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Adequate Quality (adequate + quality)
Selected AbstractsEnd-to-end network delay model for heavy-tailed environmentsEUROPEAN TRANSACTIONS ON TELECOMMUNICATIONS, Issue 5 2003David Muñoz-Rodríguez Adequate quality of Internet Protocol (IP) services demand low transmission delays. However, packets traveling in a network are subject to a variety of delays that degrade severely the quality of service in real-time applications. This paper presents a general packet jitter-assessment methodology for a multi-node path in the presence of heavy-tailed traffic. Using the extreme-value theory, it is shown that delay performance is governed by a proposed networking-processing factor |T|lambda dependent on the traffic characteristics, the processing time along the path segments and the number of nodes in a route. |T|lambda allows the establishment of design constraints and the definition of a feasibility space for a routing algorithm in order to guarantee a quality of service (QoS). Copyright © 2003 AEI. [source] Guidelines for treatment of neonatal jaundice.ACTA PAEDIATRICA, Issue 3 2001Is there a place for evidence-based medicine? Treatment of neonatal jaundice continues to be a controversial issue. Arguments that traditional practice results in over-treatment have led to the adoption of more liberal guidelines in some countries. The importation of liberal guidelines from one country to the next, however, is fraught with danger, because differences in epidemiology, sociology and healthcare delivery systems between countries may not be adequately reflected. The unreflected extension of liberalization to non-target groups of patients can expose the latter to significant risk. It is not clear that the evidence on which guidelines for treatment of neonatal jaundice are based satisfy the requirements for evidence-based medicine. Evidence of adequate quality may be hard to obtain. Conclusions: Introduction of more liberal guidelines for the treatment of neonatal jaundice, if at all contemplated, must be adapted to local circumstances, and any available evidence pertaining to local epidemiology, sociology and healthcare organization has to be carefully weighed and incorporated. The time is ripe for a joint international effort to secure adequate funding for basic and applied research within the mechanisms of bilirubin encephalopathy in the newborn. [source] Hand-Held Echocardiogram Does Not Aid in Triaging Chest Pain Patients from the Emergency DepartmentECHOCARDIOGRAPHY, Issue 6 2009Mayank Kansal M.D. Background: Accurate triage of emergency department (ED) patients presenting with chest pain is a primary goal of the ED physician. In addition to standard clinical history and examination, a hand-held echocardiogram (HHE) may aid the emergency physician in making correct decisions. We tested the hypothesis that an HHE performed and interpreted by a cardiology fellow could help risk-stratify patients presenting to the ED with chest pain. Methods: ED physicians evaluated 36 patients presenting with cardiovascular symptoms. Patients were then dispositioned to either an intensive care bed, a monitored bed, an unmonitored bed, or home. Following disposition, an HHE was performed and interpreted by a cardiology fellow to evaluate for cardiac function and pathology. The outcomes evaluated (1) a change in the level of care and (2) additional testing ordered as a result of the HHE. Results: The HHE showed wall motion abnormalities in 31% (11 out of 36) of the studies, but the level of care did not change after HHE for any patients who presented with chest pain to the ED. No additional laboratory or imaging tests were ordered for any patients based on the results of the HHE. Eighty-six percent (31 out of 36) of the studies were of adequate quality for interpretation, and 32 out of 36 (89%) interpretations correlated with an attending overread. Conclusion: Despite the high prevalence of abnormal wall motion in this population, hand-held echocardiography performed in this ED setting did not aid in the risk stratification process of chest pain patients. (ECHOCARDIOGRAPHY, Volume 26, July 2009) [source] Risk management of extravasation of cytostatic drugs at the Adult Chemotherapy Outpatient Clinic of a university hospitalJOURNAL OF CLINICAL NURSING, Issue 7 2005Nilce Piva Adami PhD Aims and objectives., To verify the incidence of extravasation of cytostatic drugs in patients treated on an outpatient basis at a university hospital in the city of São Paulo, Brazil, during the period from 1998 to 2002, and to assess the quality of care provided by the nursing team using a protocol adopted for the treatment of this adverse event as a parameter. Background., The movement for quality in healthcare