SU-E-I-71: Quality Assessment of Surrogate Metrics in Multi-Atlas-Based Image Segmentation

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

Zhao, T; Ruan, D

Purpose: With the ever-growing data of heterogeneous quality, relevance assessment of atlases becomes increasingly critical for multi-atlas-based image segmentation. However, there is no universally recognized best relevance metric and even a standard to compare amongst candidates remains elusive. This study, for the first time, designs a quantification to assess relevance metrics’ quality, based on a novel perspective of the metric as surrogate for inferring the inaccessible oracle geometric agreement. Methods: We first develop an inference model to relate surrogate metrics in image space to the underlying oracle relevance metric in segmentation label space, with a monotonically non-decreasing function subject tomore » random perturbations. Subsequently, we investigate model parameters to reveal key contributing factors to surrogates’ ability in prognosticating the oracle relevance value, for the specific task of atlas selection. Finally, we design an effective contract-to-noise ratio (eCNR) to quantify surrogates’ quality based on insights from these analyses and empirical observations. Results: The inference model was specialized to a linear function with normally distributed perturbations, with surrogate metric exemplified by several widely-used image similarity metrics, i.e., MSD/NCC/(N)MI. Surrogates’ behaviors in selecting the most relevant atlases were assessed under varying eCNR, showing that surrogates with high eCNR dominated those with low eCNR in retaining the most relevant atlases. In an end-to-end validation, NCC/(N)MI with eCNR of 0.12 compared to MSD with eCNR of 0.10 resulted in statistically better segmentation with mean DSC of about 0.85 and the first and third quartiles of (0.83, 0.89), compared to MSD with mean DSC of 0.84 and the first and third quartiles of (0.81, 0.89). Conclusion: The designed eCNR is capable of characterizing surrogate metrics’ quality in prognosticating the oracle relevance value. It has been demonstrated to be correlated with the performance of relevant atlas selection and ultimate label fusion.« less

Choosing Wisely: assessment of current US top five list recommendations’ trustworthiness using a pragmatic approach

PubMed Central

Horvath, Karl; Semlitsch, Thomas; Jeitler, Klaus; Abuzahra, Muna E; Posch, Nicole; Domke, Andreas; Siebenhofer, Andrea

2016-01-01

Objectives Identification of sufficiently trustworthy top 5 list recommendations from the US Choosing Wisely campaign. Setting Not applicable. Participants All top 5 list recommendations available from the American Board of Internal Medicine Foundation website. Main outcome measures/interventions Compilation of US top 5 lists and search for current German highly trustworthy (S3) guidelines. Extraction of guideline recommendations, including grade of recommendation (GoR), for suggestions comparable to top 5 list recommendations. For recommendations without guideline equivalents, the methodological quality of the top 5 list development process was assessed using criteria similar to that used to judge guidelines, and relevant meta-literature was identified in cited references. Judgement of sufficient trustworthiness of top 5 list recommendations was based either on an ‘A’ GoR of guideline equivalents or on high methodological quality and citation of relevant meta-literature. Results 412 top 5 list recommendations were identified. For 75 (18%), equivalents were found in current German S3 guidelines. 44 of these recommendations were associated with an ‘A’ GoR, or a strong recommendation based on strong evidence, and 26 had a ‘B’ or a ‘C’ GoR. No GoR was provided for 5 recommendations. 337 recommendations had no equivalent in the German S3 guidelines. The methodological quality of the development process was high and relevant meta-literature was cited for 87 top 5 list recommendations. For a further 36, either the methodological quality was high without any meta-literature citations or meta-literature citations existed but the methodological quality was lacking. For the remaining 214 recommendations, either the methodological quality was lacking and no literature was cited or the methodological quality was generally unsatisfactory. Conclusions 131 of current US top 5 list recommendations were found to be sufficiently trustworthy. For a substantial number of current US top 5 list recommendations, their trustworthiness remains unclear. Methodological requirements for developing top 5 lists are recommended. PMID:27855098

Expediting the Quest for Quality: The Role of IQAC in Academic Audit

ERIC Educational Resources Information Center

Nitonde, Rohidas

2016-01-01

Academic Audit is an important tool to control and maintain standards in academic sector. It has been found highly relevant by the experts across the world. Academic audit helps institutions to introspect and improve their quality. The present paper intends to probe into the possible role of Internal Quality Assurance Cell (IQAC) in Academic Audit…

[Quality criteria for scientific collections within medical associations: the collections of the German Urological Association fullfill high requirements].

PubMed

Moll, F H; Rathert, P; Fangerau, H

2013-12-01

Quality criteria are necessary for the evaluation and rating of scientific collections of medical associations and are necessary for their development in order to argue within the scientific community or with other relevant actors.

An appraisal of the trustworthiness of practice guidelines for depression and anxiety in children and youth.

PubMed

Bennett, Kathryn; Courtney, Darren; Duda, Stephanie; Henderson, Joanna; Szatmari, Peter

2018-04-26

Little is known about the trustworthiness of clinical practice guidelines (PGs) relevant to child and youth depression or anxiety. To address this gap, we used systematic review methods to identify all available relevant PGs, quality appraise them, and make recommendations regarding which PGs are trustworthy and should be used by clinicians. Prespecified inclusion criteria identified eligible PGs. Two independent trained reviewers applied the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Using three AGREE II domain scores (stakeholder involvement, rigor of development [clinical validity/trustworthiness], and editorial independence), PG quality was designated as (1) minimum (≥50%) and (2) high (≥70%). Of 25 eligible PGs, five met minimum quality criteria (depression, n = 4; anxiety, n = 1); three out of five met high-quality criteria (depression, n = 2; anxiety, n = 1). Among the five minimum quality PGs, developers included government (n = 2), independent expert groups (n = 2), and other (n = 1). No PGs developed by specialty societies achieved minimum or high-quality ratings; eight of 25 PGs were up-to-date. Trustworthy PGs are available to support clinical decisions about depression and anxiety in children and youth, but are few in number. Many existing PGs (up to 80%) may not be clinically valid. Clinicians who implement the high-quality PGs identified here can increase the number of children and youth who receive effective interventions for depression and anxiety, minimize harm, and avoid wasted resources. Clinicians, service planners, youth, and their families should encourage PG developers to increase the pool of high-quality PGs using internationally recognized PG development standards. © 2018 Wiley Periodicals, Inc.

Artificial regeneration of northern red oak and white oak on high-quality sites: effect of root morphology and relevant biological characteristics

Treesearch

Paul P. Kormanik; Shi-Jean S. Sung; Stanley J. Zarnoch; G. Thomas Tibbs

2002-01-01

Northern red oak (Quercus rubra) and white oak (Quercus alba) are important components of high-quality mesic sites and are essential as lumber species and hard mast producers. Regeneration of these species has been difficult, and their absence in newly regenerated stands is a major concern of foresters and wildlife biologists....

Faculty Qualification Policies and Strategies Relevant to Dual Enrollment Programs: An Analysis of States and Regional Accreditation Agencies. Policy Report

ERIC Educational Resources Information Center

Horn, Aaron S.; Reinert, Leah; Jang, Sung Tae; Zinth, Jennifer Dounay

2016-01-01

As dual enrollment programs continue to expand, a critical challenge is to ensure that the quality of such courses offered in high schools is equivalent to the quality of courses taught in postsecondary institutions. Standards for faculty qualifications have historically constituted one facet of efforts to regulate educational quality, and thus…

Back schools for non-specific low-back pain.

PubMed

Heymans, M W; van Tulder, M W; Esmail, R; Bombardier, C; Koes, B W

2004-10-18

Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating patients with low-back pain (LBP). However, the content of back schools has changed and appears to vary widely today. To assess the effectiveness of back schools for patients with non-specific LBP. We searched the MEDLINE and EMBASE databases and the Cochrane Central Register of Controlled Trials to May 2003 for relevant trials reported in English, Dutch, French or German. We also screened references from relevant reviews and included trials. Randomized controlled trials (RCTs) that reported on any type of back school for non-specific LBP were included. Four reviewers, blinded to authors, institution and journal, independently extracted the data and assessed the quality of the trials. We set the high quality level, a priori, at a trial meeting six or more of 11 internal validity criteria. As data were clinically and statistically too heterogeneous to perform a meta-analysis, we used a qualitative review (best evidence synthesis) to summarize the results. The evidence was classified into four levels (strong, moderate, limited or no evidence), taking into account the methodological quality of the studies. We also evaluated the clinical relevance of the studies. Nineteen RCTs (3584 patients) were included in this updated review. Overall, the methodological quality was low, with only six trials considered to be high quality. It was not possible to perform relevant subgroup analyses for LBP with radiation versus LBP without radiation. The results indicate that there is moderate evidence suggesting that back schools have better short and intermediate-term effects on pain and functional status than other treatments for patients with recurrent and chronic LBP. There is moderate evidence suggesting that back schools for chronic LBP in an occupational setting, are more effective than other treatments and placebo or waiting list controls on pain, functional status and return to work during short and intermediate-term follow-up. In general, the clinical relevance of the studies was rated as insufficient. There is moderate evidence suggesting that back schools, in an occupational setting, reduce pain, and improve function and return-to-work status, in the short and intermediate-term, compared to exercises, manipulation, myofascial therapy, advice, placebo or waiting list controls, for patients with chronic and recurrent LBP. However, future trials should improve methodological quality and clinical relevance and evaluate the cost-effectiveness of back schools.

Query-based biclustering of gene expression data using Probabilistic Relational Models.

PubMed

Zhao, Hui; Cloots, Lore; Van den Bulcke, Tim; Wu, Yan; De Smet, Riet; Storms, Valerie; Meysman, Pieter; Engelen, Kristof; Marchal, Kathleen

2011-02-15

With the availability of large scale expression compendia it is now possible to view own findings in the light of what is already available and retrieve genes with an expression profile similar to a set of genes of interest (i.e., a query or seed set) for a subset of conditions. To that end, a query-based strategy is needed that maximally exploits the coexpression behaviour of the seed genes to guide the biclustering, but that at the same time is robust against the presence of noisy genes in the seed set as seed genes are often assumed, but not guaranteed to be coexpressed in the queried compendium. Therefore, we developed ProBic, a query-based biclustering strategy based on Probabilistic Relational Models (PRMs) that exploits the use of prior distributions to extract the information contained within the seed set. We applied ProBic on a large scale Escherichia coli compendium to extend partially described regulons with potentially novel members. We compared ProBic's performance with previously published query-based biclustering algorithms, namely ISA and QDB, from the perspective of bicluster expression quality, robustness of the outcome against noisy seed sets and biological relevance.This comparison learns that ProBic is able to retrieve biologically relevant, high quality biclusters that retain their seed genes and that it is particularly strong in handling noisy seeds. ProBic is a query-based biclustering algorithm developed in a flexible framework, designed to detect biologically relevant, high quality biclusters that retain relevant seed genes even in the presence of noise or when dealing with low quality seed sets.

Species identification of adult African blowflies (Diptera: Calliphoridae) of forensic importance.

PubMed

Lutz, Lena; Williams, Kirstin A; Villet, Martin H; Ekanem, Mfon; Szpila, Krzysztof

2018-05-01

Necrophagous blowflies can provide an excellent source of evidence for forensic entomologists and are also relevant to problems in public health, medicine, and animal health. However, access to useful information about these blowflies is constrained by the need to correctly identify the flies, and the poor availability of reliable, accessible identification tools is a serious obstacle to the development of forensic entomology in the majority of African countries. In response to this need, a high-quality key to the adults of all species of forensically relevant blowflies of Africa has been prepared, drawing on high-quality entomological materials and modern focus-stacking photomicroscopy. This new key can be easily applied by investigators inexperienced in the taxonomy of blowflies and is made available through a highly accessible online platform. Problematic diagnostic characters used in previous keys are discussed.

Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

PubMed

Janamian, Tina; Upham, Susan J; Crossland, Lisa; Jackson, Claire L

2016-04-18

To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility. Systematic review of the international published and grey literature. CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013. GreyNet International and other relevant websites and repositories were also searched in March-April 2014 for documents dated between 1992 and 2012. All citations were imported into a bibliographic database. Published and unpublished tools and resources were included in the review if they were in English, related to primary care quality improvement and addressed any of the seven PC-PIT elements of a high-performing practice. Tools and resources that met the eligibility criteria were then evaluated for their accessibility, relevance, utility and comprehensiveness using a four-criteria appraisal framework. We used a data extraction template to systematically extract information from eligible tools and resources. A content analysis approach was used to explore the tools and resources and collate relevant information: name of the tool or resource, year and country of development, author, name of the organisation that provided access and its URL, accessibility information or problems, overview of each tool or resource and the quality improvement element(s) it addresses. If available, a copy of the tool or resource was downloaded into the bibliographic database, along with supporting evidence (published or unpublished) on its use in primary care. This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in improving the quality of their practice, to achieve improved health outcomes.

High engagement, high quality: A guiding framework for developing empirically informed asynchronous e-learning programs for health professional educators.

PubMed

Sinclair, Peter M; Levett-Jones, Tracey; Morris, Amanda; Carter, Ben; Bennett, Paul N; Kable, Ashley

2017-03-01

E-learning involves the transfer of skills and knowledge via technology so that learners can access meaningful and authentic educational materials. While learner engagement is important, in the context of healthcare education, pedagogy must not be sacrificed for edu-tainment style instructional design. Consequently, health professional educators need to be competent in the use of current web-based educational technologies so that learners are able to access relevant and engaging e-learning materials without restriction. The increasing popularity of asynchronous e-learning programs developed for use outside of formal education institutions has made this need more relevant. In these contexts, educators must balance design and functionality to deliver relevant, cost-effective, sustainable, and accessible programs that overcome scheduling and geographic barriers for learners. This paper presents 10 guiding design principles and their application in the development of an e-learning program for general practice nurses focused on behavior change. Consideration of these principles will assist educators to develop high quality, pedagogically sound, engaging, and interactive e-learning resources. © 2017 John Wiley & Sons Australia, Ltd.

BIOREL: the benchmark resource to estimate the relevance of the gene networks.

PubMed

Antonov, Alexey V; Mewes, Hans W

2006-02-06

The progress of high-throughput methodologies in functional genomics has lead to the development of statistical procedures to infer gene networks from various types of high-throughput data. However, due to the lack of common standards, the biological significance of the results of the different studies is hard to compare. To overcome this problem we propose a benchmark procedure and have developed a web resource (BIOREL), which is useful for estimating the biological relevance of any genetic network by integrating different sources of biological information. The associations of each gene from the network are classified as biologically relevant or not. The proportion of genes in the network classified as "relevant" is used as the overall network relevance score. Employing synthetic data we demonstrated that such a score ranks the networks fairly in respect to the relevance level. Using BIOREL as the benchmark resource we compared the quality of experimental and theoretically predicted protein interaction data.

[AIDS prevention among adolescents in school: a systematic review of the efficacy of interventions].

PubMed

Juárez, O; Díez, E

1999-01-01

Preventive interventions are considered useful although poorly evaluated. Since 1990 there are growing evidences of effective school aids prevention interventions. This paper aims to identify school aids prevention programs among youngsters aged 13 to 19, published between 1990 and 1995, to analyze each evaluation and intervention quality, to assess their effectiveness as well as identifying the possible contributing factors. Location of reports by means of a Medline computerized search of published articles and reviews, which should include the following criteria: school aids prevention programs, addressed to youngsters aged 13 to 19, published in Spanish, French or English between 1990 and 1995 in scientific literature, and evaluating changes in behavior or its determinants through quantitative measures. Analysis of the evaluation quality through the assessment of the sample size, the use of a control group, the groups comparability, the drop out analysis and the time between the pretest and the posttest. Intervention quality analysis through the use of a psychological behavioral change model and the number of sessions. The effectiveness of the high quality interventions in changing behaviors, intentions, attitudes and knowledge was assessed. 29 studies were selected. Of these studies, relating the quality of evaluation criteria, a 28% was considered a high quality study, a 14% an intermediate quality study and a 58% a low quality one. In relation to intervention quality criteria, a 27% was found to be a high quality study, a 41% an intermediate quality study and 32% a low quality one. 38% (11 studies) showed high or intermediate quality criteria at the same time in intervention and in evaluation. All these studies modified knowledge and attitudes, an 80% modified the intention to behave and a 86% modified behavior. The increase in knowledge and attitudes was in general quite important, greater than 10%, and changes in intentions and behaviors were smaller than 10%, although relevant. Only 38% of the studies may be considered of high or intermediate quality. Preventive interventions correctly evaluated which rely on a theoretical model and offer 4 or more sessions show evidence of moderate but relevant reduction of aids risk practices, and important changes of the future behavior determinants.

Rural relevant quality measures for critical access hospitals.

PubMed

Casey, Michelle M; Moscovice, Ira; Klingner, Jill; Prasad, Shailendra

2013-01-01

To identify current and future relevant quality measures for Critical Access Hospitals (CAHs). Three criteria (patient volume, internal usefulness for quality improvement, and external usefulness for public reporting and payment reform) were used to analyze quality measures for their relevance for CAHs. A 6-member panel with expertise in rural hospital quality measurement and improvement provided input regarding the final measure selection. The relevant quality measures for CAHs include measures that are ready for reporting now and measures that need specifications to be finalized and/or a data reporting mechanism to be established. They include inpatient measures for specific medical conditions, global measures that address appropriate care across multiple medical conditions, and Emergency Department measures. All CAHs should publicly report on relevant quality measures. Acceptance of a single consolidated set of quality measures with common specifications for CAHs by all entities involved in regulation, accreditation, and payment; a phased process to implement the relevant measures; and the provision of technical assistance would help CAHs meet the challenge of reporting. © 2012 National Rural Health Association.

Can the theoretical domains framework account for the implementation of clinical quality interventions?

PubMed

Lipworth, Wendy; Taylor, Natalie; Braithwaite, Jeffrey

2013-12-21

The health care quality improvement movement is a complex enterprise. Implementing clinical quality initiatives requires attitude and behaviour change on the part of clinicians, but this has proven to be difficult. In an attempt to solve this kind of behavioural challenge, the theoretical domains framework (TDF) has been developed. The TDF consists of 14 domains from psychological and organisational theory said to influence behaviour change. No systematic research has been conducted into the ways in which clinical quality initiatives map on to the domains of the framework. We therefore conducted a qualitative mapping experiment to determine to what extent, and in what ways, the TDF is relevant to the implementation of clinical quality interventions. We conducted a thematic synthesis of the qualitative literature exploring clinicians' perceptions of various clinical quality interventions. We analysed and synthesised 50 studies in total, in five domains of clinical quality interventions: clinical quality interventions in general, structural interventions, audit-type interventions, interventions aimed at making practice more evidence-based, and risk management interventions. Data were analysed thematically, followed by synthesis of these themes into categories and concepts, which were then mapped to the domains of the TDF. Our results suggest that the TDF is highly relevant to the implementation of clinical quality interventions. It can be used to map most, if not all, of the attitudinal and behavioural barriers and facilitators of uptake of clinical quality interventions. Each of these 14 domains appeared to be relevant to many different types of clinical quality interventions. One possible additional domain might relate to perceived trustworthiness of those instituting clinical quality interventions. The TDF can be usefully applied to a wide range of clinical quality interventions. Because all 14 of the domains emerged as relevant, and we did not identify any obvious differences between different kinds of clinical quality interventions, our findings support an initially broad approach to identifying barriers and facilitators, followed by a "drilling down" to what is most contextually salient. In future, it may be possible to establish a model of clinical quality policy implementation using the TDF.

Can the theoretical domains framework account for the implementation of clinical quality interventions?

PubMed Central

2013-01-01

Background The health care quality improvement movement is a complex enterprise. Implementing clinical quality initiatives requires attitude and behaviour change on the part of clinicians, but this has proven to be difficult. In an attempt to solve this kind of behavioural challenge, the theoretical domains framework (TDF) has been developed. The TDF consists of 14 domains from psychological and organisational theory said to influence behaviour change. No systematic research has been conducted into the ways in which clinical quality initiatives map on to the domains of the framework. We therefore conducted a qualitative mapping experiment to determine to what extent, and in what ways, the TDF is relevant to the implementation of clinical quality interventions. Methods We conducted a thematic synthesis of the qualitative literature exploring clinicians’ perceptions of various clinical quality interventions. We analysed and synthesised 50 studies in total, in five domains of clinical quality interventions: clinical quality interventions in general, structural interventions, audit-type interventions, interventions aimed at making practice more evidence-based, and risk management interventions. Data were analysed thematically, followed by synthesis of these themes into categories and concepts, which were then mapped to the domains of the TDF. Results Our results suggest that the TDF is highly relevant to the implementation of clinical quality interventions. It can be used to map most, if not all, of the attitudinal and behavioural barriers and facilitators of uptake of clinical quality interventions. Each of these 14 domains appeared to be relevant to many different types of clinical quality interventions. One possible additional domain might relate to perceived trustworthiness of those instituting clinical quality interventions. Conclusions The TDF can be usefully applied to a wide range of clinical quality interventions. Because all 14 of the domains emerged as relevant, and we did not identify any obvious differences between different kinds of clinical quality interventions, our findings support an initially broad approach to identifying barriers and facilitators, followed by a “drilling down” to what is most contextually salient. In future, it may be possible to establish a model of clinical quality policy implementation using the TDF. PMID:24359085

Knowledge and Beliefs of Early Childhood Education Students at Different Levels of Professional Preparation

ERIC Educational Resources Information Center

Goble, Carla B.; Horm, Diane M.; Atanasov, Amy M.; Williamson, Amy C.; Choi, Ji Young

2015-01-01

The expansion of early childhood education programming has heightened the focus on teachers' educational preparation and its role in providing high-quality services for young children. The interest in teachers' education is especially relevant in early childhood since differentiated levels of preparation are commonly used in quality rating and…

Information-Seeking in Family Day Care: Access, Quality and Personal Cost

ERIC Educational Resources Information Center

Corr, L.; Davis, E.; Cook, K.; Mackinnon, A.; Sims, M.; Herrman, H.

2014-01-01

Family day-care (FDC) educators work autonomously to provide care and education for children of mixed ages, backgrounds and abilities. To meet the demands and opportunities of their work and regulatory requirements, educators need access to context-relevant and high quality information. No previous research has examined how and where these workers…

Most systematic reviews of high methodological quality on psoriasis interventions are classified as high risk of bias using ROBIS tool.

PubMed

Gómez-García, Francisco; Ruano, Juan; Gay-Mimbrera, Jesus; Aguilar-Luque, Macarena; Sanz-Cabanillas, Juan Luis; Alcalde-Mellado, Patricia; Maestre-López, Beatriz; Carmona-Fernández, Pedro Jesús; González-Padilla, Marcelino; García-Nieto, Antonio Vélez; Isla-Tejera, Beatriz

2017-12-01

No gold standard exists to assess methodological quality of systematic reviews (SRs). Although Assessing the Methodological Quality of Systematic Reviews (AMSTAR) is widely accepted for analyzing quality, the ROBIS instrument has recently been developed. This study aimed to compare the capacity of both instruments to capture the quality of SRs concerning psoriasis interventions. Systematic literature searches were undertaken on relevant databases. For each review, methodological quality and bias risk were evaluated using the AMSTAR and ROBIS tools. Descriptive and principal component analyses were conducted to describe similarities and discrepancies between both assessment tools. We classified 139 intervention SRs as displaying high/moderate/low methodological quality and as high/low risk of bias. A high risk of bias was detected for most SRs classified as displaying high or moderate methodological quality by AMSTAR. When comparing ROBIS result profiles, responses to domain 4 signaling questions showed the greatest differences between bias risk assessments, whereas domain 2 items showed the least. When considering SRs published about psoriasis, methodological quality remains suboptimal, and the risk of bias is elevated, even for SRs exhibiting high methodological quality. Furthermore, the AMSTAR and ROBIS tools may be considered as complementary when conducting quality assessment of SRs. Copyright © 2017 Elsevier Inc. All rights reserved.

Academic Rigour, Managerial Relevance and Triangulation of Research Methods: A Perspective of Expectations Fulfilment in Postgraduate Education

ERIC Educational Resources Information Center

Hui, Loi Teck; Fatt, Quek Kia

2008-01-01

Developing high-quality human capital and advancing existing knowledge stocks are crucial for the competitive advantage of a nation. The authors argue that offering postgraduate programmes that give great emphasis to academic rigour, managerial relevance and the triangulation of research methods is vital if these ends are to be achieved. They…

Meteorological determinants of air quality

NASA Astrophysics Data System (ADS)

Turoldo, F.; Del Frate, S.; Gallai, I.; Giaiotti, D. B.; Montanari, F.; Stel, F.; Goi, D.

2010-09-01

Air quality is the result of complex phenomena, among which the major role is played by human emissions of pollutants. Atmospheric processes act as determinants, e.g., modulating, dumping or amplifying the effects of emissions as an orchestra's director does with musical instruments. In this work, a series of small-scale and meso-scale meteorological determinants of air-quality are presented as they are observed in an area characterized by complex orography (Friuli Venezia Giulia, in the north-eastern side of Italy). In particular, attention is devoted to: i) meso-scale flows favouring the persistence of high concentrations of particulate matter; ii) meso-scale periodic flows (breezes) favouring high values of particulate matter; iii) local-scale thermodynamic behaviour favouring high atmospheric values of nitrogen oxides. The effects of these different classes of determinants are shown through comparisons between anthropic emissions (mainly traffic) and ground-based measurements. The relevance of complex orography (relatively steep relieves near to the sea) is shown for the meso-scale flows and, in particular, for local-scale periodic flows, which favour the increase of high pollutants concentrations mainly in summer, when the breezes regime is particularly relevant. Part of these results have been achieved through the ETS - Alpine Space EU project iMONITRAF!

Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews.

PubMed

Andersen, Johan H; Fallentin, Nils; Thomsen, Jane F; Mikkelsen, Sigurd

2011-05-12

To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.

For the General Internist: A Summary of Key Innovations in Medical Education.

PubMed

Roy, Brita; Chheda, Shobhina G; Bates, Carol; Dunn, Kathel; Karani, Reena; Willett, Lisa L

2016-08-01

We conducted a review of published medical education articles to identify high-quality research and innovation relevant to educators in general medicine. Our review team consisted of six general internists with expertise in medical education and a professional medical librarian. We manually searched 15 journals in pairs (a total of 3062 citations) for original research articles in medical education published in 2014. Each pair of reviewers independently rated the relevance, importance, and generalizability of articles on medical education in their assigned journals using a 27-point scale (maximum of 9 points for each characteristic). From this list, each team member independently reviewed the 22 articles that received a score of 20 or higher from both initial reviewers, and for each selected article rated the quality and global relevance for the generalist educator. We included the seven top-rated articles for presentation in this review, and categorized the studies into four general themes: continuity clinic scheduling, remediation, interprofessional education, and quality improvement and patient safety. We summarized key findings and identified significant limitations of each study. Further studies assessing patient outcomes are needed to strengthen the literature in medical education. This summary of relevant medical education articles can inform future research, teaching, and practice.

Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group.

PubMed

Heymans, M W; van Tulder, M W; Esmail, R; Bombardier, C; Koes, B W

2005-10-01

A systematic review within the Cochrane Collaboration Back Review Group. To assess the effectiveness of back schools for patients with nonspecific low back pain (LBP). Since the introduction of the Swedish back school in 1969, back schools have frequently been used for treating patients with LBP. However, the content of back schools has changed and appears to vary widely today. We searched the MEDLINE and EMBASE databases and the Cochrane Central Register of Controlled Trials to November 2004 for relevant trials reported in English, Dutch, French, or German. We also screened references from relevant reviews and included trials. Randomized controlled trials that reported on any type of back school for nonspecific LBP were included. Four reviewers, blinded to authors, institution, and journal, independently extracted the data and assessed the quality of the trials. We set the high-quality level, a priori, at a trial meeting six or more of 11 internal validity criteria. Because data were clinically and statistically too heterogeneous to perform a meta-analysis, we used a qualitative review (best evidence synthesis) to summarize the results. The evidence was classified into four levels (strong, moderate, limited, or no evidence), taking into account the methodologic quality of the studies. We also evaluated the clinical relevance of the studies. Nineteen randomized controlled trials (3,584 patients) were included in this updated review. Overall, the methodologic quality was low, with only six trials considered to be high-quality. It was not possible to perform relevant subgroup analyses for LBP with radiation versus LBP without radiation. The results indicate that there is moderate evidence suggesting that back schools have better short- and intermediate-term effects on pain and functional status than other treatments for patients with recurrent and chronic LBP. There is moderate evidence suggesting that back schools for chronic LBP in an occupational setting are more effective than other treatments and placebo or waiting list controls on pain, functional status, and return to work during short- and intermediate-term follow-up. In general, the clinical relevance of the studies was rated as insufficient. There is moderate evidence suggesting that back schools, in an occupational setting, reduce pain and improve function and return-to-work status, in the short- and intermediate-term, compared with exercises, manipulation, myofascial therapy, advice, placebo, or waiting list controls, for patients with chronic and recurrent LBP. However, future trials should improve methodologic quality and clinical relevance and evaluate the cost-effectiveness of back schools.

[The German DRG system 2003-2010 from the perspective of intensive care medicine].

PubMed

Franz, Dominik; Bunzemeier, Holger; Roeder, Norbert; Reinecke, Holger

2010-01-01

Intensive care medicine is extremely heterogeneous, expensive and can only be partially planned and controlled. A correct and fair representation of intensive care medicine in the G-DRG system is an essential requirement for the use as a pricing system. From the perspective of intensive care medicine, pertinent changes of the DRG structure and differentiation of relevant parameters have been established within the G-DRG systems 2003-2010. Analysis of relevant diagnoses, medical procedures, co-payment structures and G-DRGs in the versions 2003-2010 based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Since the first G-DRG system version 2003, numerous measures improved quality of case allocation of intensive care medicine. Highly relevant to the system version 2010 are duration of mechanical ventilation, the intensive care treatment complex and complicating constellations. The number of G-DRGs relevant to intensive medical care increased from n = 3 (2003) to n = 58 (2010). For standard cases, quality of case allocation and G-DRG reimbursement are adequate in 2010. The G-DRG system gained complexity again. High demands are made on correct and complete coding of complex cases. Nevertheless, further adjustments of the G-DRG system especially for cases with extremely high costs are necessary. Where the G-DRG system is unable to cover extremely high-cost cases, reimbursement solutions beyond the G-DRG structure should be taken into account.

Creating the Future of Evidence-Based Nutrition Recommendations: Case Studies from Lipid Research123

PubMed Central

Dwyer, Johanna T; Rubin, Kristin H; Psota, Tricia L; Liska, DeAnn J; Montain, Scott J

2016-01-01

Strategic translational research is designed to address research gaps that answer specific guidance questions. It provides translational value with respect to nutrition guidance and regulatory and public policy. The relevance and the quality of evidence both matter in translational research. For example, design decisions regarding population, intervention, comparator, and outcome criteria affect whether or not high-quality studies are considered relevant to specific guidance questions and are therefore included as evidence within the context of systematic review frameworks used by authoritative food and health organizations. The process used in systematic reviews, developed by the USDA for its Nutrition Evidence Library, is described. An eating pattern and cardiovascular disease (CVD) evidence review is provided as an example, and factors that differentiated the studies considered relevant and included in that evidence base from those that were excluded are noted. Case studies on ω-3 (n–3) fatty acids (FAs) and industrial trans-FAs illustrate key factors vital to relevance and translational impact, including choice of a relevant population (e.g., healthy, at risk, or diseased subjects; general population or high-performance soldiers); dose and form of the intervention (e.g., food or supplement); use of relevant comparators (e.g., technically feasible and realistic); and measures for both exposure and outcomes (e.g., inflammatory markers or CVD endpoints). Specific recommendations are provided to help increase the impact of nutrition research on future dietary guidance, policy, and regulatory issues, particularly in the area of lipids. PMID:27422509

Evaluation of United States Department of Agriculture-sponsored consumer materials addressing food security.

PubMed

Tolma, Eleni; John, Robert; Garner, Jane

2007-01-01

Food insecurity in the United States is a major public health issue. The main objective of this study was to evaluate the availability and quality of printed materials addressing food security targeted to special populations by the United States Department of Agriculture (USDA). Nutrition education resources addressing food security available from USDA websites were selected for analysis. Not applicable. The review team consisted of project staff (n = 6), two of who were fluent in Spanish. Selection criteria were established to identify the food-security materials, and a group of reviewers assessed the quality of each publication both quantitatively and qualitatively. A consensus meeting among the reviewers was held to make final determinations of the quality of the materials. The quantitative data analysis consisted of basic descriptive statistics. Among the 27 materials initially identified, 20 were either irrelevant or of low relevance to food security. Moreover, very few of them were intended for minority populations. The quality of most of the materials ranged from "average" to "good." Some of the major weaknesses include readability level, lack of cultural relevance, and inadequate coverage of food insecurity. Very few materials on food insecurity are of high quality. In the development of such materials, emphasis should be given to the readability level, content, and cultural relevance.

Product quality as the main factor of increase of competitiveness (on the example of JSC “Kazan helicopter plant”)

NASA Astrophysics Data System (ADS)

Khafizov, I. I.; Nurullin, I. G.

2017-09-01

Planning for effective development, and timely research perspectives and opportunities, States, markets, regulations, competition and competitiveness of its production, helps to achieve the stable business success in the market. The relevance of the study of the production of high quality products is that the quality of goods and services should always comply with the requirements established in state regulations, standards, regulations or conditions.

Medical literature searches: a comparison of PubMed and Google Scholar.

PubMed

Nourbakhsh, Eva; Nugent, Rebecca; Wang, Helen; Cevik, Cihan; Nugent, Kenneth

2012-09-01

Medical literature searches provide critical information for clinicians. However, the best strategy for identifying relevant high-quality literature is unknown. We compared search results using PubMed and Google Scholar on four clinical questions and analysed these results with respect to article relevance and quality. Abstracts from the first 20 citations for each search were classified into three relevance categories. We used the weighted kappa statistic to analyse reviewer agreement and nonparametric rank tests to compare the number of citations for each article and the corresponding journals' impact factors. Reviewers ranked 67.6% of PubMed articles and 80% of Google Scholar articles as at least possibly relevant (P = 0.116) with high agreement (all kappa P-values < 0.01). Google Scholar articles had a higher median number of citations (34 vs. 1.5, P < 0.0001) and came from higher impact factor journals (5.17 vs. 3.55, P = 0.036). PubMed searches and Google Scholar searches often identify different articles. In this study, Google Scholar articles were more likely to be classified as relevant, had higher numbers of citations and were published in higher impact factor journals. The identification of frequently cited articles using Google Scholar for searches probably has value for initial literature searches. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

EPAs DSSTox Chemical Database: A Resource for the Non-Targeted Testing Community (EPA NTA workshop)

EPA Science Inventory

EPA’s DSSTox database project, which includes coverage of the ToxCast and Tox21 high-throughput testing inventories, provides high-quality chemical-structure files for inventories of toxicological and environmental relevance. A feature of the DSSTox project, which differentiates ...

The relationship between ground conditions and injury: what level of evidence do we have?

PubMed

Petrass, Lauren A; Twomey, Dara M

2013-03-01

To identify studies which address the relationship between ground conditions and injury, in a sporting context and to evaluate current practice and provide recommendations for future studies that measure ground conditions and injury risk. Systematic review. A comprehensive search of electronic databases from the earliest records available until the end of 2011, and supplemental hand searching was conducted to identify relevant studies. A classification scale was used to rate the methodological quality of studies. 79 potentially relevant articles were identified, and 27 met all inclusion criteria. They varied in methodological quality, with analytical observational studies the most common design, although four descriptive observational studies, considered to be of lower quality were also identified. Only five studies objectively measured ground conditions, and of studies that used subjective assessment, only one provided descriptors to explain their classifications. It appears that harder/drier grounds are associated with an increased injury risk but the presence of major limitations necessitates cautious interpretation of many key findings. There is limited high quality evidence of the relationship between injury risk and ground conditions. Further research with high quality designs, and measurement of ground conditions are required to draw more definitive conclusions regarding this relationship. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Enriching science, practice, and policy relevant to school psychology around the globe.

PubMed

Jimerson, Shane R

2016-03-01

This editorial provides a brief synthesis of the past, present, and future of School Psychology Quarterly, highlighting important contributions as an international resource to enrich, invigorate, enhance, and advance science, practice, and policy relevant to school psychology around the globe. Information herein highlights (a) the value of high quality and timely reviews, (b) publishing manuscripts that address a breadth of important topics relevant to school psychology, and (c) the structure and contributions of the special topic sections featured in School Psychology Quarterly. (c) 2016 APA, all rights reserved).

Enhancing science, practice, and policy relevant to school psychology around the world.

PubMed

Jimerson, Shane R

2014-03-01

This editorial provides a brief update related to the present and future of School Psychology Quarterly as an international resource to enhance and advance science, practice, and policy relevant to school psychology around the world. Information is presented regarding; (a) the breadth of important topics relevant to school psychology, (b) the international contributions, (c) the value of high quality and timely reviews, (d) the structure of and opportunity to contribute to special topic sections of School Psychology Quarterly, and (e) the importance of an international emphasis on children's rights and the relevance for school psychology. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Information bias in contingent valuation: effects of personal relevance, quality of information, and motivational orientation

Treesearch

Icek Ajzen; Thomas C. Brown; Lori H. Rosenthal

1996-01-01

A laboratory experiment examined the potential for information bias in contingent valuation (CV). Consistent with the view that information about a public or private good can function as a persuasive communication, willingness to pay (WTP) was found to increase with the quality of arguments used to describe the good, especially under conditions of high personal...

A Study of Flame Physics and Solid Propellant Rocket Physics

DTIC Science & Technology

2007-10-01

and ellipsoids, and the packing of pellets relevant to igniter modeling. Other topics are the instabilities of smolder waves, premixed flame...instabilities in narrow tubes, and flames supported by a spinning porous plug burner . Much of this work has been reported in the high-quality archival...perchlorate in fuel binder, the combustion of model propellant packs of ellipses and ellipsoids, and the packing of pellets relevant to igniter modeling

Thermal, High Pressure, and Electric Field Processing Effects on Plant Cell Membrane Integrity and Relevance to Fruit and Vegetable Quality

PubMed Central

Gonzalez, Maria E; Barrett, Diane M

2010-01-01

Advanced food processing methods that accomplish inactivation of microorganisms but minimize adverse thermal exposure are of great interest to the food industry. High pressure (HP) and pulsed electric field (PEF) processing are commercially applied to produce high quality fruit and vegetable products in the United States, Europe, and Japan. Both microbial and plant cell membranes are significantly altered following exposure to heat, HP, or PEF. Our research group sought to quantify the degree of damage to plant cell membranes that occurs as a result of exposure to heat, HP, or PEF, using the same analytical methods. In order to evaluate whether new advanced processing methods are superior to traditional thermal processing methods, it is necessary to compare them. In this review, we describe the existing state of knowledge related to effects of heat, HP, and PEF on both microbial and plant cells. The importance and relevance of compartmentalization in plant cells as it relates to fruit and vegetable quality is described and various methods for quantification of plant cell membrane integrity are discussed. These include electrolyte leakage, cell viability, and proton nuclear magnetic resonance (1H-NMR). PMID:20492210

Thermal, high pressure, and electric field processing effects on plant cell membrane integrity and relevance to fruit and vegetable quality.

PubMed

Gonzalez, Maria E; Barrett, Diane M

2010-09-01

Advanced food processing methods that accomplish inactivation of microorganisms but minimize adverse thermal exposure are of great interest to the food industry. High pressure (HP) and pulsed electric field (PEF) processing are commercially applied to produce high quality fruit and vegetable products in the United States, Europe, and Japan. Both microbial and plant cell membranes are significantly altered following exposure to heat, HP, or PEF. Our research group sought to quantify the degree of damage to plant cell membranes that occurs as a result of exposure to heat, HP, or PEF, using the same analytical methods. In order to evaluate whether new advanced processing methods are superior to traditional thermal processing methods, it is necessary to compare them. In this review, we describe the existing state of knowledge related to effects of heat, HP, and PEF on both microbial and plant cells. The importance and relevance of compartmentalization in plant cells as it relates to fruit and vegetable quality is described and various methods for quantification of plant cell membrane integrity are discussed. These include electrolyte leakage, cell viability, and proton nuclear magnetic resonance (¹H-NMR).

An experimental search strategy retrieves more precise results than PubMed and Google for questions about medical interventions

PubMed Central

Dylla, Daniel P.; Megison, Susan D.

2015-01-01

Objective. We compared the precision of a search strategy designed specifically to retrieve randomized controlled trials (RCTs) and systematic reviews of RCTs with search strategies designed for broader purposes. Methods. We designed an experimental search strategy that automatically revised searches up to five times by using increasingly restrictive queries as long at least 50 citations were retrieved. We compared the ability of the experimental and alternative strategies to retrieve studies relevant to 312 test questions. The primary outcome, search precision, was defined for each strategy as the proportion of relevant, high quality citations among the first 50 citations retrieved. Results. The experimental strategy had the highest median precision (5.5%; interquartile range [IQR]: 0%–12%) followed by the narrow strategy of the PubMed Clinical Queries (4.0%; IQR: 0%–10%). The experimental strategy found the most high quality citations (median 2; IQR: 0–6) and was the strategy most likely to find at least one high quality citation (73% of searches; 95% confidence interval 68%–78%). All comparisons were statistically significant. Conclusions. The experimental strategy performed the best in all outcomes although all strategies had low precision. PMID:25922798

Successful Magnet High Schools. Innovations in Education

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

Lack of relevant course work is a top reason why high school students drop out, and studies have shown that low-income and minority students are less likely to be enrolled in college preparatory curricula than their more affluent peers. In today's world, it is critical to ensure that all students have access to a rigorous, high-quality education…

What is a good life? Selecting capabilities to assess women's quality of life in rural Malawi.

