The quality indicators of cotton will change during storage.Taking the 5.89 million t of Xinjiang cotton from 2016 to 2021 as a sample,this paper analyzed the main fiber quality indicator data of warehouse-in and ware...The quality indicators of cotton will change during storage.Taking the 5.89 million t of Xinjiang cotton from 2016 to 2021 as a sample,this paper analyzed the main fiber quality indicator data of warehouse-in and warehouse-out cotton for storage of 1.5,3.0,4.0,5.0,6.0,and 7.0 years.It was found that the color grade of cotton decreased with the extension of storage time.The cotton with storage time of 5.0 years mainly changed from white cotton grade 2 and white cotton grade 3 to light yellow stained cotton grade 1 and yellow stained cotton grade 1.Among them,the increase of light yellow stained cotton grade 1 was the largest,and the change to yellow stained cotton grade 1 was the largest at the storage 6.0-7.0 years.In addition,there were no significant changes in moisture regain,Micronaire value,upper half mean length,length uniformity index and fiber strength.展开更多
Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other st...Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other stakeholders in maternal and child health recommend regular quality measurement. Quality indicators are the key components in the quality measurement process. However, the literature shows neither an indicator selection process nor a set of quality indicators for quality measurement that is universally accepted. The lack of a universally accepted quality indicator selection process and set of quality indicators results in the establishment of a variety of quality indicator selection processes and several sets of quality indicators whenever the need for quality measurement arises. This adds extra processes that render quality measurement process. This study, therefore, aims to establish a set of quality indicators from a broad set of quality indicators recommended by the World Health Organization (WHO). The study deployed a machine learning technique, specifically a random forest classifier to select important indicators for quality measurement. Twenty-nine indicators were identified as important features and among those, eight indicators namely maternal mortality ratio, still-birth rate, delivery at a health facility, deliveries assisted by skilled attendants, proportional breach delivery, normal delivery rate, born before arrival rate and antenatal care visit coverage were identified to be the most important indicators for quality measurement.展开更多
Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivaria...Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivariate soil quality indice (SQI) models, such as additive quality index (AQI), weighted quality indexes (WQI<sub>add</sub> and WQI<sub>com</sub>) and Nemoro quality index (NQI), applied to two approaches of indicator selection: total data set (TDS) and minimum data set (MDS). Physical and chemical soil indicators were extracted from the ORSTOM’s reports resulting from a sampling campaign in different provinces of Gabon. The TDS approach shows soil quality status according to eleven soil indicators extracted from the analysis of 1,059 samples from arable soil layer (0 - 30 cm depth). The results indicated that 87% of all provinces presented a very low soil quality (Q5) whatever the model. Among soil indicators, exchangeable K<sup>+</sup> and Mg<sup>2+</sup>, bulk density and C/N ratio were retained in MDS, using principal component analysis (PCA). In the MDS approach, 50 to 63% of provinces had low soil quality grades with AQI, WQI<sub>add</sub> and NQI, whereas the total was observed with WQI<sub>com</sub>. Only 25% of provinces had medium soil quality grades with AQI and NQI models, while 12.5% (NQI) and 25% (AQI) presented high quality grades. Robust statistical analyses confirmed the accuracy and validation (0.80 r P ≤ 0.016) of AQI, WQI<sub>add</sub> and NQI into the TDS and MDS approaches. The same sensitivity index value (1.53) was obtained with AQI and WQI<sub>add</sub>. However, WQI<sub>add</sub> was chosen as the best SQI model, according to its high linear regression value (R<sup>2</sup> = 0.82) between TDS and MDS. This study has important implications in decision-making on monitoring, evaluation and sustainable management of Gabonese soils in a pedoclimatic context unfavorable to plant growth.展开更多
Alcohol,total sugar,total acid,and total phenol contents are the main indicators of wine quality detection.This study aims to establish simultaneous analysis models for the four indicators through near-infrared(NIR)sp...Alcohol,total sugar,total acid,and total phenol contents are the main indicators of wine quality detection.This study aims to establish simultaneous analysis models for the four indicators through near-infrared(NIR)spectroscopy with wavelength optimization.A Norris derivative filter(NDF)platform with multiparameter optimization was established for spectral pretreatment.The optimal parameters(i.e.,derivative order,number of smoothing points,and number of differential gaps)were(2,9,3)for alcohol,(1,19,5)for total sugar,(1,17,11)for total acid,and(1,1,1)for total phenol.The equidistant combinationpartial least squares(EC-PLS)was used for large-scale wavelength screening.The wavelength step-by-step phaseout PLS(WSP-PLS)and exhaustive methods were used for secondary optimization.The final optimization models for the four indicators included 7,10,15,and 13 wavelengths located in the overtone or combination regions,respectively.In an independent validation,the root mean square errors,correlation coefficient for prediction(i.e.,SEP and RP),and ratio of performance-to-deviation(RPD)were 0.41 v/v,0.947,and 3.2 for alcohol;1.48 g/L,0.992,and 6.8 for total sugar;0.68 g/L,0.981,and5.1 for total acid;and 0.181 g/L,0.948,and 2.9 for total phenol.The results indicate high correlation,low error,and good overall prediction performance.Consequently,the established reagent-free NIR analytical models are important in the rapid and real-time quality detection of the wine fermentation process and finished products.The proposed wavelength models provide a valuable reference for designing small dedicated instruments.展开更多
Endoscopic resection,particularly endoscopic submucosal dissection(ESD),is widely used as a standard treatment modality for early gastric cancer(EGC)when the risk of lymph node metastasis is negligible.Compared with s...Endoscopic resection,particularly endoscopic submucosal dissection(ESD),is widely used as a standard treatment modality for early gastric cancer(EGC)when the risk of lymph node metastasis is negligible.Compared with surgical gastrectomy,ESD is a minimally invasive procedure with additional advantages,such as preservation of the entire stomach and maintenance of the patient’s quality of life.However,not all patients achieve curative resection after ESD of EGC.Several patients require surgical gastrectomy after ESD to achieve a curative treatment.Additional surgery after ESD,owing to non-curative resection,places considerable emotional and financial burdens on patients.Recently,as the number of endoscopists performing ESD has increased,the rate of non-curative resection after ESD has increased correspondingly.In order to decrease the non-curative resection rate,as well as determine the ideal rate of non-curative resection after ESD,it is time to consider quality indicators for the outcomes of ESD for EGC.展开更多
