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1
Schuh, Christine. "Performance indicators for indoor air quality". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0016/NQ54809.pdf.
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Yau, Yick-yee Joyce, e 丘奕怡. "Bacterial indicators for beach water quality". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31254445.
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Yau, Yick-yee Joyce. "Bacterial indicators for beach water quality /". Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21301554.
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Robinson, David Keith. "Developing clinical quality indicators in psychiatric nursing". Thesis, Anglia Ruskin University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259517.
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van, Ree H. J. "Service quality indicators for business support services". Thesis, University College London (University of London), 2010. http://discovery.ucl.ac.uk/19902/.
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Quality is critical to corporate success as it plays a vital role in improving organisational productivity. It can be defined as ‘the totality of inherent characteristics of a product or service that bear on its ability to increase the demand for that product or service at a fixed price’ and can best be measured by capturing customer perceptions of the performance of those characteristics. Customising the SERVPERF methodology to measure service quality in a business-to-business context and subsequently testing it on both customers and suppliers of cleaning, catering and security services, the research led to a number of important and valuable insights concerning the service quality construct in a business-to-business environment. First, service quality in relation to cleaning, catering and security services consists of nine clear dimensions: reliability, clout, reputation, awareness, competitiveness, collaboration, accessibility, competence and assurance. The nine-dimensional construct identified shows high reliability and good validity in statistical terms. Furthermore, eight of the nine service quality dimensions are strongly or moderately yet significantly related to customer perceived service quality and customer satisfaction - clout being the exception. The same eight dimensions are significantly, but moderately related to purchase intention - suggesting that that there might be other constructs important in making a purchase decision (e.g. the costs of service delivery). Third, relating the nine service quality dimensions to the financial performance of supplier organisations, it was identified that six of the nine dimensions have significant relationships with one or more of the ten financial performance measures investigated - reliability, accessibility and competence being the exceptions. Finally, it was identified that customer organisations have significantly lower perceptions of the service quality they receive than do supplier organisations for competitiveness, collaboration, accessibility and competence. Moreover, customer perceived performance is significantly lower than customer perceived importance for eight of the nine service quality dimensions. For customer organisations, the empirical findings can be used to develop a framework of Service Quality Indicators, which can be used for monitoring and benchmarking service quality perception. For supplier organisations, the findings can be used for resource-allocation decisions pertaining to improve service quality, customer satisfaction and ultimately purchase intentions. It should be noted that the research is exploratory in nature and has only begun to address the many issues that are important in the management of business support services, but the questions addressed - what quality dimensions are important for customer satisfaction and what quality dimensions are important for supplier performance - are arguably among the most important in service quality management.
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Smirl, Julie E. "QUALITY-OF-LIFE INDICATORS IMPACTING OLDER ADULTS". OpenSIUC, 2015. https://opensiuc.lib.siu.edu/dissertations/1044.
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Radical changes in the senior citizen population have been triggered by the addition of the baby-boomer generation, which drastically increased the growth of this cohort group. A determination of needs for this diverse group of people is necessary for clinical professionals to employ evidence-based practices in the daily provision of services. Purpose: The focus of this study was to measure quality-of-life indicators by concentrating on the association of chronic illness and mental well-being in predicting long-term relationship satisfaction. A sample of older adults were studied in relationship with health and wellness concerns guided by previous research conducted by the Centers for Disease Control and Prevention (CDC, 2011a), and the World Health Organization (1991). Methods: The population selected for this study was older adults participating in outpatient mental health services. A representative sample of 111 participants was used in the statistical analysis of this project. The utilization of the Revised Dyadic Adjustment Scale (Busby, Crane, Larson, & Christensen, 1995) established relationship satisfaction scores among this varied population. Correlation analysis was used to determine the association between seven variables. The factors of interest were: chronic health, chronic pain, mental health acute or chronic, and scores on mental health screenings routinely used in the outpatient mental health clinics included in this study. These variables were broken down in a hierarchical multiple regression model to find out if any factors predicted overall relationship satisfaction. Results: Hierarchical multiple regression analysis delineated an inverse relationship between mental health status (acute or chronic) and degree of overall relationship satisfaction. Chronic health conditions and pain ratings were positively related, however, did not associate negatively with overall relationship satisfaction as hypothesized. Positive relationships were found among the following variables: anxiety ratings and pain-related impairment, increased reports of anxiety with chronic mental health status, and pain ratings with higher risk for suicide. Low correlation coefficient values found throughout the statistical analysis make these findings tentative. Conclusions: The indications of this study confirmed a negative association between chronic mental illness and overall relationship satisfaction scores. This highlights the importance of addressing long-term psychiatric issues as an integral part of working with older adults. Age-related decline creates a functional need for reliance on others complicating satisfaction in intimate partnerships. Mental health practitioners need to be aware of the struggles found among the growing population of older adults to address their treatment and case management needs. Additional research is necessary to determine the indicators of relationship satisfaction impacting quality-of-life among older adults. Key words: quality-of-life, older adults, generational status, chronic illness, chronic pain, mental health, revised dyadic adjustment scale.
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Baginetas, Konstantinos N. "Agri-environmental sustainability indicators : inter-disciplinary development of soil quality indicators in Nottinghamshire, UK". Thesis, University of Nottingham, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.422761.
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Gill, Peter John. "Developing paediatric quality indicators for UK general practice". Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:1837f24f-e501-4e56-906d-6080191f09cb.
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The overall aim of this thesis is to define a candidate set of quality indicators that are evidence-based, feasible to implement, and have the potential to improve the quality of care provided for children in UK general practice. The indicators were developed using a three-stage process. First, the areas and aspects of care of highest priority for quality indicator development were identified. This was achieved by seeking the views of primary care clinicians and by undertaking a formal analysis of unplanned hospital admissions for ambulatory care sensitive conditions. Then, the evidence-base to underpin indicator development was identified through an overview of Cochrane systematic reviews of interventions relevant to the primary care of children. A search of SIGN and NICE national guidelines was also conducted to inform the evidence-base. Lastly, an expert panel determined the formulation and selection of indicators by applying the RAND appropriateness methodology. This process created a final set of 26 quality indicators in six priority areas: early recognition of potentially serious illness (n=7); child protection and safeguarding (n=4); mental health (n=4); health promotion (n=1); routinely managed conditions (n=6); and general practice management (n=4). The main strength of these indicators is that they reflect a strong professional consensus on their validity and feasibility. The main weakness is that the indicators are underpinned by evidence mainly derived from expert opinion rather than formal research; the requirement for professional consensus means that they do not challenge existing models of care delivery.
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Kwong, Pui-ki. "Surface water quality indicators in China and their implications for sustainability". Click to view the E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36618718.
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STRICKLER, WENDY LORRAINE ALINE. "A DESCRIPTIVE STUDY OF INDICATORS OF EFFECTIVE INTERVENTIONS FOR SUPPORTING STUDENTS". University of Cincinnati / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1085433787.
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Riopelle, Donna Michele. "Hemodialysis patients' psychosocial characteristics and quality of life indicators". Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=99169.
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This research examines Hemodialysis patients' psycho-social characteristics and predictors of quality of life and compliance at a small rural hospital. Sixty-four patients from the hemodialysis unit at Renfrew Victoria Hospital in Renfrew, Ontario, and a satellite unit at St. Francis Memorial Hospital in Barry's Bay, Ontario, were assessed using the Social Work Patient Profile, Perceived Quality of Life and Compliance Indices. Bivariate correlation and multiple regressions were conducted on psychosocial, physical and mental health variables to determine if they correlated, and could be predictors of, social worker and nurses' perceptions of patients' quality of life and compliance.Findings support multiple correlations between variables. Younger age, recreation, family support, self driving to dialysis, dementia, diabetes as the cause of chronic kidney failure (CKF), and other as the cause of CKF were significant individual predictors of social work quality of life score. Significant individual predictors for the nurses' quality of life scores were dementia, glomeruloneph, compliance, level of education, and polycystic kidney disease as the cause of CKF. The statistically significant risk factors for nurses' quality of life were lower levels of education and dementia. The four psychosocial variables that predicted compliance to treatment, suggested that there was increased compliance for patients who had recreation and family support, and increased risk factors with age and lower levels of education.