PubMed

Greco, Giulia; Skordis-Worrall, Jolene; Mkandawire, Bryan; Mills, Anne

2015-04-01

There is growing interest in using Sen's Capability Approach to assess quality of life and to evaluate social policies. This paper describes the formative stages of developing a quality of life measure: the selection of the relevant capabilities. This measure is intended to provide a more comprehensive outcome measure for the evaluation of complex interventions such as Maimwana womens' groups, a community based participatory intervention to improve maternal health in rural Malawi. Fifteen focus group discussions with 129 women were conducted to explore relevant concepts of quality of life in rural Malawi. Data collection started in October 2009. Findings were elicited based on framework analysis. The findings portray a complex and highly nuanced perception that women in rural Malawi have of their life and wellbeing. Quality of life was described using a variety of dimensions that are highly interconnected. Quality of life emerges to be not only shaped by the realisation of basic material needs such as being sufficiently nourished and adequately sheltered, but is also highly dependent on complex feelings, relations and social norms. The full exposition of wellbeing with its domains was organised into a framework constituting six different spheres of wellbeing: physical strength, inner wellbeing, household wellbeing, community relations, economic security and happiness. Despite the list being developed in a specific context and for a specific group of people, the similarities with lists developed in other contexts, with different methods and for different purposes, are considerable. This suggests that there are a number of core aspects of wellbeing considered a minimum requirement for a life of human dignity, that should be included in any attempt to assess quality of life and human development across populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Retrieval of diagnostic and treatment studies for clinical use through PubMed and PubMed's Clinical Queries filters.

PubMed

Lokker, Cynthia; Haynes, R Brian; Wilczynski, Nancy L; McKibbon, K Ann; Walter, Stephen D

2011-01-01

Clinical Queries filters were developed to improve the retrieval of high-quality studies in searches on clinical matters. The study objective was to determine the yield of relevant citations and physician satisfaction while searching for diagnostic and treatment studies using the Clinical Queries page of PubMed compared with searching PubMed without these filters. Forty practicing physicians, presented with standardized treatment and diagnosis questions and one question of their choosing, entered search terms which were processed in a random, blinded fashion through PubMed alone and PubMed Clinical Queries. Participants rated search retrievals for applicability to the question at hand and satisfaction. For treatment, the primary outcome of retrieval of relevant articles was not significantly different between the groups, but a higher proportion of articles from the Clinical Queries searches met methodologic criteria (p=0.049), and more articles were published in core internal medicine journals (p=0.056). For diagnosis, the filtered results returned more relevant articles (p=0.031) and fewer irrelevant articles (overall retrieval less, p=0.023); participants needed to screen fewer articles before arriving at the first relevant citation (p<0.05). Relevance was also influenced by content terms used by participants in searching. Participants varied greatly in their search performance. Clinical Queries filtered searches returned more high-quality studies, though the retrieval of relevant articles was only statistically different between the groups for diagnosis questions. Retrieving clinically important research studies from Medline is a challenging task for physicians. Methodological search filters can improve search retrieval.

[The significance of meat quality in marketing].

PubMed

Kallweit, E

1994-07-01

Food quality in general and meat quality in particular are not only evaluated by means of objective quality traits but the entire production process is gaining more attention by the modern consumer. Due to this development quality programs were developed to define the majority of the processes in all production and marketing steps which are again linked by contracts. Not all of these items are quality relevant, but are concessions to ethic principles (animal welfare etc.). This is demonstrated by the example of Scharrel-pork production. The price differentiation at the pork market is still influenced predominantly by quantitative carcass traits. On the European market quality programs still are of minor significance. Premiums which are paid for high quality standards are more or less compensated by higher production costs and lower lean meat percentages, which must be expected in stress susceptible strains. The high efforts to establish quality programs, however, help to improve the quality level in general, and secure the market shares for local producers.

What do evidence-based secondary journals tell us about the publication of clinically important articles in primary healthcare journals?

PubMed Central

McKibbon, Kathleen Ann; Wilczynski, Nancy L; Haynes, Robert Brian

2004-01-01

Background We conducted this analysis to determine i) which journals publish high-quality, clinically relevant studies in internal medicine, general/family practice, general practice nursing, and mental health; and ii) the proportion of clinically relevant articles in each journal. Methods We performed an analytic survey of a hand search of 170 general medicine, general healthcare, and specialty journals for 2000. Research staff assessed individual articles by using explicit criteria for scientific merit for healthcare application. Practitioners assessed the clinical importance of these articles. Outcome measures were the number of high-quality, clinically relevant studies published in the 170 journal titles and how many of these were published in each of four discipline-specific, secondary "evidence-based" journals (ACP Journal Club for internal medicine and its subspecialties; Evidence-Based Medicine for general/family practice; Evidence-Based Nursing for general practice nursing; and Evidence-Based Mental Health for all aspects of mental health). Original studies and review articles were classified for purpose: therapy and prevention, screening and diagnosis, prognosis, etiology and harm, economics and cost, clinical prediction guides, and qualitative studies. Results We evaluated 60,352 articles from 170 journal titles. The pass criteria of high-quality methods and clinically relevant material were met by 3059 original articles and 1073 review articles. For ACP Journal Club (internal medicine), four titles supplied 56.5% of the articles and 27 titles supplied the other 43.5%. For Evidence-Based Medicine (general/family practice), five titles supplied 50.7% of the articles and 40 titles supplied the remaining 49.3%. For Evidence-Based Nursing (general practice nursing), seven titles supplied 51.0% of the articles and 34 additional titles supplied 49.0%. For Evidence-Based Mental Health (mental health), nine titles supplied 53.2% of the articles and 34 additional titles supplied 46.8%. For the disciplines of internal medicine, general/family practice, and mental health (but not general practice nursing), the number of clinically important articles was correlated withScience Citation Index (SCI) Impact Factors. Conclusions Although many clinical journals publish high-quality, clinically relevant and important original studies and systematic reviews, the articles for each discipline studied were concentrated in a small subset of journals. This subset varied according to healthcare discipline; however, many of the important articles for all disciplines in this study were published in broad-based healthcare journals rather than subspecialty or discipline-specific journals. PMID:15350200

Development of a web-based toolkit to support improvement of care coordination in primary care.

PubMed

Ganz, David A; Barnard, Jenny M; Smith, Nina Z Y; Miake-Lye, Isomi M; Delevan, Deborah M; Simon, Alissa; Rose, Danielle E; Stockdale, Susan E; Chang, Evelyn T; Noël, Polly H; Finley, Erin P; Lee, Martin L; Zulman, Donna M; Cordasco, Kristina M; Rubenstein, Lisa V

2018-05-23

Promising practices for the coordination of chronic care exist, but how to select and share these practices to support quality improvement within a healthcare system is uncertain. This study describes an approach for selecting high-quality tools for an online care coordination toolkit to be used in Veterans Health Administration (VA) primary care practices. We evaluated tools in three steps: (1) an initial screening to identify tools relevant to care coordination in VA primary care, (2) a two-clinician expert review process assessing tool characteristics (e.g. frequency of problem addressed, linkage to patients' experience of care, effect on practice workflow, and sustainability with existing resources) and assigning each tool a summary rating, and (3) semi-structured interviews with VA patients and frontline clinicians and staff. Of 300 potentially relevant tools identified by searching online resources, 65, 38, and 18 remained after steps one, two and three, respectively. The 18 tools cover five topics: managing referrals to specialty care, medication management, patient after-visit summary, patient activation materials, agenda setting, patient pre-visit packet, and provider contact information for patients. The final toolkit provides access to the 18 tools, as well as detailed information about tools' expected benefits, and resources required for tool implementation. Future care coordination efforts can benefit from systematically reviewing available tools to identify those that are high quality and relevant.

Strategic Agility: Using the Expeditionary Aerospace Force as a Framework for Assuring Strategic Relevancy in the USAF

DTIC Science & Technology

2014-06-01

increases quality of life , which, in turn, leads to better retention metrics; better retention metrics translate into higher experience levels...the quality of life for Airmen, particularly two-parent military families assigned to different AEFs.46 Cognizant of an already high operations...a desire to achieve the highest quality of life for Airmen. Ryan settled on a 1:4 AEF dwell ratio to ensure Airmen were not away from home- station

A Text-Mining Framework for Supporting Systematic Reviews.

PubMed

Li, Dingcheng; Wang, Zhen; Wang, Liwei; Sohn, Sunghwan; Shen, Feichen; Murad, Mohammad Hassan; Liu, Hongfang

2016-11-01

Systematic reviews (SRs) involve the identification, appraisal, and synthesis of all relevant studies for focused questions in a structured reproducible manner. High-quality SRs follow strict procedures and require significant resources and time. We investigated advanced text-mining approaches to reduce the burden associated with abstract screening in SRs and provide high-level information summary. A text-mining SR supporting framework consisting of three self-defined semantics-based ranking metrics was proposed, including keyword relevance, indexed-term relevance and topic relevance. Keyword relevance is based on the user-defined keyword list used in the search strategy. Indexed-term relevance is derived from indexed vocabulary developed by domain experts used for indexing journal articles and books. Topic relevance is defined as the semantic similarity among retrieved abstracts in terms of topics generated by latent Dirichlet allocation, a Bayesian-based model for discovering topics. We tested the proposed framework using three published SRs addressing a variety of topics (Mass Media Interventions, Rectal Cancer and Influenza Vaccine). The results showed that when 91.8%, 85.7%, and 49.3% of the abstract screening labor was saved, the recalls were as high as 100% for the three cases; respectively. Relevant studies identified manually showed strong topic similarity through topic analysis, which supported the inclusion of topic analysis as relevance metric. It was demonstrated that advanced text mining approaches can significantly reduce the abstract screening labor of SRs and provide an informative summary of relevant studies.

Steps Toward Innovative Childbirth Education: Selected Strategies From the Blueprint for Action

PubMed Central

Jolivet, R. Rima; Corry, Maureen P.

2010-01-01

To mark the 50th anniversary of Lamaze International, Childbirth Connection celebrates landmark accomplishments in education for childbearing women and families, and takes stock of the changing educational needs and preferences of current childbearing families in looking toward the future. Childbirth Connection's multi-year, multi-stakeholder Transforming Maternity Care initiative resulted in two landmark reports: 2020 Vision for a High-Quality, High-Value Maternity Care System and Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System. Selected recommendations of greatest relevance to the field of childbirth education are discussed, and the new Transforming Maternity Care Partnership is introduced. PMID:21629389

Social Anxiety and Friendship Quality over Time.

PubMed

Rodebaugh, Thomas L; Lim, Michelle H; Shumaker, Erik A; Levinson, Cheri A; Thompson, Tess

2015-01-01

High social anxiety in adults is associated with self-report of impaired friendship quality, but not necessarily with impairment reported by friends. Further, prospective prediction of social anxiety and friendship quality over time has not been tested among adults. We therefore examined friendship quality and social anxiety prospectively in 126 young adults (67 primary participants and 59 friends, aged 17-22 years); the primary participants were screened to be extreme groups to increase power and relevance to clinical samples (i.e., they were recruited based on having very high or very low social interaction anxiety). The prospective relationships between friendship quality and social anxiety were then tested using an Actor-Partner Interdependence Model. Friendship quality prospectively predicted social anxiety over time within each individual in the friendship, such that higher friendship quality at Time 1 predicted lower social anxiety approximately 6 months later at Time 2. Social anxiety did not predict friendship quality. Although the results support the view that social anxiety and friendship quality have an important causal relationship, the results run counter to the assumption that high social anxiety causes poor friendship quality. Interventions to increase friendship quality merit further consideration.

Richardson-Lucy deconvolution as a general tool for combining images with complementary strengths.

PubMed

Ingaramo, Maria; York, Andrew G; Hoogendoorn, Eelco; Postma, Marten; Shroff, Hari; Patterson, George H

2014-03-17

We use Richardson-Lucy (RL) deconvolution to combine multiple images of a simulated object into a single image in the context of modern fluorescence microscopy techniques. RL deconvolution can merge images with very different point-spread functions, such as in multiview light-sheet microscopes,1, 2 while preserving the best resolution information present in each image. We show that RL deconvolution is also easily applied to merge high-resolution, high-noise images with low-resolution, low-noise images, relevant when complementing conventional microscopy with localization microscopy. We also use RL deconvolution to merge images produced by different simulated illumination patterns, relevant to structured illumination microscopy (SIM)3, 4 and image scanning microscopy (ISM). The quality of our ISM reconstructions is at least as good as reconstructions using standard inversion algorithms for ISM data, but our method follows a simpler recipe that requires no mathematical insight. Finally, we apply RL deconvolution to merge a series of ten images with varying signal and resolution levels. This combination is relevant to gated stimulated-emission depletion (STED) microscopy, and shows that merges of high-quality images are possible even in cases for which a non-iterative inversion algorithm is unknown. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

An Investigation of Factors Related to Teachers' Organizational Commitment in Rural High Schools

ERIC Educational Resources Information Center

Walker, Victoria LaShawn

2013-01-01

Relevant literature indicates that teachers who are not committed to their organization do not perform, do not provide a quality education for their students, and do not remain members of the organization; thus, making staffing, retaining, and maintaining highly qualified teachers problematic for rural schools. Limited research has been conducted…

Curated Collections for Educators: Five Key Papers on Evaluating Digital Scholarship.

PubMed

Quinn, Antonia; Chan, Teresa M; Sampson, Christopher; Grossman, Catherine; Butts, Christine; Casey, John; Caretta-Weyer, Holly; Gottlieb, Michael

2018-01-03

Traditionally, scholarship that was recognized for promotion and tenure consisted of clinical research, bench research, and grant funding. Recent trends have allowed for differing approaches to scholarship, including digital publication. As increasing numbers of trainees and faculty turn to online educational resources, it is imperative to critically evaluate these resources. This article summarizes five key papers that address the appraisal of digital scholarship and describes their relevance to junior clinician educators and faculty developers. In May 2017, the Academic Life in Emergency Medicine Faculty Incubator program focused on the topic of digital scholarship, providing and discussing papers relevant to the topic. We augmented this list of papers with further suggestions by guest experts and by an open call via Twitter for other important papers. Through this process, we created a list of 38 papers in total on the topic of evaluating digital scholarship. In order to determine which of these papers best describe how to evaluate digital scholarship, the authorship group assessed the papers using a modified Delphi approach to build consensus. In this paper we present the five most highly rated papers from our process about evaluating digital scholarship. We summarize each paper and discuss its specific relevance to junior faculty members and to faculty developers. These papers provide a framework for assessing the quality of digital scholarship, so that junior faculty can recommend high-quality educational resources to their trainees. These papers help guide educators on how to produce high quality digital scholarship and maximize recognition and credit in respect to receiving promotion and tenure.

Curated Collections for Educators: Five Key Papers on Evaluating Digital Scholarship

PubMed Central

Chan, Teresa M; Sampson, Christopher; Grossman, Catherine; Butts, Christine; Casey, John; Caretta-Weyer, Holly; Gottlieb, Michael

2018-01-01

Traditionally, scholarship that was recognized for promotion and tenure consisted of clinical research, bench research, and grant funding. Recent trends have allowed for differing approaches to scholarship, including digital publication. As increasing numbers of trainees and faculty turn to online educational resources, it is imperative to critically evaluate these resources. This article summarizes five key papers that address the appraisal of digital scholarship and describes their relevance to junior clinician educators and faculty developers. In May 2017, the Academic Life in Emergency Medicine Faculty Incubator program focused on the topic of digital scholarship, providing and discussing papers relevant to the topic. We augmented this list of papers with further suggestions by guest experts and by an open call via Twitter for other important papers. Through this process, we created a list of 38 papers in total on the topic of evaluating digital scholarship. In order to determine which of these papers best describe how to evaluate digital scholarship, the authorship group assessed the papers using a modified Delphi approach to build consensus. In this paper we present the five most highly rated papers from our process about evaluating digital scholarship. We summarize each paper and discuss its specific relevance to junior faculty members and to faculty developers. These papers provide a framework for assessing the quality of digital scholarship, so that junior faculty can recommend high-quality educational resources to their trainees. These papers help guide educators on how to produce high quality digital scholarship and maximize recognition and credit in respect to receiving promotion and tenure. PMID:29531874

Risk Factors for Neck and Upper Extremity Disorders among Computers Users and the Effect of Interventions: An Overview of Systematic Reviews

PubMed Central

Andersen, Johan H.; Fallentin, Nils; Thomsen, Jane F.; Mikkelsen, Sigurd

2011-01-01

Background To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. Methodology/Principal Findings PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Conclusions/Significance Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented. PMID:21589875

Quantity and Quality of Economic Evaluations in U.S. Nursing Research, 1997-2015: A Systematic Review.

PubMed

Cook, Wendy A; Morrison, Megan L; Eaton, Linda H; Theodore, Brian R; Doorenbos, Ardith Z

The United States has a complex healthcare system that is undergoing substantial reformations. There is a need for high-quality, economic evaluations of nursing practice. An updated review of completed economic evaluations relevant to the field of nursing within the U.S. healthcare system is timely and needed. The purpose of this study was to evaluate and describe the quantity and quality of economic evaluations in nursing-relevant research performed in the United States between 1997 and 2015. Four databases were searched. Titles, abstracts, and full-text content were reviewed to identify studies that analyzed both costs and outcomes, relevant to nursing, performed in the United States, and used the quality-adjusted life year to measure effectiveness. For included studies, data were extracted from full-text articles using criteria from U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine. Twenty-eight studies met the inclusion criteria. Most (n = 25, 89%) were published in the last decade of the analysis, from 2006 to 2015. Assessment of quality, based on selected items from the panel guidelines, found that the evaluations did not consistently use the recommended societal perspective, use multiple resource utilization categories, use constant dollars, discount future costs and outcomes, use a lifetime horizon, or include an indication of uncertainty in results. The only resource utilization category consistently included across studies was healthcare resources. Only 28 nursing-related studies meeting the inclusion criteria were identified as meeting robust health economic evaluation methodological criteria, and most did not include all important guideline items. Despite increases in absolute numbers of published studies over the past decade, economic evaluation has been underutilized in U.S. nursing-relevant research in the past two decades.

The influence of organic production on food quality - research findings, gaps and future challenges.

PubMed

Załęcka, Aneta; Bügel, Susanne; Paoletti, Flavio; Kahl, Johannes; Bonanno, Adriana; Dostalova, Anne; Rahmann, Gerold

2014-10-01

Although several meta-analysis studies have been published comparing the quality of food derived from organic and non-organic origin, it is still not clear if food from organic production per se can guarantee product-related added value to consumers. This paper aims to summarize the status quo in order to identify research gaps and suggest future research challenges. Organic food is described according to a quality model already published. The influence of organic production on food quality is structured in primary production and processing. Furthermore, organic food authentication is discussed. Organic food seems to contain fewer pesticide residues and statistically more selected health-related compounds such as polyphenols in plant products and polyunsaturated fatty acids in milk and meat products, but the health relevance for consumers is not clear yet. Comparing food from organic origin with so called 'conventional' food seems not to be appropriate, because 'conventional' is not defined. In organic food quality research a system approach is needed from which systemic markers can be selected. Research on the impact of processing technologies on the quality according to organic principles seems of high relevance, since most of the food is processed. © 2014 Society of Chemical Industry.

Quality Information--Informed Choices: Advancing the Workforce Information System. Secretary of Labor's Workforce Information System Plan for Federal Fiscal Years 2001-2005.

ERIC Educational Resources Information Center

Workforce Information Council (DOL), Washington, DC.

The Workforce Investment Act of 1998 emphasizes the importance of high quality, accessible, and relevant information about the labor market for making sound decisions. In order to help both workers and employers, as well as the government agencies that serve them, the Workforce Information System was created and is being improved. The action plan…

[Criteria for choice and purchase of gloves: quality or cheapness? The role of the Occupational Health Physician].

PubMed

Micheloni, G; Baruffini, Adriana

2008-01-01

The choice of gloves in the healthcare settings is very important because of the high biological and chemical risks present in these workplaces. In order to rationalize and optimize this choice we must balance cost, quality, security and comfort. The aim of this study was to analyse the rules in force and to point out the relevant role of the Occupational Health Physician in the right choice and purchase of sanitary gloves. We reviewed the rules in force and the most relevant studies on these topics. The regulations in force provide that the manufacturers must perform tests to supply evidence for the quality of the products but they do not indicate which analytical method should be used and they do not require that the results are reported in the technical sheets. Thus the manufacturers have only to declare to be "in accordance with the rules". Therefore purchasers should require the manufacturing companies to give detailed information and verify their reliability. Moreover rules could be adapted to higher quality standards. The Occupational Health Physician should suggest the purchase of gloves with high biocompatibility, assuring the protection from the risks of specific tasks and suitable for preventing the onset of new glove-related diseases and the relapses in workers with already diagnosed occupational diseases.

The development of an instrument for evaluating clinical teachers: involving stakeholders to determine content validity.

PubMed

Stalmeijer, Renée E; Dolmans, Diana H J M; Wolfhagen, Ineke H A P; Muijtjens, Arno M M; Scherpbier, Albert J J A

2008-01-01

Research indicates that the quality of supervision strongly influences the learning of medical students in clinical practice. Clinical teachers need feedback to improve their supervisory skills. The available instruments either lack a clear theoretical framework or are not suitable for providing feedback to individual teachers. We developed an evaluation instrument based on the 'cognitive apprenticeship model'. The aim was to estimate the content validity of the developed instrument. Item relevance was rated on a five-point scale (1 = highly irrelevant, 5 = highly relevant) by three groups of stakeholders in undergraduate clinical teaching: educationalists (N = 12), doctors (N = 16) and students (N = 12). Additionally, stakeholders commented on content, wording and omission of items. The items were generally rated as very relevant (Mean = 4.3, SD = 0.38, response = 95%) and any differences between the stakeholder groups were small. The results led to elimination of 4 items, rewording of 13 items and addition of 1 item. The cognitive apprenticeship model appears to offer a useful framework for the development of an evaluation instrument aimed at providing feedback to individual clinical teachers on the quality of student supervision. Further studies in larger populations will have to establish the instrument's statistical validity and generalizability.

Developing a long-term condition's information service in collaboration with third sector organisations.

PubMed

McShane, Lesley; Greenwell, Kate; Corbett, Sally; Walker, Richard

2014-06-01

People with long-term conditions need to be signposted to high quality information and advice to understand and manage their condition. Information seeking tools combined with third sector information could help address their information needs. To describe the development and implementation of an information service for people living with long-term conditions at one NHS acute trust in the Northeast of England. An information service was trialled using bespoke information models for three long-term conditions in collaboration with third sector organisations. These guided people to relevant, timely and reliable information. Both clinician and service user questionnaires were used to evaluate satisfaction with the service. Appropriately designed information models can be used interchangeably across all services. Between 75% and 91% of users agreed that they were satisfied with various aspects of the service. Generally, users received relevant, understandable and high quality information at the right time. Nearly all health professionals (94-100%) felt the service was accessible, provided high quality information and did not significantly impact on their consultation time. The developed information service was well received by service users and health professionals. Specifically, the use of information prescriptions and menus facilitated access to information for people with long-term conditions. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

Towards high-quality, useful practice guidelines for child and youth mental health disorders: protocol for a systematic review and consensus exercise

PubMed Central

Bennett, Kathryn; Duda, Stephanie; Brouwers, Melissa; Szatmari, Peter; Newton, Amanda; McLennan, John; Sundar, Purnima; Cleverley, Kristin; Charach, Alice; Courtney, Darren; Rice, Maureen

2018-01-01

Introduction The quality of clinical practice guidelines (PGs) has not been evaluated in child and youth mental health (CYMH). To address this gap, we will: (1) conduct a systematic review (SR) to answer the question ‘among eligible PGs relevant to the prevention or treatment of CYMH conditions, which PGs meet criteria for minimum and high quality?’; (2) apply nominal group methods to create recommendations for how CYMH PG quality, completeness and usefulness can be strengthened. Methods and analysis SR: Potentially eligible PGs will be identified in 12 databases using a reproducible search strategy developed by a research librarian. Trained raters will: (1) apply prespecified criteria to identify eligible PGs relevant to depression, anxiety, suicidality, bipolar disorder, behaviour disorder (attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder) and substance use disorder; (2) extract descriptive data and (3) assess PG quality using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Scores on three AGREE II domains (rigour of development, stakeholder involvement, editorial independence) will designate PGs as minimum (≥50%) or high quality (≥70%). Nominal group: Four CYMH PG knowledge user groups (clinicians, mental health service planners, youth and adult family members) will participate in structured exercises derived using nominal group methods to generate recommendations to improve PG quality, completeness and usefulness. Ethics and dissemination Ethics approval is not required. Study products will be disseminated as follows. A cross-platform website will house eligible CYMH PGs and their quality ratings. Twitter and Facebook tools will promote it to a wide variety of PG users. Data from Google Analytics, Twitonomy and Altmetrics will inform usage evaluation. Complementary educational workshops will be conducted for CYMH professionals. Print materials and journal articles will be produced. PROSPERO registration number CRD42017060738. PMID:29437752

Towards high-quality, useful practice guidelines for child and youth mental health disorders: protocol for a systematic review and consensus exercise.

PubMed

Bennett, Kathryn; Duda, Stephanie; Brouwers, Melissa; Szatmari, Peter; Newton, Amanda; McLennan, John; Sundar, Purnima; Cleverley, Kristin; Charach, Alice; Henderson, Joanna; Courtney, Darren; Rice, Maureen

2018-02-06

The quality of clinical practice guidelines (PGs) has not been evaluated in child and youth mental health (CYMH). To address this gap, we will: (1) conduct a systematic review (SR) to answer the question 'among eligible PGs relevant to the prevention or treatment of CYMH conditions, which PGs meet criteria for minimum and high quality?'; (2) apply nominal group methods to create recommendations for how CYMH PG quality, completeness and usefulness can be strengthened. SR: Potentially eligible PGs will be identified in 12 databases using a reproducible search strategy developed by a research librarian. Trained raters will: (1) apply prespecified criteria to identify eligible PGs relevant to depression, anxiety, suicidality, bipolar disorder, behaviour disorder (attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder) and substance use disorder; (2) extract descriptive data and (3) assess PG quality using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Scores on three AGREE II domains (rigour of development, stakeholder involvement, editorial independence) will designate PGs as minimum (≥50%) or high quality (≥70%). Nominal group: Four CYMH PG knowledge user groups (clinicians, mental health service planners, youth and adult family members) will participate in structured exercises derived using nominal group methods to generate recommendations to improve PG quality, completeness and usefulness. Ethics approval is not required. Study products will be disseminated as follows. A cross-platform website will house eligible CYMH PGs and their quality ratings. Twitter and Facebook tools will promote it to a wide variety of PG users. Data from Google Analytics, Twitonomy and Altmetrics will inform usage evaluation. Complementary educational workshops will be conducted for CYMH professionals. Print materials and journal articles will be produced. CRD42017060738. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A study on mastectomy samples to evaluate breast imaging quality and potential clinical relevance of differential phase contrast mammography.

PubMed

Hauser, Nik; Wang, Zhentian; Kubik-Huch, Rahel A; Trippel, Mafalda; Singer, Gad; Hohl, Michael K; Roessl, Ewald; Köhler, Thomas; van Stevendaal, Udo; Wieberneit, Nataly; Stampanoni, Marco

2014-03-01

Differential phase contrast and scattering-based x-ray mammography has the potential to provide additional and complementary clinically relevant information compared with absorption-based mammography. The purpose of our study was to provide a first statistical evaluation of the imaging capabilities of the new technique compared with digital absorption mammography. We investigated non-fixed mastectomy samples of 33 patients with invasive breast cancer, using grating-based differential phase contrast mammography (mammoDPC) with a conventional, low-brilliance x-ray tube. We simultaneously recorded absorption, differential phase contrast, and small-angle scattering signals that were combined into novel high-frequency-enhanced images with a dedicated image fusion algorithm. Six international, expert breast radiologists evaluated clinical digital and experimental mammograms in a 2-part blinded, prospective independent reader study. The results were statistically analyzed in terms of image quality and clinical relevance. The results of the comparison of mammoDPC with clinical digital mammography revealed the general quality of the images to be significantly superior (P < 0.001); sharpness, lesion delineation, as well as the general visibility of calcifications to be significantly more assessable (P < 0.001); and delineation of anatomic components of the specimens (surface structures) to be significantly sharper (P < 0.001). Spiculations were significantly better identified, and the overall clinically relevant information provided by mammoDPC was judged to be superior (P < 0.001). Our results demonstrate that complementary information provided by phase and scattering enhanced mammograms obtained with the mammoDPC approach deliver images of generally superior quality. This technique has the potential to improve radiological breast diagnostics.

Technology in Community-Based Organizations that Serve Older People: High Tech Meets High Touch

ERIC Educational Resources Information Center

Renold, Carl; Meronk, Cheryl; Kelly, Christopher

2005-01-01

Appropriate implementation of information technology (IT) can help create a more efficient, less costly, and higher-quality service-delivery environment for community-based organizations that serve older people. Relevant studies and reports on technology in healthcare can be compared and applied to these organizations. This study is the result of…

Health Information Retrieval Tool (HIRT)

PubMed Central

Nyun, Mra Thinzar; Ogunyemi, Omolola; Zeng, Qing

2002-01-01

The World Wide Web (WWW) is a powerful way to deliver on-line health information, but one major problem limits its value to consumers: content is highly distributed, while relevant and high quality information is often difficult to find. To address this issue, we experimented with an approach that utilizes three-dimensional anatomic models in conjunction with free-text search.

Apparent diffusion coefficient value of diffusion-weighted imaging for differential diagnosis of ductal carcinoma in situ and infiltrating ductal carcinoma.

PubMed

Ding, Jian-Rong; Wang, Dong-Nv; Pan, Jing-Li

2016-01-01

The present meta-analysis investigated the clinical value of apparent diffusion coefficient (ADC) values in diffusion-weighted imaging (DWI) for differential diagnosis of ductal carcinoma in situ (DCIS) and infiltrating ductal carcinoma (IDC). Electronic databases searches were employed to identify relevant scientific literature, and the search results were screened to selected high-quality studies for this meta-analysis. Methodological quality of the enrolled studies was evaluated by quality evaluation of diagnostic accuracy studies (QUADAS). Summary odds ratios (ORs) and its corresponding 95% confidence interval (95% CI) were calculated for DCIS versus IDC category of ADC value using Z test. Our meta-analysis contained a combined total of 1,097 subjects (928 patients with IDC and 169 patients with DCIS) from 9 relevant high-quality cohort studies. Pooled ORs demonstrated that ADC value in IDC patients was significantly lower than DCIS patients. Subgroup analysis stratified by ethnicity indicated a higher ADC value in DCIS patients compared to IDC, in Asian population, but not in Caucasians. Magnetic resonance imaging (MRI) machine type-stratified analysis revealed that the ADC value of DWI obtained from both non- General Electric Company (GE) 1.5T and GE 1.5T machines were highly reliable in the differential diagnosis of DCIS and IDC. Our meta-analysis provides evidence that ADC values in DWI accurately conveys the differences in tumor architecture between IDC and DCIS, which has high clinical value in differentiatal diagnosis of IDC and DCIS. This may lead to improved BC prediction and treatment.

An economic cost analysis of emergency department key performance indicators in Ireland.

PubMed

Gannon, Brenda; Jones, Cheryl; McCabe, Aileen; O'Sullivan, Ronan; Wakai, Abel

2017-06-01

High quality data is fundamental to using key performance indicators (KPIs) for performance monitoring. However, the resources required to collect high quality data are often significant and should usually be targeted at high priority areas. As part of a study of 11 emergency department (ED) KPIs in Ireland, the primary objective of this study was to estimate the relative cost of collecting the additional minimum data set (MDS) elements for those 11 KPIs. An economic cost analysis focused on 12 EDs in the Republic of Ireland. The resource use data were obtained using two separate focus group interviews. The number of available MDS elements was obtained from a sample of 100 patient records per KPI per participating ED. Unit costs for all resource use were taken at the midpoint of the relevant staff salary scales. An ED would need to spend an estimated additional &OV0556;3561 per month on average to capture all the MDS elements relevant to the 11 KPIs investigated. The additional cost ranges from 14.8 to 39.2%; this range is 13.9-32.3% for small EDs, whereas the range for medium EDs is 11.7-40%. Regional EDs have a higher additional estimated cost to capture all the relevant MDS elements (&OV0556;3907), compared with urban EDs (&OV0556;3353). The additional cost of data collection, contingent on that already collected, required to capture all the relevant MDS elements for the KPIs examined, ranges from 14.8 to 39.2% per KPI, with variation identified between regional and urban hospitals.

Do systematic reviews address community healthcare professionals' wound care uncertainties? Results from evidence mapping in wound care.

PubMed

Christie, Janice; Gray, Trish A; Dumville, Jo C; Cullum, Nicky A

2018-01-01

Complex wounds such as leg and foot ulcers are common, resource intensive and have negative impacts on patients' wellbeing. Evidence-based decision-making, substantiated by high quality evidence such as from systematic reviews, is widely advocated for improving patient care and healthcare efficiency. Consequently, we set out to classify and map the extent to which up-to-date systematic reviews containing robust evidence exist for wound care uncertainties prioritised by community-based healthcare professionals. We asked healthcare professionals to prioritise uncertainties based on complex wound care decisions, and then classified 28 uncertainties according to the type and level of decision. For each uncertainty, we searched for relevant systematic reviews. Two independent reviewers screened abstracts and full texts of reviews against the following criteria: meeting an a priori definition of a systematic review, sufficiently addressing the uncertainty, published during or after 2012, and identifying high quality research evidence. The most common uncertainty type was 'interventions' 24/28 (85%); the majority concerned wound level decisions 15/28 (53%) however, service delivery level decisions (10/28) were given highest priority. Overall, we found 162 potentially relevant reviews of which 57 (35%) were not systematic reviews. Of 106 systematic reviews, only 28 were relevant to an uncertainty and 18 of these were published within the preceding five years; none identified high quality research evidence. Despite the growing volume of published primary research, healthcare professionals delivering wound care have important clinical uncertainties which are not addressed by up-to-date systematic reviews containing high certainty evidence. These are high priority topics requiring new research and systematic reviews which are regularly updated. To reduce clinical and research waste, we recommend systematic reviewers and researchers make greater efforts to ensure that research addresses important clinical uncertainties and is of sufficient rigour to inform practice.

Anticoagulants (extended duration) for prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair.

PubMed

Forster, Rachel; Stewart, Marlene

2016-03-30

The optimal duration of thromboprophylaxis after total hip or knee replacement, or hip fracture repair remains controversial. It is common practice to administer prophylaxis using low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) until discharge from hospital, usually seven to 14 days after surgery. International guidelines recommend extending thromboprophylaxis for up to 35 days following major orthopaedic surgery but the recommendation is weak due to moderate quality evidence. In addition, recent oral anticoagulants that exert effect by direct inhibition of thrombin or activated factor X lack the need for monitoring and have few known drug interactions. Interest in this topic remains high. To assess the effects of extended-duration anticoagulant thromboprophylaxis for the prevention of venous thromboembolism (VTE) in people undergoing elective hip or knee replacement surgery, or hip fracture repair. The Cochrane Vascular Information Specialist searched the Specialised Register (last searched May 2015) and CENTRAL (2015, Issue 4). Clinical trials databases were searched for ongoing or unpublished studies. Randomised controlled trials assessing extended-duration thromboprophylaxis (five to seven weeks) using accepted prophylactic doses of LMWH, UFH, vitamin K antagonists (VKA) or direct oral anticoagulants (DOAC) compared with short-duration thromboprophylaxis (seven to 14 days) followed by placebo, no treatment or similar extended-duration thromboprophylaxis with LMWH, UFH, VKA or DOACs in participants undergoing hip or knee replacement or hip fracture repair. We independently selected trials and extracted data. Disagreements were resolved by discussion. We performed fixed-effect model meta-analyses with odds ratios (ORs) and 95% confidence intervals (CIs). We used a random-effects model when there was heterogeneity. We included 16 studies (24,930 participants); six compared heparin with placebo, one compared VKA with placebo, two compared DOAC with placebo, one compared VKA with heparin, five compared DOAC with heparin and one compared anticoagulants chosen at investigators' discretion with placebo. Three trials included participants undergoing knee replacement. No studies assessed hip fracture repair.Trials were generally of good methodological quality. The main reason for unclear risk of bias was insufficient reporting. The quality of evidence according to GRADE was generally moderate, as some comparisons included a single study, low number of events or heterogeneity between studies leading to wide CIs.We showed no difference between extended-duration heparin and placebo in symptomatic VTE (OR 0.59, 95% CI 0.35 to 1.01; 2329 participants; 5 studies; high quality evidence), symptomatic deep vein thrombosis (DVT) (OR 0.73, 95% CI 0.39 to 1.38; 2019 participants; 4 studies; moderate quality evidence), symptomatic pulmonary embolism (PE) (OR 0.61, 95% CI 0.16 to 2.33; 1595 participants; 3 studies; low quality evidence) and major bleeding (OR 0.59, 95% CI 0.14 to 2.46; 2500 participants; 5 studies; moderate quality evidence). Minor bleeding was increased in the heparin group (OR 2.01, 95% CI 1.43 to 2.81; 2500 participants; 5 studies; high quality evidence). Clinically relevant non-major bleeding was not reported.We showed no difference between extended-duration VKA and placebo (one study, 360 participants) for symptomatic VTE (OR 0.10, 95% CI 0.01 to 1.94; moderate quality evidence), symptomatic DVT (OR 0.13, 95% CI 0.01 to 2.62; moderate quality evidence), symptomatic PE (OR 0.32, 95% CI 0.01 to 7.84; moderate quality evidence) and major bleeding (OR 2.89, 95% CI 0.12 to 71.31; low quality evidence). Clinically relevant non-major bleeding and minor bleeding were not reported.Extended-duration DOAC showed reduced symptomatic VTE (OR 0.20, 95% CI 0.06 to 0.68; 2419 participants; 1 study; moderate quality evidence) and symptomatic DVT (OR 0.18, 95% CI 0.04 to 0.81; 2459 participants; 2 studies; high quality evidence) compared to placebo. No differences were found for symptomatic PE (OR 0.25, 95% CI 0.03 to 2.25; 1733 participants; 1 study; low quality evidence), major bleeding (OR 1.00, 95% CI 0.06 to 16.02; 2457 participants; 1 study; low quality evidence), clinically relevant non-major bleeding (OR 1.22, 95% CI 0.76 to 1.95; 2457 participants; 1 study; moderate quality evidence) and minor bleeding (OR 1.18, 95% CI 0.74 to 1.88; 2457 participants; 1 study; moderate quality evidence).We showed no difference between extended-duration anticoagulants chosen at investigators' discretion and placebo (one study, 557 participants, low quality evidence) for symptomatic VTE (OR 0.50, 95% CI 0.09 to 2.74), symptomatic DVT (OR 0.33, 95% CI 0.03 to 3.21), symptomatic PE (OR 1.00, 95% CI 0.06 to 16.13), and major bleeding (OR 5.05, 95% CI 0.24 to 105.76). Clinically relevant non-major bleeding and minor bleeding were not reported.We showed no difference between extended-duration VKA and heparin (one study, low quality evidence) for symptomatic VTE (OR 1.64, 95% CI 0.85 to 3.16; 1279 participants), symptomatic DVT (OR 1.36, 95% CI 0.69 to 2.68; 1279 participants), symptomatic PE (OR 9.16, 95% CI 0.49 to 170.42; 1279 participants), major bleeding (OR 3.87, 95% CI 1.91 to 7.85; 1272 participants) and minor bleeding (OR 1.33, 95% CI 0.64 to 2.76; 1279 participants). Clinically relevant non-major bleeding was not reported.We showed no difference between extended-duration DOAC and heparin for symptomatic VTE (OR 0.70, 95% CI 0.28 to 1.70; 15,977 participants; 5 studies; low quality evidence), symptomatic DVT (OR 0.60, 95% CI 0.11 to 3.27; 15,977 participants; 5 studies; low quality evidence), symptomatic PE (OR 0.91, 95% CI 0.43 to 1.94; 14,731 participants; 5 studies; moderate quality evidence), major bleeding (OR 1.11, 95% CI 0.79 to 1.54; 16,199 participants; 5 studies; high quality evidence), clinically relevant non-major bleeding (OR 1.08, 95% CI 0.90 to 1.28; 15,241 participants; 4 studies; high quality evidence) and minor bleeding (OR 0.95, 95% CI 0.82 to 1.10; 11,766 participants; 4 studies; high quality evidence). Moderate quality evidence suggests extended-duration anticoagulants to prevent VTE should be considered for people undergoing hip replacement surgery, although the benefit should be weighed against the increased risk of minor bleeding. Further studies are needed to better understand the association between VTE and extended-duration oral anticoagulants in relation to knee replacement and hip fracture repair, as well as outcomes such as distal and proximal DVT, reoperation, wound infection and healing.