This study analyzes the role of financial development(FD)on the impact of technologi-cal innovation(TI)on six environmental quality indicators for the 25 economies that are part of the Organization for Economic Cooper...This study analyzes the role of financial development(FD)on the impact of technologi-cal innovation(TI)on six environmental quality indicators for the 25 economies that are part of the Organization for Economic Cooperation and Development for the period from 2000 to 2019.We use a two-step dynamic generalized method of moments approach to understand this relationship.The results show that FD augments the posi-tive effects of TI on four of the six environmental indicators,namely ecological foot-print,adjusted net savings,pressure on nature,and environmental performance.However,no significant effects on environmental sustainability and environmental vulnerability indices were found.When considering all of the environmental quality indicators,TI appears to enhance environmental quality.We find evidence to support the existence of the environmental Kuznets curve in the context of each environmen-tal indicator and economic growth.Moreover,FD and energy consumption appear to accelerate environmental degradation.Based on these results,FD should be viewed as an important parameter in designing policies for innovation to achieve the goal of net-zero carbon emissions.Highlights.Technological innovation and environmental quality nexus is studied.The moderating role of financial development is analyzed.Six different environmental quality indicators are used for OECD countries.Financial development intensifies the environmental benefits of innovation.•The EKC hypothesis is confirmed for all six environmental indicators.展开更多
Globally,groundwater has globally emerged as a crucial freshwater source for domestic,irrigation,and industrial needs.The evaluation of groundwater quality in the Toshka region is imperative to ensure its suitability ...Globally,groundwater has globally emerged as a crucial freshwater source for domestic,irrigation,and industrial needs.The evaluation of groundwater quality in the Toshka region is imperative to ensure its suitability for the extensive agricultural and industrial activities underway in this promising,groundwater-dependent development area.This is particularly significant as Egypt increasingly relies on groundwater reserves to address freshwater deficits and to implement mega-development projects in barren lands.In this study,fifty-two samples were collected from the recently drilled wells tapping into the Nubian Sandstone Aquifer(NSA)in the Toshka region.Groundwater quality was assessed through hydrochemical analysis,Piper diagram,and various indicators such as Na%,SAR,RSC,KR,MH and PI.The hydrochemical analysis revealed improved groundwater quality characteristics,attributed to continuous recharge from Lake Nasser.The Piper diagram categorised most of the water samples as"secondary salinity"water type.Almost all wells proved suitable for irrigation with only two wells unsuitable based on MH values and six wells based on KR values.Considering Total Hardness(TH)values,all samples were classified as"Soft",indicating their suitability for domestic and industrial purposes.Water Quality Index(WQI)results concluded that all samples met WHO and FAO guidelines for drinking and irrigation,respectively.Spatial distribution maps,constructed using GIS,facilitate the interpretation of the results.Regular monitoring of quality parameters is essential to detect any deviation from permissible limits.展开更多
BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and m...BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and mortality rates of HCC across different geographical regions.With the advent of new widely available treatment modalities,such as direct-acting antivirals,it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis C.Furthermore,gender disparities in HCC mortality related to Hepatitis C are a crucial,yet underexplored aspect that adds to the disease's global impact.While some studies shed light on gender-specific trends,there is a lack of comprehensive data on global and regional mortality rates,particularly those highlighting gender disparities.This gap in knowledge hinders the development of targeted interventions and resource allocation strategies.DISCUSSION The results of our study show an overall decline in the mortality rates of patients with hepatitis C-related HCC over the last two decades.Notably,females exhibited a remarkable decrease in mortality compared to males.Regionally,East Asia and the Pacific displayed a significant decline in mortality,while Europe and Central Asia witnessed an upward trend.Latin America and the Caribbean also experienced an increase in mortality rates.However,no significant difference was observed in the Middle East and North Africa.North America exhibited a notable upward trend.South Asia and Sub-Saharan Africa significantly declined throughout the study period.This raises the hope of identifying areas for implementing more targeted resources.Despite some progress,multiple challenges remain in meeting the WHO 2030 goal of eliminating viral hepatitis[24].展开更多
The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations(CORS) situated in and around Mexico using the data of about ten years(January 2010 to January 2020).To accomplish the ...The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations(CORS) situated in and around Mexico using the data of about ten years(January 2010 to January 2020).To accomplish the assessment,we considered 4 quality indexes for performing the quality check,incluing the multipath effect on L1 and L2 bands,signal-to-noise ratio in both bands,cycle slips,and integrity.Meanwhile,a new reference parameter named regio nal values for Mexico(RVM) was calculated for the stations situated in Mexico.Additionally,an exhaustive analysis of the quality indicators in the worst and best cases was performed.The signal degradation was proved by a long-term time series and cru stal defo rmation analysis in GAMIT/GLOBK platform.The results showed a stro ng correlation between integrity,cycle slips and daily observations time,and the multipath effect is strong in the case of outdated systems.The study indicates that the estimated quality indexes and values could be the basis for establishing new CORS in Mexico,and the errors corrections which cannot be mitigated in the postprocessing stage would greatly help utilize the data for different scientific applications.The results were supported by deformation analysis in part of Baja California Peninsula in Mexico indicating northern and eastern velocity vector of -3.08±0.02 mm/yr,-7.85±0.02 mm/yr and-0.07±0.03 mm/yr,-9.33±0.02 mm/yr respectively at MPR1 and INEG stations.展开更多