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Mehdizadeh, Ali. "Food industry supply chain planning with product quality indicators". Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/25335.
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Quantitative supply chain modelling has contributed substantially to a number of fields, such as the automotive industry, logistics and computer hardware. The inherent methods and optimisation techniques could also be explored in relation to the food industry in order to offer potential benefits. One of the major issues of the food industry is to overcome supply seasonality and on-shelf demand. On the shelf demand is the consumer's in store demand which could also be seasonal. Objective of this work is to add flexibility to seasonal products (i.e. soup) in order to meet the on-shelf demand. In order to achieve this, a preparation process is introduced and integrated into the manufacturing system. This process increases the shelf-life of raw materials before starting the production process. This process, however, affects the quality of fresh raw materials and requires energy. Therefore, a supply chain model is developed, which is based on the link between the quality of the raw material and the processing conditions, which have an effect on the process' energy consumption and on the overall product quality. It is challenging to quantify the quality by looking at the processing conditions (degrees of freedom) and by linking it with energy in order to control and optimise the quality and energy consumption for each product. The degrees of freedom are defined differently for each process and state. Therefore, the developed model could be applied to all states and processes in order to generate an optimum solution. Moreover, based on the developed model, we have determined key factors in the whole chain, which are most likely to affect the product quality and consequently overall demand. There are two main quality indicator classes to be optimised, which are both considered in the model: static and time dependent indicators. Also, this work considers three different preparation processes - the air-dry, freeze-dry and freezing process - in order to increase the shelf-life of fresh raw materials and to add flexibility to them. A model based on the interrelationship between the quality and the processing conditions has been developed. This new methodology simplifies and enables the model to find the optimum processing conditions in order to obtain optimum quality across all quality indicators, whilst ensuring minimum energy consumption. This model is later integrated into the supply chain system, where it generates optimum solutions, which are then fed into the supply chain model. The supply chain model optimises the quality in terms of customer satisfaction, energy consumption and wastage of the system linked to environmental issues, and cost, so that the final products are more economical. In this system, both the manufacturing and inventory systems are optimised. This model is later implemented with a real world industrial case study (provided by the industrial collaborator). Two case studies are considered (soya milk and soup) and interestingly enough only one of them (soup) corresponds with this model. The advantage of this model is that it compares the two systems and then establishes which system generates an optimum end product.
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Myers, Donna J. "Assessing Quality Indicators in Asynchronous Undergraduate Distance Education Courses". NSUWorks, 2008. http://nsuworks.nova.edu/gscis_etd/743.
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The purpose of this study was to determine quality indicators within asynchronous distance education undergraduate courses at an accredited institution. The definition of quality is in and of itself obscure. Therefore, the identification of indicators or characteristics of quality in courses was a primary focus. The identification of such characteristics was based on input from the primary stakeholders in distance education, namely, the students, the administrators, and the instructors. Collecting data from each stakeholder group allowed for a comparison of those characteristics of quality deemed most important by each group. Initially an expert panel meeting was conducted to help categorize topic areas of importance as gleaned from the literature. Those topics were the basis for survey items that were submitted to a body of students, instructors, and administrators involved in distance education undergraduate courses. The survey was emailed to 2,360 participants that included 60 administrators, 300 instructors, and 2,000 students. The response rate was 60% from the administrator group, 61 % from the instructors, and 22.8% from the students for a total of 675 responses or a 28.6% return rate. The responses to the survey were analyzed using descriptive and inferential statistics. A comparison of the responses from the three stakeholder groups was performed.
The data analyses indicated that each group agreed that technical issues, course design, class procedures and expectations, interaction, and content delivery are factors that identify quality in distance education courses. A consensus among all stakeholders as to what constitutes quality could be the catalyst for possible improvements to distance education courses in the future. Distance education is still forging new ground and input from the stakeholders should be advantageous for advancing and improving the quality of courses.
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Morgan, Michael D. (Michael Darold). "Identifying Perceived Indicators of Institutional Quality in Theological Schools". Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc278481/.
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The purpose of this study was to identify a set of perceived indicators of institutional quality for theological schools. To identify the most commonly agreed upon indicators of perceived quality for theological schools, 69 variable indicators of quality were selected from research regarding quality in higher education and in theological schools and compiled into the Inventory of Determinants of Quality for Theological Schools (IDQTS). This instrument was mailed to presidents or deans of non-Catholic theological schools, theological school faculty members, theological school graduates who are practicing ministers, and church leaders. Of the 487 surveys mailed, 288 were returned to be included in this study. The analysis of variance (ANOVA) procedure was executed for each of the 69 IDQTS items to determine if the group means of the four study group responses were significantly different. The level of significance was set at .01. Thirty-nine IDQTS items were found to have no significant difference in the group means for responses at the .01 level. Twenty-nine of these 39 items were rated as Important or Most Important perceived indicators of institutional quality for theological schools with overall means of 3.00 or higher. Ten other items were rated as Less important to Unimportant perceived indicators of institutional quality for theological schools with overall means of 2.99 or lower. When the four study groups were treated as four individual raters and Kendall's Coefficient of Concordance was applied to their responses on the IDQTS, a W of .8881 was calculated with p < .01. Of the IDQTS items perceived to be ranked in the highest one-third of indicators of institutional quality in theological schools, eight were associated with student outcomes, five were associated with faculty, four were associated with administration and organization, four were associated with curriculum, one was associated with institutional demographics, one was associated with student services and none were associated with institutional resources.
15
Connors, Donald R. 1936. "Quality Indicators for Private Liberal Arts Colleges and Universities". Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc279089/.
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The purpose of this study was to identify indicators of quality for liberal arts colleges and universities as defined by internal and external constituents, and to compare the results of this study with those of two-year public institutions. The internal constituents included college and university presidents and faculty, and the external constituents consisted of officers of Chambers of Commerce and the Kiwanis International, representing business and industry. A survey instrument of 70 items was sent to the constituents of 148 institutions accredited by the Southern Association of Colleges and Schools. A total of 592 surveys were sent with an average response rate of 56.93%. The study was limited to Baccalaureate (Liberal Arts) Colleges I and Baccalaureate (Liberal Arts) Colleges II according to the Carnegie Foundation for the Advancement of Teaching. There were 57 survey items identified as indicators of quality by agreement of all respondent group means. The highest ranked indicator of quality was faculty commitment to teaching. The Analysis of Variance revealed close agreement by constituents on 17 of the quality indicators. There was close agreement also that three of the survey items were not indicators of quality. Fisher's Multiple Comparison test revealed that various constituents rated some survey items significantly higher than all other groups. The items that presidents, faculty representatives, and Chamber of Commerce officers each rated significantly high indicated the unique perspective of each constituent group. The Kiwanis officers responded similarly to the Chamber officers but did not rate any survey items significantly higher than other groups. Internal constituents rated seven items significantly higher than external constituents. These items centered mainly on faculty characteristics. External constituents rated three items higher than internal constituents. These survey items focused mainly on curriculum issues that related to the community and real-world problems. Seventeen conclusions were drawn from the study and implications for practice were formulated in areas such as faculty teaching, student interaction, learning outcomes, institutional effectiveness, external constituents, goal setting, advertising, and recruiting.
