Survey on image quality and dose levels used in Europe for mammography.

Quality assurance programmes are becoming a common practice in the field of mammography. At the present time several recommendations exist and different test objects are used to optimize this radiological procedure. The goal of this study was to check if geographically distant centres using different quality control procedures were comparable when using a common objective way of assessing image quality. The results show that consensus still needs to be found among radiologists to reach a satisfactory level of harmony between patient doses and image quality in Europe.

Estudio comparativo de la calidad de la información ofrecida sobre los servicios en las webs de las bibliotecas virtuales de universidades a distancia

S'exposa el resultat d'un estudi comparatiu sobre la comunicació web dels serveis de les biblioteques virtuals universitàries d'una selecció d'universitats a distància entre les quals hi ha la UNED, la UOC i l'Open University. Aquest estudi es fa observant les diferències qualitatives de diversos aspectes, com ara l'organització, l'accessibilitat, els formats, el redactat, la utilitat i la presentació de la informació sobre els serveis de la biblioteca oferta en la web als usuaris d'aquelles universitats i/o Biblioteques que han realitzat el procés de gestió de qualitat o han confeccionat la carta de serveis i les que no. Entre diverses recomanacions i exemples de bones pràctiques, l'estudi conclou que les universitats i biblioteques que no mostren cap tipus de procés de qualitat en la seva institució podem veure que són les que obliden alguns elements essencials i molts detalls pel que fa a la descripció de la oferta de serveis es refereix. Conclusió i recomanacions extensibles a qualsevol biblioteca universitària que ofereixi informació en línia sobre els seus serveis. A partir de l'elaboració de fitxes que recullen els diversos aspectes a observar de cadascuna de les biblioteques hem ponderat, d'acord amb la diversa bibliografia consultada, cadascun com desaconsellable, recomanable i excel·lent amb el resultat d'un informe que mostra totes les recomanacions per a cadascun dels elements.

Conceiving Comparative Policy Analysis : Implementing Air Quality Improvement Programs

The comparative analysis of air quality control policies provides an interesting field for studies of comparative policy analysis including program formulation and implementation processes. In European countries, the problem is comparable, whereas implementation structures, programs and policy impacts vary to a considerable extent. Analysis testing possibilities and constraints of air control policies under varying conditions are likely to contribute to a further development of a theory of policy analysis. This paper presents the analytical framework applied in a continuing empirical study explaining program formulation and implementation processes with respect to the different actors involved. Concrete emitter behavior can be explained by interaction processes at the very local level, by program elements of national legislation, and by structural constraints under which such programs are produced.

Cercles de qualité médecins-pharmaciens, pour une responsabilité partagée de la liberté de prescription [Physicians-pharmacists quality circles: shared responsibility of the freedom of prescription].

Physicians-pharmacists quality circles (PPQCs) were introduced in 1997-98 by visionary healthcare practitioners of the French-speaking part of Switzerland with the aim to improve the quality of drug prescription. Indeed the challenge is to manage the 7917 brand names of the Swiss drug market (2010), including 19793 different dosages, galenic formulations and packaging. The impact of these PPQCs on the containment of drug costs and on drug prescribing profiles has been demonstrated and has led to their spread throughout Switzerland. PPQCs provide clear educational benefits and have thus been accredited by various continuous education bodies. In this article, participating physicians and pharmacists share their vision and illustrate how they work and influence the safety and efficiency of drug prescription, a routine process complex enough to warrant sharing of its burden in a constructive interdisciplinary collaboration.

Causa de las roturas del recubrimiento en una de las costuras de la prenda cuando se somete a tensiones mínimas

Dictamen

A hybrid method for sag source location in power network

The work presented in this paper belongs to the power quality knowledge area and deals with the voltage sags in power transmission and distribution systems. Propagating throughout the power network, voltage sags can cause plenty of problems for domestic and industrial loads that can financially cost a lot. To impose penalties to responsible party and to improve monitoring and mitigation strategies, sags must be located in the power network. With such a worthwhile objective, this paper comes up with a new method for associating a sag waveform with its origin in transmission and distribution networks. It solves this problem through developing hybrid methods which hire multiway principal component analysis (MPCA) as a dimension reduction tool. MPCA reexpresses sag waveforms in a new subspace just in a few scores. We train some well-known classifiers with these scores and exploit them for classification of future sags. The capabilities of the proposed method for dimension reduction and classification are examined using the real data gathered from three substations in Catalonia, Spain. The obtained classification rates certify the goodness and powerfulness of the developed hybrid methods as brand-new tools for sag classification

Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts.

Recent data for the global burden of disease reflect major demographic and lifestyle changes, leading to a rise in non-communicable diseases. Most countries with high levels of tuberculosis face a large comorbidity burden from both non-communicable and communicable diseases. Traditional disease-specific approaches typically fail to recognise common features and potential synergies in integration of care, management, and control of non-communicable and communicable diseases. In resource-limited countries, the need to tackle a broader range of overlapping comorbid diseases is growing. Tuberculosis and HIV/AIDS persist as global emergencies. The lethal interaction between tuberculosis and HIV coinfection in adults, children, and pregnant women in sub-Saharan Africa exemplifies the need for well integrated approaches to disease management and control. Furthermore, links between diabetes mellitus, smoking, alcoholism, chronic lung diseases, cancer, immunosuppressive treatment, malnutrition, and tuberculosis are well recognised. Here, we focus on interactions, synergies, and challenges of integration of tuberculosis care with management strategies for non-communicable and communicable diseases without eroding the functionality of existing national programmes for tuberculosis. The need for sustained and increased funding for these initiatives is greater than ever and requires increased political and funder commitment.