Obesity and global warming are two major challengesthat affect communities’health and quality of life.Providing good walking environments,with appropriate pedestrian infrastructure,green areas and access to commercia...Obesity and global warming are two major challengesthat affect communities’health and quality of life.Providing good walking environments,with appropriate pedestrian infrastructure,green areas and access to commercial retail and transport hubs favour liveable,healthy,and sustainable cities.The Lisbon City Hall has implemented an intervention program in the public space as a strategy to improve environmental quality and mitigate the effects of climate change.The program“A square in each neighbourhood”intends not only to reinforce the economic base of Lisbon,namely tourism,restaurants,commerce,and creative activities but also to promote physical activity and improve the quality of living of all citizens.For studying the impact of the public space quality on the walking environment,Campolide,a typical Lisbon neighbourhood,Portugal,which includes one of the requalified squares,was selected.A two-step methodology based on spatial modelling is proposed.In the first step,the public space quality was evaluated based on a set of 13 urban quality attributes.Attributes,intended for the street level,were collected from open data platforms and complemented with a field survey.Then,through spatial analysis,these attributes were used to build the Pedestrian Environment Quality Indicator and the Priority Intervention Indicator.Using these indicators,walking-friendly streets were mapped and the most critical sites that require priority intervention were identified to prepare for the requalification planning process.The street with the highest quality in the study area according to the dimensions evaluated-connectivity,convenience,comfort,cleanliness,and conviviality-has a great offer of trees,bus stops,commercial establishments,commercial diversity,crossings,paper bins/eco points and esplanades.On the opposite side of the rank,the street with the lowest quality has no trees or green areas,transport stops,benches and tables,or commercial activity.The urban quality indicators constitute a helpful tool for city planners and policymakers when planning sustainable living neighbourhoods.展开更多
In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor ...In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer Barricor<sup>TM</sup> tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.展开更多
The paper reports quality analysis and evaluation at 6 - 10/0.4 kV low-voltage distribution grids in Uzbekistan. Power quality frequently does not correspond to the rated value which is largely due to unbalanced phase...The paper reports quality analysis and evaluation at 6 - 10/0.4 kV low-voltage distribution grids in Uzbekistan. Power quality frequently does not correspond to the rated value which is largely due to unbalanced phase loading in grids and which also results in increased power loss. The study of the asymmetrical operating modes of the rural distribution networks of 0.4 kV was conducted in three steps: measurement, calculations and analysis of relevant data;providing practical guidelines and finally, implementing instruments to normalize grid operation. Measuring was conducted using certified instrumentation analyzer “MALIKA” designed by authors. The study and analysis of additional power losses as the function of indicators of asymmetrical features of voltage and current in operating 0.4 kV grids reveals that, quality of electric power at grids under investigation, merely does not meet the requirements of the Interstate Standard.展开更多
This study aimed to evaluate the quality of healthcare services pertaining to the dietary intake and swallowing functions of residents, nutrition management practices, and performance of residents at long-term care fa...This study aimed to evaluate the quality of healthcare services pertaining to the dietary intake and swallowing functions of residents, nutrition management practices, and performance of residents at long-term care facilities. We investigated outcome indicators, such as changes in dietary intake and swallowing function levels of residents, and clarified which structural and process indicators were associated with the outcome indicators. This was a retrospective study, analyzing information on healthcare services from 1067 long-term care facilities during the fiscal year 2012, sampled from among those registered with the Welfare, Health and Medical Care Information Network of the Welfare and Medical Service Agency in Japan. Five outcome indicators were identified. Next, we examined the relationships between the outcome indicators and structural or process indicators using a multivariate linear regression model, adjusting for facility type. The findings showed how the five outcome indicators were used in long-term care facilities over a period of one year and determined the independent predictors of these outcome indicators. The amplification of dietary function 1 was associated with “assessment of oral functions using a feeding and swallowing assessment checklist every three months”, “holding care conferences related to ingestion and swallowing every three months”, and “maintaining a 1:2 ratio for meal-time assistants to residents”. To improve the quality of care, it is necessary to increase the number of staff (e.g., to provide meal assistance to residents) and to understand changes in the residents’ status through accurate assessment and monitoring.展开更多
Flavored vegetable oils have attracted more and more attentions from consumers and researchers due to their high oxidative stability and sensory quality.In the present study,the quality indices,chemical composition an...Flavored vegetable oils have attracted more and more attentions from consumers and researchers due to their high oxidative stability and sensory quality.In the present study,the quality indices,chemical composition and frying performance of galangal flavored sunflower oil prepared by infusion method(GFSO-I),combination pressing method(GFSO-C)and direct addition method(GFSO-A)were investigated.The results displayed that the preparation time,the levels for the acid value(AV),peroxide value(PV),p-anisidine value(AnV),total oxidation value(TOTOX),and the values for total polar compounds(TPC),thiobarbituric acid(TBA),K232 and K268 of GFSO-C were prominently low(P<0.05),compared with that of GFSO-I and GFSO-A,while the fatty acid composition of them were similar.In the frying of Chinese Maye(tradional Chinese food,fried dough stick)at 180°C for 30 h,the values for TPC,TBA,K232 and K268,polymer,viscosity and b*of GFSO-C were obviously low(P<0.05),while the value for L*was obviously high(P<0.05),compared with that of GFSO-I and GFSO-A.In the sensory evaluation,the flavor,taste,crispness and overall acceptance of Chinese Maye fried by GFSO-C were better than that of Chinese Maye fried by GFSO-I and GFSO-A.Consequently,GFSO-C is more suitable for cooking,and the combination pressing method is optimal for industrial production of GFSO.展开更多
Security is the one of the major challenges for routing the data between the source and destination in an Internet of Things(IoT)network.To overcome this challenge,a secure Lightweight On-demand Ad hoc Distancevector...Security is the one of the major challenges for routing the data between the source and destination in an Internet of Things(IoT)network.To overcome this challenge,a secure Lightweight On-demand Ad hoc Distancevector—Next Generation(LOADng)Routing Protocol is proposed in this paper.As the LOADng protocol is the second version of Ad Hoc On-Demand Distance Vector(AODV)protocol,it retains most of the basic functionality and characteristics of AODV.During the route discovery process,the cyclic shift transposition algorithm(CSTA)is used to encrypt the control packets of the LOADng protocol to improve its security.CSTA approach only derives transposition and substitution without product cipher with respect to input data.Besides this,for choosing the best probable path between the source and destination,routing metrics such as link quality Indicator(LQI),hop count(HC)and queue length(QL)are included in the control packets.The data is then securely sent using CSTA using the optimal secure path selected.Experimental Results depict that the proposed secure and optimal LOADng(SO-LOADng)using CSTA encryption obtains better throughput,delivery ratio encryption time and decryption time than the existing state-ofart approaches.展开更多