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Lawson, Nicolette Patricia. "Environmental performance indicators in industrial management systems". Thesis, Brunel University, 1999. http://bura.brunel.ac.uk/handle/2438/5218.
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Measuring the Environmental Performance of industry is an essential element in the movement to minimise the impact that industry has on the environment. There has been a significant increase in interest in this area over the last few years, however it is recognised that the available literature still tends towards the conceptual and theoretical and there is little practical advice for a business wishing to undertake environmental performance measurement. This project has concentrated on the practical development of tools and techniques for measuring environmental performance in a large, complex engineering company, using LucasVarity as an example. The portfolio discusses the general trends and approaches in environmental performance measurement, explains the specific aspects developed in practice and their results. Finally, the general conclusions for industry are discussed.
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Driessen, Jennifer Petronella 1973. "Microbial populations as indicators of river 'health'". Monash University, Dept. of Chemistry, 2000. http://arrow.monash.edu.au/hdl/1959.1/8780.
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Al-Awa, Bahjat. "Impact of hospital accreditation on patients' safety and quality indicators". Doctoral thesis, Universite Libre de Bruxelles, 2011. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209917.
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Ecole de Santé Publique Université Libre de Bruxelles
Academic Year 2010-2011
Al-Awa, Bahjat
Impact of Hospital Accreditation on Patients' Safety and Quality Indicators
Dissertation Summary
I.\
Doctorat en Sciences
info:eu-repo/semantics/nonPublished
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Lin, Che-Ying. "The development of quality indicators for Taiwanese institutional dementia care". Thesis, University of Stirling, 2010. http://hdl.handle.net/1893/2542.
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This study is a mixed-method study that seeks to develop a set of institutional dementia care indicators to evaluate quality of care and inform the improvement of quality of life (QOL) for Taiwanese people with dementia living in care homes. It also uses comparative analysis to compare the different features of policy and its delivery in dementia care between Scotland and Taiwan, a comparison designed to aid the development of dementia care policy, and the establishment of quality indicators for institutional dementia care, in Taiwan. This study employed the person-centred care approach at the micro perspective, and the total quality management (TQM) approach at the macro perspective, in order to inform a seamless care model for people with dementia living in care homes. Data were collected in two stages: comments from experts in dementia care were recorded in an exercise using “Delphi” methodology; subsequently the opinions of service receivers were recorded in a fieldwork exercise. The Delphi exercise (stage one) acted as the pre-test, involving 24 experts in dementia care in Scotland and Taiwan in evaluating the usefulness and applicability of proposed quality indicators for institutional dementia care. Quantitative and qualitative data from the Delphi panel were analyzed. The fieldwork (stage two) collected 237 questionnaires (from 122 residents with dementia and 115 family members) in 14 Taiwanese care homes for people with dementia (including special care units within care homes). The field test data were analyzed using reliability and item analysis, confirmatory factor analysis (CFA), and descriptive and inferential statistics. Initially, 43 proposed quality indicators for institutional dementia care were identified through literature review. However, after two Delphi rounds, only six key dimensions (41 quality indicators) were identified by consensus as the important items for use in measurement of quality of care for people with dementia living in Taiwanese care homes. Through reliability and item analysis, and CFA, this research developed a model which is a three-factor structure (social care, health and personal care, and environment) with 18 quality indicators. The 18 quality indicators have high reliability, validity, and credibility and load onto a second order factor which represents quality of care for people with dementia living in care homes. Further analysis was then conducted to explore how relative ratings on these three factors differed according to measured characteristics of the residents and their family members. In general, only a few strong patterns of difference emerged and multiple linear regression analysis suggested that differences in ratings could not be attributed to influences of socio-economic and socio-demographic differences between respondents. The study concludes that the Delphi method could be used as a methodology for health services research to integrate the opinions of multidisciplinary dementia experts and that CFA is an effective technique to study the empirical factor structure. The findings suggest that the 18 quality indicators could be suitable criteria for people with dementia and their family members to evaluate care quality and select an appropriate care home. The indicators also have important policy implications for the Taiwanese Government and regulations intended to ensure that care homes meet the requirements of service receivers.
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Owen, Robert Campbell. "The development and testing of indicators of prehospital care quality". Thesis, University of Manchester, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.527413.
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Hirner, Leo J. "Quality indicators for evaluating distance education programs at community colleges". Diss., Columbia, Mo. : University of Missouri-Columbia, 2008. http://hdl.handle.net/10355/5599.
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Thesis (Ph. D.)--University of Missouri-Columbia, 2008.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on June 8, 2009) Vita. Includes bibliographical references.
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Aull, Malia Elizabeth. "Water Quality Indicators in Watershed Subbasins with Multiple Land Uses". Link to electronic thesis, 2005. http://www.wpi.edu/Pubs/ETD/Available/etd-050305-170523/.
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Stuart, Marta Elva, Darcy Tessman, Juanita O'Campo Waits, Lisa Lauxman, Brent Strickland, Jan Norquest e Margaret Stone. "Identifying High Quality Youth Programs: Quality Indicators for Out of School Time -- Quick Reference Guide". College of Agriculture and Life Sciences, University of Arizona (Tucson, AZ), 2007. http://hdl.handle.net/10150/157571.
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2 pp.This is a series of 6 fact sheets related to identifying high quality youth programs from several perspectives: middle/high school youth, parents, youth development professionals and identifying resources in the community. It also includes a check list that will be included with each of the fact sheets.
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Kwong, Pui-ki, e 鄺沛琪. "Surface water quality indicators in China and their implications for sustainability". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B36618718.
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Fujita, Kenji. "The development of quality indicators for home pharmaceutical care in Japan". Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/22994.
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Taking into account the challenges posed by an ageing society, Japan, one of the most rapidly ageing countries in the world, has recently seen a shift in focus of its health delivery system for the elderly from hospital care to home healthcare. In Japan, home pharmaceutical care (HPC) is provided to home-bound elderly who have difficulties in accessing a community pharmacy, for regular medicine supplies and medication management. Although the number of HPC services provided has increased, little is known about the quality of care provided. Quality indicators (QIs) are a recognised mechanism for evaluating the quality of health services, if they have been robustly developed and their measurement properties scientifically tested. The overall aim of the research described in this thesis was to develop a set of QIs for HPC in Japan and assess their measurement properties. A 4-step QI development procedure was applied. First, the results of a qualitative study regarding what constitutes ‘quality’ in HPC revealed that multiple stages of the home care pathway should be covered in order to comprehensively evaluate the quality of HPC. Second, in line with the determined scope, 52 QIs were developed based on the following three sources; 1) national guidelines, 2) existing QIs, and 3) healthcare professionals’ experiences and opinions. Third, appropriateness of the preliminary set of 52 QIs was assessed using the RAND/UCLA appropriateness method. Of these, 45 QIs were judged as ‘appropriate’ by the expert panel. Fourth, a 6-month observational study followed by semi-structured interviews were carried out to evaluate measurement properties of each QI (feasibility, applicability, improvement potential, discriminatory capacity, sensitivity to change, acceptability and implementation issues). As a result, 9 QIs met all measurement properties. A set of QIs for HPC was rigorously developed and tested. This QI set may be useful in evaluating the quality of HPC services in Japan.
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Turnbull, David Andrew. "The water quality of the Ouseburn : a part urban, part rural catchment". Thesis, Northumbria University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241516.
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Steel, Nicholas. "National Population Evaluation Of Quality Of Health Care: Developing And Using Quality Of Health Care Indicators". Thesis, University of East Anglia, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490364.
