[Quality of recovery after anaesthesia measured with QoR-40: a prospective observational study].

PubMed

Guimarães-Pereira, Luís; Costa, Maria; Sousa, Gabriela; Abelha, Fernando

2016-01-01

QoR-40, a 40-item questionnaire on quality of recovery from anaesthesia, has been shown to measure health status after surgery. Our aim was to evaluate the incidence of poor quality of recovery in our Post Anaesthesia Care Unit and to compare their QoR-40 scores before surgery and 3 months later. A prospective observational study was conducted in adult patients consecutively admitted from 18 June to 12 July 2012. The follow-up period was 3 months. We exclude patients submitted to cardiac surgery, neurosurgery, obstetric surgery and with a mini-mental state examination test score lower than 25. The primary endpoint was quality of recovery measured with the validated Portuguese for Portugal version of the QoR-40 before surgery (T0), 24h after surgery (T1) and 3 months after (T2). A total of 114 patients completed the study. Mean QoR-40 score was 169 and patients with poor quality of recovery were identified if their QoR-40 score was lesser than 142. This occurred in 26 patients (24%). Global median scores for patients with poor quality of recovery were lower at T0 (121 vs. 184, p<0.001), at T1 (120 vs. 177, p<0.001) and at T2 (119 vs. 189, p<0.001). Patients with poor quality of recovery had lower quality of life. This fact may allow earlier and more effective interventions, in order to improve quality of life after surgery. Beside its utility after surgery, QoR-40 may be important prior to surgery to identify patients who will develop a poor quality of recovery. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Influence of variable milk quality premiums on observed milk quality.

PubMed

Nightingale, C; Dhuyvetter, K; Mitchell, R; Schukken, Y

2008-03-01

The objective of this study was to evaluate a premium program for very high quality milk in a US cooperative. Data were available on a monthly basis from a large US milk cooperative from April 1998 through December 2005. The data set consisted of 36,930 observations representing producer-months. The actual amount of the low bulk tank somatic cell count (BTSCC) premium varied from $0.15 per hundred pounds (cwt.) of milk to $1.00/cwt. with steps in between of $0.50 and $0.60 per cwt. of milk during the data collection period. Data analysis was done to evaluate the impact of the premium program on average BTSCC and on the probability of a producer to ship milk with <100,000 cells/mL in a given month. The results showed a strong effect of the premium program on both the average BTSCC and the probability of producing milk with very low BTSCC. On average, the BTSCC of all the milk in the cooperative was reduced by 22,000 cells during the high premium period. The probability of producing milk with BTSCC <100,000 doubled during some months of the high premium period from 4 to 8%, and an associated 10% increase in probability to produce milk below 200,000 cells/mL was observed. The data clearly indicate that premium offerings for very high quality milk affect the overall milk quality in the population affected by the premium. Producers responded to the high premiums and the overall impact on milk quality was substantial. We argue that the combination of a penalty program for high BTSCC milk with a premium program for very high quality milk (low BTSCC) provides a strong incentive for improvement of milk quality.

The GRACE Checklist: A Validated Assessment Tool for High Quality Observational Studies of Comparative Effectiveness.

PubMed

Dreyer, Nancy A; Bryant, Allison; Velentgas, Priscilla

2016-10-01

Recognizing the growing need for robust evidence about treatment effectiveness in real-world populations, the Good Research for Comparative Effectiveness (GRACE) guidelines have been developed for noninterventional studies of comparative effectiveness to determine which studies are sufficiently rigorous to be reliable enough for use in health technology assessments. To evaluate which aspects of the GRACE Checklist contribute most strongly to recognition of quality. We assembled 28 observational comparative effectiveness articles published from 2001 to 2010 that compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. Twenty-two volunteers from academia, pharmaceutical companies, and government agencies applied the GRACE Checklist to those articles, providing 56 assessments. Ten senior academic and industry experts provided assessments of overall article quality for the purpose of decision support. We also rated each article based on the number of annual citations and impact factor of the journal in which the article was published. To identify checklist items that were most predictive of quality, classification and regression tree (CART) analysis, a binary, recursive, partitioning methodology, was used to create 3 decision trees, which compared the 56 article assessments with 3 external quality outcomes: (1) expert assessment of overall quality, (2) citation frequency, and (3) impact factor. A fourth tree looked at the composite outcome of all 3 quality indicators. The best predictors of quality included the following: use of concurrent comparators, limiting the study to new initiators of the study drug, equivalent measurement of outcomes in study groups, collecting data on most if not all known confounders or effect modifiers, accounting for immortal time bias in the analysis, and use of sensitivity analyses to test how much effect estimates depended on various assumptions. Only sensitivity analyses appeared consistently as

Air quality: from observation to applied studies

NASA Astrophysics Data System (ADS)

Weber, Christiane H.; Wania, Annett; Hirsch, Jacky; Bruse, Michael

2004-10-01

Air qualities studies in urban areas embrace several directions that are strongly associated with urban complexity. In the last centuries cities evolution implied changes in urbanization trends: urban sprawl has modified the relationship between cities and surroundings settlements. The existence and protection of urban green and open areas is promoted as a mean to improve the quality of life of their citizens and increase the satisfactory level of the inhabitants against pollution and noise adverse effects. This paper outlines the methods and approaches used in the EU research project Benefits of Urban Green Space (BUGS). The main target of BUGS is to assess the role of urban green spaces in alleviating the adverse effects of urbanization trends by developing an integrative methodology, ranging from participatory planning tools to numerical simulation models. The influence of urban structures on atmospheric pollutants distribution is investigated as a multi-scale problem ranging from micro to macro/regional scale. Traditionally, air quality models are applied on a single scale, seldom considering the joint effects of traffic network and urban development together. In BUGS, several numerical models are applied to cope with urban complexity and to provide quantitative and qualitative results. The differing input data requirements for the various models demanded a methodology which ensures a coherent data extraction and application procedure. In this paper, the stepwise procedure used for BUGS is presented after a general presentation of the research project and the models implied. A discussion part will highlight the statements induced by the choices made and a conclusive part bring to the stage some insights for future investigations.

Quality standards for real-world research. Focus on observational database studies of comparative effectiveness.

PubMed

Roche, Nicolas; Reddel, Helen; Martin, Richard; Brusselle, Guy; Papi, Alberto; Thomas, Mike; Postma, Dirjke; Thomas, Vicky; Rand, Cynthia; Chisholm, Alison; Price, David

2014-02-01

Real-world research can use observational or clinical trial designs, in both cases putting emphasis on high external validity, to complement the classical efficacy randomized controlled trials (RCTs) with high internal validity. Real-world research is made necessary by the variety of factors that can play an important a role in modulating effectiveness in real life but are often tightly controlled in RCTs, such as comorbidities and concomitant treatments, adherence, inhalation technique, access to care, strength of doctor-caregiver communication, and socio-economic and other organizational factors. Real-world studies belong to two main categories: pragmatic trials and observational studies, which can be prospective or retrospective. Focusing on comparative database observational studies, the process aimed at ensuring high-quality research can be divided into three parts: preparation of research, analyses and reporting, and discussion of results. Key points include a priori planning of data collection and analyses, identification of appropriate database(s), proper outcomes definition, study registration with commitment to publish, bias minimization through matching and adjustment processes accounting for potential confounders, and sensitivity analyses testing the robustness of results. When these conditions are met, observational database studies can reach a sufficient level of evidence to help create guidelines (i.e., clinical and regulatory decision-making).

Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

PubMed Central

Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

2016-01-01

Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The

An integrated view of data quality in Earth observation

PubMed Central

Yang, X.; Blower, J. D.; Bastin, L.; Lush, V.; Zabala, A.; Masó, J.; Cornford, D.; Díaz, P.; Lumsden, J.

2013-01-01

Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research. PMID:23230156

An integrated view of data quality in Earth observation.

PubMed

Yang, X; Blower, J D; Bastin, L; Lush, V; Zabala, A; Masó, J; Cornford, D; Díaz, P; Lumsden, J

2013-01-28

Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research.

Development of a quality assessment tool for systematic reviews of observational studies (QATSO) of HIV prevalence in men having sex with men and associated risk behaviours

PubMed Central

Wong, William CW; Cheung, Catherine SK; Hart, Graham J

2008-01-01

Background Systematic reviews based on the critical appraisal of observational and analytic studies on HIV prevalence and risk factors for HIV transmission among men having sex with men are very useful for health care decisions and planning. Such appraisal is particularly difficult, however, as the quality assessment tools available for use with observational and analytic studies are poorly established. Methods We reviewed the existing quality assessment tools for systematic reviews of observational studies and developed a concise quality assessment checklist to help standardise decisions regarding the quality of studies, with careful consideration of issues such as external and internal validity. Results A pilot version of the checklist was developed based on epidemiological principles, reviews of study designs, and existing checklists for the assessment of observational studies. The Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO) Score consists of five items: External validity (1 item), reporting (2 items), bias (1 item) and confounding factors (1 item). Expert opinions were sought and it was tested on manuscripts that fulfil the inclusion criteria of a systematic review. Like all assessment scales, QATSO may oversimplify and generalise information yet it is inclusive, simple and practical to use, and allows comparability between papers. Conclusion A specific tool that allows researchers to appraise and guide study quality of observational studies is developed and can be modified for similar studies in the future. PMID:19014686

Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts.

PubMed

Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

2016-08-05

The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions

Effect of accreditation on the quality of chronic disease management: a comparative observational study.

PubMed

van Doorn-Klomberg, Arna L; Braspenning, Jozé C C; Wolters, René J; Bouma, Margriet; Wensing, Michel

2014-11-04

Practice accreditation is widely used to assess and improve quality of healthcare providers. Little is known about its effectiveness, particularly in primary care. In this study we examined the effect of accreditation on quality of care regarding diabetes, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). A comparative observational study with two cohorts was performed. We included 138 Dutch family practices that participated in the national accreditation program for primary care. A first cohort of 69 practices was measured at start and completion of a 3-year accreditation program. A second cohort of 69 practices was included and measured simultaneously with the final measurement of the first cohort. In separate multilevel regression analyses, we compared both within-group changes in the first cohort and between-groups differences at follow-up (first cohort) and start (second cohort). Outcome measures consisted of 24 systematically developed indicators of quality of care in targeted chronic diseases. In the within-group comparison, we found improvements on 6 indicators related to diabetes (feet examination, cholesterol measurement, lipid lowering medication prescription) and COPD (spirometry performance, stop smoking advice). In the between-groups comparison we found that first cohort practices performed better on 4 indicators related to diabetes (cholesterol outcome) and CVD (blood pressure outcome, smoke status registration, glucose measurement). Improvements of the quality of primary care for patients with chronic diseases were found, but few could be attributed to the accreditation program. Further development of accreditation is needed to enhance its effectiveness on chronic disease management.

Using direct clinical observation to assess the quality of cesarean delivery in Afghanistan: an exploratory study

PubMed Central

2014-01-01

Background As part of a National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment, a special study was undertaken in July 2010 to examine the quality of cesarean deliveries in Afghanistan and examine the utility of direct clinical observation as an assessment method in low-resource settings. Methods This cross-sectional assessment of the quality of cesareans at 14 facilities in Afghanistan included a survey of surgeons regarding their routine cesarean practices, direct observation of 29 cesarean deliveries and comparison of observations with facility records for 34 additional cesareans conducted during the 3 days prior to the observation period at each facility. For both observed cases and record reviews, we assessed time intervals between specified points of care-arrival to the ward, first evaluation, detection of a complication, decision for cesarean, incision, and birth. Results All time intervals with the exception of “decision to skin incision” were longer in the record reviews than in observed cases. Prior cesarean was the most common primary indication for all cases. All mothers in both groups observed survived through one hour postpartum. Among newborns there were two stillbirths (7%) in observed births and seven (21%) record reviews. Although our sample is too small to show statistical significance, the difference is noteworthy. In six of the reviewed cesareans resulting in stillbirth, a fetal heart rate was recorded in the operating theater, although four were recorded as macerated. For the two fresh stillbirths, the cesarean surgeries were recorded as scheduled and not urgent. Conclusions Direct observation of cesarean deliveries enabled us to assess a number of preoperative, postoperative, and intraoperative procedures that are often not described in medical records in low resource settings. Comparison of observations with findings from provider interviews and facility records allowed us to infer whether observed practices were typical

Quality of care in integrated community case management services in Bugoye, Uganda: a retrospective observational study.

PubMed

Miller, James S; English, Lacey; Matte, Michael; Mbusa, Rapheal; Ntaro, Moses; Bwambale, Shem; Kenney, Jessica; Siedner, Mark J; Reyes, Raquel; Lee, Patrick T; Mulogo, Edgar; Stone, Geren S

2018-02-27

Village health workers (VHWs) in five villages in Bugoye subcounty (Kasese District, Uganda) provide integrated community case management (iCCM) services, in which VHWs evaluate and treat malaria, pneumonia, and diarrhoea in children under 5 years of age. VHWs use a "Sick Child Job Aid" that guides them through the evaluation and treatment of these illnesses. A retrospective observational study was conducted to measure the quality of iCCM care provided by 23 VHWs in 5 villages in Bugoye subcounty over a 2-year period. Patient characteristics and clinical services were summarized using existing aggregate programme data. Lot quality assurance sampling of individual patient records was used to estimate adherence to the iCCM algorithm, VHW-level quality (based on adherence to the iCCM protocol), and change over time in quality of care (using generalized estimating equations regression modelling). For each of 23 VHWs, 25 patient visits were randomly selected from a 2-year period after iCCM care initiation. In these visits, 97% (150) of patients with diarrhoea were treated with oral rehydration and zinc, 95% (216) of patients with pneumonia were treated with amoxicillin, and 94% (240) of patients with malaria were treated with artemisinin-based combination therapy or rectal artesunate. However, only 44% (44) of patients with a negative rapid test for malaria were appropriately referred to a health facility. Overall, 75% (434) of patients received all the correct evaluation and management steps. Only 9 (39%) of the 23 VHWs met the pre-determined LQAS threshold for high-quality care over the 2-year observation period. Quality of care increased significantly in the first 6 months after initiation of iCCM services (p = 0.003), and then plateaued during months 7-24. Quality of care was high for uncomplicated malaria, pneumonia and diarrhoea. Overall quality of care was lower, in part because VHWs often did not follow the guidelines to refer patients with fever who tested

An Observational and modeling strategy to investigate the impact of remote sources on local air quality: A Houston, Texas case study from the Second Texas Air Quality Study (TEXAQS II)

DOE Office of Scientific and Technical Information (OSTI.GOV)

McMillan, W. W.; Pierce, R.; Sparling, L. C.

2010-01-05

Quantifying the impacts of remote sources on individual air quality exceedances remains a significant challenge for air quality forecasting. One goal of the 2006 Texas Air Quality Study (TEXAQS II) was to assess the impact of distant sources on air quality in east Texas. From 23-30 August 2006, retrievals of tropospheric carbon monoxide (CO) from NASA’s Atmospheric InfraRed Sounder (AIRS) reveal the transport of CO from fires in the United States Pacific Northwest to Houston, Texas. This transport occurred behind a cold front and contributed to the worst ozone exceedance period of the summer in the Houston area. We presentmore » supporting satellite observations from the NASA A-Train constellation of the vertical distribution of smoke aerosols and CO. Ground-based in situ CO measurements in Oklahoma and Texas track the CO plume as it moves south and indicate mixing of the aloft plume to the surface by turbulence in the nocturnal boundary layer and convection during the day. Ground-based aerosol speciation and lidar observations do not find appreciable smoke aerosol transport for this case. However, MODIS aerosol optical depths and model simulations indicate some smoke aerosols were transported from the Pacific Northwest through Texas to the Gulf of Mexico. Chemical transport and forward trajectory models confirm the three major observations: (1) the AIRS envisioned CO transport, (2) the satellite determined smoke plume height, and (3) the timing of the observed surface CO increases. Further, the forward trajectory simulations find two of the largest Pacific Northwest fires likely had the most significant impact.« less

The GRACE checklist for rating the quality of observational studies of comparative effectiveness: a tale of hope and caution.

PubMed

Dreyer, Nancy A; Velentgas, Priscilla; Westrich, Kimberly; Dubois, Robert

2014-03-01

While there is growing demand for information about comparative effectiveness (CE), there is substantial debate about whether and when observational studies have sufficient quality to support decision making. To develop and test an item checklist that can be used to qualify those observational CE studies sufficiently rigorous in design and execution to contribute meaningfully to the evidence base for decision support. An 11-item checklist about data and methods (the GRACE checklist) was developed through literature review and consultation with experts from professional societies, payer groups, the private sector, and academia. Since no single gold standard exists for validation, checklist item responses were compared with 3 different types of external quality ratings (N=88 articles). The articles compared treatment effectiveness and/or safety of drugs, medical devices, and medical procedures. We validated checklist item responses 3 ways against external quality ratings, using published articles of observational CE or safety studies: (a) Systematic Review-quality assessment from a published systematic review; (b) Single Expert Review-quality assessment made according to the solicited "expert opinion" of a senior researcher; and (c) Concordant Expert Review-quality assessments from 2 experts for which there was concordance. Volunteers (N=113) from 5 continents completed 280 article assessments using the checklist. Positive and negative predictive values (PPV, NPV, respectively) of individual items were estimated to compare testers' assessments with those of experts. Taken as a whole, the scale had better NPV than PPV, for both data and methods. The most consistent predictor of quality relates to the validity of the primary outcomes measurement for the study purpose. Other consistent markers of quality relate to using concurrent comparators, minimizing the effects of bias by prudent choice of covariates, and using sensitivity analysis to test robustness of results

[Changes in quality of life and work function during phase prophylactic lamotrigine treatment in bipolar patients: 6 month, prospective, observational study].

PubMed

Gonda, Xenia; Kalman, Janos; Dome, Peter; Rihmer, Zoltan

2016-03-01

Bipolar disorder is a lifelong illness requiring lifelong pharmacotherapy. Therefore besides symptomatic remission, achievement of full work-related functioning and restoration of quality of life is a priority during successful treatment. The present prospective, observational, non-intervention study focused on investigating the effect of lamotrigine therapy on the quality of life and work-related function of bipolar patients in outpatient care. 969 bipolar or schizoaffective outpatients participated in the study who previously did not receive lamotrigine therapy. Our present phase-prophylactic study was a prospective, observational, non-intervention study with a six-month follow-up. Evaluations took place at baseline and at months 1, 2, 3 and 6. Patients were followed with a Clinical Global Impression-Severity (CGI-S) and Clinical Global Impression-Improvement (CGI-I). Changes in work-related function was evaluated using Social Adjustment Scale (SAS), while quality of life was assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) scale. SAS scoreds showed a consistent decrease in the overall sample and in all CGI-S initial groups reflecting the improvement of work-related function during the six months of the follow-up. Q-LES-Q values in the whole sample and in all initial CGI-S groups showed a steady increase indicating a continuous increase in quality of life during the study. Our results indicate that during long-term prophylactic lamotrigine therapy the work function and quality of life of bipolar patients shows a significant improvement, therefore lamotrigine provides a possibility for full functional remission and restoration of quality of life.

Organisational quality, nurse staffing and the quality of chronic disease management in primary care: observational study using routinely collected data.

PubMed

Griffiths, Peter; Maben, Jill; Murrells, Trevor

2011-10-01

experience surveys. Organisational factors contribute significantly to observed variation in the quality of care in English general practices. Levels of nurse staffing have an independent association with quality but also interact with organisational factors. The observed relationships are not necessarily causal but a causal relationship is plausible. The benefits and importance of education, training and personal development of nursing and other practice staff was clearly indicated. Copyright © 2011. Published by Elsevier Ltd.

Sleep Quality Improves During Treatment With Bryophyllum pinnatum: An Observational Study on Cancer Patients.

PubMed

Simões-Wüst, Ana Paula; Hassani, Taziri Al; Müller-Hübenthal, Boris; Pittl, Sandra; Kuck, Angela; Meden, Harald; Eberhard, Jutta; Decker, Michael; Fürer, Karin; von Mandach, Ursula

2015-09-01

Cancer patients frequently suffer from poor sleep quality. Bryophyllum pinnatum is a herbal medication used in anthroposophic medicine, which has been shown to be associated with improvements in sleep quality during pregnancy with only few and minor or moderate side-effects reported. In this study, the sleep quality of cancer patients during treatment with B pinnatum was investigated. In this prospective, observational study, cancer patients suffering from sleep problems were treated with B pinnatum (350 mg tablets, corresponding to 50% of leaf pressed juice [Weleda AG, Arlesheim, Switzerland], dosage at physician's consideration, but most frequently 2 tablets with evening meal and 2 before going to bed). Sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daily sleepiness (Epworth Sleeping Scale [ESS]), and fatigue (Fatigue Severity Scale [FSS]) were assessed at the beginning of the treatment and after 3 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded. From the 28 recruited patients, 20 completed both questionnaires and were considered in the present analysis. Data are expressed as mean ± standard deviation. Patients were 61 ± 10.4 years old and the majority were female (17 out of 20). During treatment with B pinnatum, the PSQI decreased from 12.2 ± 3.62 to 9.1 ± 3.61 (P < .01), and ESS changed from 8.4 ± 3.18 to 7.1 ± 3.98 (P < .05). There was no change in FSS. The treatment was well tolerated by the majority of patients, with only 6 patients reporting discomfort that might have been caused by B pinnatum (fatigue n = 3, dry throat n = 1, agitation n = 1, difficult digestion n = 1). No serious adverse drug reactions were detected. B pinnatum may be a suitable treatment for sleep problems of cancer patients. Controlled, randomized clinical trials of the use of B pinnatum in sleep disorders are urgently needed. © The Author(s) 2015.

Earth Observation Data Quality Monitoring and Control: A Case Study of STAR Central Data Repository

NASA Astrophysics Data System (ADS)

Han, W.; Jochum, M.

2017-12-01

Earth observation data quality is very important for researchers and decision makers involved in weather forecasting, severe weather warning, disaster and emergency response, environmental monitoring, etc. Monitoring and control earth observation data quality, especially accuracy, completeness, and timeliness, is very useful in data management and governance to optimize data flow, discover potential transmission issues, and better connect data providers and users. Taking a centralized near real-time satellite data repository, STAR (Center for Satellite Applications and Research of NOAA) Central Data Repository (SCDR), as an example, this paper describes how to develop new mechanism to verify data integrity, check data completeness, and monitor data latency in an operational data management system. Such quality monitoring and control of large volume satellite data help data providers and managers improve data transmission of near real-time satellite data, enhance its acquisition and management, and overcome performance and management issues to better serve research and development activities.

Ozone Lidar Observations for Air Quality Studies

NASA Technical Reports Server (NTRS)

Wang, Lihua; Newchurch, Mike; Kuang, Shi; Burris, John F.; Huang, Guanyu; Pour-Biazar, Arastoo; Koshak, William; Follette-Cook, Melanie B.; Pickering, Kenneth E.; McGee, Thomas J.;

Observed Classroom Quality Profiles of Kindergarten Classrooms in Finland

ERIC Educational Resources Information Center

Salminen, Jenni; Lerkkanen, Marja-Kristiina; Poikkeus, Anna-Maija; Pakarinen, Eija; Siekkinen, Martti; Hannikainen, Maritta; Poikonen, Pirjo-Liisa; Rasku-Puttonen, Helena

2012-01-01

Research Findings: The aim of the present study was to examine classroom quality profiles of kindergarten classrooms using a person-centered approach and to analyze these patterns in regard to teacher and classroom characteristics. Observations of the domains of Emotional Support, Classroom Organization, and Instructional Support were conducted in…

Predicting Near-Term Water Quality from Satellite Observations of Watershed Conditions

NASA Astrophysics Data System (ADS)

Weiss, W. J.; Wang, L.; Hoffman, K.; West, D.; Mehta, A. V.; Lee, C.

2017-12-01

Despite the strong influence of watershed conditions on source water quality, most water utilities and water resource agencies do not currently have the capability to monitor watershed sources of contamination with great temporal or spatial detail. Typically, knowledge of source water quality is limited to periodic grab sampling; automated monitoring of a limited number of parameters at a few select locations; and/or monitoring relevant constituents at a treatment plant intake. While important, such observations are not sufficient to inform proactive watershed or source water management at a monthly or seasonal scale. Satellite remote sensing data on the other hand can provide a snapshot of an entire watershed at regular, sub-monthly intervals, helping analysts characterize watershed conditions and identify trends that could signal changes in source water quality. Accordingly, the authors are investigating correlations between satellite remote sensing observations of watersheds and source water quality, at a variety of spatial and temporal scales and lags. While correlations between remote sensing observations and direct in situ measurements of water quality have been well described in the literature, there are few studies that link remote sensing observations across a watershed with near-term predictions of water quality. In this presentation, the authors will describe results of statistical analyses and discuss how these results are being used to inform development of a desktop decision support tool to support predictive application of remote sensing data. Predictor variables under evaluation include parameters that describe vegetative conditions; parameters that describe climate/weather conditions; and non-remote sensing, in situ measurements. Water quality parameters under investigation include nitrogen, phosphorus, organic carbon, chlorophyll-a, and turbidity.

Measuring Afterschool Program Quality Using Setting-Level Observational Approaches

ERIC Educational Resources Information Center

Oh, Yoonkyung; Osgood, D. Wayne; Smith, Emilie P.

2015-01-01

The importance of afterschool hours for youth development is widely acknowledged, and afterschool settings have recently received increasing attention as an important venue for youth interventions, bringing a growing need for reliable and valid measures of afterschool quality. This study examined the extent to which the two observational tools,…

An Examination of the Quality of Wind Observations with Smartphones

NASA Astrophysics Data System (ADS)

Hintz, Kasper; Vedel, Henrik; Muñoz-Gomez, Juan; Woetmann, Niels

2017-04-01

Over the last years, the number of devices connected to the internet has increased significantly making it possible for internal and external sensors to communicate via the internet, opening up many possibilities for additional data for use in the atmospheric sciences. Vaavud has manufactured small anemometer devices which can measure wind speed and wind direction when connected to a smartphone. This work examines the quality of such crowdsourced Handheld Wind Observations (HWO). In order to examine the quality of the HWO, multiple idealised measurement sessions were performed at different sites in different atmospheric conditions. In these sessions, a high-precision ultrasonic anemometer was installed to work as a reference measurement. The HWO are extrapolated to 10 m in order to compare these to the reference observations. This allows us to examine the effect of stability correction in the surface layer and the quality of height extrapolated HWO. The height extrapolation is done using the logarithmic wind profile law with and without stability correction. Furthermore, this study examines the optimal ways of using traditional observations and numerical models to validate HWO. In order to do so, a series of numerical reanalysis have been run for a period of 5 months to quantise the effect of including crowdsourced HWO in a traditional observation dataset.

NASA Tropospheric Composition Program field campagins as prototypes to advance the Integrated Observing System for Air Quality

NASA Astrophysics Data System (ADS)

Lefer, B. L.; Crawford, J. H.; Pierce, R. B.; Berkoff, T.; Swap, R.; Janz, S. J.; Ahn, J.; Al-Saadi, J. A.

2017-12-01

With the launch over the virtual constellation of earth observing satellites for atmospheric composition (e.g., TROPOMI, GEMS, TEMPO, and Sentinel-4) over the next several years, we have a unique opportunity to develop an Integrated Observing System (IOS) for air quality in the northern hemisphere. Recently, NASA's Tropospheric Composition Program (TCP) has participated in several different air quality related field campaigns as an effort to explore various prototypes of the IOS for Air Quality. The IOS for air quality could be a system were space-based observations of air quality (generally, column abundances of NO2, HCHO, O3, SO2, and AOD) are given added "value" by being integrated with: a) long-term ground-based observations;b) regional and global air quality and chemical transport models; as well as c) measurements from targeted airborne field campaigns. The recent Korea-US Air Quality Study (KORUS-AQ), the Lake Michigan Ozone Study 2017 (LMOS), and the Ozone Water-Land Environmental Transition Study (OWLETS) field campaigns were held in different locations and made measurements over different scale. However, all of these provide an opportunity to learn about how a future integrated air quality observing system can be implemented to serve a variety of air quality related objectives. NASA TCP is also exploring enchancements to our routine observations to strengthen the IOS for air quality in the future.

The effect of wind turbine noise on sleep and quality of life: A systematic review and meta-analysis of observational studies.

PubMed

Onakpoya, Igho J; O'Sullivan, Jack; Thompson, Matthew J; Heneghan, Carl J

2015-09-01

Noise generated by wind turbines has been reported to affect sleep and quality of life (QOL), but the relationship is unclear. Our objective was to explore the association between wind turbine noise, sleep disturbance and quality of life, using data from published observational studies. We searched Medline, Embase, Global Health and Google Scholar databases. No language restrictions were imposed. Hand searches of bibliography of retrieved full texts were also conducted. The reporting quality of included studies was assessed using the STROBE guidelines. Two reviewers independently determined the eligibility of studies, assessed the quality of included studies, and extracted the data. We included eight studies with a total of 2433 participants. All studies were cross-sectional, and the overall reporting quality was moderate. Meta-analysis of six studies (n=2364) revealed that the odds of being annoyed is significantly increased by wind turbine noise (OR: 4.08; 95% CI: 2.37 to 7.04; p<0.00001). The odds of sleep disturbance was also significantly increased with greater exposure to wind turbine noise (OR: 2.94; 95% CI: 1.98 to 4.37; p<0.00001). Four studies reported that wind turbine noise significantly interfered with QOL. Further, visual perception of wind turbine generators was associated with greater frequency of reported negative health effects. In conclusion, there is some evidence that exposure to wind turbine noise is associated with increased odds of annoyance and sleep problems. Individual attitudes could influence the type of response to noise from wind turbines. Experimental and observational studies investigating the relationship between wind turbine noise and health are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Effect of Observation Length and Presentation Order on the Reliability and Validity of an Observational Measure of Teaching Quality

ERIC Educational Resources Information Center

Mashburn, Andrew J.; Meyer, J. Patrick; Allen, Joseph P.; Pianta, Robert C.

2014-01-01

Observational methods are increasingly being used in classrooms to evaluate the quality of teaching. Operational procedures for observing teachers are somewhat arbitrary in existing measures and vary across different instruments. To study the effect of different observation procedures on score reliability and validity, we conducted an experimental…

Toward a Global Water Quality Observing and Forecasting System

EPA Science Inventory

The Group on Earth Observations (GEO) Coastal and Inland Water Quality Working Group held a Water Quality Summit at the World Meteorological Organization (WMO) in Geneva, Switzerland April 20 to 22, 2015. The goal was to define specific water quality component requirements and de...

Surgical Quality in Rectal Cancer Management: What Can Be Achieved by a Voluntary Observational Study?

PubMed Central

Dziki, Łukasz; Otto, Ronny; Lippert, Hans; Jannasch, Olof

2018-01-01

Purpose Countries with nationwide quality programmes in colorectal cancer report an improved outcome. In Germany, a self-organized and self-financed observational quality assurance project exists, based on voluntary participation. The object of the present study was to ascertain whether this nationwide project also improves the outcome of colorectal cancer. Methods The German Quality Assurance in Colorectal Cancer Project started in 2000 and by 2012 contained 85,000 patients. Inclusion criteria for the study were participation for the entire period of 13 years and treatment of rectal cancer. The following parameters were analysed: (1) patient related: age, gender, ASA classification, T-stage, and N-stage, (2) system related: frequency of preoperative CT and MRI, and (3) outcome related: CRM status, complications, and hospital mortality. Results Forty-one of the 345 hospitals treating 11,597 patients fulfilled the inclusion criteria. The median age increased from 67 to 69 years (p = 0.002). ASA stages III and IV increased from 32.0% to 37.6% (p = 0.005) and from 2.0% to 3.3% (p = 0.022), respectively. The use of CT rose from 67.2% to 88.8% (p < 0.001) and that of MRI from 5.0% to 35.2% (p < 0.001). The proportion of patients suffering from complications decreased from 7.9% to 5.3% (p < 0.001) for intraoperative and from 28.0% to 18.6% (p < 0.001) for postoperative surgical complications, but general postoperative complications increased from 25.8% to 29.5% (p = 0.006). The distribution of histopathological stage, anastomotic leakage, and in-hospital mortality did not change significantly. Conclusion Participation in a quality assurance project improves compliance with treatment standards, especially for diagnostic procedures. An improvement of surgical results will require further investment in training. PMID:29853860

Surgical Quality in Rectal Cancer Management: What Can Be Achieved by a Voluntary Observational Study?

PubMed

Dziki, Łukasz; Otto, Ronny; Lippert, Hans; Mroczkowski, Paweł; Jannasch, Olof

2018-01-01

Countries with nationwide quality programmes in colorectal cancer report an improved outcome. In Germany, a self-organized and self-financed observational quality assurance project exists, based on voluntary participation. The object of the present study was to ascertain whether this nationwide project also improves the outcome of colorectal cancer. The German Quality Assurance in Colorectal Cancer Project started in 2000 and by 2012 contained 85,000 patients. Inclusion criteria for the study were participation for the entire period of 13 years and treatment of rectal cancer. The following parameters were analysed: (1) patient related: age, gender, ASA classification, T-stage, and N-stage, (2) system related: frequency of preoperative CT and MRI, and (3) outcome related: CRM status, complications, and hospital mortality. Forty-one of the 345 hospitals treating 11,597 patients fulfilled the inclusion criteria. The median age increased from 67 to 69 years ( p = 0.002). ASA stages III and IV increased from 32.0% to 37.6% ( p = 0.005) and from 2.0% to 3.3% ( p = 0.022), respectively. The use of CT rose from 67.2% to 88.8% ( p < 0.001) and that of MRI from 5.0% to 35.2% ( p < 0.001). The proportion of patients suffering from complications decreased from 7.9% to 5.3% ( p < 0.001) for intraoperative and from 28.0% to 18.6% ( p < 0.001) for postoperative surgical complications, but general postoperative complications increased from 25.8% to 29.5% ( p = 0.006). The distribution of histopathological stage, anastomotic leakage, and in-hospital mortality did not change significantly. Participation in a quality assurance project improves compliance with treatment standards, especially for diagnostic procedures. An improvement of surgical results will require further investment in training.

Use of Air Quality Observations by the National Air Quality Forecast Capability

NASA Astrophysics Data System (ADS)

Stajner, I.; McQueen, J.; Lee, P.; Stein, A. F.; Kondragunta, S.; Ruminski, M.; Tong, D.; Pan, L.; Huang, J. P.; Shafran, P.; Huang, H. C.; Dickerson, P.; Upadhayay, S.

2015-12-01

The National Air Quality Forecast Capability (NAQFC) operational predictions of ozone and wildfire smoke for the United States (U.S.) and predictions of airborne dust for continental U.S. are available at http://airquality.weather.gov/. NOAA National Centers for Environmental Prediction (NCEP) operational North American Mesoscale (NAM) weather predictions are combined with the Community Multiscale Air Quality (CMAQ) model to produce the ozone predictions and test fine particulate matter (PM2.5) predictions. The Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model provides smoke and dust predictions. Air quality observations constrain emissions used by NAQFC predictions. NAQFC NOx emissions from mobile sources were updated using National Emissions Inventory (NEI) projections for year 2012. These updates were evaluated over large U.S. cities by comparing observed changes in OMI NO2 observations and NOx measured by surface monitors. The rate of decrease in NOx emission projections from year 2005 to year 2012 is in good agreement with the observed changes over the same period. Smoke emissions rely on the fire locations detected from satellite observations obtained from NESDIS Hazard Mapping System (HMS). Dust emissions rely on a climatology of areas with a potential for dust emissions based on MODIS Deep Blue aerosol retrievals. Verification of NAQFC predictions uses AIRNow compilation of surface measurements for ozone and PM2.5. Retrievals of smoke from GOES satellites are used for verification of smoke predictions. Retrievals of dust from MODIS are used for verification of dust predictions. In summary, observations are the basis for the emissions inputs for NAQFC, they are critical for evaluation of performance of NAQFC predictions, and furthermore they are used in real-time testing of bias correction of PM2.5 predictions, as we continue to work on improving modeling and emissions important for representation of PM2.5.

Satellite Observations of Trace Gases and Their Application for Studying Air Quality Near Oil and Gas Operations

NASA Astrophysics Data System (ADS)

Kollonige, D. E.; Thompson, A. M.; Nichols, M.; Fasnacht, Z.; Martins, D. K.; Dickerson, R. R.

2014-12-01

The increase in the natural gas component of the energy sector has led many state and local municipalities to begin regulation of emissions from the oil and natural gas operators with air quality (AQ) as a concern. "Top-down" measurements of trace gases in the air above wells complement "bottom-up" inventories, used by EPA and AQ stakeholders, through a more accurate depiction of regional variability of methane and other species near and downwind of oil and gas operations. Satellite observations of methane, nitrogen dioxide, formaldehyde, ozone, and other carbon gases enhance the spatial and temporal coverage of the data needed to demonstrate any long-term impacts from shale gas development. As part of a NASA AQAST (Air Quality Applied Sciences Team) project, we are evaluating satellite measurements of trace gases in regions with oil and gas operations for their application as a "top-down" constraint. For validation of the satellite instruments' sensitivities to emitted gases, we focus on regions where the DISCOVER-AQ (Deriving Information on Surface Conditions from Column and Vertically Resolved Observations Relevant to Air Quality) campaign deployed with ground and aircraft measurements, including, Maryland (2011), California and Texas (2013), and Colorado (2014). We compare vertical distributions of methane and volatile organic compounds (VOCs) nearby and downwind of oil and gas wells to locate any regional differences during the campaign time periods. This allows for better characterization of the satellite observations and their limitations for application in air quality studies in similar environments. Taking advantage of current EOS-era satellites' data records, we also analyze methane anomalies and gas correlations in the free troposphere from 2005 to present to identify trends for basins with oil and gas extraction sites and their influence on background concentrations downwind of wells. In most regions with oil and gas activity, we see continually

Using climate models to estimate the quality of global observational data sets.

PubMed

Massonnet, François; Bellprat, Omar; Guemas, Virginie; Doblas-Reyes, Francisco J

2016-10-28

Observational estimates of the climate system are essential to monitoring and understanding ongoing climate change and to assessing the quality of climate models used to produce near- and long-term climate information. This study poses the dual and unconventional question: Can climate models be used to assess the quality of observational references? We show that this question not only rests on solid theoretical grounds but also offers insightful applications in practice. By comparing four observational products of sea surface temperature with a large multimodel climate forecast ensemble, we find compelling evidence that models systematically score better against the most recent, advanced, but also most independent product. These results call for generalized procedures of model-observation comparison and provide guidance for a more objective observational data set selection. Copyright © 2016, American Association for the Advancement of Science.

The importance of standardized observations to evaluate nutritional care quality in the survey process.

PubMed

Schnelle, John F; Bertrand, Rosanna; Hurd, Donna; White, Alan; Squires, David; Feuerberg, Marvin; Hickey, Kelly; Simmons, Sandra F

2009-10-01

Guidelines written for government surveyors who assess nursing home (NH) compliance with federal standards contain instructions to observe the quality of mealtime assistance. However, these instructions are vague and no protocol is provided for surveyors to record observational data. This study compared government survey staff observations of mealtime assistance quality to observations by research staff using a standardized protocol that met basic standards for accurate behavioral measurement. Survey staff used either the observation instructions in the standard survey process or those written for the revised Quality Improvement Survey (QIS). Trained research staff observed mealtime care in 20 NHs in 5 states during the same time period that survey staff evaluated care in the same facilities, although it could not be determined if survey and research staff observed the same residents during the same meals. Ten NHs were evaluated by government surveyors using the QIS survey instructions and 10 NHs were evaluated by surveyors using the standard survey instructions. Research staff observations using a standardized observation protocol identified a higher proportion of residents receiving inadequate feeding assistance during meals relative to survey staff using either the standard or QIS survey instructions. For example, more than 50% of the residents who ate less than half of their meals based on research staff observation were not offered an alternative to the served meal, and the lack of alternatives, or meal substitutions, was common in all 20 NHs. In comparison, the QIS survey teams documented only 2 instances when meal substitutes were not offered in 10 NHs and the standard survey teams documented no instances in 10 NHs. Standardized mealtime observations by research staff revealed feeding assistance care quality issues in all 20 study NHs. Surveyors following the instructions in either the standard or revised QIS surveys did not detect most of these care quality

Observed Classroom Quality during Teacher Education and Two Years of Professional Practice

ERIC Educational Resources Information Center

Malmberg, Lars-Erik; Hagger, Hazel; Burn, Katharine; Mutton, Trevor; Colls, Helen

2010-01-01

The aims of the present study are to investigate whether and how teachers change in their observed classroom quality (emotional and instructional support, classroom organization, and students' engagement; measured with the Classroom Assessment Scoring System observation measure for secondary school [CLASS-S]; Pianta, La Paro, & Hamre, 2006)…

A simple parametric model observer for quality assurance in computer tomography

NASA Astrophysics Data System (ADS)

Anton, M.; Khanin, A.; Kretz, T.; Reginatto, M.; Elster, C.

2018-04-01

Model observers are mathematical classifiers that are used for the quality assessment of imaging systems such as computer tomography. The quality of the imaging system is quantified by means of the performance of a selected model observer. For binary classification tasks, the performance of the model observer is defined by the area under its ROC curve (AUC). Typically, the AUC is estimated by applying the model observer to a large set of training and test data. However, the recording of these large data sets is not always practical for routine quality assurance. In this paper we propose as an alternative a parametric model observer that is based on a simple phantom, and we provide a Bayesian estimation of its AUC. It is shown that a limited number of repeatedly recorded images (10–15) is already sufficient to obtain results suitable for the quality assessment of an imaging system. A MATLAB® function is provided for the calculation of the results. The performance of the proposed model observer is compared to that of the established channelized Hotelling observer and the nonprewhitening matched filter for simulated images as well as for images obtained from a low-contrast phantom on an x-ray tomography scanner. The results suggest that the proposed parametric model observer, along with its Bayesian treatment, can provide an efficient, practical alternative for the quality assessment of CT imaging systems.

Quality Reporting of Multivariable Regression Models in Observational Studies: Review of a Representative Sample of Articles Published in Biomedical Journals.

PubMed

Real, Jordi; Forné, Carles; Roso-Llorach, Albert; Martínez-Sánchez, Jose M

2016-05-01

Controlling for confounders is a crucial step in analytical observational studies, and multivariable models are widely used as statistical adjustment techniques. However, the validation of the assumptions of the multivariable regression models (MRMs) should be made clear in scientific reporting. The objective of this study is to review the quality of statistical reporting of the most commonly used MRMs (logistic, linear, and Cox regression) that were applied in analytical observational studies published between 2003 and 2014 by journals indexed in MEDLINE.Review of a representative sample of articles indexed in MEDLINE (n = 428) with observational design and use of MRMs (logistic, linear, and Cox regression). We assessed the quality of reporting about: model assumptions and goodness-of-fit, interactions, sensitivity analysis, crude and adjusted effect estimate, and specification of more than 1 adjusted model.The tests of underlying assumptions or goodness-of-fit of the MRMs used were described in 26.2% (95% CI: 22.0-30.3) of the articles and 18.5% (95% CI: 14.8-22.1) reported the interaction analysis. Reporting of all items assessed was higher in articles published in journals with a higher impact factor.A low percentage of articles indexed in MEDLINE that used multivariable techniques provided information demonstrating rigorous application of the model selected as an adjustment method. Given the importance of these methods to the final results and conclusions of observational studies, greater rigor is required in reporting the use of MRMs in the scientific literature.

Quality of life, treatment satisfaction and efficacy of non-biological systemic therapies in patients with plaque psoriasis: study protocol for a prospective observational study.

PubMed

Fink, Christine; Schank, Timo E; Trenkler, Nina; Uhlmann, Lorenz; Schäkel, Knut

2017-06-30

Psoriasis vulgaris often leads to a significant impaired quality of life and dissatisfaction with the existing therapeutic approaches. However, patients' quality of life and treatment satisfaction are of utmost importance, since it is positively related to therapy adherence and encourages patient's compliance. The study described herein evaluates the quality of life, treatment satisfaction and efficacy during the initial 6 months of treatment with a non-biological systemic agent in a real-life clinical setting. This observational study compares quality of life, treatment satisfaction and the efficacy of non-biological systemic therapy between 60 patients suffering from plaque psoriasis receiving the non-biological systemic therapies with apremilast, methotrexate and fumaric acid esters. Ethics approval was provided by the ethics committee of the medical faculty of the University of Heidelberg. Ethics approval number is S-298/2015. The design and the final results of the study will be published and made available to the public. German Clinical Trial Register (DRKS): DRKS00008721 (https://www.germanctr.de/). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mandatory quality reports in Germany from the hospitals’ point of view: a cross-sectional observational study

PubMed Central

2012-01-01

Background Public reporting of hospital quality is to enable providers, patients and the public to make comparisons regarding the quality of care and thus contribute to informed decisions. It stimulates quality improvement activities in hospitals and thus positively impacts treatment results. Hospitals often use publicly reported data for further internal or external purposes. As of 2005, German hospitals are obliged to publish structured quality reports (QR) every two years. This gives them the opportunity to demonstrate their performance by number, type and quality in a transparent way. However, it constitutes a major burden to hospitals to generate and publish data required, and it is yet unknown if hospitals feel adequately represented and at the same time consider the effort appropriate. This study assesses hospital leaders’ judgement about the capability of QR to put legally defined aims effectively and efficiently into practice. It also explores the additional purposes hospitals use their QR for. Methods In a cross-sectional observational study, a representative random sample out of 2,064 German hospitals (N=748) was invited to assess QR via questionnaire; 333 hospitals participated. We recorded the suitability of QR for representing number, type and quality of services, the adequacy of cost and benefits (6-level Likert scales) and additional purposes QR are used for (free text question). For representation purposes, the net sample was weighted for hospital size and hospital ownership (direct standardization). Data was analyzed descriptively and using inferential statistics (chi-2 test) or for the purpose of generating hypotheses. Results German hospitals rated the QR as suitable to represent the number of services but less so for the type and quality of services. The cost-benefit ratio was seen as inadequate. There were no significant differences between hospitals of different size or ownership. Public hospitals additionally used their reports for mostly

Observed Classroom Quality in First Grade: Associations with Teacher, Classroom, and School Characteristics

ERIC Educational Resources Information Center

Cadima, Joana; Peixoto, Carla; Leal, Teresa

2014-01-01

The observation and assessment of quality of teacher--child interactions in elementary school settings are increasingly recognized as important; however, research is still very limited in European countries. In this study, we examined the quality of the interactions between teacher and children in first-grade classrooms in Portugal and the extent…

Utilization of satellite observation of ozone and aerosols in providing initial and boundary condition for regional air quality studies

NASA Astrophysics Data System (ADS)

Pour-Biazar, Arastoo; Khan, Maudood; Wang, Lihua; Park, Yun-Hee; Newchurch, Mike; McNider, Richard T.; Liu, Xiong; Byun, Daewon W.; Cameron, Robert

2011-09-01

To demonstrate the efficacy of satellite observations in the realization of the background and transboundary transport of pollution in regional air quality modeling practices, satellite observations of ozone and aerosol optical depth were incorporated in the EPA Models-3 Community Multiscale Air Quality (CMAQ) model (http://www.cmascenter.org). Observations from Ozone Monitoring Instrument (OMI) aboard NASA's Aura satellite and AOD products from the Moderate Resolution Imaging Spectroradiometer (MODIS) onboard Terra (EOS AM) and Aqua (EOS PM) satellites were used to specify initial and lateral boundary conditions (IC/BC) for a simulation that spanned over August 2006. The tools and techniques using the satellite data were tested in the context of current regulatory air quality modeling practices. Daily satellite observations were remapped onto the modeling domain and used as IC/BC for daily segments of a month-long simulation and the results were evaluated against surface and ozonesonde observations. Compared to the standard application of CMAQ, OMI O3 profiles significantly improved model performance in the free troposphere and MODIS aerosol products substantially improved PM2.5 predictions in the boundary layer. The utilization of satellite data for BC helped in the realization of transboundary transport of pollution and was able to explain the recirculation of pollution from Northeast Corridor to the southeastern region. Ozone in the mid- to upper-troposphere was largely dominated by transport and thus benefited most from satellite provided BC. The ozone within the boundary layer was mostly affected by fast production/loss mechanisms that are impacted by surface emissions, chemistry and removal processes and was not impacted as much. A case study for August 18-22 demonstrated that model errors in the placement of a stationary front were the main reason for errors in PM2.5 predictions as the front acted as a boundary between high and low PM2.5 concentrations.

Automated characterization of perceptual quality of clinical chest radiographs: Validation and calibration to observer preference

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samei, Ehsan, E-mail: samei@duke.edu; Lin, Yuan; Choudhury, Kingshuk R.

Purpose: The authors previously proposed an image-based technique [Y. Lin et al. Med. Phys. 39, 7019–7031 (2012)] to assess the perceptual quality of clinical chest radiographs. In this study, an observer study was designed and conducted to validate the output of the program against rankings by expert radiologists and to establish the ranges of the output values that reflect the acceptable image appearance so the program output can be used for image quality optimization and tracking. Methods: Using an IRB-approved protocol, 2500 clinical chest radiographs (PA/AP) were collected from our clinical operation. The images were processed through our perceptual qualitymore » assessment program to measure their appearance in terms of ten metrics of perceptual image quality: lung gray level, lung detail, lung noise, rib–lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm–lung contrast, and subdiaphragm area. From the results, for each targeted appearance attribute/metric, 18 images were selected such that the images presented a relatively constant appearance with respect to all metrics except the targeted one. The images were then incorporated into a graphical user interface, which displayed them into three panels of six in a random order. Using a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions, each of five participating attending chest radiologists was tasked to spatially order the images based only on the targeted appearance attribute regardless of the other qualities. Once ordered, the observer also indicated the range of image appearances that he/she considered clinically acceptable. The observer data were analyzed in terms of the correlations between the observer and algorithmic rankings and interobserver variability. An observer-averaged acceptable image appearance was also statistically derived for each quality attribute based on the collected individual acceptable

Impact of Laparoscopic Repair of Large Hiatus Hernia on Quality of Life: Observational Cohort Study.

