Family attitudes toward the deinstitutionalization of individuals with developmental disabilities in Ontario : a quality of life analysis

The deinstitutionalization of individuals with developmental disabilities to community-based residential services is a pervasive international trend. Although controversial, the remaining three institutions in Ontario were closed in March of 2009. Since these closures, there has been limited research on the effects of deinstitutionalization. The following retrospective study evaluated family perceptions of the impact of deinstitutionalization on the quality of life of fifty-five former residents one year post-closure utilizing a survey design and conceptual quality of life framework. The methods used to analyze the survey results included descriptive statistical analyses and thematic analyses. Overall, the results suggest that most family members are satisfied with community placement and supports, and report an improved quality of life for their family member with a developmental disability. These findings were consistent with previously published studies demonstrating the short-term and long-term benefits of community living for most individuals with developmental disabilities and their families.

Transformation of wealth produced into quality of life: analysis of the social efficiency of nation-states with the DEA's triple index approach

Although an essential condition for the occurrence of human development, economic growth is not always efficiently converted into quality of life by nation-states. Accordingly, the objective of this study is to measure the social efficiency-the ability of a nation-state to convert its produced wealth into quality of life-of a set of 101 countries. To achieve this goal, the Data Envelopment Analysis method was used in its standard, cross-multiplicative and inverted form, by means of a new approach called 'triple index'. The main results indicated that the former Soviet republics and Eastern European countries stood out in terms of social efficiency. The developed countries, notwithstanding their high social indicators, did not excel in efficiency; however, the countries of south of Africa, despite having the worst social conditions, were also the most inefficient.

Executive summary of systems analysis to develop future civil aircraft noise reduction alternatives /

Mode of access: Internet.

Systems Analysis: the Structure-and-Purpose Approach Based on Logic-linguistic Formalisation

Systems analysis (SA) is widely used in complex and vague problem solving. Initial stages of SA are analysis of problems and purposes to obtain problems/purposes of smaller complexity and vagueness that are combined into hierarchical structures of problems(SP)/purposes(PS). Managers have to be sure the PS and the purpose realizing system (PRS) that can achieve the PS-purposes are adequate to the problem to be solved. However, usually SP/PS are not substantiated well enough, because their development is based on a collective expertise in which logic of natural language and expert estimation methods are used. That is why scientific foundations of SA are not supposed to have been completely formed. The structure-and-purpose approach to SA based on a logic-and-linguistic simulation of problems/purposes analysis is a step towards formalization of the initial stages of SA to improve adequacy of their results, and also towards increasing quality of SA as a whole. Managers of industrial organizing systems using the approach eliminate logical errors in SP/PS at early stages of planning and so they will be able to find better decisions of complex and vague problems.

Patient-reported quality-of-life analysis of radium-223 dichloride from the phase III ALSYMPCA study

BACKGROUND: Radium-223 dichloride (radium-223), a first-in-class α-emitting radiopharmaceutical, is recommended in both pre- and post-docetaxel settings in patients with castration-resistant prostate cancer (CRPC) and symptomatic bone metastases based on overall survival benefit demonstrated in the phase III ALSYMPCA study. ALSYMPCA included prospective measurements of health-related quality of life (QOL) using two validated instruments: the general EuroQoL 5D (EQ-5D) and the disease-specific Functional Assessment of Cancer Therapy-Prostate (FACT-P).

PATIENTS AND METHODS: Analyses were conducted to determine treatment effects of radium-223 plus standard of care (SOC) versus placebo plus SOC on QOL using FACT-P and EQ-5D. Outcomes assessed were percentage of patients experiencing improvement, percentage of patients experiencing worsening, and mean QOL scores during the study.

