This study purposes an in situ testing method on quality assessment of soil improvement.Factual drilling data includes the spatial distribution and in situ strength of untreated and treated soil along three different ...This study purposes an in situ testing method on quality assessment of soil improvement.Factual drilling data includes the spatial distribution and in situ strength of untreated and treated soil along three different drillholes measured by on-site drilling monitoring method.These factual drilling data can characterize the degree of soil improvement by penetration injection with permeable polyurethane.Result from on-site drilling monitoring shows that the linear zones represent constant drilling speeds shown in the plot of drill bit advancement vs.net drilling time,which indicates the spatial distributions of soil profile.The soil profile at the study site is composed of four layers,which includes fill,untreated silty clay,treated silty clay,and mucky soil.The results of soil profile are verified by the parallel site loggings.The constant drilling speeds profile the coring-resistant strength of drilled soils.By comparing with the untreated silty clay,the constant drilling speeds of the treated silty clay have been decreased by 13.0-62.8%.Two drilling-speed-based indices of 61.2%and 65.6%are proposed to assess the decreased average drilling speed and the increased in situ strength of treated silty clay.Laboratory tests,i.e.uniaxial compressive strength(UCS)test,have been performed with core sample to investigate and characterize in situ strength by comparing that with drilling speeds.Results show that the average predicted strengths of treated silty clay are 2.4-6.9 times higher than the average measured strength of untreated silty clay.The UCS-based indices of 374.5%and 344.2%verified the quality assessment(QA)results by this new in situ method.This method provides a cost-effective tool for quality assessment of soil improvement by utilizing the digital drilling data.展开更多
On the basis of the data of biological and nonbiological factors collected respectively from 1989 to 1990 and from 1995 to 1996 in the waters nearby the Qinshan Nuclear Power Station, the ecological environment and wa...On the basis of the data of biological and nonbiological factors collected respectively from 1989 to 1990 and from 1995 to 1996 in the waters nearby the Qinshan Nuclear Power Station, the ecological environment and water quality of the waters are analyzed and assessed in the paper. The results show: (a) the surveyed area has the typical ecological characteristics of high tidal range estuary, rich nutrients and low biological productivity, (b) tide, runoff and offshore seawater intrusion are the key factors which result in seasonal and annual changes of various biological and non-biological factors, (c) the risking of seawater eutrophication index is resulted from enormous amount of the discharges of industrial and domestic sewage, (d) because the survey area is located in a high tidal-range estuary, thermal effluent from cooling system does not induce significant temperature changes, ( e) the first stage project of Qinshan nuclear power station has no notable impacts on the ecological environment in展开更多
[Objective] The aim was to explore evaluated precision on quality of soil environment polluted with zinc in agricultural production areas and to provide references for verification of production area.[Method] In Shula...[Objective] The aim was to explore evaluated precision on quality of soil environment polluted with zinc in agricultural production areas and to provide references for verification of production area.[Method] In Shulan City in Jilin Province,soils were sampled and analyzed in a laboratory using single-factor pollution index and GIS based spatial interpolation.The quality of environment polluted with zinc was assessed and related methods were compared according to Environment Quality Standard of Green Food Production Area.[Result] Spatial interpolation of zinc in soils based on GIS proved more precise than traditional methods;cokriging method with co-factors was higher in precision than common cokriging;cokriging method with zinc and organic matter was higher in precision than cokriging with zinc alone.[Conclusion] Quality assessment on environment polluted with zinc based on GIS interpolation is more scientific and reasonable than traditional methods.展开更多
The attribute recognition model (ARM) has been widely used to make comprehensive assessment in many engineering fields, such as environment, ecology, and economy. However, large numbers of experiments indicate that th...The attribute recognition model (ARM) has been widely used to make comprehensive assessment in many engineering fields, such as environment, ecology, and economy. However, large numbers of experiments indicate that the value of weight vector has no relativity to its initial value but depends on the data of Quality Standard and actual samples. In the present study, the ARM is enhanced with the technique of data driving, which means some more groups of data from the Quality Standard are selected with the uniform random method to make the calculation of weight values more rational and more scientific. This improved attribute recognition model (IARM) is applied to a real case of assessment on seawater quality. The given example shows that the IARM has the merits of being simple in principle, easy to operate, and capable of producing objective results, and is therefore of use in evaluation problems in marine environment science.展开更多
