, performing, and assessing the adequacy of work

  3. Optimizing basin-scale coupled water quantity and water quality man-agement with stochastic dynamic programming

    Science.gov (United States)

    Davidsen, Claus; Liu, Suxia; Mo, Xingguo; Engelund Holm, Peter; Trapp, Stefan; Rosbjerg, Dan; Bauer-Gottwein, Peter

    2015-04-01

    Few studies address water quality in hydro-economic models, which often focus primarily on optimal allocation of water quantities. Water quality and water quantity are closely coupled, and optimal management with focus solely on either quantity or quality may cause large costs in terms of the oth-er component. In this study, we couple water quality and water quantity in a joint hydro-economic catchment-scale optimization problem. Stochastic dynamic programming (SDP) is used to minimize the basin-wide total costs arising from water allocation, water curtailment and water treatment. The simple water quality module can handle conservative pollutants, first order depletion and non-linear reactions. For demonstration purposes, we model pollutant releases as biochemical oxygen demand (BOD) and use the Streeter-Phelps equation for oxygen deficit to compute the resulting min-imum dissolved oxygen concentrations. Inelastic water demands, fixed water allocation curtailment costs and fixed wastewater treatment costs (before and after use) are estimated for the water users (agriculture, industry and domestic). If the BOD concentration exceeds a given user pollution thresh-old, the user will need to pay for pre-treatment of the water before use. Similarly, treatment of the return flow can reduce the BOD load to the river. A traditional SDP approach is used to solve one-step-ahead sub-problems for all combinations of discrete reservoir storage, Markov Chain inflow clas-ses and monthly time steps. Pollution concentration nodes are introduced for each user group and untreated return flow from the users contribute to increased BOD concentrations in the river. The pollutant concentrations in each node depend on multiple decision variables (allocation and wastewater treatment) rendering the objective function non-linear. Therefore, the pollution concen-tration decisions are outsourced to a genetic algorithm, which calls a linear program to determine the remainder of the decision

  4. Nuclear Waste Treatment Program annual report for FY 1988

    Energy Technology Data Exchange (ETDEWEB)

    Brouns, R.A.; Powell, J.A. (comps.)

    1989-11-01

    Much emphasis continues to be on the transfer of remote design technology for components integral to the West Valley Demonstration Project's (WVDP) vitrification process. In addition to preparing equipment specifications and drawings, Pacific Northwest Laboratory (PNL) staff also participated in numerous design coordination meetings and reviews of drawings prepared by other WVDP contractors. Nearly 200 jumper drawings for the vitrification cell were prepared by this program in FY 1988. The remote jumpers connect vessels in the cell to each other for the transfer of solutions and provide for the flow of materials, instrumentation signals, and power from outside the cell. Analysis required in preparing the jumper designs involved balance, thermal stress, seismic, set-down stress, and displacement calculations. Design efforts were begun on the canister decontamination and swipe station and on the remote maintenance station. Equipment selection and layouts of the vitrification off-gas treatment system, including a reamer to remotely clean the melter off-gas line, were finalized. Also finalized were the designs for the high-efficiency particulate air (HEPA) filter assemblies for heating, cooling and air conditioning of the vitrification cell.

  5. Results of the quality assurance testing program for radiopharmaceuticals 1995

    International Nuclear Information System (INIS)

    Baldas, J.; Binnyman, J.; Ivanov, Z.; Lauder, R.

    1996-07-01

    The results of the quality assurance testing conducted by the Australian Radiation Laboratory is summarised. Overall 111 batches of 27 different types of radiopharmaceuticals were tested on samples obtained through normal commercial channels. Failure to meet full specifications was observed in 10 of the 111 batches. All technetium-99m cold kits were reconstituted according to the directions in the package insert using sodium pertechnetate ( 99m Tc) injection. Radionuclidic purity has been determined at the calibration time, except for Thallous [ 201 Tl] Chloride injection where the highest impurity level up to product expiry is quoted. Non-compliance of the vial label was observed in one of the ten batches failing specification and was the sole cause of product failure for this batch. Vial label non-compliance consisted of, absence of volume in the vial. Six batches failed the biodistribution test but in no case did this involve failure of the distribution for the target organs. tabs

  6. Quality control in radiotherapy treatment: Radiation induced myelopathy

    International Nuclear Information System (INIS)

    Fernandez-Vicioso, E.; Ruiz-Cruces, R.