RESULTS: Analyses were carried out on the intent-to-treat population of patients randomized to receive radium-223 (n = 614) or placebo (n = 307). The mean baseline EQ-5D utility and FACT-P total scores were similar between treatment groups. A significantly higher percentage of patients receiving radium-223 experienced meaningful improvement in EQ-5D utility score on treatment versus placebo {29.2% versus 18.5%, respectively; P = 0.004; odds ratio (OR) = 1.82 [95% confidence interval (CI) 1.21-2.74]}. Findings were similar for FACT-P total score [24.6% versus 16.1%, respectively; P = 0.020; OR = 1.70 (95% CI 1.08-2.65)]. A lower percentage of patients receiving radium-223 experienced meaningful worsening versus placebo measured by EQ-5D utility score and FACT-P total score. Prior docetaxel use and current bisphosphonate use did not affect these findings. Treatment was a significant predictor of EQ-5D utility score, with radium-223 associated with higher scores versus placebo (0.56 versus 0.50, respectively; P = 0.002). Findings were similar for FACT-P total score (99.08 versus 95.22, respectively; P = 0.004).

CONCLUSIONS: QOL data from ALSYMPCA demonstrated that improved survival with radium-223 is accompanied by significant QOL benefits, including a higher percentage of patients with meaningful QOL improvement and a slower decline in QOL over time in patients with CRPC.

Patterns and quality of object-oriented software systems

Lors de ces dix dernières années, le coût de la maintenance des systèmes orientés objets s'est accru jusqu' à compter pour plus de 70% du coût total des systèmes. Cette situation est due à plusieurs facteurs, parmi lesquels les plus importants sont: l'imprécision des spécifications des utilisateurs, l'environnement d'exécution changeant rapidement et la mauvaise qualité interne des systèmes. Parmi tous ces facteurs, le seul sur lequel nous ayons un réel contrôle est la qualité interne des systèmes. De nombreux modèles de qualité ont été proposés dans la littérature pour contribuer à contrôler la qualité. Cependant, la plupart de ces modèles utilisent des métriques de classes (nombre de méthodes d'une classe par exemple) ou des métriques de relations entre classes (couplage entre deux classes par exemple) pour mesurer les attributs internes des systèmes. Pourtant, la qualité des systèmes par objets ne dépend pas uniquement de la structure de leurs classes et que mesurent les métriques, mais aussi de la façon dont celles-ci sont organisées, c'est-à-dire de leur conception, qui se manifeste généralement à travers les patrons de conception et les anti-patrons. Dans cette thèse nous proposons la méthode DEQUALITE, qui permet de construire systématiquement des modèles de qualité prenant en compte non seulement les attributs internes des systèmes (grâce aux métriques), mais aussi leur conception (grâce aux patrons de conception et anti-patrons). Cette méthode utilise une approche par apprentissage basée sur les réseaux bayésiens et s'appuie sur les résultats d'une série d'expériences portant sur l'évaluation de l'impact des patrons de conception et des anti-patrons sur la qualité des systèmes. Ces expériences réalisées sur 9 grands systèmes libres orientés objet nous permettent de formuler les conclusions suivantes: • Contre l'intuition, les patrons de conception n'améliorent pas toujours la qualité des systèmes; les implantations très couplées de patrons de conception par exemple affectent la structure des classes et ont un impact négatif sur leur propension aux changements et aux fautes. • Les classes participantes dans des anti-atrons sont beaucoup plus susceptibles de changer et d'être impliquées dans des corrections de fautes que les autres classes d'un système. • Un pourcentage non négligeable de classes sont impliquées simultanément dans des patrons de conception et dans des anti-patrons. Les patrons de conception ont un effet positif en ce sens qu'ils atténuent les anti-patrons. Nous appliquons et validons notre méthode sur trois systèmes libres orientés objet afin de démontrer l'apport de la conception des systèmes dans l'évaluation de la qualité.

A comparative, prospective and randomized evaluation of roux-en-y gastric bypass with and without the silastic ring: a 2-year follow up preliminary report on weight loss and quality of life

Currently, Roux-en-Y gastric bypass (RYGB) is one of the most widely used bariatric surgeries. Banding the pouch forms a banded gastric bypass operation, an accepted and frequently used variant. Placing a silastic ring around the pouch to band the gastric bypass operation increases the restriction mechanism. However, the ubiquitous use of the banded gastric bypass remains controversial. One of the controversies is the effect of the silastic ring on patients' perception of their well being after surgery because of the frequency of vomiting. A prospective, blindly randomized, comparative trial was undertaken to resolve this controversy. Four hundred subjects scheduled for gastric bypass surgery were randomized into two arms of the trial, 200 with a silastic ring (WR) and 200 without (NR). After 2-year follow-up, the variables associated with the scores of Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed. The initial median weight (125 kg), BMI (47), and age (36 years) were the same in both the NR and WR groups. The median excess weight loss, weight regain, and incidence of vomiting were 71, 10.5, and 7.75 %, respectively, in the NR group vs. 75.4 and 1.1, and 24.4 % in the WR group. The mean QOL score was 79 % in the NR group vs. 80 % in the WR group. After 2-year follow-up, silastic ring placement in the RYGB resulted in greater weight loss and weight stability and a threefold greater incidence of vomiting. There was no difference in the scores in the quality of life analysis.