Irrigation of fish farms with agricultural drainage water may affect cultured fish species. So, the present study utilizes antioxidants supplemented diet to overcome deterioration of drainage water and its negative ef...Irrigation of fish farms with agricultural drainage water may affect cultured fish species. So, the present study utilizes antioxidants supplemented diet to overcome deterioration of drainage water and its negative effect on fish. The studied groups are fish cultured in dechlorinated tap water as control group or drainage water and fed commercial basal diet. While, the other studied groups represented by Oreochromis niloticus fish cultured in drainage water and fed either commercial diet supplemented with vitamin C (5 g/kg diet) or fennel (5 g/kg diet) for 12 weeks. Results of the water physico-chemical parameters of all studied treatments revealed deterioration of the drainage water with a decrease in dissolved oxygen and an increase in pH, total hardness, total alkalinity, salinity, ammonia, nitrite and heavy metals (Cu, Pb and Cd) with significant differences (P ≤ 0.01) in comparison to that of the control dechlorinated tap water group. Data clarified also that Oreochromis niloticus cultured in drainage water showed a decrease in growth rate accompanied by deterioration of fish meat quality. However, fish reared in the same drainage water for the same exposure period and fed vitamin C or fennel supplemented basal diet (5 g/kg diet) recorded values of the studied parameters more or less similar to that of control group fish. Data of the present study, empowered aquaculturist to supplement fish rations with fennel or vitamin C as antioxidants to improve fish growth rate, meat quality as well as protect fish against heavy metals toxicity that could threat Human Being.展开更多
BACKGROUND Esophageo-gastro-duodenoscopy(EGD)is an important procedure used for detection and diagnosis of esophago-gastric lesions.There exists no consensus on the technique of examination.AIM To identify recent adva...BACKGROUND Esophageo-gastro-duodenoscopy(EGD)is an important procedure used for detection and diagnosis of esophago-gastric lesions.There exists no consensus on the technique of examination.AIM To identify recent advances in diagnostic EGDs to improve diagnostic yield.METHODS We queried the PubMed database for relevant articles published between January 2001 and August 2019 as well as hand searched references from recently published endoscopy guidelines.Keywords used included free text and MeSH terms addressing quality indicators and technological innovations in EGDs.Factors affecting diagnostic yield and EGD quality were identified and divided into the follow segments:Pre endoscopy preparation,sedation,examination schema,examination time,routine biopsy,image enhanced endoscopy and future developments.RESULTS We identified 120 relevant abstracts of which we utilized 67 of these studies in our review.Adequate pre-endoscopy preparation with simethicone and pronase increases gastric visibility.Proper sedation,especially with propofol,increases patient satisfaction after procedure and may improve detection of superficial gastrointestinal lesions.There is a movement towards mandatory picture documentation during EGD as well as dedicating sufficient time for examination improves diagnostic yield.The use of image enhanced endoscopy and magnifying endoscopy improves detection of squamous cell carcinoma and gastric neoplasm.The magnifying endoscopy simple diagnostic algorithm is useful for diagnosis of early gastric cancer.CONCLUSION There is a steady momentum in the past decade towards improving diagnostic yield,quality and reporting in EGDs.Other interesting innovations,such as Raman spectroscopy,endocytoscopy and artificial intelligence may have widespread endoscopic applications in the near future.展开更多
Endosonography(EUS) has an estimated long learning curve including the acquisition of both technical and cognitive skills. Trainees in EUS must learn to master intraprocedural steps such as echoendoscope handling and ...Endosonography(EUS) has an estimated long learning curve including the acquisition of both technical and cognitive skills. Trainees in EUS must learn to master intraprocedural steps such as echoendoscope handling and ultrasonographic imaging with the interpretation of normal anatomy and any pathology. In addition, there is a need to understand the periprocedural parts of the EUS-examination such as the indications and contraindications for EUS and potential adverse events that could occur post-EUS. However, the learning process and progress vary widely among endosonographers in training. Consequently, the performance of a certain number of supervised procedures during training does not automatically guarantee adequate competence in EUS. Instead, the assessment of EUScompetence should preferably be performed by the use of an assessment tool developed specifically for the evaluation of endosonographers in training. Such a tool, covering all the different steps of the EUSprocedure, would better depict the individual learning curve and better reflect the true competence of each trainee. This mini-review will address the issue of clinical education in EUS with respect to the evaluation of endosonographers in training. The aim of the article is to provide an informative overview of the topic. The relevant literature of the field will be reviewed and discussed. The current knowledge on how to assess the skills and competence of endosonographers in training is presented in detail.展开更多
The importance-performance analysis method (IPA) is used in market research in order to measure the level of customer satisfaction. The aim of this study was to evaluate and highlight the use of IPA as a management to...The importance-performance analysis method (IPA) is used in market research in order to measure the level of customer satisfaction. The aim of this study was to evaluate and highlight the use of IPA as a management tool to measure quality of dental services. We suggest that this method can be easily implemented in a dental educational setting, as a performance outcome measure that includes patient input. The study was conducted in a dental service through a valid questionnaire, SERVQUAL. This instrument explores levels of service quality perceived by patients. It was conducted in four companies in Brazil in 2011 (derived from different industry segments;two from textiles, one from hospital care and the other from the manufacturing industry) in two States (S?o Paulo and Minas Gerais). These companies were covered by the same dental managed care organization which contracted with independent dentists to provide care. The study was divided into two stages: the first, in which beneficiaries answered the questionnaire prior to receiving dental treatment, and the second when the same beneficiaries answered after completing their dental treatment. Data obtained from SERVQUAL generated graphs that were used to characterize the IPA matrix using several dimensions of care. The Assurance Dimension had the highest average in both expectation and perception. The Reliability dimension showed the value of the most negative GAP among the dimensions, and the best value occurred in the Responsiveness dimension. The IPA tool may be effective in Dental Medicine since it highlights the key points to be improved in the delivery of dental services in a clinical setting.展开更多
基金Supported by 2021 Science and Technology Project of China Grain Reserves Group Limited Company(Sinograin)"Research on Natural Variation Law of Reserve Cotton Quality"(2021-11).