In order to study the groundwater environment in the Longkou plain,48 groups of water samples are collected,consisting of 7 groups of surface water samples and 41 groups of groundwater samples.The quality of groundwat...In order to study the groundwater environment in the Longkou plain,48 groups of water samples are collected,consisting of 7 groups of surface water samples and 41 groups of groundwater samples.The quality of groundwater in the Longkou Plain is poor,with class V water quality accounting for more than 90%,and no class I,II water quality,sporadic distribution of Class III and IV water quality.The influencing factors of water quality are mainly inorganic indicators such as nitrate,total hardness,chloride,salinity and sulfate,the detection rate of heavy metals is low.Nitrate is the main pollution index in this area,and the increase of nitrate content is closely related to the construction of underground reservoir.Based on the characteristics of groundwater pollution in the Longkou Plain,the in-situ chemical remediation of groundwater pollution is proposed.展开更多
This paper introduced the objectives, instruments and methods for the evaluation firstly, Then the paper exemplified the criteria to evaluate the learntng management system and online courses. At the end, the author c...This paper introduced the objectives, instruments and methods for the evaluation firstly, Then the paper exemplified the criteria to evaluate the learntng management system and online courses. At the end, the author came the conclusion that the results of evaluation should be implemented continuously to implore the systems services and submitted to the scientific community to check their rigidity and validity.展开更多
Software projects influenced by many human factors generate various risks. In order to develop highly quality software, it is important to respond to these risks reasonably and promptly. In addition, it is not easy fo...Software projects influenced by many human factors generate various risks. In order to develop highly quality software, it is important to respond to these risks reasonably and promptly. In addition, it is not easy for project managers to deal with these risks completely. Therefore, it is essential to manage the process quality by promoting activities of process monitoring and design quality assessment. In this paper, we discuss statistical data analysis for actual project management activities in process monitoring and design quality assessment, and analyze the effects for these software process improvement quantitatively by applying the methods of multivariate analysis. Then, we show how process factors affect the management measures of QCD (Quality, Cost, Delivery) by applying the multiple regression analyses to observed process monitoring data. Further, we quantitatively evaluate the effect by performing design quality assessment based on the principal component analysis and the factor analysis. As a result of analysis, we show that the design quality assessment activities are so effective for software process improvement. Further, based on the result of quantitative project assessment, we discuss the usefulness of process monitoring progress assessment by using a software reliability growth model. This result may enable us to give a useful quantitative measure of product release determination.展开更多
On the bases of the field survey and a large number of testing data, we process the qualitative and quantitative assessment of the mine environment in the mid south of Shandong Province using the following grade Ⅰ fa...On the bases of the field survey and a large number of testing data, we process the qualitative and quantitative assessment of the mine environment in the mid south of Shandong Province using the following grade Ⅰ factors:the surface subsidence in mining area, the three wastes of mine industries, the pollution sources, the surface water pollution, the underground water pollution and the air pollution. By means of emitting factor judgment and water quality indexes, we locate pollution sources, main pollutants, pollution type and pollution grade in the study area. Using the MAPGIS, we draw a zonality map of the mine environment. This paper attempts to offer a concrete example, including valuable assessment method, data and conclusion, for the assessment of mine environment from the integrated assessment of mineral resources and mine environment. This research is oriented towards the sustainable development and the ecological environment optimization.展开更多
Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthc...Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.展开更多
Due to the impact of globalization,more and more universities in China dedicate to improve the quality of undergraduate education.The particular emphasis was given on the universities in Mid-west university of China,w...Due to the impact of globalization,more and more universities in China dedicate to improve the quality of undergraduate education.The particular emphasis was given on the universities in Mid-west university of China,where the economics and transportation facility are relatively less developed comparing to other regions.In contrast of the traditional methodologies of social science,this research was conducted using an engineering design methodology,called Environment-Based Design(EBD).The EBD procedure allows to derive the solutions step-by-step based on a holistic environment analysis and thus an identification of major challenges.展开更多