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Background: Good quality health care can improve individual and population health. This study aimed to assess the receipt of effective health care interventions by middle aged and older people with common chronic diseases and health problems. Methods: 119 quality indicators were reviewed by an expert panel. Approved indicators were developed into a structured questionnaire for the English Longitudinal Study of Ageing (ELSA). 8,688 participants aged 50 years and over were interviewed in 2004-5 in England, of whom 4,419 reported diagnoses of one or more of 14 study conditions. Outcome measures were the percentage of indicated interventions received by eligible participants for 39 indicators, and aggregate scores. Receipt of hip or knee joint replacement was analysed as an example ofhow receipt could be compared with need, in 7,101 people aged 60 yrs or older in ELSA 2002-3, and 14,807 adults aged 60 years or over in the USA Health and Retirement Study 19982004. Results: Participants were eligible for 19,450 person-disease level quality indicators, and received 62.4% (95% confidence interval 61.5 to 63.3) of all recommended care items. Receipt of indicated care varied substantially by condition, from warfarin 'monitoring at 100.0% (92.0-100.0) to osteoarthritis at 29.0% (26.0-31.9). Indicators were more likely to be achieved for general medical (75.0%, 73.8-76.3) than geriatric conditions (56.1 %, 54.6-57.7). There were few associations between quality achievement and socio-economic factors. Factors associated with lower likelihood of receipt ofjoint replacements, relative to need, were living in the North, being a woman, or being poorer, in England, and in the USA were being Black or less educated. Interpretation: Deficits in the receipt of effective health care for chronic conditions appeared common. Shortfalls were most marked in areas associated with frailty, but few areas were exempt. Efforts to improve care have substantial scope to achieve better population health.
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O'Reilly, Maria Therese. "Clinical indicators of quality for Australian residential aged care facilities : establishing reliability, validity, and quality thresholds". Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/40314/1/Maria_O%27Reilly_Thesis.pdf.
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Background: In response to the need for more comprehensive quality assessment within Australian residential aged care facilities, the Clinical Care Indicator (CCI) Tool was developed to collect outcome data as a means of making inferences about quality. A national trial of its effectiveness and a Brisbane-based trial of its use within the quality improvement context determined the CCI Tool represented a potentially valuable addition to the Australian aged care system. This document describes the next phase in the CCI Tool.s development; the aims of which were to establish validity and reliability of the CCI Tool, and to develop quality indicator thresholds (benchmarks) for use in Australia. The CCI Tool is now known as the ResCareQA (Residential Care Quality Assessment). Methods: The study aims were achieved through a combination of quantitative data analysis, and expert panel consultations using modified Delphi process. The expert panel consisted of experienced aged care clinicians, managers, and academics; they were initially consulted to determine face and content validity of the ResCareQA, and later to develop thresholds of quality. To analyse its psychometric properties, ResCareQA forms were completed for all residents (N=498) of nine aged care facilities throughout Queensland. Kappa statistics were used to assess inter-rater and test-retest reliability, and Cronbach.s alpha coefficient calculated to determine internal consistency. For concurrent validity, equivalent items on the ResCareQA and the Resident Classification Scales (RCS) were compared using Spearman.s rank order correlations, while discriminative validity was assessed using known-groups technique, comparing ResCareQA results between groups with differing care needs, as well as between male and female residents. Rank-ordered facility results for each clinical care indicator (CCI) were circulated to the panel; upper and lower thresholds for each CCI were nominated by panel members and refined through a Delphi process. These thresholds indicate excellent care at one extreme and questionable care at the other. Results: Minor modifications were made to the assessment, and it was renamed the ResCareQA. Agreement on its content was reached after two Delphi rounds; the final version contains 24 questions across four domains, enabling generation of 36 CCIs. Both test-retest and inter-rater reliability were sound with median kappa values of 0.74 (test-retest) and 0.91 (inter-rater); internal consistency was not as strong, with a Chronbach.s alpha of 0.46. Because the ResCareQA does not provide a single combined score, comparisons for concurrent validity were made with the RCS on an item by item basis, with most resultant correlations being quite low. Discriminative validity analyses, however, revealed highly significant differences in total number of CCIs between high care and low care groups (t199=10.77, p=0.000), while the differences between male and female residents were not significant (t414=0.56, p=0.58). Clinical outcomes varied both within and between facilities; agreed upper and lower thresholds were finalised after three Delphi rounds. Conclusions: The ResCareQA provides a comprehensive, easily administered means of monitoring quality in residential aged care facilities that can be reliably used on multiple occasions. The relatively modest internal consistency score was likely due to the multi-factorial nature of quality, and the absence of an aggregate result for the assessment. Measurement of concurrent validity proved difficult in the absence of a gold standard, but the sound discriminative validity results suggest that the ResCareQA has acceptable validity and could be confidently used as an indication of care quality within Australian residential aged care facilities. The thresholds, while preliminary due to small sample size, enable users to make judgements about quality within and between facilities. Thus it is recommended the ResCareQA be adopted for wider use.
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Shaikh, Junaid. "Non-Intrusive Network-Based Estimation of Web Quality of Experience Indicators". Licentiate thesis, Blekinge Tekniska Högskola, Sektionen för datavetenskap och kommunikation, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-00529.
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Quality of Experience (QoE) deals with the acceptance of a service quality by the users and has evolved significantly as an important concept over the past 10 years. Network operators and service providers have gained interest in QoE-aware management of networks, in order to better fulfill end-user demands and gain a competitive edge in the market. While this growth promises new business opportunities, it also presents several challenges to the networking researchers, which are mainly related to the assessment of user experience. Several QoE assessment models have been proposed to estimate the user satisfaction for a given service quality. Most of them are intrusive and require knowledge of the content reference. In contrast, the network operators require non-intrusive methods, which allow models to be implementable on the network-level without having much knowledge about that reference. The methods should be able to monitor QoE passively in real-time, based on the information readily available on network level. This thesis investigates indicators, which are intended to be used in the development of non-intrusive network-based methods for the real-time QoE assessment and monitoring. First, a bridge is made between the user and the network perspectives by correlating the user traffic characteristics measured on an operational network and user subjective experience tested on an experimental platform. It is shown that the user session volume appears to be an indicator of users’ interest in the service. Second, the TCP connection interruptions are investigated as an indicator to infer the user experience. It is found out that the request-level performance metrics show stronger correlations between the interruption rates and the network Quality of Service (QoS). Third, a wavelet-based criterion is devised to assist in the identification of those traffic gaps, which may result in the degradation of QoE. It can be implemented on the network-level in quasi-real-time to quickly identify the user-perceived performance issues.
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Al-Omirah, Husam F. "Proteolytic degradation products as indicators of quality in meat and fish". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape16/PQDD_0004/MQ29642.pdf.
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Quinlan, Roberto. "Fossil chironomids as indicators of water quality impacts from aquaculture activities". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/NQ56097.pdf.
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Clerk, Saloni. "Fossil chironomids as indicators of water quality impacts from aquaculture activities". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2002. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ65611.pdf.
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Idvall, Ewa. "Development of strategic and clinical quality indicators in postoperative pain management /". Doctoral thesis, Linköping : Univ, 2001. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5158.
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Nödler, Karsten. "Testing selected micro-contaminants for their applicability as water quality indicators". Thesis, Niedersächsische Staats- und Universitätsbibliothek Göttingen, 2012. http://hdl.handle.net/11858/00-1735-0000-000D-FABC-C.
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Die Verwendung anthropogener organischer Spurenstoffe wie beispielsweise Pharmazeutika, Lifestyle-Produkte, Biozide und Pestizide als Indikatoren für die Bewertung der Wasserqualität hat großes Interesse in der Wissenschaftsgemeinde geweckt, und die Verwendung dieser Substanzen als Indikatoren für die Prozessoptimierung, Quellzuordnung und zur Abschätzung des Ausmaßes einer möglichen Kontamination (z. B. den Abwasseranteil von Oberflächen- und Grundwasser) besitzt ein sehr großes Anwendungspotential. Die hier präsentierte Arbeit ist die erfolgreiche und konsequente Weiterführung bestehender Forschungsaktivitäten zur Eignung ausgewählter Spurenstoffe als Indikatoren für die Bewertung der Wasserqualität, ihrem Vorkommen und Verhalten in der Umwelt sowie ihrer Redox-spezifischen Transformation.