    2001-01-01

    Direct injury of the spinal cord has been reported many times, particularly in cases of overexposures with radiotherapy of neoplasm that occurred outside the Central Nervous System. Permanent damage to the spinal cord is the most feared complication of radiation therapy treatments and one of the relatively common causes of litigation for medical malpractice in the context of cancer treatment. We have learned from clinical experience, data from randomized trials and animal experimentation, the dose tolerance as well as the interfraction interval for hyperfractionation regimes. We are still lacking precious clinical information, in particular the dose tolerance in combined modality treatments that represent the vast majority of modern treatments. (author)

  7. Compression planning for continuous improvement in quality programs

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  8. Register data in the evaluation and program planning of addiction treatment programs: using Sweden as an example.

    Science.gov (United States)

    Blom, Björn; Dukes, Kimberly A; Lundgren, Lena; Sullivan, Lisa M

    2015-04-01

    Data from large-scale registers is often underutilized when evaluating addiction treatment programs. Since many programs collect register data regarding clients and interventions, there is a potential to make greater use of such records for program evaluation. The purpose of this article is to discuss the value of using large-scale registers in the evaluation and program planning of addiction treatment systems and programs. Sweden is used as an example of a country where register data is both available and is starting to be used in national evaluation and program planning efforts. The article focuses on possibilities, limitations and practicalities when using large-scale register data to conduct evaluations and program planning of addiction treatment programs. Main conclusions are that using register data for evaluation provides large amounts of data at low cost, limitations associated to the use of register data may be handled statistically, register data can answer important questions in planning of addiction treatment programs, and more accurate measures are needed to account for the diversity of client populations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Overdose prevention in injecting opioid users: The role of substance abuse treatment and training programs

    Directory of Open Access Journals (Sweden)

    Ana Sarasa-Renedo

    2014-03-01

    Conclusions: These findings suggest that preventive programs would benefit from accounting for linguistic and educational limitations and from participation in every treatment episode. Comprehensiveness and broad coverage of such programs could help to maximize their impact.

  10. Does Scoliosis-Specific Exercise Treatment in Adolescence Alter Adult Quality of Life?

    Directory of Open Access Journals (Sweden)

    Maciej Płaszewski

    2014-01-01

    Full Text Available Objective. Health-related quality of life in adults, who in adolescence participated in a scoliosis-specific exercise program, was not previously studied. Design. Cross-sectional study, with retrospective data collection. Material and Methods. Homogenous groups of 68 persons (43 women aged 30.10 (25–39 years, with mild or moderate scoliosis, and 76 (38 women able-bodied persons, aged 30.11 (24–38 years, who 16.5 (12–26 years earlier had completed scoliosis-specific exercise or observation regimes, participated. Their respiratory characteristics did not differ from predicted values. The WHOQOL-BREF questionnaire, Oswestry Disability Questionnaire, and pain scale (VAS were applied. Results. The transformed WHOQOL-BREF scores ranged from 54.6 ± 11.19 in the physical domain in the mild scoliotic subgroup to 77.1 ± 16.05 in the social domain in the able-bodied subgroup. The ODQ values did not generally exceed 5.3 ± 7.53. Inter- and intragroup differences were nonsignificant. Age, marital status, education, and gender were significantly associated with the ODQ scores. Significant association between the ODQ and WHOQOL-BREF social relationships domain scores with the participation in exercise treatment was found. Conclusions. Participants with the history of exercise treatment generally did not differ significantly from their peers who were only under observation. This study cannot conclude that scoliosis-specific exercise treatment in adolescence alters quality of life in adulthood.