Analysis of quality of experience in 3D video systems

Esta tesis presenta un estudio exhaustivo sobre la evaluación de la calidad de experiencia (QoE, del inglés Quality of Experience) percibida por los usuarios de sistemas de vídeo 3D, analizando el impacto de los efectos introducidos por todos los elementos de la cadena de procesamiento de vídeo 3D. Por lo tanto, se presentan varias pruebas de evaluación subjetiva específicamente diseñadas para evaluar los sistemas considerados, teniendo en cuenta todos los factores perceptuales relacionados con la experiencia visual tridimensional, tales como la percepción de profundidad y la molestia visual. Concretamente, se describe un test subjetivo basado en la evaluación de degradaciones típicas que pueden aparecer en el proceso de creación de contenidos de vídeo 3D, por ejemplo debidas a calibraciones incorrectas de las cámaras o a algoritmos de procesamiento de la señal de vídeo (p. ej., conversión de 2D a 3D). Además, se presenta el proceso de generación de una base de datos de vídeos estereoscópicos de alta calidad, disponible gratuitamente para la comunidad investigadora y que ha sido utilizada ampliamente en diferentes trabajos relacionados con vídeo 3D. Asimismo, se presenta otro estudio subjetivo, realizado entre varios laboratorios, con el que se analiza el impacto de degradaciones causadas por la codificación de vídeo, así como diversos formatos de representación de vídeo 3D. Igualmente, se describen tres pruebas subjetivas centradas en el estudio de posibles efectos causados por la transmisión de vídeo 3D a través de redes de televisión sobre IP (IPTV, del inglés Internet Protocol Television) y de sistemas de streaming adaptativo de vídeo. Para estos casos, se ha propuesto una innovadora metodología de evaluación subjetiva de calidad vídeo, denominada Content-Immersive Evaluation of Transmission Impairments (CIETI), diseñada específicamente para evaluar eventos de transmisión simulando condiciones realistas de visualización de vídeo en ámbitos domésticos, con el fin de obtener conclusiones más representativas sobre la experiencia visual de los usuarios finales. Finalmente, se exponen dos experimentos subjetivos comparando varias tecnologías actuales de televisores 3D disponibles en el mercado de consumo y evaluando factores perceptuales de sistemas Super Multiview Video (SMV), previstos a ser la tecnología futura de televisores 3D de consumo, gracias a una prometedora visualización de contenido 3D sin necesidad de gafas específicas. El trabajo presentado en esta tesis ha permitido entender los factores perceptuales y técnicos relacionados con el procesamiento y visualización de contenidos de vídeo 3D, que pueden ser de utilidad en el desarrollo de nuevas tecnologías y técnicas de evaluación de la QoE, tanto metodologías subjetivas como métricas objetivas. ABSTRACT This thesis presents a comprehensive study of the evaluation of the Quality of Experience (QoE) perceived by the users of 3D video systems, analyzing the impact of effects introduced by all the elements of the 3D video processing chain. Therefore, various subjective assessment tests are presented, particularly designed to evaluate the systems under consideration, and taking into account all the perceptual factors related to the 3D visual experience, such as depth perception and visual discomfort. In particular, a subjective test is presented, based on evaluating typical degradations that may appear during the content creation, for instance due to incorrect camera calibration or video processing algorithms (e.g., 2D to 3D conversion). Moreover, the process of generation of a high-quality dataset of 3D stereoscopic videos is described, which is freely available for the research community, and has been already widely used in different works related with 3D video. In addition, another inter-laboratory subjective study is presented analyzing the impact of coding impairments and representation formats of stereoscopic video. Also, three subjective tests are presented studying the effects of transmission events that take place in Internet Protocol Television (IPTV) networks and adaptive streaming scenarios for 3D video. For these cases, a novel subjective evaluation methodology, called Content-Immersive Evaluation of Transmission Impairments (CIETI), was proposed, which was especially designed to evaluate transmission events simulating realistic home-viewing conditions, to obtain more representative conclusions about the visual experience of the end users. Finally, two subjective experiments are exposed comparing various current 3D displays available in the consumer market, and evaluating perceptual factors of Super Multiview Video (SMV) systems, expected to be the future technology for consumer 3D displays thanks to a promising visualization of 3D content without specific glasses. The work presented in this thesis has allowed to understand perceptual and technical factors related to the processing and visualization of 3D video content, which may be useful in the development of new technologies and approaches for QoE evaluation, both subjective methodologies and objective metrics.