Um eine Substanz als Indikator verwenden zu können, müssen sensitive und selektive Analysenmethoden verfügbar sein. In der vorliegenden Arbeit wird die Entwicklung einer Multimethode für den Nachweis von 46 basischen, neutralen und sauren Analyten mittels der Hochleistungs-Flüssigchromatographie und Elektronenspray-Ionisation (ESI) mit anschließender Tandem-Massenspektrometrie (HPLC-ESI-MS/MS) beschrieben. Das ausgewählte Analytenspektrum deckt einen weiten Bereich hinsichtlich der Polarität der Stoffe (log Kow <0–5,9) sowie ihrer repräsentierten Kontaminationsquellen ab. Die Besonderheit der entwickelten Methode stellt die simultane Festphasenanreicherung (SPE), Trennung und Detektion aller Analyten dar. Um dieses realisieren zu können, wird das ESI-Interface in beiden möglichen Operationsmodi (+/−) verwendet, so dass pro Probe nur eine Injektion notwendig ist. Die Bestimmungsgrenzen der Methode in Fluss- und Meerwasser liegen im Bereich weniger ng/L. Im weiteren Verlauf der Arbeit wird die hohe Flexibilität der Methode (Integration zusätzlicher Analyten und Anpassung an andere Wassertypen) demonstriert.
Im darauf folgenden Abschnitt werden die Ergebnisse eines intensiven Fluss-Monitorings vorgestellt. Der Fokus liegt dabei auf der Korrelation von 41 Spurenstoffen mit Kalium (K+) und deren räumlichen und zeitlichen Varianz. Da Urin je nach K+-Hintergrundkonzentration des Gewässers eine signifikante K+-Quelle darstellen kann, ist in Gewässern mit hohem Abwasseranteil eine positive Korrelation von abwasserbürtigen Stoffen und K+ zu erwarten. Diese Korrelation ist für Stoffe mit folgenden Charakteristika bestätigt worden: 1) Kläranlagenabläufe sind die Hauptquelle der Substanz; 2) Die Fracht der Substanz in der Kläranlage ist nur geringen zeitlichen Schwankungen unterworfen; und 3) Hohe Persistenz der Verbindung bei der Abwasserbehandlung und in der Umwelt. Neben anderen Spurenstoffen zeigen Carbamazepin, Sulfamethoxazol und Tolyltriazol die beste Korrelation. Darüber hinaus sind die K+-Äquivalente der einzelnen Stoffe offensichtlich abhängig von Landnutzung und Bevölkerungsstruktur im Einzugsgebiet des untersuchten Flussabschnitts. Eine Korrelation mit K+ zeigt, dass die Konzentration des korrelierenden Spurenstoffs nur vom Abfluss des Fließgewässers abhängig ist. Nach diesem Konzept könnte die Vorhersage der Konzentration entsprechender Spurenstoffe an bestimmten Flussabschnitten erheblich vereinfacht werden. Analog zu den genannten Charakteristika 1–3 kann der Ansatz zur Quellidentifizierung neu auftretender/identifizierter Substanzen genutzt werden. Darüber hinaus könnten Eintragsfunktionen für die korrelierenden Spurenstoffe hinsichtlich Oberflächenwasser/Grundwasser-Interaktion hergeleitet werden. Dies würde eine realistischere Bewertung der Reinigungsleistung von Anlagen zur (künstlichen) Grundwasseranreicherung ermöglichen.
Anschließend wird eine Methode präsentiert, mit Hilfe derer sich das Volumen von schnell transportiertem, unbehandeltem Abwasser in einem Karstaquifer abschätzen lässt. Eine Kontamination mit unbehandeltem Abwasser und die damit verbundene bakterielle Belastung stellen eine ernsthafte Bedrohung für die Trinkwasserqualität und die öffentliche Gesundheit dar. Das Ausmaß einer Kontamination quantifizieren zu können ist allerdings meist problematisch. Daher wurde ein bereits bekannter Massenbilanzansatz der aktuellen Fragestellung angepasst. In die Berechnung der Abwassermenge fließen ein: Die Coffein-Fracht an der Quelle, die übliche Coffein-Belastung in unbehandeltem Abwasser und der tägliche durchschnittliche Trinkwasserverbrauch pro Person im beobachteten Quelleinzugsgebiet. Der entwickelte Ansatz wurde zur Berechnung der täglich zuströmenden Abwassermenge an einem bereits gut charakterisierten Karstaquifer (Gallusquelle, Deutschland) angewendet.
Weiterhin werden die Ergebnisse einer Mikrokosmos-Studie zur Transformation des Antibiotikums Sulfamethoxazol (SMX) unter denitrifizierenden Bedingungen vorgestellt. Ein selektiver Reaktionsmechanismus mit den unter denitrifizierenden Bedingungen gebildeten N-Spezies Stickstoffmonoxid (NO) und Nitrit (NO2−) ist die zugrunde liegende Arbeitshypothese und die Bildung der daraus abgeleiteten Transformationsprodukte (TP) 4-Nitro-N-(5-methylisoxazol-3-yl)-benzenesulfonamid (4-Nitro-SMX) und N-(5-methylisoxazol-3-yl)-benzenesulfonamid (Desamino-SMX) während des zeitlichen Verlaufs eines Wasser/Sediment-Batchversuchs wird dargestellt. Beide TPs können auch in Umweltproben nachgewiesen werden. Unter geeigneten Reaktionsbedingungen kann das TP 4-Nitro-SMX zudem zu SMX retransformiert werden. Dies zeigt die hohe Relevanz der vorliegenden Arbeit hinsichtlich des Vorkommens und Verhaltens dieses Antibiotikums in der Umwelt und für das Monitoring der Wasserqualität. Darüber hinaus können Redox-spezifische TPs als Indikatoren für den reaktiven Stofftransport verwendet werden.
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Al-Omirah, Husam F. "Proteolytic degradation products as indicators of quality in meat and fish". Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=27268.
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Assessment of freshness and quality of meat and fish is a major activity of both food regulatory agencies and the food industry. Various methods are used for measuring fish and meat quality, each with its particular advantages and limitations. However, methods based on monitoring the products of proteolysis have received relatively little attention. The objective of the present study was to identify specific protein and peptide products of proteolysis as indicators of freshness and quality during chilled storage of fresh fish and meat.Samples of meat and fish were subjected to chilled storage; at intervals of 0, 2, 4, 8, 12 and 16 days, samples were subjected to protein and peptide extraction, and separation of individual sarcoplasmic and myofibrillar proteins by SDS and native electrophoresis. These extracted proteins along with acid soluble nitrogen (ASN) were separated by RP-HPLC, fractions were collected and identified by electrospray ionization mass spectrometry (ESI-MS).
RP-HPLC separated at least thirty fractions from the ASN extract of fresh fish. ESI-MS revealed the presence of at least twenty-five polypeptides with molecular weights (MW) ranging from 2 to 32 kDa. The relative area % of the polypeptides with MW 32.8 kDa and 42.8 kDa decreased during the storage while polypeptides of MW of 10.9 kDa and 16.7 kDa increased during storage. Changes in polypeptides of MW 12, 34.2 and 42.8 kDa was also observed. The sarcoplasmic protein extracted from ground and whole meat contained at least 12 polypeptides with MW ranging from 11 to 42 kDa. The relative area % of polypeptide of MW of 35.7 kDa decreased during storage. The results suggest that changes in proteins and polypeptides of MW 10.9, 12, 16.7, 32.8, 34.2 and 42.88 kDa in fish and 35.7 kDa in meat could serve as indicators of spoilage.