Are the CMS Hospital Outpatient Quality Measures Relevant for Rural Hospitals?

ERIC Educational Resources Information Center

Casey, Michelle M.; Prasad, Shailendra; Klingner, Jill; Moscovice, Ira

2012-01-01

Context: Quality measures focused on outpatient settings are of increasing interest to policy makers, but little research has been conducted on hospital outpatient quality measures, especially in rural settings. Purpose: To evaluate the relevance of Centers for Medicare and Medicaid Services' (CMS) outpatient quality measures for rural hospitals,…

High Plains regional ground-water study

USGS Publications Warehouse

Dennehy, Kevin F.

2000-01-01

Over the last 25 years, industry and government have made large financial investments aimed at improving water quality across the Nation. Significant progress has been made; however, many water-quality concerns remain. In 1991, the U.S. Geological Survey (USGS) began implementing a full-scale National Water-Quality Assessment Program to provide consistent and scientifically sound information for managing the Nation's water resources. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers, (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality. Assessing the quality of water in every location in the Nation would not be practical; therefore, NAWQA Program studies are conducted within a set of areas called study units (fig. 1). These study units are composed of more than 50 important river and aquifer systems that represent the diverse geography, water resources, and land and water uses of the Nation. The High Plains Regional Ground-Water Study is one such study area, designed to address issues relevant to the High Plains Aquifer system while supplementing water-quality information collected in other study units across the Nation. Implementation of the NAWQA Program for the High Plains Regional Ground-Water Study area began in 1998.

Relevance of methods and standards for the assessment of measurement system performance in a High-Value Manufacturing Industry

NASA Astrophysics Data System (ADS)

Loftus, Pete; Giudice, Seb

2014-08-01

Measurements underpin the engineering decisions that allow products to be designed, manufactured, operated, and maintained. Therefore, the quality of measured data needs to be systematically assured to allow decision makers to proceed with confidence. The use of standards is one way of achieving this. This paper explores the relevance of international documentary standards to the assessment of measurement system capability in High Value Manufacturing (HVM) Industry. An internal measurement standard is presented which supplements these standards and recommendations are made for a cohesive effort to develop the international standards to provide consistency in such industrial applications.

Health-related quality of life of cranial WHO grade I meningioma patients: are current questionnaires relevant?

PubMed

Zamanipoor Najafabadi, Amir H; Peeters, Marthe C M; Lobatto, Daniel J; Broekman, Marieke L D; Smith, Timothy R; Biermasz, Nienke R; Peerdeman, Saskia M; Peul, Wilco C; Taphoorn, Martin J B; van Furth, Wouter R; Dirven, Linda

2017-11-01

The clinical relevance of Health-Related Quality of Life (HRQoL) in meningioma patients has been increasingly acknowledged in recent years. Various questionnaires have been used. However, almost none of these questionnaires has been particularly developed for and/or validated in this patient group. Therefore, the aim of this study was to assess the relevance and comprehensiveness of existing HRQoL questionnaires used in meningioma research and to assess the agreement between patients and health care professionals (HCPs) on the most relevant and important HRQoL issues. A systematic literature search, following the PRISMA statement, was conducted to identify all HRQoL questionnaires used in meningioma research. Semi-structured interviews were organized with patients and HCPs to (1) assess the relevance of all issues covered by the questionnaires (score 0-3: not relevant-highly relevant), (2) assess the ten most important issues, and (3) identify new relevant HRQoL issues. Fourteen different questionnaires were found in the literature, comprising 140 unique issues. Interviews were conducted with 20 patients (median age 57, 71% female) and 10 HCPs (4 neurosurgeons, 2 neurologists, 2 radiotherapists, 1 rehabilitation specialist, 1 neuropsychologist; median experience 13 years). Meningioma patients rated 17-80% of the issues in each of the questionnaires as relevant, HCPs 90-100%. Patients and HCPs agreed on the relevance of only 49 issues (35%, Cohen's kappa: 0.027). Both patients and HCPs considered lack of energy the most important issue. Patients and HCPs suggested five additional relevant issues not covered by current HRQoL questionnaires. Existing HRQoL questionnaires currently used in meningioma patients do not fully cover all relevant issues to these patients. Agreement between patients and HCPs on the relevance of issues was poor. Both findings support the need to develop and validate a meningioma-specific HRQoL questionnaire.

No-reference image quality assessment based on natural scene statistics and gradient magnitude similarity

NASA Astrophysics Data System (ADS)

Jia, Huizhen; Sun, Quansen; Ji, Zexuan; Wang, Tonghan; Chen, Qiang

2014-11-01

The goal of no-reference/blind image quality assessment (NR-IQA) is to devise a perceptual model that can accurately predict the quality of a distorted image as human opinions, in which feature extraction is an important issue. However, the features used in the state-of-the-art "general purpose" NR-IQA algorithms are usually natural scene statistics (NSS) based or are perceptually relevant; therefore, the performance of these models is limited. To further improve the performance of NR-IQA, we propose a general purpose NR-IQA algorithm which combines NSS-based features with perceptually relevant features. The new method extracts features in both the spatial and gradient domains. In the spatial domain, we extract the point-wise statistics for single pixel values which are characterized by a generalized Gaussian distribution model to form the underlying features. In the gradient domain, statistical features based on neighboring gradient magnitude similarity are extracted. Then a mapping is learned to predict quality scores using a support vector regression. The experimental results on the benchmark image databases demonstrate that the proposed algorithm correlates highly with human judgments of quality and leads to significant performance improvements over state-of-the-art methods.

Effect assessment in work environment interventions: a methodological reflection.

PubMed

Neumann, W P; Eklund, J; Hansson, B; Lindbeck, L

2010-01-01

This paper addresses a number of issues for work environment intervention (WEI) researchers in light of the mixed results reported in the literature. If researchers emphasise study quality over intervention quality, reviews that exclude case studies with high quality and multifactorial interventions may be vulnerable to 'quality criteria selection bias'. Learning from 'failed' interventions is inhibited by both publication bias and reporting lengths that limit information on relevant contextual and implementation factors. The authors argue for the need to develop evaluation approaches consistent with the complexity of multifactorial WEIs that: a) are owned by and aimed at the whole organisation; and b) include intervention in early design stages where potential impact is highest. Context variety, complexity and instability in and around organisations suggest that attention might usefully shift from generalisable 'proof of effectiveness' to a more nuanced identification of intervention elements and the situations in which they are more likely to work as intended. STATEMENT OF RELEVANCE: This paper considers ergonomics interventions from perspectives of what constitutes quality and 'proof". It points to limitations of traditional experimental intervention designs and argues that the complexity of organisational change, and the need for multifactorial interventions that reach deep into work processes for greater impact, should be recognised.

Sleep, recovery, and performance: the new frontier in high-performance athletics.

PubMed

Samuels, Charles

2008-02-01

The relationship of sleep to post-exercise recovery (PER) and athletic performance is a topic of great interest because of the growing body of scientific evidence confirming a link between critical sleep factors, cognitive processes, and metabolic function. Sleep restriction (sleep deprivation), sleep disturbance (poor sleep quality), and circadian rhythm disturbance (jet lag) are the key sleep factors that affect the overall restorative quality of the sleep state. This article discusses these theoretic concepts, presents relevant clinical cases, and reviews pilot data exploring the prevalence of sleep disturbance in two groups of high-performance athletes.

Methodologic quality and relevance of references in pharmaceutical advertisements in a Canadian medical journal.

PubMed

Lexchin, J; Holbrook, A

1994-07-01

To evaluate the methodologic quality and relevance of references in pharmaceutical advertisements in the Canadian Medical Association Journal (CMAJ). Analytic study. All 114 references cited in the first 22 distinct pharmaceutical advertisements in volume 146 of CMAJ. Mean methodologic quality score (modified from the 6-point scale used to assess articles in the American College of Physicians' Journal Club) and mean relevance score (based on a new 5-point scale) for all references in each advertisement. Twenty of the 22 companies responded, sending 78 (90%) of the 87 references requested. The mean methodologic quality score was 58% (95% confidence limits [CL] 51% and 65%) and the mean relevance score 76% (95% CL 72% and 80%). The two mean scores were statistically lower than the acceptable score of 80% (p < 0.05), and the methodologic quality score was outside the preset clinically significant difference of 15%. The poor rating for methodologic quality was primarily because of the citation of references to low-quality review articles and "other" sources (i.e., other than reports of clinical trials). Half of the advertisements had a methodologic quality score of less than 65%, but only five had a relevance score of less than 65%. Although the relevance of most of the references was within minimal acceptable limits, the methodologic quality was often unacceptable. Because advertisements are an important part of pharmaceutical marketing and education, we suggest that companies develop written standards for their advertisements and monitor their advertisements for adherence to these standards. We also suggest that the Pharmaceutical Advertising Advisory Board develop more stringent guidelines for advertising and that it enforce these guidelines in a consistent, rigorous fashion.

Methodologic quality and relevance of references in pharmaceutical advertisements in a Canadian medical journal.

PubMed Central

Lexchin, J; Holbrook, A

1994-01-01

OBJECTIVE: To evaluate the methodologic quality and relevance of references in pharmaceutical advertisements in the Canadian Medical Association Journal (CMAJ). DESIGN: Analytic study. DATA SOURCE: All 114 references cited in the first 22 distinct pharmaceutical advertisements in volume 146 of CMAJ. MAIN OUTCOME MEASURES: Mean methodologic quality score (modified from the 6-point scale used to assess articles in the American College of Physicians' Journal Club) and mean relevance score (based on a new 5-point scale) for all references in each advertisement. MAIN RESULTS: Twenty of the 22 companies responded, sending 78 (90%) of the 87 references requested. The mean methodologic quality score was 58% (95% confidence limits [CL] 51% and 65%) and the mean relevance score 76% (95% CL 72% and 80%). The two mean scores were statistically lower than the acceptable score of 80% (p < 0.05), and the methodologic quality score was outside the preset clinically significant difference of 15%. The poor rating for methodologic quality was primarily because of the citation of references to low-quality review articles and "other" sources (i.e., other than reports of clinical trials). Half of the advertisements had a methodologic quality score of less than 65%, but only five had a relevance score of less than 65%. CONCLUSIONS: Although the relevance of most of the references was within minimal acceptable limits, the methodologic quality was often unacceptable. Because advertisements are an important part of pharmaceutical marketing and education, we suggest that companies develop written standards for their advertisements and monitor their advertisements for adherence to these standards. We also suggest that the Pharmaceutical Advertising Advisory Board develop more stringent guidelines for advertising and that it enforce these guidelines in a consistent, rigorous fashion. PMID:8004560

Methods for the guideline-based development of quality indicators--a systematic review

PubMed Central

2012-01-01

Background Quality indicators (QIs) are used in many healthcare settings to measure, compare, and improve quality of care. For the efficient development of high-quality QIs, rigorous, approved, and evidence-based development methods are needed. Clinical practice guidelines are a suitable source to derive QIs from, but no gold standard for guideline-based QI development exists. This review aims to identify, describe, and compare methodological approaches to guideline-based QI development. Methods We systematically searched medical literature databases (Medline, EMBASE, and CINAHL) and grey literature. Two researchers selected publications reporting methodological approaches to guideline-based QI development. In order to describe and compare methodological approaches used in these publications, we extracted detailed information on common steps of guideline-based QI development (topic selection, guideline selection, extraction of recommendations, QI selection, practice test, and implementation) to predesigned extraction tables. Results From 8,697 hits in the database search and several grey literature documents, we selected 48 relevant references. The studies were of heterogeneous type and quality. We found no randomized controlled trial or other studies comparing the ability of different methodological approaches to guideline-based development to generate high-quality QIs. The relevant publications featured a wide variety of methodological approaches to guideline-based QI development, especially regarding guideline selection and extraction of recommendations. Only a few studies reported patient involvement. Conclusions Further research is needed to determine which elements of the methodological approaches identified, described, and compared in this review are best suited to constitute a gold standard for guideline-based QI development. For this research, we provide a comprehensive groundwork. PMID:22436067

Supporting Immersion Teachers: An Autoethnography

ERIC Educational Resources Information Center

Speece, Lauren

2017-01-01

Immersion programs face a variety of challenges that are common to the field, such as lack of materials appropriate for students' language abilities, assessment, teacher recruitment and retention, balancing content and language, and relevant, high quality professional development for teachers. However, within specific micro-contexts, other issues…

Pursuit of communal values in an agentic manner: a way to happiness?

PubMed

Abele, Andrea E

2014-01-01

The present research studies the association between traits, values, and life satisfaction. While values should influence the direction of an individual's goals and behavior, his/her traits impact effort-expenditure, efficiency, and persistence in goal-pursuit. We apply the framework of the "Big Two" of agency and communion (Bakan, 1966) for distinguishing the content of values and traits. While agentic content refers to qualities relevant for goal-attainment, such as assertiveness, competence or persistence, communal content refers to qualities relevant for the establishment and maintenance of social relationships, such as being friendly, helpful, or fair. We predict that high scores on communal values and high scores on agentic traits are associated with life satisfaction. We test these predictions in two studies conducted in different countries (Germany and Russia) with different cultural background. The findings support our reasoning: across both countries we find positive associations of communal values and agentic traits with life satisfaction; and individuals high in communal values and high in agentic traits are most satisfied with their lives. In Russia, the association of communal values with life satisfaction is moderated by agentic traits; in Germany, however, there is a main effect of communal values.

Pursuit of communal values in an agentic manner: a way to happiness?

PubMed Central

Abele, Andrea E.

2014-01-01

The present research studies the association between traits, values, and life satisfaction. While values should influence the direction of an individual’s goals and behavior, his/her traits impact effort-expenditure, efficiency, and persistence in goal-pursuit. We apply the framework of the “Big Two” of agency and communion (Bakan, 1966) for distinguishing the content of values and traits. While agentic content refers to qualities relevant for goal-attainment, such as assertiveness, competence or persistence, communal content refers to qualities relevant for the establishment and maintenance of social relationships, such as being friendly, helpful, or fair. We predict that high scores on communal values and high scores on agentic traits are associated with life satisfaction. We test these predictions in two studies conducted in different countries (Germany and Russia) with different cultural background. The findings support our reasoning: across both countries we find positive associations of communal values and agentic traits with life satisfaction; and individuals high in communal values and high in agentic traits are most satisfied with their lives. In Russia, the association of communal values with life satisfaction is moderated by agentic traits; in Germany, however, there is a main effect of communal values. PMID:25477843

Publications in anesthesia journals: quality and clinical relevance.

PubMed

Lauritsen, Jakob; Moller, Ann M

2004-11-01

Clinicians performing evidence-based anesthesia rely on anesthesia journals for clinically relevant information. The objective of this study was to analyze the proportion of clinically relevant articles in five high impact anesthesia journals. We evaluated all articles published in Anesthesiology, Anesthesia & Analgesia, British Journal of Anesthesia, Anesthesia, and Acta Anaesthesiologica Scandinavica from January to June, 2000. Articles were assessed and classified according to type, outcome, and design; 1379 articles consisting of 5468 pages were evaluated and categorized. The most common types of article were animal and laboratory research (31.2%) and randomized clinical trial (20.4%). A clinically relevant article was defined as an article that used a statistically valid method and had a clinically relevant end-point. Altogether 18.6% of the pages had as their subject matter clinically relevant trials. We compared the Journal Impact Factor (a measure of the number of citations per article in a journal) and the proportion of clinically relevant pages and found that they were inversely proportional to each other.

Shared Decision Making in the Emergency Department: Development of a Policy-Relevant Patient-Centered Research Agenda

PubMed Central

Grudzen, Corita R.; Anderson, Jana R.; Carpenter, Christopher R.; Hess, Erik P.

2016-01-01

SUMMARY SDM in emergency medicine has the potential to improve the quality, safety, and outcomes of ED patients. Given that the ED is the gateway to care for patients with a variety of illnesses and injuries, SDM in the ED is relevant to numerous healthcare disciplines. We conducted a patient-centered one-day conference to define and develop a high-priority, timely research agenda. Participants included researchers, patients, stakeholder organizations, and content experts across many areas of medicine, health policy agencies, and federal and foundation funding organizations. The results of this conference published in this issue of Academic Emergency Medicine will provide an essential summary of the future research priorities for SDM to increase quality of care and patient-centered outcomes. PMID:27396583

Fruit wastes fermentation for phenolic antioxidants production and their application in manufacture of edible coatings and films.

PubMed

Martinez-Avila, G C G; Aguilera, A F; Saucedo, S; Rojas, R; Rodriguez, R; Aguilar, C N

2014-01-01

Agro-industrial by-products are important sources of potent bioactive phenolic compounds. These compounds are of extreme relevance for food and pharmacological industries due to their great variety of biological activities. Fermentation represents an environmentally clean technology for production and extraction of these bioactive compounds, providing high quality and high activity extracts, which can be incorporated in foods using coatings/films wax-based in order to avoid alterations in their quality. In this document is presented an overview about importance and benefits of solid-state fermentation, pointing out this bioprocess as an alternative technology for use agro-industrial by-products as substrates to produce valuable secondary metabolites and their applications as food quality conservatives.

Vapor Phase Growth of High-Quality Bi-Te Compounds Using Elemental Bi and Te Sources: A Comparison Between High Vacuum and Atmospheric Pressure

NASA Astrophysics Data System (ADS)

Concepción, O.; Escobosa, A.; de Melo, O.

2018-03-01

Bismuth telluride (Bi2Te3), traditionally used in the industry as thermoelectric material, has deserved much attention recently due to its properties as a topological insulator, a kind of material that might have relevant applications in spintronics or quantum computing, among other innovative uses. The preparation of high-quality material has become a very important technological task. Here, we compare the preparation of Bi2Te3 by physical vapor transport from the evaporation of elemental Bi and Te sources, under either low pressure or atmospheric pressure. The layers were characterized by different techniques to evaluate its structural properties. As a result, it is concluded that, as a consequence of the different transport regimes, films grown at atmospheric pressure present better crystal quality.

Development of the private practice management standards for psychology.

PubMed

Mathews, Rebecca; Stokes, David; Littlefield, Lyn; Collins, Leah

2011-01-01

This paper describes the process of developing a set of private practice management standards to support Australian psychologists and promote high quality services to the public. A review of the literature was conducted to identify management standards relevant to psychology, which were further developed in consultation with a panel of experts in psychology or in the development of standards. Forty-three psychologists in independent private practice took part in either a survey (n=22) to provide feedback on the relevance of, and their compliance with, the identified standards, or a 6-month pilot study (n=21) in which a web-based self-assessment instrument evaluating the final set of standards and performance indicators was implemented in their practice to investigate self-reported change in management procedures. The pilot study demonstrated good outcomes for practitioners when evaluation of compliance to the standards was operationalized in a self-assessment format. Study results are based on a small sample size. Nevertheless, relevance and utility of the standards was found providing an initial version of management standards that have relevance to the practice of psychology in Australia, along with a system for evaluating psychological service provision to ensure best practice in service delivery. © 2010 National Association for Healthcare Quality.

The association between physical activity and neck and low back pain: a systematic review.

PubMed

Sitthipornvorakul, Ekalak; Janwantanakul, Prawit; Purepong, Nithima; Pensri, Praneet; van der Beek, Allard J

2011-05-01

The effect of physical activity on neck and low back pain is still controversial. No systematic review has been conducted on the association between daily physical activity and neck and low back pain. The objective of this study was to evaluate the association between physical activity and the incidence/prevalence of neck and low back pain. Publications were systematically searched from 1980 to June 2009 in several databases. The following key words were used: neck pain, back pain, physical activity, leisure time activity, daily activity, everyday activity, lifestyle activity, sedentary, and physical inactivity. A hand search of relevant journals was also carried out. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. The strength of the evidence was based on methodological quality and consistency of the results. Seventeen studies were included in this review, of which 13 were rated as high-quality studies. Of high-quality studies, there was limited evidence for no association between physical activity and neck pain in workers and strong evidence for no association in school children. Conflicting evidence was found for the association between physical activity and low back pain in both general population and school children. Literature with respect to the effect of physical activity on neck and low back pain was too heterogeneous and more research is needed before any final conclusion can be reached.

Bleeding complications and mortality in warfarin-treated VTE patients, dependence of INR variability and iTTR.

PubMed

Sandén, Per; Renlund, Henrik; Svensson, Peter J; Själander, Anders

2017-01-05

High quality of warfarin treatment is important to prevent recurrence of venous thromboembolism (VTE) without bleeding complications. The aim of this study was to examine the effect of individual time in therapeutic range (iTTR) and International Normalised Ratio (INR) variability on bleeding risk and mortality in a large cohort of well-managed patients with warfarin due to VTE. A cohort of 16612 patients corresponding to 19502 treatment periods with warfarin due to VTE between January 1, 2006 and December 31, 2011 was retrieved from the Swedish national quality register AuriculA and matched with the Swedish National Patient Register for bleeding complications and background characteristics and the Cause of death register for occurrence and date of death. The rate of bleeding was 1.79 (confidence interval (CI) 95 % 1.66-1.93) per 100 treatment years among all patients. Those with poor warfarin treatment quality had a higher rate of clinically relevant bleeding, both when measured as iTTR below 70 %, 2.91 (CI 95 % 2.61-3.21) or as INR variability over the mean value 0.85, 2.61 (CI 95 % 2.36-2.86). Among those with both high INR variability and low iTTR the risk of clinically relevant bleeding was clearly increased hazard ratio (HR) 3.47 (CI 95 % 2.89-4.17). A similar result was found for all-cause mortality with a HR of 3.67 (CI 95 % 3.02-4.47). Both a low iTTR and a high INR variability increase the risk of bleeding complications or mortality. When combining the two treatment quality indicators patients at particular high risk of bleeding or death can be identified.

A robot control formalism based on an information quality concept

NASA Technical Reports Server (NTRS)

Ekman, A.; Torne, A.; Stromberg, D.

1994-01-01

A relevance measure based on Jaynes maximum entropy principle is introduced. Information quality is the conjunction of accuracy and relevance. The formalism based on information quality is developed for one-agent applications. The robot requires a well defined working environment where properties of each object must be accurately specified.

Biologically relevant photoacoustic imaging phantoms with tunable optical and acoustic properties

PubMed Central

Vogt, William C.; Jia, Congxian; Wear, Keith A.; Garra, Brian S.; Joshua Pfefer, T.

2016-01-01

Abstract. Established medical imaging technologies such as magnetic resonance imaging and computed tomography rely on well-validated tissue-simulating phantoms for standardized testing of device image quality. The availability of high-quality phantoms for optical-acoustic diagnostics such as photoacoustic tomography (PAT) will facilitate standardization and clinical translation of these emerging approaches. Materials used in prior PAT phantoms do not provide a suitable combination of long-term stability and realistic acoustic and optical properties. Therefore, we have investigated the use of custom polyvinyl chloride plastisol (PVCP) formulations for imaging phantoms and identified a dual-plasticizer approach that provides biologically relevant ranges of relevant properties. Speed of sound and acoustic attenuation were determined over a frequency range of 4 to 9 MHz and optical absorption and scattering over a wavelength range of 400 to 1100 nm. We present characterization of several PVCP formulations, including one designed to mimic breast tissue. This material is used to construct a phantom comprised of an array of cylindrical, hemoglobin-filled inclusions for evaluation of penetration depth. Measurements with a custom near-infrared PAT imager provide quantitative and qualitative comparisons of phantom and tissue images. Results indicate that our PVCP material is uniquely suitable for PAT system image quality evaluation and may provide a practical tool for device validation and intercomparison. PMID:26886681

Investigation of Mechanism of Action of Modifying Admixtures Based on Products of Petrochemical Synthesis on Concrete Structure

NASA Astrophysics Data System (ADS)

Tukhareli, V. D.; Tukhareli, A. V.; Cherednichenko, T. F.

2017-11-01

The creation of composite materials for generating structural elements with the desired properties has always been and still remains relevant. The basis of a modern concrete technology is the creation of a high-quality artificial stone characterized by low defectiveness and structure stability. Improving the quality of concrete compositions can be achieved by using chemical admixtures from local raw materials which is a very promising task of modern materials’ science for creation of a new generation of concretes. The new generation concretes are high-tech, high-quality, multicomponent concrete mixes and compositions with admixtures that preserve the required properties in service under all operating conditions. The growing complexity of concrete caused by systemic effects that allow you to control the structure formation at all stages of the technology ensures the obtaining of composites with "directional" quality, compositions, structure and properties. The possibility to use the organic fraction of oil refining as a multifunctional hydrophobic-plasticizing admixture in the effective cement concrete is examined.

Updates in venous thromboembolism management: evidence published in 2017.

PubMed

Bartlett, Matthew A; Bierle, Dennis M; Saadiq, Rayya A; Mauck, Karen F; Daniels, Paul R

2018-06-20

Venous thromboembolism (VTE) management is rapidly evolving and staying up-to-date is challenging. We identified the most practice-informing articles published in 2017 relevant to the nonspecialist provider managing VTE. We performed a systematic search of the literature (Appendix A), limiting the search to a publication date of 2017. Two reviewers screened the 2735 resulting abstracts to identify high-quality, clinically relevant publications related to VTE management. One-hundred and six full-text articles were considered for inclusion. The five authors used a modified Delphi method to reach consensus on inclusion of seven articles for in-depth appraisal, following predetermined criteria of clinical relevance to nonspecialist providers, potential for practice change, and strength of the evidence.

Education in cardiopulmonary resuscitation in Russia: A systematic review of the available evidence

PubMed Central

Birkun, Alexei; Glotov, Maksim

2017-01-01

BACKGROUND: To summarise and appraise cumulative published scientific evidence relevant to cardiopulmonary resuscitation (CPR) education in Russia. DATA RESOURCES: We searched Medline, Scopus, Science Direct and Russian Science Citation Index databases from December 1991 to December 2016 to identify studies pertaining to the field of CPR education that were carried out by Russian researchers and/or investigated the topic of interest for Russia/Russian population. Reference lists of eligible publications, contents pages of relevant Russian journals and Google Scholar were also searched. There was no limitation based on publication language or study design. RESULTS: Of 7 964 unique citations identified, 22 studies were included. All studies were published from 2009 to 2016, mainly in Russian. Only three studies were reported to be randomized controlled. Non-medical individuals constituted 17% of studied populations. Most of the studies aimed to assess effects of CPR educational interventions, generally suggesting positive influence of the training conducted. The studies were highly heterogeneous as for methodological approaches, structure and duration of educational interventions, evaluation methods and criteria being used. Methodological quality was generally poor, with >40% publications not passing quality screening and only 2 studies meeting the criteria of moderate high quality. CONCLUSION: The results suggest paucity, low population coverage, high thematic and methodological heterogeneity and low quality of the studies addressing CPR education, which were carried out in the Russian Federation. There is a critical need in conducting methodologically consistent, large-scale, randomized, controlled studies evaluating and comparing efficiency of educational interventions for teaching CPR in different population categories of Russia. PMID:29123601

Psychosocial work characteristics and sleep quality: a systematic review of longitudinal and intervention research.

PubMed

Van Laethem, Michelle; Beckers, Debby G J; Kompier, Michiel A J; Dijksterhuis, Ap; Geurts, Sabine A E

2013-11-01

The objective of this study was to review longitudinal and intervention studies examining the association between psychosocial work characteristics (eg, job demands, job control, and social support) and sleep quality. Our main research aims were to examine whether (i) psychosocial work characteristics are a predictor of sleep quality, and (ii) sleep quality, in turn, is a predictor of psychosocial work characteristics. A systematic literature search resulted in 20 relevant papers, of which 16 were longitudinal studies and 3 were intervention studies (1 study was discussed in separate papers). To quantify results, we assessed the strength of evidence of all examined associations and subsequently evaluated the studies' research quality based on predefined quality criteria. One intervention and three longitudinal studies studies were categorized as being of high-quality. In longitudinal studies, we found consistent and strong evidence for a negative relation between job demands and sleep quality as well as evidence for a positive relation between job control and sleep quality. Other psychosocial work characteristics were examined in an insufficient number of (high-quality) studies. Moreover, both intervention studies as well as studies investigating reversed and reciprocal relations are rare, which further limits the possibility of drawing conclusions on causality. Based on the current literature, it can be concluded that high job demands and low job control are predictors of poor sleep quality. More high-quality research is needed to examine the possible causal relationship between these and other psychosocial work characteristics with sleep quality, in addition to research focusing on reversed and reciprocal relations.

[Update: studies in intensive care medicine. Results of the last 12 months].

PubMed

Knapp, J; Marx, G; Weismüller, K; Steinebach, S; Lichtenstern, C; Popp, E; Mayer, K; Brunkhorst, F M; Weigand, M A; Bernhard, M

2011-11-01

Intensive care medicine plays an important role in the medical care of patients as well as the economic success of hospitals. Knowledge and implementation of recent relevant scientific evidence are prerequisites for high quality care in intensive care medicine. The aim of this review is to present an overview of the most important publications in intensive care medicine published in 2010 and the first half of the year 2011 and to comment on their attributable clinical relevance for intensive care practitioners. In 2010 and up to June 2011 many studies with high patient numbers have been published. The main topics were the treatment of respiratory failure, sepsis and investigations to improve analgosedation.

The relevancy of forage quality to beef production

USDA-ARS?s Scientific Manuscript database

Low cost and abundant fossil fuels have driven the USA beef industry toward greater dependence on feed grains as the major feedstuff for finished beef cattle production and has lead to a centralized beef cattle feeding and processing system concentrated in the High Plains states. Low cost fuel and m...

Standards Policies to Support Young Dual Language Learners

ERIC Educational Resources Information Center

Rendon, Thomas; Harjusola-Webb, Sanna; Gatmaitan, Michelle

2014-01-01

In response to increasing numbers of young dual language learners (DLL) in American early childhood programs, teachers and administrators have made many and varied attempts to address the unique needs of this population. Educational success for DLLs comes through skilled educators who address relevant content through high-quality programs and…

Operations Management in the Design and Execution of MBA Programs

ERIC Educational Resources Information Center

Busing, Michael E.; Palocsay, Susan W.

2016-01-01

Master of business administration (MBA) programs are under intense pressure to improve efficiencies, lower tuition, and offer refreshed curriculum that is of high quality and regarded as relevant by the marketplace. In light of this environment, the authors propose a conceptual framework for effectively employing operations management (OM)…

Cumulative assessment of steroid receptor mediated activity of contaminants in water samples using in vitro bioassays. -EMGS

EPA Science Inventory

Cell-based in vitro assays show promise for water quality monitoring applications due to high sensitivity, the ability to quantitatively detect a biologically relevant effect endpoint such as receptor transactivation (i.e., effect-based monitoring), and the ability to assess comp...

Latino Immigration: Preparing School Psychologists to Meet Students' Needs

ERIC Educational Resources Information Center

Garcia-Joslin, Jacqueline J.; Carrillo, Gerardo L.; Guzman, Veronica; Vega, Desireé; Plotts, Cynthia A.; Lasser, Jon

2016-01-01

As the population of immigrant Latino students continues to rise, school psychologists serving Latino children and families must develop the knowledge and skills necessary to provide high-quality psychological services to culturally and linguistically diverse students from immigrant families. Following a review of the relevant literature on the…

Squaring the Circle: A New Alternative to Alternative-Assessment

ERIC Educational Resources Information Center

Williams, Peter

2014-01-01

Many quality assurance systems rely on high-stakes assessment for course certification. Such methods are not as objective as they might appear; they can have detrimental effects on student motivation and may lack relevance to the needs of degree courses increasingly oriented to vocational utility. "Alternative assessment" methods can…

Targeted Water Quality Assessment in Small Reservoirs in Brazil, Zimbabwe, Morocco and Burkina Faso

NASA Astrophysics Data System (ADS)

Boelee, Eline; Rodrigues, Lineu; Senzanje, Aidan; Laamrani, Hammou; Cecchi, Philippe

2010-05-01

Background Physical and chemical parameters of water in reservoirs can be affected by natural and manmade pollutants, causing damage to the aquatic life and water quality. However, the exact water quality considerations depend on what the water will be used for. Brick making, livestock watering, fisheries, irrigation and domestic uses all have their own specific water quality requirements. In turn, these uses impact on water quality. Methodology Water quality was assessed with a variety of methods in small multipurpose reservoirs in the São Francisco Basin in Brazil, Limpopo in Zimbabwe, Souss Massa in Morocco and Nakambé in Burkina Faso. In each case the first step was to select the reservoirs for which the water quality was to be monitored, then identify the main water uses, followed by a determination of key relevant water quality parameters. In addition, a survey was done in some cases to identify quality perceptions of the users. Samples were taken from the reservoir itself and related water bodies such as canals and wells where relevant. Results Accordingly in the four basins different methods gave different locally relevant results. In the Preto River in the Sao Francisco in Brazil small reservoirs are mainly used for irrigated agriculture. Chemical analysis of various small reservoirs showed that water quality was mainly influenced by geological origins. In addition there was nutrient inflow from surrounding areas of intensive agriculture with high fertilizer use. In the Limpopo basin in Zimbabwe small reservoirs are used for almost all community water needs. Plankton was selected as indicator and sampling was carried out in reservoirs in communal areas and in a national park. Park reservoirs were significantly more diversified in phytoplankton taxa compared to those in the communal lands, but not for zooplankton, though communal lands had the highest zooplankton abundance. In Souss Massa in Morocco a combination of perceptions and scientific water quality analyses was applied to a small reservoir. High levels of fecal coliform bacteria were found in the reservoir, which made it unfit for human and animal consumption but suitable for most other purposes. In Burkina Faso, the Nakambé basin has been targeted because of its elevated densities of both population and (small) reservoirs that are used for irrigation, livestock, fishing and other purposes. While a large diversity of phytoplankton was found, the massive dominance of aquatic cyanobacteria was the most significant result. Two lakes exhibited significant cyanotoxins concentrations, which had never been documented before. The presence of the involved bacteria in a large number of sites indicated that such contamination with toxins could potentially affect large populations. Classical limnological descriptors failed to explain the observed situations. Conversely, the cyanobacterial abundances were positively correlated with population densities and land-use. This is probably associated with agricultural intensification and particularly horticulture around most reservoirs, because of the high use of pesticides and their selective impacts on plankton communities that tend to favor cynaobacteria. Still, the scientific hypotheses linking human activities to water quality remain to be formally assessed. Discussion and conclusion Both financial difficulties and the frequent absence of specific and academic local competences limit the implementation of relevant water quality monitoring programs. However, on the basis of our findings in four basins we postulate that while the mobilization of water resources has been an emergency priority for a long time, now the time has come to explicitly target the preservation and protection of aquatic ecosystems. This urgent need should dominate the debate on sustainable multipurpose exploitation of small reservoirs whose several benefits (especially fisheries) appear clearly linked to their quality.

Development of Cardiovascular Quality Indicators for Rheumatoid Arthritis: Results from an International Expert Panel Using a Novel Online Process

PubMed Central

Barber, Claire E. H.; Marshall, Deborah A; Alvarez, Nanette; John Mancini, G. B.; Lacaille, Diane; Keeling, Stephanie; Aviña-Zubieta, J. Antonio; Khodyakov, Dmitry; Barnabe, Cheryl; Faris, Peter; Smith, Alexa; Noormohamed, Raheem; Hazlewood, Glen; Martin, Liam O.; Esdaile, John M.

2016-01-01

Objective Patients with rheumatoid arthritis (RA) have a high risk of premature cardiovascular disease (CVD). We developed CVD quality indicators (QIs) for screening and use in Rheumatology clinics. Methods A systematic review of the literature on CVD risk reduction in RA and the general population was conducted. Based on the best practices identified from this review, a draft set of 12 candidate QIs were presented to a Canadian panel of rheumatologists and cardiologists (n=6) from three academic centers to achieve consensus on the QI specifications. The resulting 11 QIs were then evaluated by an online modified-Delphi panel of multidisciplinary health professionals and patients (n = 43) to determine their relevance, validity and feasibility in three rounds of online voting and threaded discussion using a modified RAND/UCLA Appropriateness Methodology. Results Response rates for the online panel were 86%. All 11 QIs were rated as highly relevant, valid and feasible (median rating ≥7 on a 1–9 scale) with no significant disagreement. The final QI set addresses the following themes: communication to primary care about increased CV risk in RA, CV risk assessment, defining smoking status and providing cessation counseling, screening and addressing hypertension, dyslipidemia and diabetes, exercise recommendations, body mass index screening and lifestyle counseling, minimizing corticosteroid use and communicating to patients at high risk of CVD about the risks/benefits of non-steroidal anti-inflammatory drugs. Conclusion Eleven QIs for CVD care in RA patients have been developed and are rated as highly relevant, valid and feasible by an international multidisciplinary panel. PMID:26178275

Fabrication of high-quality single-crystal Cu thin films using radio-frequency sputtering.

PubMed

Lee, Seunghun; Kim, Ji Young; Lee, Tae-Woo; Kim, Won-Kyung; Kim, Bum-Su; Park, Ji Hun; Bae, Jong-Seong; Cho, Yong Chan; Kim, Jungdae; Oh, Min-Wook; Hwang, Cheol Seong; Jeong, Se-Young

2014-08-29

Copper (Cu) thin films have been widely used as electrodes and interconnection wires in integrated electronic circuits, and more recently as substrates for the synthesis of graphene. However, the ultra-high vacuum processes required for high-quality Cu film fabrication, such as molecular beam epitaxy (MBE), restricts mass production with low cost. In this work, we demonstrated high-quality Cu thin films using a single-crystal Cu target and radio-frequency (RF) sputtering technique; the resulting film quality was comparable to that produced using MBE, even under unfavorable conditions for pure Cu film growth. The Cu thin film was epitaxially grown on an Al2O3 (sapphire) (0001) substrate, and had high crystalline orientation along the (111) direction. Despite the 10(-3) Pa vacuum conditions, the resulting thin film was oxygen free due to the high chemical stability of the sputtered specimen from a single-crystal target; moreover, the deposited film had >5× higher adhesion force than that produced using a polycrystalline target. This fabrication method enabled Cu films to be obtained using a simple, manufacturing-friendly process on a large-area substrate, making our findings relevant for industrial applications.

Association of Computed Tomography Ischemic Lesion Location With Functional Outcome in Acute Large Vessel Occlusion Ischemic Stroke.

PubMed

Ernst, Marielle; Boers, Anna M M; Aigner, Annette; Berkhemer, Olvert A; Yoo, Albert J; Roos, Yvo B; Dippel, Diederik W J; van der Lugt, Aad; van Oostenbrugge, Robert J; van Zwam, Wim H; Fiehler, Jens; Marquering, Henk A; Majoie, Charles B L M

2017-09-01

Ischemic lesion volume (ILV) assessed by follow-up noncontrast computed tomography correlates only moderately with clinical end points, such as the modified Rankin Scale (mRS). We hypothesized that the association between follow-up noncontrast computed tomography ILV and outcome as assessed with mRS 3 months after stroke is strengthened when taking the mRS relevance of the infarct location into account. An anatomic atlas with 66 areas was registered to the follow-up noncontrast computed tomographic images of 254 patients from the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands). The anatomic brain areas were divided into brain areas of high, moderate, and low mRS relevance as reported in the literature. Based on this distinction, the ILV in brain areas of high, moderate, and low mRS relevance was assessed for each patient. Binary and ordinal logistic regression analyses with and without adjustment for known confounders were performed to assess the association between the ILVs of different mRS relevance and outcome. The odds for a worse outcome (higher mRS) were markedly higher given an increase of ILV in brain areas of high mRS relevance (odds ratio, 1.42; 95% confidence interval, 1.31-1.55 per 10 mL) compared with an increase in total ILV (odds ratios, 1.16; 95% confidence interval, 1.12-1.19 per 10 mL). Regression models using ILV in brain areas of high mRS relevance instead of total ILV showed a higher quality. The association between follow-up noncontrast computed tomography ILV and outcome as assessed with mRS 3 months after stroke is strengthened by accounting for the mRS relevance of the affected brain areas. Future prediction models should account for the ILV in brain areas of high mRS relevance. © 2017 American Heart Association, Inc.

A guide to calculating habitat-quality metrics to inform conservation of highly mobile species

USGS Publications Warehouse

Bieri, Joanna A.; Sample, Christine; Thogmartin, Wayne E.; Diffendorfer, James E.; Earl, Julia E.; Erickson, Richard A.; Federico, Paula; Flockhart, D. T. Tyler; Nicol, Sam; Semmens, Darius J.; Skraber, T.; Wiederholt, Ruscena; Mattsson, Brady J.