Inferential, non-parametric statistics to assess quality of probabilistic forecast systems

Many statistical forecast systems are available to interested users. In order to be useful for decision-making, these systems must be based on evidence of underlying mechanisms. Once causal connections between the mechanism and their statistical manifestation have been firmly established, the forecasts must also provide some quantitative evidence of `quality’. However, the quality of statistical climate forecast systems (forecast quality) is an ill-defined and frequently misunderstood property. Often, providers and users of such forecast systems are unclear about what ‘quality’ entails and how to measure it, leading to confusion and misinformation. Here we present a generic framework to quantify aspects of forecast quality using an inferential approach to calculate nominal significance levels (p-values) that can be obtained either by directly applying non-parametric statistical tests such as Kruskal-Wallis (KW) or Kolmogorov-Smirnov (KS) or by using Monte-Carlo methods (in the case of forecast skill scores). Once converted to p-values, these forecast quality measures provide a means to objectively evaluate and compare temporal and spatial patterns of forecast quality across datasets and forecast systems. Our analysis demonstrates the importance of providing p-values rather than adopting some arbitrarily chosen significance levels such as p < 0.05 or p < 0.01, which is still common practice. This is illustrated by applying non-parametric tests (such as KW and KS) and skill scoring methods (LEPS and RPSS) to the 5-phase Southern Oscillation Index classification system using historical rainfall data from Australia, The Republic of South Africa and India. The selection of quality measures is solely based on their common use and does not constitute endorsement. We found that non-parametric statistical tests can be adequate proxies for skill measures such as LEPS or RPSS. The framework can be implemented anywhere, regardless of dataset, forecast system or quality measure. Eventually such inferential evidence should be complimented by descriptive statistical methods in order to fully assist in operational risk management.

Approval of systems of Biological Indication of Water Quality under the auspices of the Severn-Trent Water Authority, UK

In accordance with the plan for joint Anglo-Soviet scientific and technical collaboration on environmental problems, the comparative evaluation of systems of hydrobiological analysis of the surface water quality started in 1977 at the Regional Laboratory of the Severn-Trent Water Authority in Nottingham were continued in the spring of 1978. The investigations were carried out under the auspices of the Institute of Hydrobiology of the Academy of Sciences of the Ukrainian SSR. Hydrobiological and hydrochemical samples were collected by Soviet and British specialists from the Kiev reservoir and the rivers Dnieper, Sozh, Desna and Snov. The possible approved methods to be adopted were evaluated from the samples using the phytoperiphyton, phytoplankton, zooplankton and zoobenthos against a background of hydrochemical characteristics.

Studies on the Quality of Rainwater at Various Land Use Locations and Variations by Interaction with Domestic Rainwater Harvesting Systems