The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention...The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention has been given to determining a combined weight for improving the traditional comprehensive water quality identification index(ICWQII)by the game theory.Seven water quality parameters were investigated monthly along the main stream of the Yongding New River from May 2018 to April 2019.Organic contaminants and nitrogen pollution were mainly caused by point sources pollution,and the total phosphorus mainly by non-point source pollution.Dramatic spatio-temporal variations of water quality parameters were jointly caused by different pollutant sources and hydrometeorological factors.In terms of this study,an improved comprehensive water quality identification index(ICWQII)based on entropy weight or variation coefficient and traditional CWQII underestimated the water qualities,and an ICWQII based on the superstandard multiple method overvalued the assessments.By contrast,water qualities assessments done with an ICWQII based on the game theory matched perfectly with the practical situation.The ICWQII based on game theory proposed in this study takes into account not only the degree of disorder and variation of water quality data,but also the influence of standard-exceeded pollution indicators,whose results are relatively reasonable.All findings and the ICWQII based on game theory can provide scientific support for decisions related to the water environment management of the Yongding New River and other waters.展开更多
Aiming at the unsafe of water quality which is the core problem in rural drinking water safety, the study col-lected 221 water samples of rural drinking water sources in Ya'an and detected the concentrations of th...Aiming at the unsafe of water quality which is the core problem in rural drinking water safety, the study col-lected 221 water samples of rural drinking water sources in Ya'an and detected the concentrations of the car-cinogen and the non-carcinogen. Based on the analysis of water environment characteristics and the identifi-cation of water environment health risk source of Sichuan Ya’an City, which includes seven counties and a district and is the typical region of the western margin of Sichuan Basin, this study calculated and analyzed the carcinogenic risk (R) and non-carcinogenic risk (hazard index, HI) by applying the health risk model recommended by the US National Research Council of National Academy of Science. Then, taking advan-tage of the geo-statistic spatial analysis function of ArcGIS, this study analyzed the assessment result data (R and HI), selected the proper interpolation approach and educed R and HI spatial distribution maps of the study area. R and HI of the single factor and integrate factors were evaluated and thus obtained the following conclusions: For one thing, the cancerous risk indexes of the vast majority of water sources (about 94%) is the level of 10-7 and it belong to the safety extension. The main carcinogen in the water sources are As, Cr6+ and Pb, their concentrations are in the ranges of 0.004-0.01, 0.005, 0.01mg/l respectively and such water source mainly distributed in Yucheng district and Mingshan county. For another, the non-cancerous hazard indexes of the vast majority of water sources (about 98%) is also less than the limit value 1 and will not harm the local residents. The health risk of non-carcinogen comes mainly from As and fluoride, their concentra-tions are in the ranges of 0.004-0.01 and 0.1-4.2mg/l respectively. The results of the integrate factors health risk assessment showed that the total cancerous risk were still at the level of 10-6, only 12 drinking water source investigation sites (5%) exceeded the drinking water management standard value of EPA (the limit value is 10-6);the total non-cancerous hazard indexes are still in the range of 10-2-10-1, and will not harm the local residents either, only 18 drinking water source investigation sites (8%) exceeded the drinking water management standard value of EPA(the limit value is 1).The densely populated areas such as Yucheng Dis-trict, Tianquan County, Yingjing County and Shimian County are where the four contaminating materials, i.e., As, Cr6+, Pb and fluoride should be monitored with emphasis. Study results disclosed the health risk control indexes of source water quality of the studied area and thus provided the scientific basis for the water quality control of water sources. This study had worked efficiently in practice. Compared with the same kind of methods which had been found, the paper had the outstanding results for the health risk assessment of the rural drinking water safety.展开更多
From a regulatory perspective,drug quality consistency evaluation must concern different processes used for the same drug.In this study,an assessment strategy based on quality by design(QbD)was developed for populatio...From a regulatory perspective,drug quality consistency evaluation must concern different processes used for the same drug.In this study,an assessment strategy based on quality by design(QbD)was developed for population pharmaceutical quality evaluation.A descriptive analysis method based on QbD concept was first established to characterize the process by critical evaluation attributes(CEAs).Then quantitative analysis method based on an improved statistical process control(SPC)method was established to investigate the process indicators(PIs)in the process population,such as mean distribution,batch-to-batch difference and abnormal quality probability.After that rules for risk assessment were established based on the SPC limitations and parameters.Both the SPC parameters of the CEAs and the risk of PIs were visualized according to the interaction test results to obtain a better understanding of the population pharmaceutical quality.Finally,an assessment strategy was built and applied to generic drug consistency assessment,process risk assessment and quality trend tracking.The strategy demonstrated in this study could help reveal quality consistency from the perspective of process control and process risk,and further show the recent development status of domestic pharmaceutical production processes.In addition,a process risk assessment and population quality trend tracking provide databased information for approval.Not only can this information serve as a further basis for decisionmaking by the regulatory authority regarding early warnings,but it can also reduce some avoidable adverse reactions.With continuous addition of data,dynamic population pharmaceutical quality is meaningful for emergencies and decision-making regarding drug regulation.展开更多
