Evaluation of the quality of the management of cancer of the corpus uteri-Selection of relevant quality indicators and implementation in Belgium

Objective Describe the methodology and selection of quality indicators (QI) to be implemented in the EFFECT (EFFectiveness of Endometrial Cancer Treatment) project. EFFECT aims to monitor the variability in Quality of Care (QoC) of uterine cancer in Belgium, to compare the effectiveness of different treatment strategies to improve the QoC and to check the internal validity of the QI to validate the impact of process indicators on outcome. Methods A QI list was retrieved from literature, recent guidelines and QI databases. The Belgian Healthcare Knowledge Center methodology was used for the selection process and involved an expert's panel rating the QI on 4 criteria. The resulting scores and further discussion resulted in a final QI list. An online EFFECT module was developed by the Belgian Cancer Registry including the list of variables required for measuring the QI. Three test phases were performed to evaluate the relevance, feasibility and understanding of the variables and to test the compatibility of the dataset. Results 138 QI were considered for further discussion and 82 QI were eligible for rating. Based on the rating scores and consensus among the expert's panel, 41 QI were considered measurable and relevant. Testing of the data collection enabled optimization of the content and the user-friendliness of the dataset and online module. Conclusions This first Belgian initiative for monitoring the QoC of uterine cancer indicates that the previously used QI selection methodology is reproducible for uterine cancer. The QI list could be applied by other research groups for comparison. © 2013 Elsevier Inc.

A refined physical model of the clarinet using a variable air jet height

A time-domain formulation of a lumped model ap-
proximation of a clarinet reed excitation mechanism is presented.
The lumped model is based on an analytical representation of
the ow within the reed channel, incorporating a contraction
coefcient (vena contracta factor) that is dened as the ratio of
the effective ow over the Bernoulli ow. This coefcient has
been considered to be constant in previous studies focusing on
sound synthesis. In this paper it will be treated as a function
of the reed opening, varying between 0 and 1 as predicted by
boundary layer ow theory. Focussing on a specic mouthpiece
geometry, the effect of modelling a variable air jet height on the
synthesised sound is analysed.

Physical origin of the high reactivity of subsurface hydrogen in catalytic hydrogenation

In the catalytic hydrogenation of hydrocarbons, subsurface hydrogen is known experimentally to be much more reactive than surface hydrogen. We use density functional theory to identify low-energy pathways for the hydrogenation of methyl adsorbed on Ni(111) by surface and subsurface hydrogen. The metastability of subsurface hydrogen with respect to chemisorbed hydrogen is mainly responsible for the low activation barrier for subsurface reactions. (C) 1999 American Institute of Physics.

The quality of the mother-child relationship during collaborative problem solving /

The quality of the mother-child relationship was examined in relation to joint planning, maternal teaching strategies, maternal emotional support, mutual positive affect and attachment security. Fifty-five grade five children and their mothers participated in a laboratory session comprised of various activities and completed questionnaires to evaluate attachment security. Joint planning and social problem solving were assessed observationally during an origami task. Problem solving effectiveness was unrelated to maternal teaching strategies, maternal encouragement and mutual positive affect. A marginally significant relationship was found between maternal encouragement and active child participation. Attachment security was found to be significantly related to sharing of responsibility during local planning, but only for child autonomous performance. An examination of conditional probabilities revealed that mutual positive affect did not increase the likelihood of subsequent mother-child dyadic regulation. However, mutual positive affect was found to be significantly related to both active child participation and dyadic regulation. The hypothesis predicting a mediational model was not supported. The implications of these findings in the theoretical and empirical literature were considered and suggestions for future research were made.

The FCLT with Dependent Errors: an Helicopter Tour of the Quality of the Approximation

This note investigates the adequacy of the finite-sample approximation provided by the Functional Central Limit Theorem (FCLT) when the errors are allowed to be dependent. We compare the distribution of the scaled partial sums of some data with the distribution of the Wiener process to which it converges. Our setup is purposely very simple in that it considers data generated from an ARMA(1,1) process. Yet, this is sufficient to bring out interesting conclusions about the particular elements which cause the approximations to be inadequate in even quite large sample sizes.

Studies on the, Physical Aspects of the Mud Banks along the Kerala Coast

A detailed survey of the present knowledge on the physical aspects of the mud banks has been presented in chapter 1.The physical geographical and geological aspects of the kerala coast, the shore-line and the sea bed and the various views on the formation,movements and dissipation of the mud banks have been discussed.The scope of the present work and a description of the area of study have also been given in this chapter. The horizontal and vertical distribution and the seasonal variations of the concentration of suspended matter in the mud bank region are discussed in chapter 3.it is seen that the mud bank reses above the bottom in the form of a ridged ,irregular,solid come with a flat top. Chapter vi deals with waves and currents in the region of the mud bank. The orientation of the breakers on either side of the mud bank suggests the possibility of formation of opposing alongshore currents and convergence of energy caused by wave refraction.The distribution of currents during the formative nature and dissipating stages of the mud bank show that the converging alongshore currents give rise to offshore flows

Physical characteristics of the coastal waters off the south-west coast of india with an attempt to study the possible relationship with sardine mackerel and anchovy fisheries

The present study is aimed at observing the variations, in space and time, of see of the important hydrographic parameters such as sea water temperature, salinity and Resolved oxygen within the coastal waters along the south-west coast of Indiametween Ratnagiri (17°OO*N,73°20'E) and cape comorin ( 8°10'N,77°30*E). Specific data relating to the process of upwelling and sinking was collected mainly to evaluate the extent and intensity of the vertical mixing processes active in the area under study. The study also attempted possible correlations between the observed parameters and the occurrence and migrations of some of the major pelagic fishery resources such as sardine,mackerel and anchovy in the area under study

Studies On The Dynamics And Water Quality Of The Muvattupuzha River In Relation To Effluent Discharge

The present study aims at the investigation of the 1ysico—chemical features of a tropical tidal river viz. we Muvattupuzha river. This river is expected to receive Jderate to heavy pollution loads in years to come, from we lone industrial unit, already set up on its bank. ilike other rivers, the geographical disposition of this Lver attains unique importance as regards its dynamics for 3) availability of natural runoff water from catchment :eas, which becomes very heavy during the monsoon season 3) regular steady availability of tail race water from a /dro—electric power station throughout the yearThe study also aims at arriving at the balancing forces of inherent self~purification of the river verses pollution loads from the factory effluents. The investigation period falls ahead of actual pollution occurrence and so the ambient conditions for a period of nearly one-and-a—half years were investigated, the analyses of which providflz to formulate the inter-relations of parameters varying with seasons. Tracer experiments were carried out which revealed the dispersion and dilution characteristics of the river in the vicinity of effluent outfall. The studv covers the trial—cum-capacity production periods of the factory during which effluents of various strength and quantity were discharged into the river; a few computed values arQ’cjmpgrQdl ... with the observed values. The base data along with the profiles of Oxygen sag equation have been utilized fb develop a mathematical model of the river with regard to its water quality