services has been a recent event in Brazil, mainly as the result of the Brazilian Program of Hospital Accreditation instituted in 1998. Considering the emphasis on risk management, it is important to mention the monitoring of the occurrence of extravasations of cytostatic drugs in order to improve the quality of nursing care provided to cancer patients. Design and methods., An evaluative study with a descriptive, prospective and longitudinal design was conducted, based on the documentary analysis of the notification of 216 extravasations of vesicant and irritant drugs that occurred between 1998 and 2002 and the corresponding prescriptions of cold or hot compresses. Results., The mean incidence of extravasations ranged from 0·2 to 1·4% over the five years of the study. Incorrect prescription of the type of compress was observed for three patients. Undesired effects were ulcers caused by the extravasation of vinblastine and dacarbazine in two cases. Conclusions., The low incidence of both extravasation and tissue damage demonstrates the adequate quality of nursing care provided to cancer patients at the outpatient clinic studied. However, the identification of the lack of 12 records of thermal treatment and of three erroneous prescriptions requires the implementation of educational measures to prevent these types of incident. Relevance to clinical practice., The relevance of this study to clinical practice is to increase the awareness and involvement of the nursing team in the maintenance of a continuous surveillance system of the process and results of chemotherapy administration in order to increase the quality of care and the safety of the patient. [source] Optimization of RT,PCR for the Detection of Bean leaf roll virus in Plant Hosts and Insect VectorsJOURNAL OF PHYTOPATHOLOGY, Issue 2 2005V. Ortiz Abstract The detection of luteoviruses by reverse transcription polymerase chain reaction (RT,PCR) depends on the adequate quality and quantity of extracted viral nucleic acids. We have optimized the detection of Bean leaf roll virus (BLRV) using selective precipitation by LiCl of viral RNA from a small quantity of infected plant tissues and insect vectors. The optimal template for PCR was 15 ,l of RT reaction mixture. BLRV was detected in different plant hosts and aphid vectors and Aphis fabae, previously considered to be a non-vector of BLRV, was found to acquire the virus from infected plants. [source] Non-empirical calculations of NMR indirect carbon,carbon coupling constants.MAGNETIC RESONANCE IN CHEMISTRY, Issue 8 2004Monocycloalkanes, Part Abstract Carbon,carbon and carbon,hydrogen spin,spin coupling constants were calculated in the series of the first six monocycloalkanes using SOPPA and SOPPA(CCSD) methods, and very good agreement with the available experimental data was achieved, with the latter method showing slightly better results in most cases, at least in those involving calculations of J(C,C). Benchmark calculations of all possible 21 coupling constants J(C,C), J(C,H) and J(H,H) in chair cyclohexane revealed the importance of using the appropriate level of theory and adequate quality of the basis sets. Many unknown couplings in this series were predicted with high confidence and several interesting structural trends (hybridization effects, multipath coupling transmission mechanisms, hyperconjugative interactions) were elucidated and are discussed based on the present calculations of spin,spin couplings. Copyright © 2004 John Wiley & Sons, Ltd. [source] Universal access to water and sanitation: Why the private sector must participateNATURAL RESOURCES FORUM, Issue 4 2003Terence Lee Abstract Against the background of the current state of provision of drinking water and sanitation in the world , with one billion lacking safe water, and 2.2 billion not having adequate sanitation , this article argues that private participation is necessary. The most important issues for the management of water utilities in the 21st century are identified as mobilizing investment for the highly capital intensive operation of water supply and sanitation infrastructure, and achieving efficiency in the delivery of services. The article highlights the issues that need to be raised if private investment is to be seriously considered as an alternative. Case studies, especially from Latin America (Argentina, Chile, Peru, Bolivia), illustrate different modes of private participation, and possible reasons for successes and failures are discussed. The article stresses that regardless of the modality of private sector involvement, on-going government regulatory responsibility in the water sector is crucial. It suggests that regulatory policy must go beyond just setting tariffs, to develop standards for drinking water quality