Purpose: The purpose of this paper is to discuss how the Six Sigma (SS) methodology can be used to improve the performance of students in English as a second language and enhance the teaching process by utilizing qual...Purpose: The purpose of this paper is to discuss how the Six Sigma (SS) methodology can be used to improve the performance of students in English as a second language and enhance the teaching process by utilizing quality tools in an educational environment. Design/Methodology/Approach: The paper uses the different quality improvement tools within the Define, Measure, Analyze, Improve and Control (DMAIC) phases to improve student performance in an English language class at a private school. Findings: Quality tools, such as cause and effect diagrams and quality function deployment, have been successfully applied within the Six Sigma DMAIC framework in the educational sector to improve the performance of students and enhance the teaching process. Practical Implications: This paper helps school administrations to analyze student performance and implement improvement actions to improve their performance. Originality/Value: The principal objective of this paper is to demonstrate how quality improvement tools can be introduced and successfully applied in an elementary school to improve student performance and communication between the school administration, teachers and parents.展开更多
BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our c...BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our center, CP are now offered outpatient telephonic transitional care (OTTC) by a care coordinator for 30 d after hospital discharge. AIM To determine the effect of OTTC on survival in CP. METHODS In this cohort study from a tertiary center, CP who received OTTC formed the intervention group. They were compared with a control group discharged during the same period. Mortality and RR were compared between the groups. RESULTS After OTTC introduction, 194 CP were discharged. After applying exclusion criteria, 169 CP (51% male, mean age 58 years ± 12 years) were included. OTTC group comprised 76 patients and was compared with 93 controls. Baseline disease and index admission related characteristics were not significantly different between the groups. The intervention group showed significantly higher 6 mo survival compared to controls (84.2% vs 68.8%;P = 0.03), while RR at 1, 3, and 6 mo were comparable. On multivariable analysis, the intervention group showed lower odds for mortality compared to the controls (hazard ratio: 0.4;95% confidence interval: 0.2-0.82;P = 0.012), while higher model for endstage liver disease scores were associated with higher mortality (hazard ratio: 1.05;95% confidence interval: 1.01-1.1;P = 0.024).CONCLUSION CP provided OTTC had higher 6 mo survival compared to controls without a difference in RR. Use of RR to gauge quality of care provided during hospitalization or subsequent transitional care programs should be revisited.展开更多
基金supported by grants from the Research Grant Council of the Hong Kong Special Administrative Region,PR China(Project Nos.HKU 17207518 and R5037-18).
文摘This study purposes an in situ testing method on quality assessment of soil improvement.Factual drilling data includes the spatial distribution and in situ strength of untreated and treated soil along three different drillholes measured by on-site drilling monitoring method.These factual drilling data can characterize the degree of soil improvement by penetration injection with permeable polyurethane.Result from on-site drilling monitoring shows that the linear zones represent constant drilling speeds shown in the plot of drill bit advancement vs.net drilling time,which indicates the spatial distributions of soil profile.The soil profile at the study site is composed of four layers,which includes fill,untreated silty clay,treated silty clay,and mucky soil.The results of soil profile are verified by the parallel site loggings.The constant drilling speeds profile the coring-resistant strength of drilled soils.By comparing with the untreated silty clay,the constant drilling speeds of the treated silty clay have been decreased by 13.0-62.8%.Two drilling-speed-based indices of 61.2%and 65.6%are proposed to assess the decreased average drilling speed and the increased in situ strength of treated silty clay.Laboratory tests,i.e.uniaxial compressive strength(UCS)test,have been performed with core sample to investigate and characterize in situ strength by comparing that with drilling speeds.Results show that the average predicted strengths of treated silty clay are 2.4-6.9 times higher than the average measured strength of untreated silty clay.The UCS-based indices of 374.5%and 344.2%verified the quality assessment(QA)results by this new in situ method.This method provides a cost-effective tool for quality assessment of soil improvement by utilizing the digital drilling data.