PubMed

Siboni, Stefano; Asti, Emanuele; Milito, Pamela; Bonitta, Gianluca; Sironi, Andrea; Aiolfi, Alberto; Bonavina, Luigi

2018-06-20

Laparoscopic surgery has proven safe and effective in the treatment of large hiatus hernia. Differences may exist between objectively assessed surgical outcomes, symptomatic scores, and patient-reported outcomes. An observational, single-arm cohort study was conducted in patients undergoing primary laparoscopic repair with crura mesh augmentation and Toupet fundoplication for large (> 50% of intrathoracic stomach) type III-IV hiatus hernia. Data were extracted from hospital charts and a prospectively updated research database. The main study outcome was quality of life assessed by the Gastroesophageal reflux disease Health-Related Quality of Life (GERD-HRQL) score and the Short-form 36 (SF-36). Between 2013 and 2016, 37 out of 49 operated patients completed the comprehensive quality-of-life evaluation at the 2-year follow-up. The GERD-HRQL score significantly decreased compared to baseline (p < 0.001). All items of the SF-36 significantly improved compared to baseline (p < 0.05). Both Physical and Mental Component Summary scores were significantly higher than preoperative scores, with a medium Cohen's effect size (-0.77 and 0.56, respectively). At the 2-year follow-up, symptoms had disappeared in the majority of patients. The use of proton-pump inhibitors significantly decreased compared to baseline (13.5 vs. 86.4%, p < 0.001). Also, the use of antidepressants and benzodiazepines significantly decreased after surgery (8.1 vs. 32.4%, p < 0.001). The overall alimentary satisfaction score was > 8 in 92% of patients. There were no safety issues related to the use of the absorbable synthetic mesh. The incidence of anatomical hernia recurrence was 5.4%, but no patient with recurrent hernia required surgical revision. Laparoscopic repair of large hiatus hernia with mesh and partial fundoplication is associated with symptomatic relief, no side-effects, and a significant improvement in disease-specific and generic quality of life at 2-year follow-up. © 2018 S. Karger AG

Neighbourhood environment, physical activity, quality of life and depressive symptoms in Hong Kong older adults: a protocol for an observational study

PubMed Central

Cerin, Ester; Sit, Cindy H P; Zhang, Casper J P; Barnett, Anthony; Cheung, Martin M C; Lai, Poh-chin; Johnston, Janice M; Lee, Ruby S Y

2016-01-01

Introduction The neighbourhood environment can assist the adoption and maintenance of an active lifestyle and affect the physical and mental well-being of older adults. The psychosocial and behavioural mechanisms through which the environment may affect physical and mental well-being are currently poorly understood. Aim This observational study aims to examine associations between the physical and social neighbourhood environments, physical activity, quality of life and depressive symptoms in Chinese Hong Kong older adults. Methods and analyses An observational study of the associations of measures of the physical and social neighbourhood environment, and psychosocial factors, with physical activity, quality of life and depressive symptoms in 900 Hong Kong older adults aged 65+ years is being conducted in 2012–2016. The study involves two assessments taken 6 months apart. Neighbourhood walkability and access to destinations are objectively measured using Geographic Information Systems and environmental audits. Demographics, socioeconomic status, walking for different purposes, perceived neighbourhood and home environments, psychosocial factors, health status, social networks, depressive symptoms and quality of life are being assessed using validated interviewer-administered self-report measures and medical records. Physical functionality is being assessed using the Short Physical Performance Battery. Physical activity and sedentary behaviours are also being objectively measured in approximately 45% of participants using accelerometers over a week. Physical activity, sedentary behaviours, quality of life and depressive symptoms are being assessed twice (6 months apart) to examine seasonality effects on behaviours and their associations with quality of life and depressive symptoms. Ethics and dissemination The study received ethical approval from the University of Hong Kong Human Research Ethics Committee for Non-Clinical Faculties (EA270211) and the Department

Observed Parent-Child Relationship Quality Predicts Antibody Response to Vaccination in Children

PubMed Central

O'Connor, Thomas G; Wang, Hongyue; Moynihan, Jan A; Wyman, Peter A.; Carnahan, Jennifer; Lofthus, Gerry; Quataert, Sally A.; Bowman, Melissa; Burke, Anne S.; Caserta, Mary T

2015-01-01

Background Quality of the parent-child relationship is a robust predictor of behavioral and emotional health for children and adolescents; the application to physical health is less clear. Methods We investigated the links between observed parent-child relationship quality in an interaction task and antibody response to meningococcal conjugate vaccine in a longitudinal study of 164 ambulatory 10-11 year-old children; additional analyses examine associations with cortisol reactivity, BMI, and somatic illness. Results Observed negative/conflict behavior in the interaction task predicted a less robust antibody response to meningococcal serotype C vaccine in the child over a 6 month-period, after controlling for socio-economic and other covariates. Observer rated interaction conflict also predicted increased cortisol reactivity following the interaction task and higher BMI, but these factors did not account for the link between relationship quality and antibody response. Conclusions The results begin to document the degree to which a major source of child stress exposure, parent-child relationship conflict, is associated with altered immune system development in children, and may constitute an important public health consideration. PMID:25862953

NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

NASA Technical Reports Server (NTRS)

Estes, Sue; Haynes, John; Omar, Ali

2013-01-01

Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

NASA Earth Observation Systems and Applications for Public Health and Air Quality Models and Decisions Support

NASA Technical Reports Server (NTRS)

Estes, Sue; Haynes, John; Omar, Ali

2012-01-01

Health and Air Quality providers and researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. This presentation will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential of utilizing Earth Observations in studying health. Satellite earth observations present a unique vantage point of the earth's environment from space, which offers a wealth of health applications for the imaginative investigator. The presentation is directly related to Earth Observing systems and Global Health Surveillance and will present research results of the remote sensing environmental observations of earth and health applications, which can contribute to the public health and air quality research. As part of NASA approach and methodology they have used Earth Observation Systems and Applications for Public Health and Air Quality Models to provide a method for bridging gaps of environmental, spatial, and temporal data for tracking disease. This presentation will provide an overview of projects dealing with infectious diseases, water borne diseases and air quality and how many environmental variables effect human health. This presentation will provide a venue where the results of both research and practice using satellite earth observations to study weather and it's role in public health research.

The reporting of observational research studies in dermatology journals: a literature-based study.

PubMed

Langan, Sinéad; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

2010-05-01

To assess the quality of reporting in observational studies in dermatology. Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta Dermato-Venereologica. Cohort, case-control, and cross-sectional studies published as original articles during the period January 2005 through December 2007. Studies were identified with a literature search of PubMed combining the journal title and the term epidemiological studies (free text) and by hand searching all of the issues of each journal to identify relevant articles. All articles were extracted by 2 reviewers independently using standardized checklists based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. The number and proportion of reported STROBE items were analyzed for each article. The proportion of studies with good reporting for each item was also assessed. A total of 138 articles were included and analyzed. Reporting quality was very mixed. Key areas that were infrequently reported included sample size calculations (n = 10 [7%]), missing data (n = 8 [6%]), losses to follow-up (n = 17 [12%]), and statistical methods (n = 19 [14%]). Only 13 studies (9%) explained the role of funders in the research. The quality of reporting was similar across study designs for "critical" questions with the exception of reporting of participant details, which was better reported in cohort studies (96%) compared with cross-sectional (80%) and case-control (70%) studies. It is difficult to judge the quality of dermatological research unless it is reported well. This study has identified a clear need to improve the quality of reporting of observational studies in dermatology. We recommend that dermatology journals adopt the STROBE criteria.

Improving Air Quality Forecasts with AURA Observations

NASA Technical Reports Server (NTRS)

Newchurch, M. J.; Biazer, A.; Khan, M.; Koshak, W. J.; Nair, U.; Fuller, K.; Wang, L.; Parker, Y.; Williams, R.; Liu, X.

2008-01-01

Past studies have identified model initial and boundary conditions as sources of reducible errors in air-quality simulations. In particular, improving the initial condition improves the accuracy of short-term forecasts as it allows for the impact of local emissions to be realized by the model and improving boundary conditions improves long range transport through the model domain, especially in recirculating anticyclones. During the August 2006 period, we use AURA/OMI ozone measurements along with MODIS and CALIPSO aerosol observations to improve the initial and boundary conditions of ozone and Particulate Matter. Assessment of the model by comparison of the control run and satellite assimilation run to the IONS06 network of ozonesonde observations, which comprise the densest ozone sounding campaign ever conducted in North America, to AURA/TES ozone profile measurements, and to the EPA ground network of ozone and PM measurements will show significant improvement in the CMAQ calculations that use AURA initial and boundary conditions. Further analyses of lightning occurrences from ground and satellite observations and AURA/OMI NO2 column abundances will identify the lightning NOx signal evident in OMI measurements and suggest pathways for incorporating the lightning and NO2 data into the CMAQ simulations.

Neighbourhood environment, physical activity, quality of life and depressive symptoms in Hong Kong older adults: a protocol for an observational study.

PubMed

Cerin, Ester; Sit, Cindy H P; Zhang, Casper J P; Barnett, Anthony; Cheung, Martin M C; Lai, Poh-Chin; Johnston, Janice M; Lee, Ruby S Y

2016-01-05

The neighbourhood environment can assist the adoption and maintenance of an active lifestyle and affect the physical and mental well-being of older adults. The psychosocial and behavioural mechanisms through which the environment may affect physical and mental well-being are currently poorly understood. This observational study aims to examine associations between the physical and social neighbourhood environments, physical activity, quality of life and depressive symptoms in Chinese Hong Kong older adults. An observational study of the associations of measures of the physical and social neighbourhood environment, and psychosocial factors, with physical activity, quality of life and depressive symptoms in 900 Hong Kong older adults aged 65+ years is being conducted in 2012-2016. The study involves two assessments taken 6 months apart. Neighbourhood walkability and access to destinations are objectively measured using Geographic Information Systems and environmental audits. Demographics, socioeconomic status, walking for different purposes, perceived neighbourhood and home environments, psychosocial factors, health status, social networks, depressive symptoms and quality of life are being assessed using validated interviewer-administered self-report measures and medical records. Physical functionality is being assessed using the Short Physical Performance Battery. Physical activity and sedentary behaviours are also being objectively measured in approximately 45% of participants using accelerometers over a week. Physical activity, sedentary behaviours, quality of life and depressive symptoms are being assessed twice (6 months apart) to examine seasonality effects on behaviours and their associations with quality of life and depressive symptoms. The study received ethical approval from the University of Hong Kong Human Research Ethics Committee for Non-Clinical Faculties (EA270211) and the Department of Health (Hong Kong SAR). Data are stored in a password

Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study.

PubMed

Seo, Eun Hee; Kim, Tae Oh; Park, Min Jae; Joo, Hee Rin; Heo, Nae Yun; Park, Jongha; Park, Seung Ha; Yang, Sung Yeon; Moon, Young Soo

2012-03-01

Several factors influence bowel preparation quality. Recent studies have indicated that the time interval between bowel preparation and the start of colonoscopy is also important in determining bowel preparation quality. To evaluate the influence of the preparation-to-colonoscopy (PC) interval (the interval of time between the last polyethylene glycol dose ingestion and the start of the colonoscopy) on bowel preparation quality in the split-dose method for colonoscopy. Prospective observational study. University medical center. A total of 366 consecutive outpatients undergoing colonoscopy. Split-dose bowel preparation and colonoscopy. The quality of bowel preparation was assessed by using the Ottawa Bowel Preparation Scale according to the PC interval, and other factors that might influence bowel preparation quality were analyzed. Colonoscopies with a PC interval of 3 to 5 hours had the best bowel preparation quality score in the whole, right, mid, and rectosigmoid colon according to the Ottawa Bowel Preparation Scale. In multivariate analysis, the PC interval (odds ratio [OR] 1.85; 95% CI, 1.18-2.86), the amount of PEG ingested (OR 4.34; 95% CI, 1.08-16.66), and compliance with diet instructions (OR 2.22l 95% CI, 1.33-3.70) were significant contributors to satisfactory bowel preparation. Nonrandomized controlled, single-center trial. The optimal time interval between the last dose of the agent and the start of colonoscopy is one of the important factors to determine satisfactory bowel preparation quality in split-dose polyethylene glycol bowel preparation. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Study on the influence of ground and satellite observations on the numerical air-quality for PM10 over Romanian territory

NASA Astrophysics Data System (ADS)

Dumitrache, Rodica Claudia; Iriza, Amalia; Maco, Bogdan Alexandru; Barbu, Cosmin Danut; Hirtl, Marcus; Mantovani, Simone; Nicola, Oana; Irimescu, Anisoara; Craciunescu, Vasile; Ristea, Alina; Diamandi, Andrei

2016-10-01

The numerical forecast of particulate matter concentrations in general, and PM10 in particular is a theme of high socio-economic relevance. The aim of this study was to investigate the impact of ground and satellite data assimilation of PM10 observations into the Weather Research and Forecasting model coupled with Chemistry (WRF-CHEM) numerical air quality model for Romanian territory. This is the first initiative of the kind for this domain of interest. Assimilation of satellite information - e.g. AOT's in air quality models is of interest due to the vast spatial coverage of the observations. Support Vector Regression (SVR) techniques are used to estimate the PM content from heterogeneous data sources, including EO products (Aerosol Optical Thickness), ground measurements and numerical model data (temperature, humidity, wind, etc.). In this study we describe the modeling framework employed and present the evaluation of the impact from the data assimilation of PM10 observations on the forecast of the WRF-CHEM model. Integrations of the WRF-CHEM model in data assimilation enabled/disabled configurations allowed the evaluation of satellite and ground data assimilation impact on the PM10 forecast performance for the Romanian territory. The model integration and evaluation were performed for two months, one in winter conditions (January 2013) and one in summer conditions (June 2013).

Bystander first aid in trauma - prevalence and quality: a prospective observational study.

PubMed

Bakke, H K; Steinvik, T; Eidissen, S-I; Gilbert, M; Wisborg, T

2015-10-01

Bystander first aid and basic life support can likely improve victim survival in trauma. In contrast to bystander first aid and out-of-hospital cardiac arrest, little is known about the role of bystanders in trauma response. Our aim was to determine how frequently first aid is given to trauma victims by bystanders, the quality of this aid, the professional background of first-aid providers, and whether previous first-aid training affects aid quality. We conducted a prospective 18-month study in two mixed urban-rural Norwegian counties. The personnel on the first ambulance responding to trauma calls assessed and documented first aid performed by bystanders using a standard form. A total of 330 trauma calls were included, with bystanders present in 97% of cases. Securing an open airway was correctly performed for 76% of the 43 patients in need of this first-aid measure. Bleeding control was provided correctly for 81% of 63 patients for whom this measure was indicated, and prevention of hypothermia for 62% of 204 patients. Among the first-aid providers studied, 35% had some training in first aid. Bystanders with documented first-aid training gave better first aid than those where first-aid training status was unknown. A majority of the trauma patients studied received correct pre-hospital first aid, but still there is need for considerable improvement, particularly hypothermia prevention. Previous first-aid training seems to improve the quality of first aid provided. The effect on patient survival needs to be investigated. © 2015 The Authors. The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Inverse U-shaped Association between Sleep Duration and Semen Quality: Longitudinal Observational Study (MARHCS) in Chongqing, China

PubMed Central

Chen, Qing; Yang, Huan; Zhou, Niya; Sun, Lei; Bao, Huaqiong; Tan, Lu; Chen, Hongqiang; Ling, Xi; Zhang, Guowei; Huang, Linping; Li, Lianbing; Ma, Mingfu; Yang, Hao; Wang, Xiaogang; Zou, Peng; Peng, Kaige; Liu, Taixiu; Cui, Zhihong; Ao, Lin; Roenneberg, Till; Zhou, Ziyuan; Cao, Jia

2016-01-01

Study Objectives: To investigate the association between sleep duration and semen parameters as well as reproductive hormone levels. Methods: We designed a cohort of male college students in Chongqing, China. A total of 796 subjects were recruited in 2013 and 656 (82.4%) were followed up in 2014. Each time, semen and peripheral blood samples were collected for semen quality and reproductive hormone measurement. Sleep duration was estimated by revised Munich Chronotype Questionnaire. In 2014, sleep quality was also measured by Pittsburgh Sleep Quality Index (PSQI). Results: There was a substantial inverse U-shaped association between sleep duration and two semen parameters (semen volume and total sperm number), with 7.0–7.5 h/day of sleep showing highest parameters. Either longer or shorter sleep was associated with decreased semen parameters in a dose-response manner (P = 0.002 and 0.001, respectively). Sleeping > 9.0 h was associated with a 21.5% (95% confidence interval 9.2, 32.2) reduction in semen volume and 39.4% (23.3, 52.1) reduction in total sperm number; sleeping ≤ 6.5 h was associated with 4.6% (−10.5, 22.3) and 25.7% (−1.2, 60.1) reduction. Increase of the two parameters was found in those who changed sleep duration toward 7.0–7.5 h/day from 2013 to 2014. The U-shaped association was independent from PSQI and was replicated in another dataset of 1,346 males. No association found between sleep duration and reproductive hormone. Conclusions: Either restricted or excessive sleep may impair semen quality. Further research is needed to validate this finding. Citation: Chen Q, Yang H, Zhou N, Sun L, Bao H, Tan L, Chen H, Ling X, Zhang G, Huang L, Li L, Ma M, Yang H, Wang X, Zou P, Peng K, Liu T, Cui Z, Ao L, Roenneberg T, Zhou Z, Cao J. Inverse u-shaped association between sleep duration and semen quality: longitudinal observational study (MARHCS) in Chongqing, China. SLEEP 2016;39(1):79–86. PMID:26350472

Diet Quality and Colorectal Cancer Risk in the Women's Health Initiative Observational Study

PubMed Central

Vargas, Ashley J.; Neuhouser, Marian L.; George, Stephanie M.; Thomson, Cynthia A.; Ho, Gloria Y. F.; Rohan, Thomas E.; Kato, Ikuko; Nassir, Rami; Hou, Lifang; Manson, JoAnn E.

2016-01-01

Abstract Diet quality index scores on Healthy Eating Index 2010 (HEI-2010), Alternative HEI-2010, alternative Mediterranean Diet Index, and the Dietary Approaches to Stop Hypertension (DASH) index have been inversely associated with all-cause and cancer-specific death. This study assessed the association between these scores and colorectal cancer (CRC) incidence as well as CRC-specific mortality in the Women's Health Initiative Observational Study (1993–2012), a US study of postmenopausal women. During an average of 12.4 years of follow-up, there were 938 cases of CRC and 238 CRC-specific deaths. We estimated multivariate hazard ratios and 95% confidence intervals for relationships between quintiles of diet scores (from baseline food frequency questionnaires) and outcomes. HEI-2010 score (hazard ratios were 0.81, 0.77, and 0.73 with P values of 0.04, 0.01, and <0.01 for quintiles 3–5 vs. quintile 1, respectively) and DASH score (hazard ratios were 0.72, 0.74, and 0.78 with P values of <0.01, <0.01, and 0.03 for quintiles 3–5 vs. quintile 1, respectively), but not other diet scores, were associated with a lower risk of CRC in adjusted models. No diet scores were significantly associated with CRC-specific mortality. Closer adherence to HEI-2010 and DASH dietary recommendations was inversely associated with risk of CRC in this large cohort of postmenopausal women. PMID:27267948

Family Income, Parent Education, and Perceived Constraints as Predictors of Observed Program Quality and Parent Rated Program Quality

ERIC Educational Resources Information Center

Torquati, Julia C.; Raikes, Helen H.; Huddleston-Casas, Catherine A.; Bovaird, James A.; Harris, Beatrice A.

2011-01-01

Observed child care quality and parent perceptions of child care quality received by children in poor (below Federal Poverty Line, FPL), low-income (between FPL and 200% of FPL), and non-low-income families were examined. Observations were completed in 359 center- and home-based child care programs in four Midwestern states and surveys were…

Development of a direct observation Measure of Environmental Qualities of Activity Settings.

PubMed

King, Gillian; Rigby, Patty; Batorowicz, Beata; McMain-Klein, Margot; Petrenchik, Theresa; Thompson, Laura; Gibson, Michelle

2014-08-01

The aim of this study was to develop an observer-rated measure of aesthetic, physical, social, and opportunity-related qualities of leisure activity settings for young people (with or without disabilities). Eighty questionnaires were completed by sets of raters who independently rated 22 community/home activity settings. The scales of the 32-item Measure of Environmental Qualities of Activity Settings (MEQAS; Opportunities for Social Activities, Opportunities for Physical Activities, Pleasant Physical Environment, Opportunities for Choice, Opportunities for Personal Growth, and Opportunities to Interact with Adults) were determined using principal components analyses. Test-retest reliability was determined for eight activity settings, rated twice (4-6wk interval) by a trained rater. The factor structure accounted for 80% of the variance. The Kaiser-Meyer-Olkin Measure of Sampling Adequacy was 0.73. Cronbach's alphas for the scales ranged from 0.76 to 0.96, and interrater reliabilities (ICCs) ranged from 0.60 to 0.93. Test-retest reliabilities ranged from 0.70 to 0.90. Results suggest that the MEQAS has a sound factor structure and preliminary evidence of internal consistency, interrater, and test-retest reliability. The MEQAS is the first observer-completed measure of environmental qualities of activity settings. The MEQAS allows researchers to assess comprehensively qualities and affordances of activity settings, and can be used to design and assess environmental qualities of programs for young people. © 2014 Mac Keith Press.

Observed Emotions as Predictors of Quality of Kindergartners’ Social Relationships

PubMed Central

Hernández, Maciel M.; Eisenberg, Nancy; Valiente, Carlos; Spinrad, Tracy L.; VanSchyndel, Sarah K.; Diaz, Anjolii; Silva, Kassondra M.; Berger, Rebecca H.; Southworth, Jody

2018-01-01

This study evaluated whether positive and anger emotional frequency (the proportion of instances an emotion was observed) and intensity (the strength of an emotion when it was observed) uniquely predicted social relationships among kindergarteners (N = 301). Emotions were observed as naturally occurring at school in the fall term and multiple reporters (peers and teachers) provided information on quality of relationships with children in the spring term. In structural equation models, positive emotion frequency, but not positive emotion intensity, was positively related to peer acceptance and negatively related to peer rejection. In contrast, the frequency of anger provided unique positive prediction of teacher–student conflict and negative prediction of peer acceptance. Furthermore, anger intensity negatively predicted teacher–student closeness and positively predicted teacher–student conflict. Implications for promoting social relationships in school are discussed. PMID:29861553

Observations on quality senior health business: success patterns and policy implications.

PubMed

Yang, Ya-Ting; Hsu, Yi-Hsin Elsa; Chen, Ya-Mei; Su, Shyi; Chang, Yao-Mao; Iqbal, Usman; Yujiro, Handa; Lin, Neng-Pai

2016-04-01

Population ageing is a global issue that affects almost every country. Most ageing researches focused on demand side and studies related to supply side were relatively scarce. This study selected quality enterprises focus on ageing health and analysed their patterns on providing quality services successfully. Our study selected quality senior health enterprises and explored their success patterns through face-to-face semi-structured in-depth interviews with CEO of each enterprise in 2013. Thirty-three quality senior health enterprises in Taiwan. Thirty-three CEO's of enterprises were interviewed individually. None. Core values and vision, historical development, organization structure, services/products provided, delivering channels, customer relationships and further development strategies. Our results indicated success patterns for senior enterprises that there were meeting diversified lifestyles and substitutive needs for the elderly and their caregivers, providing a total solution for actual/virtual integration and flexible one-stop shopping services. We classified these enterprises by used degree of clicks-and-mortar of services and residing situation of the elderly. Industry characteristics and policy implications were summarized. Our observations will serve as a primary evidenced base for enterprises developing their senior market, and also for opening dialogue between customers and enterprises to facilitate valuable opportunities for co-creation between the supply and demand sides. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

The association between observed mobility and quality of life in the near elderly

PubMed Central

Sullivan, Jeff; Goldman, Dana P.; Gill, Thomas M.

2017-01-01

Introduction Chronic diseases associated with aging, such as arthritis, frequently cause reduced mobility, pain and diminished quality of life. To date, research on the association between mobility and quality of life has primarily focused in the elderly; hence, much less is known about this association in the near elderly. This cross-sectional study aimed to assess the association between mobility and quality of life measures in the near elderly. Methods A prospective observational study of persons aged 50–69 years was conducted. The primary endpoint was quality of life measured by EQ-5D-5L, and the primary explanatory variable was observed mobility assessed using the 6-minute walk distance (6MWD). We applied regression models controlling for demographic, health status and other factors to evaluate the association between 6MWD and EQ-5D-5L. Results Of the 183 participants analyzed in the study, 37% were male and the average age was 59.8 years. After adjusting for differences in demographic characteristics and health status, EQ-5D-5L-based utility values were 0.046 points (p<0.001), or 5.2% (95% CI: 2.7% to 7.8%), higher on average for individuals with 100 meters longer 6MWD. Holding constant the mobility-specific component of EQ-5D-5L, we still found that walking an additional 100 meters was associated with an EQ-5D-5L utility value that was 0.029 points (p<0.001), or 3.5% (95% CI: 1.7% to 5.5%), higher than the average participant. Among persons with arthritis, the association between 6MWD and EQ-5D-5L was slightly stronger. Conclusions Near elderly persons with better mobility had higher quality of life. Diseases that decrease mobility, such as arthritis, are likely to have a significant impact on quality of life. PMID:28827806

[How to write high-quality epidemiological research paper Ⅵ. Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut)].

PubMed

Ding, C Y; Cao, Y; Yang, C; Sun, F; Zhan, S Y

2017-01-10

Concerns have been raised about the reporting quality in nutritional epidemiology. Therefore, strengthening the reporting of observational studies in epidemiology-nutritional epidemiology (STROBE-nut) has been proposed by extending the STROBE statement to include additional recommendations on issues related to nutritional epidemiology and dietary assessment, aiming to provide more specific guidelines on how to report observational research in the field. This paper presents a brief introduction to STROBE-nut and also an explanation of the key points in the additional items, with an example illustrating the application of the checklist.

Generalizing from Observations of Mathematics Teachers' Instructional Practice Using the Instructional Quality Assessment

ERIC Educational Resources Information Center

Wilhelm, Anne Garrison; Kim, Sungyeun

2015-01-01

One crucial question for researchers who study teachers' classroom practice is how to maximize information about what is happening in classrooms while minimizing costs. This report extends prior studies of the reliability of the Instructional Quality Assessment (IQA), a widely used classroom observation toolkit, and offers insight into the often…

Assessment of the quality of reporting observational studies in the pediatric dental literature.

PubMed

Butani, Yogita; Hartz, Arthur; Levy, Steven; Watkins, Catherine; Kanellis, Michael; Nowak, Arthur

2006-01-01

The purpose of this assessment was to evaluate reporting of observational studies in the pediatric dental literature. This assessment included the following steps: (1) developing a model for reporting information in clinical dentistry studies; (2) identifying treatment comparisons in pediatric dentistry that were evaluated by at least 5 observational studies; (3) abstracting from these studies any data indicated by applying the reporting model; and (4) comparing available data elements to the desired data elements in the reporting model. The reporting model included data elements related to: (1) patients; (2) providers; (3) treatment details; and (4) study design. Two treatment comparisons in pediatric dentistry were identified with 5 or more observational studies: (1) stainless steel crowns vs amalgams (10 studies); and (2) composite restorations vs amalgam (5 studies). Results from studies comparing the same treatments varied substantially. Data elements from the reporting model that could have explained some of the variation were often reported inadequately or not at all. Reporting of observational studies in the pediatric dental literature may be inadequate for an informed interpretation of the results. Models similar to that used in this study could be used for developing standards for the conduct and reporting of observational studies in pediatric dentistry.

Quality of pharmaceutical care at the pharmacy counter: patients' experiences versus video observation.

PubMed

Koster, Ellen S; Blom, Lyda; Overbeeke, Marloes R; Philbert, Daphne; Vervloet, Marcia; Koopman, Laura; van Dijk, Liset

2016-01-01

Consumer Quality Index questionnaires are used to assess quality of care from patients' experiences. To provide insight into the agreement about quality of pharmaceutical care, measured both by a patient questionnaire and video observations. Pharmaceutical encounters in four pharmacies were video-recorded. Patients completed a questionnaire based upon the Consumer Quality Index Pharmaceutical Care after the encounter containing questions about patients' experiences regarding information provision, medication counseling, and pharmacy staff's communication style. An observation protocol was used to code the recorded encounters. Agreement between video observation and patients' experiences was calculated. In total, 109 encounters were included for analysis. For the domains "medication counseling" and "communication style", agreement between patients' experiences and observations was very high (>90%). Less agreement (45%) was found for "information provision", which was rated more positive by patients compared to the observations, especially for the topic, encouragement of patients' questioning behavior. A questionnaire is useful to assess the quality of medication counseling and pharmacy staff's communication style, but might be less suitable to evaluate information provision and pharmacy staff's encouragement of patients' questioning behavior. Although patients may believe that they have received all necessary information to use their new medicine, some information on specific instructions was not addressed during the encounter. When using questionnaires to get insight into information provision, observations of encounters are very informative to validate the patient questionnaires and make necessary adjustments.

NASA Earth Observation Systems and Applications for Health and Air Quality

NASA Technical Reports Server (NTRS)

Omar, Ali H.

2015-01-01

There is a growing body of evidence that the environment can affect human health in ways that are both complex and global in scope. To address some of these complexities, NASA maintains a diverse constellation of Earth observing research satellites, and sponsors research in developing satellite data applications across a wide spectrum of areas. These include environmental health; infectious disease; air quality standards, policies, and regulations; and the impact of climate change on health and air quality in a number of interrelated efforts. The Health and Air Quality Applications fosters the use of observations, modeling systems, forecast development, application integration, and the research to operations transition process to address environmental health effects. NASA has been a primary partner with Federal operational agencies over the past nine years in these areas. This talk presents the background of the Health and Air Quality Applications program, recent accomplishments, and a plan for the future.

Enhancing mathematics teachers' quality through Lesson Study.

PubMed

Lomibao, Laila S

2016-01-01

The efficiency and effectivity of the learning experience is dependent on the teacher quality, thus, enhancing teacher's quality is vital in improving the students learning outcome. Since, the usual top-down one-shot cascading model practice for teachers' professional development in Philippines has been observed to have much information dilution, and the Southeast Asian Ministers of Education Organization demanded the need to develop mathematics teachers' quality standards through the Southeast Asia Regional Standards for Mathematics Teachers (SEARS-MT), thus, an intensive, ongoing professional development model should be provided to teachers. This study was undertaken to determine the impact of Lesson Study on Bulua National High School mathematics teachers' quality level in terms of SEARS-MT dimensions. A mixed method of quantitative-qualitative research design was employed. Results of the analysis revealed that Lesson Study effectively enhanced mathematics teachers' quality and promoted teachers professional development. Teachers positively perceived Lesson Study to be beneficial for them to become a better mathematics teacher.

Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study.

PubMed

Torke, Alexia M; Callahan, Christopher M; Sachs, Greg A; Wocial, Lucia D; Helft, Paul R; Monahan, Patrick O; Slaven, James E; Montz, Kianna; Burke, Emily S; Inger, Lev

2018-03-01

Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient's hospitalization. To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults. Observational study at three hospitals in a Midwest metropolitan area. Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study. Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4-6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems). The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate-severe anxiety); 29% reported depression, (14.0% moderate-severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = -0.30, p = 0.003) and higher decision quality (β = -0.44, p < 0.0001). Information was associated with higher post-traumatic stress (β = 0.23, p

Changes in quality of life after elective surgery: an observational study comparing two measures.

PubMed

Kronzer, Vanessa L; Jerry, Michelle R; Ben Abdallah, Arbi; Wildes, Troy S; McKinnon, Sherry L; Sharma, Anshuman; Avidan, Michael S

2017-08-01

Our main objective was to compare the change in a validated quality of life measure to a global assessment measure. The secondary objectives were to estimate the minimum clinically important difference (MCID) and to describe the change in quality of life by surgical specialty. This prospective cohort study included 7902 adult patients undergoing elective surgery. Changes in the Veterans RAND 12-Item Health Survey (VR-12), composed of a physical component summary (PCS) and a mental component summary (MCS), were calculated using preoperative and postoperative questionnaires. The latter also contained a global assessment question for quality of life. We compared PCS and MCS to the global assessment using descriptive statistics and weighted kappa. MCID was calculated using an anchor-based approach. Analyses were pre-specified and registered (NCT02771964). By the change in VR-12 scores, an equal proportion of patients experienced improvement and deterioration in quality of life (28% for PCS, 25% for MCS). In contrast, by the global assessment measure, 61% reported improvement, while only 10% reported deterioration. Agreement with the global assessment was slight for both PCS (kappa = 0.20, 57% matched) and MCS (kappa = 0.10, 54% matched). The MCID for the overall VR-12 score was approximately 2.5 points. Patients undergoing orthopedic surgery showed the most improvement in quality of life measures, while patients undergoing gastrointestinal/hepatobiliary or urologic surgery showed the most deterioration. Subjective global quality of life report does not agree well with a validated quality of life instrument, perhaps due to patient over-optimism.

Quality, management, and the interplay of self-assessment, process assessments, and performance-based observations

NASA Astrophysics Data System (ADS)

Willett, D. J.

1993-04-01

In this document, the author presents his observations on the topic of quality assurance (QA). Traditionally the focus of quality management has been on QA organizations, manuals, procedures, audits, and assessments; quality was measured by the degree of conformance to specifications or standards. Today quality is defined as satisfying user needs and is measured by user satisfaction. The author proposes that quality is the responsibility of line organizations and staff and not the responsibility of the QA group. This work outlines an effective Conduct of Operations program. The author concludes his observations with a discussion of how quality is analogous to leadership.

A Novel Scoring Metrics for Quality Assurance of Ocean Color Observations

NASA Astrophysics Data System (ADS)

Wei, J.; Lee, Z.

2016-02-01

Interpretation of the ocean bio-optical properties from ocean color observations depends on the quality of the ocean color data, specifically the spectrum of remote sensing reflectance (Rrs). The in situ and remotely measured Rrs spectra are inevitably subject to errors induced by instrument calibration, sea-surface correction and atmospheric correction, and other environmental factors. Great efforts have been devoted to the ocean color calibration and validation. Yet, there exist no objective and consensus criteria for assessment of the ocean color data quality. In this study, the gap is filled by developing a novel metrics for such data quality assurance and quality control (QA/QC). This new QA metrics is not intended to discard "suspicious" Rrs spectra from available datasets. Rather, it takes into account the Rrs spectral shapes and amplitudes as a whole and grades each Rrs spectrum. This scoring system is developed based on a large ensemble of in situ hyperspectral remote sensing reflectance data measured from various aquatic environments and processed with robust procedures. This system is further tested with the NASA bio-Optical Marine Algorithm Data set (NOMAD), with results indicating significant improvements in the estimation of bio-optical properties when Rrs spectra marked with higher quality assurance are used. This scoring system is further verified with simulated data and satellite ocean color data in various regions, and we envision higher quality ocean color products with the implementation of such a quality screening system.

Impact of acquisition and interpretation on total inter-observer variability in echocardiography: results from the quality assurance program of the STAAB cohort study.

PubMed

Morbach, Caroline; Gelbrich, Götz; Breunig, Margret; Tiffe, Theresa; Wagner, Martin; Heuschmann, Peter U; Störk, Stefan

2018-02-14

Variability related to image acquisition and interpretation is an important issue of echocardiography in clinical trials. Nevertheless, there is no broadly accepted standard method for quality assessment of echocardiography in clinical research reports. We present analyses based on the echocardiography quality-assurance program of the ongoing STAAB cohort study (characteristics and course of heart failure stages A-B and determinants of progression). In 43 healthy individuals (mean age 50 ± 14 years; 18 females), duplicate echocardiography scans were acquired and mutually interpreted by one of three trained sonographers and an EACVI certified physician, respectively. Acquisition (AcV), interpretation (InV), and inter-observer variability (IOV; i.e., variability between the acquisition-interpretation sequences of two different observers), were determined for selected M-mode, B-mode, and Doppler parameters. We calculated Bland-Altman upper 95% limits of absolute differences, implying that 95% of measurement differences were smaller/equal to the given value: e.g. LV end-diastolic volume (mL): 25.0, 25.0, 27.9; septal e' velocity (cm/s): 3.03, 1.25, 3.58. Further, 90, 85, and 80% upper limits of absolute differences were determined for the respective parameters. Both, acquisition and interpretation, independently and sizably contributed to IOV. As such, separate assessment of AcV and InV is likely to aid in echocardiography training and quality-assurance. Our results further suggest to routinely determine IOV in clinical trials as a comprehensive measure of imaging quality. The derived 95, 90, 85, and 80% upper limits of absolute differences are suggested as reproducibility targets of future studies, thus contributing to the international efforts of standardization in quality-assurance.

Quality of pharmaceutical care at the pharmacy counter: patients’ experiences versus video observation

PubMed Central

Koster, Ellen S; Blom, Lyda; Overbeeke, Marloes R; Philbert, Daphne; Vervloet, Marcia; Koopman, Laura; van Dijk, Liset

2016-01-01

Introduction Consumer Quality Index questionnaires are used to assess quality of care from patients’ experiences. Objective To provide insight into the agreement about quality of pharmaceutical care, measured both by a patient questionnaire and video observations. Methods Pharmaceutical encounters in four pharmacies were video-recorded. Patients completed a questionnaire based upon the Consumer Quality Index Pharmaceutical Care after the encounter containing questions about patients’ experiences regarding information provision, medication counseling, and pharmacy staff’s communication style. An observation protocol was used to code the recorded encounters. Agreement between video observation and patients’ experiences was calculated. Results In total, 109 encounters were included for analysis. For the domains “medication counseling” and “communication style”, agreement between patients’ experiences and observations was very high (>90%). Less agreement (45%) was found for “information provision”, which was rated more positive by patients compared to the observations, especially for the topic, encouragement of patients’ questioning behavior. Conclusion A questionnaire is useful to assess the quality of medication counseling and pharmacy staff’s communication style, but might be less suitable to evaluate information provision and pharmacy staff’s encouragement of patients’ questioning behavior. Although patients may believe that they have received all necessary information to use their new medicine, some information on specific instructions was not addressed during the encounter. When using questionnaires to get insight into information provision, observations of encounters are very informative to validate the patient questionnaires and make necessary adjustments. PMID:27042025

Quality of life at the Dead Sea region: the lower the better? An observational study.

PubMed

Avriel, Avital; Fuchs, Lior; Plakht, Ygal; Cicurel, Assi; Apfelbaum, Armando; Satran, Robert; Friger, Michael; Dartava, Dimitry; Sukenik, Shaul

2011-05-27

The Dead Sea region, the lowest in the world at 410 meters below sea level, is considered a potent climatotherapy center for the treatment of different chronic diseases. To assess the prevalence of chronic diseases and the quality of life of residents of the Dead Sea region compared with residents of the Ramat Negev region, which has a similar climate, but is situated 600 meters above sea level. An observational study based on a self-administered questionnaire. Data were collected from kibbutz (communal settlement) members in both regions. Residents of the Dead Sea were the study group and of Ramat Negev were the control group. We compared demographic characteristics, the prevalence of different chronic diseases and health-related quality of life (HRQOL) using the SF-36 questionnaire. There was a higher prevalence of skin nevi and non-inflammatory rheumatic diseases (NIRD) among Dead Sea residents, but they had significantly higher HRQOL mean scores in general health (68.7 ± 21 vs. 64.4 ± 22, p = 0.023) and vitality (64.7 ± 17.9 vs. 59.6 ± 17.3, p = 0.001), as well as significantly higher summary scores: physical component score (80.7 ± 18.2 vs. 78 ± 18.6, p = 0.042), and mental component score (79 ± 16.4 vs. 77.2 ± 15, p = 0.02). These results did not change after adjusting for social-demographic characteristics, health-related habits, and chronic diseases. No significant difference between the groups was found in the prevalence of most chronic diseases, except for higher rates of skin nevi and NIRD among Dead Sea residents. HRQOL was significantly higher among Dead Sea residents, both healthy or with chronic disease.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

PubMed

von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

2014-12-01

Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Signal Quality and the Reliability of Seismic Observations

NASA Astrophysics Data System (ADS)

Zeiler, C. P.; Velasco, A. A.; Pingitore, N. E.

2009-12-01

The ability to detect, time and measure seismic phases depends on the location, size, and quality of the recorded signals. Additional constraints are an analyst’s familiarity with a seismogenic zone and with the seismic stations that record the energy. Quantification and qualification of an analyst’s ability to detect, time and measure seismic signals has not been calculated or fully assessed. The fundamental measurement for computing the accuracy of a seismic measurement is the signal quality. Several methods have been proposed to measure signal quality; however, the signal-to-noise ratio (SNR) has been adopted as a short-term average over the long-term average. While the standard SNR is an easy and computationally inexpensive term, the overall statistical significance has not been computed for seismic measurement analysis. The prospect of canonizing the process of cataloging seismic arrivals hinges on the ability to repeat measurements made by different methods and analysts. The first step in canonizing phase measurements has been done by the IASPEI, which established a reference for accepted practices in naming seismic phases. The New Manual for Seismological Observatory Practices (NMSOP, 2002) outlines key observations for seismic phases recorded at different distances and proposes to quantify timing uncertainty with a user-specified windowing technique. However, this added measurement would not completely remove bias introduced by different techniques used by analysts to time seismic arrivals. The general guideline to time a seismic arrival is to record the time where a noted change in frequency and/or amplitude begins. This is generally achieved by enhancing the arrivals through filtering or beam forming. However, these enhancements can alter the characteristics of the arrival and how the arrival will be measured. Furthermore, each enhancement has user-specified parameters that can vary between analysts and this results in reduced ability to repeat

Clinical research on postoperative trauma care: has the position of observational studies changed?

PubMed

Smeeing, D P J; Houwert, R M; Kruyt, M C; van der Meijden, O A J; Hietbrink, F

2017-02-01

The postoperative care regimes of ankle fractures are studied for over 30 years and recommendations have shifted only slightly in the last decades. However, study methodology might have evolved. The aim of this study was to evaluate the changes in time in the design, quality and outcome measures of studies investigating the postoperative care of ankle fractures. The MEDLINE and EMBASE database were searched for both RCTs and cohort studies. The original studies were divided into decades of publication over the last 30 years. The methodological quality of the studies was assessed using the 'traditional' risk of bias assessment tool provided by The Cochrane Collaboration and the 'newer' MINORS criteria. The percentage of RCTs on this subject declined from 67 to 38 % in the last decades. According to the Cochrane tool, the reported quality of RCTs has improved in the last three decades whereas the reported quality of observational studies has remained unchanged. However, when quality was evaluated with the MINORS criteria, equal improvement was observed for both RCTs and observational studies. In the 80s, 67 % of all studies used the range of motion as the primary outcome measure, which decreased to 45 % in the 90s. In the 00s, none of the studies used the range of motion as the primary outcome. For postoperative care of ankle fractures, results of this study showed a relative decrease in the published number of RCTs. The overall quality of the published articles did not decline. In addition, a gradual shift from physician measured to patient-reported outcome variables was observed. However, it should be borne in mind that the findings are based on a small sample (n = 25).

Associations between the neighbourhood food environment, neighbourhood socioeconomic status, and diet quality: An observational study.

PubMed

McInerney, Maria; Csizmadi, Ilona; Friedenreich, Christine M; Uribe, Francisco Alaniz; Nettel-Aguirre, Alberto; McLaren, Lindsay; Potestio, Melissa; Sandalack, Beverly; McCormack, Gavin R

2016-09-15

The neighbourhood environment may play an important role in diet quality. Most previous research has examined the associations between neighbourhood food environment and diet quality, and neighbourhood socioeconomic status and diet quality separately. This study investigated the independent and joint effects of neighbourhood food environment and neighbourhood socioeconomic status in relation to diet quality in Canadian adults. We undertook a cross-sectional study with n = 446 adults in Calgary, Alberta (Canada). Individual-level data on diet and socio-demographic and health-related characteristics were captured from two self-report internet-based questionnaires, the Canadian Diet History Questionnaire II (C-DHQ II) and the Past Year Physical Activity Questionnaire (PAQ). Neighbourhood environment data were derived from dissemination area level Canadian Census data, and Geographical Information Systems (GIS) databases. Neighbourhood was defined as a 400 m network-based 'walkshed' around each participant's household. Using GIS we objectively-assessed the density, diversity, and presence of specific food destination types within the participant's walkshed. A seven variable socioeconomic deprivation index was derived from Canadian Census variables and estimated for each walkshed. The Canadian adapted Healthy Eating Index (C-HEI), used to assess diet quality was estimated from food intakes reported on C-DHQ II. Multivariable linear regression was used to test for associations between walkshed food environment variables, walkshed socioeconomic status, and diet quality (C-HEI), adjusting for individual level socio-demographic and health-related covariates. Interaction effects between walkshed socioeconomic status and walkshed food environment variables on diet quality (C-HEI) were also tested. After adjustment for covariates, food destination density was positively associated with the C-HEI (β 0.06, 95 % CI 0.01-0.12, p = 0.04) though the magnitude of the

Study on water quality around mangrove ecosystem for coastal rehabilitation

NASA Astrophysics Data System (ADS)

Guntur, G.; Sambah, A. B.; Arisandi, D. M.; Jauhari, A.; Jaziri, A. A.

2018-01-01

Coastal ecosystems are vulnerable to environmental degradation including the declining water quality in the coastal environment due to the influence of human activities where the river becomes one of the input channels. Some areas in the coastal regions of East Java directly facing the Madura Strait indicate having experienced the environmental degradation, especially regarding the water quality. This research was conducted in the coastal area of Probolinggo Regency, East Java, aiming to analyze the water quality as the basis for coastal rehabilitation planning. This study was carried out using survey and observation methods. Water quality measurement results were analyzed conforming to predetermined quality standards. The coastal area rehabilitation planning as a means to restore the degraded water quality parameters is presumably implemented through mangrove planting. Thus, the mangrove mapping was also devised in this research. Based on 40 sampling points, the results illustrate that according to the quality standard, the water quality in the study area is likely to be deteriorated. On account of the mapping analysis of mangrove distribution in the study area, the rehabilitation of the coastal zone can be done through planning the mangrove forest plantation. The recommended coastal area maintenance is a periodic water quality observation planning in the river region which is divided into three zones to monitor the impact of fluctuating changes in land use or human activities on the coastal water quality.

Analysis of the isoprene chemistry observed during the New England Air Quality Study (NEAQS) 2002 intensive experiment

NASA Astrophysics Data System (ADS)

Roberts, James M.; Marchewka, Mathew; Bertman, Steven B.; Goldan, Paul; Kuster, William; de Gouw, Joost; Warneke, Carsten; Williams, Eric; Lerner, Brian; Murphy, Paul; Apel, Eric; Fehsenfeld, Fred C.

2006-12-01

Isoprene and its first and second generation photochemical products, methyl vinyl ketone (MVK), methacrolein (MACR), and peroxymethacrylic nitric anhydride (MPAN), were measured off the coast of New England during the 2002 New England Air Quality Study (NEAQS) on board the NOAA Research Vessel Ronald H. Brown. The results of these measurements were analyzed using a simple sequential reaction model that has been used previously to examine regional oxidant chemistry. The highest isoprene impact was observed in air masses that had passed over an area of high isoprene emission WSW of Boston. The relative concentrations of isoprene and its first generation products show that the photochemistry is consistently "older" than the isoprene photochemistry observed at continental sites. The sequential reaction model was also applied to the aldehyde-PANs (Peroxycarboxylic nitric anhydride) system, and the resulting PPN (peroxypropionic nitric anhydride)/propanal and PAN (peroxyacetic nitric anhydride)/acetaldehyde relationships were consistent with additional sources of PAN in this environment, e.g., isoprene photochemistry. This isoprene source was estimated to result in approximately 1.6 to 4 times more PAN in this environment relative to that produced from anthropogenic VOCs (volatile organic compounds) alone.

A Sparse Representation-Based Deployment Method for Optimizing the Observation Quality of Camera Networks

PubMed Central

Wang, Chang; Qi, Fei; Shi, Guangming; Wang, Xiaotian

2013-01-01

Deployment is a critical issue affecting the quality of service of camera networks. The deployment aims at adopting the least number of cameras to cover the whole scene, which may have obstacles to occlude the line of sight, with expected observation quality. This is generally formulated as a non-convex optimization problem, which is hard to solve in polynomial time. In this paper, we propose an efficient convex solution for deployment optimizing the observation quality based on a novel anisotropic sensing model of cameras, which provides a reliable measurement of the observation quality. The deployment is formulated as the selection of a subset of nodes from a redundant initial deployment with numerous cameras, which is an ℓ0 minimization problem. Then, we relax this non-convex optimization to a convex ℓ1 minimization employing the sparse representation. Therefore, the high quality deployment is efficiently obtained via convex optimization. Simulation results confirm the effectiveness of the proposed camera deployment algorithms. PMID:23989826

The Alberta smoke plume observation study

NASA Astrophysics Data System (ADS)

Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

2018-02-01

A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at http://cwfis.cfs.nrcan.gc.ca/datamart.

Quality of Life Is Poorer for Patients With Stroke Who Require an Interpreter: An Observational Australian Registry Study.

PubMed

Kilkenny, Monique F; Lannin, Natasha A; Anderson, Craig S; Dewey, Helen M; Kim, Joosup; Barclay-Moss, Karen; Levi, Chris; Faux, Steven; Hill, Kelvin; Grabsch, Brenda; Middleton, Sandy; Thrift, Amanda G; Grimley, Rohan; Donnan, Geoffrey; Cadilhac, Dominique A

2018-03-01

In multicultural Australia, some patients with stroke cannot fully understand, or speak, English. Language barriers may reduce quality of care and consequent outcomes after stroke, yet little has been reported empirically. An observational study of patients with stroke or transient ischemic attack (2010-2015) captured from 45 hospitals participating in the Australian Stroke Clinical Registry. The use of interpreters in hospitals, which is routinely documented, was used as a proxy for severe language barriers. Health-Related Quality of Life was assessed using the EuroQoL-5 dimension-3 level measured 90 to 180 days after stroke. Logistic regression was undertaken to assess the association between domains of EuroQoL-5 dimension and interpreter status. Among 34 562 registrants, 1461 (4.2%) required an interpreter. Compared with patients without interpreters, patients requiring an interpreter were more often women (53% versus 46%; P <0.001), aged ≥75 years (68% versus 51%; P <0.001), and had greater access to stroke unit care (85% versus 78%; P <0.001). After accounting for patient characteristics and stroke severity, patients requiring interpreters had comparable discharge outcomes (eg, mortality, discharged to rehabilitation) to patients not needing interpreters. However, these patients reported poorer Health-Related Quality of Life (visual analogue scale coefficient, -9; 95% CI, -12.38, -5.62), including more problems with self-care (odds ratio: 2.22; 95% CI, 1.82, 2.72), pain (odds ratio: 1.84; 95% CI, 1.52, 2.34), anxiety or depression (odds ratio: 1.60; 95% CI, 1.33, 1.93), and usual activities (odds ratio: 1.62; 95% CI, 1.32, 2.00). Patients requiring interpreters reported poorer Health Related Quality of Life after stroke/transient ischemic attack despite greater access to stroke units. These findings should be interpreted with caution because we are unable to account for prestroke Health Related Quality of Life. Further research is needed. © 2018 American

A 12-Month Prospective, Observational Study of Treatment Regimen and Quality of Life Associated with ADHD in Central and Eastern Europe and Eastern Asia

ERIC Educational Resources Information Center

Goetz, Michal; Yeh, Chin-Bin; Ondrejka, Igor; Akay, Aynur; Herczeg, Ilona; Dobrescu, Iuliana; Kim, Boong Nyun; Jin, Xingming; Riley, Anne W.; Martenyi, Ferenc; Harrison, Gavan; Treuer, Tamas

2012-01-01

Objectives: This prospective, observational, non-randomized study aimed to describe the relationship between treatment regimen prescribed and the quality of life (QoL) of ADHD patients in countries of Central and Eastern Europe (CEE) and Eastern Asia over 12 months. Methods: 977 Male and female patients aged 6-17 years seeking treatment for…

Feasibility of 48 quality indicators in ambulatory care in Germany: a cross-sectional observational study.

PubMed

de Cruppé, Werner; Kleudgen, Susanne; Diel, Franziska; Burgdorf, Friederike; Geraedts, Max

2015-01-01

The National Association of Statutory Health Insurance Physicians develops quality indicators (QIs) for ambulatory care in Germany. This study explores the feasibility of a total of 48 QIs. Cross-sectional observational study with primary data collection in writing from medical practices in 10 specialist fields of outpatient care. "Feasibility" covers 7 criteria for indicator assessment and data collection: applicability, availability, retrievability, complexity, relevance, reliability, and acceptance. A questionnaire consisting of 10 questions was used to evaluate these feasibility criteria for each indicator. Survey results were subjected to descriptive analysis. The analyzed sample comprises 103 participants who have been working as practice-based physicians for an average of 13 years. 40% only keep electronic medical records and 2% only paper records, and the rest uses both. The rating of QIs in the field-specific QI sets shows the following mean values: 67% of the participants consider the QIs assigned to them as corresponding to their practice care mandate. Data on these QIs deemed to be applicable are collected by 94% of respondents, documented by 91%, and by 51% electronically. 58% of the data required for the denominator, and 38% for the numerator are retrievable from the practice management system. The time required to access data on a QI is more than 30minutes for 84% of respondents, and 67% consider the effort involved as unacceptable. The rating received was 61% for the relevance of QIs to the assessment of a practitioner's own quality of health care, 69% for the estimated reliability of data collection, and 58% for the acceptance of being evaluated via QIs. In order to improve the feasibility of QI-based practice assessments it will be necessary to a) fine-tune the selection of QIs for the respective groups of specialist, b) to promote the use of computerized practice management systems, and c) integrate effective and user-friendly retrieval functions

A Quality-Control-Oriented Database for a Mesoscale Meteorological Observation Network

NASA Astrophysics Data System (ADS)

Lussana, C.; Ranci, M.; Uboldi, F.