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Zabala, Joy Smiley. "THE DEVELOPMENT AND EVALUATION OF QUALITY INDICATORS FOR ASSISTIVE TECHNOLOGY SERVICES". UKnowledge, 2007. http://uknowledge.uky.edu/gradschool_diss/517.
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Survey research was used to conduct a formative evaluation of Quality Indicators for Assistive Technology Services (QIAT) by 120 leaders in the field of assistive technology. Survey respondents represented five different types of assistive technology interest and responsibilities: consumers of assistive technology services and family members, district and regional assistive technology leaders, state and national assistive technology leaders, assistive technology leaders in higher education, and assistive technology policy leaders. Respondents reviewed QIAT and completed either print or online electronic versions of a survey in which they provided their perspectives on the need for quality indicators, the importance of each quality indicator contained in QIAT, the clarity of each accompanying intent statement, and the usefulness of QIAT to people with assistive technology interests and responsibilities similar to their own. Results of this investigation suggested that quality indicators are needed to guide the development and delivery of assistive technology services, that the 39 quality indicators contained in QIAT are important, and that QIAT would be useful to people with varied interests and responsibilities in assistive technology. The perceptions of the majority of the participants about QIAT were positive. Analysis of the rankings indicated that every quality indicator contained in QIAT was considered important by greater than 92% of the participants and every intent statement was considered clear by greater than 82% of the participants. Results also indicated that participants believed that some revisions in the wording and reordering of the items contained in QIAT would increase clarity and that the identification and development of training and products aligned to QIAT could aid in the development and delivery of effective assistive technology services. Proposed revisions were made in QIAT as a result of respondent recommendations. Implications for practice, future development, and additional research also were proposed.
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Crutcher, Candice M. "Diatoms as indicators of stream water quality in east central Indiana". Virtual Press, 2003. http://liblink.bsu.edu/uhtbin/catkey/1266021.
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Three streams with watersheds of different land uses (urban, agricultural, and forested) were chosen for this study. A composite sample of diatoms was obtained from small rocks in a riffle of each stream and identified to genera. Water chemistry measurements included chloride, sulfate, nitrate, conductivity, pH, alkalinity and temperature.Conductivity, chloride, and sulfate were significantly higher in the urban watershed and lowest in the forested watershed. However, the forested watershed had the highest levels of nitrate, which may have come from groundwater or organic matter decomposition. Alkalinity, pH andtemperature did not vary among watersheds.Diatom diversity was significantly higher in the forested watershed. Several diatom genera, Amphora, Cymbella and Gyrosigma, were positively correlated with nitrate and negatively correlated with conductivity, chloride and sulfate, which indicate their potential use as indicators of water quality.Department of Natural Resources and Environmental Management
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Davis, Marjorie A. "A stakeholder analysis of school quality indicators : Ohio's venture capital program /". The Ohio State University, 1997. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487948158626049.
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Meyer, Leigh Anne. "Professional Quality of Life Indicators and Turnover Intention in Forensic Nurses". Otterbein University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1622051900393966.
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Smith, Mariette. "Professional women's use of quality indicators during evaluation of career wear". Diss., University of Pretoria, 2010. http://hdl.handle.net/2263/25980.
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Quality is a multi-dimensional concept and can be viewed from different perspectives (Fiore &Kimle, 1997:5). From the professional women’s (consumer) perspective career wear quality can be measured on both tangible (functional or sensory) and non-tangible (emotional, cognitive and importance of the self and others) levels. From the retailer’s perspective quality is measured mostly based on intrinsic product features (durability), thus relating to one component of career wear quality of professional women. The discrepancy between the two may result in consumer dissatisfaction and impacts negatively on return sales to the retailer. Quality evaluation occurs at two stages during the consumer decision making process. Firstly, quality is evaluated in-store, during the decision-making stage, and secondly during product use. The quality indicators that professional women use during these stages may not be the same. In this study an exploration was thus done on the tangible and non-tangible quality indicators that professional women use to evaluate career wear quality both during the purchase decision-making stage and during product use. Each of these was measured according to its importance to the respondents during the decision-making stage and during product use and subsequently compared, since the importance of quality indicators may differ between the two stages. The systems theory approach was used to compile the conceptual framework for this study. The systems perspective acknowledges the sequence, relationship and interdependency of the individual indicators that are used to evaluate clothing products. These indicators are considered as so-called inputs and are transformed in terms of outputs, which are interpreted in terms of customer satisfaction or dissatisfaction. The respondents were full-time employed professional women in the legal, financial, engineering and medical industries, as these women require the suitable qualification and registration with the appropriate professional body. This group has spending power and their third largest household expenditure is clothing products. A snowball technique was used to recruit participants/respondents for both the qualitative phase, during which a focus group was held, and for the quantitative data collection (questionnaire) phase. The qualitative technique (focus group) was used to gain insight into the exact quality indicators and specific terminology the target population uses when evaluating career wear quality during the purchase decision making stage and during product use. The questionnaire was compiled against the theoretical background and the information gained from the focus group. Through the use of t-tests and the Pearson’s correlation coefficient it was found that respondents used similar quality indicators to evaluate career wear quality both during the decision-making stage and during product use. Tangible quality indicators were seen as significantly more important than non-tangible quality indicators to respondents during both stages of quality evaluation. Appropriate and adequate information regarding tangible quality indicators must thus be made available by retailers to professional women at the point of purchase. This may ensure consumer satisfaction during product use and facilitate return sales for the retailer.Dissertation (MConsumer Science)--University of Pretoria, 2011.
Consumer Science
unrestricted
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Aljamal, Mohammed Sulaiman I. "Developing quality indicators to evaluate medicines reconciliation on admission to hospital". Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/developing-quality-indicators-to-evaluate-medicines-reconciliation-on-admission-to-hospital(b0cc6745-224c-48ad-aec1-acad607fed23).html.
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Background, aim and objectives: Evaluating quality of care is essential when redesigning or improving practice. Medicines reconciliation (MR) on hospital admission is now policy in the UK. It is the process of obtaining an up-to-date and accurate medication list and documenting any discrepancies. The overall aim of this work was to develop quality indicators to evaluate MR on admission to hospital; the specific objectives include developing MR quality indicators, achieving consensus on their appropriateness and testing their feasibility by applying them in a hospital setting. Design: The study was designed in three parts, each consisting of three steps. In part I, ideas about potential indicators were obtained from two sources: a literature search and the nominal group technique. These ideas were converted to potential indicators using criteria for good indicators and then reviewed by nine reviewers. Part II was designed to achieve consensus on the appropriateness of the indicators to evaluate MR. It involved pre-piloting, piloting and conducting the main two-round online Delphi study. Several methods were used to approach predefined experts. Part III involved applying in hospital settings those MR indicators that had achieved consensus. It included developing operational definitions and directly observing the MR process as conducted by pharmacy staff in two hospitals. The indicators were further tested by collecting data about the MR process for all patients seen by pharmacy staff on one weekday in the two hospitals. Results: A systematic approach was followed to develop MR indicators. The idea generation step produced over 90 ideas about potential indicators, which were converted to 85 MR indicators. The assessment by the nine practicing hospital pharmacists discarded 29 of them and the remaining 56 MR indicators were carried forward to the Delphi study, during which 41 indicators achieved consensus as appropriate for evaluating MR on admission to hospital. In the feasibility study, 5 MR indicators were found not to be feasible and three not adequately assessed, while 33 indicators were considered feasible to be used in a hospital setting. Conclusions: This work provided a novel list of 33 indicators that achieved consensus and were found to be feasible to evaluate the MR process on admission to hospital. Further research should explore the use of these indicators, among others, to assess and improve the overall quality of care provided to patients on admission and throughout the hospitalization journey.