Sisäilma- ja kosteusteknisten asantuntijapalvelujen käyttö rakennuttamisprosessissa

Tämä insinöörityö tehtiin HKR-Rakennuttajan Taloteknisen toimiston Kiinteistöjen elinkaaripalvelut- yksikölle. Työ on osa HKR-Rakennuttajan laatujärjestelmän uudistusta ja selkeytystä. Tavoitteena oli selvittää millaisiin asioihin tulisi kiinnittää huomiota kosteusteknisessä mielessä HKR-Rakennuttajan hankkeissa. Samoin Kiinteistöjen elinkaaripalvelut -yksikön asiantuntijapalveluiden käyttö rakennuttamisprosessissa ei ollut selvästi dokumentoituna HKR-Rakennuttajan laatujärjestelmään, joten tähän pyrittiin saamaan selkeytys. Lisäksi käynnissä on kuntotutkimustoiminnan uudistus, jossa kosteusteknisten asiantuntijapalvelujen konsulttitoiminnan käytössä tapahtuu muutoksia. Omalta osaltaan tämä insinöörityö pyrki selvittämään konsultin toimia hankkeen eri vaiheissa. Insinöörityössä kartoitettiin yksikön omat toimintakuvaukset kosteus- ja sisäilmateknisissä asioissa. Tämän jälkeen käydään läpi kaksi eri HKR-Rakennuttajan kohdetta, jossa oli kosteusteknisesti ongelmia. Kohteet valittiin ohjaajien toimesta, sillä näin saatiin esille työn kannalta oleellisia puutteita. Lisäksi kartoitettiin HKR-Rakennuttajan hankkeiden eri vaiheissa eri osapuolien tehtävät kosteus- ja sisäilmatekniseltä kannalta. Kartoitusten ja toimintakuvausten perusteella tehtiin ohje, joka liitettiin HKR-Rakennuttajan laatujärjestelmään. Lisäksi tehtiin urakkarajaliitteeseen velvoite, jossa määritellään kosteudenhallintasuunnitelman sisältö. Tietolähteinä tässä insinöörityössä oli alan kirjallisuus, HKR-Rakennuttajan Taloteknisen toimiston henkilökunnalta saatu suullinen informaatio ja internet.

Epidemiology of pulmonary hypertension: new data from the Swiss registry.

since 1999 data from pulmonary hypertension (PH) patients from all PH centres in Switzerland were prospectively collected. We analyse the epidemiological aspects of these data. PH was defined as a mean pulmonary artery pressure of >25 mm Hg at rest or >30 mm Hg during exercise. Patients with pulmonary arterial hypertension (PAH), PH associated with lung diseases, PH due to chronic thrombotic and/or embolic disease (CTEPH), or PH due to miscellaneous disorders were registered. Data from adult patients included between January 1999 and December 2004 were analysed. 250 patients were registered (age 58 +/- 16 years, 104 (41%) males). 152 patients (61%) had PAH, 73 (29%) had CTEPH and 18 (7%) had PH associated with lung disease. Patients <50 years (32%) were more likely to have PAH than patients >50 years (76% vs. 53%, p <0.005). Twenty-four patients (10%) were lost to followup, 58 patients (26%) died and 150 (66%) survived without transplantation or thrombendarterectomy. Survivors differed from patients who died in the baseline six-minute walking distance (400 m [300-459] vs. 273 m [174-415]), the functional impairment (NYHA class III/IV 86% vs. 98%), mixed venous saturation (63% [57-68] vs. 56% [50-61]) and right atrial pressure (7 mm Hg [4-11] vs. 11 mm Hg [4-18]). PH is a disease affecting adults of all ages. The management of these patients in specialised centres guarantees a high quality of care. Analysis of the registry data could be an instrument for quality control and might help identify weak points in assessment and treatment of these patients.

Quality assurance mechanisms in agrifood: The case of the Spanish fresh meat sector

The largest fresh meat brand names in Spain are analyzed here to studyhow quality is signaled in agribusiness and how the underlying quality-assurance organizations work. Results show, first, that organizationalform varies according to the specialization of the brand name.Publicly-controlled brand names are grounded on market contracting withindividual producers, providing stronger incentives. In contrast,private brands rely more on hierarchy, taking advantage of itssuperiority in solving specific coordination problems. Second, theseemingly redundant coexistence of several quality indicators for agiven product is explained in efficiency terms. Multiple brands areshown to be complementary, given their specialization in guaranteeingdifferent attributes of the product.

The drive for quality - the impact on accounting in the wine industry

There is a substancial literature on the accounting procedures needed to trackdown the costs of quality control and quality failure. In a drive for improved quality the changes in the process of production or service delivery will also give rise to new accounting needs. In this article we take one example of an industry, wine production, where in most countries there has been a movement towards expanding higher quality production. We report on interviews with wine producers in the US, Australia, Canada, New Zealand and Spain, and identify avariety of ways in which a more sophisticated approach to accounting has become necessary as a result of the drive for quality.