2012-04-01

In the operational context of a local weather service, data accessibility and quality related issues must be managed by taking into account a wide set of user needs. This work describes the structure and the operational choices made for the operational implementation of a database system storing data from highly automated observing stations, metadata and information on data quality. Lombardy's environmental protection agency, ARPA Lombardia, manages a highly automated mesoscale meteorological network. A Quality Assurance System (QAS) ensures that reliable observational information is collected and disseminated to the users. The weather unit in ARPA Lombardia, at the same time an important QAS component and an intensive data user, has developed a database specifically aimed to: 1) providing quick access to data for operational activities and 2) ensuring data quality for real-time applications, by means of an Automatic Data Quality Control (ADQC) procedure. Quantities stored in the archive include hourly aggregated observations of: precipitation amount, temperature, wind, relative humidity, pressure, global and net solar radiation. The ADQC performs several independent tests on raw data and compares their results in a decision-making procedure. An important ADQC component is the Spatial Consistency Test based on Optimal Interpolation. Interpolated and Cross-Validation analysis values are also stored in the database, providing further information to human operators and useful estimates in case of missing data. The technical solution adopted is based on a LAMP (Linux, Apache, MySQL and Php) system, constituting an open source environment suitable for both development and operational practice. The ADQC procedure itself is performed by R scripts directly interacting with the MySQL database. Users and network managers can access the database by using a set of web-based Php applications.

An Adaptive Buddy Check for Observational Quality Control

NASA Technical Reports Server (NTRS)

Dee, Dick P.; Rukhovets, Leonid; Todling, Ricardo; DaSilva, Arlindo M.; Larson, Jay W.; Einaudi, Franco (Technical Monitor)

2000-01-01

An adaptive buddy check algorithm is presented that adjusts tolerances for outlier observations based on the variability of surrounding data. The algorithm derives from a statistical hypothesis test combined with maximum-likelihood covariance estimation. Its stability is shown to depend on the initial identification of outliers by a simple background check. The adaptive feature ensures that the final quality control decisions are not very sensitive to prescribed statistics of first-guess and observation errors, nor on other approximations introduced into the algorithm. The implementation of the algorithm in a global atmospheric data assimilation is described. Its performance is contrasted with that of a non-adaptive buddy check, for the surface analysis of an extreme storm that took place in Europe on 27 December 1999. The adaptive algorithm allowed the inclusion of many important observations that differed greatly from the first guess and that would have been excluded on the basis of prescribed statistics. The analysis of the storm development was much improved as a result of these additional observations.

A New Quality Control Method base on IRMCD for Wind Profiler Observation towards Future Assimilation Application

NASA Astrophysics Data System (ADS)

Chen, Min; Zhang, Yu

2017-04-01

A wind profiler network with a total of 65 profiling radars was operated by the MOC/CMA in China until July 2015. In this study, a quality control procedure is constructed to incorporate the profiler data from the wind-profiling network into the local data assimilation and forecasting system (BJRUC). The procedure applies a blacklisting check that removes stations with gross errors and an outlier check that rejects data with large deviations from the background. Instead of the bi-weighting method, which has been commonly implemented in outlier elimination for one-dimensional scalar observations, an outlier elimination method is developed based on the iterated reweighted minimum covariance determinant (IRMCD) for multi-variate observations such as wind profiler data. A quality control experiment is separately performed for subsets containing profiler data tagged in parallel with/without rain flags at every 00UTC/12UTC from 20 June to 30 Sep 2015. From the results, we find that with the quality control, the frequency distributions of the differences between the observations and model background become more Gaussian-like and meet the requirements of a Gaussian distribution for data assimilation. Further intensive assessment for each quality control step reveals that the stations rejected by blacklisting contain poor data quality, and the IRMCD rejects outliers in a robust and physically reasonable manner.

Quality assurance in non-interventional studies.

PubMed

Theobald, Karlheinz; Capan, Müge; Herbold, Marlis; Schinzel, Stefan; Hundt, Ferdinand

2009-11-09

Nowadays, drug research and surveillance after authorisation becomes more and more important for several reasons. Non-interventional studies (NIS) investigate various aspects of drug use including efficacy and safety under real life conditions. Such kind of health services research should be on a high scientific, methodological and organisational level. Therefore accompanying measures to improve or to keep the quality are highly recommended. The aim of quality management is: first to avoid bias of results by using an appropriate study design and an adequate data analysis, second to assure authenticity, completeness and validity of the data and third to identify and resolve deficiencies at an early stage. Basic principles are laid down in corresponding guidelines and recommendations of authorities, institutes and societies. Various guidelines for good epidemiological practice (GEP) were published by the U.S. Food and Drug Administration (FDA) and international and regional societies for epidemiology. In addition in Germany the Federal Institute for Drugs and Medical Devices (BfArM) together with the Paul Ehrlich Institute (PEI) and the German Association of Research-Based Pharmaceutical Companies (VFA) have published respectively recommendations dealing with quality aspects of non-interventional observational studies. Key points are the advanced publishing of information about the project, developing of a study plan/protocol containing the scientific objectives, a sample size justification and a description of the planned analyses and the publishing of a summary of the results timely after completion of the study. The quality of the data can be improved by using standardized case report forms (CRF) and the CRF should be reviewed and tested before start of study by some participants. A source data verification (SDV) should be performed in randomly selected centres - in between 2% and 5% of the centres depending on the number of participating centres. Before start of

Quality assurance in non-interventional studies

PubMed Central

Theobald, Karlheinz; Capan, Müge; Herbold, Marlis; Schinzel, Stefan; Hundt, Ferdinand

2009-01-01

Nowadays, drug research and surveillance after authorisation becomes more and more important for several reasons. Non-interventional studies (NIS) investigate various aspects of drug use including efficacy and safety under real life conditions. Such kind of health services research should be on a high scientific, methodological and organisational level. Therefore accompanying measures to improve or to keep the quality are highly recommended. The aim of quality management is: first to avoid bias of results by using an appropriate study design and an adequate data analysis, second to assure authenticity, completeness and validity of the data and third to identify and resolve deficiencies at an early stage. Basic principles are laid down in corresponding guidelines and recommendations of authorities, institutes and societies. Various guidelines for good epidemiological practice (GEP) were published by the U.S. Food and Drug Administration (FDA) and international and regional societies for epidemiology. In addition in Germany the Federal Institute for Drugs and Medical Devices (BfArM) together with the Paul Ehrlich Institute (PEI) and the German Association of Research-Based Pharmaceutical Companies (VFA) have published respectively recommendations dealing with quality aspects of non-interventional observational studies. Key points are the advanced publishing of information about the project, developing of a study plan/protocol containing the scientific objectives, a sample size justification and a description of the planned analyses and the publishing of a summary of the results timely after completion of the study. The quality of the data can be improved by using standardized case report forms (CRF) and the CRF should be reviewed and tested before start of study by some participants. A source data verification (SDV) should be performed in randomly selected centres – in between 2% and 5% of the centres depending on the number of participating centres. Before start

The value of including observational studies in systematic reviews was unclear: a descriptive study.

PubMed

Seida, Jennifer; Dryden, Donna M; Hartling, Lisa

2014-12-01

To evaluate (1) how often observational studies are included in comparative effectiveness reviews (CERs); (2) the rationale for including observational studies; (3) how data from observational studies are appraised, analyzed, and graded; and (4) the impact of observational studies on strength of evidence (SOE) and conclusions. Descriptive study of 23 CERs published through the Effective Health Care Program of the U.S. Agency for Healthcare Research and Quality. Authors searched for observational studies in 20 CERs, of which 18 included a median of 11 (interquartile range, 2-31) studies. Sixteen CERs incorporated the observational studies in their SOE assessments. Seventy-eight comparisons from 12 CERs included evidence from both trials and observational studies; observational studies had an impact on SOE and conclusions for 19 (24%) comparisons. There was diversity across the CERs regarding decisions to include observational studies; study designs considered; and approaches used to appraise, synthesize, and grade SOE. Reporting and methods guidance are needed to ensure clarity and consistency in how observational studies are incorporated in CERs. It was not always clear that observational studies added value in light of the additional resources needed to search for, select, appraise, and analyze such studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparisons of Observed Process Quality in German and American Infant/Toddler Programs

ERIC Educational Resources Information Center

Tietze, Wolfgang; Cryer, Debby

2004-01-01

Observed process quality in infant/toddler classrooms was compared in Germany (n = 75) and the USA (n = 219). Process quality was assessed with the Infant/Toddler Environment Rating Scale(ITERS) and parent attitudes about ITERS content with the ITERS Parent Questionnaire (ITERSPQ). The ITERS had comparable reliabilities in the two countries and…

Prospective study of recovery from copperhead snake envenomation: an observational study.

PubMed

Lavonas, Eric J; Gerardo, Charles J

2015-05-15

Although much is known about signs, symptoms, and management in the acute phase of crotaline snake envenomation, little is known about signs, symptoms, function, and quality of life during the recovery phase. The purpose of this observational pilot investigation is to evaluate the utility of several clinical outcome instruments in the setting of copperhead snakebite, and to characterize the clinical course of recovery. This is a multi-center prospective, open-label, observational study of patients envenomated by copperhead snakes. We administered the Disabilities of the Arm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS), Patient-Specific Functional Scale (PSFS), Work Productivity and Ability Impairment: Special Health Problem (WPAI: SHP), Patients' Global Impression of Change (PGIC), Patient's Global Assessment of Recovery (PGAR), and SF-36 instruments, obtained numeric pain rating scales, and measured grip strength, walking speed, and swelling prior to hospital discharge and 3, 7, 14, 21, and 28 days after envenomation. 20 subjects were enrolled; none were lost to follow-up. Most (80%) had moderate severity swelling, and most (75%) received antivenom. Across the broad range of measures, abnormalities of pain, swelling, impairments of physical and role function, and quality of life persisted for 7-14 days in most subjects. Validated self-reported outcome measures, such as the DASH, LEFS, PSFS, PGIC, SF-36, and the daily activities impairment portion of the WPAI: SHP were more responsive than measurements of swelling or walking speed. Data quality issues limited the utility of the work impairment portion of the WPAI: SHP. Residual signs, symptoms, and impairment in some subjects lasted through the 28-day study period. The study design precluded any assessment of the effectiveness of antivenom. Signs, symptoms, impaired function, and decreased quality of life typically last 7 - 14 days after copperhead envenomation. Several tools appear

Qualitative observation instrument to measure the quality of parent-child interactions in young children with type 1 diabetes mellitus.

PubMed

Nieuwesteeg, Anke; Hartman, Esther; Pouwer, Frans; Emons, Wilco; Aanstoot, Henk-Jan; Van Mil, Edgar; Van Bakel, Hedwig

2014-06-10

In young children with type 1 diabetes mellitus (T1DM), parents have complete responsibility for the diabetes-management. In toddlers and (pre)schoolers, the tasks needed to achieve optimal blood glucose control may interfere with normal developmental processes and could negatively affect the quality of parent-child interaction. Several observational instruments are available to measure the quality of the parent-child interaction. However, no observational instrument for diabetes-specific situations is available. Therefore, the aim of the present study was to develop a qualitative observation instrument, to be able to assess parent-child interaction during diabetes-specific situations. First, in a pilot study (n = 15), the observation instrument was developed in four steps: (a) defining relevant diabetes-specific situations; (b) videotaping these situations; (c) describing all behaviors in a qualitative observation instrument; (d) evaluating usability and reliability. Next, we examined preliminary validity (total n = 77) by testing hypotheses about correlations between the observation instrument for diabetes-specific situations, a generic observation instrument and a behavioral questionnaire. The observation instrument to assess parent-child interaction during diabetes-specific situations, which consists of ten domains: "emotional involvement", "limit setting", "respect for autonomy", "quality of instruction", "negative behavior", "avoidance", "cooperative behavior", "child's response to injection", "emphasis on diabetes", and "mealtime structure", was developed for use during a mealtime situation (including glucose monitoring and insulin administration). The present study showed encouraging indications for the usability and inter-rater reliability (weighted kappa was 0.73) of the qualitative observation instrument. Furthermore, promising indications for the preliminary validity of the observation instrument for diabetes-specific situations were found (r ranged

Using aircraft and satellite observations to improve regulatory air quality models

NASA Astrophysics Data System (ADS)

Canty, T. P.; Vinciguerra, T.; Anderson, D. C.; Carpenter, S. F.; Goldberg, D. L.; Hembeck, L.; Montgomery, L.; Liu, X.; Salawitch, R. J.; Dickerson, R. R.

2014-12-01

Federal and state agencies rely on EPA approved models to develop attainment strategies that will bring states into compliance with the National Ambient Air Quality Standards (NAAQS). We will describe modifications to the Community Multi-Scale Air Quality (CMAQ) model and Comprehensive Air Quality Model with Extensions (CAMx) frameworks motivated by analysis of NASA satellite and aircraft measurements. Observations of tropospheric column NO2 from OMI have already led to the identification of an important deficiency in the chemical mechanisms used by models; data collected during the DISCOVER-AQ field campaign has been instrumental in devising an improved representation of the chemistry of nitrogen species. Our recent work has focused on the use of: OMI observations of tropospheric O3 to assess and improve the representation of boundary conditions used by AQ models, OMI NO2 to derive a top down NOx emission inventory from commercial shipping vessels that affect air quality in the Eastern U.S., and OMI HCHO to assess the C5H8 emission inventories provided by bioegenic emissions models. We will describe how these OMI-driven model improvements are being incorporated into the State Implementation Plans (SIPs) being prepared for submission to EPA in summer 2015 and how future modeling efforts may be impacted by our findings.

Trend in Air Quality of Kathmandu Valley: A Satellite, Observation and Modelling Perspective

NASA Astrophysics Data System (ADS)

Mahapatra, P. S.; Praveen, P. S.; Adhikary, B.; Panday, A. K.; Putero, D.; Bonasoni, P.

2016-12-01

Kathmandu (floor area of 340 km2) in Nepal is considered to be a `hot spot' of urban air pollution in South Asia. Its structure as a flat basin surrounded by tall mountains provides a unique case study for analyzing pollution trapped by topography. Only a very small number of cities with similar features have been studied extensively including Mexico and Santiago-de-Chile. This study presents the trend in satellite derived Aerosol Optical Depth (AOD) from MODIS AQUA and TERRA (3x3km, Level 2) over Kathmandu from 2000 to 2015. Trend analysis of AOD shows 35% increase during the study period. Determination of the background pollution would reveal the contribution of only Kathmandu Valley for the observation period. For this, AOD at 1340m altitude outside Kathmandu, but nearby areas were considered as background. This analysis was further supported by investigating AOD at different heights around Kathmandu as well as determining AOD from CALIPSO vertical profiles. These analysis suggest that background AOD contributed 30% in winter and 60% in summer to Kathmandu Valley's observed AOD. Thereafter the background AOD was subtracted from total Kathmandu AOD to determine contribution of only Kathmandu Valley's AOD. Trend analysis of only Kathmandu Valley AOD (subtracting background AOD) suggested an increase of 50% during the study period. Further analysis of Kathmandu's visibility and AOD suggest profound role of background AOD on decreasing visibility. In-situ Black Carbon (BC) mass concentration measurements (BC being used as a proxy for surface observations) at two sites within Kathmandu valley have been analyzed. Kathmandu valley lacks long term trends of ambient air quality measurement data. Therefore, surface observations would be coupled with satellite measurements for understanding the urban air pollution scenario. Modelling studies to estimate the contribution of background pollution to Kathmandu's own pollution as well as the weekend effect on air quality will

The study of surgical image quality evaluation system by subjective quality factor method

NASA Astrophysics Data System (ADS)

Zhang, Jian J.; Xuan, Jason R.; Yang, Xirong; Yu, Honggang; Koullick, Edouard

2016-03-01

GreenLightTM procedure is an effective and economical way of treatment of benign prostate hyperplasia (BPH); there are almost a million of patients treated with GreenLightTM worldwide. During the surgical procedure, the surgeon or physician will rely on the monitoring video system to survey and confirm the surgical progress. There are a few obstructions that could greatly affect the image quality of the monitoring video, like laser glare by the tissue and body fluid, air bubbles and debris generated by tissue evaporation, and bleeding, just to name a few. In order to improve the physician's visual experience of a laser surgical procedure, the system performance parameter related to image quality needs to be well defined. However, since image quality is the integrated set of perceptions of the overall degree of excellence of an image, or in other words, image quality is the perceptually weighted combination of significant attributes (contrast, graininess …) of an image when considered in its marketplace or application, there is no standard definition on overall image or video quality especially for the no-reference case (without a standard chart as reference). In this study, Subjective Quality Factor (SQF) and acutance are used for no-reference image quality evaluation. Basic image quality parameters, like sharpness, color accuracy, size of obstruction and transmission of obstruction, are used as subparameter to define the rating scale for image quality evaluation or comparison. Sample image groups were evaluated by human observers according to the rating scale. Surveys of physician groups were also conducted with lab generated sample videos. The study shows that human subjective perception is a trustworthy way of image quality evaluation. More systematic investigation on the relationship between video quality and image quality of each frame will be conducted as a future study.

QUIT EMR trial: a prospective, observational, multicentre study to evaluate quality and 24 hours post-transport morbidity of interhospital transportation of critically ill patients: study protocol.

PubMed

Strauch, Ulrich; Bergmans, Dennis C J J; Habers, Joachim; Jansen, Jochen; Winkens, Bjorn; Veldman, Dirk J; Roekaerts, Paul M H J; Beckers, Stefan K

2017-03-10

It is widely accepted that transportation of critically ill patients is high risk. Unfortunately, however, there are currently no evidence-based criteria with which to determine the quality of various interhospital transport systems and their impact on the outcomes for patients. We aim to rectify this by assessing 2 scores which were developed in our hospital in a prospective, observational study. Primarily, we will be examining the Quality of interhospital critical care transportation in the Euregion Meuse-Rhine (QUIT EMR) score, which focuses on the quality of the transport system, and secondarily the SEMROS (Simplified EMR outcome score) which detects changes in the patient's clinical condition in the 24 hours following their transportation. A web-based application will be used to document around 150 pretransport, intratransport and post-transport items of each patient case.To be included, patients must be at least 18-years of age and should have been supervised by a physician during an interhospital transport which was started in the study region.The quality of the QUIT EMR score will be assessed by comparing 3 predefined levels of transport facilities: the high, medium and low standards. Subsequently, SEMROS will be used to determine the effect of transport quality on the morbidity 24 hours after transportation.It is estimated that there will be roughly 3000 appropriate cases suitable for inclusion in this study per year. Cases shall be collected from 1 April 2015 until 31 December 2017. This trial was approved by the Ethics committees of the university hospitals of Maastricht (Netherlands) and Aachen (Germany). The study results will be published in a peer reviewed journal. Results of this study will determine if a prospective randomised trial involving patients of various categories being randomly assigned to different levels of transportation system shall be conducted. NTR4937. Published by the BMJ Publishing Group Limited. For permission to use (where

The effects of lifestyle modification on symptoms and quality of life in patients with irritable bowel syndrome: a prospective observational study.

PubMed

Kang, Sun Hyung; Choi, Seong-Woo; Lee, Seung Jun; Chung, Woo Suk; Lee, Hye Ran; Chung, Ki-Young; Lee, Eaum Seok; Moon, Hee Seok; Kim, Seok Hyun; Sung, Jae Kyu; Lee, Byung Seok; Jeong, Hyun Yong

2011-12-01

Although notably common, irritable bowel syndrome (IBS) has no specific cure. Lifestyle modification may be as important as medication; however, few studies support the effectiveness of such modifications. We performed this observational study of IBS patients to explore further the role of lifestyle changes in treatment. This study included 831 men who enlisted in 2010 as armed surgeon cadets and 85 women who concurrently entered the Armed Forces Nursing Academy. Of these 916 participants, 89 were diagnosed with IBS using the Rome III criteria. Subjective changes in bowel habits, quality of life, pain, stress, stool frequency and stool consistency were surveyed before and after 9 weeks of army training. We evaluated the lifestyle risk factors that impacted improvement in IBS symptoms by comparing those who responded to lifestyle modification (the responding group) to those who did not respond (the nonresponding group). More than half of the participants (63%) reported that their symptoms improved after training. The quality of life and levels of pain and stress significantly improved after military training. Initial stress levels before military training and smoking history affected IBS symptom improvement. Lifestyle modification may be effective in managing IBS patients.

Toxicities Affecting Quality of Life After Chemo-IMRT of Oropharyngeal Cancer: Prospective Study of Patient-Reported, Observer-Rated, and Objective Outcomes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hunter, Klaudia U.; Schipper, Matthew; Feng, Felix Y.

2013-03-15

Purpose: To test the hypothesis that intensity modulated radiation therapy (IMRT) aiming to spare the salivary glands and swallowing structures would reduce or eliminate the effects of xerostomia and dysphagia on quality of life (QOL). Methods and Materials: In this prospective, longitudinal study, 72 patients with stage III-IV oropharyngeal cancer were treated uniformly with definitive chemo-IMRT sparing the salivary glands and swallowing structures. Overall QOL was assessed by summary scores of the Head Neck QOL (HNQOL) and University of Washington QOL (UWQOL) questionnaires, as well as the HNQOL “Overall Bother” question. Quality of life, observer-rated toxicities (Common Toxicity Criteria Adversemore » Effects scale, version 2), and objective evaluations (videofluoroscopy assessing dysphagia and saliva flow rates assessing xerostomia) were recorded from before therapy through 2 years after therapy. Correlations between toxicities/objective evaluations and overall QOL were assessed using longitudinal repeated measures of analysis and Pearson correlations. Results: All observer-rated toxicities and QOL scores worsened 1-3 months after therapy and improved through 12 months, with minor further improvements through 24 months. At 12 months, dysphagia grades 0-1, 2, and 3, were observed in 95%, 4%, and 1% of patients, respectively. Using all posttherapy observations, observer-rated dysphagia was highly correlated with all overall QOL measures (P<.0001), whereas xerostomia and mucosal and voice toxicities were significantly correlated with some, but not all, overall QOL measures, with lower correlation coefficients than dysphagia. Late overall QOL (≥6 or ≥12 months after therapy) was primarily associated with observer-rated dysphagia, and to a lesser extent with xerostomia. Videofluoroscopy scores, but not salivary flows, were significantly correlated with some of the overall QOL measures. Conclusion: After chemo-IMRT, although late dysphagia was on average

Cost-efficiency of knowledge creation: randomized controlled trials vs. observational studies.

PubMed

Struck, Rafael; Baumgarten, Georg; Wittmann, Maria

2014-04-01

This article reviews traditional and current perspectives on randomized, controlled trials (RCTs) and observational studies relative to the economic implications for public healthcare stakeholders. It takes an average of 17 years to bring 14% of original research into clinical practice. Results from high-quality observational studies may complement limited RCTs in primary and secondary literature bases, and enhance the incorporation of sound evidence-based guidelines. Observational findings from comprehensive medical databases may offer valuable clues on the effectiveness and relevance of public healthcare interventions. Major expenditures associated with RCTs relate to recruitment, inappropriate site selection, conduct and reporting. Application of business strategies and economic evaluation tools, in addition to the planning and conduct of RCTs, may enhance clinical trial site performances. Considering the strengths and limitations of each study type, clinical researchers should explore the contextual worthiness of either design in promulgating knowledge. They should focus on quality of conduct and reporting that may allow for the liberation of limited public and private clinical research funding.

Water quality observations of ice-covered, stagnant, eutrophic water bodies and analysis of influence of ice-covered period on water quality

NASA Astrophysics Data System (ADS)

sugihara, K.; Nakatsugawa, M.

2013-12-01

The water quality characteristics of ice-covered, stagnant, eutrophic water bodies have not been clarified because of insufficient observations. It has been pointed out that climate change has been shortening the duration of ice-cover; however, the influence of climate change on water quality has not been clarified. This study clarifies the water quality characteristics of stagnant, eutrophic water bodies that freeze in winter, based on our surveys and simulations, and examines how climate change may influence those characteristics. We made fixed-point observation using self-registering equipment and vertical water sampling. Self-registering equipment measured water temperature and dissolved oxygen(DO).vertical water sampling analyzed biological oxygen demand(BOD), total nitrogen(T-N), nitrate nitrogen(NO3-N), nitrite nitrogen(NO2-N), ammonium nitrogen(NH4-N), total phosphorus(TP), orthophosphoric phosphorus(PO4-P) and chlorophyll-a(Chl-a). The survey found that climate-change-related increases in water temperature were suppressed by ice covering the water area, which also blocked oxygen supply. It was also clarified that the bottom sediment consumed oxygen and turned the water layers anaerobic beginning from the bottom layer, and that nutrient salts eluted from the bottom sediment. The eluted nutrient salts were stored in the water body until the ice melted. The ice-covered period of water bodies has been shortening, a finding based on the analysis of weather and water quality data from 1998 to 2008. Climate change was surveyed as having caused decreases in nutrient salts concentration because of the shortened ice-covered period. However, BOD in spring showed a tendency to increase because of the proliferation of phytoplankton that was promoted by the climate-change-related increase in water temperature. To forecast the water quality by using these findings, particularly the influence of climate change, we constructed a water quality simulation model that

Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: an observational transversal study.

PubMed

Chaar, Emile Abou; Hallit, Souheil; Hajj, Aline; Aaraj, Racha; Kattan, Joseph; Jabbour, Hicham; Khabbaz, Lydia Rabbaa

2018-02-16

Spiritual well-being was found to have some protective effect against end-of life despair in cancer patients. We aimed at assessing the impact of spirituality on the quality of life, depression, and anxiety of Lebanese cancer patients. Our observational transversal monocentric study was conducted between January and April 2016 among a convenient sample of 115 Lebanese cancer patients admitted to Hôtel-Dieu de France Hospital (HDF), Beirut-Lebanon. In addition to socio-demographic and clinical data, three questionnaires were used: EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, 3rd version), FACIT-Sp-12 (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being; The 12-item Spiritual Well-Being Scale, 4th version), and HADS (Hospital Anxiety and Depression Scale). Eighteen patients taking anxiolytic and/or antidepressants were not included in the analysis. The remaining 97 patients were analyzed. Better emotional and cognitive functioning was seen in patients with higher meaning, peace, faith, and total FACIT scores. Meaning, peace, and total FACIT scores were also higher among patients with better global health status and quality of life. Anxiety as well as depression was significantly associated to all spiritual well-being factors. Spirituality can improve quality of life and decrease the incidence of anxiety and depression in cancer patients. Our results highlight the need to incorporate spiritual care in healthcare systems.

Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis.

PubMed

Bastuji-Garin, Sylvie; Sbidian, Emilie; Gaudy-Marqueste, Caroline; Ferrat, Emilie; Roujeau, Jean-Claude; Richard, Marie-Aleth; Canoui-Poitrine, Florence

2013-01-01

In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series. For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥ 4) were selected. We compared the proportions of STROBE items (STROBE score) adequately reported in each article during three periods, two pre STROBE period (2004-2005 and 2006-2007) and one post STROBE period (2008-2010). Segmented regression analysis of interrupted time series was also performed. Of the 456 included articles, 187 (41%) reported cohort studies, 166 (36.4%) cross-sectional studies, and 103 (22.6%) case-control studies. The median STROBE score was 57% (range, 18%-98%). Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004-05 48% versus median score2008-10 58%, p<0.001) but not between the immediate pre-STROBE period and the post-STROBE period (median score2006-07 58% versus median score2008-10 58%, p = 0.42). In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016). By segmented analysis, no significant changes in STROBE score trends occurred (-0.40%; 95%CI, -2.20 to 1.41; p = 0.64) in the post STROBE statement publication. The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

PubMed Central

Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

2007-01-01

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. PMID:17941715

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.

PubMed

Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

2014-12-01

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies.

PubMed

Loosemore, Mike; Knowles, Charles H; Whyte, Greg P

2007-10-20

To evaluate the risk of chronic traumatic brain injury from amateur boxing. Secondary research performed by combination of sport physicians and clinical academics. DESIGN, DATA SOURCES, AND METHODS: Systematic review of observational studies in which chronic traumatic brain injury was defined as any abnormality on clinical neurological examination, psychometric testing, neuroimaging studies, and electroencephalography. Studies were identified through database (1950 to date) and bibliographic searches without language restrictions. Two reviewers extracted study characteristics, quality, and data, with adherence to a protocol developed from a widely recommended method for systematic review of observational studies (MOOSE). 36 papers had relevant extractable data (from a detailed evaluation of 93 studies of 943 identified from the initial search). Quality of evidence was generally poor. The best quality studies were those with a cohort design and those that used psychometric tests. These yielded the most negative results: only four of 17 (24%) better quality studies found any indication of chronic traumatic brain injury in a minority of boxers studied. There is no strong evidence to associate chronic traumatic brain injury with amateur boxing.

Occipital nerve stimulation improves the quality of life in medically-intractable chronic cluster headache: Results of an observational prospective study.

PubMed

Fontaine, Denys; Blond, Serge; Lucas, Christian; Regis, Jean; Donnet, Anne; Derrey, Stéphane; Guegan-Massardier, Evelyne; Jarraya, Bechir; Dang-Vu, Bich; Bourdain, Frederic; Valade, Dominique; Roos, Caroline; Creach, Christèle; Chabardes, Stéphan; Giraud, Pierric; Voirin, Jimmy; Bloch, Jocelyne; Rocca, Alda; Colnat-Coulbois, Sophie; Caire, Francois; Roger, Coralie; Romettino, Sylvie; Lanteri-Minet, Michel

2017-10-01

Background Occipital nerve stimulation (ONS) has been proposed to treat chronic medically-intractable cluster headache (iCCH) in small series of cases without evaluation of its functional and emotional impacts. Methods We report the multidimensional outcome of a large observational study of iCCH patients, treated by ONS within a nationwide multidisciplinary network ( https://clinicaltrials.gov NCT01842763), with a one-year follow-up. Prospective evaluation was performed before surgery, then three and 12 months after. Results One year after ONS, the attack frequency per week was decreased >30% in 64% and >50% in 59% of the 44 patients. Mean (Standard Deviation) weekly attack frequency decreased from 21.5 (16.3) to 10.7 (13.8) ( p = 0.0002). About 70% of the patients responded to ONS, 47.8% being excellent responders. Prophylactic treatments could be decreased in 40% of patients. Functional (HIT-6 and MIDAS scales) and emotional (HAD scale) impacts were significantly improved, as well as the health-related quality of life (EQ-5D). The mean (SD) EQ-5D visual analogic scale score increased from 35.2 (23.6) to 51.9 (25.7) ( p = 0.0037). Surgical minor complications were observed in 33% of the patients. Conclusion ONS significantly reduced the attack frequency per week, as well as the functional and emotional headache impacts in iCCH patients, and dramatically improved the health-related quality of life of responders.

Observational study of sleep disturbances in advanced cancer.

PubMed

Davies, Andrew Neil; Patel, Shuchita D; Gregory, Amanda; Lee, Bernadette

2017-12-01

To determine the prevalence of nightmares, sleep terrors and vivid dreams in patients with advanced cancer (and the factors associated with them in this group of patients). The study was a multicentre, prospective observational study. Participants were patients with locally advanced/metastatic cancer, who were under the care of a specialist palliative care team. Data were collected on demographics, cancer diagnosis, cancer treatment, current medication, performance status, sleep quality (Pittsburgh Sleep Quality Index), dreams and nightmares, and physical and psychological symptoms (Memorial Symptom Assessment Scale-Short Form). 174 patients completed the study. Sleep quality was poor in 70.5% participants and was worse in younger patients and in inpatients (hospital, hospice). 18% of patients reported nightmares, 8% sleep terrors and 34% vivid dreams. Nightmares were associated with poor sleep quality and greater sleep disturbance; nightmares were also associated with greater physical and psychological burden. Nightmares (and vivid dreams) were not associated with the use of opioid analgesics. Nightmares do not seem to be especially common in patients with advanced cancer, and when they do occur, there is often an association with sleep disturbance, and/or physical and psychological burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Home parenteral nutrition improves quality of life and nutritional status in patients with cancer: a French observational multicentre study.

PubMed

Culine, S; Chambrier, C; Tadmouri, A; Senesse, P; Seys, P; Radji, A; Rotarski, M; Balian, A; Dufour, P

2014-07-01

Malnutrition is a predictor of poor outcomes in patients with cancer. Little is known about the benefit of nutritional support in these patients. The purpose of this study was to assess the impact of home parenteral nutrition (HPN) on quality of life (Qol) in cancer patients. We performed an observational prospective study to determine the impact of HPN on Qol in a population of patients with heterogeneous cancer. Physicians, patients and family members had to complete a questionnaire before HPN administration and 28 days after the course of HPN. Qol was evaluated using the self-administered questionnaire FACT-G. We included 767 patients with cancer of whom 437 ended the study. Mean patient age was 63±11.4 years and 60.5% were men. Primary gastrointestinal cancer was reported in 50% of patients and 65.3% were presenting metastases. Malnutrition was reported in 98.3%. After 28 days of HPN intake, significant improvement was observed in the Qol (49.95±5.82 vs. 48.35±5.01 at baseline, p<0.0001). The mean weight, serum albumin and the nutrition risk index had also improved significantly. Most patients (78%) had perceived a positive impact of the HPN. A significant improvement in patient's well-being was perceived also by family members and physicians. Our data suggest that preventing and correcting malnutrition using HPN in patients with cancer might have a significant benefit on their well-being. Randomized controlled studies are required to confirm this finding.

Monitoring water quality from LANDSAT. [satellite observation of Virginia

NASA Technical Reports Server (NTRS)

Barker, J. L.

1975-01-01

Water quality monitoring possibilities from LANDSAT were demonstrated both for direct readings of reflectances from the water and indirect monitoring of changes in use of land surrounding Swift Creek Reservoir in a joint project with the Virginia State Water Control Board and NASA. Film products were shown to have insufficient resolution and all work was done by digitally processing computer compatible tapes. Land cover maps of the 18,000 hectare Swift Creek Reservoir watershed, prepared for two dates in 1974, are shown. A significant decrease in the pine cover was observed in a 740 hectare construction site within the watershed. A measure of the accuracy of classification was obtained by comparing the LANDSAT results with visual classification at five sites on a U-2 photograph. Such changes in land cover can alert personnel to watch for potential changes in water quality.

Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies

PubMed Central

Knowles, Charles H; Whyte, Greg P

2007-01-01

Objective To evaluate the risk of chronic traumatic brain injury from amateur boxing. Setting Secondary research performed by combination of sport physicians and clinical academics. Design, data sources, and methods Systematic review of observational studies in which chronic traumatic brain injury was defined as any abnormality on clinical neurological examination, psychometric testing, neuroimaging studies, and electroencephalography. Studies were identified through database (1950 to date) and bibliographic searches without language restrictions. Two reviewers extracted study characteristics, quality, and data, with adherence to a protocol developed from a widely recommended method for systematic review of observational studies (MOOSE). Results 36 papers had relevant extractable data (from a detailed evaluation of 93 studies of 943 identified from the initial search). Quality of evidence was generally poor. The best quality studies were those with a cohort design and those that used psychometric tests. These yielded the most negative results: only four of 17 (24%) better quality studies found any indication of chronic traumatic brain injury in a minority of boxers studied. Conclusion There is no strong evidence to associate chronic traumatic brain injury with amateur boxing. PMID:17916811

Influence of quality of care and individual patient characteristics on quality of life and return to work in survivors of the acute respiratory distress syndrome: protocol for a prospective, observational, multi-centre patient cohort study (DACAPO).

PubMed

Brandstetter, Susanne; Dodoo-Schittko, Frank; Blecha, Sebastian; Sebök, Philipp; Thomann-Hackner, Kathrin; Quintel, Michael; Weber-Carstens, Steffen; Bein, Thomas; Apfelbacher, Christian

2015-12-17

Health-related quality of life (HRQoL) and return to work are important outcomes in critical care medicine, reaching beyond mortality. Little is known on factors predictive of HRQoL and return to work in critical illness, including the acute respiratory distress syndrome (ARDS), and no evidence exists on the role of quality of care (QoC) for outcomes in survivors of ARDS. It is the aim of the DACAPO study ("Surviving ARDS: the influence of QoC and individual patient characteristics on quality of life") to investigate the role of QoC and individual patient characteristics on quality of life and return to work. A prospective, observational, multi-centre patient cohort study will be performed in Germany, using hospitals from the "ARDS Network Germany" as the main recruiting centres. It is envisaged to recruit 2400 patients into the DACAPO study and to analyse a study population of 1500 survivors. They will be followed up until 12 months after discharge from hospital. QoC will be assessed as process quality, structural quality and volume at the institutional level. The main outcomes (HRQoL and return to work) will be assessed by self-report questionnaires. Further data collection includes general medical and ARDS-related characteristics of patients as well as sociodemographic and psycho-social parameters. Multilevel hierarchical modelling will be performed to analyse the effects of QoC and individual patient characteristics on outcomes, taking the cluster structure of the data into account. By obtaining comprehensive data at patient and hospital level using a prospective multi-centre design, the DACAPO-study is the first study investigating the influence of QoC on individual outcomes of ARDS survivors.

ASQ Program Observation Instrument: A Tool for Assessing School-Age Child Care Quality.

ERIC Educational Resources Information Center

O'Connor, Susan; And Others

ASQ (Assessing School-Aged Child Care Quality) is a system for determining the quality of school-age child care programs. The ASQ Program Observation Instrument is a ten-step, self assessment process to guide program improvement. This instrument does not work well in full-day programs that have a single focus, but works well in programs that offer…

Cross-comparison of diet quality indices for predicting chronic disease risk: findings from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study.

PubMed

Alkerwi, Ala'a; Vernier, Cédric; Crichton, Georgina E; Sauvageot, Nicolas; Shivappa, Nitin; Hébert, James R

2015-01-28

The scientific community has become increasingly interested in the overall quality of diets rather than in single food-based or single nutrient-based approaches to examine diet-disease relationships. Despite the plethora of indices used to measure diet quality, there still exist questions as to which of these can best predict health outcomes. The present study aimed to compare the ability of five diet quality indices, namely the Recommendation Compliance Index (RCI), Diet Quality Index-International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet Score (MDS), and Dietary Inflammatory Index (DII), to detect changes in chronic disease risk biomarkers. Nutritional data from 1352 participants, aged 18-69 years, of the Luxembourg nationwide cross-sectional ORISCAV-LUX (Observation of Cardiovascular Risk Factors in Luxembourg) study, 2007-8, were used to calculate adherence to the diet quality index. General linear modelling was performed to assess trends in biomarkers according to adherence to different dietary patterns, after adjustment for age, sex, education level, smoking status, physical activity and energy intake. Among the five selected diet quality indices, the MDS exhibited the best ability to detect changes in numerous risk markers and was significantly associated with lower levels of LDL-cholesterol, apo B, diastolic blood pressure, renal function indicators (creatinine and uric acid) and liver enzymes (serum γ-glutamyl-transpeptidase and glutamate-pyruvate transaminase). Compared with other dietary patterns, higher adherence to the Mediterranean diet is associated with a favourable cardiometabolic, hepatic and renal risk profile. Diets congruent with current universally accepted guidelines may be insufficient to prevent chronic diseases. Clinicians and public health decision makers should be aware of needs to improve the current dietary guidelines.

Impact of STROBE Statement Publication on Quality of Observational Study Reporting: Interrupted Time Series versus Before-After Analysis

PubMed Central

Bastuji-Garin, Sylvie; Sbidian, Emilie; Gaudy-Marqueste, Caroline; Ferrat, Emilie; Roujeau, Jean-Claude; Richard, Marie-Aleth; Canoui-Poitrine, Florence

2013-01-01

Background In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series. Methods For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥4) were selected. We compared the proportions of STROBE items (STROBE score) adequately reported in each article during three periods, two pre STROBE period (2004–2005 and 2006–2007) and one post STROBE period (2008–2010). Segmented regression analysis of interrupted time series was also performed. Results Of the 456 included articles, 187 (41%) reported cohort studies, 166 (36.4%) cross-sectional studies, and 103 (22.6%) case-control studies. The median STROBE score was 57% (range, 18%–98%). Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004–05 48% versus median score2008–10 58%, p<0.001) but not between the immediate pre-STROBE period and the post-STROBE period (median score2006–07 58% versus median score2008–10 58%, p = 0.42). In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016). By segmented analysis, no significant changes in STROBE score trends occurred (−0.40%; 95%CI, −2.20 to 1.41; p = 0.64) in the post STROBE statement publication. Interpretation The quality of reports increased over time but was not affected by STROBE. Our findings raise

A conceptual framework for evaluating data suitability for observational studies.

PubMed

Shang, Ning; Weng, Chunhua; Hripcsak, George

2017-09-08

To contribute a conceptual framework for evaluating data suitability to satisfy the research needs of observational studies. Suitability considerations were derived from a systematic literature review on researchers' common data needs in observational studies and a scoping review on frequent clinical database design considerations, and were harmonized to construct a suitability conceptual framework using a bottom-up approach. The relationships among the suitability categories are explored from the perspective of 4 facets of data: intrinsic, contextual, representational, and accessible. A web-based national survey of domain experts was conducted to validate the framework. Data suitability for observational studies hinges on the following key categories: Explicitness of Policy and Data Governance, Relevance, Availability of Descriptive Metadata and Provenance Documentation, Usability, and Quality. We describe 16 measures and 33 sub-measures. The survey uncovered the relevance of all categories, with a 5-point Likert importance score of 3.9 ± 1.0 for Explicitness of Policy and Data Governance, 4.1 ± 1.0 for Relevance, 3.9 ± 0.9 for Availability of Descriptive Metadata and Provenance Documentation, 4.2 ± 1.0 for Usability, and 4.0 ± 0.9 for Quality. The suitability framework evaluates a clinical data source's fitness for research use. Its construction reflects both researchers' points of view and data custodians' design features. The feedback from domain experts rated Usability, Relevance, and Quality categories as the most important considerations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Parent-Adolescent Relationship Qualities, Internal Working Models, and Styles as Predictors of Adolescents’ Observed Interactions with Friends

PubMed Central

Shomaker, Lauren B.; Furman, Wyndol

2010-01-01

This study examined how current parent-adolescent relationship qualities and adolescents’ representations of relationships with parents were related to friendship interactions in 200 adolescent-close friend dyads. Adolescents and friends were observed discussing problems during a series of structured tasks. Negative interactions with mothers were significantly related to adolescents’ greater conflict with friends, poorer focus on tasks, and poorer communication skills. Security of working models (as assessed by interview) was significantly associated with qualities of friendship interactions, whereas security of attachment styles (as assessed by questionnaire) was not. More dismissing (vs. secure) working models were associated with poorer focus on problem discussions and weaker communication skills with friends, even after accounting for gender differences and current parent-adolescent relationship qualities. We discuss possible mechanisms for the observed links between dimensions of parent-adolescent relationships and friendships. We also consider methodological and conceptual differences between working model and style measures of attachment representations. PMID:20174459

Identifying and attributing common data quality problems: temperature and precipitation observations in Bolivia and Peru

NASA Astrophysics Data System (ADS)

Hunziker, Stefan; Gubler, Stefanie; Calle, Juan; Moreno, Isabel; Andrade, Marcos; Velarde, Fernando; Ticona, Laura; Carrasco, Gualberto; Castellón, Yaruska; Oria Rojas, Clara; Brönnimann, Stefan; Croci-Maspoli, Mischa; Konzelmann, Thomas; Rohrer, Mario

2016-04-01

Assessing climatological trends and extreme events requires high-quality data. However, for many regions of the world, observational data of the desired quality is not available. In order to eliminate errors in the data, quality control (QC) should be applied before data analysis. If the data still contains undetected errors and quality problems after QC, a consequence may be misleading and erroneous results. A region which is seriously affected by observational data quality problems is the Central Andes. At the same time, climatological information on ongoing climate change and climate risks are of utmost importance in this area due to its vulnerability to meteorological extreme events and climatic changes. Beside data quality issues, the lack of metadata and the low station network density complicate quality control and assessment, and hence, appropriate application of the data. Errors and data problems may occur at any point of the data generation chain, e.g. due to unsuitable station configuration or siting, poor station maintenance, erroneous instrument reading, or inaccurate data digitalization and post processing. Different measurement conditions in the predominantly conventional station networks in Bolivia and Peru compared to the mostly automated networks e.g. in Europe or Northern America may cause different types of errors. Hence, applying QC methods used on state of the art networks to Bolivian and Peruvian climate observations may not be suitable or sufficient. A comprehensive amount of Bolivian and Peruvian maximum and minimum temperature and precipitation in-situ measurements were analyzed to detect and describe common data quality problems. Furthermore, station visits and reviews of the original documents were done. Some of the errors could be attributed to a specific source. Such information is of great importance for data users, since it allows them to decide for what applications the data still can be used. In ideal cases, it may even allow to

Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

PubMed

Janicak, Philip G; Dunner, David L; Aaronson, Scott T; Carpenter, Linda L; Boyadjis, Terrence A; Brock, David G; Cook, Ian A; Lanocha, Karl; Solvason, Hugh B; Bonneh-Barkay, Dafna; Demitrack, Mark A

2013-12-01

Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS. Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase. Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity. These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

Water-quality data from the observation-well network in Illinois, 1985-87

USGS Publications Warehouse

Voelker, D.C.; Oberg, D.J.; Grober, M.J.

1988-01-01

The report presents water-quality and well-site information for public water-supply wells in Illinois. These wells were sampled during the period January 1985 through June 1987 as part of an ongoing cooperative ground-water observation network in the State. Water-quality data are tabulated for physical parameters, nutrients, common constituents, metals, phenols, cyanide, and volative organic compounds. A subnetwork of wells also have data on several pesticides and herbicides. Some well-site information is also presented in this report.

Mammogram image quality as a potential contributor to disparities in breast cancer stage at diagnosis: an observational study

PubMed Central

2013-01-01

Background In an ongoing study of racial/ethnic disparities in breast cancer stage at diagnosis, we consented patients to allow us to review their mammogram images, in order to examine the potential role of mammogram image quality on this disparity. Methods In a population-based study of urban breast cancer patients, a single breast imaging specialist (EC) performed a blinded review of the index mammogram that prompted diagnostic follow-up, as well as recent prior mammograms performed approximately one or two years prior to the index mammogram. Seven indicators of image quality were assessed on a five-point Likert scale, where 4 and 5 represented good and excellent quality. These included 3 technologist-associated image quality (TAIQ) indicators (positioning, compression, sharpness), and 4 machine associated image quality (MAIQ) indicators (contrast, exposure, noise and artifacts). Results are based on 494 images examined for 268 patients, including 225 prior images. Results Whereas MAIQ was generally high, TAIQ was more variable. In multivariable models of sociodemographic predictors of TAIQ, less income was associated with lower TAIQ (p < 0.05). Among prior mammograms, lower TAIQ was subsequently associated with later stage at diagnosis, even after adjusting for multiple patient and practice factors (OR = 0.80, 95% CI: 0.65, 0.99). Conclusions Considerable gains could be made in terms of increasing image quality through better positioning, compression and sharpness, gains that could impact subsequent stage at diagnosis. PMID:23621946

Clinical Knowledge from Observational Studies: Everything You Wanted to Know but Were Afraid to Ask.

PubMed

Gershon, Andrea S; Jafarzadeh, S Reza; Wilson, Kevin C; Walkey, Allan J

2018-05-07

Well-done randomized trials provide accurate estimates of treatment effect by producing groups that are similar on all measures except for the intervention of interest. However, inferences of efficacy in tightly-controlled experimental settings may not translate into similar effectiveness in real-world settings. Observational studies generally enable inferences over a wider range of patient characteristics and evaluation of a broader range of outcomes over a longer period than randomized trials. However, clinicians are often reluctant to incorporate the findings of observational studies into clinical practice. Reason for uncertainty regarding observational studies include a lack of familiarity with observational research methods, occasional disagreements between results of observational studies and randomized trials, the perceived risk of spurious results from systematic bias, and prior teaching that randomized trials are the most reliable source of medical evidence. We propose that a better understanding of observational research will enhance clinicians' ability to distinguish reliable observational studies from those that are subjected to biases and, therefore, provide more confidence to apply observational research results into clinical practice when appropriate. Herein, we explain why observational studies may be perceived as less conclusive than randomized trials, address situations in which observational research and randomized trials produced different findings, and provide information on observational study design so that quality can be evaluated. We conclude that observational research is a valuable source of medical evidence and that clinical action is strongest when supported by both high quality observational studies and randomized trials.

Professional quality of life and organizational changes: a five-year observational study in Primary Care

PubMed Central

Martin-Fernandez, Jesus; Gomez-Gascon, Tomas; Beamud-Lagos, Milagros; Cortes-Rubio, Jose Alfonso; Alberquilla-Menendez-Asenjo, Angel

2007-01-01

Background The satisfaction and the quality of life perceived by professionals have implications for the performance of health organizations. We have assessed the variations in professional quality of life (PQL) and their explanatory factors during a services management decentralization process. Methods It was designed as a longitudinal analytical observational study in a Health Area in Madrid, Spain. Three surveys were sent out during an ongoing management decentralization process between 2001 and 2005. The professionals surveyed were divided into three groups: Group I (97.3% physicians), group II (92.5% nurses) and group III (auxiliary personnel). Analysis of the tendency and elaboration of an explanatory multivariate model was made. The PQL -35 questionnaire, based on Karasek's demand-control theory, was used to measure PQL. This questionnaire recognizes three PQL dimensions: management support (MS), workload (WL) and intrinsic motivation (IM). Results 1444 responses were analyzed. PQL increased 0.16 (CI 95% 0.04 – 0.28) points in each survey. Group II presents over time a higher PQL score than group I of 0.38 (IC 95% 0.18 – 0.59) points. There is no difference between groups I and III. For each point that MS increases, PQL increases between 0.44 and 0.59 points. PQL decreases an average of between 0.35 and 0.49 point, for each point that WL increases. Age appears to have a marginal association with PQL (CI 95% 0.00 – 0.02), as it occurs with being single or not having a stable relationship (CI 95% 0.01 – 0.41). Performing management tasks currently or in the past is related to poorer PQL perception (CI 95% -0.45 – -0.06), and the same occurs with working other than morning shifts (CI 95% -0.03 – -0.40 points). PQL is not related to sex, location of the centre (rural/urban), time spent working in the organization or contractual situation. Conclusion With the improvement in work control and avoiding increases in workloads, PQL perception can be

Evaluation of Observation-Fused Regional Air Quality Model Results for Population Air Pollution Exposure Estimation

PubMed Central

Chen, Gang; Li, Jingyi; Ying, Qi; Sherman, Seth; Perkins, Neil; Rajeshwari, Sundaram; Mendola, Pauline

2014-01-01

In this study, Community Multiscale Air Quality (CMAQ) model was applied to predict ambient gaseous and particulate concentrations during 2001 to 2010 in 15 hospital referral regions (HRRs) using a 36-km horizontal resolution domain. An inverse distance weighting based method was applied to produce exposure estimates based on observation-fused regional pollutant concentration fields using the differences between observations and predictions at grid cells where air quality monitors were located. Although the raw CMAQ model is capable of producing satisfying results for O3 and PM2.5 based on EPA guidelines, using the observation data fusing technique to correct CMAQ predictions leads to significant improvement of model performance for all gaseous and particulate pollutants. Regional average concentrations were calculated using five different methods: 1) inverse distance weighting of observation data alone, 2) raw CMAQ results, 3) observation-fused CMAQ results, 4) population-averaged raw CMAQ results and 5) population-averaged fused CMAQ results. It shows that while O3 (as well as NOx) monitoring networks in the HRR regions are dense enough to provide consistent regional average exposure estimation based on monitoring data alone, PM2.5 observation sites (as well as monitors for CO, SO2, PM10 and PM2.5 components) are usually sparse and the difference between the average concentrations estimated by the inverse distance interpolated observations, raw CMAQ and fused CMAQ results can be significantly different. Population-weighted average should be used to account spatial variation in pollutant concentration and population density. Using raw CMAQ results or observations alone might lead to significant biases in health outcome analyses. PMID:24747248

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries

PubMed Central

Sun, Zeye

2017-01-01

Background It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)—the structural inputs to care—predicts the clinical quality of care provided to patients. Methods and findings Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers’ adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from −0.03 for family planning in Senegal to 0.40 for ANC in Tanzania

Association between infrastructure and observed quality of care in 4 healthcare services: A cross-sectional study of 4,300 facilities in 8 countries.