文摘On the basis of the data of biological and nonbiological factors collected respectively from 1989 to 1990 and from 1995 to 1996 in the waters nearby the Qinshan Nuclear Power Station, the ecological environment and water quality of the waters are analyzed and assessed in the paper. The results show: (a) the surveyed area has the typical ecological characteristics of high tidal range estuary, rich nutrients and low biological productivity, (b) tide, runoff and offshore seawater intrusion are the key factors which result in seasonal and annual changes of various biological and non-biological factors, (c) the risking of seawater eutrophication index is resulted from enormous amount of the discharges of industrial and domestic sewage, (d) because the survey area is located in a high tidal-range estuary, thermal effluent from cooling system does not induce significant temperature changes, ( e) the first stage project of Qinshan nuclear power station has no notable impacts on the ecological environment in
基金Supported by National 973 Program(2010CB951500)National 863 Program(2006AA-120103)~~
文摘[Objective] The aim was to explore evaluated precision on quality of soil environment polluted with zinc in agricultural production areas and to provide references for verification of production area.[Method] In Shulan City in Jilin Province,soils were sampled and analyzed in a laboratory using single-factor pollution index and GIS based spatial interpolation.The quality of environment polluted with zinc was assessed and related methods were compared according to Environment Quality Standard of Green Food Production Area.[Result] Spatial interpolation of zinc in soils based on GIS proved more precise than traditional methods;cokriging method with co-factors was higher in precision than common cokriging;cokriging method with zinc and organic matter was higher in precision than cokriging with zinc alone.[Conclusion] Quality assessment on environment polluted with zinc based on GIS interpolation is more scientific and reasonable than traditional methods.
基金The authors would like to acknowledge the funding support of the National Natural Science Foundation of China (50579009, 70471090) the National 10 th Five Year Scientific Project of China for Tackling the Key Problems (2004BA608B-02 - 02) and the Excellence Youth Teacher Sustentation Fund Program of the Ministry of Education of China (Department of Education and Personnel [2002] 350).
文摘The attribute recognition model (ARM) has been widely used to make comprehensive assessment in many engineering fields, such as environment, ecology, and economy. However, large numbers of experiments indicate that the value of weight vector has no relativity to its initial value but depends on the data of Quality Standard and actual samples. In the present study, the ARM is enhanced with the technique of data driving, which means some more groups of data from the Quality Standard are selected with the uniform random method to make the calculation of weight values more rational and more scientific. This improved attribute recognition model (IARM) is applied to a real case of assessment on seawater quality. The given example shows that the IARM has the merits of being simple in principle, easy to operate, and capable of producing objective results, and is therefore of use in evaluation problems in marine environment science.
文摘In order to study the groundwater environment in the Longkou plain,48 groups of water samples are collected,consisting of 7 groups of surface water samples and 41 groups of groundwater samples.The quality of groundwater in the Longkou Plain is poor,with class V water quality accounting for more than 90%,and no class I,II water quality,sporadic distribution of Class III and IV water quality.The influencing factors of water quality are mainly inorganic indicators such as nitrate,total hardness,chloride,salinity and sulfate,the detection rate of heavy metals is low.Nitrate is the main pollution index in this area,and the increase of nitrate content is closely related to the construction of underground reservoir.Based on the characteristics of groundwater pollution in the Longkou Plain,the in-situ chemical remediation of groundwater pollution is proposed.
文摘This paper introduced the objectives, instruments and methods for the evaluation firstly, Then the paper exemplified the criteria to evaluate the learntng management system and online courses. At the end, the author came the conclusion that the results of evaluation should be implemented continuously to implore the systems services and submitted to the scientific community to check their rigidity and validity.
文摘Software projects influenced by many human factors generate various risks. In order to develop highly quality software, it is important to respond to these risks reasonably and promptly. In addition, it is not easy for project managers to deal with these risks completely. Therefore, it is essential to manage the process quality by promoting activities of process monitoring and design quality assessment. In this paper, we discuss statistical data analysis for actual project management activities in process monitoring and design quality assessment, and analyze the effects for these software process improvement quantitatively by applying the methods of multivariate analysis. Then, we show how process factors affect the management measures of QCD (Quality, Cost, Delivery) by applying the multiple regression analyses to observed process monitoring data. Further, we quantitatively evaluate the effect by performing design quality assessment based on the principal component analysis and the factor analysis. As a result of analysis, we show that the design quality assessment activities are so effective for software process improvement. Further, based on the result of quantitative project assessment, we discuss the usefulness of process monitoring progress assessment by using a software reliability growth model. This result may enable us to give a useful quantitative measure of product release determination.