  11. N286.7-99, A Canadian standard specifying software quality management system requirements for analytical, scientific, and design computer programs and its implementation at AECL

    International Nuclear Information System (INIS)

    Abel, R.

    2000-01-01

    Analytical, scientific, and design computer programs (referred to in this paper as 'scientific computer programs') are developed for use in a large number of ways by the user-engineer to support and prove engineering calculations and assumptions. These computer programs are subject to frequent modifications inherent in their application and are often used for critical calculations and analysis relative to safety and functionality of equipment and systems. N286.7-99(4) was developed to establish appropriate quality management system requirements to deal with the development, modification, and application of scientific computer programs. N286.7-99 provides particular guidance regarding the treatment of legacy codes

  12. Multicenter external quality assessment program for PCR detection of Mycobacterium ulcerans in clinical and environmental specimens.

    Science.gov (United States)

    Eddyani, Miriam; Lavender, Caroline; de Rijk, Willem Bram; Bomans, Pieter; Fyfe, Janet; de Jong, Bouke; Portaels, Françoise

    2014-01-01

    Mycobacterium ulcerans is the causative agent of Buruli ulcer (BU), a necrotizing disease of the skin, soft tissue and bone. PCR is increasingly used in the diagnosis of BU and in research on the mode of transmission and environmental reservoir of M. ulcerans. The aim of this study was to evaluate the performance of laboratories in detecting M. ulcerans using molecular tests in clinical and environmental samples by implementing sequential multicenter external quality assessment (EQA) programs. The second round of the clinical EQA program revealed somewhat improved performance. Ongoing EQA programs remain essential and continued participation in future EQA programs by laboratories involved in the molecular testing of clinical and environmental samples for M. ulcerans for diagnostic and research purposes is strongly encouraged. Broad participation in such EQA programs also benefits the harmonization of quality in the BU research community and enhances the credibility of advances made in solving the transmission enigma of M. ulcerans.

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

    Science.gov (United States)

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

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

  14. Preslaughter treatment of pigs : consequences for welfare and meat quality

    NARCIS (Netherlands)

    Geverink, N.A.

    1998-01-01

    Chapter 1 is a general introduction to this thesis. Welfare of slaughter pigs may be impaired by preslaughter treatment. Frequently used welfare indicators are behavioural and physiological responses. The responses to preslaughter treatment may also have an effect on perimortem muscle

  15. Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program.

    Science.gov (United States)

    Shah, Nikhil; Reintjes, Frances; Courtney, Mark; Klarenbach, Scott W; Ye, Feng; Schick-Makaroff, Kara; Jindal, Kailash; Pauly, Robert P

    2017-07-24

    Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance. Records were reviewed for the 6 months before exit, and vital statistics were assessed up to 90 days postexit. Ninety-four patients completed training; 25 (27%) received a transplant, 11 (12%) died, and 23 (25%) were transferred to in-center hemodialysis. Compared with the positive disposition group, patients in the negative disposition group had a longer mean dialysis vintage (3.15 [SD=4.98] versus 1.06 [SD=1.16] years; P =0.003) and were performing conventional versus a more intensive hemodialysis prescription (23 of 34 versus 23 of 60; P <0.01). In the 6 months before exit, the negative disposition group had significantly more in-center respite dialysis sessions, had more and longer hospitalizations, and required more on-call care team support in terms of phone calls and drop-in visits (each P <0.05). The most common reason for modality conversion was medical instability in 15 of 23 (65%) followed by caregiver or care partner burnout in three of 23 (13%) each. The 90-day mortality among patients undergoing modality conversion was 26%. Over a 6-year period, approximately one third of patients exited the program due to death or modality conversion. Patients who die or transfer to another modality have significantly higher health care resource utilization ( e.g. , hospitalization, respite treatments, nursing time, etc. ). Copyright © 2017 by the American Society of Nephrology.