PubMed

Leslie, Hannah H; Sun, Zeye; Kruk, Margaret E

2017-12-01

It is increasingly apparent that access to healthcare without adequate quality of care is insufficient to improve population health outcomes. We assess whether the most commonly measured attribute of health facilities in low- and middle-income countries (LMICs)-the structural inputs to care-predicts the clinical quality of care provided to patients. Service Provision Assessments are nationally representative health facility surveys conducted by the Demographic and Health Survey Program with support from the US Agency for International Development. These surveys assess health system capacity in LMICs. We drew data from assessments conducted in 8 countries between 2007 and 2015: Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania, and Uganda. The surveys included an audit of facility infrastructure and direct observation of family planning, antenatal care (ANC), sick-child care, and (in 2 countries) labor and delivery. To measure structural inputs, we constructed indices that measured World Health Organization-recommended amenities, equipment, and medications in each service. For clinical quality, we used data from direct observations of care to calculate providers' adherence to evidence-based care guidelines. We assessed the correlation between these metrics and used spline models to test for the presence of a minimum input threshold associated with good clinical quality. Inclusion criteria were met by 32,531 observations of care in 4,354 facilities. Facilities demonstrated moderate levels of infrastructure, ranging from 0.63 of 1 in sick-child care to 0.75 of 1 for family planning on average. Adherence to evidence-based guidelines was low, with an average of 37% adherence in sick-child care, 46% in family planning, 60% in labor and delivery, and 61% in ANC. Correlation between infrastructure and evidence-based care was low (median 0.20, range from -0.03 for family planning in Senegal to 0.40 for ANC in Tanzania). Facilities with similar infrastructure scores

Effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality: A clinical observation study.

PubMed

Yang, Rui-Qi; Mao, Hua; Huang, Li-Yun; Su, Pei-Zhu; Lu, Min

2017-02-21

To evaluate the effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality. Forty-eight patients diagnosed with gastric ulcer between June 2014 and February 2016 were randomly allocated to the combination therapy group or monotherapy group. The former received hydrotalcite combined with esomeprazole, and the latter received esomeprazole alone, for 8 wk. Twenty-four healthy volunteers were recruited and acted as the healthy control group. Endoscopic ulcer healing was observed using white light endoscopy and narrow band imaging magnifying endoscopy. The composition of collagen fibers, amount of collagen deposition, expression of factor VIII and TGF-β1, and hydroxyproline content were analyzed by Masson staining, immunohistochemistry, immunofluorescent imaging and ELISA. Following treatment, changes in the gastric microvascular network were statistically different between the combination therapy group and the monotherapy group ( P < 0.05). There were significant differences ( P < 0.05) in collagen deposition, expression level of Factor VIII and TGF-β1, and hydroxyproline content in the two treatment groups compared with the healthy control group. These parameters in the combination therapy group were significantly higher than in the monotherapy group ( P < 0.05). The ratio of collagen I to collagen III was statistically different among the three groups, and was significantly higher in the combination therapy group than in the monotherapy group ( P < 0.05). Hydrotalcite combined with esomeprazole is superior to esomeprazole alone in improving gastric ulcer healing quality in terms of improving microvascular morphology, degree of structure maturity and function of regenerated mucosa.

Effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality: A clinical observation study

PubMed Central

Yang, Rui-Qi; Mao, Hua; Huang, Li-Yun; Su, Pei-Zhu; Lu, Min

2017-01-01

AIM To evaluate the effects of hydrotalcite combined with esomeprazole on gastric ulcer healing quality. METHODS Forty-eight patients diagnosed with gastric ulcer between June 2014 and February 2016 were randomly allocated to the combination therapy group or monotherapy group. The former received hydrotalcite combined with esomeprazole, and the latter received esomeprazole alone, for 8 wk. Twenty-four healthy volunteers were recruited and acted as the healthy control group. Endoscopic ulcer healing was observed using white light endoscopy and narrow band imaging magnifying endoscopy. The composition of collagen fibers, amount of collagen deposition, expression of factor VIII and TGF-β1, and hydroxyproline content were analyzed by Masson staining, immunohistochemistry, immunofluorescent imaging and ELISA. RESULTS Following treatment, changes in the gastric microvascular network were statistically different between the combination therapy group and the monotherapy group (P < 0.05). There were significant differences (P < 0.05) in collagen deposition, expression level of Factor VIII and TGF-β1, and hydroxyproline content in the two treatment groups compared with the healthy control group. These parameters in the combination therapy group were significantly higher than in the monotherapy group (P < 0.05). The ratio of collagen I to collagen III was statistically different among the three groups, and was significantly higher in the combination therapy group than in the monotherapy group (P < 0.05). CONCLUSION Hydrotalcite combined with esomeprazole is superior to esomeprazole alone in improving gastric ulcer healing quality in terms of improving microvascular morphology, degree of structure maturity and function of regenerated mucosa. PMID:28275307

Bullying Predicts Reported Dating Violence and Observed Qualities in Adolescent Dating Relationships.

PubMed

Ellis, Wendy E; Wolfe, David A

2015-10-01

The relationship between reported bullying, reported dating violence, and dating relationship quality measured through couple observations was examined. Given past research demonstrating similarity between peer and dating contexts, we expected that bullying would predict negative dating experiences. Participants with dating experience (n = 585; 238 males, M(age) = 15.06) completed self-report assessments of bullying and dating violence perpetration and victimization. One month later, 44 opposite-sex dyads (M(age) = 15.19) participated in behavioral observations. In 10-min sessions, couples were asked to rank and discuss areas of relationship conflict while being video-recorded. Qualities of the relationship were later coded by trained observers. Regression analysis revealed that bullying positively predicted dating violence perpetration and victimization. Self-reported bullying also predicted observations of lower relationship support and higher withdrawal. Age and gender interactions further qualified these findings. The bullying of boys, but not girls, was significantly related to dating violence perpetration. Age interactions showed that bullying was positively predictive of dating violence perpetration and victimization for older, but not younger adolescents. Positive affect was also negatively predicted by bullying, but only for girls. These findings add to the growing body of evidence that adolescents carry forward strategies learned in the peer context to their dating relationships. © The Author(s) 2014.

Application of Deconvolution Algorithm of Point Spread Function in Improving Image Quality: An Observer Preference Study on Chest Radiography.

PubMed

Chae, Kum Ju; Goo, Jin Mo; Ahn, Su Yeon; Yoo, Jin Young; Yoon, Soon Ho

2018-01-01

To evaluate the preference of observers for image quality of chest radiography using the deconvolution algorithm of point spread function (PSF) (TRUVIEW ART algorithm, DRTECH Corp.) compared with that of original chest radiography for visualization of anatomic regions of the chest. Prospectively enrolled 50 pairs of posteroanterior chest radiographs collected with standard protocol and with additional TRUVIEW ART algorithm were compared by four chest radiologists. This algorithm corrects scattered signals generated by a scintillator. Readers independently evaluated the visibility of 10 anatomical regions and overall image quality with a 5-point scale of preference. The significance of the differences in reader's preference was tested with a Wilcoxon's signed rank test. All four readers preferred the images applied with the algorithm to those without algorithm for all 10 anatomical regions (mean, 3.6; range, 3.2-4.0; p < 0.001) and for the overall image quality (mean, 3.8; range, 3.3-4.0; p < 0.001). The most preferred anatomical regions were the azygoesophageal recess, thoracic spine, and unobscured lung. The visibility of chest anatomical structures applied with the deconvolution algorithm of PSF was superior to the original chest radiography.

Bio-optical water quality dynamics observed from MERIS in Pensacola Bay, Florida

EPA Science Inventory

Observed bio-optical water quality data collected from 2009 to 2011 in Pensacola Bay, Florida were used to develop empirical remote sensing retrieval algorithms for chlorophyll a (Chla), colored dissolved organic matter (CDOM), and suspended particulate matter (SPM). Time-series ...

A new method to evaluate image quality of CBCT images quantitatively without observers

PubMed Central

Shimizu, Mayumi; Okamura, Kazutoshi; Yoshida, Shoko; Weerawanich, Warangkana; Tokumori, Kenji; Jasa, Gainer R; Yoshiura, Kazunori

2017-01-01

Objectives: To develop an observer-free method for quantitatively evaluating the image quality of CBCT images by applying just-noticeable difference (JND). Methods: We used two test objects: (1) a Teflon (polytetrafluoroethylene) plate phantom attached to a dry human mandible; and (2) a block phantom consisting of a Teflon step phantom and an aluminium step phantom. These phantoms had holes with different depths. They were immersed in water and scanned with a CB MercuRay (Hitachi Medical Corporation, Tokyo, Japan) at tube voltages of 120 kV, 100 kV, 80 kV and 60 kV. Superimposed images of the phantoms with holes were used for evaluation. The number of detectable holes was used as an index of image quality. In detecting holes quantitatively, the threshold grey value (ΔG), which differentiated holes from the background, was calculated using a specific threshold (the JND), and we extracted the holes with grey values above ΔG. The indices obtained by this quantitative method (the extracted hole values) were compared with the observer evaluations (the observed hole values). In addition, the contrast-to-noise ratio (CNR) of the shallowest detectable holes and the deepest undetectable holes were measured to evaluate the contribution of CNR to detectability. Results: The results of this evaluation method corresponded almost exactly with the evaluations made by observers. The extracted hole values reflected the influence of different tube voltages. All extracted holes had an area with a CNR of ≥1.5. Conclusions: This quantitative method of evaluating CBCT image quality may be more useful and less time-consuming than evaluation by observation. PMID:28045343

Successful integration efforts in water quality from the integrated Ocean Observing System Regional Associations and the National Water Quality Monitoring Network

USGS Publications Warehouse

Ragsdale, R.; Vowinkel, E.; Porter, D.; Hamilton, P.; Morrison, R.; Kohut, J.; Connell, B.; Kelsey, H.; Trowbridge, P.

2011-01-01

The Integrated Ocean Observing System (IOOS??) Regional Associations and Interagency Partners hosted a water quality workshop in January 2010 to discuss issues of nutrient enrichment and dissolved oxygen depletion (hypoxia), harmful algal blooms (HABs), and beach water quality. In 2007, the National Water Quality Monitoring Council piloted demonstration projects as part of the National Water Quality Monitoring Network (Network) for U.S. Coastal Waters and their Tributaries in three IOOS Regional Associations, and these projects are ongoing. Examples of integrated science-based solutions to water quality issues of major concern from the IOOS regions and Network demonstration projects are explored in this article. These examples illustrate instances where management decisions have benefited from decision-support tools that make use of interoperable data. Gaps, challenges, and outcomes are identified, and a proposal is made for future work toward a multiregional water quality project for beach water quality.

Uncertainty in air quality observations using low-cost sensors

NASA Astrophysics Data System (ADS)

Castell, Nuria; Dauge, Franck R.; Dongol, Rozina; Vogt, Matthias; Schneider, Philipp

2016-04-01

Air pollution poses a threat to human health, and the WHO has classified air pollution as the world's largest single environmental health risk. In Europe, the majority of the population lives in areas where air quality levels frequently exceed WHO's ambient air quality guidelines. The emergence of low-cost, user-friendly and very compact air pollution platforms allowing observations at high spatial resolution in near real-time, provides us with new opportunities to simultaneously enhance existing monitoring systems as well as enable citizens to engage in more active environmental monitoring (citizen science). However the data sets generated by low-cost sensors show often questionable data quality. For many sensors, neither their error characteristics nor how their measurement capability holds up over time or through a range of environmental conditions, have been evaluated. We have conducted an exhaustive evaluation of the commercial low-cost platform AQMesh (measuring NO, NO2, CO, O3, PM10 and PM2.5) in laboratory and in real-world conditions in the city of Oslo (Norway). Co-locations in field of 24 platforms were conducted over a 6 month period (April to September 2015) allowing to characterize the temporal variability in the performance. Additionally, the field performance included the characterization on different monitoring urban monitoring sites characteristic of both traffic and background conditions. All the evaluations have been conducted against CEN reference method analyzers maintained according to the Norwegian National Reference Laboratory quality system. The results show clearly that a good performance in laboratory does not imply similar performance in real-world outdoor conditions. Moreover, laboratory calibration is not suitable for subsequent measurements in urban environments. In order to reduce the errors, sensors require on-site field calibration. Even after such field calibration, the platforms show a significant variability in the performance

Quality of life of caregivers: a cross-sectional study.

PubMed

Ovayolu, Ozlem; Ovayolu, Nimet; Tuna, Döndü; Serçe, Sibel; Sevinç, Alper; Pirbudak Çöçelli, Lütfiye

2014-08-01

This descriptive study was conducted to evaluate the quality of life of cancer caregivers. One hundred and seventy-eight caregivers of patients who were diagnosed with cancer in Gaziantep oncology hospital participated in the study. Data were collected by using a questionnaire and quality of life scale. The scale was scored between 0 and 10, where '10' indicated the best and '0' indicated the worst level. It was determined that the majority of caregivers were young and female, the overall total score average of quality of life was 4.5 ± 1.1, and the subdomain with the lowest value was the psychological subdomain. All quality of life subdomain score averages and the overall total score averages were observed to be low in women, as well as in those who provided care for their own children, who lived in the same house with the patient and who gave care for 19-24 h daily. © 2013 Wiley Publishing Asia Pty Ltd.

A simple method for low-contrast detectability, image quality and dose optimisation with CT iterative reconstruction algorithms and model observers.

PubMed

Bellesi, Luca; Wyttenbach, Rolf; Gaudino, Diego; Colleoni, Paolo; Pupillo, Francesco; Carrara, Mauro; Braghetti, Antonio; Puligheddu, Carla; Presilla, Stefano

2017-01-01

The aim of this work was to evaluate detection of low-contrast objects and image quality in computed tomography (CT) phantom images acquired at different tube loadings (i.e. mAs) and reconstructed with different algorithms, in order to find appropriate settings to reduce the dose to the patient without any image detriment. Images of supraslice low-contrast objects of a CT phantom were acquired using different mAs values. Images were reconstructed using filtered back projection (FBP), hybrid and iterative model-based methods. Image quality parameters were evaluated in terms of modulation transfer function; noise, and uniformity using two software resources. For the definition of low-contrast detectability, studies based on both human (i.e. four-alternative forced-choice test) and model observers were performed across the various images. Compared to FBP, image quality parameters were improved by using iterative reconstruction (IR) algorithms. In particular, IR model-based methods provided a 60% noise reduction and a 70% dose reduction, preserving image quality and low-contrast detectability for human radiological evaluation. According to the model observer, the diameters of the minimum detectable detail were around 2 mm (up to 100 mAs). Below 100 mAs, the model observer was unable to provide a result. IR methods improve CT protocol quality, providing a potential dose reduction while maintaining a good image detectability. Model observer can in principle be useful to assist human performance in CT low-contrast detection tasks and in dose optimisation.

QUALITY SCIENCE AND QUALITY ASSURANCE: OBSERVATIONS OR AN ENVIRONMENTAL SCIENTIST

EPA Science Inventory

--

ABSTRACT
The purpose of this manuscript is to examine the relationship between quality science (QS) and quality assurance (QA). Many research scientists definitely want to do QS, but are afraid or do not want to do QA because they are intimidated by the QA proc...

Radiologic assessment of quality of root canal fillings and periapical status in an Austrian subpopulation – An observational study

PubMed Central

Frank, Wilhelm; Madaus, Theresa

2017-01-01

Background/Objective Progress in endodontic techniques and methodological advances have altered root canal therapy over the last decades. These techniques and methods need periodical documentation. This observational study determined the current prevalence of endodontic treatments, and investigated the relationship of various factors with the periapical status in a Lower Austrian subpopulation. Methodology One thousand orthopantomograms of first-time university adult patients radiographed at an outpatient clinic were evaluated. For each tooth, the presence of periradicular pathosis and/or endodontic treatment was recorded, as was the quality of (post-)endodontic treatment (homogeneity and length of root canal fillings; preparation failures; posts/screws; apicoectomies; coronal restorations). Two evaluators, blinded to each other, scored all teeth. In cases of disagreement, they joined for a consensus score. Results In all, 22,586 teeth were counted. Of these, 2,907 teeth (12.9%) had periapical pathosis, while 2,504 teeth had undergone root canal treatment. Of the endodontically treated teeth, 52% showed no radiographic signs of apical periodontitis, while 44.9% had overt apical lesions, and 3,1% revealed widened periodontal ligament space. The majority of the root canal fillings was inhomogeneous (70.4%); 75.4% were rated too short, and 3.8% too long. The presence of apical pathosis was significantly correlated (odds ratio (OR) 2.556 [confidence interval (CI) 2.076–3.146]; P<0.0001) with poor root canal fillings (length and homogeneity). Posts or screws positively affected periapical status (OR 1.853 [CI 1.219–2.819]; P = 0.004), but endodontically treated posterior teeth were infrequently restored (posts, 7.5%; screws, 2.7%). Best results were found for teeth with both appropriate endodontic treatment and adequate coronal restoration. Conclusion A high prevalence of periradicular radiolucencies was observed with root canal filled teeth, along with high numbers

SU-F-J-178: A Computer Simulation Model Observer for Task-Based Image Quality Assessment in Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dolly, S; Mutic, S; Anastasio, M

Purpose: Traditionally, image quality in radiation therapy is assessed subjectively or by utilizing physically-based metrics. Some model observers exist for task-based medical image quality assessment, but almost exclusively for diagnostic imaging tasks. As opposed to disease diagnosis, the task for image observers in radiation therapy is to utilize the available images to design and deliver a radiation dose which maximizes patient disease control while minimizing normal tissue damage. The purpose of this study was to design and implement a new computer simulation model observer to enable task-based image quality assessment in radiation therapy. Methods: A modular computer simulation framework wasmore » developed to resemble the radiotherapy observer by simulating an end-to-end radiation therapy treatment. Given images and the ground-truth organ boundaries from a numerical phantom as inputs, the framework simulates an external beam radiation therapy treatment and quantifies patient treatment outcomes using the previously defined therapeutic operating characteristic (TOC) curve. As a preliminary demonstration, TOC curves were calculated for various CT acquisition and reconstruction parameters, with the goal of assessing and optimizing simulation CT image quality for radiation therapy. Sources of randomness and bias within the system were analyzed. Results: The relationship between CT imaging dose and patient treatment outcome was objectively quantified in terms of a singular value, the area under the TOC (AUTOC) curve. The AUTOC decreases more rapidly for low-dose imaging protocols. AUTOC variation introduced by the dose optimization algorithm was approximately 0.02%, at the 95% confidence interval. Conclusion: A model observer has been developed and implemented to assess image quality based on radiation therapy treatment efficacy. It enables objective determination of appropriate imaging parameter values (e.g. imaging dose). Framework flexibility allows for

Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity.

PubMed

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M Teresa; Losada, José L; Portell, Mariona; Lozano-Lozano, José A

2018-01-01

Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity

PubMed Central

Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M. Teresa; Losada, José L.; Portell, Mariona; Lozano-Lozano, José A.

2018-01-01

Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

Technology Needs Assessment of an Atmospheric Observation System for Multidisciplinary Air Quality/Meteorology Missions, Part 2

NASA Technical Reports Server (NTRS)

Alvarado, U. R.; Bortner, M. H.; Grenda, R. N.; Brehm, W. F.; Frippel, G. G.; Alyea, F.; Kraiman, H.; Folder, P.; Krowitz, L.

1982-01-01

The technology advancements that will be necessary to implement the atmospheric observation systems are considered. Upper and lower atmospheric air quality and meteorological parameters necessary to support the air quality investigations were included. The technology needs were found predominantly in areas related to sensors and measurements of air quality and meteorological measurements.

The impact of airway management on quality of cardiopulmonary resuscitation: an observational study in patients during cardiac arrest.

PubMed

Yeung, Joyce; Chilwan, Mehboob; Field, Richard; Davies, Robin; Gao, Fang; Perkins, Gavin D

2014-07-01

Minimising interruptions in chest compressions is associated with improved survival from cardiac arrest. Current in-hospital guidelines recommend continuous chest compressions after the airway is secured on the premise that this will reduce no flow time. The aim of this study was to determine the effect of advanced airway use on the no flow ratio and other measures of CPR quality. Consecutive adult patients who sustained an in-hospital cardiac arrest were enrolled in this prospective observational study. The quality of CPR was measured using the Q-CPR device (Phillips, UK) before and after an advanced airway device (endotracheal tube [ET] or laryngeal mask airway [LMA]) was inserted. Patients receiving only bag-mask ventilation were used as the control cohort. The primary outcome was no flow ratio (NFR). Secondary outcomes were chest compression rate, depth, compressions too shallow, compressions with leaning, ventilation rate, inflation time, change in impedance and time required to successfully insert airway device. One hundred patients were enrolled in the study (2008-2011). Endotracheal tube and LMA placement took similar durations (median 15.8 s (IQR 6.8-19.4) vs. LMA median 8.0s (IQR 5.5-15.9), p=0.1). The use of an advanced airway was associated with improved no flow ratios (endotracheal tube placement (n=50) improved NFR from baseline median 0.24 IQR 0.17-0.40) to 0.15 to (IQR 0.09-0.28), p=0.012; LMA (n=25) from median 0.28 (IQR 0.23-0.40) to 0.13 (IQR 0.11- 0.19), p=0.0001). There was no change in NFR in patients managed solely with bag valve mask (BVM) (n=25) (median 0.29 (IQR 0.18-0.59) vs. median 0.26 (IQR 0.12-0.37), p=0.888). There was no significant difference in time taken to successfully insert the airway device between the two groups. The use of an advanced airway (ETT or LMA) during in-hospital cardiac arrest was associated with improved no flow ratio. Further studies are required to determine the effect of airway devices on overall patient

Technological aspects of hospital communication challenges: an observational study.

PubMed

Popovici, Ilinca; Morita, Plinio P; Doran, Diane; Lapinsky, Stephen; Morra, Dante; Shier, Ashleigh; Wu, Robert; Cafazzo, Joseph A

2015-06-01

To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. N/A. N/A. The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. The issues listed should be considered in the design of new technology for hospital communications. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Quality of dispatch-assisted cardiopulmonary resuscitation by lay rescuers following a standard protocol in Japan: an observational simulation study.

PubMed

Asai, Hideki; Fukushima, Hidetada; Bolstad, Francesco; Okuchi, Kazuo

2018-04-01

Bystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch-assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study. We recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation. Dispatchers provided instruction in accordance with the standard DACPR protocol in Japan. Twenty-three laypersons (13 with CPR training experience within the past 2 years and 10 with no training experience) participated in this study. The median chest compression rate and depth were 106/min and 33 mm, respectively. The median time interval from placing the 119 call to the start of chest compressions was 119 s. No significant difference was found between the groups with and without training experience. However, subjects with training experience more frequently placed their hands correctly on the manikin (84.6% versus 40.0%; P = 0.026). Twelve participants (52.2%, seven in trained and five in untrained group) interrupted chest compressions for 3-18 s, because dispatchers asked if the patient started breathing or moving. This current simulation study showed that the quality of DACPR carried out by lay rescuers can be less than optimal in terms of depth, hand placement, and minimization of pauses. Further studies are required to explore better DACPR instruction methods to help lay rescuers perform CPR with optimal quality.

How Many Classroom Observations Are Sufficient? Empirical Findings in the Context of a Longitudinal Study

ERIC Educational Resources Information Center

Shih, Jeffrey C.; Ing, Marsha; Tarr, James E.

2013-01-01

One method to investigate classroom quality is for a person to observe what is happening in the classroom. However, this method raises practical and technical concerns such as how many observations to collect, when to collect these observations and who should collect these observations. The purpose of this study is to provide empirical evidence to…

Socioeconomic and race/ethnic disparities in observed park quality.

PubMed

Engelberg, Jessa K; Conway, Terry L; Geremia, Carrie; Cain, Kelli L; Saelens, Brian E; Glanz, Karen; Frank, Lawrence D; Sallis, James F

2016-05-12

Though park presence and access disparities are well studied for their associations with physical activity (PA), disparities in the availability and quality of amenities and facilities within parks have been infrequently examined. Five hundred forty-three parks from 472 block groups in the Seattle, WA and Baltimore, MD regions were audited using the Environmental Assessment of Public Recreation Spaces (EAPRS) to assess presence and quality (e.g., condition, cleanliness) of amenities (e.g., restrooms, seating) and facilities (e.g., fields, courts). General linear model regressions investigated Census 2000-derived neighborhood race/ethnicity and income main effect and interactive relationships with 7 park quality summary scores: 1) trails, 2) open space, 3) sports facilities, 4) PA facilities count, 5) PA facilities quality, 6) aesthetics, and 7) overall amenities, controlling for park size. The regions were analyzed separately due to differing race/ethnicity distributions. In the Seattle region, neighborhood income was significantly negatively associated with sports quality score (p < .043), PA facilities total count (p < .015) and the overall amenities quality score (p < .004) (unexpected direction). In the Baltimore region, neighborhood race/ethnicity (percent White/non-Hispanic) was significantly positively related to the open spaces quality score (p < .011) (expected direction). A significant income-by-race/ethnicity interaction was found for PA facilities quality (p = .014), with high-percent minority neighborhoods having higher quality parks in high- vs. low-income neighborhoods, yet was opposite in mostly White/non-Hispanic neighborhoods. The other income-by-race/ethnicity interaction was for overall amenities quality score (p = .043), where scores in high-percent minority neighborhoods were best in high- vs. low-income neighborhoods. There was little difference in scores within mostly White or mixed neighborhoods by income. Patterns

Using EFSO/PQC to Improve the Quality of Observations and Analyses

NASA Astrophysics Data System (ADS)

Chen, T. C.; Kalnay, E.

2017-12-01

Massive amounts of observations are assimilated every day into modern Numerical Weather Prediction (NWP) systems. This makes difficult to estimate the impact of a new observing system using the current approach (Observing System Experiments, OSEs) because there is already so much information provided by existing observations. In addition, the large volume of data also prevents monitoring the impact of each assimilated observation with OSEs. We demonstrate here how using Ensemble Forecast Sensitivity to Observations (EFSO) allows monitoring and improving the impact of observations on the analyses and forecasts in the Hybrid GSI/LETKF system. In addition, we show how EFSO can identify flow dependent detrimental observations from observing systems that, on the average, are beneficial. For example, using EFSO we find that positive zonal wind innovations in MODIS polar winds are generally detrimental, whereas no such bias is present in other satellite wind systems. We also show how EFSO can be used to identify and reject very detrimental observations (Proactive Quality Control, PQC). The withdrawal of these detrimental observations leads to improved analyses and 5-day forecasts, which also serves as a verification of EFSO. The operational implementation of PQC/EFSO is computationally very feasible, and will provide detailed QC monitoring of every observing system. Finally, we provide a theoretical justification of the PQC and its connection to dynamical instabilities with a simple Lorenz 96 model.

A prospective observational study assessing home parenteral nutrition in patients with gastrointestinal cancer: benefits for quality of life.

PubMed

Senesse, Pierre; Tadmouri, Abir; Culine, Stéphane; Dufour, Patrick R; Seys, Patrick; Radji, Abderraouf; Rotarski, Maciej; Balian, Axel; Chambrier, Cecile

2015-02-01

Patients with gastrointestinal cancer are at high risk for deterioration of nutrition. Home parenteral nutrition (HPN) could improve nutritional status and quality of life (QoL). The purpose of this study was 1) to evaluate the impact of HPN on QoL, 2) to assess changes in nutritional status, and 3) to assess proxy perception of patient well-being. We conducted a prospective, observational, and a multicenter study. Inclusion criteria were adult patients with gastrointestinal cancer, for whom HPN was indicated and prescribed for at least 14 days. The physician, the patient, and a family member completed questionnaires at inclusion and 28 days later. The QoL was assessed by the patients using the Functional Assessment of Cancer Therapy-General questionnaire, at inclusion and 28 days later. The study included 370 patients with gastrointestinal cancer. The HPN was indicated for cancer-related undernutrition in 89% of the patients and was used as a complement to oral intake in 84%. After 28 days of parenteral intake, global QoL was significantly increased (48.9 at inclusion vs. 50.3, P=0.007). The patients' weight improved significantly by 2.7% (P<0.001). The nutrition risk screening also decreased significantly (3.2±1.1 vs. 2.8±1.3, P=0.003). HPN could provide benefit for malnourished patients with gastrointestinal cancer. However, randomized controlled studies are required to confirm this benefit and the safety profile. Copyright © 2015. Published by Elsevier Inc.

Observational Needs for Four-Dimensional Air Quality Characterization

EPA Science Inventory

Surface-based monitoring programs provide the foundation for associating air pollution and causal effects in human health studies, and they support the development of air quality standards and the preparation of emission reduction strategies. While surface oriented networks remai...

Construction activity, emissions, and air quality impacts : real-world observations from an Arizona road-widening case study.

DOT National Transportation Integrated Search

2010-10-22

The Arizona Department of Transportation (ADOT) sponsored this investigation, a field : study of emissions and air quality impacts generated from a road widening project, to gain : insight into construction-related emissions of particulate matter (PM...

STRengthening Analytical Thinking for Observational Studies: the STRATOS initiative

PubMed Central

Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

2014-01-01

The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even ‘standard’ analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. PMID:25074480

STRengthening analytical thinking for observational studies: the STRATOS initiative.

PubMed

Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

2014-12-30

The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even 'standard' analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

A statistical model for water quality predictions from a river discharge using coastal observations

NASA Astrophysics Data System (ADS)

Kim, S.; Terrill, E. J.

2007-12-01

Understanding and predicting coastal ocean water quality has benefits for reducing human health risks, protecting the environment, and improving local economies which depend on clean beaches. Continuous observations of coastal physical oceanography increase the understanding of the processes which control the fate and transport of a riverine plume which potentially contains high levels of contaminants from the upstream watershed. A data-driven model of the fate and transport of river plume water from the Tijuana River has been developed using surface current observations provided by a network of HF radar operated as part of a local coastal observatory that has been in place since 2002. The model outputs are compared with water quality sampling of shoreline indicator bacteria, and the skill of an alarm for low water quality is evaluated using the receiver operating characteristic (ROC) curve. In addition, statistical analysis of beach closures in comparison with environmental variables is also discussed.

The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit.

PubMed

Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

2017-04-01

The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care.

The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit

PubMed Central

Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

2017-01-01

The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care. PMID:28288104

Tweets about hospital quality: a mixed methods study

PubMed Central

Greaves, Felix; Laverty, Antony A; Cano, Daniel Ramirez; Moilanen, Karo; Pulman, Stephen; Darzi, Ara; Millett, Christopher

2014-01-01

Background Twitter is increasingly being used by patients to comment on their experience of healthcare. This may provide information for understanding the quality of healthcare providers and improving services. Objective To examine whether tweets sent to hospitals in the English National Health Service contain information about quality of care. To compare sentiment on Twitter about hospitals with established survey measures of patient experience and standardised mortality rates. Design A mixed methods study including a quantitative analysis of all 198 499 tweets sent to English hospitals over a year and a qualitative directed content analysis of 1000 random tweets. Twitter sentiment and conventional quality metrics were compared using Spearman's rank correlation coefficient. Key results 11% of tweets to hospitals contained information about care quality, with the most frequent topic being patient experience (8%). Comments on effectiveness or safety of care were present, but less common (3%). 77% of tweets about care quality were positive in tone. Other topics mentioned in tweets included messages of support to patients, fundraising activity, self-promotion and dissemination of health information. No associations were observed between Twitter sentiment and conventional quality metrics. Conclusions Only a small proportion of tweets directed at hospitals discuss quality of care and there was no clear relationship between Twitter sentiment and other measures of quality, potentially limiting Twitter as a medium for quality monitoring. However, tweets did contain information useful to target quality improvement activity. Recent enthusiasm by policy makers to use social media as a quality monitoring and improvement tool needs to be carefully considered and subjected to formal evaluation. PMID:24748372

[Study on seed quality test and quality standard of Pesudostellaria heterophylla].

PubMed

Xiao, Cheng-Hong; Zhou, Tao; Jiang, Wei-Ke; Chen, Min; Xiong, Hou-Xi; Liao, Ming-Wu

2014-08-01

Referring to the rules for agricultural seed testing (GB /T 3543-1995) issued by China, the test of sampling, seed purity, weight per 1 000 seeds, seed moisture, seed viability and germination rate had been studied for screening seed quality test methods of Pesudostellaria heterophylla. The seed quality from different collection areas was measured. The results showed that at least 6.5 g seeds should be sampled and passed through 10-mesh sieve for purity analysis. The weight of 1 000 seeds was determined by using the 500-seed method. The phenotypic observation and size measurement were used for authenticity testing. The seed moisture was determined under the higher temperature (130 ± 2) degrees C for 5 hours. The seeds were dipped into 0.2% TTC sustaining 1 hour at 40 degrees C, then the viability could be determined. The break dormancy seeds were cultured on sand at 10 degrees C. K cluster analysis was applied for the data analysis, the seed quality from different collection areas grading of P. Heterophylla was described as three grades. The seed quality of each grade should reach following requirements: for first grade seeds, germination rate ≥ 86%, 1 000-grain weight ≥ 2.59 g, purity ≥ 87%, moisture ≤ 13.1%; for second grade seeds, germination rate ≥ 70%, 1 000-grain weight ≥ 2.40 g, purity ≥ 77%, moisture ≤ 14.3%; for third grade seeds, germination rate ≥ 41%, 1 000-grain weight ≥ 2.29 g, purity ≥ 76%, moisture ≤ 15.8%. The seed testing methods for quality items of P. heterophylla had been initially established, as well as the primary P. heterophylla seed quality classification standard.

Perceptions of Friendship Quality and Observed Behaviors with Friends: How Do Sociometrically Rejected, Average, and Popular Girls Differ?

ERIC Educational Resources Information Center

Lansford, Jennifer E.; Putallaz, Martha; Grimes, Christina L.; Schiro-Osman, Kimberlea A.; Kupersmidt, Janis B.; Coie, John D.

2006-01-01

This study examined associations between sociometric status and friendship quality using observational and questionnaire data from 139 fourth-grade girls and their friends. Multivariate analyses of covariance (controlling for ethnicity and socioeconomic status) showed that rejected girls and their friends did not differ in their reported…

Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study.

PubMed

Iacono Isidoro, Serena; Salvaggio, Adriana; Lo Bue, Anna; Romano, Salvatore; Marrone, Oreste; Insalaco, Giuseppe

2016-12-01

Perceived Health Related Quality of Life (HRQoL) is impaired in obstructive sleep apnea (OSA). This study examines changes in HRQoL aspects occurring immediately after CPAP titration. Furthermore, we analyzed variations in each gender and in patients undergoing home or laboratory-based CPAP titration pathways. Twohundredfive outpatients (151 M) (56.7 ± 10.3 years) were evaluated, before first visit and nocturnal diagnostic examination (T0), and the morning after CPAP titration (T1). Two self-reported HRQoL questionnaires were administered: Psychological General Well-Being Index (PGWBI), composed by six subscales, and 12-Item Short-Form Health Survey (SF-12), including Physical (PCS) and Mental Component Summaries (MCS). CPAP titration was performed using auto-adjusting CPAP units at patients' home or in the sleep laboratory. PGWBI scores at T1 improved compared to T0 (p < 0.0001). A similar improvement was observed in SF-12 MCS (p = 0.0011), but not in SF-12 PCS. Changes were independent from anthropometric parameters, OSA severity and excessive daytime sleepiness. Gender comparisons showed better HRQoL in males at both times. At T0, patients who received home or laboratory CPAP titration pathways did not show any differences in PGWBI and SF-12 scores. At T1, PGWBI and SF-12 MCS improved in both home and laboratory groups. This study gives evidence that first time CPAP application for titration can lead to a general increase in perceived well-being. Gender comparisons showed better perceived HRQoL with more subscales improvements in males after CPAP titration. The improvement was similar with both home and laboratory CPAP titration pathways.

Quality of life in patients referring to private osteopathic clinical practice: a prospective observational study.

PubMed

Cerritelli, Francesco; Verzella, Marco; Barlafante, Gina

2014-08-01

Health improvement is one of the main priorities of both public and private health systems. In recent years, more attention has been given to the use of complementary and alternative medicines, including osteopathic manipulative treatment (OMT), as possible effective interventions in increasing patients' health reported outcomes. With regard to OMT, very little research was focused on its effectiveness in enhancing health in the general population. To explore the extent to which OMT is effective in improving quality of life in referring patients. Cohort study. Private osteopathic clinical practices in Italy. 25 osteopaths from Central and Southern Italy participated in the study. Self-referred patients, with a diagnosed musculo-skeletal disorder and older than 18 years of age, who did not undergo any OMT session in the previous 12 months and/or contemporarily additional manual therapies were enrolled. Changing from baseline SF36 general health sub-domain scores was used as the study primary outcomes. 1000 patients with primary diagnosis of musculo-skeletal disorder were initially enrolled. 988 patients completed the study. After 4 weeks, mean general health score was 14.7 points higher (95% CI 13.9-15.6; Cohen's d=0.84). Similarly, physical and mental component scores increased (11.5; 95% CI 10.8-12.1; d=0.87 and 9.6; 95% CI 8.6-10.5; d=0.61 respectively). No association between SF36 domains and socio-demographic exposures was found to be statistically significant. Positive changes on various quality of life dimensions were reported by patients receiving osteopathic treatment. The trial was registered on clinicaltrials.gov (identifier NCT01965678). Copyright © 2014 Elsevier Ltd. All rights reserved.

Observational study of sleep, respiratory mechanics and quality of life in patients with non-cystic fibrosis bronchiectasis: a protocol study

PubMed Central

Faria Júnior, Newton Santos; Oliveira, Luis Vicente Franco; Perez, Eduardo Araújo; de Oliveira, Ezequiel Fernandes; Apostolico, Nadua; Pereira, Nixon Alves; dos Santos, Israel dos Reis; Urbano, Jessica Julioti; Souza, Ismael Dias; Polonio, Igor Bastos; Romaldini, José Gustavo Barian; Pereira, Déborah Madeu; Alves, Vera Lúcia dos Santos; Souza, Ângela Honda; Nascimento, Oliver Augusto; Jardim, José Roberto; Stirbulov, Roberto

2015-01-01

Introduction Bronchiectasis is a chronic disorder characterised by permanent and irreversible abnormal dilation of the bronchi and bronchioles, primarily caused by repeated cycles of pulmonary infections and inflammation, which lead to reduced mucociliary clearance and to the excessive production of sputum. Patients with non-cystic fibrosis bronchiectasis may be predisposed to hypoxemia during sleep, or to symptoms that may lead to arousals and thereby reduce the quality of life, because of the irreversible dilation of the bronchi and the presence of secretions and airflow obstruction. Methods and analysis For this cross-sectional observational study, patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis will be recruited from the Bronchiectasis Clinic of the Pneumology Department of the Santa Casa de Misericordia Hospital and the Federal University of São Paulo (São Paulo, Brazil). Patients of either sex will be included if high-resolution CT of the thorax and classic sweat test confirms they have non-cystic fibrosis bronchiectasis, are between 18 and 80 years old, use long-acting bronchodilators, are clinically stable for a least 1 month, agree to participate in the study and they sign a statement of informed consent. The first part of the study will involve a clinical evaluation, maximal respiratory pressures, spirometry and the Saint George's Respiratory Questionnaire. The Sleep Laboratory of the Master's and Doctoral Postgraduate Program in Rehabilitation Sciences of the Nove de Julho University (São Paulo, Brazil) will perform the polysomnographic studies, Berlin Questionnaire, Epworth Sleepiness Scale, waist and neck circumferences, modified Mallampati classification and tonsil index. Ethics and dissemination This protocol has been approved by the Human Research Ethics Committees of Santa Casa de Misericordia Hospital (process number 178/2012) and Human Research Ethics Committee of Nove de Julho University (process number 370474

Clinical leadership: using observations of care to focus risk management and quality improvement activities in the clinical setting.

PubMed

Ferguson, Lorraine; Calvert, Judy; Davie, Marilyn; Fallon, Mark; Fred, Nada; Gersbach, Vicki; Sinclair, Lynn

2007-04-01

In an era when patient safety and quality of care are a daily concern for health care professionals, it is important for nurse managers and other clinical leaders to have a repertoire of skills and interventions that can be used to motivate and engage clinical teams in risk assessment and continuous quality improvement at the level of patient care delivery. This paper describes how a cohort of clinical leaders who were undertaking a leadership development program used a relatively simple, patient-focused intervention called the 'observation of care' to help focus the clinical team's attention on areas for improvement within the clinical setting. The main quality and safety themes arising out of the observations that were undertaken by the Clinical Leaders (CLs) were related to the environment, occupational health and safety, communication and team function, clinical practice and patient care. The observations of care also provided the CLs with many opportunities to acknowledge and celebrate exemplary practice as it was observed as a means of enhancing the development of a quality and safety culture within the clinical setting. The 'observation of care' intervention can be used by Clinical Leader's to engage and motivate clinical teams to focus on continuously improving the safety and quality of their own work environment and the care delivered to patients within that environment.

Methodological quality of meta-analyses of single-case experimental studies.

PubMed

Jamshidi, Laleh; Heyvaert, Mieke; Declercq, Lies; Fernández-Castilla, Belén; Ferron, John M; Moeyaert, Mariola; Beretvas, S Natasha; Onghena, Patrick; Van den Noortgate, Wim

2017-12-28

Methodological rigor is a fundamental factor in the validity and credibility of the results of a meta-analysis. Following an increasing interest in single-case experimental design (SCED) meta-analyses, the current study investigates the methodological quality of SCED meta-analyses. We assessed the methodological quality of 178 SCED meta-analyses published between 1985 and 2015 through the modified Revised-Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. The main finding of the current review is that the methodological quality of the SCED meta-analyses has increased over time, but is still low according to the R-AMSTAR checklist. A remarkable percentage of the studies (93.80% of the included SCED meta-analyses) did not even reach the midpoint score (22, on a scale of 0-44). The mean and median methodological quality scores were 15.57 and 16, respectively. Relatively high scores were observed for "providing the characteristics of the included studies" and "doing comprehensive literature search". The key areas of deficiency were "reporting an assessment of the likelihood of publication bias" and "using the methods appropriately to combine the findings of studies". Although the results of the current review reveal that the methodological quality of the SCED meta-analyses has increased over time, still more efforts are needed to improve their methodological quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mixing Heights and Three-Dimensional Ozone Structure Observed by Airborne Lidar During the 2006 Texas Air Quality Study

NASA Astrophysics Data System (ADS)

Hardesty, R. M.; Senff, C. J.; Alvarez, R. J.; Banta, R. M.; Sandberg, S. P.; Weickmann, A. M.; Darby, L. S.

2007-12-01

A new all solid state ozone lidar was deployed on a NOAA Twin Otter to study boundary layer ozone and aerosol, mostly around Houston, during the 2006 Texas Air Quality Study. The new instrument transmits high pulse-rate, low pulse-energy light at 3 wavelengths in the ultraviolet to obtain ozone profiles with 500 m horizontal resolution and 90 m vertical resolution. During the Texas field study, 20 research flights resulted in nearly 70 hours of ozone measurements during the period from August 1 to September 15. Science objectives included characterization of background ozone levels over rural areas near Houston and Dallas and variability and structure of the boundary layer over different surface types, including urban, wooded, and agricultural land surface areas as well as over Galveston Bay and the Gulf of Mexico. A histogram of all boundary layer ozone concentration measurements showed a bimodal distribution with modes at 45 ppb and 70 ppb. The lower mode correlated with southerly flow, when relatively clean air was transported onshore into the Houston area. Segmenting the observations during southerly flow by region, including the Gulf of Mexico, land within about 55 km from the coast, and further inland indicated that background levels increased by about 10 ppb as air was transported onshore. During the latter part of the experiment, as more pollution was imported into the Houston region, background levels rose to nearly 80 ppb in regions N of Houston. Two flights aimed at observing import of ozone into Texas from the east showed that ozone concentrations increased and boundary layer depths deepened upwind of Houston between September 4 and September 8. Background levels rose by more than 10 ppb over this period. In addition to ozone measurements, we also estimated boundary layer height based on maximum gradient in observed backscatter. The technique worked well when the layer topped by the strongest gradient extends down to the surface. Investigation of the

Linking Meteorology, Air Quality Models and Observations to Characterize Human Exposures in Support of the Environmental Health Studies

EPA Science Inventory

Epidemiologic studies are critical in establishing the association between exposure to air pollutants and adverse health effects. Results of epidemiologic studies are used by U.S. EPA in developing air quality standards to protect the public from the health effects of air polluta...

Access, quality, and costs of care at physician owned hospitals in the United States: observational study.

PubMed

Blumenthal, Daniel M; Orav, E John; Jena, Anupam B; Dudzinski, David M; Le, Sidney T; Jha, Ashish K

2015-09-02

To compare physician owned hospitals (POHs) with non-POHs on metrics around patient populations, quality of care, costs, and payments. Observational study. Acute care hospitals in 95 hospital referral regions in the United States, 2010. 2186 US acute care hospitals (219 POHs and 1967 non-POHs). Proportions of patients using Medicaid and those from ethnic and racial minority groups; hospital performance on patient experience metrics, care processes, risk adjusted 30 day mortality, and readmission rates; costs of care; care payments; and Medicare market share. The 219 POHs were more often small (<100 beds), for profit, and in urban areas. 120 of these POHs were general (non-specialty) hospitals. Compared with patients from non-POHs, those from POHs were younger (77.4 v 78.4 years, P<0.001), less likely to be admitted through an emergency department (23.2% v. 29.0%, P<0.001), equally likely to be black (5.1% v 5.5%, P=0.85) or to use Medicaid (14.9% v 15.4%, P=0.75), and had similar numbers of chronic diseases and predicted mortality scores. POHs and non-POHs performed similarly on patient experience scores, processes of care, risk adjusted 30 day mortality, 30 day readmission rates, costs, and payments for acute myocardial infarction, congestive heart failure, and pneumonia. Although POHs may treat slightly healthier patients, they do not seem to systematically select more profitable or less disadvantaged patients or to provide lower value care. © Blumenthal et al 2015.

Design of a practical model-observer-based image quality assessment method for x-ray computed tomography imaging systems

PubMed Central

Tseng, Hsin-Wu; Fan, Jiahua; Kupinski, Matthew A.

2016-01-01

Abstract. The use of a channelization mechanism on model observers not only makes mimicking human visual behavior possible, but also reduces the amount of image data needed to estimate the model observer parameters. The channelized Hotelling observer (CHO) and channelized scanning linear observer (CSLO) have recently been used to assess CT image quality for detection tasks and combined detection/estimation tasks, respectively. Although the use of channels substantially reduces the amount of data required to compute image quality, the number of scans required for CT imaging is still not practical for routine use. It is our desire to further reduce the number of scans required to make CHO or CSLO an image quality tool for routine and frequent system validations and evaluations. This work explores different data-reduction schemes and designs an approach that requires only a few CT scans. Three different kinds of approaches are included in this study: a conventional CHO/CSLO technique with a large sample size, a conventional CHO/CSLO technique with fewer samples, and an approach that we will show requires fewer samples to mimic conventional performance with a large sample size. The mean value and standard deviation of areas under ROC/EROC curve were estimated using the well-validated shuffle approach. The results indicate that an 80% data reduction can be achieved without loss of accuracy. This substantial data reduction is a step toward a practical tool for routine-task-based QA/QC CT system assessment. PMID:27493982

Observational Studies: Cohort and Case-Control Studies

PubMed Central

Song, Jae W.; Chung, Kevin C.

2010-01-01

Observational studies are an important category of study designs. To address some investigative questions in plastic surgery, randomized controlled trials are not always indicated or ethical to conduct. Instead, observational studies may be the next best method to address these types of questions. Well-designed observational studies have been shown to provide results similar to randomized controlled trials, challenging the belief that observational studies are second-rate. Cohort studies and case-control studies are two primary types of observational studies that aid in evaluating associations between diseases and exposures. In this review article, we describe these study designs, methodological issues, and provide examples from the plastic surgery literature. PMID:20697313

Observation of a high-quality quasi-periodic rapidly propagating wave train using SDO/AIA

NASA Astrophysics Data System (ADS)

Nisticò, G.; Pascoe, D. J.; Nakariakov, V. M.

2014-09-01

Context. We present a new event of quasi-periodic wave trains observed in EUV wavebands that rapidly propagate away from an active region after a flare. Aims: We measured the parameters of a wave train observed on 7 December 2013 after an M1.2 flare, such as the phase speeds, periods and wavelengths, in relationship to the local coronal environment and the energy sources. Methods: We compared our observations with a numerical simulation of fast magnetoacoustic waves that undergo dispersive evolution and leakage in a coronal loop embedded in a potential magnetic field. Results: The wave train is observed to propagate as several arc-shaped intensity disturbances for almost half an hour, with a speed greater than 1000 km s-1 and a period of about 1 min. The wave train followed two different patterns of propagation, in accordance with the magnetic structure of the active region. The oscillatory signal is found to be of high-quality, i.e. there is a large number (10 or more) of subsequent wave fronts observed. The observations are found to be consistent with the numerical simulation of a fast wave train generated by a localised impulsive energy release. Conclusions: Transverse structuring in the corona can efficiently create and guide high-quality quasi-periodic propagating fast wave trains. The movies are available in electronic form at http://www.aanda.org

Utilizing Tropospheric Emission Spectrometer (TES) Special Observations to Study Air Quality Over Megacities: A Case Study of Mexico City

NASA Astrophysics Data System (ADS)

Osterman, G. B.; Neu, J. L.; Cady-Pereira, K.; Fu, D.; Payne, V.; Pfister, G.

