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Objective:To construct a sensitive index system of nursing quality for patients with acute ischemic stroke patients undergoing interventional thrombectomy, so as to provide a scientific basis for interventional thrombectomy care for acute ischemic stroke.Methods:Taking the "structure-process-result" three-dimensional quality model as the theoretical framework, through evidence-based literature search, the item pool was drawn up, and finally the indicators and their weights at each level were determined by two rounds of Delphi method in December 2021 and January 2022 and analytic hierarchy process.Results:The positive coefficients of the two rounds of inquiries to experts were 0.92 and 1.00, respectively, the authority coefficients were 0.913 and 0.917, and the Kendall coefficients were 0.141 and 0.202, respectively. The final index system consisted of 3 primary indicators, 9 secondary indicators and 50 three-level indicators.Conclusions:The nursing sensitive quality index system for patients with acute stroke patients undergoing interventional thrombectomy constructed in this study has high reliability and scientificity, which can provide target incentives for clinical nurses and provide reference for the development of specialized nursing sensitive quality indicators.
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ObjectiveTo explore the influence of structure and process variables on the satisfaction of government purchasing pension service quality based on framework of Donabedian Three-Dimensional Quality Model, Community-based Rehabilitation Guideline and Rehabilitation in Health System. MethodsFrom June to December, 2019, 952 elderly from Changsha, Zhuzhou and Xiangtan in Hunan were randomly selected. Hierarchical regression was used to analyze the influence of structure and process variables on satisfaction of home care and institutional care service quality. ResultsThe satisfaction degree of rehabilitation service quality for older adults was generally abvoe the average level with the score of (21.19±6.84). And the score was higher in the institutional rehabilitation (23.06±7.67) than in the home rehabilitation (19.31±6.85) (t = 7.93, P = 0.001). Among the structural variables, only staffs training could predict the satisfaction of rehabilitation service (B = 0.088, P < 0.05), and finance was not significant (P > 0.05) after adding process variables. The effect of process variables on satisfaction degree of quality of rehabilitation services was greater than that of structural variables. Information obtaining, autonomy, trust and treat with respect had significant positive effects on rehabilitation service of all the elderly (B = 0.282~0.410, P < 0.05). ConclusionProcess variables are important determinants for satisfaction of rehabilitation service quality. Relevant departments should pay more attention on service process factors such as the interaction between service personnel and the elderly.
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RESUMO Este artigo discute a dispersão no ambiente da matéria orgânica presente no esgoto doméstico a partir de modelos oxigênio dissolvido-demanda bioquímica de oxigênio (OD-DBO). O modelo relaciona a poluição de corpos d'água por matéria orgânica e a queda dos níveis de OD. Dá-se destaque à modelagem de diferentes tipos de lançamentos da carga poluidora, com a apresentação de quatro tipos, e os efeitos sobre a capacidade de autodepuração do corpo d'água, a partir de dois padrões de transporte apresentados pelo corpo receptor; primeiramente para uma vazão menor e posteriormente havendo um incremento de vazão. Discute-se, ainda, como modelos podem intervir com eficiência no lançamento de esgoto após tratamento e como podem contribuir com a saúde pública, o saneamento e na melhoria de conservação dos recursos hídricos.
ABSTRACT The focus of this article is to analyze the presence of organic matter in sewage from BOD-DO models. The model relates to the pollution of a water body by organic matter and the decrease in dissolved oxygen levels caused by the respiration of microorganisms involved in sewage purification. It is highlighted the modeling of different types of pollutant loading release, presenting four types of them, and the effects on the natural water bodies' self-purification, from two patterns of transport provided by the receiving body; first for a smaller flow and then there is a flow increase. This work also discusses how mathematical models can intervene effectively in the discharge of sewage after treatment and if these can contribute to public health, sanitation and improved conservation of water resources.
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Existen diferentes modelos de calidad del software que permiten un proceso de mejora continua con su implementación. En el presente escrito se exponen características de los modelos investigados a través de una revisión de información, se realiza una clasificación de los mismos de acuerdo con el nivel de proceso o de producto; cada modelo cuenta con unas características y una estructura la cual se enuncia brevemente en el escrito. Las diferentes empresas, con el fin de verse inmersas en una mejora continua de sus procesos, han identificado la importancia de hacerse a la implementación de modelos que permitan certificar y garantizar la calidad de sus productos y procesos, se encontraron algunos casos de éxito de la implementación de los modelos estudiados, los cuales permitieron a las empresas posicionarse o destacarse por mejorar los procesos de su negocio.