2018-01-01

Many metrics exist for quantifying the relative value of habitats and pathways used by highly mobile species. Properly selecting and applying such metrics requires substantial background in mathematics and understanding the relevant management arena. To address this multidimensional challenge, we demonstrate and compare three measurements of habitat quality: graph-, occupancy-, and demographic-based metrics. Each metric provides insights into system dynamics, at the expense of increasing amounts and complexity of data and models. Our descriptions and comparisons of diverse habitat-quality metrics provide means for practitioners to overcome the modeling challenges associated with management or conservation of such highly mobile species. Whereas previous guidance for applying habitat-quality metrics has been scattered in diversified tracks of literature, we have brought this information together into an approachable format including accessible descriptions and a modeling case study for a typical example that conservation professionals can adapt for their own decision contexts and focal populations.Considerations for Resource ManagersManagement objectives, proposed actions, data availability and quality, and model assumptions are all relevant considerations when applying and interpreting habitat-quality metrics.Graph-based metrics answer questions related to habitat centrality and connectivity, are suitable for populations with any movement pattern, quantify basic spatial and temporal patterns of occupancy and movement, and require the least data.Occupancy-based metrics answer questions about likelihood of persistence or colonization, are suitable for populations that undergo localized extinctions, quantify spatial and temporal patterns of occupancy and movement, and require a moderate amount of data.Demographic-based metrics answer questions about relative or absolute population size, are suitable for populations with any movement pattern, quantify demographic processes and population dynamics, and require the most data.More real-world examples applying occupancy-based, agent-based, and continuous-based metrics to seasonally migratory species are needed to better understand challenges and opportunities for applying these metrics more broadly.

What information is used in treatment decision aids? A systematic review of the types of evidence populating health decision aids.

PubMed

Clifford, Amanda M; Ryan, Jean; Walsh, Cathal; McCurtin, Arlene

2017-02-23

Patient decision aids (DAs) are support tools designed to provide patients with relevant information to help them make informed decisions about their healthcare. While DAs can be effective in improving patient knowledge and decision quality, it is unknown what types of information and evidence are used to populate such decision tools. Systematic methods were used to identify and appraise the relevant literature and patient DAs published between 2006 and 2015. Six databases (Academic Search Complete, AMED, CINAHL, Biomedical Reference Collection, General Sciences and MEDLINE) and reference list searching were used. Articles evaluating the effectiveness of the DAs were appraised using the Cochrane Risk of Bias tool. The content, quality and sources of evidence in the decision aids were evaluated using the IPDASi-SF and a novel classification system. Findings were synthesised and a narrative analysis was performed on the results. Thirteen studies representing ten DAs met the inclusion criteria. The IPDASI-SF score ranged from 9 to 16 indicating many of the studies met the majority of quality criteria. Sources of evidence were described but reports were sometimes generic or missing important information. The majority of DAs incorporated high quality research evidence including systematic reviews and meta-analyses. Patient and practice evidence was less commonly employed, with only a third of included DAs using these to populate decision aid content. The quality of practice and patient evidence ranged from high to low. Contextual factors were addressed across all DAs to varying degrees and covered a range of factors. This is an initial study examining the information and evidence used to populate DAs. While research evidence and contextual factors are well represented in included DAs, consideration should be given to incorporating high quality information representing all four pillars of evidence based practice when developing DAs. Further, patient and expert practice evidence should be acquired rigorously and DAs should report the means by which such evidence is obtained with citations clearly provided.

A systematic review of questionnaires measuring the health of resettling refugee women.

PubMed

Gagnon, Anita J; Tuck, Jodi; Barkun, Laurie

2004-02-01

Because many ethnically diverse refugee women resettle in industrialized countries, several biopsychosocial factors need to be considered in caring for them. This systematic review of studies conducted with female refugees, asylum-seekers, or "unspecified" immigrants based on six electronic databases was conducted to determine which questionnaires best measure relevant variables. Questionnaires were reviewed for measurement properties, application of translation theory, and quality of representation. Studies must have included > or = 1 measure of the following: general health; torture, abuse, sex-and-gender-based violence (SGBV); depression; stress; posttraumatic stress disorder (PTSD); anxiety; somatization; migration history; social support; socioeconomic status; discrimination; or mother-child interactions. Fifty-six studies using 47 questionnaires were identified; only five had strong evidence for use with resettling refugee women. Thus, few high-quality tools are available to measure concepts relevant to resettling refugee women's health.

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

PubMed

Hanna, Timothy P; Kangolle, Alfred C T

2010-10-13

Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

Evaluating the quality, clinical relevance, and resident perception of the radiation oncology in-training examination: A national survey.

PubMed

Kim, Hyun; Bar Ad, Voichita; McAna, John; Dicker, Adam P

2016-01-01

The yearly radiation oncology in-training examination (ITE) by the American College of Radiology is a widely used, norm-referenced educational assessment, with high test reliability and psychometric performance. We distributed a national survey to evaluate the academic radiation oncology community's perception of the ITE. In June 2014, a 7-question online survey was distributed via e-mail to current radiation oncology residents, program directors, and attending physicians who had completed residency in the past 5 years or junior attendings. Survey questions were designed on a 5-point Likert scale. Sign test was performed with P ≤ .05 considered statistically different from neutral. Thirty-one program directors (33.3%), 114 junior attendings (35.4%), and 225 residents (41.2%) responded. Junior attendings and program directors reported that the ITE directly contributed to their preparation for the American Board of Radiology written certification (P = .050 and .004, respectively). Residents did not perceive the examination as an accurate assessment of relevant clinical and scientific knowledge (P < .0001) and feel the quality assurance is insufficient in its current form (P < .0001). Residents and junior attendings agree that there are factual errors, and unclear questions/answers (P < .0001 and .04, respectively). Free response suggestions included: less questions on rare disease sites (16.4%), more relevance to clinical practice (15.4%), avoiding questions that discriminate between a few percentage points (11.8%), and designing the test similar to the written certification examination (9.2%). Despite high examination reliability and psychometric performance, resident and attending physicians report a need for improved quality assurance and clinical relevance in the ITE. Although the current examination allows limited feedback, establishing a venue for individualized feedback may allow continual and timely improvement of the ITE. Adopting a criterion-referenced examination may further increase resident investment in and utilization of this valuable learning tool. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

UK quality statements on end of life care in dementia: a systematic review of research evidence.

PubMed

Candy, Bridget; Elliott, Margaret; Moore, Kirsten; Vickerstaff, Victoria; Sampson, Elizabeth; Jones, Louise

2015-10-19

Globally, the number of people who die with dementia is increasing. The importance of a palliative approach in the care of people with dementia is recognised and there are national polices to enhance current care. In the UK implementation of these polices is promoted by the National Institute for Health and Care Excellence (NICE) Dementia Quality Standards (QS). Since publication of the QS new care interventions have been developed. To explore critically the current international research evidence on effect available to inform NICE Dementia QS relevant to end of life (EOL) care. We used systematic review methods to seek the research evidence for three statements within the Dementia QS. These are those that recommend: (1) a case management approach, (2) discussing and consideration of making a statement about future care (SFC) and (3) a palliative care assessment (PCA). We included evaluative studies of relevant interventions that used a comparative design, such as trials and cohort studies, and measured EOL care outcomes for persons dying with moderate to severe dementia. Our primary outcome of interest was whether the intervention led to a measurable impact on wellbeing for the person with dementia and their family. We assessed included studies for quality using a scale by Higginson and colleagues (2002) for assessment of quality of studies in palliative care, and two authors undertook key review processes. Data sources included Cinahl, Embase, and PsychINFO from 2001 to August 2014. Our search strategy included free text and medical subject headings relevant to population and recommended care. We found seven studies evaluating a care intervention; four assessed SFC, three PCA. None assessed case management. Studies were of weak design; all used retrospective data and relied on others for precise record keeping and for accurate recall of events. There was limited overlap in outcome measurements. Overall reported benefits were mixed. Quality statements relevant to EOL care are useful to advance practice however they have a limited evidence base. High quality empirical work is needed to establish that the recommendations in these statements are best practice.

[Continuing medical education in Germany--the northrhenian experience].

PubMed

Griebenow, R; Lösche, P; Lehmacher, W; Schmülling, A; Chon, S; Christ, H; Stützer, H; Stosch, Ch

2003-04-04

For Germany there exist only very little data concerning the practice of continuous medical education (CME). The introduction of the CME certificate has made it possible to gather data about the CME activities and their evaluation which are presented here for the northrhenian chamber of physicians. In 2002 the northrhenian academy for CME has certified more than 5500 CME activities and more than 2000 maintenance-of-quality group activities. In addition the evaluation forms of the first 4486 consecutive participants have been evaluated,including those of the northrhenian CME congress on the isle of Norderney. 94 % of the participants had received their license between 1 and 30 years ago and 81 % attended > or = 1 CME activity per month. Currently there exist only very few digital media certified for CME, which is dominated by oral presentations of which 85 % have gained > or = 2 points for the certificate (150 points in 3 years). General practitioners and internists together represented nearly 40 % of the participants, the others represent a broad spectrum of specialties. Topics and presentation were rated as of high quality and clinical relevance, which was also true for sponsored CME. Certified CME is currently dominated by oral presentations which mostly take place outside the working hours and which are rated as of high quality and clinical relevance.

Conclusion: applying South East Asia Rainforest Research Programme science to land-use management policy and practice in a changing landscape and climate

PubMed Central

Walsh, Rory P. D.; Nussbaum, Ruth; Fowler, David; Weilenmann, Maja; Hector, Andy

2011-01-01

The context and challenges relating to the remaining tropical rainforest are briefly reviewed and the roles which science can play in addressing questions are outlined. Key messages which articles in the special issue, mainly based on projects of the Royal Society South East Asia Rainforest Research Programme (SEARRP), have raised of relevance to policies on land use, land management and REDD+ are then considered. Results from the atmospheric science and hydrology papers, and some of the ecological ones, demonstrate the very high ecosystem service values of rainforest (compared with oil palm) in maintaining high biodiversity, good local air quality, reducing greenhouse emissions, and reducing landslide, flooding and sedimentation consequences of climate change—and hence provide science to underpin the protection of remaining forest, even if degraded and fragmented. Another group of articles test ways of restoring forest quality (in terms of biodiversity and carbon value) or maintaining as high biodiversity and ecological functioning levels as possible via intelligent design of forest zones and fragments within oil palm landscapes. Finally, factors that have helped to enhance the policy relevance of SEARRP projects and dissemination of their results to decision-makers are outlined. PMID:22006974

iHelp: an intelligent online helpdesk system.

PubMed

Wang, Dingding; Li, Tao; Zhu, Shenghuo; Gong, Yihong

2011-02-01

Due to the importance of high-quality customer service, many companies use intelligent helpdesk systems (e.g., case-based systems) to improve customer service quality. However, these systems face two challenges: 1) Case retrieval measures: most case-based systems use traditional keyword-matching-based ranking schemes for case retrieval and have difficulty to capture the semantic meanings of cases and 2) result representation: most case-based systems return a list of past cases ranked by their relevance to a new request, and customers have to go through the list and examine the cases one by one to identify their desired cases. To address these challenges, we develop iHelp, an intelligent online helpdesk system, to automatically find problem-solution patterns from the past customer-representative interactions. When a new customer request arrives, iHelp searches and ranks the past cases based on their semantic relevance to the request, groups the relevant cases into different clusters using a mixture language model and symmetric matrix factorization, and summarizes each case cluster to generate recommended solutions. Case and user studies have been conducted to show the full functionality and the effectiveness of iHelp.

Ultra-high-pressure homogenization (UHPH) system for producing high-quality vegetable-based beverages: physicochemical, microbiological, nutritional and toxicological characteristics.

PubMed

Ferragut, Victoria; Hernández-Herrero, Manuela; Veciana-Nogués, María Teresa; Borras-Suarez, Miquel; González-Linares, Javier; Vidal-Carou, María Carmen; Guamis, Buenaventura

2015-03-30

A relatively new technology based on a continuous system of ultra-high-pressure homogenization (UHPH) was used for producing high-quality soy and almond beverages as an alternative to conventional heat treatments (pasteurization and UHT). The aim of this study was to compare those treatments by analyzing the most relevant quality parameters with a broad vision from the production to the potential toxicological changes, passing through the main nutritional characteristics. UHPH treatment at 200 MPa, 55 °C T(in) produced a higher reduction of microorganisms than pasteurization. UHPH treatment at 300 MPa, 75 °C T(in) led to complete inactivation of microorganisms, similar to UHT treatment. A much better colloidal stability was observed in both UHPH-treated almond and soy beverages compared with those processed by conventional heat treatments. UHPH treatments led to the same increase in digestibility as heat treatments and did not produce a reduction in the availability of lysine. In addition, UHPH samples of soy beverage seem to be less allergenic based on their lower gut immune response in comparison with heat-treated samples. UHPH treatments could be used to produce high-quality commercial vegetable beverages with different quality standards (fresh or long-life storage) according to consumer preference. © 2014 Society of Chemical Industry.

Assessment of the water quality monitoring network of the Piabanha River experimental watersheds in Rio de Janeiro, Brazil, using autoassociative neural networks.

PubMed

Villas-Boas, Mariana D; Olivera, Francisco; de Azevedo, Jose Paulo S

2017-09-01

Water quality monitoring is a complex issue that requires support tools in order to provide information for water resource management. Budget constraints as well as an inadequate water quality network design call for the development of evaluation tools to provide efficient water quality monitoring. For this purpose, a nonlinear principal component analysis (NLPCA) based on an autoassociative neural network was performed to assess the redundancy of the parameters and monitoring locations of the water quality network in the Piabanha River watershed. Oftentimes, a small number of variables contain the most relevant information, while the others add little or no interpretation to the variability of water quality. Principal component analysis (PCA) is widely used for this purpose. However, conventional PCA is not able to capture the nonlinearities of water quality data, while neural networks can represent those nonlinear relationships. The results presented in this work demonstrate that NLPCA performs better than PCA in the reconstruction of the water quality data of Piabanha watershed, explaining most of data variance. From the results of NLPCA, the most relevant water quality parameter is fecal coliforms (FCs) and the least relevant is chemical oxygen demand (COD). Regarding the monitoring locations, the most relevant is Poço Tarzan (PT) and the least is Parque Petrópolis (PP).

Does a research article's country of origin affect perception of its quality and relevance? A national trial of US public health researchers.

PubMed

Harris, M; Macinko, J; Jimenez, G; Mahfoud, M; Anderson, C

2015-12-30

The source of research may influence one's interpretation of it in either negative or positive ways, however, there are no robust experiments to determine how source impacts on one's judgment of the research article. We determine the impact of source on respondents' assessment of the quality and relevance of selected research abstracts. Web-based survey design using four healthcare research abstracts previously published and included in Cochrane Reviews. All Council on the Education of Public Health-accredited Schools and Programmes of Public Health in the USA. 899 core faculty members (full, associate and assistant professors) Each of the four abstracts appeared with a high-income source half of the time, and low-income source half of the time. Participants each reviewed the same four abstracts, but were randomly allocated to receive two abstracts with high-income source, and two abstracts with low-income source, allowing for within-abstract comparison of quality and relevance Within-abstract comparison of participants' rating scores on two measures--strength of the evidence, and likelihood of referral to a peer (1-10 rating scale). OR was calculated using a generalised ordered logit model adjusting for sociodemographic covariates. Participants who received high income country source abstracts were equal in all known characteristics to the participants who received the abstracts with low income country sources. For one of the four abstracts (a randomised, controlled trial of a pharmaceutical intervention), likelihood of referral to a peer was greater if the source was a high income country (OR 1.28, 1.02 to 1.62, p<0.05). All things being equal, in one of the four abstracts, the respondents were influenced by a high-income source in their rating of research abstracts. More research may be needed to explore how the origin of a research article may lead to stereotype activation and application in research evaluation. 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/

Optimizing the quality of breast cancer care at certified german breast centers: a benchmarking analysis for 2003-2009 with a particular focus on the interdisciplinary specialty of radiation oncology.

PubMed

Brucker, Sara Y; Wallwiener, Markus; Kreienberg, Rolf; Jonat, Walter; Beckmann, Matthias W; Bamberg, Michael; Wallwiener, Diethelm; Souchon, Rainer

2011-02-01

A voluntary, external, science-based benchmarking program was established in Germany in 2003 to analyze and improve the quality of breast cancer (BC) care. Based on recent data from 2009, we aim to show that such analyses can also be performed for individual interdisciplinary specialties, such as radiation oncology (RO). Breast centers were invited to participate in the benchmarking program. Nine guideline-based quality indicators (QIs) were initially defined, reviewed annually, and modified, expanded, or abandoned accordingly. QI changes over time were analyzed descriptively, with particular emphasis on relevance to radiation oncology. During the 2003-2009 study period, there were marked increases in breast center participation and postoperatively confirmed primary BCs. Starting from 9 process QIs, 15 QIs were developed by 2009 as surrogate indicators of long-term outcome. During 2003-2009, 2/7 RO-relevant QIs (radiotherapy after breast-conserving surgery or after mastectomy) showed considerable increases (from 20 to 85% and 8 to 70%, respectively). Another three, initially high QIs practically reached the required levels. The current data confirm proof-of-concept for the established benchmarking program, which allows participating institutions to be compared and changes in quality of BC care to be tracked over time. Overall, marked QI increases suggest that BC care in Germany improved from 2003-2009. Moreover, it has become possible for the first time to demonstrate improvements in the quality of BC care longitudinally for individual breast centers. In addition, subgroups of relevant QIs can be used to demonstrate the progress achieved, but also the need for further improvement, in specific interdisciplinary specialties.

Personality and Relationship Quality During the Transition From High School to Early Adulthood

PubMed Central

Parker, Philip D.; Lüdtke, Oliver; Trautwein, Ulrich; Roberts, Brent W.

2013-01-01

The post–high school transition period is believed to be associated with considerable changes in social networks, yet longitudinal studies documenting these changes are scarce. To address this gap, the current research explored 3 relevant issues. First, changes in participants’ relationship characteristics during the transition from high school were examined. Second, the roles of personality traits as antecedents of these changes were studied. Third, the association between change in relationship characteristics and personality during the transition was explored. A sample of over 2,000 German emerging adults, surveyed before leaving school and then 2 years after the transition from high school, was assessed on personality traits and a multidimensional assessment of the quality of their relationships. Findings indicated that participants experienced mostly positive changes in relationship quality during the transition from high school and that antecedent personality at school was an important predictor of the nature of this change. Finally, change in relationship quality was found to be associated with personality change during the post-school transition. Findings indicated that personality traits may influence transition success and that change in relationships during this transition may influence personality development. The implications of the research for post-school transition success are discussed. PMID:22224909

International standards for tuberculosis care: relevance and implications for laboratory professionals.

PubMed

Pai, M; Daley, P; Hopewell, P C

2007-04-01

On World Tuberculosis (TB) Day 2006, the International Standards for Tuberculosis Care (ISTC) was officially released and widely endorsed by several agencies and organizations. The ISTC release was the culmination of a year long global effort to develop and set internationally acceptable, evidence-based standards for tuberculosis care. The ISTC describes a widely endorsed level of care that all practitioners, public and private, should seek to achieve in managing individuals who have or are suspected of having, TB and is intended to facilitate the effective engagement of all healthcare providers in delivering high quality care for patients of all ages, including those with smear-positive, smear-negative and extra-pulmonary TB, TB caused by drug-resistant Mycobacterium tuberculosis and TB/HIV coinfection. In this article, we present the ISTC, with a special focus on the diagnostic standards and describe their implications and relevance for laboratory professionals in India and worldwide. Laboratory professionals play a critical role in ensuring that all the standards are actually met by providing high quality laboratory services for smear microscopy, culture and drug susceptibility testing and other services such as testing for HIV infection. In fact, if the ISTC is widely followed, it can be expected that there will be a greater need and demand for quality assured laboratory services and this will have obvious implications for all laboratories in terms of work load, requirement for resources and trained personnel and organization of quality assurance systems.

A new framework for designing programmes of assessment

PubMed Central

Van der Vleuten, C. P. M.; Schuwirth, L. W. T.

2009-01-01

Research on assessment in medical education has strongly focused on individual measurement instruments and their psychometric quality. Without detracting from the value of this research, such an approach is not sufficient to high quality assessment of competence as a whole. A programmatic approach is advocated which presupposes criteria for designing comprehensive assessment programmes and for assuring their quality. The paucity of research with relevance to programmatic assessment, and especially its development, prompted us to embark on a research project to develop design principles for programmes of assessment. We conducted focus group interviews to explore the experiences and views of nine assessment experts concerning good practices and new ideas about theoretical and practical issues in programmes of assessment. The discussion was analysed, mapping all aspects relevant for design onto a framework, which was iteratively adjusted to fit the data until saturation was reached. The overarching framework for designing programmes of assessment consists of six assessment programme dimensions: Goals, Programme in Action, Support, Documenting, Improving and Accounting. The model described in this paper can help to frame programmes of assessment; it not only provides a common language, but also a comprehensive picture of the dimensions to be covered when formulating design principles. It helps identifying areas concerning assessment in which ample research and development has been done. But, more importantly, it also helps to detect underserved areas. A guiding principle in design of assessment programmes is fitness for purpose. High quality assessment can only be defined in terms of its goals. PMID:19821042

A new framework for designing programmes of assessment.

PubMed

Dijkstra, J; Van der Vleuten, C P M; Schuwirth, L W T

2010-08-01

Research on assessment in medical education has strongly focused on individual measurement instruments and their psychometric quality. Without detracting from the value of this research, such an approach is not sufficient to high quality assessment of competence as a whole. A programmatic approach is advocated which presupposes criteria for designing comprehensive assessment programmes and for assuring their quality. The paucity of research with relevance to programmatic assessment, and especially its development, prompted us to embark on a research project to develop design principles for programmes of assessment. We conducted focus group interviews to explore the experiences and views of nine assessment experts concerning good practices and new ideas about theoretical and practical issues in programmes of assessment. The discussion was analysed, mapping all aspects relevant for design onto a framework, which was iteratively adjusted to fit the data until saturation was reached. The overarching framework for designing programmes of assessment consists of six assessment programme dimensions: Goals, Programme in Action, Support, Documenting, Improving and Accounting. The model described in this paper can help to frame programmes of assessment; it not only provides a common language, but also a comprehensive picture of the dimensions to be covered when formulating design principles. It helps identifying areas concerning assessment in which ample research and development has been done. But, more importantly, it also helps to detect underserved areas. A guiding principle in design of assessment programmes is fitness for purpose. High quality assessment can only be defined in terms of its goals.

Measuring patient safety in a UK dental hospital: development of a dental clinical effectiveness dashboard.

PubMed

Pemberton, M N; Ashley, M P; Shaw, A; Dickson, S; Saksena, A

2014-10-01

Patient safety is an important marker of quality for any healthcare organisation. In 2008, the British Government white paper entitled High quality care for all, resulting from a review led by Lord Darzi, identified patient safety as a key component of quality and discussed how it might be measured, analysed and acted upon. National and local clinically curated metrics were suggested, which could be displayed via a 'clinical dashboard'. This paper explains the development of a clinical effectiveness dashboard focused on patient safety in an English dental hospital and how it has helped us identify relevant patient safety issues in secondary dental care.

Identifying Research Priorities for School Improvement in the Developing World

ERIC Educational Resources Information Center

Read, Robyn; Fernandez-Hermosilla, Magdalena; Anderson, Stephen; Mundy, Karen

2016-01-01

This paper discusses a research agenda setting project conducted for an international non-governmental organization which aims to help create a regionally relevant, high-quality knowledge base on key education issues of policy and practice. Specifically, we illustrate how our team adapted the Child Health and Nutrition Research Initiative (CHRNI)…

A Comprehensive, Competency-Based Education Framework Using Medium-Sized ERP Systems

ERIC Educational Resources Information Center

Scholtz, Brenda; Cilliers, Charmain; Calitz, Andre

2012-01-01

Graduates with industry-relevant ERP competencies are highly sought after. This requirement is due to a dominance of Enterprise Resource Planning (ERP) systems and the positive affect which good quality ERP specialists have on the success rate of ERP system implementation projects. Universities are therefore increasingly pressurised to supply…

Modeling streams and hydrogeomorphic attributes in Oregon from digital and field data

Treesearch

Sharon E. Clarke; Kelly M. Burnett; Daniel J. Miller

2008-01-01

Managers, regulators, and researchers of aquatic ecosystems are increasingly pressed to consider large areas. However, accurate stream maps with geo-referenced attributes are uncommon over relevant spatial extents. Field inventories provide high-quality data, particularly for habitat characteristics at fine spatial resolutions (e.g., large wood), but are costly and so...

Psychopathic Features Moderate the Relationship between Harsh and Inconsistent Parental Discipline and Adolescent Antisocial Behavior

ERIC Educational Resources Information Center

Edens, John F.; Skopp, Nancy A.; Cahill, Melissa A.

2008-01-01

Although the quality of parenting predicts externalizing behavior problems generally, ineffective parenting may be less relevant to explaining the behavior problems of children high in callous-unemotional traits. This study tested the potential moderating role of psychopathic features among juvenile offenders (n = 76). Youths were administered the…

Development of Creative Potential of Cinema Tourism

ERIC Educational Resources Information Center

Dzhandzhugazova, Elena A.; Ilinaa, Elena L.; Latkin, Aleksander N.; Koshelevava, Anna I.

2016-01-01

The relevance of the problem indicated in the article is caused by the fact that under current conditions it is necessary to offer high-quality and demanded tourist products, formed at the combination of various industries on the basis of wide application of creative potential of different industries, including tourism and cinema, a harmonious…

A Case for Authoring Multi-Touch Interactive Open Educational Resources

ERIC Educational Resources Information Center

Mills, Michael S.

2016-01-01

As textbook prices continue to skyrocket, open educational resources (OER) offer a significant way to deliver high quality content to students in higher education. The pressing issue is whether these OER are engaging, relevant, and accurate. Authoring multi-touch interactive resources that are delivered to students as open-access may not only…

Cross-Age Reading Buddies and Cultural-Sensitive Literature: Student-Centered English Language Instruction in an Ethiopian Budget School

ERIC Educational Resources Information Center

Cianca, Sherri

2012-01-01

The Ethiopian government has called for educational improvement, emphasizing the employment of active, student-centered pedagogy. One way of maximizing an interactive learning approach involves blending a cross-age reading buddies program with high-quality, culturally relevant children's literature. Employing descriptive, mixed-method research,…

A Systematic Review Evaluating the Effect of Vitamin B6 on Semen Quality.

PubMed

Banihani, Saleem Ali

2017-12-30

This review systematically discusses and summarizes the effect of vitamin B6 on semen quality. To achieve this contribution, we searched the PubMed, Scopus, and Web of Science databases for English language papers from 1984 through 2017 using the key words "sperm" versus "Vitamin B6", "pyridoxine", and "pyridoxal". Also, the references from selected published papers were included, only if relevant. To date, as revealed by rodent studies, high doses of vitamin B6 impair semen quality and sperm parameters. While in humans, it is suggested, but not yet directly approved, that seminal vitamin B6 levels may alter sperm quality (i.e., sperm quantity and quality), and that vitamin B6 deficiency may trigger the chemical toxicity to sperm (i.e., hyperhomocysteinemia, oxidative injury). The adverse effect of vitamin B6, when used at high doses, has been revealed in experimental animals, but not yet directly approved in humans. Consequently, in vitro studies on human ejaculate as well as clinical studies that investigate the direct effect of vitamin B6 on semen quality seem very significant.

Relationships between abstract features and methodological quality explained variations of social media activity derived from systematic reviews about psoriasis interventions.

PubMed

Ruano, J; Aguilar-Luque, M; Isla-Tejera, B; Alcalde-Mellado, P; Gay-Mimbrera, J; Hernandez-Romero, José Luis; Sanz-Cabanillas, J L; Maestre-López, B; González-Padilla, M; Carmona-Fernández, P J; Gómez-García, F; García-Nieto, A Vélez

2018-05-24

The aim of this study was to describe the relationship among abstract structure, readability, and completeness, and how these features may influence social media activity and bibliometric results, considering systematic reviews (SRs) about interventions in psoriasis classified by methodological quality. Systematic literature searches about psoriasis interventions were undertaken on relevant databases. For each review, methodological quality was evaluated using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. Abstract extension, structure, readability, and quality and completeness of reporting were analyzed. Social media activity, which consider Twitter and Facebook mention counts, as well as Mendeley readers and Google scholar citations were obtained for each article. Analyses were conducted to describe any potential influence of abstract characteristics on review's social media diffusion. We classified 139 intervention SRs as displaying high/moderate/low methodological quality. We observed that abstract readability of SRs has been maintained high for last 20 years, although there are some differences based on their methodological quality. Free-format abstracts were most sensitive to the increase of text readability as compared with more structured abstracts (IMRAD or 8-headings), yielding opposite effects on their quality and completeness depending on the methodological quality: a worsening in low quality reviews and an improvement in those of high-quality. Both readability indices and PRISMA for Abstract total scores showed an inverse relationship with social media activity and bibliometric results in high methodological quality reviews but not in those of lower quality. Our results suggest that increasing abstract readability must be specially considered when writing free-format summaries of high-quality reviews, because this fact correlates with an improvement of their completeness and quality, and this may help to achieve broader social media visibility and article usage. Copyright © 2018 Elsevier Inc. All rights reserved.

Developing a national framework of quality indicators for public hospitals.

PubMed

Simou, Effie; Pliatsika, Paraskevi; Koutsogeorgou, Eleni; Roumeliotou, Anastasia

2014-01-01

The current study describes the development of a preliminary set of quality indicators for public Greek National Health System (GNHS) hospitals, which were used in the "Health Monitoring Indicators System: Health Map" (Ygeionomikos Chartis) project, with the purpose that these quality indicators would assess the quality of all the aspects relevant to public hospital healthcare workforce and services provided. A literature review was conducted in the MEDLINE database to identify articles referring to international and national hospital quality assessment projects, together with an online search for relevant projects. Studies were included if they were published in English, from 1980 to 2010. A consensus panel took place afterwards with 40 experts in the field and tele-voting procedure. Twenty relevant projects and their 1698 indicators were selected through the literature search, and after the consensus panel process, a list of 67 indicators were selected to be implemented for the assessment of the public hospitals categorized under six distinct dimensions: Quality, Responsiveness, Efficiency, Utilization, Timeliness, and Resources and Capacity. Data gathered and analyzed in this manner provided a novel evaluation and monitoring system for Greece, which can assist decision-makers, healthcare professionals, and patients in Greece to retrieve relevant information, with the long-term goal to improve quality in care in the GNHS hospital sector. Copyright © 2014 John Wiley & Sons, Ltd.

Quality and relevance of master degree education for the professional development of nurses and midwives.

PubMed

Massimi, Azzurra; Marzuillo, Carolina; Di Muzio, Marco; Vacchio, Maria Rosaria; D'Andrea, Elvira; Villari, Paolo; De Vito, Corrado

2017-06-01

Advanced education in nursing is essential to provide safe, high quality and efficient health services in line with population needs. However, there is an almost complete lack of studies on how nurses view the usefulness of post-graduate education for their current employment and for professional advancement. To evaluate how nurse graduates view the quality, relevance and applicability of the knowledge and skills acquired during the Master of Science in Nursing (MSN) degree. Multicentre cross-sectional study. A multicenter cross-sectional study was carried out through an online questionnaire mailed (July 2014-June 2015) to 560 nurses who obtained the MSN degree from 23 Italian universities in the academic year 2010-2011. A total of 426 nurses completed the survey (response rate 76.1%), 80% of whom believed they had acquired knowledge and skills useful in their professional life after graduation. A multiple logistic regression model highlighted the characteristics of nurse graduates who judged the master's course relevant for their present role. In brief, they are expert nurses (OR=3.41, 95% CI=1.54-7.54) who achieved professional growth after the course (OR=5.25, 95% CI=2.67-10.33) and who judged the course very good or excellent (OR=2.16, 95% CI=1.04-4.52). Only 8% of the respondents achieved a full professional growth after the course. In Italy, MSN courses are able to provide a high level of skills and competencies. However, given the low rate of professional growth after the course, specific policies should increase the employment rates of new master's graduate nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

Systematic review of interventions to improve prescribing.

PubMed

Ostini, Remo; Hegney, Desley; Jackson, Claire; Williamson, Margaret; Mackson, Judith M; Gurman, Karin; Hall, Wayne; Tett, Susan E

2009-03-01

To update 2 comprehensive reviews of systematic reviews on prescribing interventions and identify the latest evidence about the effectiveness of the interventions. Systematic searches for English-language reports of experimental and quasi-experimental research were conducted in PubMed (1951-May 2007), EMBASE (1974-March 2008), International Pharmaceutical Abstracts (1970-March 2008), and 11 other bibliographic databases of medical, social science, and business research. Following an initial title screening process and after selecting 6 specific intervention categories (identified from the previous reviews) in community settings, 2 reviewers independently assessed abstracts and then full studies for relevance and quality and extracted relevant data using formal assessment and data extraction tools. Results were then methodically incorporated into the findings of the 2 earlier reviews of systematic reviews. DATA SELECTION AND SYNTHESIS: Twenty-nine of 26,314 articles reviewed were assessed to be of relevant, high-quality research. Audit and feedback, together with educational outreach visits, were the focus of the majority of recent, high-quality research into prescribing interventions. These interventions were also the most effective in improving prescribing practice. A smaller number of studies included a patient-mediated intervention; this intervention was not consistently effective. There is insufficient recent research into manual reminders to confidently update earlier reviews and there remains insufficient evidence to draw conclusions regarding the effectiveness of local consensus processes or multidisciplinary teams. Educational outreach as well as audit and feedback continue to dominate research into prescribing interventions. These 2 prescribing interventions also most consistently show positive results. Much less research is conducted into other types of interventions and there is still very little effort to systematically test why interventions do or do not work.

Reflections on relevance: Psychotherapy and Psychosomatics in 2004.

PubMed

Balon, Richard

2005-01-01

Relevance of an article is a highly desirable yet hardly predictable quality at the time of its publication. Article relevance is frequently measured by the impact factor of the journal where the article is published. Furthermore, impact factor, citation index and citation analysis are used as a measure of research progress and scientific wealth of a nation. The wisdom and significance of this approach to relevance is debatable and thus discussed here. In 2004, Psychotherapy and Psychosomatics published a variety of articles which, in the author's view, are clinically relevant. Several selected clinically relevant issues reviewed in this article include: the conceptualization of fibromyalgia as a stress disorder; the psychosocial impact and psychosocial interventions in cancer; the impact of alexithymia on patient care; the possible relationship between depression and nutrition (namely intake of folate and pyridoxal phosphate); the significance of hypercoagulability in panic-like anxiety; the questionable value of single isomer drugs, and the relevance and adequacy of clinimetrics versus psychometrics in clinical research. The reviewed issues seem to be relevant to clinical practice, research or both, but also to our critical thinking, and the critical review of the developments in psychiatry and psychology. Copyright 2005 S. Karger AG, Basel.

Non-invasive interventions for improving well-being and quality of life in patients with lung cancer.

PubMed

Solà, I; Thompson, E; Subirana, M; López, C; Pascual, A

2004-10-18

Lung cancer is one of the leading causes of death globally. Despite advances in treatment, outlook for the majority of patients remains grim and most face a pessimistic outlook accompanied by sometimes devastating effects on emotional and psychological health. Although chemotherapy is accepted as an effective treatment for advanced lung cancer, the high prevalence of treatment-related side effects as well the symptoms of disease progression highlight the need for high quality palliative and supportive care to minimise symptom distress and to promote quality of life. To assess the effectiveness of non-invasive interventions delivered by healthcare professionals in improving symptoms, psychological functioning and quality of life in patients with lung cancer. The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2003), MEDLINE (1966-March 2003), EMBASE (1974-March 2003), CINAHL (1982-September 2002), CancerLit (1975-October 2002), PsycINFO (1873-March 2003), reference lists of relevant articles and contact with authors. Randomised or quasi-randomised clinical trials assessing the effects of non-invasive interventions in improving well-being and quality of life in patients diagnosed with lung cancer. Two reviewers independently assessed relevant studies for inclusion. Data extraction and quality assessment of relevant studies was performed by one reviewer and checked by a second reviewer. Nine trials were included and categorised into six groups. Two trials of a nursing intervention to manage breathlessness showed benefit on symptom experience, performance status and emotional functioning. Three trials assessed structured nursing programmes and found positive effects on delay in clinical deterioration, dependency and symptom distress, and improvements in emotional functioning and satisfaction with care. One trial assessing counselling showed benefit on some emotional components of the illness but findings were not conclusive. One trial assessing an exercise programme, found a beneficial effect on self-empowerment. One trial of nutritional interventions found positive effects for increasing energy intake, but no improvement in quality of life. One trial of reflexology showed some positive, but short-lasting effects on anxiety. Nurse follow-up programmes and a nurse intervention to manage breathlessness may produce beneficial effects. Psychotherapeutic study indicates that counselling may help patients cope more effectively with emotional symptoms, but the evidence is not conclusive. Findings from the included studies reinforce the necessity for increased training and education of healthcare professionals giving in these interventions. More research, of higher methodological quality is needed in this area to explore possible underlying explanatory mechanisms.

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases

PubMed Central

Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas OF; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

2016-01-01

Background The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. Objective The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. Methods First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. Results We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. Conclusions The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality. PMID:27562540

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases.

PubMed

Pauer, Frédéric; Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas Of; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

2016-08-25

The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality.

A systematic review of the factors that influence the quality and effectiveness of telesupervision for health professionals.

PubMed

Martin, Priya; Lizarondo, Lucylynn; Kumar, Saravana

2018-05-01

Introduction Whilst telesupervision (clinical supervision undertaken using communication technology) is being used more frequently, there is limited information on what factors influence its effectiveness and quality. We undertook this systematic review to address this gap. Methods Eligible telesupervision studies were identified following targeted search of electronic databases and the grey literature. Data were synthesised thematically, resulting in development of core themes. Results We identified 286 papers for initial relevancy screening by title and abstract. The full text of 36 papers were then retrieved and assessed for further relevance. A total of 11 papers were included in the final analysis. We identified eight themes that contribute to effective and high-quality telesupervision: supervisee characteristics, supervisor characteristics, supervision characteristics, supervisory relationship, communication strategies, prior face-to-face contact, environmental factors and technological considerations. Conclusion From the available evidence, telesupervision can be a feasible and acceptable form of clinical supervision if set up well. Further studies with robust designs are required to strengthen the existing evidence on what makes telesupervision effective, as well as to examine its cost-effectiveness.

Health Sector Reform in the Kurdistan Region - Iraq: Financing Reform, Primary Care, and Patient Safety.

PubMed

Anthony, C Ross; Moore, Melinda; Hilborne, Lee H; Mulcahy, Andrew W

2014-12-30

In 2010, the Kurdistan Regional Government asked the RAND Corporation to help guide reform of the health care system in the Kurdistan Region of Iraq. The overarching goal of reform was to help establish a health system that would provide high-quality services efficiently to everyone to prevent, treat, and manage physical and mental illnesses and injuries. This article summarizes the second phase of RAND's work, when researchers analyzed three distinct but intertwined health policy issue areas: development of financing policy, implementation of early primary care recommendations, and evaluation of quality and patient safety. For health financing, the researchers reviewed the relevant literature, explored the issue in discussions with key stakeholders, developed and assessed various policy options, and developed plans or approaches to overcome barriers and achieve stated policy objectives. In the area of primary care, they developed and helped to implement a new management information system. In the area of quality and patient safety, they reviewed relevant literature, discussed issues and options with health leaders, and recommended an approach toward incremental implementation.

Specialized medical search-engines are no better than general search-engines in sourcing consumer information about androgen deficiency.

PubMed

Ilic, D; Bessell, T L; Silagy, C A; Green, S

2003-03-01

The Internet provides consumers with access to online health information; however, identifying relevant and valid information can be problematic. Our objectives were firstly to investigate the efficiency of search-engines, and then to assess the quality of online information pertaining to androgen deficiency in the ageing male (ADAM). Keyword searches were performed on nine search-engines (four general and five medical) to identify website information regarding ADAM. Search-engine efficiency was compared by percentage of relevant websites obtained via each search-engine. The quality of information published on each website was assessed using the DISCERN rating tool. Of 4927 websites searched, 47 (1.44%) and 10 (0.60%) relevant websites were identified by general and medical search-engines respectively. The overall quality of online information on ADAM was poor. The quality of websites retrieved using medical search-engines did not differ significantly from those retrieved by general search-engines. Despite the poor quality of online information relating to ADAM, it is evident that medical search-engines are no better than general search-engines in sourcing consumer information relevant to ADAM.

Selected highly charged ions as prospective candidates for optical clocks with quality factors larger than 1015

NASA Astrophysics Data System (ADS)

Yu, Yan-mei; Sahoo, B. K.

2018-04-01

The Ni12 +, Cu13 +, Pd12 +, and Ag13 + highly charged ions (HCIs) are proposed for making very accurate optical clocks with the fractional uncertainties below 10-19 level. These HCIs have simple atomic energy levels, clock transitions with quality factors larger than 1015, and optical magnetic-dipole (M 1 ) transitions that can be used for laser cooling and detecting quantum jumps on the clock transitions by the shelving method. To demonstrate the projected fractional uncertainties, we estimate orders of magnitude of the Zeeman, Stark, blackbody radiation, and electric quadrupole shifts of the clock transitions by performing calculations of the relevant atomic properties in the above HCIs.

Key elements of high-quality practice organisation in primary health care: a systematic review.