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Alves, Paula Rute Pereira Matono. "Fish assemblages as biological indicators of ecological quality in portuguese rivers". Doctoral thesis, Universidade de Évora, 2012. http://hdl.handle.net/10174/16172.
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No contexto da aplicação da Directiva-Quadro da Água, a ictiofauna é considerada como um
relevante elemento biológico. Pela primeira vez foi desenvolvido um sistema de classificação
para avaliação do estado ecológico dos ecossistemas aquáticos em Portugal, apesar dos
constrangimentos impostos pela variedade e ubiquidade das pressões humanas e pelas
peculiaridades dos agrupamentos piscícolas. Foram definidos grupos piscícolas para posterior
estabelecimento de uma tipologia nacional de rios, foram seleccionadas métricas responsivas ás
pressões humanas e foi desenvolvido um índice biótico piscícola. Os resultados evidenciam a
necessidade de diferenciar correctamente a resposta da ictiofauna ás perturbações naturais e
antropogénicas, considerando quer a variabilidade espacial, quer temporal dos agrupamentos
piscícolas, típica dos cursos de tipo Mediterrânico. O uso de solo tem fortes consequências na
degradação dos rios e na integridade da ictiofauna, sendo importante que a avaliação dos
impactos considere a interacção entre diferentes pressões. A compreensão da influência relativa
dos factores ambientais e humanos na ocorrência e abundância das espécies não nativas
permitiu evidenciar o potencial papel das mesmas como indicadores biológicos. Esta tese
contribuiu para o desenvolvimento e aperfeiçoamento de ferramentas de avaliação ecológica em
Portugal, permitindo igualmente um aumento do conhecimento sobre a ecologia das
comunidades piscícolas e funcionamento dos ecossistemas em rios de tipo Mediterrânico, com
vista à sua conservação e reabilitação; ABSTRACT:Under the implementation of the Water Framework Directive fish fauna is considered a useful
biological element. For the first time a Portuguese classification system to assess the ecological
status of aquatic ecosystems was established, despite several constrains posed by the variety
and ubiquity of human pressures and by the peculiarities of the fish assemblages. It was possible
to define fish-based geographical groups for the subsequent establishment of a national river
typology, to select metrics responsive to human pressures and to develop a fish biotic index.
Results underline the needs for accurately differentiate between fish responses to natural and
anthropogenic disturbances by accounting for the spatial and temporal variability of fish
assemblages. Land use may lead to strong impacts on stream degradation and fish assemblages
integrity and this evaluation must consider the interaction of different pressures. Understanding
the influence of environmental and human factors in the occurrence and abundance of non-native
species enlightened their role as a reliable tool in the ecological assessment of rivers. This thesis
represents an important contribution to improve the ecological assessment tools in Portugal,
while increasing knowledge on the ecology of fish communities and ecosystem functioning in
Mediterranean climate rivers in view of their urgent conservation.
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Arnold, Long Mary Caroleen. "Building Expert Consensus on Including Indicators of Moisture-Associated Skin Damagein The National Database of Nursing Quality Indicators (NDNQI)". Otterbein University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1461076119.
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Lai, Yuk-lin. "Analysis of incomplete survey data with application to the construction of social indicators of Hong Kong /". Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19929523.
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Vartak, Smruti Chandrakant. "Association between organizational factors and quality of care: an examination of hospital performance indicators". Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/2784.
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The recent reports by Institute of Medicine, `To Err is Human' and `Crossing Quality Chasm', revealed a large prevalence of medical errors and substandard care in US hospitals. Since then there has been a substantial increase in the efforts to measure and improve quality of care. The objective of this study was to compare the quality of care across hospitals using available performance indicators and examine the association between organizational factors and hospital performance. The main focus of this study was on important structural attributes of hospitals, namely - teaching status, location and market competition. The Nationwide Inpatient Sample for years 2003 and 2005, and the State Inpatient Database for years 2004 to 2006 were used for analyses. Two types of hospital performance indicators were examined to compare quality of care - Patient safety indicators developed by Agency for Healthcare Research and Quality, and process of care indicators developed by Centers for Medicare and Medicaid services. Multivariable regression analyses were performed using generalized estimating equations and random effects regression models. Several organizational factors as well as patient characteristics were included in the multivariable models as control variables.
Overall, the results from this study showed an inconsistent relationship between teaching status, location of hospitals or market competition and quality of care in hospitals. In addition, the results demonstrated that isolating potential effects of hospital structure on outcomes requires controlling for the variation in patient characteristics, such as age and comorbidities, which increase patients' risk for incurring patient safety events. The findings from this study provide useful insight into the areas where the patient safety and quality initiatives should be focused. Moreover, the results identified the organizational factors that are relevant to certain types of hospitals and which should be considered before evaluating quality of care and enacting any policies about publicly reporting of performance or payment initiatives that are relevant to these hospitals.
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Begum, Ferdausi. "Proteomic measures of albumen degradation as indicators of egg freshness". Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/25678.
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With prolonged storage especially at elevated temperatures, thick albumen deteriorates as it loses its viscous characteristics and this is regarded as a sign of reduced egg freshness and quality. Currently, HU is a widely used procedure for determining albumen quality. Proteomic analysis of egg albumen changes could provide a comprehensive understanding of egg freshness and used to assess egg quality during storage and processing. A core objective of this research was to identify and quantify proteins that change during albumen degradation with the potential to identify novel biomarkers of egg freshness and quality. The first efforts of identifying the protein changes in albumen used 2D-PAGE. The changes in albumen proteins were obvious after just 7d of storage at room temperature and this fitted with the more pronounced changes observed using conventional measures of egg quality. The N-TAILS approach to identifying protein changes in egg albumen was instigated and a number of antibacterial proteins were identified. Lysozyme C was identified in all samples. Lysozyme C changes associated with albumen degradation provides a potential biomarker of albumen quality and by association egg aging. The second objective of the project was to evaluate egg quality from different production systems. In retrospect, such an evaluation would have little relevance if some of the other factors such as hen age, ambient temperature and acute stress, could not be accounted for. After accounting for these there was no differences in the deterioration of egg quality during storage at commercial cool room conditions for eggs collected from free range or conventional cage production systems.
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Davila, Claudia Jazmin, e Claudia Jazmin Davila. "A Quality Improvement Project Designed to Increase Diabetes Quality Indicators at a Primary Care Community Health Center". Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/621749.
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ABSTRACT Background: Diabetes has become an epidemic in the United States, affecting nearly 30 million people per year (National Center for Chronic Disease Prevention and Health Promotion [NCCDPHP], 2014). Type 2 Diabetes Mellitus (T2DM) disproportionately affects Hispanics. The American Diabetes Association (ADA) has established diabetes care guidelines that focus on improving diabetes care and patient outcomes. Quality improvement (QI) efforts have been developed and proven effective at targeting specific diabetes care indicators. Problem: Wesley Health Center (WHC) has identified deficiencies in select ADA diabetes quality care indicators of ophthalmologist referral, annual foot exam, smoking cessation counseling and pneumococcal vaccines for all patients with T2DM (ADA,2015). Design: A QI project applying the Plan-Do-Study-Act (PDSA) cycle was implemented to improve the select diabetes quality care indicators of ophthalmologist referral, annual foot exam, smoking cessation counseling and pneumococcal vaccines for all patients with T2DM. Setting: WHC, a community health center located in Phoenix, Arizona, services mostly uninsured and underinsured Hispanic patients. Intervention: One PDSA cycle was carried out utilizing the fishbone diagram in an effort to identify root cause of the stated problem. The team of stakeholders identified modifications of the current electronic adult template as a key contributing factor. Workflow process changes that complemented the new modifications to the template were also made. The intervention was carried out for six (6) weeks with weekly stakeholder meetings. Expected Outcome: To improve select ADA diabetes quality care indicators for adult patients with T2DM within six (6) weeks of implementation by at least 10% from baseline. Results: Errors in data querying parameters limited data accuracy and interpretation thus the impact of the intervention was not able to be evaluated. Significance: QI interventions are important to nursing practice because they emphasize the importance of a doctorally prepared Advanced Practice Nurse (APRN) to be able to identify a problem in clinical practice and carry out a QI intervention in an effort to improve patient care and outcomes. A QI intervention provides the DNP prepared APRN an opportunity to synthesize into one project the skills and knowledge learned throughout their DNP program.