文摘The quality indicators of cotton will change during storage.Taking the 5.89 million t of Xinjiang cotton from 2016 to 2021 as a sample,this paper analyzed the main fiber quality indicator data of warehouse-in and warehouse-out cotton for storage of 1.5,3.0,4.0,5.0,6.0,and 7.0 years.It was found that the color grade of cotton decreased with the extension of storage time.The cotton with storage time of 5.0 years mainly changed from white cotton grade 2 and white cotton grade 3 to light yellow stained cotton grade 1 and yellow stained cotton grade 1.Among them,the increase of light yellow stained cotton grade 1 was the largest,and the change to yellow stained cotton grade 1 was the largest at the storage 6.0-7.0 years.In addition,there were no significant changes in moisture regain,Micronaire value,upper half mean length,length uniformity index and fiber strength.
文摘Quality of Maternal, Neonatal and Child (MNCH) care is an important aspect in ensuring healthy outcomes and survival of mothers and children. To maintain quality in health services provided, organizations and other stakeholders in maternal and child health recommend regular quality measurement. Quality indicators are the key components in the quality measurement process. However, the literature shows neither an indicator selection process nor a set of quality indicators for quality measurement that is universally accepted. The lack of a universally accepted quality indicator selection process and set of quality indicators results in the establishment of a variety of quality indicator selection processes and several sets of quality indicators whenever the need for quality measurement arises. This adds extra processes that render quality measurement process. This study, therefore, aims to establish a set of quality indicators from a broad set of quality indicators recommended by the World Health Organization (WHO). The study deployed a machine learning technique, specifically a random forest classifier to select important indicators for quality measurement. Twenty-nine indicators were identified as important features and among those, eight indicators namely maternal mortality ratio, still-birth rate, delivery at a health facility, deliveries assisted by skilled attendants, proportional breach delivery, normal delivery rate, born before arrival rate and antenatal care visit coverage were identified to be the most important indicators for quality measurement.
文摘Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivariate soil quality indice (SQI) models, such as additive quality index (AQI), weighted quality indexes (WQI<sub>add</sub> and WQI<sub>com</sub>) and Nemoro quality index (NQI), applied to two approaches of indicator selection: total data set (TDS) and minimum data set (MDS). Physical and chemical soil indicators were extracted from the ORSTOM’s reports resulting from a sampling campaign in different provinces of Gabon. The TDS approach shows soil quality status according to eleven soil indicators extracted from the analysis of 1,059 samples from arable soil layer (0 - 30 cm depth). The results indicated that 87% of all provinces presented a very low soil quality (Q5) whatever the model. Among soil indicators, exchangeable K<sup>+</sup> and Mg<sup>2+</sup>, bulk density and C/N ratio were retained in MDS, using principal component analysis (PCA). In the MDS approach, 50 to 63% of provinces had low soil quality grades with AQI, WQI<sub>add</sub> and NQI, whereas the total was observed with WQI<sub>com</sub>. Only 25% of provinces had medium soil quality grades with AQI and NQI models, while 12.5% (NQI) and 25% (AQI) presented high quality grades. Robust statistical analyses confirmed the accuracy and validation (0.80 r P ≤ 0.016) of AQI, WQI<sub>add</sub> and NQI into the TDS and MDS approaches. The same sensitivity index value (1.53) was obtained with AQI and WQI<sub>add</sub>. However, WQI<sub>add</sub> was chosen as the best SQI model, according to its high linear regression value (R<sup>2</sup> = 0.82) between TDS and MDS. This study has important implications in decision-making on monitoring, evaluation and sustainable management of Gabonese soils in a pedoclimatic context unfavorable to plant growth.
基金This work was supported by the National Natural Science Foundation of China(Grant No.61078040)the Science and Technology Project of Guangdong Province of China(No.2014A020212445).
文摘Alcohol,total sugar,total acid,and total phenol contents are the main indicators of wine quality detection.This study aims to establish simultaneous analysis models for the four indicators through near-infrared(NIR)spectroscopy with wavelength optimization.A Norris derivative filter(NDF)platform with multiparameter optimization was established for spectral pretreatment.The optimal parameters(i.e.,derivative order,number of smoothing points,and number of differential gaps)were(2,9,3)for alcohol,(1,19,5)for total sugar,(1,17,11)for total acid,and(1,1,1)for total phenol.The equidistant combinationpartial least squares(EC-PLS)was used for large-scale wavelength screening.The wavelength step-by-step phaseout PLS(WSP-PLS)and exhaustive methods were used for secondary optimization.The final optimization models for the four indicators included 7,10,15,and 13 wavelengths located in the overtone or combination regions,respectively.In an independent validation,the root mean square errors,correlation coefficient for prediction(i.e.,SEP and RP),and ratio of performance-to-deviation(RPD)were 0.41 v/v,0.947,and 3.2 for alcohol;1.48 g/L,0.992,and 6.8 for total sugar;0.68 g/L,0.981,and5.1 for total acid;and 0.181 g/L,0.948,and 2.9 for total phenol.The results indicate high correlation,low error,and good overall prediction performance.Consequently,the established reagent-free NIR analytical models are important in the rapid and real-time quality detection of the wine fermentation process and finished products.The proposed wavelength models provide a valuable reference for designing small dedicated instruments.