文摘On the bases of the field survey and a large number of testing data, we process the qualitative and quantitative assessment of the mine environment in the mid south of Shandong Province using the following grade Ⅰ factors:the surface subsidence in mining area, the three wastes of mine industries, the pollution sources, the surface water pollution, the underground water pollution and the air pollution. By means of emitting factor judgment and water quality indexes, we locate pollution sources, main pollutants, pollution type and pollution grade in the study area. Using the MAPGIS, we draw a zonality map of the mine environment. This paper attempts to offer a concrete example, including valuable assessment method, data and conclusion, for the assessment of mine environment from the integrated assessment of mineral resources and mine environment. This research is oriented towards the sustainable development and the ecological environment optimization.
文摘Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.
基金one of outcomes of a research program numbered KYJY201605
文摘Due to the impact of globalization,more and more universities in China dedicate to improve the quality of undergraduate education.The particular emphasis was given on the universities in Mid-west university of China,where the economics and transportation facility are relatively less developed comparing to other regions.In contrast of the traditional methodologies of social science,this research was conducted using an engineering design methodology,called Environment-Based Design(EBD).The EBD procedure allows to derive the solutions step-by-step based on a holistic environment analysis and thus an identification of major challenges.
基金supported by the National Natural Science Foundation of China(No.41807386)Tianjin Financial Budget Project of 2018。
文摘The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention has been given to determining a combined weight for improving the traditional comprehensive water quality identification index(ICWQII)by the game theory.Seven water quality parameters were investigated monthly along the main stream of the Yongding New River from May 2018 to April 2019.Organic contaminants and nitrogen pollution were mainly caused by point sources pollution,and the total phosphorus mainly by non-point source pollution.Dramatic spatio-temporal variations of water quality parameters were jointly caused by different pollutant sources and hydrometeorological factors.In terms of this study,an improved comprehensive water quality identification index(ICWQII)based on entropy weight or variation coefficient and traditional CWQII underestimated the water qualities,and an ICWQII based on the superstandard multiple method overvalued the assessments.By contrast,water qualities assessments done with an ICWQII based on the game theory matched perfectly with the practical situation.The ICWQII based on game theory proposed in this study takes into account not only the degree of disorder and variation of water quality data,but also the influence of standard-exceeded pollution indicators,whose results are relatively reasonable.All findings and the ICWQII based on game theory can provide scientific support for decisions related to the water environment management of the Yongding New River and other waters.
文摘Aiming at the unsafe of water quality which is the core problem in rural drinking water safety, the study col-lected 221 water samples of rural drinking water sources in Ya'an and detected the concentrations of the car-cinogen and the non-carcinogen. Based on the analysis of water environment characteristics and the identifi-cation of water environment health risk source of Sichuan Ya’an City, which includes seven counties and a district and is the typical region of the western margin of Sichuan Basin, this study calculated and analyzed the carcinogenic risk (R) and non-carcinogenic risk (hazard index, HI) by applying the health risk model recommended by the US National Research Council of National Academy of Science. Then, taking advan-tage of the geo-statistic spatial analysis function of ArcGIS, this study analyzed the assessment result data (R and HI), selected the proper interpolation approach and educed R and HI spatial distribution maps of the study area. R and HI of the single factor and integrate factors were evaluated and thus obtained the following conclusions: For one thing, the cancerous risk indexes of the vast majority of water sources (about 94%) is the level of 10-7 and it belong to the safety extension. The main carcinogen in the water sources are As, Cr6+ and Pb, their concentrations are in the ranges of 0.004-0.01, 0.005, 0.01mg/l respectively and such water source mainly distributed in Yucheng district and Mingshan county. For another, the non-cancerous hazard indexes of the vast majority of water sources (about 98%) is also less than the limit value 1 and will not harm the local residents. The health risk of non-carcinogen comes mainly from As and fluoride, their concentra-tions are in the ranges of 0.004-0.01 and 0.1-4.2mg/l respectively. The results of the integrate factors health risk assessment showed that the total cancerous risk were still at the level of 10-6, only 12 drinking water source investigation sites (5%) exceeded the drinking water management standard value of EPA (the limit value is 10-6);the total non-cancerous hazard indexes are still in the range of 10-2-10-1, and will not harm the local residents either, only 18 drinking water source investigation sites (8%) exceeded the drinking water management standard value of EPA(the limit value is 1).The densely populated areas such as Yucheng Dis-trict, Tianquan County, Yingjing County and Shimian County are where the four contaminating materials, i.e., As, Cr6+, Pb and fluoride should be monitored with emphasis. Study results disclosed the health risk control indexes of source water quality of the studied area and thus provided the scientific basis for the water quality control of water sources. This study had worked efficiently in practice. Compared with the same kind of methods which had been found, the paper had the outstanding results for the health risk assessment of the rural drinking water safety.