2016-12-01

Since the beginning of 2013, the Tropospheric Emission Spectrometer (TES) on the NASA Aura spacecraft has been making special "transect" observations over 19 large cities across the globe. In all there are over 50 transect observations of each city, allowing for studying the chemistry of the troposphere during different seasons and differing atmospheric conditions. The cities that have been observed include, Beijing, Delhi and Mexico City. In addition, the TES group at JPL has been developing new data products using combined radiances from other satellite instruments. They have produced an ozone data product using a combination of TES and Ozone Monitoring Instrument (OMI) radiances. There has also been progress in creating an ozone product from combining OMI and Atmospheric Infrared Sounder (AIRS) radiances using the TES retrieval framework. This product offers the possibility of better spatial coverage than the TES or TES/OMI products. We have selected an observation from October 13, 2013 over Mexico City for doing a case study where high values of ozone were seen in the lower troposphere in retrievals from TES and TES/OMI. Other trace gases measured by TES, carbon monoxide, methanol, and formic acid were also enhanced over the city. TES was also able to capture downwind conditions where the trace gases were no longer enhanced except for formic acid and peroxyacetyl nitrate which showed elevated values. We will utilize trajectory analysis, the TES data as well as combined TES-OMI retrievals, the new combined AIRS-OMI retrievals of ozone to examine this case in more detail to understand possible broader scale effects of Mexico City pollution. Model results will be utilized to provide further context in understanding the atmospheric conditions being studied. We feel the TES special observations of megacities will provide an opportunity to study the effects of local sources versus broader regional sources on pollutions of these large cities.

Data quality through a web-based QA/QC system: implementation for atmospheric mercury data from the global mercury observation system.

PubMed

D'Amore, Francesco; Bencardino, Mariantonia; Cinnirella, Sergio; Sprovieri, Francesca; Pirrone, Nicola

2015-08-01

The overall goal of the on-going Global Mercury Observation System (GMOS) project is to develop a coordinated global monitoring network for mercury, including ground-based, high altitude and sea level stations. In order to ensure data reliability and comparability, a significant effort has been made to implement a centralized system, which is designed to quality assure and quality control atmospheric mercury datasets. This system, GMOS-Data Quality Management (G-DQM), uses a web-based approach with real-time adaptive monitoring procedures aimed at preventing the production of poor-quality data. G-DQM is plugged on a cyberinfrastructure and deployed as a service. Atmospheric mercury datasets, produced during the first-three years of the GMOS project, are used as the input to demonstrate the application of the G-DQM and how it identifies a number of key issues concerning data quality. The major issues influencing data quality are presented and discussed for the GMOS stations under study. Atmospheric mercury data collected at the Longobucco (Italy) station is used as a detailed case study.

Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Debono, Josephine C, E-mail: josephine.debono@bci.org.au; Poulos, Ann E; Westmead Breast Cancer Institute, Westmead, New South Wales

The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed toolmore » applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice.« less

Quality of prescribing in community-dwelling elderly patients in France: an observational study in community pharmacies.

PubMed

Bourcier, E; Mille, F; Brunie, V; Korb-Savoldelli, V; Lafortune, C; Buyse, M; Fernandez, C; Hindlet, P

2017-12-01

Background In order to ensure safer prescriptions in the elderly, lists of potentially inappropriate medications (PIMs) and guidelines have been introduced. Whereas the effectiveness of these measures has been well studied in hospitals, data are sparse for the community-dwelling patients. Objective To assess the quality of prescriptions among community-dwelling elderly patients, and potential associations between prescription patterns, patient characteristics and medication adherence. Setting Community pharmacies in France. Method We conducted a prospective observational study between January and June 2013. Patients aged 75 and over coming to the community pharmacy with a prescription from a general practitioner were invited to participate to the study. The compliance of the prescription was assessed with regards to Beers Criteria and French Health Authority guidelines (FHA) for prescription in the elderly, the degree of adherence was assessed with the Girerd score. Main outcome measure Percentage of prescriptions compliant with Beers Criteria and FHA guidelines. Results Among the 1206 prescriptions analysed, 67.49% (n = 814) contained a PIM. Only 12.77% (n = 154) complied with mandatory requirements of the FHA. Prescriptions were ordered by therapeutic field in 51.24% (n = 618) of cases. Dosing regimen was incomplete in 57.21% (n = 690) of prescriptions. Only 29.19% (n = 352) of patients reported no difficulty with regard to adherence (Girerd score = 0). The use of International Non-proprietary Name was associated with an increased risk of nonadherence (adjusted OR = 1.59 [95% CI = 1.13-2.23] and 1.68 [95% CI = 1.12-2.49] respectively). Patient satisfaction with formulation was associated with a lower risk of non-adherence (adjusted OR = 0.63 [95% CI = 0.45-0.90]). Conclusion A substantial proportion of patients are exposed to PIMs and prescriptions that do not comply with the FHA Guidelines. This issue, as well as identified risk factors for

Elevated Bathing-Associated Disease Risks Despite Certified Water Quality: A Cohort Study

PubMed Central

Papastergiou, Panagiotis; Mouchtouri, Varvara; Pinaka, Ourania; Katsiaflaka, Anna; Rachiotis, George; Hadjichristodoulou, Christos

2012-01-01

Bacteriological water quality criteria have been recommended to ensure bathers’ health. However, this risk-assessment approach is based mainly on routine measurements of fecal pollution indicator bacteria in seawater, and may not be adequate to protect bathers effectively. The aim of this study was to assess the risks of symptoms related to infectious diseases among bathers after exposure to seawater which was of excellent quality according to EU guidelines. This study is a cohort study recruiting bathers and non-bathers. Water samples were collected for estimating bacterial indicators. Univariable and multivariable analysis was performed to compare the risks of developing symptoms/diseases between bathers and non-bathers. A total of 3805 bathers and 572 non-bathers were included in the study. Water analysis results demonstrated excellent quality of bathing water. Significantly increased risks of symptoms related to gastrointestinal infections (OR = 3.60, 95% CI 1.28–10.13), respiratory infections (OR = 1.92, 95% CI 1.00–3.67), eye infections (OR = 2.43, 95% CI 1.27–4.63) and ear infections (OR = 17.21, 95% CI 2.42–122.34) were observed among bathers compared with non-bathers. Increased rates of medical consultation and medication use were also observed among bathers. There was evidence that bathers experienced increased morbidity compared with non-bathers though the bathing waters met bacteriological water quality criteria. These results suggest that risk assessments of recreational seawaters should not only focus on bacteriological water quality criteria. PMID:22754456

Social support systems as determinants of self-management and quality of life of people with diabetes across Europe: study protocol for an observational study.

PubMed

Koetsenruijter, Jan; van Lieshout, Jan; Vassilev, Ivaylo; Portillo, Mari Carmen; Serrano, Manuel; Knutsen, Ingrid; Roukova, Poli; Lionis, Christos; Todorova, Elka; Foss, Christina; Rogers, Anne; Wensing, Michel

2014-03-04

Long-term conditions pose major challenges for healthcare systems. Optimizing self-management of people with long-term conditions is an important strategy to improve quality of life, health outcomes, patient experiences in healthcare, and the sustainability of healthcare systems. Much research on self-management focuses on individual competencies, while the social systems of support that facilitate self-management are underexplored. The presented study aims to explore the role of social systems of support for self-management and quality of life, focusing on the social networks of people with diabetes and community organisations that serve them. The protocol concerns a cross-sectional study in 18 geographic areas in six European countries, involving a total of 1800 individuals with diabetes and 900 representatives of community organisations. In each country, we include a deprived rural area, a deprived urban area, and an affluent urban area. Individuals are recruited through healthcare practices in the targeted areas. A patient questionnaire comprises measures for quality of life, self-management behaviours, social network and social support, as well as individual characteristics. A community organisations' survey maps out interconnections between community and voluntary organisations that support patients with chronic illness and documents the scope of work of the different types of organisations. We first explore the structure of social networks of individuals and of community organisations. Then linkages between these social networks, self-management and quality of life will be examined, taking deprivation and other factors into account. This study will provide insight into determinants of self-management and quality of life in individuals with diabetes, focusing on the role of social networks and community organisations.

What Is the Methodologic Quality of Human Therapy Studies in ISI Surgical Publications?

PubMed Central

Manterola, Carlos; Pineda, Viviana; Vial, Manuel; Losada, Héctor

2006-01-01

Objective: To determine the methodologic quality of therapy articles about humans published in ISI surgical journals, and to explore the association between methodologic quality, origin, and subject matter. Summary Background Data: It is supposed that ISI journals contain the best methodologic articles. Methods: This is a bibliometric study. All journals listed in the 2002 ISI under the subject heading of “Surgery” were included. A simple randomized sampling was conducted for selected journals (Annals of Surgery, The American Surgeon, Archives of Surgery, British Journal of Surgery, European Journal of Surgery, Journal of the American College of Surgeons, Surgery, and World Journal of Surgery). Published articles related to therapy on humans of the selected journals were reviewed and analyzed. All kinds of clinical designs were considered, excluding editorials, review articles, letters to the editor, and experimental studies. The variables considered were: place of origin, design, and the methodologic quality of articles, which was determined by applying a valid and reliable scale. The review was performed interchangeably and independently by 2 research teams. Descriptive and analytical statistics were used. Statistical significance was defined as P values less than 1%. Results: A total of 653 articles were studied. Studies came predominantly from the United States and Europe (43.6% and 36.8%, respectively). The subject areas most frequently found were digestive and hepatobiliopancreatic surgery (29.1% and 24.5%, respectively). Average and median methodologic quality scores of the entire series were 11.6 ± 4.9 points and 11 points, respectively. The association between methodologic quality and journals was determined. Also, the association between methodologic quality and origin was observed, but no association with subject area was verified. Conclusions: The methodologic quality of therapy articles published in the journals analyzed is low; however

Studies on the current state of water quality in the Segamat River

NASA Astrophysics Data System (ADS)

Razelan, Faridah Mohd; Tahir, Wardah; E. M Yahaya, Nasehir Khan

2018-04-01

Nowadays, pollution has become a major concern in developed and developing countries. In a study on the current state of Segamat River water quality; on-site data collection and observation and also laboratory data analysis have been implemented. Studies showed that the downstream of the Segamat River has recorded a significant reduction in quality of water during the dry season compared to the wet season. The deterioration of water quality is caused by the activities along the river such as palm oil plantation, municipal waste and waste from settlements. It was also recorded that the point sources were dominating the pollution at Segamat River during the dry season. However, during the wet season, the water quality was impaired by the non-point sources which originated from the upstream of the river.

Linking Meteorology, Air Quality Models and Observations to ...

EPA Pesticide Factsheets

Epidemiologic studies are critical in establishing the association between exposure to air pollutants and adverse health effects. Results of epidemiologic studies are used by U.S. EPA in developing air quality standards to protect the public from the health effects of air pollutants. A major challenge in environmental epidemiology is adequate exposure characterization. Numerous health studies have used measurements from a few central-site ambient monitors to characterize air pollution exposures. Relying solely on central-site ambient monitors does not account for the spatial-heterogeneity of ambient air pollution patterns, the temporal variability in ambient concentrations, nor the influence of infiltration and indoor sources. Central-site monitoring becomes even more problematic for certain air pollutants that exhibit significant spatial heterogeneity. Statistical interpolation techniques and passive monitoring methods can provide additional spatial resolution in ambient concentration estimates. In addition, spatio-temporal models, which integrate GIS data and other factors, such as meteorology, have also been developed to produce more resolved estimates of ambient concentrations. Models, such as the Community Multi-Scale Air Quality (CMAQ) model, estimate ambient concentrations by combining information on meteorology, source emissions, and chemical-fate and transport. Hybrid modeling approaches, which integrate regional scale models with local scale dispersion

Steroidal contraceptives and bone fractures in women: evidence from observational studies.

PubMed

Lopez, Laureen M; Chen, Mario; Mullins Long, Sarah; Curtis, Kathryn M; Helmerhorst, Frans M

2015-07-21

Age-related decline in bone mass increases the risk of skeletal fractures, especially those of the hip, spine, and wrist. Steroidal contraceptives have been associated with changes in bone mineral density in women. Whether such changes affect the risk of fractures later in life is unclear. Hormonal contraceptives are among the most effective and most widely-used contraceptives. Concern about fractures may limit the use of these effective contraceptives. Observational studies can collect data on premenopausal contraceptive use as well as fracture incidence later in life. We systematically reviewed the evidence from observational studies of hormonal contraceptive use for contraception and the risk of fracture in women. Through June 2015, we searched for observational studies. The databases included PubMed, POPLINE, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, EMBASE, CINAHL, and Web of Science. We also searched for recent clinical trials through ClinicalTrials.gov and the ICTRP. For other studies, we examined reference lists of relevant articles and wrote to investigators for additional reports. We included cohort and case-control studies of hormonal contraceptive use. Interventions included comparisons of a hormonal contraceptive with a non-hormonal contraceptive, no contraceptive, or another hormonal contraceptive. The primary outcome was the risk of fracture. Two authors independently extracted the data. One author entered the data into RevMan, and a second author verified accuracy. We examined the quality of evidence using the Newcastle-Ottawa Quality Assessment Scale (NOS), developed for case-control and cohort studies. Sensitivity analysis included studies of moderate or high quality based on our assessment with the NOS.Given the need to control for confounding factors in observational studies, we used adjusted estimates from the models as reported by the authors. Where we did not have adjusted analyses, we calculated the odds ratio (OR

Design of a practical model-observer-based image quality assessment method for CT imaging systems

NASA Astrophysics Data System (ADS)

Tseng, Hsin-Wu; Fan, Jiahua; Cao, Guangzhi; Kupinski, Matthew A.; Sainath, Paavana

2014-03-01

The channelized Hotelling observer (CHO) is a powerful method for quantitative image quality evaluations of CT systems and their image reconstruction algorithms. It has recently been used to validate the dose reduction capability of iterative image-reconstruction algorithms implemented on CT imaging systems. The use of the CHO for routine and frequent system evaluations is desirable both for quality assurance evaluations as well as further system optimizations. The use of channels substantially reduces the amount of data required to achieve accurate estimates of observer performance. However, the number of scans required is still large even with the use of channels. This work explores different data reduction schemes and designs a new approach that requires only a few CT scans of a phantom. For this work, the leave-one-out likelihood (LOOL) method developed by Hoffbeck and Landgrebe is studied as an efficient method of estimating the covariance matrices needed to compute CHO performance. Three different kinds of approaches are included in the study: a conventional CHO estimation technique with a large sample size, a conventional technique with fewer samples, and the new LOOL-based approach with fewer samples. The mean value and standard deviation of area under ROC curve (AUC) is estimated by shuffle method. Both simulation and real data results indicate that an 80% data reduction can be achieved without loss of accuracy. This data reduction makes the proposed approach a practical tool for routine CT system assessment.

Methodological quality of diagnostic accuracy studies on non-invasive coronary CT angiography: influence of QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) items on sensitivity and specificity.

PubMed

Schueler, Sabine; Walther, Stefan; Schuetz, Georg M; Schlattmann, Peter; Dewey, Marc

2013-06-01

To evaluate the methodological quality of diagnostic accuracy studies on coronary computed tomography (CT) angiography using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) tool. Each QUADAS item was individually defined to adapt it to the special requirements of studies on coronary CT angiography. Two independent investigators analysed 118 studies using 12 QUADAS items. Meta-regression and pooled analyses were performed to identify possible effects of methodological quality items on estimates of diagnostic accuracy. The overall methodological quality of coronary CT studies was merely moderate. They fulfilled a median of 7.5 out of 12 items. Only 9 of the 118 studies fulfilled more than 75 % of possible QUADAS items. One QUADAS item ("Uninterpretable Results") showed a significant influence (P = 0.02) on estimates of diagnostic accuracy with "no fulfilment" increasing specificity from 86 to 90 %. Furthermore, pooled analysis revealed that each QUADAS item that is not fulfilled has the potential to change estimates of diagnostic accuracy. The methodological quality of studies investigating the diagnostic accuracy of non-invasive coronary CT is only moderate and was found to affect the sensitivity and specificity. An improvement is highly desirable because good methodology is crucial for adequately assessing imaging technologies. • Good methodological quality is a basic requirement in diagnostic accuracy studies. • Most coronary CT angiography studies have only been of moderate design quality. • Weak methodological quality will affect the sensitivity and specificity. • No improvement in methodological quality was observed over time. • Authors should consider the QUADAS checklist when undertaking accuracy studies.

SCORE study: quality indicators for rheumatology nursing clinics.

PubMed

Muñoz-Fernández, Santiago; Aguilar, Ma Dolores; Almodóvar, Raquel; Cano-García, Laura; Fortea, Sandra; Alcañiz-Escandell, Cristina Patricia; Rodríguez, José R; Cebrián, Laura; Lázaro, Pablo

2017-03-01

Nursing clinics in rheumatology (NCR) are organizational care models that provide care centred within the scope of nurses abilities. To analyse patients differences in the knowledge of the disease, adherence to the treatment, quality indicators of the Rheumatology Departments included quality perceived by the patients with and without NCR. National multicenter observational prospective cohort study 1 year follow-up, comparing patients attending rheumatology services with and without NCR. NCR was defined by the presence of: (1) office itself; (2) at least one dedicated nurse; (3) its own appointment schedule, and (4) phone. Variables included were (baseline and 12 months) Batalla, Haynes-Sackett, Morisky-Green and quality perceived tests. In addition, another specific questionnaire was drawn up to collect the healthcare, teaching and research activities of each Rheumatology Department. A total of 393 patients were included; 181 NCR and 212 not NCR, corresponding to 39 units, 21 with NCR and 18 without NCR (age 53 ± 11.8 vs 56 ± 13.5 years). Significant differences in favour of the NCR group were found in Haynes-Sackett (p = 0.033) and Morisky-Green (p = 0.03) tests in the basal visit. Significant differences were found in questions about "the courtesy and/or kindness received by the nurse", being "good or very good" in greater proportion in the NCR group. The publications from the last 5 years were significantly higher in the NCR group in both, national (p = 0.04) and international (p = 0.03) journals. A higher research activity and quality perceived by the patients are observed in the Rheumatology Departments with NCR.

Observed characteristics of dust storm events over the western United States using meteorological, satellite, and air quality measurements

NASA Astrophysics Data System (ADS)

Lei, H.; Wang, J. X. L.

2014-08-01

To improve dust storm identification over the western United States, historical dust events measured by air quality and satellite observations are analyzed based on their characteristics in data sets of regular meteorology, satellite-based aerosol optical depth (AOD), and air quality measurements. Based on the prevailing weather conditions associated with dust emission, dust storm events are classified into the following four typical types: (1) The key feature of cold front-induced dust storms is their rapid process with strong dust emissions. (2) Events caused by meso- to small-scale weather systems have the highest levels of emissions. (3) Dust storms caused by tropical disturbances show a stronger air concentration of dust and last longer than those in (1) and (2). (4) Dust storms triggered by cyclogenesis last the longest. In this paper, sample events of each type are selected and examined to explore characteristics observed from in situ and remote-sensing measurements. These characteristics include the lasting period, surface wind speeds, areas affected, average loading on ground-based optical and/or air quality measurements, peak loading on ground-based optical and/or air quality measurements, and loading on satellite-based aerosol optical depth. Based on these analyses, we compare the characteristics of the same dust events captured in different data sets in order to define the dust identification criteria. The analyses show that the variability in mass concentrations captured by in situ measurements is consistent with the variability in AOD from stationary and satellite observations. Our analyses also find that different data sets are capable of identifying certain common characteristics, while each data set also provides specific information about a dust storm event. For example, the meteorological data are good at identifying the lasting period and area impacted by a dust event; the ground-based air quality and optical measurements can capture the peak

Using satellite observations in performance evaluation for regulatory air quality modeling: Comparison with ground-level measurements

NASA Astrophysics Data System (ADS)

Odman, M. T.; Hu, Y.; Russell, A.; Chai, T.; Lee, P.; Shankar, U.; Boylan, J.

2012-12-01

Regulatory air quality modeling, such as State Implementation Plan (SIP) modeling, requires that model performance meets recommended criteria in the base-year simulations using period-specific, estimated emissions. The goal of the performance evaluation is to assure that the base-year modeling accurately captures the observed chemical reality of the lower troposphere. Any significant deficiencies found in the performance evaluation must be corrected before any base-case (with typical emissions) and future-year modeling is conducted. Corrections are usually made to model inputs such as emission-rate estimates or meteorology and/or to the air quality model itself, in modules that describe specific processes. Use of ground-level measurements that follow approved protocols is recommended for evaluating model performance. However, ground-level monitoring networks are spatially sparse, especially for particulate matter. Satellite retrievals of atmospheric chemical properties such as aerosol optical depth (AOD) provide spatial coverage that can compensate for the sparseness of ground-level measurements. Satellite retrievals can also help diagnose potential model or data problems in the upper troposphere. It is possible to achieve good model performance near the ground, but have, for example, erroneous sources or sinks in the upper troposphere that may result in misleading and unrealistic responses to emission reductions. Despite these advantages, satellite retrievals are rarely used in model performance evaluation, especially for regulatory modeling purposes, due to the high uncertainty in retrievals associated with various contaminations, for example by clouds. In this study, 2007 was selected as the base year for SIP modeling in the southeastern U.S. Performance of the Community Multiscale Air Quality (CMAQ) model, at a 12-km horizontal resolution, for this annual simulation is evaluated using both recommended ground-level measurements and non-traditional satellite

A cross-national study to objectively evaluate the quality of diverse simulation approaches for undergraduate nursing students.

PubMed

Kable, Ashley K; Levett-Jones, Tracy L; Arthur, Carol; Reid-Searl, Kerry; Humphreys, Melanie; Morris, Sara; Walsh, Pauline; Witton, Nicola J

2018-01-01

The aim of this paper is to report the results of a cross-national study that evaluated a range of simulation sessions using an observation schedule developed from evidence-based quality indicators. Observational data were collected from 17 simulation sessions conducted for undergraduate nursing students at three universities in Australia and the United Kingdom. The observation schedule contained 27 questions that rated simulation quality. Data were collected by direct observation and from video recordings of the simulation sessions. Results indicated that the highest quality scores were for provision of learning objectives prior to the simulation session (90%) and debriefing (72%). Student preparatiosn and orientation (67%) and perceived realism and fidelity (67%) were scored lower than other components of the simulation sessions. This observational study proved to be an effective strategy to identify areas of strength and those needing further development to improve simulation sessions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Case Study on Quality Education

ERIC Educational Resources Information Center

Habib, Zahida

2011-01-01

Quality of Education, especially at Primary level, is an important issue to be discussed at the International Forum. This study highlights the quality of primary education through a comparison of the quality of Community Model Schools and Govt. Girls Primary Schools in Pakistan. Community Model Schools were established under Girls Primary…

Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review

PubMed Central

Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S.; Jager, Kitty J.; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

2016-01-01

Background The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and study design quality in the nephrology literature. Study Design Systematic literature review. Setting & Population European and North American, Pre-dialysis Chronic Kidney Disease (CKD) cohort studies. Selection Criteria for Studies Studies assessing the association between CKD and mortality in the elderly (>65 years) published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE. Predictor Time period before and after the publication of the STROBE statement. Outcome Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS), Scottish Intercollegiate Guidelines Network (SIGN) and Critical Appraisal Skills Programme (CASP) tools. Results 37 papers (11 Pre & 26 Post STROBE) were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis) showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7–82.0) vs 83% (IQR, 78.4–84.9, p = 0.05). There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9), SIGN (Manuscript SIGN score 83.3) and CASP (Manuscript CASP score 91.7) tools. Limitations Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good

An International Coordinated Effort to Further the Documentation & Development of Quality Assurance, Quality Control, and Best Practices for Oceanographic Observations

NASA Astrophysics Data System (ADS)

Bushnell, M.; Waldmann, C.; Hermes, J.; Tamburri, M.

2017-12-01

Many oceanographic observation groups create and maintain QA, QC, and best practices (BP) to ensure efficient and accurate data collection and quantify quality. Several entities - IOOS® QARTOD, AtlantOS, ACT, WMO/IOC JCOMM OCG - have joined forces to document existing practices, identify gaps, and support development of emerging techniques. While each group has a slightly different focus, many underlying QA/QC/BP needs can be quite common. QARTOD focuses upon real-time data QC, and has produced manuals that address QC tests for eleven ocean variables. AtlantOS is a research and innovation project working towards the integration of ocean-observing activities across all disciplines in the Atlantic Basin. ACT brings together research institutions, resource managers, and private companies to foster the development and adoption of effective and reliable sensors for coastal, freshwater, and ocean environments. JCOMM promotes broad international coordination of oceanographic and marine meteorological observations and data management and services. Leveraging existing efforts of these organizations is an efficient way to consolidate available information, develop new practices, and evaluate the use of ISO standards to judge the quality of measurements. ISO standards may offer accepted support for a framework for an ocean data quality management system, similar to the meteorological standards defined by WMO (https://www.wmo.int/pages/prog/arep/gaw/qassurance.html). We will first cooperatively develop a plan to create a QA/QC/BP manual. The resulting plan will describe the need for such a manual, the extent of the manual, the process used to engage the community in creating it, the maintenance of the resultant document, and how these things will be done. It will also investigate standards for metadata. The plan will subsequently be used to develop the QA/QC/BP manual, providing guidance which advances the standards adopted by IOOS, AtlantOS, JCOMM, and others.

Exposure to fluoride in drinking water and hip fracture risk: a meta-analysis of observational studies.

PubMed

Yin, Xin-Hai; Huang, Guang-Lei; Lin, Du-Ren; Wan, Cheng-Cheng; Wang, Ya-Dong; Song, Ju-Kun; Xu, Ping

2015-01-01

Many observational studies have shown that exposure to fluoride in drinking water is associated with hip fracture risk. However, the findings are varied or even contradictory. In this work, we performed a meta-analysis to assess the relationship between fluoride exposure and hip fracture risk. PubMed and EMBASE databases were searched to identify relevant observational studies from the time of inception until March 2014 without restrictions. Data from the included studies were extracted and analyzed by two authors. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were pooled using random- or fixed-effects models as appropriate. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Finally, publication bias was assessed. Fourteen observational studies involving thirteen cohort studies and one case-control study were included in the meta-analysis. Exposure to fluoride in drinking water does not significantly increase the incidence of hip fracture (RRs, 1.05; 95% CIs, 0.96-1.15). Sensitivity analyses based on adjustment for covariates, effect measure, country, sex, sample size, quality of Newcastle-Ottawa Scale scores, and follow-up period validated the strength of the results. Meta-regression showed that country, gender, quality of Newcastle-Ottawa Scale scores, adjustment for covariates and sample size were not sources of heterogeneity. Little evidence of publication bias was observed. The present meta-analysis suggests that chronic fluoride exposure from drinking water does not significantly increase the risk of hip fracture. Given the potential confounding factors and exposure misclassification, further large-scale, high-quality studies are needed to evaluate the association between exposure to fluoride in drinking water and hip fracture risk.

Exposure to Fluoride in Drinking Water and Hip Fracture Risk: A Meta-Analysis of Observational Studies

PubMed Central

Yin, Xin-Hai; Huang, Guang-Lei; Lin, Du-Ren; Wan, Cheng-Cheng; Wang, Ya-Dong; Song, Ju-Kun; Xu, Ping

2015-01-01

Background Many observational studies have shown that exposure to fluoride in drinking water is associated with hip fracture risk. However, the findings are varied or even contradictory. In this work, we performed a meta-analysis to assess the relationship between fluoride exposure and hip fracture risk. Methods PubMed and EMBASE databases were searched to identify relevant observational studies from the time of inception until March 2014 without restrictions. Data from the included studies were extracted and analyzed by two authors. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were pooled using random- or fixed-effects models as appropriate. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Finally, publication bias was assessed. Results Fourteen observational studies involving thirteen cohort studies and one case-control study were included in the meta-analysis. Exposure to fluoride in drinking water does not significantly increase the incidence of hip fracture (RRs, 1.05; 95% CIs, 0.96–1.15). Sensitivity analyses based on adjustment for covariates, effect measure, country, sex, sample size, quality of Newcastle–Ottawa Scale scores, and follow-up period validated the strength of the results. Meta-regression showed that country, gender, quality of Newcastle–Ottawa Scale scores, adjustment for covariates and sample size were not sources of heterogeneity. Little evidence of publication bias was observed. Conclusion The present meta-analysis suggests that chronic fluoride exposure from drinking water does not significantly increase the risk of hip fracture. Given the potential confounding factors and exposure misclassification, further large-scale, high-quality studies are needed to evaluate the association between exposure to fluoride in drinking water and hip fracture risk. PMID:26020536

Assessment and Quality Social Studies

ERIC Educational Resources Information Center

Savage, Tom V.

2003-01-01

Those anonymous individuals who develop high-stakes tests by which educational quality is measured exercise great influence in defining educational quality. In this article, the author examines the impact of high-stakes testing on the welfare of the children and the quality of social studies instruction. He presents the benefits and drawbacks of…

Quality of Reporting and Study Design of CKD Cohort Studies Assessing Mortality in the Elderly Before and After STROBE: A Systematic Review.

PubMed

Rao, Anirudh; Brück, Katharina; Methven, Shona; Evans, Rebecca; Stel, Vianda S; Jager, Kitty J; Hooft, Lotty; Ben-Shlomo, Yoav; Caskey, Fergus

2016-01-01

The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was published in October 2007 to improve quality of reporting of observational studies. The aim of this review was to assess the impact of the STROBE statement on observational study reporting and study design quality in the nephrology literature. Systematic literature review. European and North American, Pre-dialysis Chronic Kidney Disease (CKD) cohort studies. Studies assessing the association between CKD and mortality in the elderly (>65 years) published from 1st January 2002 to 31st December 2013 were included, following systematic searching of MEDLINE & EMBASE. Time period before and after the publication of the STROBE statement. Quality of study reporting using the STROBE statement and quality of study design using the Newcastle Ottawa Scale (NOS), Scottish Intercollegiate Guidelines Network (SIGN) and Critical Appraisal Skills Programme (CASP) tools. 37 papers (11 Pre & 26 Post STROBE) were identified from 3621 potential articles. Only four of the 22 STROBE items and their sub-criteria (objectives reporting, choice of quantitative groups and description of and carrying out sensitivity analysis) showed improvements, with the majority of items showing little change between the period before and after publication of the STROBE statement. Pre- and post-period analysis revealed a Manuscript STROBE score increase (median score 77.8% (Inter-quartile range [IQR], 64.7-82.0) vs 83% (IQR, 78.4-84.9, p = 0.05). There was no change in quality of study design with identical median scores in the two periods for NOS (Manuscript NOS score 88.9), SIGN (Manuscript SIGN score 83.3) and CASP (Manuscript CASP score 91.7) tools. Only 37 Studies from Europe and North America were included from one medical specialty. Assessment of study design largely reliant on good reporting. This study highlights continuing deficiencies in the reporting of STROBE items and their sub-criteria in cohort

Within-Day Variability in the Quality of Classroom Interactions during Third and Fifth Grade: Implications for Children's Experiences and Conducting Classroom Observations

ERIC Educational Resources Information Center

Curby, Timothy W.; Stuhlman, Megan; Grimm, Kevin; Mashburn, Andrew; Chomat-Mooney, Lia; Downer, Jason; Hamre, Bridget; Pianta, Robert C.

2011-01-01

The quality of classroom interactions has typically been studied using aggregates of ratings over time. However, within-day ratings may contain important variability. This study investigated within-day variability using the NICHD Study of Early Childcare and Youth Development's observational data during grades 3 and 5. The first question examined…

Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement

PubMed Central

Hawwash, Dana; Ocké, Marga C.; Berg, Christina; Forsum, Elisabet; Sonestedt, Emily; Wirfält, Elisabet; Åkesson, Agneta; Kolsteren, Patrick; Byrnes, Graham; De Keyzer, Willem; Van Camp, John; Slimani, Nadia; Cevallos, Myriam; Egger, Matthias; Huybrechts, Inge

2016-01-01

Background Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut). Methods and Findings Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. Conclusion When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health. PMID:27270749

Conflict, social support, and relationship quality: an observational study of heterosexual, gay male, and lesbian couples' communication.

PubMed

Julien, Danielle; Chartrand, Elise; Simard, Marie-Claude; Bouthillier, Donald; Bégin, Jean

2003-09-01

Data from 42 heterosexual, 46 gay male, and 33 lesbian couples were used to assess the contribution of conflict and support discussions to relationship quality. Couples completed questionnaires, and videotaped discussions were coded for levels of negative and positive behaviors. Correlations showed that behaviors were associated with relationship quality in the expected directions. Hierarchical linear modeling analyses assessed the unique contributions of individual and dyadic behaviors to the variability of relationship quality. The findings indicated that, beyond the contribution of individual negative behaviors in the conflict task, the variables of dyadic positive behaviors in the conflict task, individual positive behaviors in the support task, and perceived help accounted for unexplained variance in relationship quality. There were no differences between types of couples on levels of behaviors or on their contributions to relationship quality.

The Roles of Cost and Quality Information in Medicare Advantage Plan Enrollment Decisions: an Observational Study.

PubMed

Reid, Rachel O; Deb, Partha; Howell, Benjamin L; Conway, Patrick H; Shrank, William H

2016-02-01

To facilitate informed decision-making in the Medicare Advantage marketplace, the Centers for Medicare & Medicaid Services publishes plan information on the Medicare Plan Finder website, including costs, benefits, and star ratings reflecting quality. Little is known about how beneficiaries weigh costs versus quality in enrollment decisions. We aimed to assess associations between publicly reported Medicare Advantage plan attributes (i.e., costs, quality, and benefits) and brand market share and beneficiaries' enrollment decisions. We performed a nationwide, beneficiary-level cross-sectional analysis of 847,069 beneficiaries enrolling in Medicare Advantage for the first time in 2011. Matching beneficiaries with their plan choice sets, we used conditional logistic regression to estimate associations between plan attributes and enrollment to assess the proportion of enrollment variation explained by plan attributes and willingness to pay for quality. Relative to the total variation explained by the model, the variation in plan choice explained by premiums (25.7 %) and out-of-pocket costs (11.6 %) together explained nearly three times as much as quality ratings (13.6 %), but brand market share explained the most variation (35.3 %). Further, while beneficiaries were willing to pay more in total annual combined premiums and out-of-pocket costs for higher-rated plans (from $4,154.93 for 2.5-star plans to $5,698.66 for 5-star plans), increases in willingness to pay diminished at higher ratings, from $549.27 (95 %CI: $541.10, $557.44) for a rating increase from 2.5 to 3 stars to $68.22 (95 %CI: $61.44, $75.01) for an increase from 4.5 to 5 stars. Willingness to pay varied among subgroups: beneficiaries aged 64-65 years were more willing to pay for higher-rated plans, while black and rural beneficiaries were less willing to pay for higher-rated plans. While beneficiaries prefer higher-quality and lower-cost Medicare Advantage plans, marginal utility for quality

Benefits of using enhanced air quality information in human health studies

EPA Science Inventory

The ability of four (4) enhancements of gridded PM_2.5 concentrations derived from observations and air quality models to detect the relative risk of long-term exposure to PM_2.5 are evaluated with a simulation study. The four enhancements include nearest-nei...

Observed and Perceived Disclosure and Empathy Are Associated With Better Relationship Adjustment and Quality of Life in Couples Coping With Vulvodynia.

PubMed

Rosen, Natalie O; Bois, Katy; Mayrand, Marie-Hélène; Vannier, Sarah; Bergeron, Sophie

2016-11-01

Vulvodynia is a common idiopathic vulvovaginal pain condition that adversely affects the quality of life and intimate relationships of afflicted couples. Cross-sectional interpersonal factors, including how couples with vulvodynia communicate with each other, have been linked to women's pain and couples' relationship well-being. The current study investigated the observed and perceived associations between disclosure and empathic response, and couples' relationship adjustment, as well as women's pain during intercourse, and quality of life. Fifty women (M age = 24.50, SD = 4.03) diagnosed with vulvodynia and their partners (M age = 26.10, SD = 5.70) participated in a filmed discussion of the impact of this condition on their lives. Disclosure and empathic response were assessed by a trained observer and self-reported by participants immediately following the discussion. Analyses were based on the Actor-Partner Interdependence Model. Greater observed empathic response and perceived disclosure in women were associated with their higher quality of life. When women demonstrated greater empathic response, they and their partners reported higher relationship adjustment. In addition, when partners perceived greater empathic response, women reported higher relationship adjustment. There were no significant associations between disclosure or empathic response and women's pain during intercourse. Disclosure and empathic response may help women sustain the quality of their lives, and couples maintain the quality of their overall relationship while coping with the challenges that vulvodynia poses to their intimate connection. Increasing disclosure and empathic response might be a valuable target for enhancing the efficacy of couple-based interventions for vulvodynia.

Association of Facial Paralysis-Related Disability With Patient- and Observer-Perceived Quality of Life.

PubMed

Goines, Jennifer B; Ishii, Lisa E; Dey, Jacob K; Phillis, Maria; Byrne, Patrick J; Boahene, Kofi D O; Ishii, Masaru

2016-09-01

The interaction between patient- and observer-perceived quality of life (QOL) and facial paralysis-related disability and the resulting effect of these interactions on social perception are incompletely understood. To measure the associations between observer-perceived disability and QOL and patient-perceived disability and QOL in patients with facial paralysis. This prospective study in an academic tertiary referral center included 84 naive observers who viewed static and dynamic images of faces with unilateral, House-Brackmann grades IV to VI facial paralysis (n = 16) and demographically matched images of nonparalyzed control individuals (n = 4). Data were collected from June 1 to August 1, 2014, and analyzed from August 2 to December 1, 2014. Observers rated the patient and control images in 6 clinically relevant domains. The patients self-reported their disability and QOL using validated tools, such as the Facial Clinimetric Evaluation Scale. Quality of life, severity of paralysis, and disability were measured on a 100-point visual analog scale. The 84 observers (59 women [70%] and 25 men [30%]) ranged in age from 20 to 68 years (mean [SD] age, 35.2 [11.9]). Structural equation modeling showed that for each 1-point decrease in a patient's Facial Clinimetric Evaluation Scale score, the patient's visual analog scale QOL improved by 0.36 (SE, 0.03; 95% CI, 0.31-0.42) points. Similarly, from an observer perspective, as the perceived disability (-0.29 [SE, 0.04; 95% CI, -0.36 to -0.22]) and severity (-0.21 [SE, 0.03; 95% CI, -0.28 to -0.14]) decreased, the perceived QOL improved. Furthermore, attractive faces were viewed as having better QOL (disability, severity, and attractiveness regression coefficients, -0.29 [SE, 0.04; 95% CI, -0.36 to -0.22], -0.21 [SE, 0.03; 95% CI, -0.28 to -0.14], and 0.32 [SE, 0.03; 95% CI, 0.26 to 0.39], respectively). An inverse association was found between a paralyzed patient's self-reported QOL rating and the observers

Oral health related quality of life (OHRQoL) following third molar surgery in Sub-Saharan Africans: an observational study.

PubMed

Braimah, Ramat Oyebunmi; Ndukwe, Kizito Chioma; Owotade, Foluso John; Aregbesola, Stephen Babatunde

2016-01-01

Surgical extraction of the impacted third molar is one of the commonest minor oral surgical procedures carried out in oral surgery. Problems created by the disturbances in post-extraction wound healing and physiologic sequelae of third molar surgery can significantly affect the patient's quality of life. The study population consisted of 135 subjects that required surgical extraction of mandibular third molar under local anesthesia and met the inclusion criteria. Patients were assessed pre-operatively and post-operatively on days 1,3,5,7, and 14 using the United Kingdom Oral Health related Quality of Life questionnaire (UK-OHRQoL). This study also showed that surgical removal of impacted teeth exerted a negative influence on patient's Quality of life (QoL) across various physical, social, psychological aspects of life. UK-OHRQoL-16 mean scores showed that severe difficulty in eating was experienced by 106 (78%) patients on postoperative day (POD) 1. The symptom however improved within the first week with only 16 (11.9%) experiencing this symptom by POD 7 and none by POD 14. There was a deterioration in oral health related quality of life in the immediate postoperative period particularly POD 1 and 3 following third molar surgery, which slowly returned to preoperative level by 7th day. Routines such as eating, laughing and smiling, work and speech were also affected. Patients need to be informed of these symptoms after third molar removal so as to enable them prepare very well for the procedure and its sequelae.

Performance and diagnostic evaluation of ozone predictions by the Eta-Community Multiscale Air Quality Forecast System during the 2002 New England Air Quality Study.

PubMed

Yu, Shaocai; Mathur, Rohit; Kang, Daiwen; Schere, Kenneth; Eder, Brian; Pleim, Jonathan

2006-10-01

A real-time air quality forecasting system (Eta-Community Multiscale Air Quality [CMAQ] model suite) has been developed by linking the National Centers for Environmental Estimation Eta model to the U.S. Environmental Protection Agency (EPA) CMAQ model. This work presents results from the application of the Eta-CMAQ modeling system for forecasting ozone (O3) over the Northeastern United States during the 2002 New England Air Quality Study (NEAQS). Spatial and temporal performance of the Eta-CMAQ model for O3 was evaluated by comparison with observations from the EPA Air Quality System (AQS) network. This study also examines the ability of the model to simulate the processes governing the distributions of tropospheric O3 on the basis of the intensive datasets obtained at the four Atmospheric Investigation, Regional Modeling, Analysis, and Estimation (AIRMAP) and Harvard Forest (HF) surface sites. The episode analysis reveals that the model captured the buildup of O3 concentrations over the northeastern domain from August 11 and reproduced the spatial distributions of observed O3 very well for the daytime (8:00 p.m.) of both August 8 and 12 with most of normalized mean bias (NMB) within +/- 20%. The model reproduced 53.3% of the observed hourly O3 within a factor of 1.5 with NMB of 29.7% and normalized mean error of 46.9% at the 342 AQS sites. The comparison of modeled and observed lidar O3 vertical profiles shows that whereas the model reproduced the observed vertical structure, it tended to overestimate at higher altitude. The model reproduced 64-77% of observed NO2 photolysis rate values within a factor of 1.5 at the AIRMAP sites. At the HF site, comparison of modeled and observed O3/nitrogen oxide (NOx) ratios suggests that the site is mainly under strongly NOx-sensitive conditions (>53%). It was found that the modeled lower limits of the O3 production efficiency values (inferred from O3-CO correlation) are close to the observations.

The Quality of Mediational Teaching Practiced by Teachers in Special Education: An Observational Study in Norwegian Primary Schools

ERIC Educational Resources Information Center

Nyborg, Geir

2011-01-01

In this case study the quality of mediational teaching was evaluated for interactions between teachers and pupils in special education in regular Norwegian primary schools. Mediational teaching is interpreted as a process by which a teacher mediates a given curriculum using certain categories in interactions with a pupil. The categories are…

Use of benzodiazepine and risk of cancer: A meta-analysis of observational studies.

PubMed

Kim, Hong-Bae; Myung, Seung-Kwon; Park, Yon Chul; Park, Byoungjin

2017-02-01

Several observational epidemiological studies have reported inconsistent results on the association between the use of benzodiazepine and the risk of cancer. We investigated the association by using a meta-analysis. We searched PubMed, EMBASE, and the bibliographies of relevant articles to locate additional publications in January 2016. Three evaluators independently reviewed and selected eligible studies based on predetermined selection criteria. Of 796 articles meeting our initial criteria, a total of 22 observational epidemiological studies with 18 case-control studies and 4 cohort studies were included in the final analysis. Benzodiazepine use was significantly associated with an increased risk of cancer (odds ratio [OR] or relative risk [RR] 1.19; 95% confidence interval 1.16-1.21) in a random-effects meta-analysis of all studies. Subgroup meta-analyses by various factors such as study design, type of case-control study, study region, and methodological quality of study showed consistent findings. Also, a significant dose-response relationship was observed between the use of benzodiazepine and the risk of cancer (p for trend <0.01). The current meta-analysis of observational epidemiological studies suggests that benzodiazepine use is associated with an increased risk of cancer. © 2016 UICC.

Tall-tower observations of pollution from near-field sources in central Texas during the Texas Air Quality Study 2006

NASA Astrophysics Data System (ADS)

Andrews, A. E.; Kort, E.; Hirsch, A.; Eluszkiewicz, J.; Nehrkorn, T.; Michalak, A. M.; Petron, G.; Frost, G. J.; Gurney, K. R.; Stohl, A.; Wofsy, S. C.; Angevine, W. M.; White, A. B.; Oltmans, S. J.; Montzka, S. A.; Tans, P. P.

2008-12-01

The NOAA Earth System Research Laboratory has been measuring CO2, CO and basic meteorology from a television transmitter tower outside of Waco, TX since 2001. Sample intakes are located at 30, 122 and 457 meters above ground level. From July through November 2006, O3 measurements were added at 9 and 457 magl to support the Texas Air Quality Study (TexAQS 2006). There are several large point sources and metropolitan areas in the vicinity of the tower with distinct chemical signatures. Here, we evaluate the extent to which the Stochastic Time Inverted Lagrangian Transport (STILT) model reproduces pollution events that were observed at the tower during summer and fall 2006. For this study, STILT is driven by customized output from the WRF model v2.2, which was run with a 2km nested grid surrounding the tower embedded in a 10km nest that covers most of the southern and eastern US and a 40km nest that includes all of North America. Inaccurate representation of atmospheric transport is a major source of error in inverse estimates of fluxes of CO2 and other gases, and we selected this period for in depth analysis in part because a dense network of radar profilers was deployed for TexAQS 2006. The radar profilers report wind and boundary layer height, which can be used to evaluate the fidelity of the simulated transport. STILT is a particle dispersion model that can be run either forward or backward in time, which allows us to compare the agreement between forward runs from individual pollution sources and backward runs from the tower. We will also quantitatively compare the STILT-WRF results with similar output from the FLEXPART particle dispersion model driven by high-resolution ECMWF meteorological fields. We will use several different emissions inventories to evaluate model-to-model differences and differences between modeled and observed pollution influences.

Land Cover and Seasonality Effects on Biomass Burning Emissions and Air Quality Impacts Observed from Satellites

NASA Astrophysics Data System (ADS)

Zoogman, P.; Hoffman, A.; Gonzalez Abad, G.; Miller, C. E.; Nowlan, C. R.; Huang, G.; Liu, X.; Chance, K.

2016-12-01

Trace gas emissions from biomass burning can vary greatly both regionally and from event to event, but our current scientific understanding is unable to fully explain this variability. The large uncertainty in ozone formation resulting from fire emissions has posed a great challenge for assessing fire impacts on air quality and atmospheric composition. Satellite observations from OMI offer a powerful tool to observe biomass burning events by providing observations globally over a range of environmental conditions that effect emissions of NOx, formaldehyde, and glyoxal. We have investigated the seasonal relationship of biomass burning enhancements of these trace gases derived from OMI observations over tropical South America, Africa, and Indonesia. Land cover type (also derived from satellite observations) has a significant impact on formaldehyde and glyoxal enhancements from fire activity. We have found that the chemical ratio between formaldehyde and glyoxal is dependent on the burned land type and will present our current hypotheses for the spatial variation of this ratio in the tropics. Furthermore, in individual case studies we will investigate how these chemical ratios can inform our knowledge of the secondary formation of ozone, particularly during exceptional pollution events.

Total Quality Management in Logistics: A Case Study from the Trucking Industry

DTIC Science & Technology

1992-06-01

Quality Management (TQM) movement on the logistics industry as a whole, and, more specifically, its impact within the trucking industry. Its focus then narrows to study the practical aspects of implementing a W. Edwards Deming-based quality program within a particular trucking company, Mason Transporters, Inc. The effectiveness of the company’s implementation effort is assessed using data collected from a survey questionnaire, formal interviews, and personal observations during an on- site visit. Successes and shortcomings of the implementation process are highlighted

Intimate partner violence and breastfeeding practices: a systematic review of observational studies.

PubMed

Mezzavilla, Raquel de Souza; Ferreira, Marina de Figueiredo; Curioni, Cintia Chaves; Lindsay, Ana Cristina; Hasselmann, Maria Helena

To review the association between intimate partner violence and breastfeeding practices in the literature. The search was carried out in five databases, including MEDLINE, LILACS, SCOPUS, PsycoINFO, and Science Direct. The search strategy was carried out in February 2017. The authors included original studies with observational design, which investigated forms of intimate partner violence (including emotional, physical, and/or sexual) and breastfeeding practices. The quality of the studies was assessed based on the bias susceptibility through criteria specifically developed for this review. The study included 12 original articles (10 cross-sectional, one case-control, and one cohort study) carried out in different countries. The forms of intimate partner violence observed were emotional, physical, and/or sexual. Breastfeeding was investigated by different tools and only assessed children between 2 days and 6 months of life. Of the 12 studies included in this review, eight found a lower breastfeeding intention, breastfeeding initiation, and exclusive breastfeeding during the first six months of the child's life, and a higher likelihood of early termination of exclusive breastfeeding among women living at home where violence was present. The quality varied between the studies and six were classified as having low bias susceptibility based on the assessed items. Intimate partner violence is associated with inadequate breastfeeding practices of children aged 2 days to 6 months of life. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Chest compression quality management and return of spontaneous circulation: a matched-pair registry study.

PubMed

Lukas, Roman-Patrik; Gräsner, Jan Thorsten; Seewald, Stephan; Lefering, Rolf; Weber, Thomas Peter; Van Aken, Hugo; Fischer, Matthias; Bohn, Andreas

2012-10-01

Investigating the effects of any intervention during cardiac arrest remains difficult. The ROSC after cardiac arrest score was introduced to facilitate comparison of rates of return of spontaneous circulation (ROSC) between different ambulance services. To study the influence of chest compression quality management (including training, real-time feedback devices, and debriefing) in comparison with conventional cardiopulmonary resuscitation (CPR), a matched-pair analysis was conducted using data from the German Resuscitation Registry, with the calculated ROSC after cardiac arrest score as the baseline. Matching for independent ROSC after cardiac arrest score variables yielded 319 matched cases from the study period (January 2007-March 2011). The score predicted a 45% ROSC rate for the matched pairs. The observed ROSC increased significantly with chest compression quality management, to 52% (P=0.013; 95% CI, 46-57%). No significant differences were seen in the conventional CPR group (47%; 95% CI, 42-53%). The difference between the observed ROSC rates was not statistically significant. Chest compression quality management leads to significantly higher ROSC rates than those predicted by the prognostic score (ROSC after cardiac arrest score). Matched-pair analysis shows that with conventional CPR, the observed ROSC rate was not significantly different from the predicted rate. Analysis shows a trend toward a higher ROSC rate for chest compression quality management in comparison with conventional CPR. It is unclear whether a single aspect of chest compression quality management or the combination of training, real-time feedback, and debriefing contributed to this result. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Clinical Observed Performance Evaluation: A Prospective Study in Final Year Students of Surgery

ERIC Educational Resources Information Center

Markey, G. C.; Browne, K.; Hunter, K.; Hill, A. D.

2011-01-01

We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series…

Improved Satellite-based Photosysnthetically Active Radiation (PAR) for Air Quality Studies

NASA Astrophysics Data System (ADS)

Pour Biazar, A.; McNider, R. T.; Cohan, D. S.; White, A.; Zhang, R.; Dornblaser, B.; Doty, K.; Wu, Y.; Estes, M. J.

2015-12-01

One of the challenges in understanding the air quality over forested regions has been the uncertainties in estimating the biogenic hydrocarbon emissions. Biogenic volatile organic compounds, BVOCs, play a critical role in atmospheric chemistry, particularly in ozone and particulate matter (PM) formation. In southeastern United States, BVOCs (mostly as isoprene) are the dominant summertime source of reactive hydrocarbon. Despite significant efforts in improving BVOC estimates, the errors in emission inventories remain a concern. Since BVOC emissions are particularly sensitive to the available photosynthetically active radiation (PAR), model errors in PAR result in large errors in emission estimates. Thus, utilization of satellite observations to estimate PAR can help in reducing emission uncertainties. Satellite-based PAR estimates rely on the technique used to derive insolation from satellite visible brightness measurements. In this study we evaluate several insolation products against surface pyranometer observations and offer a bias correction to generate a more accurate PAR product. The improved PAR product is then used in biogenic emission estimates. The improved biogenic emission estimates are compared to the emission inventories over Texas and used in air quality simulation over the period of August-September 2013 (NASA's Discover-AQ field campaign). A series of sensitivity simulations will be performed and evaluated against Discover-AQ observations to test the impact of satellite-derived PAR on air quality simulations.