文摘Endoscopic resection,particularly endoscopic submucosal dissection(ESD),is widely used as a standard treatment modality for early gastric cancer(EGC)when the risk of lymph node metastasis is negligible.Compared with surgical gastrectomy,ESD is a minimally invasive procedure with additional advantages,such as preservation of the entire stomach and maintenance of the patient’s quality of life.However,not all patients achieve curative resection after ESD of EGC.Several patients require surgical gastrectomy after ESD to achieve a curative treatment.Additional surgery after ESD,owing to non-curative resection,places considerable emotional and financial burdens on patients.Recently,as the number of endoscopists performing ESD has increased,the rate of non-curative resection after ESD has increased correspondingly.In order to decrease the non-curative resection rate,as well as determine the ideal rate of non-curative resection after ESD,it is time to consider quality indicators for the outcomes of ESD for EGC.
基金This research paper did not receive any financial aid from any source.
文摘This study analyzes the role of financial development(FD)on the impact of technologi-cal innovation(TI)on six environmental quality indicators for the 25 economies that are part of the Organization for Economic Cooperation and Development for the period from 2000 to 2019.We use a two-step dynamic generalized method of moments approach to understand this relationship.The results show that FD augments the posi-tive effects of TI on four of the six environmental indicators,namely ecological foot-print,adjusted net savings,pressure on nature,and environmental performance.However,no significant effects on environmental sustainability and environmental vulnerability indices were found.When considering all of the environmental quality indicators,TI appears to enhance environmental quality.We find evidence to support the existence of the environmental Kuznets curve in the context of each environmen-tal indicator and economic growth.Moreover,FD and energy consumption appear to accelerate environmental degradation.Based on these results,FD should be viewed as an important parameter in designing policies for innovation to achieve the goal of net-zero carbon emissions.Highlights.Technological innovation and environmental quality nexus is studied.The moderating role of financial development is analyzed.Six different environmental quality indicators are used for OECD countries.Financial development intensifies the environmental benefits of innovation.•The EKC hypothesis is confirmed for all six environmental indicators.
基金supported by the Ministry of Water Resources and Irrigation 2016(MWRI)which permitted access to the pumping wells,hydrogeological cross section near the study area and administered the sampling procedures。
文摘Globally,groundwater has globally emerged as a crucial freshwater source for domestic,irrigation,and industrial needs.The evaluation of groundwater quality in the Toshka region is imperative to ensure its suitability for the extensive agricultural and industrial activities underway in this promising,groundwater-dependent development area.This is particularly significant as Egypt increasingly relies on groundwater reserves to address freshwater deficits and to implement mega-development projects in barren lands.In this study,fifty-two samples were collected from the recently drilled wells tapping into the Nubian Sandstone Aquifer(NSA)in the Toshka region.Groundwater quality was assessed through hydrochemical analysis,Piper diagram,and various indicators such as Na%,SAR,RSC,KR,MH and PI.The hydrochemical analysis revealed improved groundwater quality characteristics,attributed to continuous recharge from Lake Nasser.The Piper diagram categorised most of the water samples as"secondary salinity"water type.Almost all wells proved suitable for irrigation with only two wells unsuitable based on MH values and six wells based on KR values.Considering Total Hardness(TH)values,all samples were classified as"Soft",indicating their suitability for domestic and industrial purposes.Water Quality Index(WQI)results concluded that all samples met WHO and FAO guidelines for drinking and irrigation,respectively.Spatial distribution maps,constructed using GIS,facilitate the interpretation of the results.Regular monitoring of quality parameters is essential to detect any deviation from permissible limits.
基金The present study did not require institutional review board oversight because Global Burden of Disease Study 2019 database is de-identified and freely accessible.It does not identify hospitals,health care providers,or patients.
文摘BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and mortality rates of HCC across different geographical regions.With the advent of new widely available treatment modalities,such as direct-acting antivirals,it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis C.Furthermore,gender disparities in HCC mortality related to Hepatitis C are a crucial,yet underexplored aspect that adds to the disease's global impact.While some studies shed light on gender-specific trends,there is a lack of comprehensive data on global and regional mortality rates,particularly those highlighting gender disparities.This gap in knowledge hinders the development of targeted interventions and resource allocation strategies.DISCUSSION The results of our study show an overall decline in the mortality rates of patients with hepatitis C-related HCC over the last two decades.Notably,females exhibited a remarkable decrease in mortality compared to males.Regionally,East Asia and the Pacific displayed a significant decline in mortality,while Europe and Central Asia witnessed an upward trend.Latin America and the Caribbean also experienced an increase in mortality rates.However,no significant difference was observed in the Middle East and North Africa.North America exhibited a notable upward trend.South Asia and Sub-Saharan Africa significantly declined throughout the study period.This raises the hope of identifying areas for implementing more targeted resources.Despite some progress,multiple challenges remain in meeting the WHO 2030 goal of eliminating viral hepatitis[24].
基金data provided by the GAGE Facility, operated by UNAVCO, Inc., with support from the National Science Foundation and the National Aeronautics and Space Administration under NSF Cooperative Agreement EAR-1724794。
文摘The present analysis provided the quality assessment of 65 Continuous Operating Reference Stations(CORS) situated in and around Mexico using the data of about ten years(January 2010 to January 2020).To accomplish the assessment,we considered 4 quality indexes for performing the quality check,incluing the multipath effect on L1 and L2 bands,signal-to-noise ratio in both bands,cycle slips,and integrity.Meanwhile,a new reference parameter named regio nal values for Mexico(RVM) was calculated for the stations situated in Mexico.Additionally,an exhaustive analysis of the quality indicators in the worst and best cases was performed.The signal degradation was proved by a long-term time series and cru stal defo rmation analysis in GAMIT/GLOBK platform.The results showed a stro ng correlation between integrity,cycle slips and daily observations time,and the multipath effect is strong in the case of outdated systems.The study indicates that the estimated quality indexes and values could be the basis for establishing new CORS in Mexico,and the errors corrections which cannot be mitigated in the postprocessing stage would greatly help utilize the data for different scientific applications.The results were supported by deformation analysis in part of Baja California Peninsula in Mexico indicating northern and eastern velocity vector of -3.08±0.02 mm/yr,-7.85±0.02 mm/yr and-0.07±0.03 mm/yr,-9.33±0.02 mm/yr respectively at MPR1 and INEG stations.