PubMed

Crossland, Lisa; Janamian, Tina; Jackson, Claire L

2014-08-04

To identify elements that are integral to high-quality practice and determine considerations relating to high-quality practice organisation in primary care. A narrative systematic review of published and grey literature. Electronic databases (PubMed, CINAHL, the Cochrane Library, Embase, Emerald Insight, PsycInfo, the Primary Health Care Research and Information Service website, Google Scholar) were searched in November 2013 and used to identify articles published in English from 2002 to 2013. Reference lists of included articles were searched for relevant unpublished articles and reports. Data were configured at the study level to allow for the inclusion of findings from a broad range of study types. Ten elements were most often included in the existing organisational assessment tools. A further three elements were identified from an inductive thematic analysis of descriptive articles, and were noted as important considerations in effective quality improvement in primary care settings. Although there are some validated tools available to primary care that identify and build quality, most are single-strategy approaches developed outside health care settings. There are currently no validated organisational improvement tools, designed specifically for primary health care, which combine all elements of practice improvement and whose use does not require extensive external facilitation.

Could be the future climate change an opportunity for the winegrowers? The case study of Aglianico wine in southern Italy.

NASA Astrophysics Data System (ADS)

Bonfante, Antonello; Basile, Angelo; Dragonetti, Giovanna; De Lorenzi, Francesca; De Mascellis, Roberto; Gambuti, Angelita; Giorio, Pasquale; Guida, Giampiero; Manna, Piero; Minieri, Luciana; Oliva, Marco; Orefice, Nadia; Terribile, Fabio

2015-04-01

Water deficit is a limiting factor to yield production and crop adaptation to future climate conditions. This is true for crops addressed mainly for biomass production (e.g. maize, wheat, etc.) but not for those where the quality is relevant. Specifically, in grapevine water stress (mid or limited) - occurring during specific phenological phases - is a factor to produce good quality wines. It induces for example the production of anthocyanins and aroma precursors. Therefore, the water stress, due to the future increase of temperature and the rainfall decrease, could represent an opportunity to increase winegrowers' incomes. The study was carried out in Campania region (Southern Italy), in an area vocated to high quality wines production (ZOVISA project: Viticultural zoning at farm scale) The study was realized in two different soils (calcisol and cambisol), under the same climate, on Aglianico cultivar, standard clone population on 1103 Paulsen rootstocks placed along a slope of 90 m length with 11% of gradient. The agro-hydrological model SWAP was calibrated and applied to estimate soil-plant water status at the various crop phenological phases for three vintages (2011-2013). Crop water stress index (CWSI) - estimated by the model - was related to physiological measurements (e.g leaf water potential), grape bunches measurements (e.g. sugar content) and wine quality (e.g. tannins). For both soils, the correlation between measurements and CWSI were high (e.g. -0.97** with sugar; 0.895* with anthocyanins in the skins). Then, the model was applied to future climate condition (2021-2051) obtained from statistical downscaling of GCM in order to estimate the effect of the climate on CWSI and hence on vine quality. The results show that the effects of the climate change on the vine quality is dependent by the soil, being relevant to the cambisol and less pronounced to the calcisol, with an expected improvement of wine quality in the cambisol.

Performance analysis of medical video streaming over mobile WiMAX.

PubMed

Alinejad, Ali; Philip, N; Istepanian, R H

2010-01-01

Wireless medical ultrasound streaming is considered one of the emerging application within the broadband mobile healthcare domain. These applications are considered as bandwidth demanding services that required high data rates with acceptable diagnostic quality of the transmitted medical images. In this paper, we present the performance analysis of a medical ultrasound video streaming acquired via special robotic ultrasonography system over emulated WiMAX wireless network. The experimental set-up of this application is described together with the performance of the relevant medical quality of service (m-QoS) metrics.

RAMICS: trainable, high-speed and biologically relevant alignment of high-throughput sequencing reads to coding DNA

PubMed Central

Wright, Imogen A.; Travers, Simon A.

2014-01-01

The challenge presented by high-throughput sequencing necessitates the development of novel tools for accurate alignment of reads to reference sequences. Current approaches focus on using heuristics to map reads quickly to large genomes, rather than generating highly accurate alignments in coding regions. Such approaches are, thus, unsuited for applications such as amplicon-based analysis and the realignment phase of exome sequencing and RNA-seq, where accurate and biologically relevant alignment of coding regions is critical. To facilitate such analyses, we have developed a novel tool, RAMICS, that is tailored to mapping large numbers of sequence reads to short lengths (<10 000 bp) of coding DNA. RAMICS utilizes profile hidden Markov models to discover the open reading frame of each sequence and aligns to the reference sequence in a biologically relevant manner, distinguishing between genuine codon-sized indels and frameshift mutations. This approach facilitates the generation of highly accurate alignments, accounting for the error biases of the sequencing machine used to generate reads, particularly at homopolymer regions. Performance improvements are gained through the use of graphics processing units, which increase the speed of mapping through parallelization. RAMICS substantially outperforms all other mapping approaches tested in terms of alignment quality while maintaining highly competitive speed performance. PMID:24861618

The association between higher body mass index and poor school performance in high school students.

PubMed

Tonetti, L; Fabbri, M; Filardi, M; Martoni, M; Natale, V

2016-12-01

This study aimed to examine the association between body mass index (BMI) and school performance in high school students by controlling for relevant mediators such as sleep quality, sleep duration and socioeconomic status. Thirty-seven high school students (mean age: 18.16 ± 0.44 years) attending the same school type, i.e. 'liceo scientifico' (science-based high school), were enrolled. Students' self-reported weight and height were used to calculate BMI. Participants wore an actigraph to objectively assess the quality and duration of sleep. School performance was assessed through the actual grade obtained at the final school-leaving exam, in which higher grades indicate higher performance. BMI, get-up time, mean motor activity, wake after sleep onset and number of awakenings were negatively correlated with the grade, while sleep efficiency was positively correlated. When performing a multiple regression analysis, BMI proved the only significant (negative) predictor of grade. When controlling for sleep quality, sleep duration and socioeconomic status, a higher BMI is associated with a poorer school performance in high school students. © 2015 World Obesity Federation.

Assessing the Methodological Quality of Glaucoma Clinical Practice Guidelines and Their Recommendations on Microinvasive Glaucoma Surgery: A Systematic Review.

PubMed

Michaelov, Evan; Armstrong, James J; Nguyen, Mary; Instrum, Bridget; Lam, Tracey; Denstedt, James; Hutnik, Cindy M L

2018-02-01

Clinical practice guidelines (CPG) are regarded by many as critical communications providing guidance within specific medical fields. Over a decade ago, the first microinvasive glaucoma surgical (MIGS) procedures were introduced. Since then, a number of these novel intraocular pressure controlling surgical options have been approved worldwide. Governing bodies and health care administration often utilize CPGs when considering funding for newer technologies. This highlights the importance of well-written, accurate, and up-to-date CPGs in the rapidly evolving field of MIGS. If CPGs are unable to fill this role, their use in treatment decision-making is doing a disservice to patients, who will be denied currently available and potentially superior care. To determine the overall value of a CPG, the methodological quality with which it was developed, in addition to the current relevance and appropriateness of its recommendations, should be evaluated. The objective of the present study was to assess the methodological quality of currently available international glaucoma CPGs, as well as their coverage of MIGS as a surrogate marker of relevance and appropriateness to policy-makers and ophthalmologists alike. To identify potentially relevant CPGs, a predefined search strategy was used to search the following databases: Medline, EMBASE, BIOSIS, and Web of Science. All CPGs related to adult glaucoma and published in English were included. CPG methodological quality was assessed by 3 individuals using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Studies were then assessed for coverage of MIGS devices and procedures. Search strategy and subsequent screening identified 11 CPGs for analysis. Eight were of high quality according to the AGREE II criteria. Three included basic information on MIGS, but none provided specific recommendations regarding their indications or which patient populations would benefit most. Many international glaucoma CPGs are of high methodological quality. However, coverage of MIGS is sparse, nonspecific and in many instances, absent. This causes CPGs to be a suboptimal source in guiding physicians and health policy-makers in areas characterized by novel and/or rapidly evolving technologies. Mechanisms to incorporate updated evidence in CPGs would have to be considered before they can be used as a source of contemporary clinical decision-making.

Social media as a sensor of air quality and public response in China.

PubMed

Wang, Shiliang; Paul, Michael J; Dredze, Mark

2015-03-26

Recent studies have demonstrated the utility of social media data sources for a wide range of public health goals, including disease surveillance, mental health trends, and health perceptions and sentiment. Most such research has focused on English-language social media for the task of disease surveillance. We investigated the value of Chinese social media for monitoring air quality trends and related public perceptions and response. The goal was to determine if this data is suitable for learning actionable information about pollution levels and public response. We mined a collection of 93 million messages from Sina Weibo, China's largest microblogging service. We experimented with different filters to identify messages relevant to air quality, based on keyword matching and topic modeling. We evaluated the reliability of the data filters by comparing message volume per city to air particle pollution rates obtained from the Chinese government for 74 cities. Additionally, we performed a qualitative study of the content of pollution-related messages by coding a sample of 170 messages for relevance to air quality, and whether the message included details such as a reactive behavior or a health concern. The volume of pollution-related messages is highly correlated with particle pollution levels, with Pearson correlation values up to .718 (n=74, P<.001). Our qualitative results found that 67.1% (114/170) of messages were relevant to air quality and of those, 78.9% (90/114) were a firsthand report. Of firsthand reports, 28% (32/90) indicated a reactive behavior and 19% (17/90) expressed a health concern. Additionally, 3 messages of 170 requested that action be taken to improve quality. We have found quantitatively that message volume in Sina Weibo is indicative of true particle pollution levels, and we have found qualitatively that messages contain rich details including perceptions, behaviors, and self-reported health effects. Social media data can augment existing air pollution surveillance data, especially perception and health-related data that traditionally requires expensive surveys or interviews.

Effectiveness of teaching evidence-based medicine to undergraduate medical students: a BEME systematic review.

PubMed

Ahmadi, Seyed-Foad; Baradaran, Hamid R; Ahmadi, Emad

2015-01-01

Despite the widespread teaching of evidence-based medicine (EBM) to medical students, the relevant literature has not been synthesized appropriately as to its value and effectiveness. To systematically review the literature regarding the impact of teaching EBM to medical students on their EBM knowledge, attitudes, skills and behaviors. MEDLINE, SCOPUS, Web of science, ERIC, CINAHL and Current Controlled Trials up to May 2011 were searched; backward and forward reference checking of included and relevant studies was also carried out. Two investigators independently extracted data and assessed the quality of the studies. 10,111 potential studies were initially found, of which 27 were included in the review. Six studies examined the effect of clinically integrated methods, of which five had a low quality and the other one used no validated assessment tool. Twelve studies evaluated the effects of seminars, workshops and short courses, of which 11 had a low quality and the other one lacked a validated assessment tool. Six studies examined e-learning, of which five having a high or acceptable quality reported e-learning to be as effective as traditional teaching in improving knowledge, attitudes and skills. One robust study found problem-based learning less effective compared to usual teaching. Two studies with high or moderate quality linked multicomponent interventions to improved knowledge and attitudes. No included study assessed the long-term effects of the teaching of EBM. Our findings indicated that some EBM teaching strategies have the potential to improve knowledge, attitudes and skills in undergraduate medical students, but the evidenced base does not demonstrate superiority of one method. There is no evidence demonstrating transfer to clinical practice.

An exploration of elementary science teachers' expertise, creativity skills, and motivation in relation to the use of an innovation and the delivery of high-quality science instruction

NASA Astrophysics Data System (ADS)

Falkenberg, Karen L.

This two-year study sought to uncover characteristic differences among a purposive sample of 23 elementary teachers who were using an elementary science innovation with various levels of proficiency. Two theoretical frameworks supported the development of the research, the Concerns Based Adoption Model Level of Use (LoU) (Hord, Rutherford, Huling-Austin & Hall, 1987) and Amabile's (1996) Componential Model of Creativity. Both qualitative and quantitative methodologies were employed to gather data on participants' science content knowledge, pedagogical skill, creativity relevant process skills, motivation orientation, self-efficacy, outcome expectancy and workplace environment. Results dispute the common conception among educators that "mechanical use" teachers do not provide high quality lessons. A new method for categorizing teachers' proficiency with an innovation is suggested by this study that incorporates both qualitative data from the LoU interview and classroom observation. Additionally, results show that the quality of the observed science lessons was associated with a teacher's creativity. The data suggest that a teacher's creativity relevant process skills and expertise are indicators of lesson quality. There were important differences among teachers' conceptions of creativity, how they involved students in the reported lessons and in the type of adaptations they made to the innovation. The more creative teachers tended to provide lessons that were more complex, of longer duration, had ties to student home life, and used multiple resources. Following an analysis of these results is a set of suggested professional development strategies and workplace changes to support less proficient teachers in their ability to provide higher quality elementary science lessons.

TIME-RELEVANT BEACH AND RECREATIONAL WATER QUALITY AND MONITORING AND REPORTING

EPA Science Inventory

This handbook provides information on how to design and implement a time-relevant water quality monitoring program for beaches and other recreational waters. It was developed to help interested communities learn more about the beach monitoring projects associated with EPA's Envir...

Relevance of Google-customized search engine vs. CISMeF quality-controlled health gateway.

PubMed

Gehanno, Jean-François; Kerdelhue, Gaétan; Sakji, Saoussen; Massari, Philippe; Joubert, Michel; Darmoni, Stéfan J

2009-01-01

CISMeF (acronym for Catalog and Index of French Language Health Resources on the Internet) is a quality-controlled health gateway conceived to catalog and index the most important and quality-controlled sources of institutional health information in French. The goal of this study is to compare the relevance of results provided by this gateway from a small set of documents selected and described by human experts to those provided by a search engine from a large set of automatically indexed and ranked resources. The Google-Customized search engine (CSE) was used. The evaluation was made using the 10th first results of 15 queries and two blinded physician evaluators. There was no significant difference between the relevance of information retrieval in CISMeF and Google CSE. In conclusion, automatic indexing does not lead to lower relevance than a manual MeSH indexing and may help to cope with the increasing number of references to be indexed in a controlled health quality gateway.

Theory and Practice: How Filming "Learning in the Real World" Helps Students Make the Connection

ERIC Educational Resources Information Center

Commander, Nannette Evans; Ward, Teresa E.; Zabrucky, Karen M.

2012-01-01

This article describes an assignment, titled "Learning in the Real World," designed for graduate students in a learning theory course. Students work in small groups to create high quality audio-visual films that present "real learning" through interviews and/or observations of learners. Students select topics relevant to theories we are discussing…

Transforming the Initial Marketing Education Experience: An Action Learning Approach

ERIC Educational Resources Information Center

Young, Mark R.

2010-01-01

Marketing education today is facing significant challenges in attracting and retaining high-quality students. The focus of this article is to advocate engaging 1st-year students in the practice of marketing to help develop their identity as a marketing major, to see the relevance of their studies, and to enhance their thinking and self-regulating…

Knowledge Is Power: The Issue of Censorship in Middle Grades Literacy Instruction

ERIC Educational Resources Information Center

Whitney, Jennifer D.

2007-01-01

Book challenges have become more and more frequent in recent years. In particular, those books that address issues most relevant to preteens and teenagers seem to be the object of many challenges. Many of the hundreds of challenged works represent literary classics and high-quality writing for young audiences. Teachers, administrators and other…

Assessment of fruit aroma for twenty-seven guava (Psidium guajava) accessions through three fruit developmental stages

USDA-ARS?s Scientific Manuscript database

Guava (Psidium guajava) is valued for its rich, tropical aroma, but fruit quality data are lacking for many important cultivars. Guava is native to warm-climate parts of the Americas and is grown commercially in southern Florida, USA. Varieties relevant to south Florida show a high level of morpholo...

Students' Reflections on the Relevance and Quality of Highly Ranked Doctoral Programs in Educational Administration: Beacons of Leadership Preparation?

ERIC Educational Resources Information Center

Hoyle, John R.; Torres, Mario S., Jr.

2008-01-01

The manner by which colleges and universities prepare school leaders in doctoral programs is being called into question. One report is stirring much controversy for its unflattering portrayal of administrator preparation programs. In a 2005 report entitled "Educating School Leaders," former Columbia University president Art Levine characterizes…

Nature and the Outdoor Learning Environment: The Forgotten Resource in Early Childhood Education

ERIC Educational Resources Information Center

Cooper, Allen

2015-01-01

Longitudinal studies now confirm the economic, academic, and social importance of high-quality early childhood education. At the same time, a substantial body of research indicates that an outdoor learning and play environment with diverse natural elements advances and enriches all of the domains relevant to the development, health, and well-being…

An A+ Teaching Model for Serving K-12 Gifted Students in a Technologically Rich Environment

ERIC Educational Resources Information Center

Maynard, Brandi

2012-01-01

Experts in the field have had a difficult time finding a conclusive set of attributes of high-quality gifted teachers using collaborative technology. The purpose of this multiple, exploratory case study was to examine the views of selected educators regarding the teacher characteristics and technology most relevant to the development of shared…

Leveraging Learning: The Evolving Role of Federal Policy in Education Research

ERIC Educational Resources Information Center

Knowles, Timothy; Kober, Nancy; Ludwig, Jens; Petrilli, Michael J.; Slavin, Robert; Tseng, Vivian

2013-01-01

As transformative reforms like the Common Core State Standards and educator evaluation roll out amidst a rapidly changing demographic landscape, the need for getting high-quality research on timely topics into the hands of practitioners grows all the more urgent. While rigor and relevance need not be a question of "either/or", but rather…

Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.

PubMed

Phelan, S M; Burgess, D J; Yeazel, M W; Hellerstedt, W L; Griffin, J M; van Ryn, M

2015-04-01

The objective of this study was to critically review the empirical evidence from all relevant disciplines regarding obesity stigma in order to (i) determine the implications of obesity stigma for healthcare providers and their patients with obesity and (ii) identify strategies to improve care for patients with obesity. We conducted a search of Medline and PsychInfo for all peer-reviewed papers presenting original empirical data relevant to stigma, bias, discrimination, prejudice and medical care. We then performed a narrative review of the existing empirical evidence regarding the impact of obesity stigma and weight bias for healthcare quality and outcomes. Many healthcare providers hold strong negative attitudes and stereotypes about people with obesity. There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behaviour and decision-making. These attitudes may impact the care they provide. Experiences of or expectations for poor treatment may cause stress and avoidance of care, mistrust of doctors and poor adherence among patients with obesity. Stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care. There are several potential intervention strategies that may reduce the impact of obesity stigma on quality of care. © 2015 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity (IASO).

High-quality Health Information Provision for Stroke Patients.

PubMed

Du, Hong-Sheng; Ma, Jing-Jian; Li, Mu

2016-09-05

High-quality information provision can allow stroke patients to effectively participate in healthcare decision-making, better manage the stroke, and make a good recovery. In this study, we reviewed information needs of stroke patients, methods for providing information to patients, and considerations needed by the information providers. The literature concerning or including information provision for patients with stroke in English was collected from PubMed published from 1990 to 2015. We included all the relevant articles on information provision for stroke patients in English, with no limitation of study design. Stroke is a major public health concern worldwide. High-quality and effective health information provision plays an essential role in helping patients to actively take part in decision-making and healthcare, and empowering them to effectively self-manage their long-standing chronic conditions. Different methods for providing information to patients have their relative merits and suitability, and as a result, the effective strategies taken by health professionals may include providing high-quality information, meeting patients' individual needs, using suitable methods in providing information, and maintaining active involvement of patients. It is suggested that to enable stroke patients to access high-quality health information, greater efforts need to be made to ensure patients to receive accurate and current evidence-based information which meets their individual needs. Health professionals should use suitable information delivery methods, and actively involve stroke patients in information provision.

Maintaining High Quality Data and Consistency Across a Diverse Flux Network: The Ameriflux QA/QC Technical Team

NASA Astrophysics Data System (ADS)

Chan, S.; Billesbach, D. P.; Hanson, C. V.; Biraud, S.

2014-12-01

The AmeriFlux quality assurance and quality control (QA/QC) technical team conducts short term (<2 weeks) intercomparisons using a portable eddy covariance system (PECS) to maintain high quality data observations and data consistency across the AmeriFlux network (http://ameriflux.lbl.gov/). Site intercomparisons identify discrepancies between the in situ and portable measurements and calculated fluxes. Findings are jointly discussed by the site staff and the QA/QC team to improve in the situ observations. Despite the relatively short duration of an individual site intercomparison, the accumulated record of all site visits (numbering over 100 since 2002) is a unique dataset. The ability to deploy redundant sensors provides a rare opportunity to identify, quantify, and understand uncertainties in eddy covariance and ancillary measurements. We present a few specific case studies from QA/QC site visits to highlight and share new and relevant findings related to eddy covariance instrumentation and operation.

Biological and functional relevance of CASP predictions

PubMed Central

Liu, Tianyun; Ish‐Shalom, Shirbi; Torng, Wen; Lafita, Aleix; Bock, Christian; Mort, Matthew; Cooper, David N; Bliven, Spencer; Capitani, Guido; Mooney, Sean D.

2017-01-01

Abstract Our goal is to answer the question: compared with experimental structures, how useful are predicted models for functional annotation? We assessed the functional utility of predicted models by comparing the performances of a suite of methods for functional characterization on the predictions and the experimental structures. We identified 28 sites in 25 protein targets to perform functional assessment. These 28 sites included nine sites with known ligand binding (holo‐sites), nine sites that are expected or suggested by experimental authors for small molecule binding (apo‐sites), and Ten sites containing important motifs, loops, or key residues with important disease‐associated mutations. We evaluated the utility of the predictions by comparing their microenvironments to the experimental structures. Overall structural quality correlates with functional utility. However, the best‐ranked predictions (global) may not have the best functional quality (local). Our assessment provides an ability to discriminate between predictions with high structural quality. When assessing ligand‐binding sites, most prediction methods have higher performance on apo‐sites than holo‐sites. Some servers show consistently high performance for certain types of functional sites. Finally, many functional sites are associated with protein‐protein interaction. We also analyzed biologically relevant features from the protein assemblies of two targets where the active site spanned the protein‐protein interface. For the assembly targets, we find that the features in the models are mainly determined by the choice of template. PMID:28975675

A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products.

PubMed

Hatchard, Jenny L; Fooks, Gary J; Evans-Reeves, Karen A; Ulucanlar, Selda; Gilmore, Anna B

2014-02-12

To examine the volume, relevance and quality of transnational tobacco corporations' (TTCs) evidence that standardised packaging of tobacco products 'won't work', following the UK government's decision to 'wait and see' until further evidence is available. Content analysis. We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging 'won't work'. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging 'won't work' lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria-subject matter, independence and peer-review status-to critically assess evidence submitted to them by corporate interests via Better Regulation processes.

A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products

PubMed Central

Hatchard, Jenny L; Fooks, Gary J; Evans-Reeves, Karen A; Ulucanlar, Selda; Gilmore, Anna B

2014-01-01

Objectives To examine the volume, relevance and quality of transnational tobacco corporations’ (TTCs) evidence that standardised packaging of tobacco products ‘won't work’, following the UK government's decision to ‘wait and see’ until further evidence is available. Design Content analysis. Setting We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. Outcome measures The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. Results 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging ‘won't work’. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). Conclusions With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging ‘won't work’ lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria—subject matter, independence and peer-review status—to critically assess evidence submitted to them by corporate interests via Better Regulation processes. PMID:24523419

Under which conditions can introverts achieve happiness? Mediation and moderation effects of the quality of social relationships and emotion regulation ability on happiness

PubMed Central

Cabello, Rosario

2015-01-01

Personality traits have been directly associated with happiness. One consistent finding is a strong link between extraversion and happiness: extraverts are happier than introverts. Although happy introverts exist, it is currently unclear under what conditions they can achieve happiness. The present study analyzes, generally, how the quality of social relationships and emotion regulation ability influence happiness and, specifically, how these factors can lead introverts to be happy. In the present study, 1,006 participants aged 18–80 (42% males) completed measures of extraversion, neuroticism, quality of social relationships, emotion regulation ability, and happiness. We found that extraverts had significantly higher happiness, quality of social relationships and emotion regulation ability scores than introverts. In addition, people with high quality social relationships or high emotion regulation ability were happier. Serial mediation analyses indicated that greater levels of extraversion were associated with greater happiness, with small effect size, via two indirect mechanisms: (a) higher quality of social relationships, and (b) higher quality of social relationships followed serially by higher emotion regulation ability. We also found a moderating effect due to the three-way interaction of extraversion, quality of social relationships, and emotion regulation ability: introverts were happier when they had high scores for these two variables, though the effect size was small. These results suggest that the quality of social relationships and emotion regulation ability are relevant to our understanding of complex associations between extraversion and happiness. PMID:26500814

Under which conditions can introverts achieve happiness? Mediation and moderation effects of the quality of social relationships and emotion regulation ability on happiness.

PubMed

Cabello, Rosario; Fernandez-Berrocal, Pablo

2015-01-01

Personality traits have been directly associated with happiness. One consistent finding is a strong link between extraversion and happiness: extraverts are happier than introverts. Although happy introverts exist, it is currently unclear under what conditions they can achieve happiness. The present study analyzes, generally, how the quality of social relationships and emotion regulation ability influence happiness and, specifically, how these factors can lead introverts to be happy. In the present study, 1,006 participants aged 18-80 (42% males) completed measures of extraversion, neuroticism, quality of social relationships, emotion regulation ability, and happiness. We found that extraverts had significantly higher happiness, quality of social relationships and emotion regulation ability scores than introverts. In addition, people with high quality social relationships or high emotion regulation ability were happier. Serial mediation analyses indicated that greater levels of extraversion were associated with greater happiness, with small effect size, via two indirect mechanisms: (a) higher quality of social relationships, and (b) higher quality of social relationships followed serially by higher emotion regulation ability. We also found a moderating effect due to the three-way interaction of extraversion, quality of social relationships, and emotion regulation ability: introverts were happier when they had high scores for these two variables, though the effect size was small. These results suggest that the quality of social relationships and emotion regulation ability are relevant to our understanding of complex associations between extraversion and happiness.

Factors influencing quality of life of obese students in Hangzhou, China.

PubMed

Chen, Ying-Ping; Wang, Hong-Mei; Edwards, Todd C; Wang, Ting; Jiang, Xiao-Ying; Lv, Yi-Ran; Patrick, Donald L

2015-01-01

To evaluate the quality of life (QOL) of overweight and obese middle or high school students and identify relevant factors influencing their QOL scores. 716 students were recruited from 6 middle or high schools in Hangzhou, China. The Chinese version of the Youth Quality of Life Instrument-Weight Module (YQOL-W) was self administered. The YQOL-W scores were compared among different BMI groups, gender, educational status, annual household income, parental education and recruitment community using t test or one-way analysis of variance. The independent association of these variables with QOL among overweight and obese students was examined using multivariable linear regression modeling. Overweight and obese students reported lower total scores, self, social and environment scores than their normal weight peers (all P<0.001). The QOL of overweight and obese middle and high school students was associated with BMI value, gender, educational status, parental education, and recruitment community. Girls had lower total scores, self, social and environment domain scores than boys (all P<0.001); high school students had lower total and three domain scores than middle school students (all P<0.05). Students whose fathers had higher education reported higher total scores, self and social scores than students with less educated fathers (all P<0.05). Students whose mothers had higher education reported higher environment scores than students with less educated mothers (P = 0.01). Students from migrant communities reported significantly lower total scores, self and social scores than those from rural communities (all P<0.05), but comparable scores with those from urban communities (P>0.05). Students from migrant communities reported comparable environment scores with those from rural and urban communities (P>0.05). Overweight and obesity have negative effects on students' quality of life. Therefore weight specific QOL could be included in weight reduction interventions as a relevant outcome.

Novel Insights into DNA Methylation Features in Spermatozoa: Stability and Peculiarities

PubMed Central

Sayols, Sergi; Chianese, Chiara; Giachini, Claudia; Heyn, Holger; Esteller, Manel

2012-01-01

Data about the entire sperm DNA methylome are limited to two sperm donors whereas studies dealing with a greater number of subjects focused only on a few genes or were based on low resolution arrays. This implies that information about what we can consider as a normal sperm DNA methylome and whether it is stable among different normozoospermic individuals is still missing. The definition of the DNA methylation profile of normozoospermic men, the entity of inter-individual variability and the epigenetic characterization of quality-fractioned sperm subpopulations in the same subject (intra-individual variability) are relevant for a better understanding of pathological conditions. We addressed these questions by using the high resolution Infinium 450K methylation array and compared normal sperm DNA methylomes against somatic and cancer cells. Our study, based on the largest number of subjects (n = 8) ever considered for such a large number of CpGs (n = 487,517), provided clear evidence for i) a highly conserved DNA methylation profile among normozoospermic subjects; ii) a stable sperm DNA methylation pattern in different quality-fractioned sperm populations of the same individual. The latter finding is particularly relevant if we consider that different quality fractioned sperm subpopulations show differences in their structural features, metabolic and genomic profiles. We demonstrate, for the first time, that DNA methylation in normozoospermic men remains highly uniform regardless the quality of sperm subpopulations. In addition, our analysis provided both confirmatory and novel data concerning the sperm DNA methylome, including its peculiar features in respect to somatic and cancer cells. Our description about a highly polarized sperm DNA methylation profile, the clearly distinct genomic and functional organization of hypo- versus hypermethylated loci as well as the association of histone-enriched hypomethylated loci with embryonic development, which we now extended also to hypomethylated piRNAs-linked genes, provides solid basis for future basic and clinical research. PMID:23071498

Integrating the Curriculum: Quality and Relevance for Special Needs Children.

ERIC Educational Resources Information Center

Wessel, Janet A.

A comprehensive, integrated physical education system that has quality and relevance for handicapped students and their nonhandicapped peers is proposed. The Achievement Based Curriculum (ABC) Model is a systematic decision-making process for an instructional system that incorporates curriculum, instruction, assessment, and evaluation in one…

The relevance of "non-relevant metabolites" from plant protection products (PPPs) for drinking water: the German view.

PubMed

Dieter, Hermann H

2010-03-01

"Non-relevant metabolites" are those degradation products of plant protection products (PPPs), which are devoid of the targeted toxicities of the PPP and devoid of genotoxicity. Most often, "non-relevant metabolites" have a high affinity to the aquatic environment, are very mobile within this environment, and, usually, are also persistent. Therefore, from the point of drinking water hygiene, they must be characterized as "relevant for drinking water" like many other hydrophilic/polar environmental contaminants of different origins. "Non-relevant metabolites" may therefore penetrate to water sources used for abstraction of drinking water and may thus ultimately be present in drinking water. The presence of "non-relevant metabolites" and similar trace compounds in the water cycle may endanger drinking water quality on a long-term scale. During oxidative drinking water treatment, "non-relevant metabolites" may also serve as the starting material for toxicologically relevant transformation products similar to processes observed by drinking water disinfection with chlorine. This hypothesis was recently confirmed by the detection of the formation of N-nitroso-dimethylamine from ozone and dimethylsulfamide, a "non-relevant metabolite" of the fungicide tolylfluanide. In order to keep drinking water preferably free of "non-relevant metabolites", the German drinking water advisory board of the Federal Ministry of Health supports limiting their penetration into raw and drinking water to the functionally (agriculturally) unavoidable extent. On this background, the German Federal Environment Agency (UBA) recently has recommended two health related indication values (HRIV) to assess "non-relevant metabolites" from the view of drinking water hygiene. Considering the sometimes incomplete toxicological data base for some "non-relevant metabolites", HRIV also have the role of health related precautionary values. Depending on the completeness and quality of the toxicological evaluation of a "non-relevant metabolite", its HRIV is either set as 1.0 microg/l (HRIV(a)) or as 3.0 microg/l (HRIV(b)) for lifelong exposure. In case a HRIV would be exceeded, UBA recommends to keep on a precautionary action value (PAV) of 10 microg/l for each "non-relevant metabolite". The HRIV(b) is similar to the maximal value derived by application of the TTC-concept for Cramer Class III (4.5 microg/l). The HRIV(a) and the PAV are similar to values in the EU-guidance document for assessing "non-relevant metabolites" in ground water, with the important difference that the drinking water PAV is not intended to be tolerated for permanent exposure. Drinking water containing "non-relevant metabolites" below the respective HRIVs can also be considered as being sufficiently protective against toxicologically relevant oxidative transformation products which may be formed from "non-relevant metabolites" during drinking water treatment with ozone. However, even drinking water where one or several "non-relevant metabolites" are detected above substance-specific HRIVs is suited for human consumption without health risks. Only in special cases (relatively high "non-relevant metabolite" - concentrations), it could be indicated to examine the finished water for transformation products after treatment with ozone if there are no further treatment steps to eliminate or degrade polar compounds. UBA's "non-relevant metabolite-Recommendation" from April 2008 was positively picked up in 2009 by four important stakeholders in the domain of drinking water management as part of a voluntary cooperation agreement. The aim of such cooperation is to limit the transport of "non-relevant metabolites" into the drinking water to the functionally (and agriculturally) unavoidable extent and insofar to meet special precautionary demands. (c) 2009 Elsevier Inc. All rights reserved.

Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes.

PubMed

O'Brien, Emily C; Wu, Jingjing; Zhao, Xin; Schulte, Phillip J; Fonarow, Gregg C; Hernandez, Adrian F; Schwamm, Lee H; Peterson, Eric D; Bhatt, Deepak L; Smith, Eric E

2017-02-03

Healthcare resources vary geographically, but associations between hospital-based resources and acute stroke quality and outcomes remain unclear. Using Get With The Guidelines-Stroke and Dartmouth Atlas of Health Care data, we examined associations between healthcare resource availability, stroke care, and outcomes. We categorized hospital referral regions with high-, medium-, or low-resource levels based on the 2006 national per-capita availability median of 6 relevant acute stroke care resources. Using multivariable logistic regression, we examined healthcare resource level and in-hospital quality and outcomes. Of 1 480 308 admitted ischemic stroke patients (2006-2013), 28.8% were hospitalized in low-, 44.4% in medium-, and 26.9% in high-resource hospital referral regions. Quality-of-care/timeliness metrics, adjusted length of stay, and in-hospital mortality were similar across all resource levels. Significant variation exists in regional availability of healthcare resources for acute ischemic stroke treatment, yet among Get With the Guidelines-Stroke hospitals, quality of care and in-hospital outcomes did not differ by regional resource availability. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Quality Indicators for Safe Medication Preparation and Administration: A Systematic Review

PubMed Central

Maaskant, Jolanda M.; de Boer, Monica; Krediet, C. T. Paul; Nieveen van Dijkum, Els J. M.

2015-01-01

Background One-third of all medication errors causing harm to hospitalized patients occur in the medication preparation and administration phase, which is predominantly a nursing activity. To monitor, evaluate and improve the quality and safety of this process, evidence-based quality indicators can be used. Objectives The aim of study was to identify evidence-based quality indicators (structure, process and outcome) for safe in-hospital medication preparation and administration. Methods MEDLINE, EMBASE and CINAHL were searched for relevant studies published up to January 2015. Additionally, nine databases were searched to identify relevant grey literature. Two reviewers independently selected studies if (1) the method for quality indicator development combined a literature search with expert panel opinion, (2) the study contained quality indicators on medication safety, and (3) any of the quality indicators were applicable to hospital medication preparation and administration. A multidisciplinary team appraised the studies independently using the AIRE instrument, which contains four domains and 20 items. Quality indicators applicable to in-hospital medication preparation and administration were extracted using a structured form. Results The search identified 1683 studies, of which 64 were reviewed in detail and five met the inclusion criteria. Overall, according to the AIRE domains, all studies were clear on purpose; most of them applied stakeholder involvement and used evidence reasonably; usage of the indicator in practice was scarcely described. A total of 21 quality indicators were identified: 5 structure indicators (e.g. safety management and high alert medication), 11 process indicators (e.g. verification and protocols) and 5 outcome indicators (e.g. harm and death). These quality indicators partially cover the 7 rights. Conclusion Despite the relatively small number of included studies, the identified quality indicators can serve as an excellent starting point for further development of nursing specific quality indicators for medication safety. Especially on the right patient, right route, right time and right documentation there is room future development of quality indicators. PMID:25884623

The Papers Printing Quality Complex Assessment Algorithm Development Taking into Account the Composition and Production Technological Features

NASA Astrophysics Data System (ADS)

Babakhanova, Kh A.; Varepo, L. G.; Nagornova, I. V.; Babluyk, E. B.; Kondratov, A. P.

2018-04-01

Paper is one of the printing system key components causing the high-quality printed products output. Providing the printing companies with the specified printing properties paper, while simultaneously increasing the paper products range and volume by means of the forecasting methods application and evaluation during the production process, is certainly a relevant problem. The paper presents the printing quality control algorithm taking into consideration the paper printing properties quality assessment depending on the manufacture technological features and composition variation. The information system including raw material and paper properties data and making possible pulp and paper enterprises to select paper composition optimal formulation is proposed taking into account the printing process procedure peculiarities of the paper manufacturing with specified printing properties.

Outcome-centered antiepileptic therapy: Rate, rhythm and relief.: Implementing AAN Epilepsy Quality Measures in clinical practice.

PubMed

D'Cruz, O'Neill

2015-12-01

Clinicians who manage patients with epilepsy are expected to assess the relevance of clinical trial results to their practice, integrate new treatments into the care algorithm, and implement epilepsy quality measures, with the overall goal of improving patient outcomes. A disease-based clinical framework that helps with choice and combinations of interventions facilitates provision of efficient, cost-effective, and high-quality care. This article addresses the current conceptual framework that informs clinical evaluation of epilepsy, explores gaps between development of treatment options, quality measures and clinical goals, and proposes an outcome-centered approach that bridges these gaps with the aim of improving patient and population-level clinical outcomes in epilepsy. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

Low-temperature magnetotransport in Si/SiGe heterostructures on 300 mm Si wafers

NASA Astrophysics Data System (ADS)

Scappucci, Giordano; Yeoh, L.; Sabbagh, D.; Sammak, A.; Boter, J.; Droulers, G.; Kalhor, N.; Brousse, D.; Veldhorst, M.; Vandersypen, L. M. K.; Thomas, N.; Roberts, J.; Pillarisetty, R.; Amin, P.; George, H. C.; Singh, K. J.; Clarke, J. S.

Undoped Si/SiGe heterostructures are a promising material stack for the development of spin qubits in silicon. To deploy a qubit into high volume manufacturing in a quantum computer requires stringent control over substrate uniformity and quality. Electron mobility and valley splitting are two key electrical metrics of substrate quality relevant for qubits. Here we present low-temperature magnetotransport measurements of strained Si quantum wells with mobilities in excess of 100000 cm2/Vs fabricated on 300 mm wafers within the framework of advanced semiconductor manufacturing. These results are benchmarked against the results obtained in Si quantum wells deposited on 100 mm Si wafers in an academic research environment. To ensure rapid progress in quantum wells quality we have implemented fast feedback loops from materials growth, to heterostructure FET fabrication, and low temperature characterisation. On this topic we will present recent progress in developing a cryogenic platform for high-throughput magnetotransport measurements.

A randomized trial comparing INR monitoring devices in patients with anticoagulation self-management: evaluation of a novel error-grid approach.

PubMed

Hemkens, Lars G; Hilden, Kristian M; Hartschen, Stephan; Kaiser, Thomas; Didjurgeit, Ulrike; Hansen, Roland; Bender, Ralf; Sawicki, Peter T

2008-08-01

In addition to the metrological quality of international normalized ratio (INR) monitoring devices used in patients' self-management of long-term anticoagulation, the effectiveness of self-monitoring with such devices has to be evaluated under real-life conditions with a focus on clinical implications. An approach to evaluate the clinical significance of inaccuracies is the error-grid analysis as already established in self-monitoring of blood glucose. Two anticoagulation monitors were compared in a real-life setting and a novel error-grid instrument for oral anticoagulation has been evaluated. In a randomized crossover study 16 patients performed self-management of anticoagulation using the INRatio and the CoaguChek S system. Main outcome measures were clinically relevant INR differences according to established criteria and to the error-grid approach. A lower rate of clinically relevant disagreements according to Anderson's criteria was found with CoaguChek S than with INRatio without statistical significance (10.77% vs. 12.90%; P = 0.787). Using the error-grid we found principally consistent results: More measurement pairs with discrepancies of no or low clinical relevance were found with CoaguChek S, whereas with INRatio we found more differences with a moderate clinical relevance. A high rate of patients' satisfaction with both of the point of care devices was found with only marginal differences. A principal appropriateness of the investigated point-of-care devices to adequately monitor the INR is shown. The error-grid is useful for comparing monitoring methods with a focus on clinical relevance under real-life conditions beyond assessing the pure metrological quality, but we emphasize that additional trials using this instrument with larger patient populations are needed to detect differences in clinically relevant disagreements.

A framework for automatic information quality ranking of diabetes websites.