Company observational post-marketing studies: drug risk assessment and drug research in special populations--a study-based analysis.

PubMed

Hasford, J; Lamprecht, T

1998-01-01

Company observational post-marketing studies (COPS) claim to provide essential data about drug risks and effectiveness in special populations not admitted to pre-approval clinical trials. Since COPS are often mainly regarded as a marketing activity, this study-based analysis tries to evaluate the scientific contributions of COPS. Thirty-five COPS were identified by hand-searching through medical journals, writing to pharmaceutical manufacturers and using MEDLINE. Fourteen COPS evaluated cardiovascular drugs, 9 evaluated NSAIDs and 12 evaluated various other indications. Thirty-five COPS listed effectiveness, 31 listed safety and 8 listed patient compliance as principal objectives. Not a single COPS included a control group. Seventeen of 21 evaluable COPS mentioned extensive exclusion criteria similar to those in clinical trials. Median observation time was 8 weeks, too short for chronic diseases and for adverse drug reactions with longer latency periods. One new adverse event was regarded. Global assessments of the outcomes by physicians dominated and were not based on objective clinical findings. None of the studies specified any details concerning the standardisation of observations or quality-control procedures. The current COPS scheme does not contribute significantly to our knowledge of drug safety and the effects in special populations. Despite serious criticism over the past 20 years, the poor quality of COPS compared with dramatic improvements of pre-approval trials - implies a need for detailed guidelines for non-experimental phase IV research, similar to the Good Clinical Practice-Guideline of the European Community.

Impact of sleep quality on the quality of life of patients with Parkinson's disease: a questionnaire based study.

PubMed

Pandey, Shweta; Bajaj, Bhupender Kumar; Wadhwa, Ankur; Anand, Kuljeet Singh

2016-09-01

Poor sleep quality contributes to the inferior quality of life of patients with Parkinson's disease (PD) despite appropriate treatment of motor symptoms. The literature about the impact of sleep quality on quality of life of patients with PD is as yet sparse. One hundred patients of PD diagnosed as per UK Brain Bank criteria were assessed for severity and stage of PD using UPDRS and modified Hoehn &Yahr scales. The quality of sleep was assessed by Pittsburgh Sleep Quality Index and excessive daytime somnolence (EDS) was evaluated using Epworth Sleepiness Scale. Parkinson's Disease Questionnaire -39 (PDQ-39) was used to determine quality of life of the patients. Comorbid depression and anxiety were assessed using Inventory of Depressive Symptoms-Self Rated and Hamilton Anxiety Rating Scale. Pearson's correlation and multiple linear regressions were used to analyze relation of sleep quality with quality of life of patients. Fifty patients had poor sleep quality. EDS was present in only 9 patients. Co-morbid depression and anxiety were present in 52 and 34 patients respectively. While the motor severity assessed by UPDRS-III was observed to adversely affect quality of life, it did not negatively impact quality of sleep. Higher score on UPDRS-total and UPDRS IV suggesting advanced disease correlated with poor sleep quality. Depression and anxiety were significantly more frequent in patients with poor sleep quality (p<0.01). Patients with poor sleep quality had worse quality of life (r=0.338, p<0.05). Depression and anxiety were also observed to have significant negative impact on quality of life of PD patients (p<0.01). Poor sleep quality was not found to be an independent predictor of quality of life using multiple linear regression analysis. Poor sleep quality along with comorbid depression, anxiety and advanced stage of disease is associated with poor quality of life. Copyright © 2016 Elsevier B.V. All rights reserved.

Investigating the Impact of Marine Ship Emissions on Regional Air Quality using OMI Satellite NO2 Observations and the CMAQ Model

NASA Astrophysics Data System (ADS)

Ring, A.; Canty, T. P.; He, H.; Vinciguerra, T.; Lamsal, L. N.; Dickerson, R. R.; Salawitch, R. J.; Cohen, M.; Montgomery, L. N.; Dreessen, J.

2015-12-01

Commercial marine vessels (CMVs) emit significant amounts of NOx, an ozone precursor, which may contribute to negative health consequences for people living in areas near shipping lanes. In coastal US states, many metropolitan areas such as Baltimore and New York City are located near ports with CMVs. Many studies estimate that ships account for ~15-30% of the global anthropogenic NOx emissions. EPA developed emissions inventories are widely used by states to construct model scenarios for testing air quality attainment strategies. Currently, CMV emissions are generated by simply applying growth factors to aggregated emissions data from much earlier years. Satellite retrievals from the Ozone Monitoring Instrument (OMI) have been successfully used to improve the veracity of marine emissions by incorporating observational data from the inventory year. In this study we use OMI NO2 observations and Community Multiscale Air Quality (CMAQ) model outputs to improve the EPA marine emission estimates for the Mid-Atlantic region. Back trajectories from the NOAA Air Resources Laboratory HYSPLIT model are used to identify days with minimal continental influence on OMI tropospheric column NO2 over shipping lanes. We perform sensitivity analyses to quantify the impact of marine emissions on air quality and suggest strategies to better meet the EPA mandated ozone standard.

Quality of life improvement in HIV-1 patients treated with raltegravir in a real-life observational study: RACING.

PubMed

Spire, Bruno; Nait-Ighil, Lella; Pugliese, Pascal; Poizot-Martin, Isabelle; Jullien, Vincent; Marcelin, Anne-Geneviève; Billaud, Eric

2017-01-01

Good efficacy and safety of raltegravir in person living with HIV was demonstrated in clinical trials over five years, but real-life data, particularly about quality of life (QoL), are lacking. QoL was evaluated over time in adult patients first treated or switched to regimens containing raltegravir in an observational cohort study. Patient QoL was evaluated using the Fatigue Impact Scale (FIS) and the HIV Symptom Index (HSI). Data were collected at baseline and at 1, 3, 6, 12, 18, and 24 months. Baseline FIS and HSI subscores were compared with the scores at each visit using the paired Wilcoxon test. The impact of time, sociodemographic and medical variables upon patient-perceived fatigue and symptoms was also assessed using mixed multivariate models. From baseline, all FIS and HSI subscores improved significantly after one month of treatment. In addition, psychosocial FIS subscores and both the frequency of bothersome symptoms and HSI subscores improved significantly at each visit. Physical FIS subscores also improved significantly, except at month 18, whereas both cognitive and total FIS subscores improved only after 6 months and 24 months, respectively. In multivariate analysis, employment was independently associated over time with improved improvement in both FIS and HSI subscores. Patient QoL improved significantly over a 24-month period of treatment with a raltegravir-containing regimen. FIS and HSI are sensitive tools to measure the impact of new antiretroviral combinations on a patient's perception of QoL.

Qualitative Analysis of Parental Observations on Quality of Life in Australian Children with Down Syndrome.

PubMed

Murphy, Nada; Epstein, Amy; Leonard, Helen; Davis, Elise; Reddihough, Dinah; Whitehouse, Andrew; Jacoby, Peter; Bourke, Jenny; Williams, Katrina; Downs, Jenny

There are many challenges to health, functioning, and participation for children with Down syndrome; yet, the quality-of-life (QOL) domains important for this group have never been clearly articulated. This study investigated parental observations to identify QOL domains in children with Down syndrome and determined whether domains differed between children and adolescents. The sample comprised 17 families whose child with Down syndrome was aged 6 to 18 years. Primary caregivers took part in semistructured telephone interviews to explore aspects of their child's life that were satisfying or challenging. Qualitative thematic analysis was implemented using a grounded theory framework to identify domains. The coded data set was divided into 2 groups (childhood and adolescence) at 3 age cut points to observe whether differences existed between the coded domains and domain elements: (1) 6 to 11 years with 12 to 18 years; (2) 6 to 13 years with 14 to 18 years; and (3) 6 to 15 years with 16 to 18 years. Eleven domains were identified: physical health, behavior and emotion, personal value, communication, movement and physical activity, routines and predictability, independence and autonomy, social connectedness and relationships, variety of activities, nature and outdoors, and access to services. No differences in domains and domain elements were identified across childhood and adolescence. Our data form a preliminary framework from which to design investigations of the child's perspectives on life quality and suggest a range of necessary supports and services.

Observational Versus Experimental Studies: What’s the Evidence for a Hierarchy?

PubMed Central

Concato, John

2004-01-01

Summary: The tenets of evidence-based medicine include an emphasis on hierarchies of research design (i.e., study architecture). Often, a single randomized, controlled trial is considered to provide “truth,” whereas results from any observational study are viewed with suspicion. This paper describes information that contradicts and discourages such a rigid approach to evaluating the quality of research design. Unless a more balanced strategy evolves, new claims of methodological authority may be just as problematic as the traditional claims of medical authority that have been criticized by proponents of evidence-based medicine. PMID:15717036

Perceived versus actual water quality: Community studies in rural Oaxaca, Mexico.

PubMed

Rowles, Lewis Stetson; Alcalde, Reinaldo; Bogolasky, Francisca; Kum, Soyoon; Diaz-Arriaga, Farith A; Ayres, Craig; Mikelonis, Anne M; Toledo-Flores, Luis Javier; Alonso-Gutiérrez, Manuel Gerardo; Pérez-Flores, Maria Eufemia; Lawler, Desmond F; Ward, Peter M; Lopez-Cruz, Juana Yolanda; Saleh, Navid B

2018-05-01

Compromised water quality risks public health, which becomes particularly acute in economically marginalized communities. Although the majority of the clean-water-deprived population resides in Sub-Saharan Africa and Asia, a significant portion (32 million) lives in Meso- and Latin-America. Oaxaca is one of the marginalized southern states of Mexico, which has experienced high morbidity from infectious diseases and also has suffered from a high rate of infant mortality. However, there has been a paucity of reports on the status of water quality of culturally diverse rural Oaxaca. This study follows community-based participatory research methods to address the data gap by reporting on water quality (chemical and microbiological) and by exploring social realities and water use practices within and among communities. Surveys and water quality analyses were conducted on 73 households in three rural communities, which were selected based on the choice of water sources (i.e., river water, groundwater, and spring water). Statistically significant variations among communities were observed including the sanitation infrastructure (p-value 0.001), public perception on water quality (p-value 0.007), and actual microbiological quality of water (p-value 0.001). Results indicate a high prevalence of diarrheal diseases, a desire to improve water quality and reduce the cost of water, and a need for education on water quality and health in all the surveyed communities. The complexities among the three studied communities highlight the need for undertaking appropriate policies and water treatment solutions. Copyright © 2017 Elsevier B.V. All rights reserved.

The effectiveness of Korean medicine treatment in male patients with infertility: a study protocol for a prospective observational pilot study.

PubMed

Kim, Kwan-Ii; Jo, Junyoung

2018-01-01

Male factor subfertility has increasingly been considered the cause of infertility in couples. Many men with male infertility have sperm problems such as oligozoospermia, asthenozoospermia, or teratozoospermia. Because abnormal semen parameters are idiopathic to some extent, no standard therapy has been established to date. Herbal medicine has been reported to have beneficial properties in the treatment of subfertility, especially in improving semen quality both in vivo and in human studies. Therefore, we intend to investigate the effectiveness and safety of treatment using Korean medicine (KM) for infertile male patients with poor semen quality.This will be a single-center, prospective, case-only observational pilot study. About 20 male patients with infertility who visit Conmaul Hospital of Korean Medicine will be recruited. We will follow the standard treatment protocol, which has shown good results in the treatment of male infertility. The protocol is composed mainly of a 10-week herbal decoction treatment; acupuncture and/or pharmacopuncture are added when needed. Semen samples, quality of life, and the scrotal temperatures of infertile men will be observed before and after the 10-week treatment with KM.The study has received ethical approval from the Public Institutional Review Board (approval number: P01-201708-21-008). The findings will be disseminated to appropriate audiences via peer-reviewed publication and conference presentations. Korean Clinical Trial Registry (CRIS), Republic of Korea: KCT0002611.

Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study

PubMed Central

Shamo, Farid; Wilson, Teri; Kiley, Janet; Repace, James

2015-01-01

Objectives To assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively implemented in restaurants and casinos, there will be a significant reduction in the particulate matter PM2.5 measured in the same establishments after the law is implemented. Setting Prelaw and postlaw design study. Participants 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. Methods We monitored the real-time PM2.5 in 78 restaurants and three Detroit casinos before the SFA law, and again monitored the same restaurants and casinos after implementation of the law, which was enacted on 1 May 2010. Primary and secondary outcome measures Concentration measurements of secondhand smoke (SHS) fine particles (PM2.5) were compared in each restaurant in the prelaw period to measurements of PM2.5 in the same restaurants during the postlaw period. A second comparison was made for PM2.5 levels in three Detroit casinos prelaw and postlaw; these casinos were exempted from the SFA law. Results Prelaw data indicated that 85% of the restaurants had poor to hazardous air quality, with the average venue having ‘unhealthy’ air according to Michigan's Air Quality Index for PM2.5. Postlaw, air quality in 93% of the restaurants improved to ‘good’. The differences were statistically significant (p<0.0001). By comparison, the three casinos measured had ‘unhealthy’ air both before and after the law. Conclusions The significant air quality improvement in the Michigan restaurants after implementation of the SFA law indicates that the law was very effective in reducing exposure to SHS. Since the Detroit casinos were exempted from the law, the air quality was unchanged, and remained unhealthy in both prelaw and postlaw periods. PMID:26185176

[Quality of sleep and selective attention in university students: descriptive cross-sectional study].

PubMed

Fontana, Silvia Alicia; Raimondi, Waldina; Rizzo, María Laura

2014-09-05

Sleep quality not only refers to sleeping well at night, but also includes appropriate daytime functioning. Poor quality of sleep can affect a variety of attention processes. The aim of this investigation was to evaluate the relationship between the perceived quality of sleep and selective focus in a group of college students. A descriptive cross-sectional study was carried out in a group of 52 Argentinian college students of the Universidad Adventista del Plata. The Pittsburgh Sleep Quality Index, the Continuous Performance Test and the Trail Making Test were applied. The main results indicate that students sleep an average of 6.48 hours. Generally half of the population tested had a good quality of sleep. However, the dispersion seen in some components demonstrates the heterogeneity of the sample in these variables. It was observed that the evaluated attention processes yielded different levels of alteration in the total sample: major variability in the process of process and in the divided-attention processes were detected. A lower percentage of alteration was observed in the process of attention support. Poor quality of sleep has more impact in the sub processes with greater participation of corticocortical circuits (selective and divided attention) and greater involvement of the prefrontal cortex. Fewer difficulties were found in the attention-support processes that rely on subcortical regions and have less frontal involvement.

An observational study: associations between nurse-reported hospital characteristics and estimated 30-day survival probabilities

PubMed Central

Tvedt, Christine; Sjetne, Ingeborg Strømseng; Helgeland, Jon; Bukholm, Geir

2014-01-01

Background There is a growing body of evidence for associations between the work environment and patient outcomes. A good work environment may maximise healthcare workers’ efforts to avoid failures and to facilitate quality care that is focused on patient safety. Several studies use nurse-reported quality measures, but it is uncertain whether these outcomes are correlated with clinical outcomes. The aim of this study was to determine the correlations between hospital-aggregated, nurse-assessed quality and safety, and estimated probabilities for 30-day survival in and out of hospital. Methods In a multicentre study involving almost all Norwegian hospitals with more than 85 beds (sample size=30, information about nurses’ perceptions of organisational characteristics were collected. Subscales from this survey were used to describe properties of the organisations: quality system, patient safety management, nurse–physician relationship, staffing adequacy, quality of nursing and patient safety. The average scores for these organisational characteristics were aggregated to hospital level, and merged with estimated probabilities for 30-day survival in and out of hospital (survival probabilities) from a national database. In this observational, ecological study, the relationships between the organisational characteristics (independent variables) and clinical outcomes (survival probabilities) were examined. Results Survival probabilities were correlated with nurse-assessed quality of nursing. Furthermore, the subjective perception of staffing adequacy was correlated with overall survival. Conclusions This study showed that perceived staffing adequacy and nurses’ assessments of quality of nursing were correlated with survival probabilities. It is suggested that the way nurses characterise the microsystems they belong to, also reflects the general performance of hospitals. PMID:24728887

Observations on a Montana water quality proposal.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Veil, J. A.; Puder, M. G.

2006-01-12

In May 2005, a group of petitioners led by the Northern Plains Resource Council (NPRC) submitted a petition to revise water quality requirements to the Montana Board of Environmental Review (BER). Under Montana law, the BER had to consider the petition and either reject it or propose it as a new regulation. In September 2005, the BER announced proposed changes to the Montana water quality regulations. The proposal, which included almost the exact language found in the petition, was directed toward discharges of water from coal bed natural gas (CBNG) production. The key elements of the proposal included: (1) Nomore » discharges of CBNG water are allowed to Montana surface waters unless operators can demonstrate that injection to aquifers with the potential for later recovery of the water is not feasible. (2) When operators can demonstrate the injection is not feasible, the CBNG water to be discharged must meet very strict technology-based limits for multiple parameters. (3) The Montana water quality standards for the sodium adsorption ratio (SAR) and electrical conductivity (EC) would be evaluated using the 7Q10 flow (lowest 7-consecutive-day flow in a 10-year period) rather than a monthly flow that is currently used. (4) SAR and EC would be reclassified as ''harmful parameters'', thereby greatly restricting the ability for CBNG discharges to be allowed under Montana's nondegradation regulations. The proposed regulations, if adopted in their current form, are likely to substantially reduce the amount of CBNG production in Montana. The impact also extends to Wyoming CBNG production through much greater restrictions on water quality that must be met at the interstate border.« less

[Clinical applicability of evidence-based orthopedics--a cross-sectional study of the quality of orthopedic evidence].

PubMed

Vavken, P; Culen, G; Dorotka, R

2008-01-01

The demand to routinely apply evidence-based methods in orthopedic surgery increases steadily. In order to do so, however, the validity and reliability of the "evidence" has to be scrutinized. The object of this study was to assess the quality of the most recent orthopedic evidence and to determine variables that have an influence on quality. All 2006 controlled trials from orthopedic journals with high impact factors were analysed in a cross-sectional study. A score based on the CONSORT statement was used to assess study quality. Selected variables were tested for their influence on the quality of the study. Two independent blinded observers reviewed 126 studies. The overall quality was moderate to high. The most neglected parameters were power analysis, intention-to-treat, and concealment. The participation of a methodologically trained investigator increases study quality significantly. There was no difference in study quality irrespective of whether or not there was statistically significant result. Using our quality score we were able show fairly good results for recent orthopedic studies. The most frequently neglected issues in orthopedic research are blinding, power analysis, and intention-to-treat. This may distort the results of clinical investigations considerably and, especially, lack of concealment causes false-positive findings. Our data show furthermore that participation of a methodologist significantly increases quality of the study and consequently strengthens the reliability of results.

An Observational Study of the Interactions of Socially Withdrawn/Anxious Early Adolescents and Their Friends

ERIC Educational Resources Information Center

Schneider, Barry H.

2009-01-01

Background: The friendships of socially withdrawn/anxious children and early adolescents have been found to lack critical rewarding qualities. Observational research may help elucidate the obstacles they face in forming and maintaining high-quality friendships with sociable peers. Method: We observed the interactions of 38 socially withdrawn early…

Quality of reporting in oncology studies: A systematic analysis of literature reviews and prospects.

PubMed

Rivoirard, Romain; Bourmaud, Aurélie; Oriol, Mathieu; Tinquaut, Fabien; Méry, Benoîte; Langrand-Escure, Julien; Vallard, Alexis; Fournel, Pierre; Magné, Nicolas; Chauvin, Franck

2017-04-01

The present review gives an overview of systematic reviews published in peer reviewed Journals analysing quality of reporting in oncology studies. PUBMED and Cochrane library were searched to identify systematic reviews assessing quality of reporting for randomized controlled trials (RCTs) and observational studies (OBS). Recommendations and primary endpoints used to assess the quality of reporting were described. Intrinsic quality of reporting was analyzed using an Overall Quality Score for literature Reviews (OQSR). Main evaluation themes were overall quality of reporting (20/58) and reporting of Health-Related Quality Of Life (HRQOL) in RCTs (7/58). Reporting recommendations used were not detailed in 56.9% of reviews. Insufficient reporting for the methodological description (randomization, blinding details, and allocation concealment) and the rationale for using specific measure of HRQOL were highlighted. OQSR was significantly higher for reviews published between 2010 and 2014 (after the PRISMA Publication), as compared to those published between 1996-2009 (median OQSR 10 (10-11) versus median OQSR 9 (6-10) respectively, p=0.0053). Intrinsic quality of reporting is satisfactory and has been improved in the last years. Copyright © 2017 Elsevier B.V. All rights reserved.

Observation impact studies with the Mercator Ocean analysis and forecasting systems

NASA Astrophysics Data System (ADS)

Remy, E. D.; Le Traon, P. Y.; Lellouche, J. M.; Drevillon, M.; Turpin, V.; Benkiran, M.

2016-02-01

Mercator Ocean produces and delivers in real-time ocean analysis and forecasts on a daily basis. The quality of the analysis highly relies on the availability and quality of the assimilated observations.Tools are developed to estimate the impact of the present network and to help designing the future evolutions of the observing systems in the context of near real time production of ocean analysis and forecasts. OSE and OSSE are the main approaches used in this context. They allow the assessment of the efficiency of a given data set to constrain the ocean model circulation through the data assimilation process. Illustrations will mainly focus on the present and future evolution of the Argo observation network and altimetry constellation, including the potential impact of future SWOT data. Our systems show clear sensitivities to observation array changes, mainly depending on the specified observation error and regional dynamic. Impact on non observed variables can be important and are important to evaluate. Dedicated diagnostics has to be define to measure the improvements bring by each data set. Alternative approaches to OSE and OSSE are also explored: approximate computation of DFS will be presented and discussed. Limitations of each approach will be discussed in the context of real time operation.

Investigating the application of motion accelerometers as a sleep monitoring technique and the clinical burden of the intensive care environment on sleep quality: study protocol for a prospective observational study in Australia

PubMed Central

Currie, Marian J; Huang, Hsin-Chia Carol; Litton, Edward; Wibrow, Bradley; Lopez, Violeta; Haren, Frank Van

2018-01-01

Introduction Sleep is a state of quiescence that facilitates the significant restorative processes that enhance individuals’ physiological and psychological well-being. Patients admitted to the intensive care unit (ICU) experience substantial sleep disturbance. Despite the biological importance of sleep, sleep monitoring does not form part of standard clinical care for critically ill patients. There exists an unmet need to assess the feasibility and accuracy of a range of sleep assessment techniques that have the potential to allow widespread implementation of sleep monitoring in the ICU. Key measures The coprimary outcome measures of this study are to: determine the accuracy and feasibility of motion accelerometer monitoring (ie, actigraphy) and subjective assessments of sleep (nursing-based observations and patient self-reports) to the gold standard of sleep monitoring (ie, polysomnography) in evaluating sleep continuity and disturbance. The secondary outcome measures of the study will include: (1) the association between sleep disturbance and environmental factors (eg, noise, light and clinical interactions) and (2) to describe the sleep architecture of intensive care patients. Methods and analysis A prospective, single centre observational design with a within subjects’ assessment of sleep monitoring techniques. The sample will comprise 80 adults (aged 18 years or more) inclusive of ventilated and non-ventilated patients, admitted to a tertiary ICU with a Richmond Agitation-Sedation Scale score between +2 (agitated) and −3 (moderate sedation) and an anticipated length of stay >24 hours. Patients’ sleep quality, total sleep time and sleep fragmentations will be continuously monitored for 24 hours using polysomnography and actigraphy. Behavioural assessments (nursing observations) and patients’ self-reports of sleep quality will be assessed during the 24-hour period using the Richards-Campbell Sleep Questionnaire, subjective sleepiness evaluated via

Investigating the application of motion accelerometers as a sleep monitoring technique and the clinical burden of the intensive care environment on sleep quality: study protocol for a prospective observational study in Australia.

PubMed

Delaney, Lori J; Currie, Marian J; Huang, Hsin-Chia Carol; Litton, Edward; Wibrow, Bradley; Lopez, Violeta; Haren, Frank Van

2018-01-21

Sleep is a state of quiescence that facilitates the significant restorative processes that enhance individuals' physiological and psychological well-being. Patients admitted to the intensive care unit (ICU) experience substantial sleep disturbance. Despite the biological importance of sleep, sleep monitoring does not form part of standard clinical care for critically ill patients. There exists an unmet need to assess the feasibility and accuracy of a range of sleep assessment techniques that have the potential to allow widespread implementation of sleep monitoring in the ICU. The coprimary outcome measures of this study are to: determine the accuracy and feasibility of motion accelerometer monitoring (ie, actigraphy) and subjective assessments of sleep (nursing-based observations and patient self-reports) to the gold standard of sleep monitoring (ie, polysomnography) in evaluating sleep continuity and disturbance. The secondary outcome measures of the study will include: (1) the association between sleep disturbance and environmental factors (eg, noise, light and clinical interactions) and (2) to describe the sleep architecture of intensive care patients. A prospective, single centre observational design with a within subjects' assessment of sleep monitoring techniques. The sample will comprise 80 adults (aged 18 years or more) inclusive of ventilated and non-ventilated patients, admitted to a tertiary ICU with a Richmond Agitation-Sedation Scale score between +2 (agitated) and -3 (moderate sedation) and an anticipated length of stay >24 hours. Patients' sleep quality, total sleep time and sleep fragmentations will be continuously monitored for 24 hours using polysomnography and actigraphy. Behavioural assessments (nursing observations) and patients' self-reports of sleep quality will be assessed during the 24-hour period using the Richards-Campbell Sleep Questionnaire, subjective sleepiness evaluated via the Karolinska Sleepiness Scale, along with a

Strengthening the reliability and credibility of observational epidemiology studies by creating an Observational Studies Register.

PubMed

Swaen, Gerard M H; Carmichael, Neil; Doe, John

2011-05-01

To evaluate the need for the creation of a system in which observational epidemiology studies are registered; an Observational Studies Register (OSR). The current scientific process for observational epidemiology studies is described. Next, a parallel is made with the clinical trials area, where the creation of clinical trial registers has greatly restored and improved their credibility and reliability. Next, the advantages and disadvantages of an OSR are compared. The advantages of an OSR outweigh its disadvantages. The creation of an OSR, similar to the existing Clinical Trials Registers, will improve the assessment of publication bias and will provide an opportunity to compare the original study protocol with the results reported in the publication. Reliability, credibility, and transparency of observational epidemiology studies are strengthened by the creation of an OSR. We propose a structured, collaborative, and coordinated approach for observational epidemiology studies that can provide solutions for existing weaknesses and will strengthen credibility and reliability, similar to the approach currently used in clinical trials, where Clinical Trials Registers have played a key role in strengthening their scientific value. Copyright © 2011 Elsevier Inc. All rights reserved.

Evaluation of automatic image quality assessment in chest CT - A human cadaver study.

PubMed

Franck, Caro; De Crop, An; De Roo, Bieke; Smeets, Peter; Vergauwen, Merel; Dewaele, Tom; Van Borsel, Mathias; Achten, Eric; Van Hoof, Tom; Bacher, Klaus

2017-04-01

The evaluation of clinical image quality (IQ) is important to optimize CT protocols and to keep patient doses as low as reasonably achievable. Considering the significant amount of effort needed for human observer studies, automatic IQ tools are a promising alternative. The purpose of this study was to evaluate automatic IQ assessment in chest CT using Thiel embalmed cadavers. Chest CT's of Thiel embalmed cadavers were acquired at different exposures. Clinical IQ was determined by performing a visual grading analysis. Physical-technical IQ (noise, contrast-to-noise and contrast-detail) was assessed in a Catphan phantom. Soft and sharp reconstructions were made with filtered back projection and two strengths of iterative reconstruction. In addition to the classical IQ metrics, an automatic algorithm was used to calculate image quality scores (IQs). To be able to compare datasets reconstructed with different kernels, the IQs values were normalized. Good correlations were found between IQs and the measured physical-technical image quality: noise (ρ=-1.00), contrast-to-noise (ρ=1.00) and contrast-detail (ρ=0.96). The correlation coefficients between IQs and the observed clinical image quality of soft and sharp reconstructions were 0.88 and 0.93, respectively. The automatic scoring algorithm is a promising tool for the evaluation of thoracic CT scans in daily clinical practice. It allows monitoring of the image quality of a chest protocol over time, without human intervention. Different reconstruction kernels can be compared after normalization of the IQs. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Lognormal kriging for the assessment of reliability in groundwater quality control observation networks

USGS Publications Warehouse

Candela, L.; Olea, R.A.; Custodio, E.

1988-01-01

Groundwater quality observation networks are examples of discontinuous sampling on variables presenting spatial continuity and highly skewed frequency distributions. Anywhere in the aquifer, lognormal kriging provides estimates of the variable being sampled and a standard error of the estimate. The average and the maximum standard error within the network can be used to dynamically improve the network sampling efficiency or find a design able to assure a given reliability level. The approach does not require the formulation of any physical model for the aquifer or any actual sampling of hypothetical configurations. A case study is presented using the network monitoring salty water intrusion into the Llobregat delta confined aquifer, Barcelona, Spain. The variable chloride concentration used to trace the intrusion exhibits sudden changes within short distances which make the standard error fairly invariable to changes in sampling pattern and to substantial fluctuations in the number of wells. ?? 1988.

Improving UK Air Quality Modelling Through Exploitation of Satellite Observations

NASA Astrophysics Data System (ADS)

Pope, Richard; Chipperfield, Martyn; Savage, Nick

2014-05-01

In this work the applicability of satellite observations to evaluate the operational UK Met Office Air Quality in the Unified Model (AQUM) have been investigated. The main focus involved the AQUM validation against satellite observations, investigation of satellite retrieval error types and of synoptic meteorological-atmospheric chemistry relationships simulated/seen by the AQUM/satellite. The AQUM is a short range forecast model of atmospheric chemistry and aerosols up to 5 days. It has been designed to predict potentially hazardous air pollution events, e.g. high concentrations of surface ozone. The AQUM has only been validated against UK atmospheric chemistry recording surface stations. Therefore, satellite observations of atmospheric chemistry have been used to further validate the model, taking advantage of better satellite spatial coverage. Observations of summer and winter 2006 tropospheric column NO2 from both OMI and SCIAMACHY show that the AQUM generally compares well with the observations. However, in northern England positive biases (AQUM - satellite) suggest that the AQUM overestimates column NO2; we present results of sensitivity experiments on UK emissions datasets suspected to be the cause. In winter, the AQUM over predicts background column NO2 when compared to both satellite instruments. We hypothesise that the cause is the AQUM winter night-time chemistry, where the NO2 sinks are not substantially defined. Satellite data are prone to errors/uncertainty such as random, systematic and smoothing errors. We have investigated these error types and developed an algorithm to calculate and reduce the random error component of DOAS NO2 retrievals, giving more robust seasonal satellite composites. The Lamb Weather Types (LWT), an objective method of classifying the daily synoptic weather over the UK, were used to create composite satellite maps of column NO2 under different synoptic conditions. Under cyclonic conditions, satellite observed UK column NO2 is

The quality of sputum smear microscopy in public-private mix directly observed treatment laboratories in West Amhara region, Ethiopia.

PubMed

Manalebh, Almaw; Demissie, Meaza; Mekonnen, Daniel; Abera, Bayeh

2015-01-01

Ethiopia adopted Public-Private Mix Directly Observed Treatment Short Course Chemotherapy (PPM-DOTS) strategy for tuberculosis (TB) control program. Quality of sputum smear microscopy has paramount importance for tuberculosis control program in resource-poor countries like Ethiopia. A cross-sectional study was conducted to assess the quality of sputum smear microscopy in 37 Public-Private Mix laboratories in West Amhara, Ethiopia. The three external quality assessment methods (onsite evaluation, panel testing and blind rechecking) were employed. Onsite assessment revealed that 67.6% of PPM-DOTS laboratories were below the standard physical space (5 X 6) m2. The average monthly workload per laboratory technician was 19.5 (SD±2.9) slides with 12.8% positivity rate. The quality of Acid Fast Bacilli (AFB) staining reagents was sub-standard. The overall agreement for blind rechecking of 1,123 AFB slides was 99.4% (Kappa = 0.97). Reading of 370 AFB panel slides showed 3.5% false reading (Kappa = 0.92). Moreover, the consistency of reading scanty bacilli slides was lower (93%) compared to 1+, 2+ and 3+ bacilli. Based on blind rechecking and panel testing results, PPM-DOTS site laboratories showed good agreement with the reference laboratory. Physical space and qualities of AFB reagents would be areas of intervention to sustain the quality of sputum smear microscopy. Therefore, regular external quality assessment and provision of basic laboratory supplies for TB diagnosis would be the way forward to improve the quality of sputum smear microscopy services in PPM-DOTS laboratories.

The Quality of Sputum Smear Microscopy in Public-Private Mix Directly Observed Treatment Laboratories in West Amhara Region, Ethiopia

PubMed Central

Manalebh, Almaw; Demissie, Meaza; Mekonnen, Daniel; Abera, Bayeh

2015-01-01

Ethiopia adopted Public-Private Mix Directly Observed Treatment Short Course Chemotherapy (PPM-DOTS) strategy for tuberculosis (TB) control program. Quality of sputum smear microscopy has paramount importance for tuberculosis control program in resource-poor countries like Ethiopia. A cross-sectional study was conducted to assess the quality of sputum smear microscopy in 37 Public-Private Mix laboratories in West Amhara, Ethiopia. The three external quality assessment methods (onsite evaluation, panel testing and blind rechecking) were employed. Onsite assessment revealed that 67.6% of PPM-DOTS laboratories were below the standard physical space (5 X 6) m2. The average monthly workload per laboratory technician was 19.5 (SD±2.9) slides with 12.8% positivity rate. The quality of Acid Fast Bacilli (AFB) staining reagents was sub-standard. The overall agreement for blind rechecking of 1,123 AFB slides was 99.4% (Kappa = 0.97). Reading of 370 AFB panel slides showed 3.5% false reading (Kappa = 0.92). Moreover, the consistency of reading scanty bacilli slides was lower (93%) compared to 1+, 2+ and 3+ bacilli. Based on blind rechecking and panel testing results, PPM-DOTS site laboratories showed good agreement with the reference laboratory. Physical space and qualities of AFB reagents would be areas of intervention to sustain the quality of sputum smear microscopy. Therefore, regular external quality assessment and provision of basic laboratory supplies for TB diagnosis would be the way forward to improve the quality of sputum smear microscopy services in PPM-DOTS laboratories. PMID:25849516

Real space channelization for generic DBT system image quality evaluation with channelized Hotelling observer

NASA Astrophysics Data System (ADS)

Petrov, Dimitar; Cockmartin, Lesley; Marshall, Nicholas; Vancoillie, Liesbeth; Young, Kenneth; Bosmans, Hilde

2017-03-01

Digital breast tomosynthesis (DBT) is a relatively new 3D mammography technique that promises better detection of low contrast masses than conventional 2D mammography. The parameter space for DBT is large however and finding an optimal balance between dose and image quality remains challenging. Given the large number of conditions and images required in optimization studies, the use of human observers (HO) is time consuming and certainly not feasible for the tuning of all degrees of freedom. Our goal was to develop a model observer (MO) that could predict human detectability for clinically relevant details embedded within a newly developed structured phantom for DBT applications. DBT series were acquired on GE SenoClaire 3D, Giotto Class, Fujifilm AMULET Innovality and Philips MicroDose systems at different dose levels, Siemens Inspiration DBT acquisitions were reconstructed with different algorithms, while a larger set of DBT series was acquired on Hologic Dimensions system for first reproducibility testing. A channelized Hotelling observer (CHO) with Gabor channels was developed The parameters of the Gabor channels were tuned on all systems at standard scanning conditions and the candidate that produced the best fit for all systems was chosen. After tuning, the MO was applied to all systems and conditions. Linear regression lines between MO and HO scores were calculated, giving correlation coefficients between 0.87 and 0.99 for all tested conditions.

Association between nutritional awareness and diet quality: evidence from the observation of cardiovascular risk factors in Luxembourg (ORISCAV-LUX) study.

PubMed

Alkerwi, Ala'a; Sauvageot, Nicolas; Malan, Leoné; Shivappa, Nitin; Hébert, James R

2015-04-14

This study examined the association between nutritional awareness and diet quality, as indicated by energy density, dietary diversity and adequacy to achieve dietary recommendations, while considering the potentially important role of socioeconomic status (SES). Data were derived from 1351 subjects, aged 18-69 years and enrolled in the ORISCAV-LUX study. Energy density score (EDS), dietary diversity score (DDS) and Recommendation Compliance Index (RCI) were calculated based on data derived from a food frequency questionnaire. Nutritional awareness was defined as self-perception of the importance assigned to eating balanced meals, and classified as high, moderate, or of little importance. Initially, a General Linear Model was fit that adjusted for age, sex, country of birth, and body mass index (BMI). Furthermore, simultaneous contributions to diet quality of individual-level socioeconomic factors, education, and household income were examined across levels of nutritional awareness. Attributing high importance was associated inversely with energy density (p = 0.02), positively with both dietary diversity (p < 0.0001), and adequacy to dietary recommendations (p < 0.0001), independent of demographic factors, weight status and SES. Further adjustment for household income in the EDS-related multivariable model, reduced the β coefficient by 47% for the "moderate importance" category and 36% for the "high importance" category. Likewise, the β coefficient decreased by 13.6% and 10.7% in the DDS-related model, and by 12.5%, and 7.1% in the RCI-related model, respectively, across awareness categories. Nutritional awareness has a direct effect on diet quality, with a minor component of variance explained by improved income. The impact of nutritional awareness on diet quality seems to be a promising area for both health promotion and health policy research.

Use of NEXRAD radar-based observations for quality control of in-situ rain gauge measurements

NASA Astrophysics Data System (ADS)

Nelson, B. R.; Prat, O.; Leeper, R.

2017-12-01

Rain gauge quality control is an often over looked important step in the archive of historical precipitation estimates. We investigate the possibilities that exist for using ground based radar networks for quality control of rain gauge measurements. This process includes the point to pixel comparisons of the rain gauge measurements with NEXRAD observations. There are two NEXRAD based data sets used for reference; the NCEP stage IV and the NWS MRMS gridded data sets. The NCEP stage IV data set is available at 4km hourly for the period 2002-present and includes the radar-gauge bias adjusted precipitation estimate. The NWS MRMS data set includes several different variables such as reflectivity, radar-only estimates, precipitation flag, and radar-gauge bias adjusted precipitation estimates. The latter product provides for much more information to apply quality control such as identification of precipitation type, identification of storm type and Z-R relation. In addition, some of the variables are available at 5-minute scale. The rain gauge networks that are investigated are the Climate Reference Network (CRN), the Fischer-Porter Hourly Precipitation Database (HPD), and the Hydrometeorological Automated Data System (HADS). The CRN network is available at the 5-minute scale, the HPD network is available at the 15-minute and hourly scale, and HADS is available at the hourly scale. The varying scales present challenges for comparisons. However given the higher resolution radar-based products we identify an optimal combination of rain gauge observations that can be compared to the radar-based information. The quality control process focuses on identifying faulty gauges in direct comparison while a deeper investigation focuses on event-based differences from light rain to extreme storms.

Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study.

PubMed

Shamo, Farid; Wilson, Teri; Kiley, Janet; Repace, James

2015-07-16

To assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively implemented in restaurants and casinos, there will be a significant reduction in the particulate matter PM2.5 measured in the same establishments after the law is implemented. Prelaw and postlaw design study. 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. We monitored the real-time PM2.5 in 78 restaurants and three Detroit casinos before the SFA law, and again monitored the same restaurants and casinos after implementation of the law, which was enacted on 1 May 2010. Concentration measurements of secondhand smoke (SHS) fine particles (PM2.5) were compared in each restaurant in the prelaw period to measurements of PM2.5 in the same restaurants during the postlaw period. A second comparison was made for PM2.5 levels in three Detroit casinos prelaw and postlaw; these casinos were exempted from the SFA law. Prelaw data indicated that 85% of the restaurants had poor to hazardous air quality, with the average venue having 'unhealthy' air according to Michigan's Air Quality Index for PM2.5. Postlaw, air quality in 93% of the restaurants improved to 'good'. The differences were statistically significant (p<0.0001). By comparison, the three casinos measured had 'unhealthy' air both before and after the law. The significant air quality improvement in the Michigan restaurants after implementation of the SFA law indicates that the law was very effective in reducing exposure to SHS. Since the Detroit casinos were exempted from the law, the air quality was unchanged, and remained unhealthy in both prelaw and postlaw periods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol.

PubMed

Robert, Glenn B; Anderson, Janet E; Burnett, Susan J; Aase, Karina; Andersson-Gare, Boel; Bal, Roland; Calltorp, Johan; Nunes, Francisco; Weggelaar, Anne-Marie; Vincent, Charles A; Fulop, Naomi J

2011-10-26

although there is a wealth of information available about quality improvement tools and techniques in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in complex organisations like hospitals. The 'Quality and Safety in Europe by Research' (QUASER) study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers, payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and sustain-high quality services for their patients. in-depth multi-level (macro, meso and micro-system) analysis of healthcare quality policies and practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The project design has three major features: • a working definition of quality comprising three components: clinical effectiveness, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient complaints and claims). the protocol is based on the premise that future research, policy and practice need to address the

Expectation-Based Efficiency and Quality Improvements in Research Administration: Multi-Institutional Case Studies

ERIC Educational Resources Information Center

Saha, Dhanonjoy C.; Ahmed, Abrar; Hanumandla, Shailaja

2011-01-01

Conventional wisdom may support the presumed notion that higher expectations increase efficiency and improve quality. However, this claim may only be validated when workers are equipped with appropriate tools, training, and a conducive work environment. This study implements various interventions, observes outcomes, and analyzes data collected in…

Observational study of atmospheric surface layer and coastal weather in northern Qatar

NASA Astrophysics Data System (ADS)

Samanta, Dhrubajyoti; Sadr, Reza

2016-04-01

Atmospheric surface layer is the interaction medium between atmosphere and Earth's surface. Better understanding of its turbulence nature is essential in characterizing the local weather, climate variability and modeling of turbulent exchange processes. The importance of Middle East region, with its unique geographical, economical and weather condition is well recognized. However, high quality micrometeorological observational studies are rare in this region. Here we show experimental results from micrometeorological observations from an experimental site in the coastal region of Qatar during August-December 2015. Measurements of winds are obtained from three sonic anemometers installed on a 9 m tower placed at Al Ghariyah beach in northern Qatar (26.08 °N, 51.36 °E). Different surface layer characteristics is analyzed and compared with earlier studies in equivalent weather conditions. Monthly statistics of wind speed, wind direction, temperature, humidity and heat index are made from concurrent observations from sonic anemometer and weather station to explore variations with surface layer characteristics. The results also highlights potential impact of sea breeze circulation on local weather and atmospheric turbulence. The observed daily maximum temperature and heat index during morning period may be related to sea breeze circulations. Along with the operational micrometeorological observation system, a camera system and ultrasonic wave measurement system are installed recently in the site to study coastline development and nearshore wave dynamics. Overall, the complete observational set up is going to provide new insights about nearshore wind dynamics and wind-wave interaction in Qatar.

Review of quality assessment tools for the evaluation of pharmacoepidemiological safety studies

PubMed Central

Neyarapally, George A; Hammad, Tarek A; Pinheiro, Simone P; Iyasu, Solomon

2012-01-01

Objectives Pharmacoepidemiological studies are an important hypothesis-testing tool in the evaluation of postmarketing drug safety. Despite the potential to produce robust value-added data, interpretation of findings can be hindered due to well-recognised methodological limitations of these studies. Therefore, assessment of their quality is essential to evaluating their credibility. The objective of this review was to evaluate the suitability and relevance of available tools for the assessment of pharmacoepidemiological safety studies. Design We created an a priori assessment framework consisting of reporting elements (REs) and quality assessment attributes (QAAs). A comprehensive literature search identified distinct assessment tools and the prespecified elements and attributes were evaluated. Primary and secondary outcome measures The primary outcome measure was the percentage representation of each domain, RE and QAA for the quality assessment tools. Results A total of 61 tools were reviewed. Most tools were not designed to evaluate pharmacoepidemiological safety studies. More than 50% of the reviewed tools considered REs under the research aims, analytical approach, outcome definition and ascertainment, study population and exposure definition and ascertainment domains. REs under the discussion and interpretation, results and study team domains were considered in less than 40% of the tools. Except for the data source domain, quality attributes were considered in less than 50% of the tools. Conclusions Many tools failed to include critical assessment elements relevant to observational pharmacoepidemiological safety studies and did not distinguish between REs and QAAs. Further, there is a lack of considerations on the relative weights of different domains and elements. The development of a quality assessment tool would facilitate consistent, objective and evidence-based assessments of pharmacoepidemiological safety studies. PMID:23015600

The effects of observation of walking in a living room environment, on physical, cognitive, and quality of life related outcomes in older adults with dementia: a study protocol of a randomized controlled trial.

PubMed

Douma, Johanna G; Volkers, Karin M; Vuijk, Jelle Pieter; Sonneveld, Marieke H; Goossens, Richard H M; Scherder, Erik J A

2015-03-18

The number of older adults with dementia is expected to increase. Dementia is not only characterized by a decline in cognition, also other functions, for example, physical functioning change. A possible means to decrease the decline in these functions, or even improve them, could be increasing the amount of physical activity. A feasible way hereto may be activation of the mirror neuron system through action observation. This method has already been shown beneficial for the performance of actions in, for example, stroke patients. The primary aim of this study is to examine the effect of observing videos of walking people on physical activity and physical performance, in older adults with dementia. Secondary, effects on cognition and quality of life related factors will be examined. A cluster randomized controlled trial is being performed, in which videos are shown to older adults with dementia (also additional eligibility criteria apply) in shared living rooms of residential care facilities. Due to the study design, living rooms instead of individual participants are randomly assigned to the experimental (videos of walking people) or control (videos of nature) condition, by means of drawing pieces of paper. The intervention has a duration of three months, and takes place on weekdays, during the day. There are four measurement occasions, in which physical activity, physical functioning, activities of daily living, cognition, the rest-activity rhythm, quality of life, and depression are assessed. Tests for participants are administered by a test administrator who is blind to the group the participant is in. This study examines the effect of the observation of walking people on multiple daily life functions and quality of life related factors in older adults with dementia. A strength of this study is that the intervention does not require much time and attention from caregivers or researchers. A challenge of the study is therefore to get to know for how long residents

Operational prediction of air quality for the United States: applications of satellite observations

NASA Astrophysics Data System (ADS)

Stajner, Ivanka; Lee, Pius; Tong, Daniel; Pan, Li; McQueen, Jeff; Huang, Jianping; Huang, Ho-Chun; Draxler, Roland; Kondragunta, Shobha; Upadhayay, Sikchya

2015-04-01

Operational predictions of ozone and wildfire smoke over United States (U.S.) and predictions of airborne dust over the contiguous 48 states are provided by NOAA at http://airquality.weather.gov/. North American Mesoscale (NAM) weather predictions with inventory based emissions estimates from the U.S. Environmental Protection Agency (EPA) and chemical processes within the Community Multiscale Air Quality (CMAQ) model are combined together to produce ozone predictions. Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model is used to predict wildfire smoke and dust storm predictions. Routine verification of ozone predictions relies on AIRNow compilation of observations from surface monitors. Retrievals of smoke column integrals from GOES satellites and dust column integrals from MODIS satellite instruments are used for verification of smoke and dust predictions. Recent updates of NOAA's operational air quality predictions have focused on mobile emissions using the projections of mobile sources for 2012. Since emission inventories are complex and take years to assemble and evaluate causing a lag of information, we recently began combing inventory information with projections of mobile sources. In order to evaluate this emission update, these changes in projected NOx emissions from 2005-2012 were compared with observed changes in Ozone Monitoring Instrument (OMI) NO2 observations and NOx measured by surface monitors over large U.S. cities over the same period. Comparisons indicate that projected decreases in NOx emissions from 2005 to 2012 are similar, but not as strong as the decreases in the observed NOx concentrations and in OMI NO2 retrievals. Nevertheless, the use of projected mobile NOx emissions in the predictions reduced biases in predicted NOx concentrations, with the largest improvement in the urban areas. Ozone biases are reduced as well, with the largest improvement seen in rural areas. Recent testing of PM2.5 predictions is relying on

Quality of the parent-child interaction in young children with type 1 diabetes mellitus: study protocol.

PubMed

Nieuwesteeg, Anke M; Pouwer, Frans; van Bakel, Hedwig Ja; Emons, Wilco Hm; Aanstoot, Henk-Jan; Odink, Roelof; Hartman, Esther E

2011-04-14

In young children with type 1 diabetes mellitus (T1DM) parents have full responsibility for the diabetes-management of their child (e.g. blood glucose monitoring, and administering insulin). Behavioral tasks in childhood, such as developing autonomy, and oppositional behavior (e.g. refusing food) may interfere with the diabetes-management to achieve an optimal blood glucose control. Furthermore, higher blood glucose levels are related to more behavioral problems. So parents might need to negotiate with their child on the diabetes-management to avoid this direct negative effect. This interference, the negotiations, and the parent's responsibility for diabetes may negatively affect the quality of parent-child interaction. Nevertheless, there is little knowledge about the quality of interaction between parents and young children with T1DM, and the possible impact this may have on glycemic control and psychosocial functioning of the child. While widely used global parent-child interaction observational methods are available, there is a need for an observational tool specifically tailored to the interaction patterns of parents and children with T1DM. The main aim of this study is to construct a disease-specific observational method to assess diabetes-specific parent-child interaction. Additional aim is to explore whether the quality of parent-child interactions is associated with the glycemic control, and psychosocial functioning (resilience, behavioral problems, and quality of life). First, we will examine which situations are most suitable for observing diabetes-specific interactions. Then, these situations will be video-taped in a pilot study (N = 15). Observed behaviors are described into rating scales, with each scale describing characteristics of parent-child interactional behaviors. Next, we apply the observational tool on a larger scale for further evaluation of the instrument (N = 120). The parents are asked twice (with two years in between) to fill out

Quality of the parent-child interaction in young children with type 1 diabetes mellitus: study protocol

PubMed Central

2011-01-01

Background In young children with type 1 diabetes mellitus (T1DM) parents have full responsibility for the diabetes-management of their child (e.g. blood glucose monitoring, and administering insulin). Behavioral tasks in childhood, such as developing autonomy, and oppositional behavior (e.g. refusing food) may interfere with the diabetes-management to achieve an optimal blood glucose control. Furthermore, higher blood glucose levels are related to more behavioral problems. So parents might need to negotiate with their child on the diabetes-management to avoid this direct negative effect. This interference, the negotiations, and the parent's responsibility for diabetes may negatively affect the quality of parent-child interaction. Nevertheless, there is little knowledge about the quality of interaction between parents and young children with T1DM, and the possible impact this may have on glycemic control and psychosocial functioning of the child. While widely used global parent-child interaction observational methods are available, there is a need for an observational tool specifically tailored to the interaction patterns of parents and children with T1DM. The main aim of this study is to construct a disease-specific observational method to assess diabetes-specific parent-child interaction. Additional aim is to explore whether the quality of parent-child interactions is associated with the glycemic control, and psychosocial functioning (resilience, behavioral problems, and quality of life). Methods/Design First, we will examine which situations are most suitable for observing diabetes-specific interactions. Then, these situations will be video-taped in a pilot study (N = 15). Observed behaviors are described into rating scales, with each scale describing characteristics of parent-child interactional behaviors. Next, we apply the observational tool on a larger scale for further evaluation of the instrument (N = 120). The parents are asked twice (with two years in

Assessing the Relationship Between Observed Teaching Practice and Reading Growth in First Grade English Learners: A Validation Study

ERIC Educational Resources Information Center

Baker, Scott K.; Gersten, Russell; Haager, Diane; Dingle, Mary; Goldenberg, Claude

2005-01-01

Validation of a classroom observation measure for use with English Learners (ELs) in Grade 1 is the focus of this study. Fourteen teachers were observed during reading and language arts instruction with an instrument used to generate overall ratings of instructional quality on a number of dimensions. In these classrooms, the reading performance of…

[Changes observed in three quality indicators after the implementation of improvement strategies in the respiratory intensive care unit].