There are many software quality models that allows a process of continuous improvement with its implementation. In this paper some characteristics of the investigated models are exposed, through an information revision, a classification of these models is performed according to the level of the process or product; each model count with some characteristics and a structure that is briefly stated in the written. The different enterprises in order to be immersed on a continuous improvement of their processes have identified the importance of getting the implementation of models that allows to certify an guarantee the quality of their processes and products, some success cases were found for the implementation of the studied models, which allowed the enterprises to position or stand by the improvement of their business process.
Existem diferentes modelos de qualidade de software que permitem processo de melhoria contínua com a sua implementação. Neste escrita características dos modelos investigados através de uma revisão das informações forem definidos, a mesma classificados de acordo com o nível de processo ou produto é feito; cada modelo tem características e uma estrutura que brevemente indicado na carta. Diferentes empresas, a fim de ser imerso em um processo contínuo de melhoria identificaram a importância de começar a implementação de modelos para certificar e garantir a qualidade de seus produtos e processos, alguns casos de sucesso foram encontrados implementação dos modelos estudados, o que permitiu que as empresas a posicionar ou ficar para melhorar seus processos de negócios.
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OBJECTIVE: To establish a SERVQUAL estimated model of scientific study. METHODS: By literature review, indepth interviews, expert consultation, survey, determines the evaluation index of pharmacy service quality of SERVQUAL, to devise of SERVQUAL assessment questionnaire. And then judge the scientific reliability and investigation of the questionnaire. RESULTS: SERVQUAL Evaluation model is scientific and reliable, in addition to the pharmacist instrument, behavior, and drug flow and provide drug packaging, brochures, medication labels and complete three services beyond expectation of patients, other service failed to meet the needs of patients. CONCLUSION: The SERVQUAL method could be used to evaluate the services quality of outpatient pharmacy, the mode and quality of outpatient pharmacy service still needs to be improved.
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Fish survival in lakes is strongly influenced by water temperature and dissolved oxygen (DO) concentration. A one-dimensional (vertical) lake water quality model MINLAKE 2012 was calibrated in 23 Minnesota lakes and used to simulate daily water temperature and DO concentrations in 36 representative lake types under past (1992–2008) climate conditions and a future climate scenario (MIROC 3.2). The 36 representative Minnesota lake types were developed based on three maximum depths (Hmax = 4, 13, and 24 m), three surface areas (As = 0.2, 1.7, 10 km2), and four Secchi depths (SD = 1.2, 2.5, 4.5, and 7 m, from eutrophic to oligotrophic lake). A fish habitat model using the lethal-niche- boundary curve of adult cisco (Coregnous artedi, a cold-water fish species) was then developed to evaluate cisco oxythermal habitat and survival in Minnesota lakes.The fish habitat model was validated in the 23 Minnesota lakes of which 18 had cisco mortality while 5 had no cisco mortality in the unusually warm summer of 2006. Cisco lethal and habitable conditions in the 23 lakes simulated by the model had anoverall good agreement with observations in 2006. After model validation, cisco lethal days in the 36 lake types were modeled using simulated daily temperature and DO profiles from MINLAKE2012. Polymictic shallow lakes with lake geometry ratio As 0.25/Hmax> 5.2 m-0.5 were simulated to typically not support cisco oxythermal habitat under past climate conditions and the future climate scenario. Medium-depth lakes are projected to be most vulnerable to climate warming with most increase in the number of years with cisco kill (average increase 13 years out of 17 simulation years). Strongly stratified mesotrophic and oligotrophic deep lakes are possible to support cisco habitat under both past and future climate conditions, and these deep lakes are good candidates for cisco refuge lakes that should be protected against water quality deteriorations.
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As one of the three dominant functions of medical institutes,scientific research management is essentially service oriented.By literature review of the service quality model,this study introduced the concept of service quality model to scientific research administration in medical institutes of China,and developed the framework and evaluation index,which can provide reference for future studies.
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The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.