  16. Smoking Among Adolescents in Substance Abuse Treatment: A Study of Programs, Policy, and Prevalence

    OpenAIRE

    Chun, JongSerl; Guydish, Joseph; Chan, Ya-Fen

    2007-01-01

    The study was designed to: (1) identify smoking policies and interventions in adolescent residential treatment settings; (2) examine the prevalence of smoking among adolescents in these settings; and (3) assess relationships between program-level smoking policies and client-level smoking. The Center for Substance Abuse Treatment funded 17 sites to evaluate the effectiveness of Adolescent Residential Treatment (ART) programs for substance abuse. To describe program smoking policies and interve...

  17. TH-EF-BRC-04: Quality Management Program

    International Nuclear Information System (INIS)

    Yorke, E.

    2016-01-01

    This Hands-on Workshop will be focused on providing participants with experience with the principal tools of TG 100 and hence start to build both competence and confidence in the use of risk-based quality management techniques. The three principal tools forming the basis of TG 100’s risk analysis: Process mapping, Failure-Modes and Effects Analysis and fault-tree analysis will be introduced with a 5 minute refresher presentation and each presentation will be followed by a 30 minute small group exercise. An exercise on developing QM from the risk analysis follows. During the exercise periods, participants will apply the principles in 2 different clinical scenarios. At the conclusion of each exercise there will be ample time for participants to discuss with each other and the faculty their experience and any challenges encountered. Learning Objectives: To review the principles of Process Mapping, Failure Modes and Effects Analysis and Fault Tree Analysis. To gain familiarity with these three techniques in a small group setting. To share and discuss experiences with the three techniques with faculty and participants. Director, TreatSafely, LLC. Director, Center for the Assessment of Radiological Sciences. Occasional Consultant to the IAEA and Varian.

  18. Influence of water quality on the embodied energy of drinking water treatment.

    Science.gov (United States)

    Santana, Mark V E; Zhang, Qiong; Mihelcic, James R

    2014-01-01

    Urban water treatment plants rely on energy intensive processes to provide safe, reliable water to users. Changes in influent water quality may alter the operation of a water treatment plant and its associated energy use or embodied energy. Therefore the objective of this study is to estimate the effect of influent water quality on the operational embodied energy of drinking water, using the city of Tampa, Florida as a case study. Water quality and water treatment data were obtained from the David L Tippin Water Treatment Facility (Tippin WTF). Life cycle energy analysis (LCEA) was conducted to calculate treatment chemical embodied energy values. Statistical methods including Pearson's correlation, linear regression, and relative importance were used to determine the influence of water quality on treatment plant operation and subsequently, embodied energy. Results showed that influent water quality was responsible for about 14.5% of the total operational embodied energy, mainly due to changes in treatment chemical dosages. The method used in this study can be applied to other urban drinking water contexts to determine if drinking water source quality control or modification of treatment processes will significantly minimize drinking water treatment embodied energy.

  19. Effects of a standard transfer exercise program on transfer quality and activities of daily living for transfer-dependent spinal cord injury patients

    OpenAIRE

    You, Ji-Sung; Kim, You Lim; Lee, Suk Min

    2017-01-01

    [Purpose] The objective of this study was to analyze the effect of a standard transfer exercise program on the transfer quality and activities of daily living (ADL) in wheelchair-dependent spinal cord injury patients. [Subjects and Methods] We randomly divided 22 patients into 2 groups. During the intervention period, one group received treatment with both conventional physical therapy and a standard sitting pivot transfer exercise program (experimental group, n=12) and the other group was ma...

  20. An investigation of scale effects in family substance abuse treatment programs.

    Science.gov (United States)

    Lee, A James

    2010-07-05

    This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families) was too small to be economical. Although the sample size (just nine programs) was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's) Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW) Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.