PubMed

Álvarez Maldonado, Pablo; Cueto Robledo, Guillermo; Cicero Sabido, Raúl

2015-04-01

To compare the results of quality monitoring after the implementation of improvement strategies in the respiratory intensive care unit (RICU). A prospective, comparative, longitudinal and interventional study was carried out. The RICU of Hospital General de México (Mexico). All patients admitted to the RICU from March 2012 to March 2013. An evidence-based bundle of interventions was implemented in order to reduce the ratios of three quality indicators: non-planned extubation (NPE), reintubation, and ventilator-associated pneumonia (VAP). NPE, reintubation and VAP ratios. A total of 232 patients were admitted, with a mean age of 49.5±17.8years; 119 (50.5%) were woman. The mean Simplified Acute Physiology Score (SAPS-3) was 49.8±17, and the mean Sequential Organ Failure Assessment (SOFA) score was 5.3±4.1. The mortality rate in the RICU was 38.7%. The standardized mortality ratio was 1.50 (95%CI: 1.20-1.84). An improved ratio was observed for reintubation and NPE indicators compared to the ratios of the previous 2011 cohort: 1.6% vs. 7% (P=.02) and 8.1 vs. 17 episodes per 1000 days of mechanical ventilation (P=.04), respectively. A worsened VAP ratio was observed: 18.4 vs. 15.1 episodes per 1000 days of mechanical ventilation (P=.5). Quality improvement is feasible with the identification of areas of opportunity and the implementation of strategies. Nevertheless, the implementation of a bundle of preventive measures in itself does not guarantee improvements. Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Classroom Observation Practice in Career Schools: A Multiple Case Study

ERIC Educational Resources Information Center

Withers, Marya G.

2017-01-01

Post-secondary career school educational leaders are charged with formulating sufficient, ongoing, and effective faculty development programming to ensure the delivery of quality education in their unique trade-expert led institutions. Classroom observations, which include substantive feedback exchanges from trained personnel are well documented…

Quantitative assessment of groundwater quality using a biological indicator: some preliminary observations.

PubMed

Pfeil, R M; Venkat, J A; Plimmer, J R; Sham, S; Davis, K; Nair, P P

1994-02-01

The genotoxicity of groundwater was evaluated, using a novel application of the SOS microplate assay (SOSMA). Organic residues were extracted from groundwater samples from Maryland, Pennsylvania, and Delaware by using C-18 bonded silica solid phase extraction tubes. Total organic carbon content (TOC) of water samples was also determined. The genotoxicity of the extracts was determined by the SOSMA. Relative activity (RA) as determined by the SOSMA is a quantitative measure of genotoxicity based on a comparison to the activity of the mutagen, 4-nitroquinoline oxide. Low levels of RA (about 2x background) were detected in waters from sites within these states. There was considerable temporal and spatial variation in the observed RA, but no definite patterns were observed in the variation. Between sampling sites there was a positive correlation between RA and TOC; however, this relationship appeared to be reversed occasionally within a sampling site. The extraction and bioassay methods provide an easy and relatively inexpensive means of determining water quality.

Quality of life, compliance, safety and effectiveness in fit older metastatic colorectal patients with cancer treated in first-line with chemotherapy plus cetuximab: A restrospective analysis from the ObservEr study.

PubMed

Rosati, Gerardo; Pinto, Carmine; Di Fabio, Francesca; Chiara, Silvana; Lolli, Ivan R; Ruggeri, Enzo M; Ciuffreda, Libero; Ferrara, Raimondo; Antonuzzo, Lorenzo; Adua, Daniela; Racca, Patrizia; Bilancia, Domenico; Benincasa, Elena; Stroppolo, Maria Elena; Di Costanzo, Francesco

2018-05-01

The influence of age (<70 years and ≥70 years) was retrospectively studied on the quality of life (QoL), incidence of side effects (including skin reactions) and efficacy of chemotherapy plus cetuximab in patients with KRAS wild type (WT) metastatic colorectal cancer (mCRC). 225 patients of the Observed study (PS 0-1) were retrieved based on age (< 70 and ≥70 years) and evaluated through EORTC QLQ-C30 and DLQI questionnaires. The two patient groups (141 < 70 and 84 ≥ 70 years, respectively) were balanced with no differences in any of the clinical and pathological characteristics considered. Both groups underwent similar type of first-line chemotherapy plus cetuximab, treatment duration and compliance. Cetuximab therapy caused similar incidence of side effects and impact on QoL in older and younger patients. No difference was observed in progression free survival (PFS) and in disease control rates between the two patient populations. Median overall survival (OS) was higher in patients <70 (27 months, 95% CI: 22.7-31.27) than in patients ≥70 (19 months, 95% CI: 14.65-23.35) (p = 0.002), which is likely due to higher proportions of metastatic resection (27.0% vs 8.3%; p = 0.001) and utilization of second-line therapy in younger group (58.9% vs 42.9%; p = 0.028). The current data suggest that fit older patients with mCRC can be safely treated with a cetuximab-based therapy, as QoL and safety profile do not seem to be affected by age. In addition, age did not impact the choice of chemotherapy to be associated to cetuximab and treatment compliance. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Using non-specialist observers in 4AFC human observer studies

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2017-03-01

Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

Evaluation of total workstation CT interpretation quality: a single-screen pilot study

NASA Astrophysics Data System (ADS)

Beard, David V.; Perry, John R.; Muller, Keith E.; Misra, Ram B.; Brown, P.; Hemminger, Bradley M.; Johnston, Richard E.; Mauro, J. Matthew; Jaques, P. F.; Schiebler, M.

1991-07-01

An interpretation report, generated with an electronic viewbox, is affected by two factors: image quality, which encompasses what can be seen on the display, and computer human interaction (CHI), which accounts for the cognitive load effect of locating, moving, and manipulating images with the workstation controls. While a number of subject experiments have considered image quality, only recently has the affect of CHI on total interpretation quality been measured. This paper presents the results of a pilot study conducted to evaluate the total interpretation quality of the FilmPlane2.2 radiology workstation for patient folders containing single forty-slice CT studies. First, radiologists interpreted cases and dictated reports using FilmPlane2.2. Requisition forms were provided. Film interpretation was provided by the original clinical report and interpretation forms generated from a previous experiment. Second, an evaluator developed a list of findings for each case based on those listed in all the reports for each case and then evaluated each report for its response on each finding. Third, the reports were compared to determine how well they agreed with one another. Interpretation speed and observation data was also gathered.

Quality of antiepileptic drugs in sub-Saharan Africa: A study in Gabon, Kenya, and Madagascar.

PubMed

Jost, Jeremy; Ratsimbazafy, Voa; Nguyen, Thu Trang; Nguyen, Thuy Linh; Dufat, Hanh; Dugay, Annabelle; Ba, Alassane; Sivadier, Guilhem; Mafilaza, Yattussia; Jousse, Cyril; Traïkia, Mounir; Leremboure, Martin; Auditeau, Emilie; Raharivelo, Adeline; Ngoungou, Edgard; Kariuki, Symon M; Newton, Charles R; Preux, Pierre-Marie

2018-06-12

Epilepsy is a major public health issue in low- and middle-income countries, where the availability and accessibility of quality treatment remain important issues, the severity of which may be aggravated by poor quality antiepileptic drugs (AEDs). The primary objective of this study was to measure the quality of AEDs in rural and urban areas in 3 African countries. This cross-sectional study was carried out in Gabon, Kenya, and Madagascar. Both official and unofficial supply chains in urban and rural areas were investigated. Samples of oral AEDs were collected in areas where a patient could buy or obtain them. Pharmacological analytical procedures and Medicine Quality Assessment Reporting Guidelines were used to assess quality. In total, 102 batches, representing 3782 units of AEDs, were sampled. Overall, 32.3% of the tablets were of poor quality, but no significant difference was observed across sites: 26.5% in Gabon, 37.0% in Kenya, and 34.1% in Madagascar (P = .7). The highest proportions of substandard medications were found in the carbamazepine (38.7%; 95% confidence interval [CI] 21.8-57.8) and phenytoin (83.3%; 95% CI 35.8-99.5) batches, which were mainly flawed by their failure to dissolve. Sodium valproate was the AED with the poorest quality (32.1%; 95% CI 15.8-42.3). The phenobarbital (94.1%; 95% CI 80.3-99.2) and diazepam (100.0%) batches were of better quality. The prevalence of substandard quality medications increased in samples supplied by public facilities (odds ratio [OR] 9.9; 95% CI 1.2-84.1; P < .04) and manufacturers located in China (OR 119.8; 95% CI 8.7-1651.9; P < .001). The prevalence of AEDs of bad quality increased when they were stored improperly (OR 5.4; 95% CI 1.2-24.1; P < .03). No counterfeiting was observed. However, inadequate AED storage conditions are likely to lead to ineffective and possibly dangerous AEDs, even when good-quality AEDs are initially imported. Wiley Periodicals, Inc. © 2018 International League Against

Measurements of PANs during the New England Air Quality Study 2002

NASA Astrophysics Data System (ADS)

Roberts, J. M.; Marchewka, M.; Bertman, S. B.; Sommariva, R.; Warneke, C.; de Gouw, J.; Kuster, W.; Goldan, P.; Williams, E.; Lerner, B. M.; Murphy, P.; Fehsenfeld, F. C.

2007-10-01

Measurements of peroxycarboxylic nitric anhydrides (PANs) were made during the New England Air Quality Study 2002 cruise of the NOAA RV Ronald H Brown. The four compounds observed, PAN, peroxypropionic nitric anhydride (PPN), peroxymethacrylic nitric anhydride (MPAN), and peroxyisobutyric nitric anhydride (PiBN) were compared with results from other continental and Gulf of Maine sites. Systematic changes in PPN/PAN ratio, due to differential thermal decomposition rates, were related quantitatively to air mass aging. At least one early morning period was observed when O3 seemed to have been lost probably due to NO3 and N2O5 chemistry. The highest O3 episode was observed in the combined plume of isoprene sources and anthropogenic volatile organic compounds (VOCs) and NOx sources from the greater Boston area. A simple linear combination model showed that the organic precursors leading to elevated O3 were roughly half from the biogenic and half from anthropogenic VOC regimes. An explicit chemical box model confirmed that the chemistry in the Boston plume is well represented by the simple linear combination model. This degree of biogenic hydrocarbon involvement in the production of photochemical ozone has significant implications for air quality control strategies in this region.

Observational studies in systematic [corrected] reviews of comparative effectiveness: AHRQ and the Effective Health Care Program.

PubMed

Norris, Susan L; Atkins, David; Bruening, Wendy; Fox, Steven; Johnson, Eric; Kane, Robert; Morton, Sally C; Oremus, Mark; Ospina, Maria; Randhawa, Gurvaneet; Schoelles, Karen; Shekelle, Paul; Viswanathan, Meera

2011-11-01

Systematic reviewers disagree about the ability of observational studies to answer questions about the benefits or intended effects of pharmacotherapeutic, device, or procedural interventions. This study provides a framework for decision making on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews (CERs). The conceptual model and recommendations were developed using a consensus process by members of the methods workgroup of the Effective Health Care Program of the Agency for Healthcare Research and Quality. In considering whether to use observational studies in CERs for addressing beneficial effects, reviewers should answer two questions: (1) Are there gaps in the evidence from randomized controlled trials (RCTs)? (2) Will observational studies provide valid and useful information? The latter question involves the following: (a) refocusing the study questions on gaps in the evidence from RCTs, (b) assessing the risk of bias of the body of evidence of observational studies, and (c) assessing whether available observational studies address the gap review questions. Because it is unusual to find sufficient evidence from RCTs to answer all key questions concerning benefit or the balance of benefits and harms, comparative effectiveness reviewers should routinely assess the appropriateness of inclusion of observational studies for questions of benefit. Furthermore, reviewers should explicitly state the rationale for inclusion or exclusion of observational studies when conducting CERs. Copyright © 2011 Elsevier Inc. All rights reserved.

Healthcare use, costs and quality of life in patients with end-stage kidney disease receiving conservative management: results from a multi-centre observational study (PACKS).

PubMed

Phair, Glenn; Agus, Ashley; Normand, Charles; Brazil, Kevin; Burns, Aine; Roderick, Paul; Maxwell, Alexander P; Thompson, Colin; Yaqoob, Magdi; Noble, Helen

2018-05-01

Previous research has explored the cost of providing renal replacement therapies in patients with end-stage kidney disease and their quality of life. This is the first study to examine the healthcare costs of patients receiving conservative care without dialysis for end-stage kidney disease. This alternative to dialysis is an option for patients who prefer a supportive and palliative care approach. Descriptive cost and quality of life analyses alongside a UK-based multi-centre observational study in patients receiving conservative management for end-stage kidney disease. Health service use was recorded up to 12 months after making the decision to receive conservative management. Mean costs were calculated for each 3-month time period. The annual cost was calculated in two ways: by using only patients with complete cost data and by using all available data weighted by the number of patients at each time point. In total, 42 patients who opted for conservative management over dialysis were recruited. Mean costs were £1622 (0-3 months), £1008 (3-6 months), £554 (6-9 months) and £2626 (9-12 months). Mean annual cost based on complete data ( n = 8) was £5511, and the weighted mean annual cost was £5620. The importance of this study is twofold. First, it provides substantive new information for health and social care planning of conservative management by demonstrating where demand exists for services, in both the United Kingdom and other countries with a comparable health service structure. Second, methodologically, it indicates that it is feasible to collect service use data directly from this patient population.

The potential of pigeons as surrogate observers in medical image perception studies

NASA Astrophysics Data System (ADS)

Krupinski, Elizabeth A.; Levenson, Richard M.; Navarro, Victor; Wasserman, Edward A.

2016-03-01

Assessment of medical image quality and how changes in image appearance impact performance are critical but assessment can be expensive and time-consuming. Could an animal (pigeon) observer with well-known visual skills and documented ability to distinguish complex visual stimuli serve as a surrogate for the human observer? Using sets of whole slide pathology (WSI) and mammographic images we trained pigeons (cohorts of 4) to detect and/or classify lesions in medical images. Standard training methods were used. A chamber equipped with a 15' display with a resistive touchscreen was used to display the images and record responses (pecks). Pigeon pellets were dispensed for correct responses. The pigeons readily learned to distinguish benign from malignant breast cancer histopathology in WSI (mean % correct responses rose 50% to 85% over 15 days) and generalized readily from 4X to 10X and 20X magnifications; to detect microcalcifications (mean % correct responses rose 50% to over 85% over 25 days); to distinguish benign from malignant breast masses (3 of 4 birds learned this task to around 80% and 60% over 10 days); and ignore compression artifacts in WSI (performance with uncompressed slides averaged 95% correct; 15:1 and 27:1 compression slides averaged 92% and 90% correct). Pigeons models may help us better understand medical image perception and may be useful in quality assessment by serving as surrogate observers for certain types of studies.

The EMBARC European Bronchiectasis Registry: protocol for an international observational study

PubMed Central

Aliberti, Stefano; Polverino, Eva; Vendrell, Montserrat; Crichton, Megan; Loebinger, Michael; Dimakou, Katerina; Clifton, Ian; van der Eerden, Menno; Rohde, Gernot; Murris-Espin, Marlene; Masefield, Sarah; Gerada, Eleanor; Shteinberg, Michal; Ringshausen, Felix; Haworth, Charles; Boersma, Wim; Rademacher, Jessica; Hill, Adam T.; Aksamit, Timothy; O'Donnell, Anne; Morgan, Lucy; Milenkovic, Branislava; Tramma, Leandro; Neves, Joao; Menendez, Rosario; Paggiaro, Perluigi; Botnaru, Victor; Skrgat, Sabina; Wilson, Robert; Goeminne, Pieter; De Soyza, Anthony; Welte, Tobias; Torres, Antoni; Elborn, J. Stuart; Blasi, Francesco

2016-01-01

Bronchiectasis is one of the most neglected diseases in respiratory medicine. There are no approved therapies and few large-scale, representative epidemiological studies. The EMBARC (European Multicentre Bronchiectasis Audit and Research Collaboration) registry is a prospective, pan-European observational study of patients with bronchiectasis. The inclusion criterion is a primary clinical diagnosis of bronchiectasis consisting of: 1) a clinical history consistent with bronchiectasis; and 2) computed tomography demonstrating bronchiectasis. Core exclusion criteria are: 1) bronchiectasis due to known cystic fibrosis; 2) age <18 years; and 3) patients who are unable or unwilling to provide informed consent. The study aims to enrol 1000 patients by April 2016 across at least 20 European countries, and 10 000 patients by March 2020. Patients will undergo a comprehensive baseline assessment and will be followed up annually for up to 5 years with the goal of providing high-quality longitudinal data on outcomes, treatment patterns and quality of life. Data from the registry will be available in the form of annual reports. and will be disseminated in conference presentations and peer-reviewed publications. The European Bronchiectasis Registry aims to make a major contribution to understanding the natural history of the disease, as well as guiding evidence-based decision making and facilitating large randomised controlled trials. PMID:27730179

Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

PubMed

van der Wal, Martijn B A; Vloemans, Jos F P M; Tuinebreijer, Wim E; van de Ven, Peter; van Unen, Ella; van Zuijlen, Paul P M; Middelkoop, Esther

2012-01-01

Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p < 0.001) improvement in scar quality at 12 months compared with the 3- and 6-month data. Predictors for severe scarring are depth of the wound (p < 0.001) and total body surface area burned (p < 0.001). Etiology (p = 0.753) and age (p > 0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively. © 2012 by the Wound Healing Society.

Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

PubMed

Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

2017-06-01

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

Quality of oral anticoagulation with phenprocoumon in regular medical care and its potential for improvement in a telemedicine-based coagulation service--results from the prospective, multi-center, observational cohort study thrombEVAL.

PubMed

Prochaska, Jürgen H; Göbel, Sebastian; Keller, Karsten; Coldewey, Meike; Ullmann, Alexander; Lamparter, Heidrun; Jünger, Claus; Al-Bayati, Zaid; Baer, Christina; Walter, Ulrich; Bickel, Christoph; ten Cate, Hugo; Münzel, Thomas; Wild, Philipp S

2015-01-23

The majority of studies on quality of oral anticoagulation (OAC) therapy with vitamin K-antagonists are performed with short-acting warfarin. Data on long-acting phenprocoumon, which is frequently used in Europe for OAC therapy and is considered to enable more stable therapy adjustment, are scarce. In this study, we aimed to assess quality of OAC therapy with phenprocoumon in regular medical care and to evaluate its potential for optimization in a telemedicine-based coagulation service. In the prospective observational cohort study program thrombEVAL we investigated 2,011 patients from regular medical care in a multi-center cohort study and 760 patients from a telemedicine-based coagulation service in a single-center cohort study. Data were obtained from self-reported data, computer-assisted personal interviews, and laboratory measurements according to standard operating procedures with detailed quality control. Time in therapeutic range (TTR) was calculated by linear interpolation method to assess quality of OAC therapy. Study monitoring was carried out by an independent institution. Overall, 15,377 treatment years and 48,955 international normalized ratio (INR) measurements were analyzed. Quality of anticoagulation, as measured by median TTR, was 66.3% (interquartile range (IQR) 47.8/81.9) in regular medical care and 75.5% (IQR 64.2/84.4) in the coagulation service (P <0.001). Stable anticoagulation control within therapeutic range was achieved in 63.8% of patients in regular medical care with TTR at 72.1% (IQR 58.3/84.7) as compared to 96.4% of patients in the coagulation service with TTR at 76.2% [(IQR 65.6/84.7); P = 0.001)]. Prospective follow-up of coagulation service patients with pretreatment in regular medical care showed an improvement of the TTR from 66.2% (IQR 49.0/83.6) to 74.5% (IQR 62.9/84.2; P <0.0001) in the coagulation service. Treatment in the coagulation service contributed to an optimization of the profile of time outside therapeutic range, a

Quality of antenatal and childbirth care in rural health facilities in Burkina Faso, Ghana and Tanzania: an intervention study.

PubMed

Duysburgh, Els; Temmerman, Marleen; Yé, Maurice; Williams, Afua; Massawe, Siriel; Williams, John; Mpembeni, Rose; Loukanova, Svetla; Haefeli, Walter E; Blank, Antje

2016-01-01

To assess the impact of an intervention consisting of a computer-assisted clinical decision support system and performance-based incentives, aiming at improving quality of antenatal and childbirth care. Intervention study in rural primary healthcare (PHC) facilities in Burkina Faso, Ghana and Tanzania. In each country, six intervention and six non-intervention PHC facilities, located in one intervention and one non-intervention rural districts, were selected. Quality was assessed in each facility by health facility surveys, direct observation of antenatal and childbirth care, exit interviews, and reviews of patient records and maternal and child health registers. Findings of pre- and post-intervention and of intervention and non-intervention health facility quality assessments were analysed and assessed for significant (P < 0.05) quality of care differences. Post-intervention quality scores do not show a clear difference to pre-intervention scores and scores at non-intervention facilities. Only a few variables had a statistically significant better post-intervention quality score and when this is the case this is mostly observed in only one study-arm, being pre-/post-intervention or intervention/non-intervention. Post-intervention care shows similar deficiencies in quality of antenatal and childbirth care and in detection, prevention, and management of obstetric complications as at baseline and non-intervention study facilities. Our intervention study did not show a significant improvement in quality of care during the study period. However, the use of new technology seems acceptable and feasible in rural PHC facilities in resource-constrained settings, creating the opportunity to use this technology to improve quality of care. © 2015 John Wiley & Sons Ltd.

Field Operations For The "Intelligent River" Observation System: A Basin-wide Water Quality Observation System In The Savannah River Basin And Platform Supporting Related Diverse Initiatives.

NASA Astrophysics Data System (ADS)

Sutton, A.; Koons, M.; O'Brien-Gayes, P.; Moorer, R.; Hallstrom, J.; Post, C.; Gayes, P. T.

2017-12-01

The Intelligent River (IR) initiative is an NSF sponsored study developing new data management technology for a range of basin-scale applications. The technology developed by Florida Atlantic and Clemson University established a network of real-time reporting water quality sondes; from the mountains to the estuary of the Savannah River basin. Coastal Carolina University led the field operations campaign. Ancillary studies, student projects and initiatives benefitted from the associated instrumentation, infrastructure and operational support of the IR program. This provided a vehicle for students to participate in fieldwork across the watershed and pursue individual interests. Student projects included: 1) a Multibeam sonar survey investigating channel morphology in the area of an IR sensor station and 2) field tests of developing techniques for acquiring and assimilating flood velocity data into model systems associated with a separate NSF Rapid award. The multibeam survey within the lower Savannah basin exhibited a range of complexity in bathymetry, bedforms and bottom habitat in the vicinity of one of the water quality stations. The complex morphology and bottom habitat reflect complex flow patterns, localized areas of depositional and erosive tendencies providing a valuable context for considering point-source water quality time series. Micro- Lagrangian drifters developed by ISENSE at Florida Atlantic University, a sled mounted ADCP, and particle tracking from imagery collected by a photogrammetric drone were tested and used to develop methodology for establishing velocity, direction and discharge levels to validate, initialize and assimilate data into advance models systems during future flood events. The prospect of expanding wide scale observing systems can serve as a platform to integrate small and large-scale cooperative studies across disciplines as well as basic and applied research interests. Such initiatives provide opportunities for embedded education

Highly qualified does not equal high quality: A study of urban stakeholders' perceptions of quality in science teaching

NASA Astrophysics Data System (ADS)

Miranda, Rommel Joseph

By employing qualitative methods, this study sought to determine the perceptions that urban stakeholders hold about what characteristics should distinguish a high school science teacher whom they would consider to demonstrate high quality in science teaching. A maximum variation sample of six science teachers, three school administrators, six parents and six students from a large urban public school district were interviewed using semi-structured, in-depth interview techniques. From these data, a list of observable characteristics which urban stakeholders hold as evidence of high quality in science teaching was generated. Observational techniques were utilized to determine the extent to which six urban high school science teachers, who meet the NCLB Act criteria for being "highly qualified", actually possessed the characteristics which these stakeholders hold as evidence of high quality in science teaching. Constant comparative analysis was used to analyze the data set. The findings suggest that urban stakeholders perceive that a high school science teacher who demonstrates high quality in science teaching should be knowledgeable about their subject matter, their student population, and should be resourceful; should possess an academic background in science and professional experience in science teaching; should exhibit professionalism, a passion for science and teaching, and a dedication to teaching and student learning; should be skillful in planning and preparing science lessons and in organizing the classroom, in presenting the subject matter to students, in conducting a variety of hands-on activities, and in managing a classroom; and should assess whether students complete class goals and objectives, and provide feedback about grades for students promptly. The findings further reveal that some of the urban high school science teachers who were deemed to be "highly qualified", as defined by the NCLB Act, engaged in practices that threatened quality in science

Cross-sectional and longitudinal associations of systolic blood pressure with quality of life and depressive mood in older adults with cardiovascular risk factors: Results from the observational DIAST-CHF study.

PubMed

Herrmann-Lingen, Christoph; Meyer, Thomas; Bosbach, Alexandra; Chavanon, Mira L; Hassoun, Lina; Edelmann, Frank; Wachter, Rolf

2018-04-27

While diagnosed arterial hypertension and antihypertensive medication usually have an adverse impact on quality of life, recent studies suggest that actual blood pressure may be positively related to better well-being. However, data in older patients with cardiovascular risk factors are lacking, for whom such an association may be of particular relevance. In 1,300 study participants with cardiovascular risk factors aged 50-85 years (51.5% men, mean age 65.7 ± 8.2 years) participating in an observational study, we performed standardized measurements of blood pressure and assessed quality of life and depressive symptoms at baseline and 1-year follow-up using the Short Form-36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Bivariate analysis demonstrated that systolic blood pressure was associated with higher SF-36 mental component summary scores (r=0.100, p<0.001), and reduced HADS depression (r=-0.082; p=0.003). Multivariate regression models adjusting for age, sex and disease severity confirmed that higher systolic blood pressure significantly predicted both better mental quality of life (β=0.070, p=0.012) and less depressive mood (β=-0.083, p=0.003) at baseline, independently of antihypertensive medication and diagnosed hypertension. Moreover, the beneficial effects of baseline systolic blood pressure remained stable for both summary components of the SF-36 as well as HADS depression at 1-year follow up. All results remained unchanged, when limiting the analyses to the 1,072 patients with diagnosed hypertension. In older adults with cardiovascular risk factors, higher systolic blood pressure readings are independently related to better quality of life and fewer depressive symptoms in both cross-sectional and longitudinal settings, although the magnitude of the effect sizes is typically small.

Southeast Atmosphere Studies: learning from model-observation syntheses

NASA Astrophysics Data System (ADS)

Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

2018-02-01

Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

Southeast Atmosphere Studies: learning from model-observation syntheses

PubMed Central

Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

2018-01-01

Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales. This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

Southeast Atmosphere Studies: Learning from Model-Observation Syntheses

NASA Technical Reports Server (NTRS)

Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu;

Health related quality of life and physical activity in prison: a multicenter observational study in Italy.

PubMed

Mannocci, Alice; Mipatrini, Daniele; D'Egidio, Valeria; Rizzo, Jenny; Meggiolaro, Sara; Firenze, Alberto; Boccia, Giovanni; Santangelo, Omar E; Villari, Paolo; La Torre, Giuseppe; Masala, Daniele

2017-10-24

Inmates have a poorer health status than the general population. The physical activity is well know that improve the wellness of the people. This multicentric cross-sectional study aimed to assess the relationship between Quality of Life (QoL) and physical activity levels among Italian prisoners. Inmates from eight prisons compiled a questionnaire. The Metabolic Equivalent of Task (MET) was used to measure inmates' weekly physical activity levels (MATwk). Their QoL was measured using two components of Short Form with 12 items (SF12): MCS (mental score) and PCS (physical score). A total of 636 questionnaires were compiled. High level of MET was significantly (P <0.05) associated with both PCS (OR = 1.02) and MCS (OR = 1.03). The correlations between PCS, MCS vs. METwk scores were respectively significant: r = 0.17 and r = 0.10, P < 0.05. The number of years of detention was associated to higher MET (OR = 1.04 P < 0.05). The presence of Physical Exercise Areas (PEAs) within Jails did not improve the QoL level. Jails may not seem like the ideal place to fight sedentary behavior, but, in any case, health promotion can occur within its walls. The heterogeneity of Italian jails, and particularly relative PEAs therein (areas had different characteristics between jails), suggests that such spaces should be regulated or well defined. Furthermore, the implement of training schedules could be done in a standardized way. Despite this heterogeneity both the physical and mental components of inmates' quality of life were associated to a high level of physical activity. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Characterization of shallow groundwater quality in the Lower St. Johns River Basin: a case study.

PubMed

Ouyang, Ying; Zhang, Jia-En; Parajuli, Prem

2013-12-01

Characterization of groundwater quality allows the evaluation of groundwater pollution and provides information for better management of groundwater resources. This study characterized the shallow groundwater quality and its spatial and seasonal variations in the Lower St. Johns River Basin, Florida, USA, under agricultural, forest, wastewater, and residential land uses using field measurements and two-dimensional kriging analysis. Comparison of the concentrations of groundwater quality constituents against the US EPA's water quality criteria showed that the maximum nitrate/nitrite (NO x ) and arsenic (As) concentrations exceeded the EPA's drinking water standard limits, while the maximum Cl, SO 4 (2-) , and Mn concentrations exceeded the EPA's national secondary drinking water regulations. In general, high kriging estimated groundwater NH 4 (+) concentrations were found around the agricultural areas, while high kriging estimated groundwater NO x concentrations were observed in the residential areas with a high density of septic tank distribution. Our study further revealed that more areas were found with high estimated NO x concentrations in summer than in spring. This occurred partially because of more NO x leaching into the shallow groundwater due to the wetter summer and partially because of faster nitrification rate due to the higher temperature in summer. Large extent and high kriging estimated total phosphorus concentrations were found in the residential areas. Overall, the groundwater Na and Mg concentration distributions were relatively more even in summer than in spring. Higher kriging estimated groundwater As concentrations were found around the agricultural areas, which exceeded the EPA's drinking water standard limit. Very small variations in groundwater dissolved organic carbon concentrations were observed between spring and summer. This study demonstrated that the concentrations of groundwater quality constituents varied from location to location

Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

PubMed Central

van der Eem, Lisette; Nyanza, Elias C.; van Pelt, Sandra; Ndaki, Pendo; Basinda, Namanya; Sundby, Johanne

2017-01-01

Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client’s wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria. PMID:29236699

Abdominal pain, cramping or discomfort impairs quality of life in women: An internet-based observational pilot study focussing on impact of treatment.

PubMed

Enck, Paul; Koehler, Ursula; Weigmann, Harald; Mueller-Lissner, Stefan

2017-03-01

Background  Abdominal pain, cramping, and discomfort (APCD) are experienced by up to 30 % of adults in Europe. Objective  To assess the impact of APCD on quality of life (QoL) and to investigate the effectiveness, tolerability, and impact on QoL of hyoscine butylbromide (HBB, Buscopan ® ) compared with STW 5 (Iberogast ® ) or analgesics in women with APCD. Methods  An internet-based observational pilot study was conducted in Germany in women who had predominantly used HBB, STW 5, or analgesics (n = 240 per treatment) to treat APCD. This online survey included questions on QoL, effectiveness, and tolerability. Results  A total of 720 completed questionnaires was evaluated. APCD had a major impact on QoL, with 96 % of women reporting that daily activities were disrupted at least sometimes, and 44 % at least often. Other aspects of QoL, such as quality of work, eating habits, and social activities, were also affected in most women. After taking their medication of choice, 91 % of women in the HBB group reported they could "very often" or "often" continue with their daily activities, compared with 84 % and 85 % in the STW 5 and analgesic groups, respectively (p < 0.05 for both comparisons). HBB was perceived to be the "best solution" to overcome APCD symptoms "very often" or "often" by more women (86 %) than STW 5 (75 %) and analgesics (74 %) (p < 0.05 for both comparisons). Conclusion  Women with APCD have impaired QoL. All treatments were considered effective by the majority of participants. Compared with STW 5 or analgesics, HBB was reported to facilitate return to daily activities more frequently. © Georg Thieme Verlag KG Stuttgart · New York.

New insight into the comparative power of quality-control rules that use control observations within a single analytical run.

PubMed

Parvin, C A

1993-03-01

The error detection characteristics of quality-control (QC) rules that use control observations within a single analytical run are investigated. Unlike the evaluation of QC rules that span multiple analytical runs, most of the fundamental results regarding the performance of QC rules applied within a single analytical run can be obtained from statistical theory, without the need for simulation studies. The case of two control observations per run is investigated for ease of graphical display, but the conclusions can be extended to more than two control observations per run. Results are summarized in a graphical format that offers many interesting insights into the relations among the various QC rules. The graphs provide heuristic support to the theoretical conclusions that no QC rule is best under all error conditions, but the multirule that combines the mean rule and a within-run standard deviation rule offers an attractive compromise.

Are normative sonographic values of kidney size in children valid and reliable? A systematic review of the methodological quality of ultrasound studies using the Anatomical Quality Assessment (AQUA) tool.

PubMed

Chhapola, Viswas; Tiwari, Soumya; Deepthi, Bobbity; Henry, Brandon Michael; Brar, Rekha; Kanwal, Sandeep Kumar

2018-06-01

A plethora of research is available on ultrasonographic kidney size standards. We performed a systematic review of methodological quality of ultrasound studies aimed at developing normative renal parameters in healthy children, by evaluating the risk of bias (ROB) using the 'Anatomical Quality Assessment (AQUA)' tool. We searched Medline, Scopus, CINAHL, and Google Scholar on June 04 2018, and observational studies measuring kidney size by ultrasonography in healthy children (0-18 years) were included. The ROB of each study was evaluated in five domains using a 20 item coding scheme based on AQUA tool framework. Fifty-four studies were included. Domain 1 (subject characteristics) had a high ROB in 63% of studies due to the unclear description of age, sex, and ethnicity. The performance in Domain 2 (study design) was the best with 85% of studies having a prospective design. Methodological characterization (Domain 3) was poor across the studies (< 10% compliance), with suboptimal performance in the description of patient positioning, operator experience, and assessment of intra/inter-observer reliability. About three-fourth of the studies had a low ROB in Domain 4 (descriptive anatomy). Domain 5 (reporting of results) had a high ROB in approximately half of the studies, the majority reporting results in the form of central tendency measures. Significant deficiencies and heterogeneity were observed in the methodological quality of USG studies performed to-date for measurement of kidney size in children. We hereby provide a framework for the conducting such studies in future. PROSPERO (CRD42017071601).

Quality Evaluation of Nursing Observation Based on a Survey of Nursing Documents Using NursingNAVI.

PubMed

Tsuru, Satoko; Omori, Miho; Inoue, Manami; Wako, Fumiko

2016-01-01

We have identified three foci of the nursing observation and nursing action respectively. Using these frameworks, we have developed the structured knowledge model for a number of diseases and medical interventions. We developed this structure based NursingNAVI^® contents collaborated with some quality centred hospitals. Authors analysed the nursing care documentations of post-gastrectomy patients in light of the standardized nursing care plan in the "NursingNAVI^®" developed by ourselves and revealed the "failure to observe" and "failure to document", which leaded to the volatility of the patients' data, conditions and some situation. This phenomenon should have been avoided if nurses had employed a standardized nursing care plan. So, we developed thinking process support system for planning, delivering, recording and evaluating in daily nursing using NursingNAVI^® contents. It is important to identify the problem of the volatility of the patients' data, conditions and some situation. We developed a survey tool of nursing documents using NursingNAVI^® Content for quality evaluation of nursing observation. We recommended some hospitals to use this survey tool. Fifteen hospitals participated the survey using this tool. It is estimated that the volatilizing situation. A hospital which don't participate this survey, knew the result. So the hospital decided to use NursingNAVI^® contents in HIS. It was suggested that the system has availability for nursing OJT and time reduction of planning and recording without volatilizing situation.

Work conditions, mental workload and patient care quality: a multisource study in the emergency department.

PubMed

Weigl, Matthias; Müller, Andreas; Holland, Stephan; Wedel, Susanne; Woloshynowych, Maria

2016-07-01

Workflow interruptions, multitasking and workload demands are inherent to emergency departments (ED) work systems. Potential effects of ED providers' work on care quality and patient safety have, however, been rarely addressed. We aimed to investigate the prevalence and associations of ED staff's workflow interruptions, multitasking and workload with patient care quality outcomes. We applied a mixed-methods design in a two-step procedure. First, we conducted a time-motion study to observe the rate of interruptions and multitasking activities. Second, during 20-day shifts we assessed ED staff's reports on workflow interruptions, multitasking activities and mental workload. Additionally, we assessed two care quality indicators with standardised questionnaires: first, ED patients' evaluations of perceived care quality; second, patient intrahospital transfers evaluated by ward staff. The study was conducted in a medium-sized community ED (16 600 annual visits). ED personnel's workflow was disrupted on average 5.63 times per hour. 30% of time was spent on multitasking activities. During 20 observations days, data were gathered from 76 ED professionals, 239 patients and 205 patient transfers. After aggregating daywise data and controlling for staffing levels, prospective associations revealed significant negative associations between ED personnel's mental workload and patients' perceived quality of care. Conversely, workflow interruptions were positively associated with patient-related information on discharge and overall quality of transfer. Our investigation indicated that ED staff's capability to cope with demanding work conditions was associated with patient care quality. Our findings contribute to an improved understanding of the complex effects of interruptions and multitasking in the ED environment for creating safe and efficient ED work and care systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies.

PubMed

Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

2017-04-01

The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I 2 =38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I 2 =29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I 2 =0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer.

Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies

PubMed Central

Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

2017-01-01

Purpose The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. Materials and Methods We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). Results We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I2=38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I2=29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I2=0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. Conclusion The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer. PMID:27456949

Blood glucose control and quality of health care in non-insulin-treated patients with Type 2 diabetes in Spain: a retrospective and cross-sectional observational study

PubMed Central

Rodríguez, A; Calle, A; Vázquez, L; Chacón, F; Polavieja, P; Reviriego, J

2011-01-01

Aims To assess blood glucose control and quality of health care provided to non-insulin-treated patients with Type 2 diabetes mellitus in routine clinical practice in Spain. Methods In this observational, retrospective, cross-sectional study, patients were grouped as either having good or suboptimal blood glucose control according to International Diabetes Federation or American Diabetes Association HbA1c goals. Clinical and socio-demographic data and compliance with the main standard level of care recommendations of the International Diabetes Federation were recorded during a routine visit. Correlates of glucose control were analysed by logistic regression. Results Many patients were grouped as having suboptimal control under International Diabetes Federation (61.9%) or American Diabetes Association (45.0%) criteria. The mean number of accomplished International Diabetes Federation recommendations (7.3 out of 11) was higher for endocrinologists (than for internists or primary care physicians), and significantly more patients under their care were in the good glucose control group (than with primary care physicians). More recommendations were associated with blood glucose control using International Diabetes Federation than American Diabetes Association criteria, demanding higher quality of health care for achieving stricter goals. Some recommendations were poorly observed, particularly those concerning patients’ education on diabetes, the prompt prescription of effective treatments and monitoring of complications. Diabetes complications were associated with being in the suboptimal control group. Patients’ education on diabetes and HbA1c monitoring were associated with being in the good control group. Conclusions These results demonstrate the need for improvement in the management of patients with non-insulin-treated Type 2 diabetes in actual clinical practice in Spain. Such improvement would entail a stricter adherence to International Diabetes Federation

Antidepressant use and risk of coronary heart disease: meta-analysis of observational studies

PubMed Central

Oh, Seung-Won; Kim, Joonseok; Myung, Seung-Kwon; Hwang, Seung-Sik; Yoon, Dae-Hyun

2014-01-01

Aims Our goal was to evaluate the association between antidepressant use and the risk of coronary heart disease (CHD) among subjects with no history of coronary heart disease. Methods A search of Medline, EMBASE, PsycINFO and the Cochrane Library was performed in January 2013. Two authors independently reviewed and selected eligible observational studies, based on predetermined selection criteria. Pooled relative risks (RRs) with confidence intervals (CIs) were calculated using random-effects or fixed-effects models. Results Sixteen observational studies (seven case–control studies and nine cohort studies) were included in the final analysis. There was no association between selective serotonin reuptake inhibitor use and the risk of CHD overall [odds ratio (OR), 0.93; 95% CI, 0.65–1.33] or in subgroup meta-analysis of case–control studies (OR, 0.91; 95% CI, 0.60–1.37) and cohort studies (RR, 0.96; 95% CI, 0.59–1.55). The use of tricyclic antidepressant was associated with an increased risk of CHD overall (OR, 1.51; 95% CI, 1.07–2.12), but it was observed only in case–control studies (OR, 1.56; 95% CI, 1.24–1.96) and low-quality studies (OR, 1.49; 95% CI, 1.20–1.85) in the subgroup meta-analyses. Conclusions This meta-analysis of observational studies in subjects with no history of CHD suggests that neither selective serotonin reuptake inhibitor nor tricyclic antidepressant use is associated with an increased risk of CHD. PMID:24646010

Effectiveness, safety and health-related quality of life of multiple sclerosis patients treated with fingolimod: results from a 12-month, real-world, observational PERFORMS study in the Middle East.

PubMed

Achiron, Anat; Aref, Hany; Inshasi, Jihad; Harb, Mohamad; Alroughani, Raed; Bijarnia, Mahendra; Cooke, Kathryn; Yuksel, Ozgur

2017-08-07

Evidence on the use of fingolimod in real-world clinical practice and data on patient-reported health-related quality of life (HRQoL) in countries such as the Middle East are sparse. The Prospective Evaluation of Treatment with Fingolimod for Multiple Sclerosis (PERFORMS) study assessed HRQoL and effectiveness and safety of fingolimod in patients with relapsing-remitting multiples sclerosis (RRMS), primarily in Middle Eastern countries. This 12-month, observational, multicentre, prospective, real-world study was conducted in patients with RRMS who initiated fingolimod or another approved disease-modifying treatment (DMT) within 4 weeks before study entry. Patients were enrolled in a 2:1 ratio to obtain more data in fingolimod and parallel in other DMTs cohort by physicians during routine medical care. Key study outcomes included HRQoL assessed using MS International QoL (MusiQoL), MS relapses and disability. Safety was assessed throughout the study period. Due to the observational nature of the study, no neuroimaging assessments were mandated and central reading was not performed. Of 249 enrolled patients, 247 were included in the analysis (fingolimod cohort 172; other DMTs cohort 75). Overall, the mean age of patients was 36.5 years, 64.4% were women and ~90% were Caucasians. At baseline, mean MS duration since diagnosis was 7.2 years in the fingolimod and 4.8 years in the other DMTs cohorts. Overall, mean changes in MusiQoL index scores were -2.1 in the fingolimod cohort and -0.7 in the other DMTs cohort at Month 12, but improvement was not significant vs. baseline in both cohorts. Proportion of relapse-free patients increased significantly during the study vs. 0-12 months before the study in the fingolimod cohort (80.2% vs. 24.4%; p < 0.0001). Proportion of patients free from disability progression was 86.5% in the fingolimod cohort. The incidences of AEs were 59.9% and 50.6% in the fingolimod and other DMTs cohorts, respectively. First-dose monitoring of

COMPARISON OF ADAPTIVE STATISTICAL ITERATIVE RECONSTRUCTION (ASIR™) AND MODEL-BASED ITERATIVE RECONSTRUCTION (VEO™) FOR PAEDIATRIC ABDOMINAL CT EXAMINATIONS: AN OBSERVER PERFORMANCE STUDY OF DIAGNOSTIC IMAGE QUALITY.

PubMed

Hultenmo, Maria; Caisander, Håkan; Mack, Karsten; Thilander-Klang, Anne

2016-06-01

The diagnostic image quality of 75 paediatric abdominal computed tomography (CT) examinations reconstructed with two different iterative reconstruction (IR) algorithms-adaptive statistical IR (ASiR™) and model-based IR (Veo™)-was compared. Axial and coronal images were reconstructed with 70 % ASiR with the Soft™ convolution kernel and with the Veo algorithm. The thickness of the reconstructed images was 2.5 or 5 mm depending on the scanning protocol used. Four radiologists graded the delineation of six abdominal structures and the diagnostic usefulness of the image quality. The Veo reconstruction significantly improved the visibility of most of the structures compared with ASiR in all subgroups of images. For coronal images, the Veo reconstruction resulted in significantly improved ratings of the diagnostic use of the image quality compared with the ASiR reconstruction. This was not seen for the axial images. The greatest improvement using Veo reconstruction was observed for the 2.5 mm coronal slices. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Herpes zoster-associated severity and duration of pain, health-related quality of life, and healthcare utilization in Taiwan: a prospective observational study.

PubMed

Tsai, Tsen-Fang; Yao, Chien-An; Yu, Hsin-Su; Lan, Cheng-Che; Chao, Sheau-Chiou; Yang, Jen-Hung; Yang, Kuo-Chia; Chen, Ching-Yu; White, Ron R; Psaradellis, Eliofotisti; Rampakakis, Emmanouil; Kawai, Kosuke; Acosta, Camilo J; Sampalis, John S

2015-01-01

To assess the severity and duration of herpes zoster (HZ)-associated pain (ZAP) and its impact on quality of life (QoL) and healthcare utilization (HCRU) from a patient perspective in routine care in Taiwan. A prospective, observational, single-cohort study was conducted in five centers across Taiwan. Patients were recruited at different time points during their HZ episode and were followed for ≤180 days. ZAP was assessed with the Initial Zoster Impact Questionnaire and the Zoster Brief Pain Inventory, QoL with the EQ-5D, and HCRU with a simple questionnaire. A total of 150 patients were included with a mean age of 64.9 years and mean time since rash onset of 18.8 days. Prodromal pain was experienced by 64.7% of patients, of whom 91.8% reported moderate-to-severe pain. At enrollment, 98.0% of patients experienced ZAP. Mean ± SD worst pain score decreased from 5.95 ± 3.09 at enrollment to 2.65 ± 2.98 at 30 days and 0.28 ± 0.83 at 180 days. Postherpetic neuralgia was observed in 20.7% of patients. Mean ± SD EQ-5D score significantly decreased (P < 0.001) from 0.91 ± 0.16 before rash onset to 0.67 ± 0.18 after rash onset, showing significant QoL deterioration up to 60 days. The impact of HZ on QoL and pain severity was similar across age groups. Significant HCRU was observed including visits to the doctor (83.3% of patients), specialist (30.7%), emergency department (24.7%), physiotherapist (23.3%), and hospitalizations (20.7%). Severe morbidity and significant HCRU are associated with HZ in Taiwan, supporting the need for early intervention and preventive strategies to reduce the HZ-associated burden of illness. © 2014 The International Society of Dermatology.

Observer aging and long-term avian survey data quality

PubMed Central

Farmer, Robert G; Leonard, Marty L; Mills Flemming, Joanna E; Anderson, Sean C

2014-01-01

Long-term wildlife monitoring involves collecting time series data, often using the same observers over multiple years. Aging-related changes to these observers may be an important, under-recognized source of error that can bias management decisions. In this study, we used data from two large, independent bird surveys, the Atlas of the Breeding Birds of Ontario (“OBBA”) and the North American Breeding Bird Survey (“BBS”), to test for age-related observer effects in long-term time series of avian presence and abundance. We then considered the effect of such aging phenomena on current population trend estimates. We found significantly fewer detections among older versus younger observers for 13 of 43 OBBA species, and declines in detection as an observer ages for 4 of 6 vocalization groups comprising 59 of 64 BBS species. Consistent with hearing loss influencing this pattern, we also found evidence for increasingly severe detection declines with increasing call frequency among nine high-pitched bird species (OBBA); however, there were also detection declines at other frequencies, suggesting important additional effects of aging, independent of hearing loss. We lastly found subtle, significant relationships between some species' published population trend estimates and (1) their corresponding vocalization frequency (n ≥ 22 species) and (2) their estimated declines in detectability among older observers (n = 9 high-frequency, monotone species), suggesting that observer aging can negatively bias long-term monitoring data for some species in part through hearing loss effects. We recommend that survey designers and modelers account for observer age where possible. PMID:25360286

First quality score for referral letters in gastroenterology—a validation study

PubMed Central

Eskeland, Sigrun Losada; Brunborg, Cathrine; Seip, Birgitte; Wiencke, Kristine; Hovde, Øistein; Owen, Tanja; Skogestad, Erik; Huppertz-Hauss, Gert; Halvorsen, Fred-Arne; Garborg, Kjetil; Aabakken, Lars; de Lange, Thomas

2016-01-01

Objective To create and validate an objective and reliable score to assess referral quality in gastroenterology. Design An observational multicentre study. Setting and participants 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist. Main outcome measure Correlation between the TPS and a visual analogue scale (VAS) for referral quality. Results The 327 referrals had an average TPS of 13.2 (range 1–25) and an average VAS of 4.7 (range 0.2–9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good. Conclusions The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality. PMID:27855107

Dipeptidyl peptidase-4 inhibitors and risk of heart failure in type 2 diabetes: systematic review and meta-analysis of randomised and observational studies.

PubMed

Li, Ling; Li, Sheyu; Deng, Ke; Liu, Jiali; Vandvik, Per Olav; Zhao, Pujing; Zhang, Longhao; Shen, Jiantong; Bala, Malgorzata M; Sohani, Zahra N; Wong, Evelyn; Busse, Jason W; Ebrahim, Shanil; Malaga, German; Rios, Lorena P; Wang, Yingqiang; Chen, Qunfei; Guyatt, Gordon H; Sun, Xin

2016-02-17

To examine the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and the risk of heart failure or hospital admission for heart failure in patients with type 2 diabetes. Systematic review and meta-analysis of randomised and observational studies. Medline, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov searched up to 25 June 2015, and communication with experts. Randomised controlled trials, non-randomised controlled trials, cohort studies, and case-control studies that compared DPP-4 inhibitors against placebo, lifestyle modification, or active antidiabetic drugs in adults with type 2 diabetes, and explicitly reported the outcome of heart failure or hospital admission for heart failure. Teams of paired reviewers independently screened for eligible studies, assessed risk of bias, and extracted data using standardised, pilot tested forms. Data from trials and observational studies were pooled separately; quality of evidence was assessed by the GRADE approach. Eligible studies included 43 trials (n=68,775) and 12 observational studies (nine cohort studies, three nested case-control studies; n=1,777,358). Pooling of 38 trials reporting heart failure provided low quality evidence for a possible similar risk of heart failure between DPP-4 inhibitor use versus control (42/15,701 v 33/12,591; odds ratio 0.97 (95% confidence interval 0.61 to 1.56); risk difference 2 fewer (19 fewer to 28 more) events per 1000 patients with type 2 diabetes over five years). The observational studies provided effect estimates generally consistent with trial findings, but with very low quality evidence. Pooling of the five trials reporting admission for heart failure provided moderate quality evidence for an increased risk in patients treated with DPP-4 inhibitors versus control (622/18,554 v 552/18,474; 1.13 (1.00 to 1.26); 8 more (0 more to 16 more)). The pooling of adjusted estimates from observational studies similarly suggested (with very low

Ways of learning: Observational studies versus experiments

USGS Publications Warehouse

Shaffer, T.L.; Johnson, D.H.