and waste treatment, as well as other standards. In conclusion, the article recognizes that numerous and increasingly difficult challenges face utilities in fulfilling their responsibility to deliver drinking water of adequate quality, in sufficient quantity, and at affordable prices, as well as safe and sustainable disposal of wastewaters for members of urban and rural communities. [source] An evidence-based review of yoga as a complementary intervention for patients with cancerPSYCHO-ONCOLOGY, Issue 5 2009Kelly B. Smith Abstract Objective: To conduct an evidence-based review of yoga as an intervention for patients with cancer. Specifically, this paper reviewed the impact of yoga on psychological adjustment among cancer patients. Methods: A systematic literature search was conducted between May 2007 and April 2008. Data from each identified study were extracted by two independent raters; studies were included if they assessed psychological functioning and focused on yoga as a main intervention. Using a quality rating scale (range,=,9,45), the raters assessed the methodological quality of the studies, and CONSORT guidelines were used to assess randomized controlled trials (RCTs). Effect sizes were calculated when possible. In addition, each study was narratively reviewed with attention to outcome variables, the type of yoga intervention employed, and methodological strengths and limitations. Results: Ten studies were included, including six RCTs. Across studies, the majority of participants were women, and breast cancer was the most common diagnosis. Methodological quality ranged greatly across studies (range,=,15.5,42), with the average rating (M,=,33.55) indicating adequate quality. Studies also varied in terms of cancer populations and yoga interventions sampled. Conclusions: This study provided a systematic evaluation of the yoga and cancer literature. Although some positive results were noted, variability across studies and methodological drawbacks limit the extent to which yoga can be deemed effective for managing cancer-related symptoms. However, further research in this area is certainly warranted. Future research should examine what components of yoga are most beneficial, and what types of patients receive the greatest benefit from yoga interventions. Copyright © 2008 John Wiley & Sons, Ltd. [source] Quality of Information Flow in the Backend of a Product Development Process: a Case StudyQUALITY AND RELIABILITY ENGINEERING INTERNATIONAL, Issue 4 2004Jaring Boersma Abstract The increasing need for products that are able to reliably deliver complex functionality with a high degree of innovation presents a major challenge to the modern day product creation processes. In order to be able to use information on the field behaviour of previous products in the design of new products, increasingly detailed information needs to be retrieved from the market in an increasingly shorter time. The purpose of this study is to analyse, in a typical case in the consumer electronics industry, whether the underlying business process is able to generate this information with adequate quality sufficiently quickly. Information models of the company's service centre and call centre were developed using the concepts of maturity index on reliability. The results showed that the structure of the information handling process resulted in a massive data loss (up to 60% of the data gathered by the service centres) and also in serious data quality degradation. Would this information have not been lost, it could have been used by development teams for preventive and corrective actions. Copyright © 2004 John Wiley & Sons, Ltd. [source] How precise are measurements of unit-cell dimensions from single crystals?ACTA CRYSTALLOGRAPHICA SECTION B, Issue 4 2000Frank H. Herbstein The results of single-site and many-site measurements of cell dimensions from single crystals are compared for Bond and four-circle diffractometers using samples of corundum (essentially pure rhombohedral ,-Al2O3, aluminum oxide) of high diffraction quality, where the effects of small changes in temperature and composition (Cr2O3, chromium oxide, in solid solution) can be taken into account. Similar comparisons are made for four-circle diffractometer measurements on ruby (,-Al2O3, with 0.46 wt % Cr in solid solution). The precisions are some parts in 105. There is partial support for the Taylor,Kennard [Acta Cryst. (1986), B42, 112,120] dictum that standard uncertainties (s.u.s) of cell parameters from routine four-circle diffractometer measurements are less than those for many-site measurements by factors of 5 for cell lengths and 2.5 for cell angles. For organic crystals, independent repetitions of adequate quality for comparison and analysis of routine four-circle