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Ariza, Solé Eduard. "A System of Integral Quality Indicators as a Tool for Beach Management". Doctoral thesis, Universitat Politècnica de Catalunya, 2007. http://hdl.handle.net/10803/6399.
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Esta tesis parte de la concepción de la playa como un sistema integral en el que se desarrollan procesos interrelacionados. El análisis de estos procesos y del marco físico y administrativo donde se producen, es el hilo conductor del proyecto. Para realizar el estudio, se han analizado los procesos de las playas de la Selva Marítima, en el Sur de la Costa Brava (al Nordeste del Mediterráneo). La zona constituye un buen ejemplo de un área litoral altamente afectada por el turismo. El análisis del marco legal y administrativo ha revelado algunas carencias importantes. No existe una política específica de playas que contemple la gestión de los aspectos básicos de gestión. La consecuencia de ello es que la información que se dispone sobre las playas españolas es bastante parcial. Actualmente, en el marco de la Gestión Integrada de Zonas Costeras (GIZC), se están desarrollando estrategias (nacional/regional) que incluyen indicadores de procesos que hasta la fecha actual no han sido objeto de programas de monitoreo y que pueden corregir esta tendencia.La revisión de las herramientas de gestión de playas utilizadas o potencialmente utilizadas en la gestión de la zona de estudio (Bandera Azul, Índice del CEDEX, Índice de CANTABRIA, Índices del ACA) ha revelado algunas deficiencias que son importantes para la gestión de estas playas: el uso, la seguridad y el socorrismo, el paisaje, la comunidad natural o algunos servicios, son los más importantes. Además, dichas herramientas no integran el análisis de las funciones que debe asumir una playa de acuerdo con sus características. Por otro lado, desde hace unos años se están utilizando los Sistemas de Gestión Medioambiental (SGMA) para la gestión de playas. Los SGMA son una buena herramienta de gestión de playas porque permiten una gestión proactiva y ordenada, pero necesitan ser complementados con herramientas de monitoreo adecuadas. En este trabajo también se han analizado el enfoque y los problemas que tienen los gestores locales. El conocimiento de la información disponible y las características de la zona de estudio ha llevado a analizar los procesos más importantes en la gestión de playas: la frecuentación y la producción de residuos.
La información obtenida en el desarrollo de este proyecto ha permitido elaborar un índice de calidad de playas para la zona de estudio. Este Índice incorpora los aspectos importantes, ausentes en otras herramientas de gestión. En la asignación de importancias, para la agregación de índices parciales se ha tenido en cuenta la opinión de los usuarios y expertos. El Índice ha sido diseñado para ser incluido en el marco de los SGMA e incluye el análisis de las Funciones. Puede ser usado en distintas fases del SGMA. Las más importantes son el Diagnóstico Medioambiental Inicial, la definición de los Aspectos Medioambientales Significativos, el Control Operacional y la evaluación de la Mejora Continua. Los resultados del Indicador, de los sub-indices y los índices parciales obtenidos para la zona de estudio, indican distintas situaciones. Los valores agregados son altos: para el BQI (0,63-0,85) y para los indicadores de las funciones, RF (0,53-0,73), NF (0,80-0,92) y PF (0,50-1). En el caso de los valores de los indicadores parciales, mientras algunos procesos como la calidad del agua, la calidad ambiental, las instalaciones y los servicios, las actividades, la confortabilidad, la ausencia de contaminación en el agua y en la arena, y la calidad física, se encuentran en buen estado, otros como el uso de la playa, la calidad del entorno, la seguridad y la componente natural, tienen valores bastante bajos. La futura gestión de las playas debe dirigirse al control del uso, de la transformación del entorno de la playa y a la preservación de la comunidad natural de las playas. Además, la dotación de recursos que garanticen la seguridad y asistencia de los usuarios, la protección de las infraestructuras y la limpieza de las playas debe ser también prioritaria.
This thesis stemmed from the idea that the beach is an integrated system where different and interconnected processes occur. The analyses of these processes and of the physical and administrative framework in which they occur, was the thread of the project. In the development of the study, the processes for the beaches of La Selva Marítima, located in the south of the Costa Brava (northwestern Mediterranean) were analysed. This area is a good example of a coastal area highly affected by tourism dynamics.
The analysis of the legal and administrative framework uncovered some important shortcomings. No specific beach policy exists that accounts for the management of all basic aspects. As a consequence, the information available is partial. Strategies (national/regional) are currently being developed in the framework of the Integrated Coastal Zone Management (ICZM) strategy, including indicators of processes that, until now, have been excluded from monitoring programs. This may change the current situation of a lack of information.
A review of beach assessment measurements (Blue Flag and CEDEX, ACA and CANTABRIA Index) used or potentially used for management of the studied area, revealed important deficiencies in the management of beaches, of which the most important were use, safety and rescue services, landscape, the natural community and certain services. Furthermore, these tools do not take analyses of beach functions into account. In recent years, Environmental Management Systems for Beaches (EMSBs) have begun to be used for beach management. EMSBs allow for the application of proactive and clear management practices, although they need to be complemented with adequate monitoring tools.
This research also analysed the work, focus and problems of local managers. Varied management goals are not usual (many processes remain unmanaged) and management is sometimes exclusively service-oriented. Tools that evaluate beach quality do not cover problematic aspects for local managers, such as sediment management, coordination between responsible authorities, or emergency situations.
The information available and the characteristics of the studied area demonstrated the need to analyse two particularly important beach management processes: beach use and waste/litter production.
Information obtained in the development of this project led to the creation of a Beach Quality Index (BQI) for the studied beaches. This index took into account important issues not represented in other management tools. In the process of allocating weights for the purpose of aggregating partial indexes, user and expert opinions were taken into account. The BQI, which also took account of function analysis, was designed to be used with EMSBs, and can be included at different EMSB stages. The most important index factors are initial environmental diagnosis, the definition of environmentally significant aspects, operational control, and the assessment of steady improvement. Results obtained for beaches for the BQI, its subindices and partial indices, indicated arrange of situations. Aggregated values were high for the BQI (0.63-0.85), and also for the subindices (RF (0.53-0.73), NF (0.80-0.92) and PF (0.50-1)). High scores were typically obtained for partial indices such as water quality, environmental quality, services and facilities, activities, comfort, absence of water and sand pollution, and physical quality. Scores for beach use, surrounding quality, safety, and naturality were low. Future management of studied beaches should focus on the weakest aspects, such as controls over use, transformation of beach environs, and preservation of natural beach communities. Other priorities should be the allocation of resources that guarantee user safety, protection of human facilities, and beach cleaning.
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Simfukwe, Paul. "Role of conventional soil classification in the prediction of soil quality indicators". Thesis, Bangor University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.529749.
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Potts, Elizabeth Ann. "Surface-active invertebrates of derelict land as bio-indicators of habitat quality". Thesis, Manchester Metropolitan University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.392836.
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