2008-01-01

Manipulative experimentation that features random assignment of treatments, replication, and controls is an effective way to determine causal relationships. Wildlife ecologists, however, often must take a more passive approach to investigating causality. Their observational studies lack one or more of the 3 cornerstones of experimentation: controls, randomization, and replication. Although an observational study can be analyzed similarly to an experiment, one is less certain that the presumed treatment actually caused the observed response. Because the investigator does not actively manipulate the system, the chance that something other than the treatment caused the observed results is increased. We reviewed observational studies and contrasted them with experiments and, to a lesser extent, sample surveys. We identified features that distinguish each method of learning and illustrate or discuss some complications that may arise when analyzing results of observational studies. Findings from observational studies are prone to bias. Investigators can reduce the chance of reaching erroneous conclusions by formulating a priori hypotheses that can be pursued multiple ways and by evaluating the sensitivity of study conclusions to biases of various magnitudes. In the end, however, professional judgment that considers all available evidence is necessary to render a decision regarding causality based on observational studies.

Observation and Teacher Quality: Critical Analysis of Observational Instruments in Preservice Teacher Performance Assessment

ERIC Educational Resources Information Center

Caughlan, Samantha; Jiang, Heng

2014-01-01

Teacher preparation programs commonly use observational instruments to assess the progress and the exit performances of teacher candidates. However, while these instruments have been described and several have been studied for effectiveness, the field lacks a close examination of how they position participants: teacher candidates, K-12 pupils, and…

ECAIM : Air Quality Studies and its Impact in Central Mexico.

NASA Astrophysics Data System (ADS)

Ruiz-Suárez, L. G.; Torres, R.; Garcia-Reynoso, J. A.; Zavala-Hidalgo, J.; Grutter, M.; Delgado-Campos, J.; Molina, L. T.

2014-12-01

Mexico City Metropolitan Area has been the object of several well know intensive campaigns. Since MARI (1991) , IMADA (1997), MCMA 2003 and MILAGRO (2006). The spatial scope of these studies have gone from urban to regional to continental, with the focus on MCMA as an emissions source. During MILAGRO, the influence on MCMA of wildfires and agricultural biomass burning around the megacity was considered. However, around Mexico City a crown of metropolis and middle size cities make a region known as the Central Mexico Regional Crow (CRCM for its acronym in Spanish language) or Central Mexico City Belt. It contains 32 million inhabitants and produces 40% of national gross product. The region undergoes an uncontrolled urban sprawl. Evidence is building-up on complex air pollution transport processes between the air basins within CRCM. However, only MCMA counts with reliable long-term records of criteria pollutants monitoring. Only few intensive campaigns have been done in the air basins surrounding MCMA. ECAIM project has several goals: a) To use ground and satellite observations to assess emissions inventories; b) To use ground and satellite observations to assess the performance of air quality models for the whole region; c) to produce critical levels exceedence maps; d) To produce a preliminary diagnostic of air quality for the CRCM; e) to produce a preliminary estimate of the cost of air pollution within the CRCM. In this work we show the method approach to use the best available information from local AQM networks, field campaigns, satellite observations and modeling to achieve those goals. We show some preliminary results.

Observational Study Designs for Comparative Effectiveness Research: An Alternative Approach to Close Evidence Gaps in Head-and-Neck Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goulart, Bernardo H.L., E-mail: bhg@uw.edu; University of Washington, Seattle, Washington; Ramsey, Scott D.

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H and N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H and N RCTs, which limits the validity of their results to the broader H and N cancer patient population seenmore » in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H and N cancer, including treatment comparisons for rare types of H and N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H and N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H and N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design.« less

Observational study designs for comparative effectiveness research: an alternative approach to close evidence gaps in head-and-neck cancer.

PubMed

Goulart, Bernardo H L; Ramsey, Scott D; Parvathaneni, Upendra

2014-01-01

Comparative effectiveness research (CER) has emerged as an approach to improve quality of care and patient outcomes while reducing healthcare costs by providing evidence to guide healthcare decisions. Randomized controlled trials (RCTs) have represented the ideal study design to support treatment decisions in head-and-neck (H&N) cancers. In RCTs, formal chance (randomization) determines treatment allocation, which prevents selection bias from distorting the measure of treatment effects. Despite this advantage, only a minority of patients qualify for inclusion in H&N RCTs, which limits the validity of their results to the broader H&N cancer patient population seen in clinical practice. Randomized controlled trials often do not address other knowledge gaps in the management of H&N cancer, including treatment comparisons for rare types of H&N cancers, monitoring of rare or late toxicity events (eg, osteoradionecrosis), or in some instances an RCT is simply not feasible. Observational studies, or studies in which treatment allocation occurs independently of investigators' choice or randomization, may address several of these gaps in knowledge, thereby complementing the role of RCTs. This critical review discusses how observational CER studies complement RCTs in generating the evidence to inform healthcare decisions and improve the quality of care and outcomes of H&N cancer patients. Review topics include a balanced discussion about the strengths and limitations of both RCT and observational CER study designs; a brief description of design and analytic techniques to handle selection bias in observational studies; examples of observational studies that inform current clinical practices and management of H&N cancers; and suggestions for relevant CER questions that could be addressed by an observational study design. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical outcome and quality of life after reoperative CABG: off-pump versus on-pump – observational pilot study

PubMed Central

2013-01-01

Background Coronary artery bypass grafting (CABG) on cardiopulmonary bypass (CBP) is associated with significant morbidity and mortality. In high-risk patients, doomed for reoperation the adverse effects of CBP may be more striking. We evaluated the results of reoperative CABG (redo-CABG) by either off-pump (OPCAB) or on-pump (ONCAB). Clinical endpoints were perioperative myocardial infarction, mortality, survival and as the most striking difference between prior studies the quality of life (QoL). Methods We performed a prospective, non-randomized assessment for patients who underwent redo-CABG by redo-OPCAB (n = 40) or redo-ONCAB (n = 40) at our institution between January 2007 and December 2010. For evaluation of QoL the SF-36 health survey was used with self-administered assessment. Results During follow-up 37 of 40 patients were alive in the redo-OPCAB group versus 32 of 40 patients in the redo-ONCAB group (p < 0.05). The shorter operation time, less blood loss, fewer perioperative myocardial infarctions, the higher rate of totally arterial revascularisation and shorter intensive care stay were the significantly beneficial differences for patients in the redo-OPCAB group (p < 0.05). The 3-year survival rate was higher in the redo-OPCAB group with 81 ± 12% versus 63 ± 9%in the redo-ONCAB group. The quality of life survey did not reveal any significant differences between both groups. Conclusion In conclusion, with our present retrospective study, we could demonstrate the safety and efficacy of the redo-OPCAB technique with even higher 3-year survival rate. Both techniques seem to have similar impact on the outcome of patients. PMID:23561396

Determinants of Quality of Interview and Impact on Risk Estimates in a Case-Control Study of Bladder Cancer

PubMed Central

Silverman, Debra T.; Malats, Núria; Tardon, Adonina; Garcia-Closas, Reina; Serra, Consol; Carrato, Alfredo; Fortuny, Joan; Rothman, Nathaniel; Dosemeci, Mustafa; Kogevinas, Manolis

2009-01-01

The authors evaluated potential determinants of the quality of the interview in a case-control study of bladder cancer and assessed the effect of the interview quality on the risk estimates. The analysis included 1,219 incident bladder cancer cases and 1,271 controls recruited in Spain in 1998–2001. Information on etiologic factors for bladder cancer was collected through personal interviews, which were scored as unsatisfactory, questionable, reliable, or high quality by the interviewers. Eight percent of the interviews were unsatisfactory or questionable. Increasing age, lower socioeconomic status, and poorer self-perceived health led to higher proportions of questionable or unreliable interviews. The odds ratio for cigarette smoking, the main risk factor for bladder cancer, was 6.18 (95% confidence interval: 4.56, 8.39) overall, 3.20 (95% confidence interval: 1.13, 9.04) among unsatisfactory or questionable interviews, 6.86 (95% confidence interval: 4.80, 9.82) among reliable interviews, and 7.70 (95% confidence interval: 3.64, 16.30) among high-quality interviews. Similar trends were observed for employment in high-risk occupations, drinking water containing elevated levels of trihalomethanes, and use of analgesics. Higher quality interviews led to stronger associations compared with risk estimation that did not take the quality of interview into account. The collection of quality of interview scores and the exclusion of unreliable interviews probably reduce misclassification of exposure in observational studies. PMID:19478234

Guidance on assessing the methodological and reporting quality of toxicologically relevant studies: A scoping review.

PubMed

Samuel, Gbeminiyi O; Hoffmann, Sebastian; Wright, Robert A; Lalu, Manoj Mathew; Patlewicz, Grace; Becker, Richard A; DeGeorge, George L; Fergusson, Dean; Hartung, Thomas; Lewis, R Jeffrey; Stephens, Martin L

2016-01-01

Assessments of methodological and reporting quality are critical to adequately judging the credibility of a study's conclusions and to gauging its potential reproducibility. To aid those seeking to assess the methodological or reporting quality of studies relevant to toxicology, we conducted a scoping review of the available guidance with respect to four types of studies: in vivo and in vitro, (quantitative) structure-activity relationships ([Q]SARs), physico-chemical, and human observational studies. Our aims were to identify the available guidance in this diverse literature, briefly summarize each document, and distill the common elements of these documents for each study type. In general, we found considerable guidance for in vivo and human studies, but only one paper addressed in vitro studies exclusively. The guidance for (Q)SAR studies and physico-chemical studies was scant but authoritative. There was substantial overlap across guidance documents in the proposed criteria for both methodological and reporting quality. Some guidance documents address toxicology research directly, whereas others address preclinical research generally or clinical research and therefore may not be fully applicable to the toxicology context without some translation. Another challenge is the degree to which assessments of methodological quality in toxicology should focus on risk of bias - as in clinical medicine and healthcare - or be broadened to include other quality measures, such as confirming the identity of test substances prior to exposure. Our review is intended primarily for those in toxicology and risk assessment seeking an entry point into the extensive and diverse literature on methodological and reporting quality applicable to their work. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Intravenous Chemotherapy Compounding Errors in a Follow-Up Pan-Canadian Observational Study.

PubMed

Gilbert, Rachel E; Kozak, Melissa C; Dobish, Roxanne B; Bourrier, Venetia C; Koke, Paul M; Kukreti, Vishal; Logan, Heather A; Easty, Anthony C; Trbovich, Patricia L

2018-05-01

Intravenous (IV) compounding safety has garnered recent attention as a result of high-profile incidents, awareness efforts from the safety community, and increasingly stringent practice standards. New research with more-sensitive error detection techniques continues to reinforce that error rates with manual IV compounding are unacceptably high. In 2014, our team published an observational study that described three types of previously unrecognized and potentially catastrophic latent chemotherapy preparation errors in Canadian oncology pharmacies that would otherwise be undetectable. We expand on this research and explore whether additional potential human failures are yet to be addressed by practice standards. Field observations were conducted in four cancer center pharmacies in four Canadian provinces from January 2013 to February 2015. Human factors specialists observed and interviewed pharmacy managers, oncology pharmacists, pharmacy technicians, and pharmacy assistants as they carried out their work. Emphasis was on latent errors (potential human failures) that could lead to outcomes such as wrong drug, dose, or diluent. Given the relatively short observational period, no active failures or actual errors were observed. However, 11 latent errors in chemotherapy compounding were identified. In terms of severity, all 11 errors create the potential for a patient to receive the wrong drug or dose, which in the context of cancer care, could lead to death or permanent loss of function. Three of the 11 practices were observed in our previous study, but eight were new. Applicable Canadian and international standards and guidelines do not explicitly address many of the potentially error-prone practices observed. We observed a significant degree of risk for error in manual mixing practice. These latent errors may exist in other regions where manual compounding of IV chemotherapy takes place. Continued efforts to advance standards, guidelines, technological innovation, and

[Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies].

PubMed

Lianhui, Yang; Meifei, Lian; Zhongyue, Hu; Yunzhi, Feng

2017-08-01

Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence. Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, P<0.000 01), as well as serum total cholesterol (TC) (MD=17.54, 95% confidence interval=10.91-24.18, P<0.000 01). Furthermore, the risks of TG and TC in the serum of patients with chronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, P<0.000 01) and 3.62 times (OR=3.62, 95% confidence interval=2.18-6.03, P<0.000 01) of that of periodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipoprotein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.

Trends in Classroom Observation Scores

PubMed Central

Lockwood, J. R.; McCaffrey, Daniel F.

2014-01-01

Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System–Secondary (CLASS-S) protocol from 458 middle school teachers over a 2-year period to study changes over time in (a) the average quality of teaching for the population of teachers, (b) the average severity of the population of raters, and (c) the severity of individual raters. To obtain these estimates and assess them in the context of other factors that contribute to the variability in scores, we develop an augmented G study model that is broadly applicable for modeling sources of variability in classroom observation ratings data collected over time. In our data, we found that trends in teaching quality were small. Rater drift was very large during raters’ initial days of observation and persisted throughout nearly 2 years of scoring. Raters did not converge to a common level of severity; using our model we estimate that variability among raters actually increases over the course of the study. Variance decompositions based on the model find that trends are a modest source of variance relative to overall rater effects, rater errors on specific lessons, and residual error. The discussion provides possible explanations for trends and rater divergence as well as implications for designs collecting ratings over time. PMID:29795823

Trends in Classroom Observation Scores.

PubMed

Casabianca, Jodi M; Lockwood, J R; McCaffrey, Daniel F

2015-04-01

Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from 458 middle school teachers over a 2-year period to study changes over time in (a) the average quality of teaching for the population of teachers, (b) the average severity of the population of raters, and (c) the severity of individual raters. To obtain these estimates and assess them in the context of other factors that contribute to the variability in scores, we develop an augmented G study model that is broadly applicable for modeling sources of variability in classroom observation ratings data collected over time. In our data, we found that trends in teaching quality were small. Rater drift was very large during raters' initial days of observation and persisted throughout nearly 2 years of scoring. Raters did not converge to a common level of severity; using our model we estimate that variability among raters actually increases over the course of the study. Variance decompositions based on the model find that trends are a modest source of variance relative to overall rater effects, rater errors on specific lessons, and residual error. The discussion provides possible explanations for trends and rater divergence as well as implications for designs collecting ratings over time.

A New Era of Air Quality Monitoring from Space in East Asia: Korea's Geostationary Environmental Monitoring Spectrometer (GEMS) and an Integrated Korea-US Air Quality (KORUS-AQ) Study

NASA Astrophysics Data System (ADS)

Hong, J.; Hong, Y.; Song, C. K.; Kim, S. K.; Chang, L. S.; Lim, J.; Ahn, J.; Park, J. H.; Kim, J. Y.; Han, Y. J.; Kim, J.; Park, R.; Lee, G.; Lefer, B. L.; Al-Saadi, J. A.; Crawford, J. H.

2015-12-01

Due to remarkable economic growth over the last two decades, East Asia has become a region experiencing some of the poorest air quality in the world. In addition to local sources of pollution, the Korea peninsula is downwind of the largest emission sources in East Asia, complicating the understanding of air quality over Korea. Thus, knowing the factors controlling changes in air pollution across urban-rural and marine-continental interfaces, in addition to the contributions from local emissions and transboundary transport, is important for building effective management strategies and improving air quality in East Asia. GEMS (Geostationary Environmental Monitoring Spectrometer) is a satellite instrument planned for launch in 2019 by the Republic of Korea. The instrument will observe East Asia and the western Pacific region, providing real-time monitoring of air quality (e.g. O3, NO2, SO2, HCHO, AOD, etc.) and enabling better scientific understanding of the transboundary transport of air pollutants. The KORUS-AQ (the Korea and U.S. Air Quality) field campaign will take place in May - June 2016 and will employ an integrated observing strategy including multiplatform observations (i.e. ground stations, aircraft, ships, and satellites) and chemical transport models. This mission aims to not only strengthen our knowledge of atmospheric chemistry but also provide important data sets for validating GEMS retrieval algorithms. In preparation for KORUS-AQ, a pre-campaign has been successfully conducted in Korea during early summer 2015 with observations from multiple ground sites and a small aircraft. A brief summary of pre-field campaign results will be presented. Moving forward, the GEMS mission and KORUS-AQ study will lead to a new era of air quality monitoring in East Asia. GEMS will also make critical contributions to the global air quality perspective working in concert with geostationary missions launched by the U.S. (TEMPO: Tropospheric Emissions: Monitoring of

Quality of life in patients with Irritable Bowel Syndrome (IBS), assessed using the IBS-Quality of Life (IBS-QOL) measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide: results of an international prospective observational cohort study in Poland, Egypt, Mexico and China.

PubMed

Hou, Xiaohua; Chen, Shengliang; Zhang, Yali; Sha, Weihong; Yu, Xiaofeng; Elsawah, Hesham; Afifi, Afifi Fahmy; El-Khayat, Hisham Raafat; Nouh, Alaa; Hassan, Mohamed Fathalla; Fatah, Ayman Abdel; Rucker Joerg, Isabel; Sánchez Núñez, Juan Manuel; Osthoff Rueda, Rodolfo; Jurkowska, Grazyna; Walczak, Michal; Malecka-Panas, Ewa; Linke, Krzysztof; Hartleb, Marek; Janssen-van Solingen, Gwendolyn

2014-11-01

Irritable Bowel Syndrome (IBS) has a substantial impact on health-related quality of life (HR-QoL) but high-quality data pre- and post-treatment using the IBS-Quality of Life (IBS-QOL) measure are limited. The objective of this study was to evaluate the changes from baseline of the IBS-QOL scores, symptom scores and health economic data in IBS patients, after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide. This was a prospective observational cohort study in patients with IBS, diagnosed using the Rome III criteria in four countries (Poland, Egypt, Mexico and China). A total of 607 patients were enrolled. At baseline, the IBS-QOL total scores were 52.0 in Poland, 48.9 in Egypt, 51.9 in Mexico, 76.4 in China and 56.4 overall. Increases in IBS-QOL total score were statistically significant at Weeks 4 and 8 overall and in each country (overall: 11.8 at Week 4, 24.3 at Week 8; p < 0.001). Improvements were shown in all IBS-QOL subscales and scores. Symptoms and health economic outcomes were improved. Furthermore, the favourable safety profile of these treatments was confirmed in this study. This study demonstrated that IBS patients have a substantially reduced HR-QoL and that treatment with mebeverine hydrochloride or pinaverium bromide improved HR-QoL.

Confidence Bounds and Power for the Reliability of Observational Measures on the Quality of a Social Setting

ERIC Educational Resources Information Center

Shin, Yongyun; Raudenbush, Stephen W.

2012-01-01

Social scientists are frequently interested in assessing the qualities of social settings such as classrooms, schools, neighborhoods, or day care centers. The most common procedure requires observers to rate social interactions within these settings on multiple items and then to combine the item responses to obtain a summary measure of setting…

Quality of life of children and adolescents with cancer: revision of studies literature that used the Pediatric Quality Of Life Inventory.

PubMed

Queiroz, Débora Milena Farias; Amorim, Maria Helena Costa; Zandonade, Eliana; Miotto, Maria Helena Monteiro de Barros

2015-01-01

To assess the quality of life of children and adolescents with cancer of studies that applied the Pediatric Quality of Life Inventory 3.0 Cancer Module. The study was carried out on the basis of data Scopus Web of Science, BIREME, EBSCO host and Psychoinfo of articles in Spanish, English and Portuguese, and published from 1998 to 2013 that used the Pediatric Quality of life Inventory 3.0 Cancer Module. 21 articles were selected, of which 47.6% were carried out in America, and 61.9% of editions comprehended from 2011 to 2013. The scores variation by dimensions and in general was probably related for the selection of comparison groups, as the diversity of inclusion criteria and variants may be observed for the analysis in each study. The existence of a standard dimension could not be verified either for children ́s /adolescents reports or for parents. It is concluded that the scores averages by dimensions in general have not achieved values below 30 and the largest scores by dimension are above 80. It is suggested that the treatment anxiety dimension in children ́s and adolescents ́s reports may have obtained the largest scores within each study, that is lesser than the difficulty of the children and adolescents in face of the treatment and cancer. Nursing becomes a constant presence in the life of children and adolescents with cancer and it may provide a better quality of life for developing nursing activities and the team may demistify, clarify and help in all phases of the illness and treatment.

Shift work and diabetes mellitus: a meta-analysis of observational studies.

PubMed

Gan, Yong; Yang, Chen; Tong, Xinyue; Sun, Huilian; Cong, Yingjie; Yin, Xiaoxu; Li, Liqing; Cao, Shiyi; Dong, Xiaoxin; Gong, Yanhong; Shi, Oumin; Deng, Jian; Bi, Huashan; Lu, Zuxun

2015-01-01

Observational studies suggest that shift work may be associated with diabetes mellitus (DM). However, the results are inconsistent. No systematic reviews have applied quantitative techniques to compute summary risk estimates. To conduct a meta-analysis of observational studies assessing the association between shift work and the risk of DM. Relevant studies were identified by a search of PubMed, Embase, Web of Science and ProQuest Dissertation and Theses databases to April 2014. We also reviewed reference lists from retrieved articles. We included observational studies that reported OR with 95% CIs for the association between shift work and the risk of DM. Two authors independently extracted data and assessed the study quality. Twelve studies with 28 independent reports involving 226 652 participants and 14 595 patients with DM were included. A pooled adjusted OR for the association between ever exposure to shift work and DM risk was 1.09 (95% CI 1.05 to 1.12; p=0.014; I(2)=40.9%). Subgroup analyses suggested a stronger association between shift work and DM for men (OR=1.37, 95% CI 1.20 to 1.56) than for women (OR=1.09, 95% CI 1.04 to 1.14) (p for interaction=0.01). All shift work schedules with the exception of mixed shifts and evening shifts were associated with a statistically higher risk of DM than normal daytime schedules, and the difference among those shift work schedules was significant (p for interaction=0.04). Shift work is associated with an increased risk of DM. The increase was significantly higher among men and the rotating shift group, which warrants further studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Analysis of air quality with numerical simulation (CMAQ), and observations of trace gases

NASA Astrophysics Data System (ADS)

Castellanos, Patricia

Ozone, a secondary pollutant, is a strong oxidant that can pose a risk to human health. It is formed from a complex set of photochemical reactions involving nitrogen oxides (NOx) and volatile organic compounds (VOCs). Ambient measurements and air quality modeling of ozone and its precursors are important tools for support of regulatory decisions, and analyzing atmospheric chemical and physical processes. I worked on three methods to improve our understanding of photochemical ozone production in the Eastern U.S.: a new detector for NO2, a numerical experiment to test the sensitivity to the timing to emissions, and comparison of modeled and observed vertical profiles of CO and ozone. A small, commercially available cavity ring-down spectroscopy (CRDS) NO2 detector suitable for surface and aircraft monitoring was modified and characterized. The CRDS detector was run in parallel to an ozone chemiluminescence device with photolytic conversion of NO2 to NO. The two instruments measured ambient air in suburban Maryland. A linear least-squares fit to a direct comparison of the data resulted in a slope of 0.960+/-0.002 and R of 0.995, showing agreement between two measurement techniques within experimental uncertainty. The sensitivity of the Community Multiscale Air Quality (CMAQ) model to the temporal variation of four emissions sectors was investigated to understand the effect of emissions' daily variability on modeled ozone. Decreasing the variability of mobile source emissions changed the 8-hour maximum ozone concentration by +/-7 parts per billion by volume (ppbv). Increasing the variability of point source emissions affected ozone concentrations by +/-6 ppbv, but only in areas close to the source. CO is an ideal tracer for analyzing pollutant transport in AQMs because the atmospheric lifetime is longer than the timescale of boundary layer mixing. CO can be used as a tracer if model performance of CO is well understood. An evaluation of CO model performance in CMAQ was

Southern Nevada air quality study

DOT National Transportation Integrated Search

2007-01-01

The Southern Nevada Air Quality Study (SNAQS) created cross-plume and in-plume measurement systems to quantify emissions distributions and source profiles from transportation emissions, specifically gasoline and diesel powered vehicles. The cross-plu...

New quality regulations versus established nursing home practice: a qualitative study.

PubMed

Sandvoll, Anne Marie; Kristoffersen, Kjell; Hauge, Solveig

2012-06-07

Western governments have initiated reforms to improve the quality of care for nursing home residents. Most of these reforms encompass the use of regulations and national quality indicators. In the Norwegian context, these regulations comprise two pages of text that are easy to read and understand. They focus particularly on residents' rights to plan their day-to-day life in nursing homes. However, the research literature indicates that the implementation of the new regulations, particularly if they aim to change nursing practice, is extremely challenging. The aim of this study was to further explore and describe nursing practice to gain a deeper understanding of why it is so hard to implement the new regulations. For this qualitative study, an ethnographic design was chosen to explore and describe nursing practice. Fieldwork was conducted in two nursing homes. In total, 45 nurses and nursing aides were included in participant observation, and 10 were interviewed at the end of the field study. Findings indicate that the staff knew little about the new quality regulations, and that the quality of their work was guided by other factors rooted in their nursing practice. Further analyses revealed that the staff appeared to be committed to daily routines and also that they always seemed to know what to do. Having routines and always knowing what to do mutually strengthen and enhance each other, and together they form a powerful force that makes daily nursing care a taken-for-granted activity. New regulations are challenging to implement because nursing practices are so strongly embedded. Improving practice requires systematic and deeply rooted practical change in everyday action and thinking.

Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation.

PubMed

Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

2016-01-01

Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7-8) versus Group B: 8 (7-9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The results did not change after adjustment

Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation

PubMed Central

Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

2016-01-01

Introduction Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. Methods In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Results Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7–8) versus Group B: 8 (7–9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The

Consumption of fruits and vegetables and risk of renal cell carcinoma: a meta-analysis of observational studies.

PubMed

Zhang, Shaojing; Jia, Zhankui; Yan, Zechen; Yang, Jinjian

2017-04-25

There have been inconsistent results about the association between consumption of fruits and vegetables and renal cell carcinoma (RCC) risk. We conducted a meta-analysis of the published observational studies to explore this association. Nineteen observational studies (4 cohort, 1 pooled and 14 case-control studies), involving 10,215 subjects with RCC were part of this meta-analysis. The SRR for the highest vs. the lowest intake of vegetables was 0.73 (95% CI: 0.63-0.85; Pheterogeneity = 0.004, I2 = 53.5%), whereas for fruits it was 0.86 (95% CI: 0.75-0.98; Pheterogeneity = 0.012, I2 = 47.4%). Linear dose-response analysis also showed similar results, e.g., for per 1 serving/day increment of vegetables, the SRR was 0.90 (95% CI: 0.84-0.96) and for fruits it was 0.97 (95% CI: 0.93-1.01). Nonlinear association was only observed for vegetables (Pnonlinearity = 0.001), but not for fruits (Pnonlinearity = 0.221). Eligible studies up to August 31, 2016 were identified and retrieved by searching MEDLINE and EMBASE databases along with manual review of the reference list from the retrieved studies. Quality of included studies was evaluated using Newcastle-Ottawa Quality Assessment Scale (NOS). Random-effects model was used to calculate summary relative risk (SRR) and corresponding 95% confidence interval (CI). This meta-analysis indicated a protective effect of consumption of vegetables and fruits on RCC risk. Further studies are warranted with prospective designs that use validated questionnaires and control for important confounders.

[Study on seed quality test and quality standard of Lonicera macranthoides].

PubMed

Zhang, Ying; Xu, Jin; Li, Long-Yun; Cui, Guang-Lin; She, Yue-Hui

2016-04-01

Referring to the rules for agricultural seed testing (GB/T 3543-1995) issued by China, the test of sampling, purity, thousand seed weight, moisture, viability, relative conductivity and germination rate had been studied for seed quality test methods of Lonicera macranthoides. The seed quality from 38 different collection areas was measured to establish quality classification standard by K-means clustering. The results showed that at least 7.5 g seeds should be sampled, and passed 20-mesh sieve for purity analysis.The 500-seed method used to measure thousand seed weight. The moisture was determined by crushed seeds dried in high temperature (130±2) ℃ for 3 h.The viability determined by 25 ℃ 0.1% TTC stained 5h in dark. 1.0 g seeds soaked in 50 ml ultra pure water in 25 ℃ for 12 hours to determine the relative conductivity. The seed by 4 ℃stratification for 80 days were cultured on paper at 15 ℃. Quality of the seeds from different areas was divided into three grades. The primary seed quality classification standard was established.The I grade and II grade were recommend use in production. Copyright© by the Chinese Pharmaceutical Association.

Study of Regional Downscaled Climate and Air Quality in the United States

NASA Astrophysics Data System (ADS)

Gao, Y.; Fu, J. S.; Drake, J.; Lamarque, J.; Lam, Y.; Huang, K.

2011-12-01

Due to the increasing anthropogenic greenhouse gas emissions, the global and regional climate patterns have significantly changed. Climate change has exerted strong impact on ecosystem, air quality and human life. The global model Community Earth System Model (CESM v1.0) was used to predict future climate and chemistry under projected emission scenarios. Two new emission scenarios, Representative Community Pathways (RCP) 4.5 and RCP 8.5, were used in this study for climate and chemistry simulations. The projected global mean temperature will increase 1.2 and 1.7 degree Celcius for the RCP 4.5 and RCP 8.5 scenarios in 2050s, respectively. In order to take advantage of local detailed topography, land use data and conduct local climate impact on air quality, we downscaled CESM outputs to 4 km by 4 km Eastern US domain using Weather Research and Forecasting (WRF) Model and Community Multi-scale Air Quality modeling system (CMAQ). The evaluations between regional model outputs and global model outputs, regional model outputs and observational data were conducted to verify the downscaled methodology. Future climate change and air quality impact were also examined on a 4 km by 4 km high resolution scale.

Survival after postoperative morbidity: a longitudinal observational cohort study.

PubMed

Moonesinghe, S R; Harris, S; Mythen, M G; Rowan, K M; Haddad, F S; Emberton, M; Grocott, M P W

2014-12-01

Previous studies have suggested that there may be long-term harm associated with postoperative complications. Uncertainty exists however, because of the need for risk adjustment and inconsistent definitions of postoperative morbidity. We did a longitudinal observational cohort study of patients undergoing major surgery. Case-mix adjustment was applied and morbidity was recorded using a validated outcome measure. Cox proportional hazards modelling using time-dependent covariates was used to measure the independent relationship between prolonged postoperative morbidity and longer term survival. Data were analysed for 1362 patients. The median length of stay was 9 days and the median follow-up time was 6.5 yr. Independent of perioperative risk, postoperative neurological morbidity (prevalence 2.9%) was associated with a relative hazard for long-term mortality of 2.00 [P=0.001; 95% confidence interval (CI) 1.32-3.04]. Prolonged postoperative morbidity (prevalence 15.6%) conferred a relative hazard for death in the first 12 months after surgery of 3.51 (P<0.001; 95% CI 2.28-5.42) and for the next 2 yr of 2.44 (P<0.001; 95% CI 1.62-3.65), returning to baseline thereafter. Prolonged morbidity after surgery is associated with a risk of premature death for a longer duration than perhaps is commonly thought; however, this risk falls with time. We suggest that prolonged postoperative morbidity measured in this way may be a valid indicator of the quality of surgical healthcare. Our findings reinforce the importance of research and quality improvement initiatives aimed at reducing the duration and severity of postoperative complications. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.

Goals of Quality in Doctoral Studies and Forecasted Outcomes

ERIC Educational Resources Information Center

Zelvys, Rimantas

2007-01-01

This article discusses the quality assurance policy of doctoral studies implemented in Lithuania and its probable outcomes are forecasted. In scientific literature the quality of education is commonly defined as a holistic phenomenon composed of the quality of initial conditions, quality of process and quality of outputs. The accomplished document…

Reporting of research quality characteristics of studies published in 6 major clinical dental specialty journals.

PubMed

Pandis, Nikolaos; Polychronopoulou, Argy; Madianos, Phoebus; Makou, Margarita; Eliades, Theodore

2011-06-01

The objective of this article was to record reporting characteristics related to study quality of research published in major specialty dental journals with the highest impact factor (Journal of Endodontics, Journal of Oral and Maxillofacial Surgery, American Journal of Orthodontics and Dentofacial Orthopedics; Pediatric Dentistry, Journal of Clinical Periodontology, and International Journal of Prosthetic Dentistry). The included articles were classified into the following 3 broad subject categories: (1) cross-sectional (snap-shot), (2) observational, and (3) interventional. Multinomial logistic regression was conducted for effect estimation using the journal as the response and randomization, sample calculation, confounding discussed, multivariate analysis, effect measurement, and confidence intervals as the explanatory variables. The results showed that cross-sectional studies were the dominant design (55%), whereas observational investigations accounted for 13%, and interventions/clinical trials for 32%. Reporting on quality characteristics was low for all variables: random allocation (15%), sample size calculation (7%), confounding issues/possible confounders (38%), effect measurements (16%), and multivariate analysis (21%). Eighty-four percent of the published articles reported a statistically significant main finding and only 13% presented confidence intervals. The Journal of Clinical Periodontology showed the highest probability of including quality characteristics in reporting results among all dental journals. Copyright © 2011 Elsevier Inc. All rights reserved.

First quality score for referral letters in gastroenterology-a validation study.

PubMed

Eskeland, Sigrun Losada; Brunborg, Cathrine; Seip, Birgitte; Wiencke, Kristine; Hovde, Øistein; Owen, Tanja; Skogestad, Erik; Huppertz-Hauss, Gert; Halvorsen, Fred-Arne; Garborg, Kjetil; Aabakken, Lars; de Lange, Thomas

2016-10-08

To create and validate an objective and reliable score to assess referral quality in gastroenterology. An observational multicentre study. 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist. Correlation between the TPS and a visual analogue scale (VAS) for referral quality. The 327 referrals had an average TPS of 13.2 (range 1-25) and an average VAS of 4.7 (range 0.2-9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good. The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Interprofessional communication supporting clinical handover in emergency departments: An observation study.

PubMed

Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey

2017-08-01

Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Pinpointing Chinese Early Childhood Teachers' Professional Development Needs through Self-Evaluation and External Observation of Classroom Quality

ERIC Educational Resources Information Center

Hu, Bi Ying; Zhou, Yisu; Li, Kejian

2014-01-01

This study compared Chinese kindergarten teachers' values and perceptions of program quality with trained raters' assessments of quality in order to gain insights into effective professional development for improving teacher quality. A total of 284 Chinese kindergarten teachers self-assessed the quality of their classroom teaching and rated their…

Quality Assessment of Internationalised Studies: Theory and Practice

ERIC Educational Resources Information Center

Juknyte-Petreikiene, Inga

2013-01-01

The article reviews forms of higher education internationalisation at an institutional level. The relevance of theoretical background of internationalised study quality assessment is highlighted and definitions of internationalised studies quality are presented. Existing methods of assessment of higher education internationalisation are criticised…

Data quality assurance and control in cognitive research: Lessons learned from the PREDICT-HD study.

PubMed

Westervelt, Holly James; Bernier, Rachel A; Faust, Melanie; Gover, Mary; Bockholt, H Jeremy; Zschiegner, Roland; Long, Jeffrey D; Paulsen, Jane S

2017-09-01

We discuss the strategies employed in data quality control and quality assurance for the cognitive core of Neurobiological Predictors of Huntington's Disease (PREDICT-HD), a long-term observational study of over 1,000 participants with prodromal Huntington disease. In particular, we provide details regarding the training and continual evaluation of cognitive examiners, methods for error corrections, and strategies to minimize errors in the data. We present five important lessons learned to help other researchers avoid certain assumptions that could potentially lead to inaccuracies in their cognitive data. Copyright © 2017 John Wiley & Sons, Ltd.

Primary and secondary patient data in contrast: the use of observational studies like RABBIT.

PubMed

Richter, Adrian; Meißner, Yvette; Strangfeld, Anja; Zink, Angela

2016-01-01

The study of secondary patient data, particularly represented by claims data, has increased in recent years. The strength of this approach involves easy access to data that have been generated for administrative purposes. By contrast, collection of primary data for research is time-consuming and may therefore appear outdated. Both administrative data and data collected prospectively in clinical care can address similar research questions concerning effectiveness and safety of treatments. Therefore, why should we invest the precious time of rheumatologists to generate primary patient data? This article will outline some features of primary patient data collection illustrated by the German biologics register RABBIT (Rheumatoid arthritis: observation of biologic therapy). RABBIT is a long-term observational cohort study that was initiated more than 15 years ago. We will discuss as quality indicators: (i) study design, (ii) type of documentation, standardisation of (iii) clinical and (iv) safety data, (v) monitoring of the longitudinal follow-up, (vi) losses to follow-up as well as (vii) the possibilities to link the data base. The impact of these features on interpretation and validity of results is illustrated using recent publications. We conclude that high quality and completeness of data prospectively-collected offers many advantages over large quantities of non-standardised data collected in an unsupervised manner. We expect the enthusiasm about the use of secondary patient data to decline with more awareness of their methodological limitations while studies with primary patient data like RABBIT will maintain and broaden their impact on daily clinical practice.

Workflow interruptions and mental workload in hospital pediatricians: an observational study.

PubMed

Weigl, Matthias; Müller, Andreas; Angerer, Peter; Hoffmann, Florian

2014-09-24

Pediatricians' workload is increasingly thought to affect pediatricians' quality of work life and patient safety. Workflow interruptions are a frequent stressor in clinical work, impeding clinicians' attention and contributing to clinical malpractice. We aimed to investigate prospective associations of workflow interruptions with multiple dimensions of mental workload in pediatricians during clinical day shifts. In an Academic Children's Hospital a prospective study of 28 full shift observations was conducted among pediatricians providing ward coverage. The prevalence of workflow interruptions was based on expert observation using a validated observation instrument. Concurrently, Pediatricians' workload ratings were assessed with three workload dimensions of the well-validated NASA-Task Load Index: mental demands, effort, and frustration. Observed pediatricians were, on average, disrupted 4.7 times per hour. Most frequent were interruptions by colleagues (30.2%), nursing staff (29.7%), and by telephone/beeper calls (16.3%). Interruption measures were correlated with two workload outcomes of interest: frequent workflow interruptions were related to less cognitive demands, but frequent interruptions were associated with increased frustration. With regard to single sources, interruptions by colleagues showed the strongest associations to workload. The findings provide insights into specific pathways between different types of interruptions and pediatricians' mental workload. These findings suggest further research and yield a number of work and organization re-design suggestions for pediatric care.

What Catches the Eye in Class Observation? Observers' Perspectives in a Multidisciplinary Peer Observation of Teaching Program

ERIC Educational Resources Information Center

Torres, Ana Cristina; Lopes, Amélia; Valente, Jorge M. S.; Mouraz, Ana

2017-01-01

Peer Observation of Teaching has raised a lot of interest as a device for quality enhancement of teaching. While much research has focused on its models, implementation schemes and feedback to the observed, little attention has been paid to what the observer actually sees and can learn from the observation. A multidisciplinary peer observation of…

Protein quality and oil digestibility of Lupinus mutabilis: metabolic studies in children.

PubMed

Lopez de Romaãna, G; Graham, G G; Morales, E; Massa, E; MacLean, W C

1983-04-01

The nutritional quality of lupins (Lupinus mutabilis) for infants and children was evaluated in two sets of balance studies. In the first the digestibility and protein quality of diets based on lupin flour, with and without methionine supplementation, were compared with those of a control diet consisting of casein, sucrose and vegetable oil. Apparent nitrogen absorption from lupin flour (81.8 and 84.3% of intake) was slightly but significantly less than that during casein control periods (87.2 and 86.8% of intake, P less than 0.05 and less than 0.001). Apparent nitrogen retention from unsupplemented lupin (15.6 +/- 5.8% of intake) was significantly less than that from casein in the corresponding control periods (29.8 +/- 4.9%, P less than 0.001); a small but significant (P less than 0.05) increase in nitrogen retention was observed during the control period following the lupin diet when compared with that preceding it. Methionine supplementation of lupin produced a marked improvement in apparent nitrogen retention (to 22.2 +/- 6.9%, P less than 0.05). In the second set of studies the digestibility of lupin oil was compared with that of a blend of soybean and cottonseed oils (50:50). Excretion of fecal fat (9.8 +/- 3.0% of intake) and fecal energy (6.7 +/- 1.2% of intake) with the diet containing lupin oil were similar to those observed with the control diet. Both the protein quality and oil digestibility of Lupinus mutabilis are very similar to those from soybeans processed in a similar manner. For certain countries the lupin could be a valuable source of protein and edible oil for human consumption.

How does study quality affect the results of a diagnostic meta-analysis?

PubMed Central

Westwood, Marie E; Whiting, Penny F; Kleijnen, Jos

2005-01-01

Background The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three

Sleep quality in patients with xerostomia: a prospective and randomized case-control study.

PubMed

Lopez-Jornet, Pia; Lucero Berdugo, Maira; Fernandez-Pujante, Alba; C, Castillo Felipe; Lavella C, Zamora; A, Pons-Fuster; J, Silvestre Rangil; Silvestre, Francisco Javier

2016-01-01

Objectives To investigate sleep quality, anxiety/depression and quality-of-life in patients with xerostomia. Materials and methods This prospective, observational, cross-sectional study was conducted among a group of xerostomia patients (n = 30) compared with 30 matched control subjects. The following evaluation scales were used to assess the psychological profile of each patient: the Hospital Anxiety and Depression Scale, the Oral Health Impact Profile-14 (OHIP-14), the Xerostomia Inventory, the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Results The PSQI obtained 5.3 3 ± 1.78 for patients with xerostomia compared with 4.26 ± 1.01 for control subjects (p = 0.006); ESS obtained 5.7 ± 2.1 for test patients vs 4.4 0 ± 1 for control subjects (p = 0.010). Statistical regression analysis showed that xerostomia was significantly associated with depression (p = 0.027). Conclusions Patients with xerostomia exhibited significant decreases in sleep quality compared with control subjects.

[Impact of quality measurement, transparency and peer review on in-hospital mortality - retrospective before-after study with 63 hospitals].

PubMed

Nimptsch, Ulrike; Peschke, Dirk; Mansky, Thomas

2016-10-01

In 2008 the 'Initiative Qualitätsmedizin' (initiative for quality in medical care, IQM) was established as a voluntary non-profit association of hospital providers of all kinds of ownership. Currently, about 350 hospitals from Germany and Switzerland participate in IQM. Member hospitals are committed to a quality strategy based on measuring outcome indicators using administrative data, peer review procedures to improve medical quality, and transparency by public reporting. This study aims to investigate whether voluntary implementation of this approach is associated with improvements in medical outcome. Within a retrospective before-after study 63 hospitals, which started to participate in IQM between 2009 and 2011, were monitored. In-hospital mortality in these hospitals was studied for 14 selected inpatient services in comparison to the German national average. The analyses examine whether in-hospital mortality declined after participation of the studied hospitals in IQM, independently of secular trends or deviations in case mix when compared to the national average, and whether such findings were associated with initial hospital performance or peer review procedures. Declining in-hospital mortality was observed in hospitals with initially subpar performance. These declines were statistically significant for treatment of myocardial infarction, heart failure, pneumonia, and septicemia. Similar, but statistically non-significant trends were observed for nine further treatments. Following peer-review procedures significant declines in in-hospital mortality were observed for treatments of myocardial infarction, heart failure, and pneumonia. Mortality declines after peer reviews regarding stroke, hip fracture and colorectal resection were not significant, and after peer reviews regarding mechanically ventilated patients no changes were observed. The results point to a positive impact of the quality approach applied by IQM on clinical outcomes. A more targeted

Predicting sleep quality from stress and prior sleep--a study of day-to-day covariation across six weeks.

PubMed

Åkerstedt, Torbjörn; Orsini, Nicola; Petersen, Helena; Axelsson, John; Lekander, Mats; Kecklund, Göran

2012-06-01

The connection between stress and sleep is well established in cross-sectional questionnaire studies and in a few prospective studies. Here, the intention was to study the link between stress and sleep on a day-to-day basis across 42 days. Fifty participants kept a sleep/wake diary across 42 days and responded to daily questions on sleep and stress. The results were analyzed with a mixed model approach using stress during the prior day to predict morning ratings of sleep quality. The results showed that bedtime stress and worries were the main predictors of sleep quality, but that, also, late awakening, short prior sleep, high quality of prior sleep, and good health the prior day predicted higher sleep quality. Stress during the day predicts subsequent sleep quality on a day-to-day basis across 42 days. The observed range of variation in stress/worries was modest, which is why it is suggested that the present data underestimates the impact of stress on subsequent sleep quality. Copyright © 2012 Elsevier B.V. All rights reserved.

Service Quality Assessment Scale (SQAS): An Instrument for Evaluating Service Quality of Health-Fitness Clubs

ERIC Educational Resources Information Center

Lam, Eddie T. C.; Zhang, James J.; Jensen, Barbara E.

2005-01-01

This study was designed to develop the Service Quality Assessment Scale to evaluate the service quality of health-fitness clubs. Through a review of literature, field observations, interviews, modified application of the Delphi technique, and a pilot study, a preliminary scale with 46 items was formulated. The preliminary scale was administered to…

The impact of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical practices

PubMed Central

2012-01-01

Background Rotavirus (RV) is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK) to investigate the impact of paediatric rotavirus gastroenteritis (RVGE) on affected children and their parents. Methods A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged <5 years presenting to a general practitioner or paediatrician for RVGE at centres in Spain, Italy or Poland. RV infection was confirmed by polymerase chain reaction (PCR) testing (n = 264). The questionnaire was validated and used to assess the emotional impact of paediatric RVGE on the parents. Results Questionnaire responses showed that acute RVGE in a child adversely affects the parents’ daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale) was associated with higher parental worries due to symptoms and greater changes in the child’s behaviour, and a trend to higher impact on parents’ daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire. Conclusions Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child’s illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children. PMID:22650611

Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations.

PubMed

Mueller, Monika; D'Addario, Maddalena; Egger, Matthias; Cevallos, Myriam; Dekkers, Olaf; Mugglin, Catrina; Scott, Pippa

2018-05-21

Systematic reviews and meta-analyses of observational studies are frequently performed, but no widely accepted guidance is available at present. We performed a systematic scoping review of published methodological recommendations on how to systematically review and meta-analyse observational studies. We searched online databases and websites and contacted experts in the field to locate potentially eligible articles. We included articles that provided any type of recommendation on how to conduct systematic reviews and meta-analyses of observational studies. We extracted and summarised recommendations on pre-defined key items: protocol development, research question, search strategy, study eligibility, data extraction, dealing with different study designs, risk of bias assessment, publication bias, heterogeneity, statistical analysis. We summarised recommendations by key item, identifying areas of agreement and disagreement as well as areas where recommendations were missing or scarce. The searches identified 2461 articles of which 93 were eligible. Many recommendations for reviews and meta-analyses of observational studies were transferred from guidance developed for reviews and meta-analyses of RCTs. Although there was substantial agreement in some methodological areas there was also considerable disagreement on how evidence synthesis of observational studies should be conducted. Conflicting recommendations were seen on topics such as the inclusion of different study designs in systematic reviews and meta-analyses, the use of quality scales to assess the risk of bias, and the choice of model (e.g. fixed vs. random effects) for meta-analysis. There is a need for sound methodological guidance on how to conduct systematic reviews and meta-analyses of observational studies, which critically considers areas in which there are conflicting recommendations.

Generation and use of observational data patterns in the evaluation of data quality for AmeriFlux and FLUXNET

NASA Astrophysics Data System (ADS)

Pastorello, G.; Agarwal, D.; Poindexter, C.; Papale, D.; Trotta, C.; Ribeca, A.; Canfora, E.; Faybishenko, B.; Gunter, D.; Chu, H.

2015-12-01

The fluxes-measuring sites that are part of AmeriFlux are operated and maintained in a fairly independent fashion, both in terms of scientific goals and operational practices. This is also the case for most sites from other networks in FLUXNET. This independence leads to a degree of heterogeneity in the data sets collected at the sites, which is also reflected in data quality levels. The generation of derived data products and data synthesis efforts, two of the main goals of these networks, are directly affected by the heterogeneity in data quality. In a collaborative effort between AmeriFlux and ICOS, a series of quality checks are being conducted for the data sets before any network-level data processing and product generation take place. From these checks, a set of common data issues were identified, and are being cataloged and classified into data quality patterns. These patterns are now being used as a basis for implementing automation for certain data quality checks, speeding up the process of applying the checks and evaluating the data. Currently, most data checks are performed individually in each data set, requiring visual inspection and inputs from a data curator. This manual process makes it difficult to scale the quality checks, creating a bottleneck for the data processing. One goal of the automated checks is to free up time of data curators so they can focus on new or less common issues. As new issues are identified, they can also be cataloged and classified, extending the coverage of existing patterns or potentially generating new patterns, helping both improve existing automated checks and create new ones. This approach is helping make data quality evaluation faster, more systematic, and reproducible. Furthermore, these patterns are also helping with documenting common causes and solutions for data problems. This can help tower teams with diagnosing problems in data collection and processing, and also in correcting historical data sets. In this

HUMeral shaft fractures: measuring recovery after operative versus non-operative treatment (HUMMER): a multicenter comparative observational study.

PubMed

Mahabier, Kiran C; Van Lieshout, Esther M M; Bolhuis, Hugo W; Bos, P Koen; Bronkhorst, Maarten Wga; Bruijninckx, Milko M M; De Haan, Jeroen; Deenik, Axel R; Dwars, Boudewijn J; Eversdijk, Martin G; Goslings, J Carel; Haverlag, Robert; Heetveld, Martin J; Kerver, Albert J H; Kolkman, Karel A; Leenhouts, Peter A; Meylaerts, Sven A G; Onstenk, Ron; Poeze, Martijn; Poolman, Rudolf W; Punt, Bas J; Roerdink, W Herbert; Roukema, Gert R; Sintenie, Jan Bernard; Soesman, Nicolaj M R; Tanka, Andras K F; Ten Holder, Edgar J T; Van der Elst, Maarten; Van der Heijden, Frank H W M; Van der Linden, Frits M; Van der Zwaal, Peer; Van Dijk, Jan P; Van Jonbergen, Hans-Peter W; Verleisdonk, Egbert J M M; Vroemen, Jos P A M; Waleboer, Marco; Wittich, Philippe; Zuidema, Wietse P; Polinder, Suzanne; Verhofstad, Michael H J; Den Hartog, Dennis

2014-02-11

Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not. Since randomized controlled trials for this injury have shown feasibility issues, this study is designed to provide the best achievable evidence to answer this unresolved problem. The primary aim of this study is to evaluate functional recovery after operative versus non-operative treatment in adult patients who sustained a humeral shaft fracture. Secondary aims include the effect of treatment on pain, complications, generic health-related quality of life, time to resumption of activities of daily living and work, and cost-effectiveness. The main hypothesis is that operative treatment will result in faster recovery. The design of the study will be a multicenter prospective observational study of 400 patients who have sustained a humeral shaft fracture, AO type 12A or 12B. Treatment decision (i.e., operative or non-operative) will be left to the discretion of the treating surgeon. Critical elements of treatment will be registered and outcome will be monitored at regular intervals over the subsequent 12 months. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcome measures are the Constant score, pain level at both sides, range of motion of the elbow and shoulder joint at both sides, radiographic healing, rate of complications and (secondary) interventions, health-related quality of life (Short-Form 36 and EuroQol-5D), time to resumption of ADL/work, and cost-effectiveness. Data will be analyzed using univariate