PubMed

Belen Sağlam, Rahime; Taskaya Temizel, Tugba

2015-01-01

Objective: When searching for particular medical information on the internet the challenge lies in distinguishing the websites that are relevant to the topic, and contain accurate information. In this article, we propose a framework that automatically identifies and ranks diabetes websites according to their relevance and information quality based on the website content. Design: The proposed framework ranks diabetes websites according to their content quality, relevance and evidence based medicine. The framework combines information retrieval techniques with a lexical resource based on Sentiwordnet making it possible to work with biased and untrusted websites while, at the same time, ensuring the content relevance. Measurement: The evaluation measurements used were Pearson-correlation, true positives, false positives and accuracy. We tested the framework with a benchmark data set consisting of 55 websites with varying degrees of information quality problems. Results: The proposed framework gives good results that are comparable with the non-automated information quality measuring approaches in the literature. The correlation between the results of the proposed automated framework and ground-truth is 0.68 on an average with p < 0.001 which is greater than the other proposed automated methods in the literature (r score in average is 0.33).

Fixed functional appliances with multibracket appliances have no skeletal effect on the mandible: A systematic review and meta-analysis.

PubMed

Ishaq, Ramy Abdul Rahman; AlHammadi, Maged Sultan; Fayed, Mona M S; El-Ezz, Amr Abou; Mostafa, Yehya

2016-05-01

Our aim was to assess the skeletal mandibular changes (anteroposterior and vertical) in circumpubertal patients with fixed functional appliances installed on multibracket appliances compared with untreated patients. An open-ended electronic search of 4 databases (PubMed, Embase, Cochrane Library, and Web of Science) up to April 2014 was performed. Additional searches of relevant journals, reference lists of the retrieved articles, systematic reviews, and gray literature were performed. Specific inclusion and exclusion criteria were applied to identify relevant articles. Quality was evaluated using the Cochrane Collaboration risk of bias tool and the Newcastle-Ottawa scale for prospective controlled clinical trials. Meta-analyses were conducted with fixed and random effects models as appropriate. Statistical heterogeneity was also examined. Seven articles were included in the qualitative synthesis and 5 in the meta-analysis. The included randomized controlled trials were at high risk of bias, and the methodologic quality of the prospective controlled clinical trials was high. Based on assessment of the fixed functional appliance phase in isolation, no difference in mandibular anteroposterior positional changes (SNB angle) (standard mean difference, 0.11°; 95% CI, -0.28, 0.50) was found between the treated and control groups. The vertical dimension was not influenced by the fixed functional appliance treatment. There is little high-quality evidence concerning the relative influence of fixed functional appliances on skeletal and dentoalveolar changes. However, based on the limited evidence, it appears that they have little effect on the skeletal mandibular parameters. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Quantitative weight of evidence assessment of higher-tier studies on the toxicity and risks of neonicotinoid insecticides in honeybees 1: Methods.

PubMed

Solomon, Keith R; Stephenson, Gladys L

2017-01-01

A quantitative weight of evidence (QWoE) methodology was developed and used to assess many higher-tier studies on the effects of three neonicotinoid insecticides: clothianidin (CTD), imidacloprid (IMI), and thiamethoxam (TMX) on honeybees. A general problem formulation, a conceptual model for exposures of honeybees, and an analysis plan were developed. A QWoE methodology was used to characterize the quality of the available studies from the literature and unpublished reports of studies conducted by or for the registrants. These higher-tier studies focused on the exposures of honeybees to neonicotinoids via several matrices as measured in the field as well as the effects in experimentally controlled field studies. Reports provided by Bayer Crop Protection and Syngenta Crop Protection and papers from the open literature were assessed in detail, using predefined criteria for quality and relevance to develop scores (on a relative scale of 0-4) to separate the higher-quality from lower-quality studies and those relevant from less-relevant results. The scores from the QWoEs were summarized graphically to illustrate the overall quality of the studies and their relevance. Through mean and standard errors, this method provided graphical and numerical indications of the quality and relevance of the responses observed in the studies and the uncertainty associated with these two metrics. All analyses were conducted transparently and the derivations of the scores were fully documented. The results of these analyses are presented in three companion papers and the QWoE analyses for each insecticide are presented in detailed supplemental information (SI) in these papers.

Quality assurance and reliability sub-committee W88-0/Mk5 weapon assessment NSA lab test results (u)

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

Whitney, Earl M

2010-11-29

The purpose of this report is to gather appropriate level of relevant stockpile surveillance data to assess trends in the NEP quality, reliability, performance, and safety over the life of the system. The objectives are to gather relevant stockpile data to assess NEP quality and trends and to develop metrics to assess the suitability of the surveillance sampling regime to meet assessment process requirements.

Spectral and spatial characterisation of laser-driven positron beams

DOE PAGES

Sarri, G.; Warwick, J.; Schumaker, W.; ...

2016-10-18

The generation of high-quality relativistic positron beams is a central area of research in experimental physics, due to their potential relevance in a wide range of scientific and engineering areas, ranging from fundamental science to practical applications. There is now growing interest in developing hybrid machines that will combine plasma-based acceleration techniques with more conventional radio-frequency accelerators, in order to minimise the size and cost of these machines. Here we report on recent experiments on laser-driven generation of high-quality positron beams using a relatively low energy and potentially table-top laser system. Lastly, the results obtained indicate that current technology allowsmore » to create, in a compact setup, positron beams suitable for injection in radio-frequency accelerators.« less

Rapid assessment of antimicrobial resistance prevalence using a Lot Quality Assurance sampling approach.

PubMed

van Leth, Frank; den Heijer, Casper; Beerepoot, Mariëlle; Stobberingh, Ellen; Geerlings, Suzanne; Schultsz, Constance

2017-04-01

Increasing antimicrobial resistance (AMR) requires rapid surveillance tools, such as Lot Quality Assurance Sampling (LQAS). LQAS classifies AMR as high or low based on set parameters. We compared classifications with the underlying true AMR prevalence using data on 1335 Escherichia coli isolates from surveys of community-acquired urinary tract infection in women, by assessing operating curves, sensitivity and specificity. Sensitivity and specificity of any set of LQAS parameters was above 99% and between 79 and 90%, respectively. Operating curves showed high concordance of the LQAS classification with true AMR prevalence estimates. LQAS-based AMR surveillance is a feasible approach that provides timely and locally relevant estimates, and the necessary information to formulate and evaluate guidelines for empirical treatment.

Is the National Guideline Clearinghouse a Trustworthy Source of Practice Guidelines for Child and Youth Anxiety and Depression?

PubMed

Duda, Stephanie; Fahim, Christine; Szatmari, Peter; Bennett, Kathryn

2017-07-01

Innovative strategies that facilitate the use of high quality practice guidelines (PG) are needed. Accordingly, repositories designed to simplify access to PGs have been proposed as a critical component of the network of linked interventions needed to drive increased PG implementation. The National Guideline Clearinghouse (NGC) is a free, international online repository. We investigated whether it is a trustworthy source of child and youth anxiety and depression PGs. English language PGs published between January 2009 and February 2016 relevant to anxiety or depression in children and adolescents (≤ 18 years of age) were eligible. Two trained raters assessed PG quality using Appraisal of Guidelines for Research and Evaluation (AGREE II). Scores on at least three AGREE II domains (stakeholder involvement, rigor of development, and editorial independence) were used to designate PGs as: i) minimum quality (≥ 50%); and ii) high quality (≥ 70%). Eight eligible PGs were identified (depression, n=6; anxiety and depression, n=1; social anxiety disorder, n=1). Four of eight PGs met minimum quality criteria; three of four met high quality criteria. At present, NGC users without the time and special skills required to evaluate PG quality may unknowingly choose flawed PGs to guide decisions about child and youth anxiety and depression. The recent NGC decision to explore the inclusion of PG quality profiles based on Institute of Medicine standards provides needed leadership that can strengthen PG repositories, prevent harm and wasted resources, and build PG developer capacity.

Metrics for the Evaluation the Utility of Air Quality Forecasting

NASA Astrophysics Data System (ADS)

Sumo, T. M.; Stockwell, W. R.

2013-12-01

Global warming is expected to lead to higher levels of air pollution and therefore the forecasting of both long-term and daily air quality is an important component for the assessment of the costs of climate change and its impact on human health. Some of the risks associated with poor air quality days (where the Air Pollution Index is greater than 100), include hospital visits and mortality. Accurate air quality forecasting has the potential to allow sensitive groups to take appropriate precautions. This research builds metrics for evaluating the utility of air quality forecasting in terms of its potential impacts. Our analysis of air quality models focuses on the Washington, DC/Baltimore, MD region over the summertime ozone seasons between 2010 and 2012. The metrics that are relevant to our analysis include: (1) The number of times that a high ozone or particulate matter (PM) episode is correctly forecasted, (2) the number of times that high ozone or PM episode is forecasted when it does not occur and (3) the number of times when the air quality forecast predicts a cleaner air episode when the air was observed to have high ozone or PM. Our evaluation of the performance of air quality forecasts include those forecasts of ozone and particulate matter and data available from the U.S. Environmental Protection Agency (EPA)'s AIRNOW. We also examined observational ozone and particulate matter data available from Clean Air Partners. Overall the forecast models perform well for our region and time interval.

High-Resolution Protein Structure Determination by Serial Femtosecond Crystallography

PubMed Central

Boutet, Sébastien; Lomb, Lukas; Williams, Garth J.; Barends, Thomas R. M.; Aquila, Andrew; Doak, R. Bruce; Weierstall, Uwe; DePonte, Daniel P.; Steinbrener, Jan; Shoeman, Robert L.; Messerschmidt, Marc; Barty, Anton; White, Thomas A.; Kassemeyer, Stephan; Kirian, Richard A.; Seibert, M. Marvin; Montanez, Paul A.; Kenney, Chris; Herbst, Ryan; Hart, Philip; Pines, Jack; Haller, Gunther; Gruner, Sol M.; Philipp, Hugh T.; Tate, Mark W.; Hromalik, Marianne; Koerner, Lucas J.; van Bakel, Niels; Morse, John; Ghonsalves, Wilfred; Arnlund, David; Bogan, Michael J.; Caleman, Carl; Fromme, Raimund; Hampton, Christina Y.; Hunter, Mark S.; Johansson, Linda C.; Katona, Gergely; Kupitz, Christopher; Liang, Mengning; Martin, Andrew V.; Nass, Karol; Redecke, Lars; Stellato, Francesco; Timneanu, Nicusor; Wang, Dingjie; Zatsepin, Nadia A.; Schafer, Donald; Defever, James; Neutze, Richard; Fromme, Petra; Spence, John C. H.; Chapman, Henry N.; Schlichting, Ilme

2013-01-01

Structure determination of proteins and other macromolecules has historically required the growth of high-quality crystals sufficiently large to diffract x-rays efficiently while withstanding radiation damage. We applied serial femtosecond crystallography (SFX) using an x-ray free-electron laser (XFEL) to obtain high-resolution structural information from microcrystals (less than 1 micrometer by 1 micrometer by 3 micrometers) of the well-characterized model protein lysozyme. The agreement with synchrotron data demonstrates the immediate relevance of SFX for analyzing the structure of the large group of difficult-to-crystallize molecules. PMID:22653729

Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

PubMed Central

2010-01-01

Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important. PMID:20942937

Evaluation of an Educational Website for the Bayou Bend Collection and Gardens, Museum of Fine Arts, Houston.

ERIC Educational Resources Information Center

Jenkins, Ann G.; Robin, Bernard R.

As educators increasingly integrate Web-based resources into their curriculum, there is a growing need for high quality, educationally relevant materials. This study evaluated the Bayou Bend Web site, the result of a collaboration between staff at the Museum of Fine Arts, Houston, Texas, and faculty and graduate students at the University of…

Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

ERIC Educational Resources Information Center

Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

2014-01-01

Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

Raising the Quality and Image of TVET: Lower-Level Training or Motor for Inclusive and Sustainable Growth?

ERIC Educational Resources Information Center

Brennan, Paul

2014-01-01

Though viewed as second-class until fairly recently, Canada's system for providing technical and vocational education and training (TVET) now provides relevant post-secondary education that meets the needs of highly skilled professionals in all job categories. As the system evolved, it changed the public view of skills education. This article…

Earnings Quality Measures and Excess Returns

PubMed Central

Perotti, Pietro; Wagenhofer, Alfred

2014-01-01

This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988–2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature. PMID:26300582

Earnings Quality Measures and Excess Returns.

PubMed

Perotti, Pietro; Wagenhofer, Alfred

2014-06-01

This paper examines how commonly used earnings quality measures fulfill a key objective of financial reporting, i.e., improving decision usefulness for investors. We propose a stock-price-based measure for assessing the quality of earnings quality measures. We predict that firms with higher earnings quality will be less mispriced than other firms. Mispricing is measured by the difference of the mean absolute excess returns of portfolios formed on high and low values of a measure. We examine persistence, predictability, two measures of smoothness, abnormal accruals, accruals quality, earnings response coefficient and value relevance. For a large sample of US non-financial firms over the period 1988-2007, we show that all measures except for smoothness are negatively associated with absolute excess returns, suggesting that smoothness is generally a favorable attribute of earnings. Accruals measures generate the largest spread in absolute excess returns, followed by smoothness and market-based measures. These results lend support to the widespread use of accruals measures as overall measures of earnings quality in the literature.

Evaluation of Model Recognition for Grammar-Based Automatic 3d Building Model Reconstruction

NASA Astrophysics Data System (ADS)

Yu, Qian; Helmholz, Petra; Belton, David

2016-06-01

In recent years, 3D city models are in high demand by many public and private organisations, and the steadily growing capacity in both quality and quantity are increasing demand. The quality evaluation of these 3D models is a relevant issue both from the scientific and practical points of view. In this paper, we present a method for the quality evaluation of 3D building models which are reconstructed automatically from terrestrial laser scanning (TLS) data based on an attributed building grammar. The entire evaluation process has been performed in all the three dimensions in terms of completeness and correctness of the reconstruction. Six quality measures are introduced to apply on four datasets of reconstructed building models in order to describe the quality of the automatic reconstruction, and also are assessed on their validity from the evaluation point of view.

Patient's Perspective on Quality of Teleconsultation Services.

PubMed

Thijssing, Leonie; Tensen, Esmée; Jaspers, Monique

2016-01-01

Patient satisfaction with teleconsultation services can increase their acceptance. Validated and standardized questionnaires to measure the quality aspects of teleconsultation relevant from the patients' perspective are not available yet. We aim to develop such a questionnaire. First, a systematic literature search was performed and focus groups were held to acquire quality aspects of teleconsultations patients perceive as important. Thirty-seven unique quality aspects distilled from these activities, were used for questionnaire development based on the framework of the Consumer Quality Index. In future research, the comprehensiveness, relevance and unambiguousness of the concept questionnaire need to be tested and the reliability and internal cohesion of the questionnaire assessed.

Indicators of the quality of general practice care of patients with chronic illness: a step towards the real involvement of patients in the assessment of the quality of care.

PubMed Central

Wensing, M; Grol, R; van Montfort, P; Smits, A

1996-01-01

OBJECTIVE--To develop a list of indicators of the general practice care of people with chronic illnesses considered important by both patients and practitioners and to identify the indicators that are considered relevant for patient assessment of health care quality. DESIGN--Qualitative study with focus group interviews and a written consensus procedure. SETTING--General practice in the Netherlands in 1993. SUBJECTS--34 patients with chronic illness, mostly members of patient organisations, and 19 general practitioners with expertise in either chronic disease management or experience with patient surveys. MAIN MEASURES--Aspects of general practice care considered important for the delivery of good quality care that emerged from focus group interviews; the relevance of evaluations of 41 aspects of care for patients explored through the written consensus procedure. Those aspects of general practice care agreed to be both important and relevant by patients and general practitioners were considered to be suitable indicators for patient assessment of the quality of care. RESULTS--Patients and general practitioners differed to some extent in their assessment of the aspects of care that they considered important for quality. They agreed that most indicators of care that related to the ¿doctor-patient relation¿ and to ¿information and support¿ were relevant and therefore suitable as indicators for patient assessment of health care quality. There was less agreement about the relevance of indicators of ¿medical and technical care,¿ ¿availability and accessibility,¿ and ¿organisation of services.¿ CONCLUSIONS--Several indicators of the quality of general practice care of patients with chronic illness were thought to be suitable for the patient assessment of healthcare quality, but other indicators were not, mainly because of reservations by general practitioners. IMPLICATIONS-- Qualitative methods can contribute to the selection of indicators for assessment of the quality of health care in areas where scientific evidence is limited or where patients' and providers' preferences are particularly important. PMID:10158595

[Construction and application of economy-pollution-environment three-dimensional evaluation model for district].

PubMed

Fan, Xin-Gang; Mi, Wen-Bao; Ma, Zhen-Ning

2015-02-01

For deep analysis on the regional environmental economic system, the paper analyzes the mutual relation of regional economy development, environmental quality, environmental pollution, and builds the theoretical basis. Then, the economy-pollution-environment quality three-dimensional coupling evaluation model for district is constructed. It includes economic development level index, environmental pollution index, and environmental quality index. The model is a cube, which has spatialization and visualization characteristics. The model includes 8 sub cubes, which expresses 8 types of state, e. g. low pollution-inferior quality-low level of economic development etc. The model can be used to evaluate the status of region, divide development phase, analyze evolution trend etc. It has two ways including relative meaning evaluation (RME) and absolute meaning evaluation (AME). Based on the model, Yinchuan City in the Ningxia Hui Autonomous Region is used as an example for the empirical study. Using RME, compared with Guangzhou city, The result shows that the Yinchuan City has been a high pollution-low quality-low level of economic development state for a long period during 1996-2010. After 2007, the state changed to a high pollution-high quality-low level of economic development. Now, the environmental quality of Yinchuan city gets better, but pollutant discharge pressure is high, and tends to be the break point of high environment quality and low environment. With AME, using national standard, the Yinchuan City remains a high pollution-low quality-low level of economic development state during 1996-2010. Empirical research verifies that different target reference areas and relevant national standards have different main parameters, the evaluating result has an flexible range. The dimensionless data enhances the coupling of index. The data position in model increases the visibility to the environmental management decisions. The model improves mismatches of calculated data size, time asymmetry of spatial data, verification of the former multi-target coupling model.

Quality indicators for musculoskeletal injury management in the emergency department: a systematic review.

PubMed

Strudwick, Kirsten; Nelson, Mark; Martin-Khan, Melinda; Bourke, Michael; Bell, Anthony; Russell, Trevor

2015-02-01

There is increasing importance placed on quality of health care for musculoskeletal injuries in emergency departments (EDs). This systematic review aimed to identify existing musculoskeletal quality indicators (QIs) developed for ED use and to critically evaluate their methodological quality. MEDLINE, EMBASE, CINAHL, and the gray literature, including relevant organizational websites, were searched in 2013. English-language articles were included that described the development of at least one QI related to the ED care of musculoskeletal injuries. Data extraction of each included article was conducted. A quality assessment was then performed by rating each relevant QI against the Appraisal of Indicators through Research and Evaluation (AIRE) Instrument. QIs with similar definitions were grouped together and categorized according to the health care quality frameworks of Donabedian and the Institute of Medicine. The search revealed 1,805 potentially relevant articles, of which 15 were finally included in the review. The number of relevant QIs per article ranged from one to 11, resulting in a total of 71 QIs overall. Pain (n = 17) and fracture management (n = 13) QIs were predominant. Ten QIs scored at least 50% across all AIRE Instrument domains, and these related to pain management and appropriate imaging of the spine. Methodological quality of the development of most QIs is poor. Recommendations for a core set of QIs that address the complete spectrum of musculoskeletal injury management in emergency medicine is not possible, and more work is needed. Currently, QIs with highest methodological quality are in the areas of pain management and medical imaging. © 2015 by the Society for Academic Emergency Medicine.

An Education Millennium Development Goal for Quality: Complexity and Democracy

ERIC Educational Resources Information Center

Barrett, Angeline M.

2011-01-01

A good quality education is inclusive, relevant and democratic. Of these three characteristics, the author contends that democratic is the most fundamental and underpins the other two. Education can only truly be inclusive and relevant if its goals are continuously the subject of open democratic debate, since education is a value-based,…

Extent and quality of systematic review evidence related to minimum intervention in dentistry: essential oils, powered toothbrushes, triclosan, xylitol.

PubMed

Mickenautsch, Steffen; Yengopal, Veerasamy

2011-08-01

To investigate extent and quality of current systematic review evidence regarding: powered toothbrushes, triclosan toothpaste, essential oil mouthwashes, xylitol chewing gum. Five databases were searched for systematic reviews until 13 November 2010. relevant to topic, systematic review according to title and/or abstract, published in English. Article exclusion criteria were based on QUOROM recommendations for the reporting of systematic review methods. Systematic review quality was judged using the AMSTAR tool. All trials included by reviews were assessed for selection bias. 119 articles were found, of which 11 systematic reviews were included. Of these, six were excluded and five accepted: one for triclosan toothpaste; one for xylitol chewing gum; two for powered toothbrushes; one for essential oil mouthwashes. AMSTAR scores: triclosan toothpaste 7; powered toothbrushes 9 and 11; xylitol chewing gum 9; essential oil mouthwashes 8. In total, 75 (out of 76) reviewed trials were identified. In-depth assessment showed a high risk of selection bias for all trials. The extent of available systematic review evidence is low. Although the few identified systematic reviews could be rated as of medium and high quality, the validity of their conclusions needs to be treated with caution, owing to high risk of selection bias in the reviewed trials. High quality randomised control trials are needed in order to provide convincing evidence regarding true clinical efficacy. © 2011 FDI World Dental Federation.

The Formation of Students' Foreign Language Communicative Competence during the Learning Process of the English Language through Interactive Learning Technologies (The Study on the Basis of Kazan Federal University)

ERIC Educational Resources Information Center

Fahrutdinova, Rezida A.; Yarmakeev, Iskander E.; Fakhrutdinov, Rifat R.

2014-01-01

The relevance of this study is determined by the needs of modern society for qualified specialists, which leads to the necessity of improving the system of higher education. This dictates the need for a high-quality preparation of the teacher of English who is able to act as an active subject of the professional activity and who has high levels of…

Lost Opportunity: The High Quality, Reduced Military Force of the 1990’s: Is there a Role for the Nation’s Disadvantaged Youth?

DTIC Science & Technology

1990-12-01

others based on detailed, quantitative "manpower engineering " techniques (White and Hosek, in Scowcroft, 1982, p. 51). 3. The Military Force and...complex technology does not involve a corresponding increase in more highly trained personnel. Trends in industry suggest that job titles are often...theories of motivation, two of which are relevant to this analysis and will be briefly described below. Expectancy theory, with roots in industrial

Literature relevant to remote sensing of water quality

NASA Technical Reports Server (NTRS)

Middleton, E. M.; Marcell, R. F.

1983-01-01

References relevant to remote sensing of water quality were compiled, organized, and cross-referenced. The following general categories were included: (1) optical properties and measurement of water characteristics; (2) interpretation of water characteristics by remote sensing, including color, transparency, suspended or dissolved inorganic matter, biological materials, and temperature; (3) application of remote sensing for water quality monitoring; (4) application of remote sensing according to water body type; and (5) manipulation, processing and interpretation of remote sensing digital water data.

Designing at Scale: Lessons in Relevance, Quality, and Equity from ChangeScale, a Bay Area environmental education collaborative

NASA Astrophysics Data System (ADS)

Babcock, E.

2015-12-01

The best environmental education equips people with the know-how and drive to create healthy communities and a healthy planet. While there are many wonderful organizations providing environmental learning, ensuring quality, cultural relevance and equity of access remains an elusive goal--especially if environmental education organizations work in isolation. Organizations across 12 counties in the Bay Area have come together to create a different model. They have founded ChangeScale, a regional collaborative dedicated to providing high quality environmental education to hundreds of thousands of youth---by working together. ChangeScale's work involves setting up school district-level partnerships, providing technical assistance to local environmental education networks, and training environmental educators across the region. In this talk, the presenter, who is a founding member and steering committee chair for ChangeScale, will outline the challenges of working at a regional scale with dozens of organizations. She will share the processes ChangeScale has used to develop a business plan and build membership. She will conclude by sharing the short term and long term potential impacts of working collectively for environmental literacy in the Bay Area.

RAMICS: trainable, high-speed and biologically relevant alignment of high-throughput sequencing reads to coding DNA.

PubMed

Wright, Imogen A; Travers, Simon A

2014-07-01

The challenge presented by high-throughput sequencing necessitates the development of novel tools for accurate alignment of reads to reference sequences. Current approaches focus on using heuristics to map reads quickly to large genomes, rather than generating highly accurate alignments in coding regions. Such approaches are, thus, unsuited for applications such as amplicon-based analysis and the realignment phase of exome sequencing and RNA-seq, where accurate and biologically relevant alignment of coding regions is critical. To facilitate such analyses, we have developed a novel tool, RAMICS, that is tailored to mapping large numbers of sequence reads to short lengths (<10 000 bp) of coding DNA. RAMICS utilizes profile hidden Markov models to discover the open reading frame of each sequence and aligns to the reference sequence in a biologically relevant manner, distinguishing between genuine codon-sized indels and frameshift mutations. This approach facilitates the generation of highly accurate alignments, accounting for the error biases of the sequencing machine used to generate reads, particularly at homopolymer regions. Performance improvements are gained through the use of graphics processing units, which increase the speed of mapping through parallelization. RAMICS substantially outperforms all other mapping approaches tested in terms of alignment quality while maintaining highly competitive speed performance. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

Experimental Models of Vaginal Candidiasis and Their Relevance to Human Candidiasis

PubMed Central

Sobel, Jack D.

2016-01-01

Vulvovaginal candidiasis (VVC) is a high-incidence disease seriously affecting the quality of life of women worldwide, particularly in its chronic, recurrent forms (RVVC), and with no definitive cure or preventive measure. Experimental studies in currently used rat and mouse models of vaginal candidiasis have generated a large mass of data on pathogenicity determinants and inflammation and immune responses of potential importance for the control of human pathology. However, reflection is necessary about the relevance of these rodent models to RVVC. Here we examine the chemical, biochemical, and biological factors that determine or contrast the forms of the disease in rodent models and in women and highlight the differences between them. We also appeal for approaches to improve or replace the current models in order to enhance their relevance to human infection. PMID:26883592

European Surveillance of Antimicrobial Consumption (ESAC): quality indicators for outpatient antibiotic use in Europe

PubMed Central

Coenen, Samuel; Ferech, Matus; Haaijer‐Ruskamp, Flora M; Butler, Chris C; Stichele, Robert H Vander; Verheij, Theo J M; Monnet, Dominique L; Little, Paul; Goossens, Herman

2007-01-01

Background and objective Indicators to measure the quality of healthcare are increasingly used by healthcare professionals and policy makers. In the context of increasing antimicrobial resistance, this study aimed to develop valid drug‐specific quality indicators for outpatient antibiotic use in Europe, derived from European Surveillance of Antimicrobial Consumption (ESAC) data. Methods 27 experts (15 countries), in a European Science Foundation workshop, built on the expertise within the European Drug Utilisation Research Group, the General Practice Respiratory Infections Network, the ESCMID Study Group on Primary Care Topics, the Belgian Antibiotic Policy Coordination Committee, the World Health Organization, ESAC, and other experts. A set of proposed indicators was developed using 1997–2003 ESAC data. Participants scored the relevance of each indicator to reducing antimicrobial resistance, patient health benefit, cost effectiveness and public health policy makers (scale: 1 (completely disagree) to 9 (completely agree)). The scores were processed according to the UCLA‐RAND appropriateness method. Indicators were judged relevant if the median score was not in the 1–6 interval and if there was consensus (number of scores within the 1–3 interval was fewer than one third of the panel). From the relevant indicators providing overlapping information, the one with the highest scores was selected for the final set of quality indicators—values were updated with 2004 ESAC data. Results 22 participants (12 countries) completed scoring of a set of 22 proposed indicators. Nine were rated as relevant antibiotic prescribing indicators on all four dimensions; five were rated as relevant if only relevance to reducing antimicrobial resistance and public health policy makers was taken into account. A final set of 12 indicators was selected. Conclusion 12 of the proposed ESAC‐based quality indicators for outpatient antibiotic use in Europe have face validity and are potentially applicable. These indicators could be used to better describe antibiotic use in ambulatory care and assess the quality of national antibiotic prescribing patterns in Europe. PMID:18055888

Formation of high-quality self-assembled monolayers of conjugated dithiols on gold: base matters.

PubMed

Valkenier, Hennie; Huisman, Everardus H; van Hal, Paul A; de Leeuw, Dago M; Chiechi, Ryan C; Hummelen, Jan C

2011-04-06

This Article reports a systematic study on the formation of self-assembled monolayers (SAMs) of conjugated molecules for molecular electronic (ME) devices. We monitored the deprotection reaction of acetyl protected dithiols of oligophenylene ethynylenes (OPEs) in solution using two different bases and studied the quality of the resulting SAMs on gold. We found that the optimal conditions to reproducibly form dense, high-quality monolayers are 9-15% triethylamine (Et(3)N) in THF. The deprotection base tetrabutylammonium hydroxide (Bu(4)NOH) leads to less dense SAMs and the incorporation of Bu(4)N into the monolayer. Furthermore, our results show the importance of the equilibrium concentrations of (di)thiolate in solution on the quality of the SAM. To demonstrate the relevance of these results for molecular electronics applications, large-area molecular junctions were fabricated using no base, Et(3)N, and Bu(4)NOH. The magnitude of the current-densities in these devices is highly dependent on the base. A value of β=0.15 Å(-1) for the exponential decay of the current-density of OPEs of varying length formed using Et(3)N was obtained. © 2011 American Chemical Society

Local environmental quality positively predicts breastfeeding in the UK’s Millennium Cohort Study

PubMed Central

Sear, Rebecca

2017-01-01

ABSTRACT Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis—one ‘objective’ (based on an independent assessor’s neighbourhood scores) and one ‘subjective’ (based on respondent’s scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women’s decision making contexts when considering behaviours relevant to public health. PMID:29354262

Local environmental quality positively predicts breastfeeding in the UK's Millennium Cohort Study.

PubMed

Brown, Laura J; Sear, Rebecca

2017-01-01

Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis-one 'objective' (based on an independent assessor's neighbourhood scores) and one 'subjective' (based on respondent's scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women's decision making contexts when considering behaviours relevant to public health.

Shape-Controlled Synthesis of High-Quality Cu7 S4 Nanocrystals for Efficient Light-Induced Water Evaporation.

PubMed

Zhang, Changbo; Yan, Cong; Xue, Zhenjie; Yu, Wei; Xie, Yinde; Wang, Tie

2016-10-01

Copper sulfides (Cu 2-x S), are a novel kind of photothermal material exhibiting significant photothermal conversion efficiency, making them very attractive in various energy conversion related devices. Preparing high quality uniform Cu 2-x S nanocrystals (NCs) is a top priority for further energy-and sustainability relevant nanodevices. Here, a shape-controlled high quality Cu 7 S 4 NCs synthesis strategy is reported using sulfur in 1-octadecene as precursor by varying the heating temperature, as well as its forming mechanism. The performance of the Cu 7 S 4 NCs is further explored for light-driven water evaporation without the need of heating the bulk liquid to the boiling point, and the results suggest that as-synthesized highly monodisperse NCs perform higher evaporation rate than polydisperse NCs under the identical morphology. Furthermore, disk-like NCs exhibit higher water evaporation rate than spherical NCs. The water evaporation rate can be further enhanced by assembling the organic phase Cu 7 S 4 NCs into a dense film on the aqueous solution surface. The maximum photothermal conversion efficiency is as high as 77.1%. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Research in support of health systems transformation in South Africa: the experience of the Centre for Health Policy.

PubMed

Rispel, Laetitia C; Doherty, Jane

2011-01-01

We describe the role and experience of the Centre for Health Policy (CHP), a university-based research unit established in 1987, in influencing and supporting health systems transformation in South Africa over two decades. During 2010, we analyzed relevant documents and conducted interviews with 25 key informants. CHP's research has contributed directly to health policy development and implementation while also changing the way government understood or approached policy issues. Key success factors for policy influence are: research quality and trustworthiness, strategic alliances and networking, and capacity building. CHP's challenges include identifying new funding sources and sustaining a high public profile. The lessons for other countries are to: conduct good quality, relevant research based on strong ethical values; build and maintain open and honest relationships with government; recognize and adapt to changes in the policy environment; develop capacity as part of a continuous programme; and seek core funding that ensures research independence and public accountability.

Scientism in Medical Education and the Improvement of Medical Care: Opioids, Competencies, and Social Accountability.

PubMed

Reid, Lynette

2018-06-01

Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old "scientistic" views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and skills that medicine resists conceptualizing as objective. Academic medicine should focus its efforts instead on quality and relevance of care. The social accountability movement proposes to shift the focus of academic medicine to the goal of high quality and relevant care in the context of community service and partnership with the institutions that together with medicine create and cope with health and with health deficits. I make the case for this agenda through a discussion of the linked histories of the opioid prescribing crisis and the professionalism movement.

The initial development of the WebMedQual scale: domain assessment of the construct of quality of health web sites.

PubMed

Provost, Mélanie; Koompalum, Dayin; Dong, Diane; Martin, Bradley C

2006-01-01

To develop a comprehensive instrument assessing quality of health-related web sites. Phase I consisted of a literature review to identify constructs thought to indicate web site quality and to identify items. During content analysis, duplicate items were eliminated and items that were not clear, meaningful, or measurable were reworded or removed. Some items were generated by the authors. Phase II: a panel consisting of six healthcare and MIS reviewers was convened to assess each item for its relevance and importance to the construct and to assess item clarity and measurement feasibility. Three hundred and eighty-four items were generated from 26 sources. The initial content analysis reduced the scale to 104 items. Four of the six expert reviewers responded; high concordance on the relevance, importance and measurement feasibility of each item was observed: 3 out of 4, or all raters agreed on 76-85% of items. Based on the panel ratings, 9 items were removed, 3 added, and 10 revised. The WebMedQual consists of 8 categories, 8 sub-categories, 95 items and 3 supplemental items to assess web site quality. The constructs are: content (19 items), authority of source (18 items), design (19 items), accessibility and availability (6 items), links (4 items), user support (9 items), confidentiality and privacy (17 items), e-commerce (6 items). The "WebMedQual" represents a first step toward a comprehensive and standard quality assessment of health web sites. This scale will allow relatively easy assessment of quality with possible numeric scoring.

Fusion set selection with surrogate metric in multi-atlas based image segmentation

NASA Astrophysics Data System (ADS)

Zhao, Tingting; Ruan, Dan

2016-02-01

Multi-atlas based image segmentation sees unprecedented opportunities but also demanding challenges in the big data era. Relevant atlas selection before label fusion plays a crucial role in reducing potential performance loss from heterogeneous data quality and high computation cost from extensive data. This paper starts with investigating the image similarity metric (termed ‘surrogate’), an alternative to the inaccessible geometric agreement metric (termed ‘oracle’) in atlas relevance assessment, and probes into the problem of how to select the ‘most-relevant’ atlases and how many such atlases to incorporate. We propose an inference model to relate the surrogates and the oracle geometric agreement metrics. Based on this model, we quantify the behavior of the surrogates in mimicking oracle metrics for atlas relevance ordering. Finally, analytical insights on the choice of fusion set size are presented from a probabilistic perspective, with the integrated goal of including the most relevant atlases and excluding the irrelevant ones. Empirical evidence and performance assessment are provided based on prostate and corpus callosum segmentation.

Academic Programme Development and the Participation of Relevant Interest Groups for Quality Manpower Production in Nigeria Higher Education

ERIC Educational Resources Information Center

Agabi, Ogar G.; Obasi, Kenneth K.; Ohia, Adanma N.

2012-01-01

Quality manpower production is not just essential for national development, but very critical to national security and quick economic recovery in most of today's fragile economies of the world. This paper assessed the participation of prospective employers as relevant interest groups in the development of academic programmes in tertiary…

Return to College Education Revisited: Is Relevance Relevant?

ERIC Educational Resources Information Center

Yakusheva, Olga

2010-01-01

This study examines whether the size of the college earnings premium varies depending on the quality of the match between an individual's degree field and his/her occupation. The study uses the Occupational Information Network (O*NET) to obtain a new measure of the quality of occupational match for a sample of 2268 young adults with post-secondary…

Strategies for prevention of soccer related injuries: a systematic review

PubMed Central

Olsen, L; Scanlan, A; MacKay, M; Babul, S; Reid, D; Clark, M; Raina, P

2004-01-01

Methods: Standard systematic review methodology was modified and adopted for this review. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches. Articles were assessed for relevance and quality by two independent assessors, and the results of relevant articles were abstracted and synthesised. Results: A total of 44 potentially relevant articles from electronic (n = 37) and hand (n = 7) searches yielded four that met inclusion criteria. These four studies addressed a range of intervention strategies and varied with respect to results and quality of evidence. Conclusions: Some of the strategies look promising but lack adequate evaluation or require further research among younger players. Practice, policy, and research recommendations are provided as a result of the synthesis. PMID:14751956

First results of a national initiative to enable quality improvement of cardiovascular care by transparently reporting on patient-relevant outcomes.

PubMed

van Veghel, Dennis; Marteijn, Marloes; de Mol, Bas

2016-06-01

The aims of this study were to assess patient-relevant outcomes of delivered cardiovascular care by focusing on disease management as determined by a multidisciplinary Heart Team, to establish and share best practices by comparing outcomes and to embed value-based decision-making to improve quality and efficiency in Dutch heart centres. In 2014, 12 Dutch heart centres pooled patient-relevant outcome data, which resulted in transparent publication of the outcomes, including long-term follow-up up to 5 years, of approximately 86 000 heart patients. This study presents the results of both disease- and treatment patient-relevant outcome measures for coronary artery disease and aortic valve disease. The patients included were presented to a Heart Team and underwent invasive or operative treatment. In-hospital and out-of-hospital patient-relevant outcome measures were collected as well as initial conditions. Quality of life was assessed using the Short Form (SF)-36 or SF-12 health survey. In the Netherlands, patient-relevant and risk-adjusted outcomes of cardiovascular care in participating heart centres are published annually. Data were sufficiently reliable to enable comparisons and to subtract best practices. The statistically lower risk-adjusted mortality rate after coronary artery bypass grafting resulted in a voluntary roll-out of a perioperative safety check. The in-depth analysis of outcomes after percutaneous coronary intervention resulted in process improvements in several heart centres, such as pre-hydration for patients with renal insufficiency and the need of target vessel revascularizations within a year. Annual data collection on follow-up of patient-relevant outcomes of cardiovascular care, initiated and organized by physicians, appears feasible. Transparent publication of outcomes drives the improvement of quality within heart centres. The system of using a limited set of patient-relevant outcome measures enables reliable comparisons and exposes the quality of decision-making and the operational process. Transparent communication on outcomes is feasible, safe and cost-effective, and stimulates professional decision-making and disease management. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Should the implantable cardiac defibrillator be used for primary prevention of sudden death? A review of the issues relevant to hospital decision making.

PubMed

McGregor, Maurice; Chen, Jun

2004-10-01

New evidence suggests that the implantable cardiac defibrillator (ICD) may be effective for primary prevention of sudden death. High instrumental cost and the potentially large number of candidates will significantly impact hospital budgets. To review the information relevant to hospital policy decisions on the use of ICDs for primary prevention. Modelling based on an evaluation of reported studies and Canadian costs, detailed in a comprehensive review available at . Health outcomes: Two high-quality primary prevention trials suggest a reduction in annual mortality of 2.9% with bounds of probability (PB) of 2.0% to 3.8%, in early years. To undertake 100 implants per year may result in an increasing annual saving of life-years of acceptable quality, stabilizing by 15 years at 110 (PB 72 to 154) each year. Economic impact: The annual costs would stabilize at 15 years at approximately 4.3 million dollars. Cost-effectiveness: The incremental cost-effectiveness from the point of view of the health care system would be approximately 47,000 dollars (PB 35,000 dollars to 70,000 dollars), discounted at 3%. Ethical and legal issues: The decision should not be individual but institutional, using a process that is transparent, consistent and fair. The ICD can prolong life, with acceptable quality. Restriction of its use would be solely on grounds of expense.

Biological and functional relevance of CASP predictions.

PubMed

Liu, Tianyun; Ish-Shalom, Shirbi; Torng, Wen; Lafita, Aleix; Bock, Christian; Mort, Matthew; Cooper, David N; Bliven, Spencer; Capitani, Guido; Mooney, Sean D; Altman, Russ B

2018-03-01

Our goal is to answer the question: compared with experimental structures, how useful are predicted models for functional annotation? We assessed the functional utility of predicted models by comparing the performances of a suite of methods for functional characterization on the predictions and the experimental structures. We identified 28 sites in 25 protein targets to perform functional assessment. These 28 sites included nine sites with known ligand binding (holo-sites), nine sites that are expected or suggested by experimental authors for small molecule binding (apo-sites), and Ten sites containing important motifs, loops, or key residues with important disease-associated mutations. We evaluated the utility of the predictions by comparing their microenvironments to the experimental structures. Overall structural quality correlates with functional utility. However, the best-ranked predictions (global) may not have the best functional quality (local). Our assessment provides an ability to discriminate between predictions with high structural quality. When assessing ligand-binding sites, most prediction methods have higher performance on apo-sites than holo-sites. Some servers show consistently high performance for certain types of functional sites. Finally, many functional sites are associated with protein-protein interaction. We also analyzed biologically relevant features from the protein assemblies of two targets where the active site spanned the protein-protein interface. For the assembly targets, we find that the features in the models are mainly determined by the choice of template. © 2017 The Authors Proteins: Structure, Function and Bioinformatics Published by Wiley Periodicals, Inc.