The present study focused on the quality of rainwater at various land use locations and its variations on interaction with various domestic rainwater harvesting systems.Sampling sites were selected based upon the land use pattern of the locations and were classified as rural, urban, industrial and sub urban. Rainwater samples were collected from the south west monsoon of May 2007 to north east monsoon of October 2008, from four sampling sites namely Kothamangalam, Emakulam, Eloor and Kalamassery, in Ernakulam district of the State of Kerala, which characterized typical rural, urban, industrial and suburban locations respectively. Rain water samples at various stages of harvesting were also collected. The samples were analyzed according to standard procedures and their physico-chemical and microbiological parameters were determined. The variations of the chemical composition of the rainwater collected were studied using statistical methods. It was observed that 17.5%, 30%, 45.8% and 12.1% of rainwater samples collected at rural, urban, industrial and suburban locations respectively had pH less than 5.6, which is considered as the pH of cloud water at equilibrium with atmospheric CO,.Nearly 46% of the rainwater samples were in acidic range in the industrial location while it was only 17% in the rural location. Multivariate statistical analysls was done using Principal Component Analysis, and the sources that inf1uence the composition of rainwater at each locations were identified .which clearly indicated that the quality of rain water is site specific and represents the atmospheric characteristics of the free fall The quality of harvested rainwater showed significant variations at different stages of harvesting due to deposition of dust from the roof catchment surface, leaching of cement constituents etc. Except the micro biological quality, the harvested rainwater satisfied the Indian Standard guide lines for drinking water. Studies conducted on the leaching of cement constituents in water concluded that tanks made with ordinary portland cement and portland pozzolana cement could be safely used for storage of rain water.

Combined quality function deployment and logical framework analysis to improve quality of emergency care in Malta

Purpose – The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A&E) unit of a Maltese hospital. Design/methodology/approach – The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A&E unit of the hospital. Findings – The major and related problems being faced by the hospital under study were overcrowding at A&E and shortage of beds, respectively. The combined framework ensures better A&E services and patient flow. QFD identifies and analyses the issues and challenges of A&E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A&E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A&E unit. Practical/implications – The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value – Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A&E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.

A tudásérték meghatározása minőségügyi szempontból, hálózatelemzési módszerekkel (The knowledge value in terms of quality with network analysis methods)

A minőségügy egyik kulcsfeladata, hogy azonosítsa az értékteremtés szempontjából kritikus tényezőket, meghatározza ezek értékét, valamint intézkedjen negatív hatásuk megelőzése és csökkentése érdekében. Az értékteremtés sok esetben folyamatokon keresztül történik, amelyek tevékenységekből, elvégzendő feladatokból állnak. Ezekhez megfelelő munkatársak kellenek, akiknek az egyik legfontosabb jellemzője az általuk birtokolt tudás. Mindezek alapján a feladat-tudás-erőforrás kapcsolatrendszer ismerete és kezelése minőségügyi feladat is. A komplex rendszerek elemzésével foglalkozó hálózatkutatás eszközt biztosíthat ehhez, ezért indokolt a minőségügyi területen történő alkalmazhatóságának vizsgálata. Az alkalmazási lehetőségek rendszerezése érdekében a szerzők kategorizálták a minőségügyi hálózatokat az élek (kapcsolatok) és a csúcsok (hálózati pontok) típusai alapján. Ezt követően definiálták a multimodális (több különböző csúcstípusból álló) tudáshálózatot, amely a feladatokból, az erőforrásokból, a tudáselemekből és a közöttük lévő kapcsolatokból épül fel. A hálózat segítségével kategóriákba sorolták a tudáselemeket, valamint a fokszámok alapján meghatározták értéküket. A multimodális hálózatból képzett tudáselem-hálózatban megadták az összefüggő csoportok jelentését, majd megfogalmaztak egy összefüggést a tudáselem-elvesztés kockázatának meghatározására. _______ The aims of quality management are to identify those factors that have significant influence on value production, qualify or quantify them, and make preventive and corrective actions in order to reduce their negative effects. The core elements of value production are processes and tasks, along with workforce having the necessary knowledge to work. For that reason the task-resource-knowledge structure is pertinent to quality management. Network science provides methods to analyze complex systems; therefore it seems reasonable to study the use of tools of network analysis in association with quality management issues. First of all the authors categorized quality networks according to the types of nodes (vertices) and links (edges or arcs). Focusing on knowledge management, they defined the multimodal knowledge network, consisting of tasks, resources, knowledge items and their interconnections. Based on their degree, network nodes can be categorized and their value can be quantified. Derived from the multimodal network knowledge-item network is to be created, where the meaning of cohesive subgroups is defined. Eventually they proposed a formula for determining the risk of knowledge loss.