Report on the implementation of the recommendations of the Task Force on the Quality of Audits of Governmental Units

https://egrove.olemiss.edu/aicpa_guides/1724/thumbnail.jp

Water Quality/Use Findings Document

The purpose of this document is to present as much useful information as is available on the water quality and usage of the four ponds to assist in· community decision-making and action. The document also summarizes the concerns and suggestions made at the July 1993 and January 1994 public forums and suggests ways in which people can achieve results. Appendix F offers a list of resource persons and how to contact them. It is hoped that this document will be used by YOU and shared with others so that the communities who use these precious resources will be able to work together for solutions and improvements

Qualitative systematic literature review: the experience of being in seclusion for adults with mental health difficulties

Purpose: To conduct a systematic search of the peer-reviewed qualitative literature investigating the lived experience of seclusion for adults with mental health difficulties, to appraise the quality of the existing literature and synthesise findings. Background: Seclusion is a controversial intervention for the short-term management of unsafe behaviours in inpatient mental health services. There has been some sporadic interest in the service-users' experiences of this. Design: Systematic literature review and meta-synthesis. Data Sources: Databases MEDLINE, EMBASE, CINAHL and PSYCHINFO were searched in July 2015. Review Methods: The JBI QARI tools for critical appraisal and data extraction were used to review papers and synthesise findings. Findings: A small number of papers was found, which were of mixed quality. Value: The existing research is limited in both quantity and quality. Although most participants from the existing research described seclusion as mostly negative with the potential for causing iatrogenic harm, some described more positive experiences, often in the context of compassionate interactions with staff. Summary Statement: Why is this research or review needed? • The use of seclusion is common within mental health services but there is an absence of evidence for the purported theoretical rationale for its use. • Studies of the experiences of individuals placed in seclusion are small in number, of mixed quality and with mixed findings. • A systematic literature review and meta-synthesis of the existing qualitative literature investigating the lived experience of seclusion for adults with mental health difficulties was conducted, to synthesize the existing evidence base and make suggestions for future developments in research and practice. What are the key findings? • The existing research is limited both in quantity and quality. • Despite the limitations of existing research, the evidence does not support the purported theoretical rationale for the therapeutic use of seclusion. This poses a significant challenge to a common practice within mental health settings. • Seclusion has the potential to cause iatrogenic harm, particularly where interactions with nursing staff are not experienced as compassionate. • The actions of nursing staff in implementing seclusion procedures may mitigate iatrogenic harm. • Individuals who have experienced seclusion have suggestions for how to improve its use. How should the findings be used to influence policy/practice/research/education? • There is clearly scope for further, high quality research into people’s experiences of seclusion, particularly within the UK. • The findings include concrete ways in which the practice of seclusion can be improved. • Action research methods may offer a useful way of implementing and evaluating changes in practice

Report of the Task Force on the Quality of Audits of Governmental Units : March 1987

https://egrove.olemiss.edu/aicpa_assoc/1385/thumbnail.jp

Quality of Artemisinin-Containing Antimalarials in Tanzania's Private Sector--Results from a Nationally Representative Outlet Survey.

Ensuring that artemisinin-containing antimalarials (ACAs) are of good quality is a key component of effective malaria treatment. There are concerns that a high proportion of ACAs are falsified or substandard, though estimates are rarely based on representative data. During a nationally representative survey in Tanzania, ACAs were purchased from private retail drug outlets, and the active pharmaceutical ingredient (API) was measured. All 1,737 ACAs contained the labeled artemisinin derivative, with 4.1% being outside the 85-115% artemisinin API range defined as acceptable quality. World Health Organization (WHO) prequalified drugs had 0.1 times the odds of being poor quality compared with non-prequalified ACAs for the artemisinin component. When partner components of combination therapies were also considered, 12.1% were outside the acceptable API range, and WHO prequalified ACAs had 0.04 times the odds of being poor quality. Although the prevalence of poor quality ACAs was lower than reported elsewhere, the minority of samples found to be substandard is a cause for concern. Improvements in quality could be achieved by increasing the predominance of WHO prequalified products in the market. Continued monitoring of quality standards is essential