diffractometer measurements are available only for ,-oxalic acid dihydrate and anthracene. The experimental standard uncertainties given for these two crystals agree reasonably well with the sample s.u.s at room temperature, but appreciably less well at ,100,K, again giving partial support to the Taylor,Kennard dictum. The relation between specimen characteristics and attainable precision is emphasized; the precisions for routine measurements on good quality organic crystals are some parts in 104. Area-detector measurements of cell dimensions have also been appraised; currently published s.u.s from such measurements appear to be highly unreliable, and this is supported by a recent analysis of the operation of such diffractometers [Paciorek et al. (1999). Acta Cryst. A55, 543,557]. Formulation of a standard protocol for such measurements is badly needed. The dangers inherent in high degrees of replication are illustrated by recounting Kapteyn's Parable of the Chinese Emperor. Attention is drawn to the fact that there has been little improvement in claimed precisions over the past 40,60 years. [source] Fred Hollows lecture: Digital screening for eye diseaseCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 3 2000Ij Constable ABSTRACT The purpose of this study was to explore progress, in the adaptation to community screening for blinding eye disease, of digital imaging devices and technology for storage and transmission. Available imaging systems were compared to gold standard clinical photography in terms of sensitivity and specificity for diagnosis of common blinding eye conditions. Since the use of expensive non-portable imaging devices is likely to be limited for widespread community screening purposes, a portable fundus camera (Nidek, Chiyoda-ku, Japan) and a prototype monocular digital indirect ophthalmoscope constructed at the Lions Eye Institute (LEI) were selected for comparative trials for the screening of optic disc cupping, glaucoma and clinical signs of diabetic retinopathy. Fifty-one eyes of 27 consecutive patients being assessed at the LEI clinic for glaucoma were dilated and photographed with a Zeiss retinal camera, and digital images were taken with the portable Nidek NM100 fundus camera (Carl Zeiss, Oberkochen, Germany) or with a prototype digital monocular indirect ophthalmoscope. Vertical cup : disc ratios (VCDR) were measured on the disc photographs by one ophthalmologist while three other clinicians were presented with compressed digital images in random order to estimate VCDR. Field trials were also carried out to demonstrate the practicality of compression, local storage and then transmission by mobile telephone ISDN lines and satellite, of optic discs and fundus images of patients with diabetes in either rural Western Australia or Surabaya, Indonesia. Kappa values of correlations of measurement of agreement between measured and estimated VCDR were 0.87, 0.45 and 0.84, respectively, for the three observers, corresponding to a specificity of 79,97% and a sensitivity of 70,95%. The portable Nidek fundus camera was also assessed for specificity and sensitivity in the diagnosis of diabetic retinopathy in comparison to standard Zeiss fundus camera photographs. Of 49 eyes in 25 consecutive patients attending the LEI clinic for assessment of diabetic retinopathy, three ophthalmologists assessed photographs and images in random order. When used for screening diabetic retinopathy, the digital images of the Nidek camera were graded as adequate quality in only 56% of eyes compared to 93% of the photographs. The kappa value of agreement in analysis of diabetic retinopathy was only 0.30. The prototype digital monocular indirect ophthalmoscope compared favourably with the Nidek camera. At 1:5 compression, images of size 36 kB transmitted from Surabaya to Perth took 29 s on the mobile telephone, while uncompressed images took 170 s. Images compressed 1:5 were transmitted in 60 s using the satellite telephone, while the uncompressed images took 240 s. Satellite transmission was more expensive but the lines were more stable than telephone connections from Indonesia. Digital imaging is becoming a powerful tool for ophthalmology in clinical records, teaching and research, and interoffice diagnostic opinions. It also has enormous potential for community screening for blinding eye diseases, such as glaucoma and diabetic retinopathy. Inexpensive portable imaging devices that are easy to use, and on which local health workers might be trained, must be developed and validated in terms of sensitivity and specificity of performance. The technology of image capture, image compression, transmission, data base storage and analysis is rapidly evolving and becoming less expensive. [source] | ||||||||||||||||