基金This work was financed by national funds through FCT-Foundation for Science and Technology,I.P.,within the scope of the project“UIDB/04647/2020”of CICS.NOVA-Interdisciplinary Centre of Social Sciences from Universidade NOVA de LisboaThe first author was financed by national funds through the FCT,under the Norma Transitória-DL 57/2016/CP1453/CT0004.
文摘Obesity and global warming are two major challengesthat affect communities’health and quality of life.Providing good walking environments,with appropriate pedestrian infrastructure,green areas and access to commercial retail and transport hubs favour liveable,healthy,and sustainable cities.The Lisbon City Hall has implemented an intervention program in the public space as a strategy to improve environmental quality and mitigate the effects of climate change.The program“A square in each neighbourhood”intends not only to reinforce the economic base of Lisbon,namely tourism,restaurants,commerce,and creative activities but also to promote physical activity and improve the quality of living of all citizens.For studying the impact of the public space quality on the walking environment,Campolide,a typical Lisbon neighbourhood,Portugal,which includes one of the requalified squares,was selected.A two-step methodology based on spatial modelling is proposed.In the first step,the public space quality was evaluated based on a set of 13 urban quality attributes.Attributes,intended for the street level,were collected from open data platforms and complemented with a field survey.Then,through spatial analysis,these attributes were used to build the Pedestrian Environment Quality Indicator and the Priority Intervention Indicator.Using these indicators,walking-friendly streets were mapped and the most critical sites that require priority intervention were identified to prepare for the requalification planning process.The street with the highest quality in the study area according to the dimensions evaluated-connectivity,convenience,comfort,cleanliness,and conviviality-has a great offer of trees,bus stops,commercial establishments,commercial diversity,crossings,paper bins/eco points and esplanades.On the opposite side of the rank,the street with the lowest quality has no trees or green areas,transport stops,benches and tables,or commercial activity.The urban quality indicators constitute a helpful tool for city planners and policymakers when planning sustainable living neighbourhoods.
文摘In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer Barricor<sup>TM</sup> tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.
文摘The paper reports quality analysis and evaluation at 6 - 10/0.4 kV low-voltage distribution grids in Uzbekistan. Power quality frequently does not correspond to the rated value which is largely due to unbalanced phase loading in grids and which also results in increased power loss. The study of the asymmetrical operating modes of the rural distribution networks of 0.4 kV was conducted in three steps: measurement, calculations and analysis of relevant data;providing practical guidelines and finally, implementing instruments to normalize grid operation. Measuring was conducted using certified instrumentation analyzer “MALIKA” designed by authors. The study and analysis of additional power losses as the function of indicators of asymmetrical features of voltage and current in operating 0.4 kV grids reveals that, quality of electric power at grids under investigation, merely does not meet the requirements of the Interstate Standard.
文摘This study aimed to evaluate the quality of healthcare services pertaining to the dietary intake and swallowing functions of residents, nutrition management practices, and performance of residents at long-term care facilities. We investigated outcome indicators, such as changes in dietary intake and swallowing function levels of residents, and clarified which structural and process indicators were associated with the outcome indicators. This was a retrospective study, analyzing information on healthcare services from 1067 long-term care facilities during the fiscal year 2012, sampled from among those registered with the Welfare, Health and Medical Care Information Network of the Welfare and Medical Service Agency in Japan. Five outcome indicators were identified. Next, we examined the relationships between the outcome indicators and structural or process indicators using a multivariate linear regression model, adjusting for facility type. The findings showed how the five outcome indicators were used in long-term care facilities over a period of one year and determined the independent predictors of these outcome indicators. The amplification of dietary function 1 was associated with “assessment of oral functions using a feeding and swallowing assessment checklist every three months”, “holding care conferences related to ingestion and swallowing every three months”, and “maintaining a 1:2 ratio for meal-time assistants to residents”. To improve the quality of care, it is necessary to increase the number of staff (e.g., to provide meal assistance to residents) and to understand changes in the residents’ status through accurate assessment and monitoring.
基金the China Agriculture Research System of MOF and MARA.
文摘Flavored vegetable oils have attracted more and more attentions from consumers and researchers due to their high oxidative stability and sensory quality.In the present study,the quality indices,chemical composition and frying performance of galangal flavored sunflower oil prepared by infusion method(GFSO-I),combination pressing method(GFSO-C)and direct addition method(GFSO-A)were investigated.The results displayed that the preparation time,the levels for the acid value(AV),peroxide value(PV),p-anisidine value(AnV),total oxidation value(TOTOX),and the values for total polar compounds(TPC),thiobarbituric acid(TBA),K232 and K268 of GFSO-C were prominently low(P<0.05),compared with that of GFSO-I and GFSO-A,while the fatty acid composition of them were similar.In the frying of Chinese Maye(tradional Chinese food,fried dough stick)at 180°C for 30 h,the values for TPC,TBA,K232 and K268,polymer,viscosity and b*of GFSO-C were obviously low(P<0.05),while the value for L*was obviously high(P<0.05),compared with that of GFSO-I and GFSO-A.In the sensory evaluation,the flavor,taste,crispness and overall acceptance of Chinese Maye fried by GFSO-C were better than that of Chinese Maye fried by GFSO-I and GFSO-A.Consequently,GFSO-C is more suitable for cooking,and the combination pressing method is optimal for industrial production of GFSO.
文摘Security is the one of the major challenges for routing the data between the source and destination in an Internet of Things(IoT)network.To overcome this challenge,a secure Lightweight On-demand Ad hoc Distancevector—Next Generation(LOADng)Routing Protocol is proposed in this paper.As the LOADng protocol is the second version of Ad Hoc On-Demand Distance Vector(AODV)protocol,it retains most of the basic functionality and characteristics of AODV.During the route discovery process,the cyclic shift transposition algorithm(CSTA)is used to encrypt the control packets of the LOADng protocol to improve its security.CSTA approach only derives transposition and substitution without product cipher with respect to input data.Besides this,for choosing the best probable path between the source and destination,routing metrics such as link quality Indicator(LQI),hop count(HC)and queue length(QL)are included in the control packets.The data is then securely sent using CSTA using the optimal secure path selected.Experimental Results depict that the proposed secure and optimal LOADng(SO-LOADng)using CSTA encryption obtains better throughput,delivery ratio encryption time and decryption time than the existing state-ofart approaches.