Peyronie’s Disease: AUA Guideline

PubMed Central

Nehra, Ajay; Alterowitz, Ralph; Culkin, Daniel J.; Faraday, Martha M.; Hakim, Lawrence S.; Heidelbaugh, Joel J.; Khera, Mohit; Kirkby, Erin; McVary, Kevin T.; Miner, Martin M.; Nelson, Christian J.; Sadeghi-Nejad, Hossein; Seftel, Allen D.; Shindel, Alan W.; Burnett, Arthur L.

2016-01-01

Purpose The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie’s disease. Materials and Methods A systematic review of the literature using the PubMed®, EMBASE® and Cochrane databases (search dates 1/1/1965 to 1/26/15) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of PD. The review yielded an evidence base of 303 articles after application of inclusion/exclusion criteria. Results The systematic review was used to create guideline statements regarding treatment of PD. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high quality evidence; high certainty), B (moderate quality evidence; moderate certainty), or C (low quality evidence; low certainty). Evidence-based statements of Strong, Moderate, or Conditional Recommendation were developed based on benefits and risks/burdens to patients. Additional consensus statements related to the diagnosis of PD are provided as Clinical Principles and Expert Opinions due to insufficient published evidence. Conclusions There is a continually expanding literature on PD; the Panel notes that this document constitutes a clinical strategy and is not intended to be interpreted rigidly. The most effective approach for a particular patient is best determined by the individual clinician and patient in the context of that patient’s history, values, and goals for treatment. As the science relevant to PD evolves and improves, the strategies presented here will be amended to remain consistent with the highest standards of clinical care. PMID:26066402

Serotonin and noradrenaline reuptake inhibitors (Snris) for fibromyalgia

PubMed Central

Welsch, Patrick; Üçeyler, Nurcan; Klose, Petra; Walitt, Brian; Häuser, Winfried

2018-01-01

Background Fibromyalgia is a clinically defined chronic condition of unknown etiology characterized by chronic widespread pain that often co-exists with sleep disturbances, cognitive dysfunction and fatigue. People with fibromyalgia often report high disability levels and poor quality of life. Drug therapy, for example, with serotonin and noradrenaline reuptake inhibitors (SNRIs), focuses on reducing key symptoms and improving quality of life. This review updates and extends the 2013 version of this systematic review. Objectives To assess the efficacy, tolerability and safety of serotonin and noradrenaline reuptake inhibitors (SNRIs) compared with placebo or other active drug(s) in the treatment of fibromyalgia in adults. Search methods For this update we searched CENTRAL, MEDLINE, Embase, the US National Institutes of Health and the World Health Organization (WHO) International Clinical Trials Registry Platform for published and ongoing trials and examined the reference lists of reviewed articles, to 8 August 2017. Selection criteria We selected randomized, controlled trials of any formulation of SNRIs against placebo or any other active treatment of fibromyalgia in adults. Data collection and analysis Three review authors independently extracted data, examined study quality, and assessed risk of bias. For efficacy, we calculated the number needed to treat for an additional beneficial outcome (NNTB) for pain relief of 50% or greater and of 30% or greater, patient's global impression to be much or very much improved, dropout rates due to lack of efficacy, and the standardized mean differences (SMD) for fatigue, sleep problems, health-related quality of life, mean pain intensity, depression, anxiety, disability, sexual function, cognitive disturbances and tenderness. For tolerability we calculated number needed to treat for an additional harmful outcome (NNTH) for withdrawals due to adverse events and for nausea, insomnia and somnolence as specific adverse events. For safety we calculated NNTH for serious adverse events. We undertook meta-analysis using a random-effects model. We assessed the evidence using GRADE and created a 'Summary of findings' table. Main results We added eight new studies with 1979 participants for a total of 18 included studies with 7903 participants. Seven studies investigated duloxetine and nine studies investigated milnacipran against placebo. One study compared desvenlafaxine with placebo and pregabalin. One study compared duloxetine with L-carnitine. The majority of studies were at unclear or high risk of bias in three to five domains. The quality of evidence of all comparisons of desvenlafaxine, duloxetine and milnacipran versus placebo in studies with a parallel design was low due to concerns about publication bias and indirectness, and very low for serious adverse events due to concerns about publication bias, imprecision and indirectness. The quality of evidence of all comparisons of duloxetine and desvenlafaxine with other active drugs was very low due to concerns about publication bias, imprecision and indirectness. Duloxetine and milnacipran had no clinically relevant benefit over placebo for pain relief of 50% or greater: 1274 of 4104 (31%) on duloxetine and milnacipran reported pain relief of 50% or greater compared to 591 of 2814 (21%) participants on placebo (risk difference (RD) 0.09, 95% confidence interval (CI) 0.07 to 0.11; NNTB 11, 95% CI 9 to 14). Duloxetine and milnacipran had a clinically relevant benefit over placebo in patient's global impression to be much or very much improved: 888 of 1710 (52%) on duloxetine and milnacipran (RD 0.19, 95% CI 0.12 to 0.26; NNTB 5, 95% CI 4 to 8) reported to be much or very much improved compared to 354 of 1208 (29%) of participants on placebo. Duloxetine and milnacipran had a clinically relevant benefit compared to placebo for pain relief of 30% or greater. RD was 0.10; 95% CI 0.08 to 0.12; NNTB 10, 95% CI 8 to 12. Duloxetine and milnacipran had no clinically relevant benefit for fatigue (SMD -0.13, 95% CI -0.18 to -0.08; NNTB 18, 95% CI 12 to 29), compared to placebo. There were no differences between either duloxetine or milnacipran and placebo in reducing sleep problems (SMD -0.07; 95 % CI -0.15 to 0.01). Duloxetine and milnacipran had no clinically relevant benefit compared to placebo in improving health-related quality of life (SMD -0.20, 95% CI -0.25 to -0.15; NNTB 11, 95% CI 8 to 14). There were 794 of 4166 (19%) participants on SNRIs who dropped out due to adverse events compared to 292 of 2863 (10%) of participants on placebo (RD 0.07, 95% CI 0.04 to 0.10; NNTH 14, 95% CI 10 to 25). There was no difference in serious adverse events between either duloxetine, milnacipran or desvenlafaxine and placebo (RD -0.00, 95% CI -0.01 to 0.00). There was no difference between desvenlafaxine and placebo in efficacy, tolerability and safety in one small trial. There was no difference between duloxetine and desvenlafaxine in efficacy, tolerability and safety in two trials with active comparators (L-carnitine, pregabalin). Authors' conclusions The update did not change the major findings of the previous review. Based on low- to very low-quality evidence, the SNRIs duloxetine and milnacipran provided no clinically relevant benefit over placebo in the frequency of pain relief of 50% or greater, but for patient's global impression to be much or very much improved and in the frequency of pain relief of 30% or greater there was a clinically relevant benefit. The SNRIs duloxetine and milnacipran provided no clinically relevant benefit over placebo in improving health-related quality of life and in reducing fatigue. Duloxetine and milnacipran did not significantly differ from placebo in reducing sleep problems. The dropout rates due to adverse events were higher for duloxetine and milnacipran than for placebo. On average, the potential benefits of duloxetine and milnacipran in fibromyalgia were outweighed by their potential harms. However, a minority of people with fibromyalgia might experience substantial symptom relief without clinically relevant adverse events with duloxetine or milnacipran. We did not find placebo-controlled studies with other SNRIs than desvenlafaxine, duloxetine and milnacipran. Serotonin and noradrenaline reuptake inhibitors for fibromyalgia Bottom line Duloxetine and milnacipran may reduce pain in people with fibromyalgia. However, some of these people may also experience side effects, such as nausea (feeling sick) and drowsiness. A minority of people with fibromyalgia experience symptom relief without side effects from duloxetine and milnacipran. Background People with fibromyalgia often have chronic (longer than three months) widespread pain, as well as problems with sleep, thinking and exhaustion. They often report poor health-related quality of life. There is no cure for fibromyalgia at present, so the treatments aim to relieve the symptoms and to improve health-related quality of life. Serotonin and noradrenaline are chemicals which are produced by the human body, involved in the regulation of pain, sleep and mood. Low concentrations of serotonin have been reported in people with fibromyalgia. Serotonin and noradrenaline reuptake inhibitors (SNRIs) are a class of antidepressants that increase the concentration of serotonin and noradrenaline in the brain. Study characteristics In August 2017, we updated our searches for clinical trials in which SNRIs were used to treat symptoms of fibromyalgia in adults. We found eight new studies since the previous version of the review. In total, we found 18 studies with 7903 participants. The studies were four to 27 weeks long and compared the SNRIs desvenlafaxine, duloxetine and milnacipran against a fake medication (placebo). We rated the quality of the evidence from studies using four levels: very low, low, moderate, or high. Very low-quality evidence means that we are very uncertain about the results. High-quality evidence means that we are very confident in the results. Key results and quality of the evidence Duloxetine and milnacipran were better than placebo in reducing pain by 50% or more and in improving global well-being (low-quality evidence). Duloxetine and milnacipran were better than placebo in improving health-related quality of life and in reducing fatigue (low-quality evidence). Duloxetine and milnacipran were not better than placebo in reducing sleep problems (low-quality evidence). More people dropped out of the trial due to side effects with duloxetine and milnacipran than with placebo (low-quality evidence). More people reported nausea and drowsiness with duloxetine and milnacipran than with placebo (low-quality evidence). Duloxetine, milnacipran and placebo did not differ in the frequency of serious side effects experienced (very low-quality evidence). PMID:29489029

Assessing Quality of Data Standards: Framework and Illustration Using XBRL GAAP Taxonomy

NASA Astrophysics Data System (ADS)

Zhu, Hongwei; Wu, Harris

The primary purpose of data standards or metadata schemas is to improve the interoperability of data created by multiple standard users. Given the high cost of developing data standards, it is desirable to assess the quality of data standards. We develop a set of metrics and a framework for assessing data standard quality. The metrics include completeness and relevancy. Standard quality can also be indirectly measured by assessing interoperability of data instances. We evaluate the framework using data from the financial sector: the XBRL (eXtensible Business Reporting Language) GAAP (Generally Accepted Accounting Principles) taxonomy and US Securities and Exchange Commission (SEC) filings produced using the taxonomy by approximately 500 companies. The results show that the framework is useful and effective. Our analysis also reveals quality issues of the GAAP taxonomy and provides useful feedback to taxonomy users. The SEC has mandated that all publicly listed companies must submit their filings using XBRL. Our findings are timely and have practical implications that will ultimately help improve the quality of financial data.

Patient-reported assessment of quality care at end of life: development and validation of Quality Care Questionnaire-End of Life (QCQ-EOL).

PubMed

Yun, Young Ho; Kim, Soo-Hyun; Lee, Kyoung-Min; Park, Sang Min; Lee, Chang Geol; Choi, Youn Seon; Lee, Won Sup; Kim, Si-Young; Heo, Dae Seog

2006-09-01

Our goal was to validate an instrument with which terminally ill patients could evaluate the quality of care they receive at the end of life (EOL). Questionnaire development followed a four-phase process: item generation and reduction, construction, pilot testing, and field-testing. Using relevance and priority criteria and pilot testing, we developed a 16-item questionnaire. Factor analyses of data from 235 patients resulted in the Quality Care Questionnaire-End of Life (QCQ-EOL) covering dignity-conserving care, care by health care professionals, individualised care, and family relationships. All subscales and total scores showed high internal consistency (Cronbach alpha range, 0.73-0.89). The ability of total score and selective subscale scores clearly differentiated patients on the basis of clinical situation, sense of dignity, and general rating of care quality. Correlations of scores between patients and caregivers were substantial. The QCQ-EOL can be adopted to assess the quality of care received by terminally ill patients.

A survey of pedagogical approaches and quality mechanisms used in education programs for mental health professionals.

PubMed

McCann, Edward; Higgins, Agnes; Maguire, Gerry; Alexander, Jane; Watts, Mike; Creaner, Mary; Rani, Shobha

2012-09-01

The provision of high-quality education and training that is responsive, relevant, accessible and evidence based is critical if the vision for quality mental health services presented in recent policy initiatives in Ireland is to be fulfilled. This paper reports the findings related to pedagogical approaches and quality assurance mechanisms utilized within mental health education. The study involved canvassing all Higher Education Institutions in Ireland. A total of 227 courses in 31 educational institutes were identified and 149 questionnaires were returned from 129 Course Coordinators. Various quality processes were identified in existing programs; however, formal feedback from service providers, service users and carers was seldom reported. Ongoing evaluation and quality assurance strategies are a key element of governance and there is a need to develop strategies that explore the impact of education programs on mental health education and health outcomes. Recommendations are made in terms of future interprofessional mental health education and practice.

Where to find information about drugs

PubMed Central

Day, Richard O; Snowden, Leone

2016-01-01

SUMMARY Good medicines information is critical to medical practice. Choose high-quality, pre-appraised sources first and make sure they are current. Select the information that is most relevant to the needs of your particular patient. Take the time to become familiar with the features of the resources you use. Australian Medicines Handbook, Therapeutic Guidelines, Australian Prescriber and NPS MedicineWise cover most routine clinical practice needs. PMID:27346917

Areas of ground subsidence due to geofluid withdrawal

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

Grimsrud, G.P.; Turner, B.L.; Frame, P.A.

1978-08-01

Detailed information is provided on four geothermal areas with histories of subsidence. These were selected on the basis of: physical relevance of subsidence areas to high priority US geothermal sites in terms of withdrawn geofluid type, reservoir depth, reservoir geology and rock characteristics, and overburden characteristics; and data completeness, quality, and availability. The four areas are: Chocolate Bayou, Raft River Valley, Wairakei, and the Geysers. (MHR)

The Accessibility of Learning Content for All Students, Including Students with Disabilities, Must Be Addressed in the Shift to Digital Instructional Materials. SETDA Policy Brief

ERIC Educational Resources Information Center

Fletcher, Geoff; Levin, Doug; Lipper, Katherine; Leichty, Reg

2014-01-01

This is a time of rapid technological advancement, with innovations in education holding great promise for improving teaching and learning, particularly for students with unique needs. High-quality digital educational materials, tools, and resources offer students relevant, up-to-date, and innovative ways to acquire knowledge and skills. Created…

Monitoring Trends in Educational Growth: A Partnership Service to Monitor the Educational Growth of Students in the Early to Middle Years of Schooling

ERIC Educational Resources Information Center

Australian Council for Educational Research, 2015

2015-01-01

Monitoring Trends in Educational Growth (MTEG) offers a flexible, collaborative approach to developing and implementing an assessment of learning outcomes that yields high-quality, nationally relevant data. MTEG is a service that involves ACER staff working closely with each country to develop an assessment program that meets the country's…

Space Surveillance Tech Area Benefits from University Partnerships (Postprint)

DTIC Science & Technology

2013-12-10

Michigan Technological University’s Oculus- ASR, is a calibration satellite for AMOS’s telescopic non- resolved object characterization program...calibration satellite for AMOS’s telescopic non- resolved object characterization program. Another example is the University of Buffalo, which is... time and on-orbit data. Without partnerships such as these, a school would not be able to deliver as high quality a satellite , decreasing relevance

QUOTEchemo: a patient-centred instrument to measure quality of communication preceding chemotherapy treatment through the patient's eyes.

PubMed

van Weert, Julia C M; Jansen, Jesse; de Bruijn, Gert-Jan; Noordman, Janneke; van Dulmen, Sandra; Bensing, Jozien M

2009-11-01

Knowing patients' needs is a prerequisite to ensure high quality cancer care. This study describes the development and psychometric properties of a patient-centred instrument to measure needs and actual experiences with communication preceding chemotherapy treatment: QUOTE(chemo). QUOTE-questionnaires (Quality Of care Through the patients' Eyes) are widely used to gain insight into unmet needs, but no validated, standardised questionnaire combining patients' needs and experiences surrounding chemotherapy treatment is available yet. To evaluate the psychometric properties of the QUOTE(chemo), content validity, internal structure and convergent validity were investigated amongst 345 cancer patients, new to chemotherapy, from 10 different hospitals. Literature study, focus group discussions and a categorisation procedure of 67 relevant topics revealed seven main themes: Treatment-related information, Prognosis information, Rehabilitation information, Coping information, Interpersonal communication, Tailored communication and Affective communication. Confirmatory factor analysis using structural equation modelling indicated that the measurement model provided good fit to the data with factor loadings ranging from .43 to .77. The seven QUOTE(chemo) dimensions captured relevant issues of concern with good internal consistency (alpha .72-.92), satisfactory item-total correlations (.35-.79) and satisfactory convergent validity. Affective communication, Treatment-related information and Rehabilitation information were perceived most important by patients. The instrument also appeared to be able to determine which aspects need improvement to ensure high quality care. The highest need for improvement was found for communicating Prognosis information and Rehabilitation information and for Interpersonal communication. These findings provide preliminary evidence of the reliability and validity of the QUOTE(chemo) for use in cancer care surrounding chemotherapy treatment. Researchers and health care providers can use the instrument to measure patients' needs and experiences with communication to identify aspects that need improvement.

The effectiveness of the bone bridge transtibial amputation technique: A systematic review of high-quality evidence.

PubMed

Kahle, Jason T; Highsmith, M Jason; Kenney, John; Ruth, Tim; Lunseth, Paul A; Ertl, Janos

2017-06-01

This literature review was undertaken to determine if commonly held views about the benefits of a bone bridge technique are supported by the literature. Four databases were searched for articles pertaining to surgical strategies specific to a bone bridge technique of the transtibial amputee. A total of 35 articles were identified as potential articles. Authors included methodology that was applied to separate topics. Following identification, articles were excluded if they were determined to be low quality evidence or not pertinent. Nine articles were identified to be pertinent to one of the topics: Perioperative Care, Acute Care, Subjective Analysis and Function. Two articles sorted into multiple topics. Two articles were sorted into the Perioperative Care topic, 4 articles sorted into the Acute Care topic, 2 articles into the Subjective Analysis topic and 5 articles into the Function topic. There are no high quality (level one or two) clinical trials reporting comparisons of the bone bridge technique to traditional methods. There is limited evidence supporting the clinical outcomes of the bone bridge technique. There is no agreement supporting or discouraging the perioperative and acute care aspects of the bone bridge technique. There is no evidence defining an interventional comparison of the bone bridge technique. Current level III evidence supports a bone bridge technique as an equivalent option to the non-bone bridge transtibial amputation technique. Formal level I and II clinical trials will need to be considered in the future to guide clinical practice. Clinical relevance Clinical Practice Guidelines are evidence based. This systematic literature review identifies the highest quality evidence to date which reports a consensus of outcomes agreeing bone bridge is as safe and effective as alternatives. The clinical relevance is understanding bone bridge could additionally provide a mechanistic advantage for the transtibial amputee.

Assessment of microscale spatio-temporal variation of air pollution at an urban hotspot in Madrid (Spain) through an extensive field campaign

NASA Astrophysics Data System (ADS)

Borge, Rafael; Narros, Adolfo; Artíñano, Begoña; Yagüe, Carlos; Gómez-Moreno, Francisco Javier; de la Paz, David; Román-Cascón, Carlos; Díaz, Elías; Maqueda, Gregorio; Sastre, Mariano; Quaassdorff, Christina; Dimitroulopoulou, Chrysanthi; Vardoulakis, Sotiris

2016-09-01

Poor urban air quality is one of the main environmental concerns worldwide due to its implications for population exposure and health-related issues. However, the development of effective abatement strategies in cities requires a consistent and holistic assessment of air pollution processes, taking into account all the relevant scales within a city. This contribution presents the methodology and main results of an intensive experimental campaign carried out in a complex pollution hotspot in Madrid (Spain) under the TECNAIRE-CM research project, which aimed at understanding the microscale spatio-temporal variation of ambient concentration levels in areas where high pollution values are recorded. A variety of instruments were deployed during a three-week field campaign to provide detailed information on meteorological and micrometeorological parameters and spatio-temporal variations of the most relevant pollutants (NO2 and PM) along with relevant information needed to simulate pedestrian fluxes. The results show the strong dependence of ambient concentrations on local emissions and meteorology that turns out in strong spatial and temporal variations, with gradients up to 2 μg m-3 m-1 for NO2 and 55 μg m-3 min-1 for PM10. Pedestrian exposure to these pollutants also presents strong variations temporally and spatially but it concentrates on pedestrian crossings and bus stops. The analysis of the results show that the high concentration levels found in urban hotspots depend on extremely complex dynamic processes that cannot be captured by routinely measurements made by air quality monitoring stations used for regulatory compliance assessment. The large influence from local traffic in the concentration fields highlights the need for a detailed description of specific variables that determine emissions and dispersion at microscale level. This also indicates that city-scale interventions may be complemented with local control measures and exposure management, to improve air quality and reduce air pollution health effects more effectively.

In-process fault detection for textile fabric production: onloom imaging

NASA Astrophysics Data System (ADS)

Neumann, Florian; Holtermann, Timm; Schneider, Dorian; Kulczycki, Ashley; Gries, Thomas; Aach, Til

2011-05-01

Constant and traceable high fabric quality is of high importance both for technical and for high-quality conventional fabrics. Usually, quality inspection is carried out by trained personal, whose detection rate and maximum period of concentration are limited. Low resolution automated fabric inspection machines using texture analysis were developed. Since 2003, systems for the in-process inspection on weaving machines ("onloom") are commercially available. With these defects can be detected, but not measured quantitative precisely. Most systems are also prone to inevitable machine vibrations. Feedback loops for fault prevention are not established. Technology has evolved since 2003: Camera and computer prices dropped, resolutions were enhanced, recording speeds increased. These are the preconditions for real-time processing of high-resolution images. So far, these new technological achievements are not used in textile fabric production. For efficient use, a measurement system must be integrated into the weaving process; new algorithms for defect detection and measurement must be developed. The goal of the joint project is the development of a modern machine vision system for nondestructive onloom fabric inspection. The system consists of a vibration-resistant machine integration, a high-resolution machine vision system, and new, reliable, and robust algorithms with quality database for defect documentation. The system is meant to detect, measure, and classify at least 80 % of economically relevant defects. Concepts for feedback loops into the weaving process will be pointed out.

ELEVATING QUALITY WITH MANDITORY USE OF STANDARD REPORTING GUIDELINES

PubMed Central

L.Voight, Michael

2014-01-01

The Editorial staff of The International Journal of Sports Physical Therapy (IJSPT) is dedicated to the review, critical appraisal, and publication of high quality scientific and clinical research, systematic reviews, meta‐analyses, and case reports. As IJSPT progresses through its' ninth year of providing high quality research evidence as well as relevant clinical commentary and suggestions for the international sports physical therapy community, we offer the following editorial. We, along with many other prestigious journals are committed to elevating the quality of published research related to disability and rehabilitation and agree to adherence to the following reporting guidelines, which will be required by IJSPT as of January 1, 2015. Many of these guidelines are all ready in place and have been implemented by IJSPT. This Editorial is a reprint of a previously published Editorial in The Archives of Physical Medicine and Rehabilitation, and is used with permission. (http://dx.doi.org/10.1016/j.apmr.2013.12.010) For citation purposes, please use the original publication details: Chan L, Heinemann AW, and Roberts J, Elevating the Quality of Disability and Rehabilitation Research: Mandatory use of the Reporting Guidelines. Archives of Physical Medicine and Rehabilitation, 2014: 95: 414‐417 PMID:25133069

Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy.

PubMed

Morris, Brian J; Kennedy, Sean E; Wodak, Alex D; Mindel, Adrian; Golovsky, David; Schrieber, Leslie; Lumbers, Eugenie R; Handelsman, David J; Ziegler, John B

2017-02-08

To determine whether recent evidence-based United States policies on male circumcision (MC) apply to comparable Anglophone countries, Australia and New Zealand. Articles in 2005 through 2015 were retrieved from PubMed using the keyword "circumcision" together with 36 relevant subtopics. A further PubMed search was performed for articles published in 2016. Searches of the EMBASE and Cochrane databases did not yield additional citable articles. Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further. The most relevant and representative of the topic were included. Bibliographies were examined to retrieve further key references. Randomized controlled trials, recent high quality systematic reviews or meta-analyses (level 1++ or 1+ evidence) were prioritized for inclusion. A risk-benefit analysis of articles rated for quality was performed. For efficiency and reliability, recent randomized controlled trials, meta-analyses, high quality systematic reviews and large well-designed studies were used if available. Internet searches were conducted for other relevant information, including policies and Australian data on claims under Medicare for MC. Evidence-based policy statements by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) support infant and later age male circumcision (MC) as a desirable public health measure. Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria. Together, these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects, phimosis that causes difficult and painful erections and "ballooning" during urination, inflammatory skin conditions, inferior penile hygiene, candidiasis, various sexually transmissible infections in both sexes, genital ulcers, and penile, prostate and cervical cancer. Our risk-benefit analysis showed that benefits exceeded procedural risks, which are predominantly minor, by up to 200 to 1. We estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime. Wide-ranging evidence from surveys, physiological measurements, and the anatomical location of penile sensory receptors responsible for sexual sensation strongly and consistently suggested that MC has no detrimental effect on sexual function, sensitivity or pleasure. United States studies showed that early infant MC is cost saving. The evidence supporting early infant MC has further strengthened since the positive AAP and CDC reviews. Affirmative MC policies are needed in Australia and New Zealand. Routine provision of accurate, unbiased education, and access in public hospitals, will maximize health and financial benefits.

Spacelab Data Processing Facility

NASA Technical Reports Server (NTRS)

1983-01-01

The Spacelab Data Processing Facility (SDPF) processes, monitors, and accounts for the payload data from Spacelab and other Shuttle missions and forwards relevant data to various user facilities worldwide. The SLDPF is divided into the Spacelab Input Processing System (SIPS) and the Spacelab Output Processing System (SOPS). The SIPS division demultiplexes, synchronizes, time tags, quality checks, accounts for the data, and formats the data onto tapes. The SOPS division further edits, blocks, formats, and records the data on tape for shipment to users. User experiments must conform to the Spacelab's onboard High Rate Multiplexer (HRM) format for maximum process ability. Audio, analog, instrumentation, high density, experiment data, input/output data, quality control and accounting, and experimental channel tapes along with a variety of spacelab ancillary tapes are provided to the user by SLDPF.

[Drinking water quality indices in the Orenburg Region].

PubMed

Golubkina, N A; Burtseva, T I; Gatsenko, A Iu

2011-01-01

The quality of underground waters from 22 areas of the Orenburg Region was studied from the values of mineralization and pH and the amounts of the ions of Se, Cl, Pb, Cd, F, and phenols. High fluorine ion concentrations (5-12 mg/l), high mineralization (> 1 g/l), and alkalinity (pH > 8.0) were shown to be human risk factors in a considerable number of areas. Districts with cadmium, lead, and phenol ion-polluted underground waters were identified. The amount of selenium in the drinking water (18-319 ng/l) and in the sera of donors in Orenburg, Buzuluk, and Orsk (86-97 microg/l) fails to support the data available in the literature on environmental selenium pollution and is comparable with the relevant data for the Moscow Region.

Understanding Consumer Perceptions and Awareness of Hospital-Based Maternity Care Quality Measures.

PubMed

Maurer, Maureen; Firminger, Kirsten; Dardess, Pam; Ikeler, Kourtney; Sofaer, Shoshanna; Carman, Kristin L

2016-06-01

To explore factors that may influence use of comparative public reports for hospital maternity care. Four focus groups conducted in 2013 with 41 women and preintervention survey data collected in 2014 to 2015 from 245 pregnant women in North Carolina. As part of a larger randomized controlled trial, we conducted qualitative formative research to develop an intervention that will be evaluated through pre- and postintervention surveys. Analysis of focus group transcripts examined participants' perceptions of high-quality maternity care and the importance of different quality measures. Quantitative analysis included descriptive results of the preintervention survey and subgroup analyses to examine the impact of race, education, and being a first-time mom on outcomes. When describing high-quality maternity care, participants focused on interactions with providers, including respect for preferences and communication. The importance of quality measures was influenced by the extent to which they focused on babies' health, were perceived as the hospital's responsibility, and were perceived as representing "standard care." At baseline, 28 percent of survey respondents had used quality information to choose a hospital. Survey respondents were more aware of some quality measures (e.g., breastfeeding support) than others (e.g., episiotomy rates). Public reporting efforts could help increase relevance of maternity care quality measures by creating measures that reflect women's concerns, clearly explaining the hospital's role in supporting quality care, and showing how available quality measures can inform decisions about childbirth. © Health Research and Educational Trust.

Clustervision: Visual Supervision of Unsupervised Clustering.

PubMed

Kwon, Bum Chul; Eysenbach, Ben; Verma, Janu; Ng, Kenney; De Filippi, Christopher; Stewart, Walter F; Perer, Adam

2018-01-01

Clustering, the process of grouping together similar items into distinct partitions, is a common type of unsupervised machine learning that can be useful for summarizing and aggregating complex multi-dimensional data. However, data can be clustered in many ways, and there exist a large body of algorithms designed to reveal different patterns. While having access to a wide variety of algorithms is helpful, in practice, it is quite difficult for data scientists to choose and parameterize algorithms to get the clustering results relevant for their dataset and analytical tasks. To alleviate this problem, we built Clustervision, a visual analytics tool that helps ensure data scientists find the right clustering among the large amount of techniques and parameters available. Our system clusters data using a variety of clustering techniques and parameters and then ranks clustering results utilizing five quality metrics. In addition, users can guide the system to produce more relevant results by providing task-relevant constraints on the data. Our visual user interface allows users to find high quality clustering results, explore the clusters using several coordinated visualization techniques, and select the cluster result that best suits their task. We demonstrate this novel approach using a case study with a team of researchers in the medical domain and showcase that our system empowers users to choose an effective representation of their complex data.

Systematic review to inform prevention and management of chronic disease for Indigenous Australians: overview and priorities.

PubMed

Gomersall, Judith Streak; Canuto, Karla; Aromataris, Edoardo; Braunack-Mayer, Annette; Brown, Alex

2016-02-01

To describe the main characteristics of systematic reviews addressing questions of chronic disease and related risk factors for Indigenous Australians. We searched databases for systematic reviews meeting inclusion criteria. Two reviewers assessed quality and extracted characteristics using pre-defined tools. We identified 14 systematic reviews. Seven synthesised evidence about health intervention effectiveness; four addressed chronic disease or risk factor prevalence; and six conducted critical appraisal as per current best practice. Only three reported steps to align the review with standards for ethical research with Indigenous Australians and/or capture Indigenous-specific knowledge. Most called for more high-quality research. Systematic review is an under-utilised method for gathering evidence to inform chronic disease prevention and management for Indigenous Australians. Relevance of future systematic reviews could be improved by: 1) aligning questions with community priorities as well as decision maker needs; 2) involvement of, and leadership by, Indigenous researchers with relevant cultural and contextual knowledge; iii) use of critical appraisal tools that include traditional risk of bias assessment criteria and criteria that reflect Indigenous standards of appropriate research. Systematic review method guidance, tools and reporting standards are required to ensure alignment with ethical obligations and promote rigor and relevance. © 2015 Public Health Association of Australia.

Quality in Teaching Laboratories.

ERIC Educational Resources Information Center

Stubington, John F.

1995-01-01

Describes a Japanese process-oriented approach called KAIZEN for improving the quality of existing teaching laboratories. It provides relevant quality measurements and indicates how quality can be improved. Use of process criteria sidesteps the difficulty of defining quality for laboratory experiments and allows separation of student assessment…

Health Disparities in Women

PubMed Central

Hornbuckle, Lyndsey M; Amutah-Onukagha, Ndidiamaka; Bryan, Alicia; Skidmore Edwards, Elizabeth; Madzima, Takudzwa; Massey, Kelly; May, Linda; Robinson, Leah E

2017-01-01

AIMS AND SCOPE Clinical Medicine Insights: Women’s Health is an international, open-access, peer-reviewed journal which considers manuscripts on all aspects of the diagnosis, management, and prevention of disorders specific to women, in addition to related genetic, pathophysiological, and epidemiological topics. Clinical Medicine Insights: Women’s Health aims to provide researchers working in this complex, quickly developing field with online, open access to highly relevant scholarly articles by leading international researchers. In a field where the literature is ever-expanding, researchers increasingly need access to up-to-date, high-quality scholarly articles on areas of specific contemporary interest. This supplement is on Health Disparities in Women. This supplement aims to address this by presenting high-quality articles that allow readers to distinguish the signal from the noise. The editor in chief hopes that through this effort, practitioners and researchers will be aided in finding answers to some of the most complex and pressing issues of our time. PMID:28579867

Lowbury Lecture 2013. Cultural determinants of infection control behaviour: understanding drivers and implementing effective change.

PubMed

Borg, M A

2014-03-01

Despite dealing with biomedical practices, infection prevention and control (IPC) is essentially a behavioural science. Human behaviour is influenced by various factors, including culture. Hofstede's model of cultural dimensions proposes that national cultures vary along consistent dimensions which can be grouped and scored as specific constructs. Studies have reported that three Hofstede constructs--power distance, uncertainty avoidance, and masculinity--show significant association with several key performance indicators relevant to IPC and antibiotic stewardship. In addition, national meticillin-resistant Staphylococcus aureus (MRSA) levels within Europe correlate well with general quality-of-care indices, including preventive strategies and patient rights. This suggests that IPC may be simply a microcosm of overall quality and safety standards within hospitals and countries. Effective improvement would therefore need to address underlying and embedded core cultural values relevant to patient safety and quality of care. Successful IPC strategies are likely to be those that are compatible with the cultural background where they are implemented. To this end, content analysis of many current IPC improvement tools identifies elements of strong compatibility with cultures that are low in uncertainty avoidance and power distance, and high in individualism and masculinity. However, this cultural combination is largely restricted to Anglo-Saxon countries, where most of the recent improvements in healthcare-associated infection (HCAI) incidence have taken place. There is a paucity of research on IPC behaviour change in different cultural backgrounds, especially countries that score high for power distance and/or uncertainty avoidance. This information is vital to inform IPC campaigns in these countries, which often show high HCAI prevalence. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

ALiEM Blog and Podcast Watch: Toxicology.

PubMed

Zaver, Fareen; Craddick, Michael; Sanford, Audrey; Sefa, Nana; Hughes, George; Lin, Michelle

2017-10-01

The WestJEM Blog and Podcast Watch presents high-quality open-access educational blogs and podcasts in emergency medicine based on the ongoing Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional (Pro) series. Both series critically appraise open-access educational blogs and podcasts in EM using an objective scoring instrument. This installment of the blog and podcast watch series curated and scored relevant posts in the specific topic of toxicology emergencies from the AIR-Pro Series. The AIR-Pro Series is a continuously building curriculum covering a new subject area every two months. For each area, eight EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net and FOAMSearcher to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro editorial board, which is comprised of EM faculty and chief residents at various institutions across North America. The scoring instrument contains five measurement outcomes based on seven-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥28 (out of 35) points. An "honorable mention" label is awarded if board members collectively felt that the blogs were valuable and the scores were > 25. A total of 31 blog posts and podcasts were included. Key educational pearls from the six high-quality AIR-Pro posts and four honorable mentions are summarized. The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro Series, which attempts to identify high-quality educational content on open-access blogs and podcasts. This series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. This installment focuses on toxicology emergencies.

ALiEM Blog and Podcast Watch: Toxicology

PubMed Central

Zaver, Fareen; Craddick, Michael; Sanford, Audrey; Sefa, Nana; Hughes, George; Lin, Michelle

2017-01-01

Introduction The WestJEM Blog and Podcast Watch presents high-quality open-access educational blogs and podcasts in emergency medicine based on the ongoing Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) and AIR-Professional (Pro) series. Both series critically appraise open-access educational blogs and podcasts in EM using an objective scoring instrument. This installment of the blog and podcast watch series curated and scored relevant posts in the specific topic of toxicology emergencies from the AIR-Pro Series. Methods The AIR-Pro Series is a continuously building curriculum covering a new subject area every two months. For each area, eight EM chief residents identify 3–5 advanced clinical questions. Using FOAMsearch.net and FOAMSearcher to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro editorial board, which is comprised of EM faculty and chief residents at various institutions across North America. The scoring instrument contains five measurement outcomes based on seven-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥28 (out of 35) points. An “honorable mention” label is awarded if board members collectively felt that the blogs were valuable and the scores were > 25. Results A total of 31 blog posts and podcasts were included. Key educational pearls from the six high-quality AIR-Pro posts and four honorable mentions are summarized. Conclusion The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro Series, which attempts to identify high-quality educational content on open-access blogs and podcasts. This series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. This installment focuses on toxicology emergencies. PMID:29085545

Development of a surgical educational research program-fundamental principles and challenges.

PubMed

Ahmed, Kamran; Ibrahim, Amel; Anderson, Oliver; Patel, Vanash M; Zacharakis, Emmanouil; Darzi, Ara; Paraskeva, Paraskevas; Athanasiou, Thanos

2011-05-15

Surgical educational research is the scientific investigation of any aspect of surgical learning, teaching, training, and assessment. The research into development and validation of educational tools is vital to optimize patient care. This can be accomplished by establishing high quality educational research programs within academic surgical departments. This article aims to identify the components involved in educational research and describes the challenges as well as solutions to establishing a high quality surgical educational research program. A variety of sources including journal articles, books, and online literature were reviewed in order to determine the pathways involved in conducting educational research and establishing a research program. It is vital to ensure that educational research is acceptable, innovative, robust in design, funded correctly, and disseminated successfully. Challenges faced by the current surgical research programs include structural organization, academic support, credibility, time, funding, relevance, and growth. The solutions to these challenges have been discussed. To ensure research in surgical education is of high quality and yields credible results, strong leadership in the organization of an educational research program is necessary. Copyright © 2011 Elsevier Inc. All rights reserved.

Effect of pilot-scale aseptic processing on tomato soup quality parameters.

PubMed

Colle, Ines J P; Andrys, Anna; Grundelius, Andrea; Lemmens, Lien; Löfgren, Anders; Buggenhout, Sandy Van; Loey, Ann; Hendrickx, Marc Van

2011-01-01

Tomatoes are often processed into shelf-stable products. However, the different processing steps might have an impact on the product quality. In this study, a model tomato soup was prepared and the impact of pilot-scale aseptic processing, including heat treatment and high-pressure homogenization, on some selected quality parameters was evaluated. The vitamin C content, the lycopene isomer content, and the lycopene bioaccessibility were considered as health-promoting attributes. As a structural characteristic, the viscosity of the tomato soup was investigated. A tomato soup without oil as well as a tomato soup containing 5% olive oil were evaluated. Thermal processing had a negative effect on the vitamin C content, while lycopene degradation was limited. For both compounds, high-pressure homogenization caused additional losses. High-pressure homogenization also resulted in a higher viscosity that was accompanied by a decrease in lycopene bioaccessibility. The presence of lipids clearly enhanced the lycopene isomerization susceptibility and improved the bioaccessibility. The results obtained in this study are of relevance for product formulation and process design of tomato-based food products. © 2011 Institute of Food Technologists®

Evaluating the Labour Government's English NHS health system reforms: the 2008 Darzi reforms.

PubMed

Mays, Nicholas

2013-10-01

Starting in 2002, the UK Labour Government of 1997-2010 introduced a series of changes to the National Health Service (NHS) in England designed to increase patients' choices of the place of elective hospital care and encourage competition among public and private providers of elective hospital services for NHS-funded patients. In 2006, the Department of Health initiated the Health Reform Evaluation Programme (HREP) to assess the impact of the changes. In June 2008, the White Paper, High quality care for all, was published. It represented the government's desire to focus the next phase of health care system reform in England as much on the quality of care as on improving its responsiveness and efficiency. The 2008 White Paper led to the commissioning of a further wave of evaluative research under the auspices of HREP, as follows: an evaluation of the implementation and outcomes of care planning for people with long-term conditions; an evaluation of the personal health budget pilots; an evaluation of the implementation and outcomes of the Commissioning for Quality and Innovation (CQUIN) framework; and an evaluation of cultural and behavioural change in the NHS focused on ensuring high quality care for all. This Supplement includes papers from each project. The evaluations present a mixed picture of the impact and success of the 2008 reforms. All the studies identify some limitations of the policies in the White Paper. The introduction of personal health budgets appears to have been the least problematic and, depending on assumptions, likely to be cost-effective for the sorts of patients involved in the pilot. For the rest of the changes, impacts ranged from little or none (CQUIN and care planning for people with chronic conditions) to patchy and highly variable (instilling a culture of quality in acute hospitals) in the three years following the publication of the White Paper. On the other hand, each of the studies identifies important insights relevant to modifying and improving the policies. These findings have continuing relevance since both the 2008 White Paper's policies, and the issues they were focused on remedying, remain central to the current Coalition Government's reform agenda.

Methodological update in Medicina Intensiva.