基金The National Major Scientific and Technological Special Project for‘Significant New Drugs Development’(Grant No.:2017ZX0901001-007)provides support for this study.
文摘From a regulatory perspective,drug quality consistency evaluation must concern different processes used for the same drug.In this study,an assessment strategy based on quality by design(QbD)was developed for population pharmaceutical quality evaluation.A descriptive analysis method based on QbD concept was first established to characterize the process by critical evaluation attributes(CEAs).Then quantitative analysis method based on an improved statistical process control(SPC)method was established to investigate the process indicators(PIs)in the process population,such as mean distribution,batch-to-batch difference and abnormal quality probability.After that rules for risk assessment were established based on the SPC limitations and parameters.Both the SPC parameters of the CEAs and the risk of PIs were visualized according to the interaction test results to obtain a better understanding of the population pharmaceutical quality.Finally,an assessment strategy was built and applied to generic drug consistency assessment,process risk assessment and quality trend tracking.The strategy demonstrated in this study could help reveal quality consistency from the perspective of process control and process risk,and further show the recent development status of domestic pharmaceutical production processes.In addition,a process risk assessment and population quality trend tracking provide databased information for approval.Not only can this information serve as a further basis for decisionmaking by the regulatory authority regarding early warnings,but it can also reduce some avoidable adverse reactions.With continuous addition of data,dynamic population pharmaceutical quality is meaningful for emergencies and decision-making regarding drug regulation.
文摘Purpose: The purpose of this paper is to discuss how the Six Sigma (SS) methodology can be used to improve the performance of students in English as a second language and enhance the teaching process by utilizing quality tools in an educational environment. Design/Methodology/Approach: The paper uses the different quality improvement tools within the Define, Measure, Analyze, Improve and Control (DMAIC) phases to improve student performance in an English language class at a private school. Findings: Quality tools, such as cause and effect diagrams and quality function deployment, have been successfully applied within the Six Sigma DMAIC framework in the educational sector to improve the performance of students and enhance the teaching process. Practical Implications: This paper helps school administrations to analyze student performance and implement improvement actions to improve their performance. Originality/Value: The principal objective of this paper is to demonstrate how quality improvement tools can be introduced and successfully applied in an elementary school to improve student performance and communication between the school administration, teachers and parents.
文摘BACKGROUND Intervention to improve outcomes in cirrhotic patients (CP) after hospital discharge often focus on 30 d readmission rate (RR). However, recent studies suggest dissociation between RR and survival. At our center, CP are now offered outpatient telephonic transitional care (OTTC) by a care coordinator for 30 d after hospital discharge. AIM To determine the effect of OTTC on survival in CP. METHODS In this cohort study from a tertiary center, CP who received OTTC formed the intervention group. They were compared with a control group discharged during the same period. Mortality and RR were compared between the groups. RESULTS After OTTC introduction, 194 CP were discharged. After applying exclusion criteria, 169 CP (51% male, mean age 58 years ± 12 years) were included. OTTC group comprised 76 patients and was compared with 93 controls. Baseline disease and index admission related characteristics were not significantly different between the groups. The intervention group showed significantly higher 6 mo survival compared to controls (84.2% vs 68.8%;P = 0.03), while RR at 1, 3, and 6 mo were comparable. On multivariable analysis, the intervention group showed lower odds for mortality compared to the controls (hazard ratio: 0.4;95% confidence interval: 0.2-0.82;P = 0.012), while higher model for endstage liver disease scores were associated with higher mortality (hazard ratio: 1.05;95% confidence interval: 1.01-1.1;P = 0.024).CONCLUSION CP provided OTTC had higher 6 mo survival compared to controls without a difference in RR. Use of RR to gauge quality of care provided during hospitalization or subsequent transitional care programs should be revisited.