文摘Irrigation of fish farms with agricultural drainage water may affect cultured fish species. So, the present study utilizes antioxidants supplemented diet to overcome deterioration of drainage water and its negative effect on fish. The studied groups are fish cultured in dechlorinated tap water as control group or drainage water and fed commercial basal diet. While, the other studied groups represented by Oreochromis niloticus fish cultured in drainage water and fed either commercial diet supplemented with vitamin C (5 g/kg diet) or fennel (5 g/kg diet) for 12 weeks. Results of the water physico-chemical parameters of all studied treatments revealed deterioration of the drainage water with a decrease in dissolved oxygen and an increase in pH, total hardness, total alkalinity, salinity, ammonia, nitrite and heavy metals (Cu, Pb and Cd) with significant differences (P ≤ 0.01) in comparison to that of the control dechlorinated tap water group. Data clarified also that Oreochromis niloticus cultured in drainage water showed a decrease in growth rate accompanied by deterioration of fish meat quality. However, fish reared in the same drainage water for the same exposure period and fed vitamin C or fennel supplemented basal diet (5 g/kg diet) recorded values of the studied parameters more or less similar to that of control group fish. Data of the present study, empowered aquaculturist to supplement fish rations with fennel or vitamin C as antioxidants to improve fish growth rate, meat quality as well as protect fish against heavy metals toxicity that could threat Human Being.
文摘BACKGROUND Esophageo-gastro-duodenoscopy(EGD)is an important procedure used for detection and diagnosis of esophago-gastric lesions.There exists no consensus on the technique of examination.AIM To identify recent advances in diagnostic EGDs to improve diagnostic yield.METHODS We queried the PubMed database for relevant articles published between January 2001 and August 2019 as well as hand searched references from recently published endoscopy guidelines.Keywords used included free text and MeSH terms addressing quality indicators and technological innovations in EGDs.Factors affecting diagnostic yield and EGD quality were identified and divided into the follow segments:Pre endoscopy preparation,sedation,examination schema,examination time,routine biopsy,image enhanced endoscopy and future developments.RESULTS We identified 120 relevant abstracts of which we utilized 67 of these studies in our review.Adequate pre-endoscopy preparation with simethicone and pronase increases gastric visibility.Proper sedation,especially with propofol,increases patient satisfaction after procedure and may improve detection of superficial gastrointestinal lesions.There is a movement towards mandatory picture documentation during EGD as well as dedicating sufficient time for examination improves diagnostic yield.The use of image enhanced endoscopy and magnifying endoscopy improves detection of squamous cell carcinoma and gastric neoplasm.The magnifying endoscopy simple diagnostic algorithm is useful for diagnosis of early gastric cancer.CONCLUSION There is a steady momentum in the past decade towards improving diagnostic yield,quality and reporting in EGDs.Other interesting innovations,such as Raman spectroscopy,endocytoscopy and artificial intelligence may have widespread endoscopic applications in the near future.
基金Supported by The Health and Medical Care Committee of the Regional Executive Board,Region Vastra Gotaland,Nos.VGFOUREG-564381 and VGFOUREG-144591Sahlgrenska University Hospital LUA-ALF,No.73830+1 种基金Magtarmfonden,No.A79211Assar Gabrielsson Foundation,No.FB 17-20
文摘Endosonography(EUS) has an estimated long learning curve including the acquisition of both technical and cognitive skills. Trainees in EUS must learn to master intraprocedural steps such as echoendoscope handling and ultrasonographic imaging with the interpretation of normal anatomy and any pathology. In addition, there is a need to understand the periprocedural parts of the EUS-examination such as the indications and contraindications for EUS and potential adverse events that could occur post-EUS. However, the learning process and progress vary widely among endosonographers in training. Consequently, the performance of a certain number of supervised procedures during training does not automatically guarantee adequate competence in EUS. Instead, the assessment of EUScompetence should preferably be performed by the use of an assessment tool developed specifically for the evaluation of endosonographers in training. Such a tool, covering all the different steps of the EUSprocedure, would better depict the individual learning curve and better reflect the true competence of each trainee. This mini-review will address the issue of clinical education in EUS with respect to the evaluation of endosonographers in training. The aim of the article is to provide an informative overview of the topic. The relevant literature of the field will be reviewed and discussed. The current knowledge on how to assess the skills and competence of endosonographers in training is presented in detail.
文摘The importance-performance analysis method (IPA) is used in market research in order to measure the level of customer satisfaction. The aim of this study was to evaluate and highlight the use of IPA as a management tool to measure quality of dental services. We suggest that this method can be easily implemented in a dental educational setting, as a performance outcome measure that includes patient input. The study was conducted in a dental service through a valid questionnaire, SERVQUAL. This instrument explores levels of service quality perceived by patients. It was conducted in four companies in Brazil in 2011 (derived from different industry segments;two from textiles, one from hospital care and the other from the manufacturing industry) in two States (S?o Paulo and Minas Gerais). These companies were covered by the same dental managed care organization which contracted with independent dentists to provide care. The study was divided into two stages: the first, in which beneficiaries answered the questionnaire prior to receiving dental treatment, and the second when the same beneficiaries answered after completing their dental treatment. Data obtained from SERVQUAL generated graphs that were used to characterize the IPA matrix using several dimensions of care. The Assurance Dimension had the highest average in both expectation and perception. The Reliability dimension showed the value of the most negative GAP among the dimensions, and the best value occurred in the Responsiveness dimension. The IPA tool may be effective in Dental Medicine since it highlights the key points to be improved in the delivery of dental services in a clinical setting.