PubMed

García Garmendia, J L

2018-04-01

Research in the critically ill is complex by the heterogeneity of patients, the difficulties to achieve representative sample sizes and the number of variables simultaneously involved. However, the quantity and quality of records is high as well as the relevance of the variables used, such as survival. The methodological tools have evolved to offering new perspectives and analysis models that allow extracting relevant information from the data that accompanies the critically ill patient. The need for training in methodology and interpretation of results is an important challenge for the intensivists who wish to be updated on the research developments and clinical advances in Intensive Medicine. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

[Epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic diseases in preschool children].

PubMed

Weng, T T; Yan, S Q; Cao, H; Gu, C L; Xu, Y Q; Ni, L L; Tao, H H; Shao, T; Tao, F B

2017-12-06

Objective: To understand the epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city. Methods: During April 2014 to April 2015, 91 kindergartens over 3 years old were investigated. In the investigation, 16 439 questionnaires were distributed to parents, and 15 291 valid questionnaires were collected. Conners abbreviated symptom questionnaire ( brief symptom questionnaire ) was filled out by parents to assess the children's hyperactive behaviors. Information of allergic disease history was reported by parents, including allergic dermatitis/eczema, food/drug allergy, allergic rhinitis and asthma. Multivariate unconditional logistic regression was used to analyze the relevant factors of comorbidity of hyperactivity behavior and allergy diseases. Results: The average age of the 15 291 children were (4.5±1.0) years old, among which 53.7% (8 218/15 291) were boys. The prevalence of hyperactive behaviors was 8.6%(1 317/15 291), and the comorbidity rate of hyperactivity and allergic deseases was 1.7% (258/15 291). After confounding factors including gender, age, delivery mode, father's age and pregnancy complications adjusted, poor sleep quality ( OR= 4.45, 95 %CI: 2.85-6.94), long duration of watching TV at weekend ( OR= 1.39, 95 %CI : 1.00-1.94) and poor eating behavior ( OR= 1.78, 95 %CI : 1.07-2.98) were relevant factors of the comorbidity of hyperactivity and allergic diseases. Conclusion: The prevalence of comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city was not high. Poor night sleep quality, long duration of watching TV and frequently picky eating were relevant factors of the comorbidity of hyperactive behaviors and allergic diseases.

The Top Ten Websites in Critical Care Medicine Education Today.

PubMed

Wolbrink, Traci A; Rubin, Lucy; Burns, Jeffrey P; Markovitz, Barry

2018-01-01

The number of websites for the critical care provider is rapidly growing, including websites that are part of the Free Open Access Med(ical ed)ucation (FOAM) movement. With this rapidly expanding number of websites, critical appraisal is needed to identify quality websites. The last major review of critical care websites was published in 2011, and thus a new review of the websites relevant to the critical care clinician is necessary. A new assessment tool for evaluating critical care medicine education websites, the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET), was modified from existing tools. A PubMed and Startpage search from 2007 to 2017 was conducted to identify websites relevant to critical care medicine education. These websites were scored based on the CCMEWQET. Ninety-seven websites relevant for critical care medicine education were identified and scored, and the top ten websites were described in detail. Common types of resources available on these websites included blog posts, podcasts, videos, online journal clubs, and interactive components such as quizzes. Almost one quarter of websites (n = 22) classified themselves as FOAM websites. The top ten websites most often included an editorial process, high-quality and appropriately attributed graphics and multimedia, scored much higher for comprehensiveness and ease of access, and included opportunities for interactive learning. Many excellent online resources for critical care medicine education currently exist, and the number is likely to continue to increase. Opportunities for improvement in many websites include more active engagement of learners, upgrading navigation abilities, incorporating an editorial process, and providing appropriate attribution for graphics and media.

Accelerating science, practice, and policy relevant to school psychology internationally: Looking backward and moving forward.

PubMed

Jimerson, Shane R

2016-12-01

Provides a brief synthesis of the past, present, and forecast for the future of School Psychology Quarterly , highlighting important contributions as an international resource to enrich, invigorate, enhance, advance, and accelerate science, practice, and policy relevant to school psychology internationally. Information highlights (a) the important contributions of those who serve on the editorial board, (b) the value of high quality and timely reviews, (c) publishing manuscripts that address a breadth of important topics relevant to school psychology, (d) international contributions, (e) an overview of special topic sections that have been featured over the years, and (f) contemporary ratings and rankings of School Psychology Quarterly . The diversity of the topics and methods that are featured in the journal continues to reflect the breadth of knowledge and skills necessary to inform the contemporary field of school psychology. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Multidisciplinary molecular diagnostics: the 9th European meeting on molecular diagnostics.

PubMed

Loonen, Anne J M; Schuurman, Rob; van den Brule, Adriaan J C

2016-01-01

This report presents a summary of the 9th European Meeting on Molecular Diagnostics held in Noordwijk, The Netherlands, 14-16 October 2015. This 3-day conference covered many relevant topics in the field of molecular diagnostics in humans, including infectious disease, oncology, outbreak management, population-based cancer screening, standardization and quality control, chronic diseases and pharmacogenetics. Beyond these different areas, shared values are new technologies and novel technical and clinical applications. Approximately 450 participants, the majority coming from European countries, attended the meeting. Besides high quality scientific presentations, more than 35 diagnostic companies presented their latest innovations, altogether in an informal and inspiring scientific ambience.

Honing process optimization algorithms

NASA Astrophysics Data System (ADS)

Kadyrov, Ramil R.; Charikov, Pavel N.; Pryanichnikova, Valeria V.

2018-03-01

This article considers the relevance of honing processes for creating high-quality mechanical engineering products. The features of the honing process are revealed and such important concepts as the task for optimization of honing operations, the optimal structure of the honing working cycles, stepped and stepless honing cycles, simulation of processing and its purpose are emphasized. It is noted that the reliability of the mathematical model determines the quality parameters of the honing process control. An algorithm for continuous control of the honing process is proposed. The process model reliably describes the machining of a workpiece in a sufficiently wide area and can be used to operate the CNC machine CC743.

Impact of industrial hammer mill rotor speed on extraction efficiency and quality of extra virgin olive oil.

PubMed

Polari, Juan J; Garcí-Aguirre, David; Olmo-García, Lucía; Carrasco-Pancorbo, Alegría; Wang, Selina C

2018-03-01

Crushing is a key step during olive oil extraction. Among commercial crushers, the hammer mill is the most widely used due to its robustness and high throughput. In the present work, the impact of hammer mill rotor speed on extraction yield and overall quality of super-high-density Arbosana olive oils were assessed in an industrial facility. Our results show that increasing the rotor speed from 2400rpm to 3600rpm led to a rise in oil yield of 1.2%, while conserving quality parameters. Sensory analysis showed more pungency with increased rotation speed, while others attributes were unaffected. Volatile compounds showed little variation with the differences in crusher speed; however, total phenols content, two relevant secoiridoids, and triterpenoids levels increased with rotor speed. Hammer mill rotor speed is a processing variable that can be tuned to increase the extraction efficiency and modulate the chemical composition of extra virgin olive oil. Copyright © 2017 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine for lowering blood lipid levels: A systematic review of systematic reviews.

PubMed

Posadzki, Paul; AlBedah, Abdullah M N; Khalil, Mohamed M K; AlQaed, Meshari S

2016-12-01

The aim of this article is to summarize and critically evaluate the evidence from systematic reviews (SRs) of complementary and alternative medicine (CAM) for lowering blood lipid levels (BLL). Eight electronic databases were searched until March 2016. Additionally, all the retrieved references were inspected manually for further relevant papers. Systematic reviews were considered eligible, if they included patients of any age and/or gender with elevated blood lipid levels using any type of CAM. We used the Oxman and AMSTAR criteria to critically appraise the methodological quality of the included SRs. Twenty-seven SRs were included in the analyses. The majority of the SRs were of high methodological quality (mean Oxman score=4.81, SD=4.88; and the mean AMSTAR score=7.22, SD=3.38). The majority of SRs (56%) arrived at equivocal conclusions (of these 8 were of high quality); 7 SRs (37%) arrived at positive conclusions (of these 6 were of high quality), and 2 (7%) arrived at negative conclusions (both were of high quality). There was conflicting evidence regarding the effectiveness of garlic; and promising evidence for yoga. To conclude, the evidence from SRs evaluating the effectiveness of CAM in lowering BLL is predominantly equivocal and confusing. Several limitations exist, such as variety of doses and preparations, confounding effects of diets and lifestyle factors, or heterogeneity of the primary trials among others. Copyright © 2016. Published by Elsevier Ltd.

Predicting sport and occupational lower extremity injury risk through movement quality screening: a systematic review.

PubMed

Whittaker, Jackie L; Booysen, Nadine; de la Motte, Sarah; Dennett, Liz; Lewis, Cara L; Wilson, Dave; McKay, Carly; Warner, Martin; Padua, Darin; Emery, Carolyn A; Stokes, Maria

2017-04-01

Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. 5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model). Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties. 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/.

Predicting Sport and Occupational Lower Extremity Injury Risk through Movement Quality Screening: A Systematic Review

PubMed Central

Whittaker, Jackie L; Booysen, Nadine; de la Motte, Sarah; Dennett, Liz; Lewis, Cara L.; Wilson, Dave; McKay, Carly; Warner, Martin; Padua, Darin; Emery, Carolyn A; Stokes, Maria

2017-01-01

Background Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. Objective To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. Material and methods Five electronic databases were systematically searched. Studies selected included: original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The PRISMA guidelines were followed. Two independent authors assessed the quality [Downs and Black (DB) criteria] and level of evidence (Oxford Centre of Evidence-Based Medicine model). Results Of 4361 potential studies, 17 were included. The majority were low quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3–15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). Four studies considered interrelationships between risk factors, seven reported diagnostic accuracy and none tested an intervention program targeting individuals identified as high-risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Conclusions Future research should focus on high quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating pre-participation screening and LE injury prevention programs through high quality randomized controlled trials targeting individuals at greater risk of injury based upon screening tests with validated test properties. PMID:27935483

Naval Postgraduate School Research. Volume 14, Number 1, February 2004

DTIC Science & Technology

2004-02-01

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...this review were to ensure officers continue to receive high quality, relevant, and responsive graduate education aligned to defense needs...Initiative (COSSI), Earned Value Management System (EVMS), Activity-Based Costing (ABC), Value Engineering, and lessons from R-TOC Pilots. Sponsored

Bioengineering a Human Plasma-Based Epidermal Substitute With Efficient Grafting Capacity and High Content in Clonogenic Cells

PubMed Central

Alexaline, Maia M.; Trouillas, Marina; Nivet, Muriel; Bourreau, Emilie; Leclerc, Thomas; Duhamel, Patrick; Martin, Michele T.; Doucet, Christelle; Fortunel, Nicolas O.

2015-01-01

Cultured epithelial autografts (CEAs) produced from a small, healthy skin biopsy represent a lifesaving surgical technique in cases of full-thickness skin burn covering >50% of total body surface area. CEAs also present numerous drawbacks, among them the use of animal proteins and cells, the high fragility of keratinocyte sheets, and the immaturity of the dermal-epidermal junction, leading to heavy cosmetic and functional sequelae. To overcome these weaknesses, we developed a human plasma-based epidermal substitute (hPBES) for epidermal coverage in cases of massive burn, as an alternative to traditional CEA, and set up critical quality controls for preclinical and clinical studies. In this study, phenotypical analyses in conjunction with functional assays (clonal analysis, long-term culture, or in vivo graft) showed that our new substitute fulfills the biological requirements for epidermal regeneration. hPBES keratinocytes showed high potential for cell proliferation and subsequent differentiation similar to healthy skin compared with a well-known reference material, as ascertained by a combination of quality controls. This work highlights the importance of integrating relevant multiparameter quality controls into the bioengineering of new skin substitutes before they reach clinical development. Significance This work involves the development of a new bioengineered epidermal substitute with pertinent functional quality controls. The novelty of this work is based on this quality approach. PMID:25848122

Bioengineering a human plasma-based epidermal substitute with efficient grafting capacity and high content in clonogenic cells.

PubMed

Alexaline, Maia M; Trouillas, Marina; Nivet, Muriel; Bourreau, Emilie; Leclerc, Thomas; Duhamel, Patrick; Martin, Michele T; Doucet, Christelle; Fortunel, Nicolas O; Lataillade, Jean-Jacques

2015-06-01

Cultured epithelial autografts (CEAs) produced from a small, healthy skin biopsy represent a lifesaving surgical technique in cases of full-thickness skin burn covering >50% of total body surface area. CEAs also present numerous drawbacks, among them the use of animal proteins and cells, the high fragility of keratinocyte sheets, and the immaturity of the dermal-epidermal junction, leading to heavy cosmetic and functional sequelae. To overcome these weaknesses, we developed a human plasma-based epidermal substitute (hPBES) for epidermal coverage in cases of massive burn, as an alternative to traditional CEA, and set up critical quality controls for preclinical and clinical studies. In this study, phenotypical analyses in conjunction with functional assays (clonal analysis, long-term culture, or in vivo graft) showed that our new substitute fulfills the biological requirements for epidermal regeneration. hPBES keratinocytes showed high potential for cell proliferation and subsequent differentiation similar to healthy skin compared with a well-known reference material, as ascertained by a combination of quality controls. This work highlights the importance of integrating relevant multiparameter quality controls into the bioengineering of new skin substitutes before they reach clinical development. This work involves the development of a new bioengineered epidermal substitute with pertinent functional quality controls. The novelty of this work is based on this quality approach. ©AlphaMed Press.

Emergency treatment of hypoglycaemia: a guideline and evidence review.

PubMed

Villani, M; de Courten, B; Zoungas, S

2017-09-01

To examine the current treatment guidelines for the emergency management of hypoglycaemia and the evidence underpinning recommendations. International diabetes agencies were searched for hypoglycaemia treatment guidelines. Guidelines were assessed using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument. An electronic database search was conducted for evidence regarding emergency treatment of hypoglycaemia in adults, and relevant articles were critically appraised. Of the international diabetes agencies, six sets of guidelines were deemed relevant and of sufficient detail for appraisal by AGREE II. The evidence search returned 2649 articles, of which 17 pertaining to the emergency management of hypoglycaemia were included. High-quality evidence for the management of hypoglycaemia was lacking, limiting treatment recommendations. In general, guidelines and studies were somewhat concordant and recommended 15-20 g of oral glucose or sucrose, repeated after 10-15 min for treatment of the responsive adult, and 10% intravenous dextrose or 1 mg intramuscular glucagon for treatment of the unresponsive adult. No evidence was found for other treatment approaches. Evidence for the emergency treatment of hypoglycaemia in adults is limited, is often low grade and mostly pre-dates contemporary management of diabetes. Guideline recommendations are limited by the lack of randomized trials. Further high-quality studies are required to inform the optimum management of this frequently occurring emergency condition. © 2017 Diabetes UK.

Finding "hard to find" literature on hard to find groups: A novel technique to search grey literature on refugees and asylum seekers.

PubMed

Enticott, Joanne; Buck, Kimberly; Shawyer, Frances

2018-03-01

There is a lack of information on how to execute effective searches of the grey literature on refugee and asylum seeker groups for inclusion in systematic reviews. High-quality government reports and other grey literature relevant to refugees may not always be identified in conventional literature searches. During the process of conducting a recent systematic review, we developed a novel strategy for systematically searching international refugee and asylum seeker-related grey literature. The approach targets governmental health departments and statistical agencies, who have considerable access to refugee and asylum seeker populations for research purposes but typically do not publish findings in academic forums. Compared to a conventional grey literature search strategy, our novel technique yielded an eightfold increase in relevant high-quality grey sources that provided valuable content in informing our review. Incorporating a search of the grey literature into systematic reviews of refugee and asylum seeker research is essential to providing a more complete view of the evidence. Our novel strategy offers a practical and feasible method of conducting systematic grey literature searches that may be adaptable to a range of research questions, contexts, and resource constraints. Copyright © 2017 John Wiley & Sons, Ltd.

A Profile of Injuries Sustained by Law Enforcement Officers: A Critical Review.

PubMed

Lyons, Kate; Radburn, Cameron; Orr, Robin; Pope, Rodney

2017-02-03

Due to the unpredictable, varied and often physical nature of law enforcement duties, police officers are at a high risk of work-related physical injury. The aim of this critical narrative review was to identify and synthesize key findings of studies that have investigated musculoskeletal injuries sustained by law enforcement officers during occupational tasks. A systematic search of four databases using key search terms was conducted to identify potentially relevant studies, which were assessed against key inclusion and exclusion criteria to determine studies to be included in the review. Included studies were critically appraised and the level of evidence determined. Relevant data were extracted, tabulated and synthesized. The 16 identified studies ranged in percentage quality scores from 25.00% to 65.00%, with a mean score of 41.25% and high interrater agreement in scores reflected in a Cohen's Kappa coefficient, κ = 0.977. The most common body site of injury was the upper extremity, the most common injury types were soft-tissue sprains and strains and the most common cause of injury was a non-compliant offender, often involving assault. However, there was limited peer reviewed research in this area and the published research had a narrow focus and was of low to fair methodological quality.

A Profile of Injuries Sustained by Law Enforcement Officers: A Critical Review

PubMed Central

Lyons, Kate; Radburn, Cameron; Orr, Robin; Pope, Rodney

2017-01-01

Due to the unpredictable, varied and often physical nature of law enforcement duties, police officers are at a high risk of work-related physical injury. The aim of this critical narrative review was to identify and synthesize key findings of studies that have investigated musculoskeletal injuries sustained by law enforcement officers during occupational tasks. A systematic search of four databases using key search terms was conducted to identify potentially relevant studies, which were assessed against key inclusion and exclusion criteria to determine studies to be included in the review. Included studies were critically appraised and the level of evidence determined. Relevant data were extracted, tabulated and synthesized. The 16 identified studies ranged in percentage quality scores from 25.00% to 65.00%, with a mean score of 41.25% and high interrater agreement in scores reflected in a Cohen’s Kappa coefficient, κ = 0.977. The most common body site of injury was the upper extremity, the most common injury types were soft-tissue sprains and strains and the most common cause of injury was a non-compliant offender, often involving assault. However, there was limited peer reviewed research in this area and the published research had a narrow focus and was of low to fair methodological quality. PMID:28165373

Process observation in fiber laser-based selective laser melting

NASA Astrophysics Data System (ADS)

Thombansen, Ulrich; Gatej, Alexander; Pereira, Milton

2015-01-01

The process observation in selective laser melting (SLM) focuses on observing the interaction point where the powder is processed. To provide process relevant information, signals have to be acquired that are resolved in both time and space. Especially in high-power SLM, where more than 1 kW of laser power is used, processing speeds of several meters per second are required for a high-quality processing results. Therefore, an implementation of a suitable process observation system has to acquire a large amount of spatially resolved data at low sampling speeds or it has to restrict the acquisition to a predefined area at a high sampling speed. In any case, it is vitally important to synchronously record the laser beam position and the acquired signal. This is a prerequisite that allows the recorded data become information. Today, most SLM systems employ f-theta lenses to focus the processing laser beam onto the powder bed. This report describes the drawbacks that result for process observation and suggests a variable retro-focus system which solves these issues. The beam quality of fiber lasers delivers the processing laser beam to the powder bed at relevant focus diameters, which is a key prerequisite for this solution to be viable. The optical train we present here couples the processing laser beam and the process observation coaxially, ensuring consistent alignment of interaction zone and observed area. With respect to signal processing, we have developed a solution that synchronously acquires signals from a pyrometer and the position of the laser beam by sampling the data with a field programmable gate array. The relevance of the acquired signals has been validated by the scanning of a sample filament. Experiments with grooved samples show a correlation between different powder thicknesses and the acquired signals at relevant processing parameters. This basic work takes a first step toward self-optimization of the manufacturing process in SLM. It enables the addition of cognitive functions to the manufacturing system to the extent that the system could track its own process. The results are based on analyzing and redesigning the optical train, in combination with a real-time signal acquisition system which provides a solution to certain technological barriers.

Application of uncertainty and sensitivity analysis to the air quality SHERPA modelling tool

NASA Astrophysics Data System (ADS)

Pisoni, E.; Albrecht, D.; Mara, T. A.; Rosati, R.; Tarantola, S.; Thunis, P.

2018-06-01

Air quality has significantly improved in Europe over the past few decades. Nonetheless we still find high concentrations in measurements mainly in specific regions or cities. This dimensional shift, from EU-wide to hot-spot exceedances, calls for a novel approach to regional air quality management (to complement EU-wide existing policies). The SHERPA (Screening for High Emission Reduction Potentials on Air quality) modelling tool was developed in this context. It provides an additional tool to be used in support to regional/local decision makers responsible for the design of air quality plans. It is therefore important to evaluate the quality of the SHERPA model, and its behavior in the face of various kinds of uncertainty. Uncertainty and sensitivity analysis techniques can be used for this purpose. They both reveal the links between assumptions and forecasts, help in-model simplification and may highlight unexpected relationships between inputs and outputs. Thus, a policy steered SHERPA module - predicting air quality improvement linked to emission reduction scenarios - was evaluated by means of (1) uncertainty analysis (UA) to quantify uncertainty in the model output, and (2) by sensitivity analysis (SA) to identify the most influential input sources of this uncertainty. The results of this study provide relevant information about the key variables driving the SHERPA output uncertainty, and advise policy-makers and modellers where to place their efforts for an improved decision-making process.

Relevance of Trust Marks and CE Labels in German-Language Store Descriptions of Health Apps: Analysis

PubMed Central

Hillebrand, Uta; von Jan, Ute

2018-01-01

Background In addition to mandatory CE marking (“CE” representing Conformité Européenne, with the CE marking being a symbol of free marketability in the European Economic Area) for medical devices, there are various seals, initiatives, action groups, etc, in the health app context. However, whether manufacturers use them to distinguish their apps and attach relevance to them is unclear. Objective The objective was to take a snapshot of quality seals, regulatory marks, and other orientation aids available on the German app market and to determine whether manufacturers deem such labels relevant enough to apply them to their apps, namely as reflected by mentions in app description texts in a typical app store (ie, Apple’s App Store). Methods A full survey of the metadata of 103,046 apps from Apple’s German App Store in the Medicine and Health & Fitness categories was carried out. For apps with German-language store descriptions (N=8767), these were automatically searched for the occurrence of relevant keywords and validated manually (N=41). In addition, the websites of various app seal providers were checked for assigned seals. Results Few manufacturers referenced seals in the descriptions (5/41), although this would have been expected more often based on the seals we were able to identify from the seal providers’ Web pages, and there were 34 of 41 that mentioned CE status in the descriptions. Two apps referenced an app directory curated by experts; however, this is not an alternative to CE marks and seals of approval. Conclusions Currently, quality seals seem to be irrelevant for manufacturers. In line with regulatory requirements, mentions of medical device status are more frequent; however, neither characteristic is effective for identifying high-quality apps. To improve this situation, a possibly legally obligatory, standardized reporting system should be implemented. PMID:29695374

Relevance of Trust Marks and CE Labels in German-Language Store Descriptions of Health Apps: Analysis.

PubMed

Albrecht, Urs-Vito; Hillebrand, Uta; von Jan, Ute

2018-04-25

In addition to mandatory CE marking ("CE" representing Conformité Européenne, with the CE marking being a symbol of free marketability in the European Economic Area) for medical devices, there are various seals, initiatives, action groups, etc, in the health app context. However, whether manufacturers use them to distinguish their apps and attach relevance to them is unclear. The objective was to take a snapshot of quality seals, regulatory marks, and other orientation aids available on the German app market and to determine whether manufacturers deem such labels relevant enough to apply them to their apps, namely as reflected by mentions in app description texts in a typical app store (ie, Apple's App Store). A full survey of the metadata of 103,046 apps from Apple's German App Store in the Medicine and Health & Fitness categories was carried out. For apps with German-language store descriptions (N=8767), these were automatically searched for the occurrence of relevant keywords and validated manually (N=41). In addition, the websites of various app seal providers were checked for assigned seals. Few manufacturers referenced seals in the descriptions (5/41), although this would have been expected more often based on the seals we were able to identify from the seal providers' Web pages, and there were 34 of 41 that mentioned CE status in the descriptions. Two apps referenced an app directory curated by experts; however, this is not an alternative to CE marks and seals of approval. Currently, quality seals seem to be irrelevant for manufacturers. In line with regulatory requirements, mentions of medical device status are more frequent; however, neither characteristic is effective for identifying high-quality apps. To improve this situation, a possibly legally obligatory, standardized reporting system should be implemented. ©Urs-Vito Albrecht, Uta Hillebrand, Ute von Jan. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 25.04.2018.

Technological Distractions (Part 2): A Summary of Approaches to Manage Clinical Alarms With Intent to Reduce Alarm Fatigue.

PubMed

Winters, Bradford D; Cvach, Maria M; Bonafide, Christopher P; Hu, Xiao; Konkani, Avinash; O'Connor, Michael F; Rothschild, Jeffrey M; Selby, Nicholas M; Pelter, Michele M; McLean, Barbara; Kane-Gill, Sandra L

2018-01-01

Alarm fatigue is a widely recognized safety and quality problem where exposure to high rates of clinical alarms results in desensitization leading to dismissal of or slowed response to alarms. Nonactionable alarms are thought to be especially problematic. Despite these concerns, the number of clinical alarm signals has been increasing as an everincreasing number of medical technologies are added to the clinical care environment. PubMed, SCOPUS, Embase, and CINAHL. We performed a systematic review of the literature focused on clinical alarms. We asked a primary key question; "what interventions have been attempted and resulted in the success of reducing alarm fatigue?" and 3-secondary key questions; "what are the negative effects on patients/families; what are the balancing outcomes (unintended consequences of interventions); and what human factor approaches apply to making an effective alarm?" Articles relevant to the Key Questions were selected through an iterative review process and relevant data was extracted using a standardized tool. We found 62 articles that had relevant and usable data for at least one key question. We found that no study used/developed a clear definition of "alarm fatigue." For our primary key question 1, the relevant studies focused on three main areas: quality improvement/bundled activities; intervention comparisons; and analysis of algorithm-based false and total alarm suppression. All sought to reduce the number of total alarms and/or false alarms to improve the positive predictive value. Most studies were successful to varying degrees. None measured alarm fatigue directly. There is no agreed upon valid metric(s) for alarm fatigue, and the current methods are mostly indirect. Assuming that reducing the number of alarms and/or improving positive predictive value can reduce alarm fatigue, there are promising avenues to address patient safety and quality problem. Further investment is warranted not only in interventions that may reduce alarm fatigue but also in defining how to best measure it.

Patient-centred care in general dental practice - a systematic review of the literature

PubMed Central

2014-01-01

Background Delivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with “patient experience” likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice. Methods A systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice. Results Three papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework. Conclusions This systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients’ views should be central to this research. PMID:24902842

Quality of reporting of randomized clinical trials in implant dentistry. A systematic review on critical aspects in design, outcome assessment and clinical relevance.

PubMed

Cairo, Francesco; Sanz, Ignacio; Matesanz, Paula; Nieri, Michele; Pagliaro, Umberto

2012-02-01

The aim of this systematic review (SR) was to assess the quality of reporting randomized clinical trials (RCTs) in the field of implant dentistry, its evolution over time and the possible relations between quality items and reported outcomes. RCTs in implant dentistry were retrieved through electronic and hand searches. Risk of bias in individual studies was assessed focusing on study design, outcome assessment and clinical relevance. Associations between quality items and year of publication of RCTs or reporting of statistically significant outcomes were tested. Among the 495 originally screened manuscripts published from 1989 to April 2011, 276 RCTs were assessed in this SR; 59% of them were published between 2006 and 2011. RCTs were mainly parallel (65%), with a single centre (83%) and a superiority design (88%). Trials in implant dentistry showed several methodological flaws: only 37% showed a random sequence generation at low risk of bias, 75% did not provide information on allocation concealment, only 12% performed a correct sample size calculation, the examiner was blind solely in 42% of studies where blinding was feasible. In addition, only 21% of RCTs declared operator experience and 31% reported patient-related outcomes. Many quality items improved over time. Allocation concealment at high risk of bias (p = 0.0125), no information on drop-out (p = 0.0318) and lack of CONSORT adherence (p = 0.0333) were associated with statistically significant reported outcomes. The overall quality of reporting of RCTs in implant dentistry is poor and only partially improved in the last years. Caution is suggested when interpreting these RCTs since risk of bias was associated with higher chance of reporting of statistically significant results. © 2012 John Wiley & Sons A/S.

Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis.

PubMed

Kuntze, Gregor; Nesbitt, Colleen; Whittaker, Jackie L; Nettel-Aguirre, Alberto; Toomey, Clodagh; Esau, Shane; Doyle-Baker, Patricia K; Shank, Jena; Brooks, Julia; Benseler, Susanne; Emery, Carolyn A

2018-01-01

To conduct a systematic review to evaluate the efficacy of exercise interventions in improving outcomes across domains of functioning and disability in children and adolescents with juvenile idiopathic arthritis (JIA). Seven electronic databases were systematically searched up to November 16, 2016. Original data, analytic prospective design, physical therapy-led exercise intervention evaluation, children and adolescents with JIA, and assessment of functional, structural, activity, participation, or quality of life outcomes. Two authors screened search results, and discrepancies were resolved by consensus. Of 5037 potentially relevant studies, 9 randomized controlled trials and 1 cohort study were included and scored. Study quality (Downs and Black quality assessment tool) and level of evidence (Oxford Centre of Evidence-Based Medicine model) were assessed and meta-analysis conducted where appropriate. Alternatively, a descriptive summary approach was chosen. All randomized controlled trials were moderate-quality intervention studies (level 2b evidence; median Downs and Black score, 20 out of 32; range, 15-27). Interventions included aquatic, strengthening, proprioceptive, aerobic, and Pilates exercises. Pediatric activity capacity (Child Health Assessment Questionnaire) improved with exercise (mean difference, .45; 95% confidence interval, .05-.76). Furthermore, descriptive summaries indicated improved activity capacity, body function and structure (pain and muscle strength), and quality of life outcomes. Exercise therapy appears to be well tolerated and beneficial across clinically relevant outcomes in patients with JIA. The paucity of high-quality evidence and study heterogeneity limited the ability to provide conclusive, generalizing evidence for the efficacy of exercise therapy and to provide specific recommendations for clinical practice at this time. Future research evaluating exercise program implementation using validated outcomes and detailed adherence and safety assessment is needed to optimize clinical decision pathways in patients with JIA. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Toolsets for Airborne Data

Atmospheric Science Data Center

2018-05-23

... from COlumn and VERtically Resolved Observations Relevant to Air Quality (DISCOVER-AQ) Campaign including Maryland, Texas, California, and ... observations to diagnose near-surface conditions relating to air quality. To diagnose air quality conditions from space, reliable satellite ...

Simulation modeling for stratified breast cancer screening - a systematic review of cost and quality of life assumptions.

PubMed

Arnold, Matthias

2017-12-02

The economic evaluation of stratified breast cancer screening gains momentum, but produces also very diverse results. Systematic reviews so far focused on modeling techniques and epidemiologic assumptions. However, cost and utility parameters received only little attention. This systematic review assesses simulation models for stratified breast cancer screening based on their cost and utility parameters in each phase of breast cancer screening and care. A literature review was conducted to compare economic evaluations with simulation models of personalized breast cancer screening. Study quality was assessed using reporting guidelines. Cost and utility inputs were extracted, standardized and structured using a care delivery framework. Studies were then clustered according to their study aim and parameters were compared within the clusters. Eighteen studies were identified within three study clusters. Reporting quality was very diverse in all three clusters. Only two studies in cluster 1, four studies in cluster 2 and one study in cluster 3 scored high in the quality appraisal. In addition to the quality appraisal, this review assessed if the simulation models were consistent in integrating all relevant phases of care, if utility parameters were consistent and methodological sound and if cost were compatible and consistent in the actual parameters used for screening, diagnostic work up and treatment. Of 18 studies, only three studies did not show signs of potential bias. This systematic review shows that a closer look into the cost and utility parameter can help to identify potential bias. Future simulation models should focus on integrating all relevant phases of care, using methodologically sound utility parameters and avoiding inconsistent cost parameters.

Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing.

PubMed

Korstjens, Irene; Moser, Albine

2018-12-01

In the course of our supervisory work over the years we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The first article provides an introduction to this series. The second article focused on context, research questions and designs. The third article focused on sampling, data collection and analysis. This fourth article addresses FAQs about trustworthiness and publishing. Quality criteria for all qualitative research are credibility, transferability, dependability, and confirmability. Reflexivity is an integral part of ensuring the transparency and quality of qualitative research. Writing a qualitative research article reflects the iterative nature of the qualitative research process: data analysis continues while writing. A qualitative research article is mostly narrative and tends to be longer than a quantitative paper, and sometimes requires a different structure. Editors essentially use the criteria: is it new, is it true, is it relevant? An effective cover letter enhances confidence in the newness, trueness and relevance, and explains why your study required a qualitative design. It provides information about the way you applied quality criteria or a checklist, and you can attach the checklist to the manuscript.

Hypogonadism associated with long-term opioid therapy: A systematic review.

PubMed

Birthi, Pravardhan; Nagar, Vittal R; Nickerson, Robert; Sloan, Paul A

2015-01-01

Sexual dysfunction and Opioid-Induced Sexual Hormone Deficiency (OPISHD) have been associated with patients on long-term opioid pain therapy. There have been few comprehensive reviews to establish a relation between hypogonadism with chronic opioid pain management. The OPISHD is often not treated and literature guiding this topic is scarce. To investigate hypogonadism associated with long-term opioid therapy based on qualitative data analysis of the available literature. Systematic review. The review included relevant literature identified through searches of PubMed, Cochrane, Clinical Trials, US National Guideline Clearinghouse, and EMBASE, for the years 1960 to September 2013. The quality assessment and clinical relevance criteria used were the Cochrane Musculoskeletal Review Group Criteria for randomized control trials and the Newcastle-Ottawa Scale Criteria for observational studies. The level of evidence was classified as good, fair, and poor, based on the quality of evidence. The primary outcome measures were clinical symptoms and laboratory markers of hypogonadism. Secondary outcome measure was management of OPISHD. Thirty-one studies were identified, of which 14 studies met inclusion criteria. There were no randomized control trials and eight of 14 studies were of moderate quality. The remaining studies were of poor quality. Four studies report most patients on long-term oral opioid therapy have associated hypogonadism and three studies of patients receiving intrathecal opioid therapy suggest that hypogonadism is common. There is lack of high-quality studies to associate chronic opioid pain management with hypogonadism. At present, there is fair evidence to associate hypogonadism with chronic opioid pain management, and only limited evidence for treatment of OPISHD.

Multimodal interventions including nutrition in the prevention and management of disease-related malnutrition in adults: a systematic review of randomised control trials.

PubMed

Thorne, Frances; Baldwin, Christine

2014-06-01

There has been a move to improve nutritional status in malnourished patients through the use of multimodal interventions (MI). There are currently no systematic reviews that have examined their effectiveness. This analysis aimed to examine the effects on nutritional, clinical, functional and patient-centred outcomes. A systematic review and meta-analysis using Cochrane methodology. 15 studies were included in the analysis, 13 comparing MI with usual care and 2 comparing MI with a nutrition intervention alone. Quality of studies varied and studies reported few relevant outcomes. Only 3 outcomes were compatible with meta-analysis; weight, mortality and length of stay (LOS). No statistically significant differences between groups were found. Narrative review was inconclusive. There was no evidence of benefit in the intervention groups in relation to body composition, functional status or quality of life (QoL). Intervention groups appeared to show a trend towards increased energy and protein intake however data was provided by only 2 studies (301 participants). No conclusive evidence of benefit for MI on any of the reviewed outcomes was found. Well designed, high quality trials addressing the impact of MI on relevant nutritional, functional and clinical outcomes are required. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

The association between shift work and sick leave: a systematic review

PubMed Central

van Drongelen, Alwin; Holte, Kari Anne; Labriola, Merete; Lund, Thomas; van Mechelen, Willem; van der Beek, Allard J

2012-01-01

Shift work is associated with a number of negative health outcomes, although it is not known whether it is associated with sick leave. This systematic review therefore aimed to determine whether an association exists between shift work and sick leave. A systematic literature search was conducted in six databases on observational studies. Two reviewers independently selected relevant articles and appraised methodological quality. Data extraction was performed independently by review couples. Articles were categorised according to shift work characteristics and summarised using a levels of evidence synthesis. In total, the search strategy yielded 1207 references, of which 24 studies met the inclusion criteria. Nine studies were appraised as high quality and used in the levels of evidence synthesis. Two high quality longitudinal studies found a positive association between fixed evening shifts and longer sick leave for female healthcare workers. The evidence was assessed as strong. Evidence was inconclusive for rotating shifts, shift work including nights, for fixed night work, and for 8-hour and 12-hour shifts. The association found between evening work and sick leave in female healthcare workers implies that the association between shift work and sick leave might be schedule and population specific. To study the association further, more high quality studies are necessary that assess and adjust for detailed shift work exposure. PMID:22767871

Using ZIP Code Business Patterns Data to Measure Alcohol Outlet Density

PubMed Central

Matthews, Stephen A.; McCarthy, John D.; Rafail, Patrick S.

2014-01-01

Some states maintain high-quality alcohol outlet databases but quality varies by state, making comprehensive comparative analysis across US communities difficult. This study assesses the adequacy of using ZIP Code Business Patterns (ZIP-BP) data on establishments as estimates of the number of alcohol outlets by ZIP code. Specifically we compare ZIP-BP alcohol outlet counts with high-quality data from state and local records surrounding 44 college campus communities across 10 states plus the District of Columbia. Results show that a composite measure is strongly correlated (R=0.89) with counts of alcohol outlets generated from official state records. Analyses based on Generalized Estimation Equation models show that community and contextual factors have little impact on the concordance between the two data sources. There are also minimal inter-state differences in the level of agreement. To validate the use of a convenient secondary data set (ZIP-BP) it is important to have a high correlation with the more complex, high quality and more costly data product (i.e., datasets based on the acquisition and geocoding of state and local records) and then to clearly demonstrate that the discrepancy between the two to be unrelated to relevant explanatory variables. Thus our overall findings support the adequacy of using a conveniently available data set (ZIP-BP data) to estimate alcohol outlet densities in ZIP code areas in future research. PMID:21411233

Using ZIP code business patterns data to measure alcohol outlet density.

PubMed

Matthews, Stephen A; McCarthy, John D; Rafail, Patrick S

2011-07-01

Some states maintain high-quality alcohol outlet databases but quality varies by state, making comprehensive comparative analysis across US communities difficult. This study assesses the adequacy of using ZIP Code Business Patterns (ZIP-BP) data on establishments as estimates of the number of alcohol outlets by ZIP code. Specifically we compare ZIP-BP alcohol outlet counts with high-quality data from state and local records surrounding 44 college campus communities across 10 states plus the District of Columbia. Results show that a composite measure is strongly correlated (R=0.89) with counts of alcohol outlets generated from official state records. Analyses based on Generalized Estimation Equation models show that community and contextual factors have little impact on the concordance between the two data sources. There are also minimal inter-state differences in the level of agreement. To validate the use of a convenient secondary data set (ZIP-BP) it is important to have a high correlation with the more complex, high quality and more costly data product (i.e., datasets based on the acquisition and geocoding of state and local records) and then to clearly demonstrate that the discrepancy between the two to be unrelated to relevant explanatory variables. Thus our overall findings support the adequacy of using a conveniently available data set (ZIP-BP data) to estimate alcohol outlet densities in ZIP code areas in future research. Copyright © 2011 Elsevier Ltd. All rights reserved.

Outcomes associated with community-based research projects in teaching undergraduate public health.

PubMed

Bouhaimed, Manal; Thalib, Lukman; Doi, Suhail A R

2008-01-01

Community based research projects have been widely used in teaching public health in many institutions. Nevertheless, there is a paucity of information on the learning outcomes of such a teaching strategy. We therefore attempted to evaluate our experience with such a project based teaching process. The objective of this study was to evaluate the factors related to quality, impact and relevance of a 6-week student project for teaching public health in the faculty of medicine at Kuwait University. Interactive sessions familiarized students with research methods. Concurrently, they designed and completed a participatory project with a Community Medicine mentor. Questionnaires were used to assess quality, impact and relevance of the project, and these were correlated with multiple demographic, statistical and research design factors. We evaluated a total of 104 projects that were completed during the period of September 2001 to June 2006. Three dimensions of outcome were assessed: quality; impact and relevance. The average (mean + SE; maximum of 5) scores across all projects were 2.6 + 0.05 (range 1.7-3.7) for quality, 2.8 + 0.06 (range 1.7-4.3) for impact and 3.3 + 0.08 (range 1.3-5) for relevance. The analysis of the relationship between various factors and the scores on each dimension of assessment revealed that various factors were associated with improved quality, impact or relevance to public health practice. We conclude that use of more objective measurement instruments with better a priori conceptualization along with appropriate use of statistics and a more developed study design were likely to result in more meaningful research outcomes. We also found that a biostatistics or epidemiology mentor improved the research outcome.

Quality in the Professions.

ERIC Educational Resources Information Center

Becher, Tony

1999-01-01

Reviews quality assurance and quality control procedures of the main requirements affecting United Kingdom medicine, pharmacy, law, accountancy, architecture, and structural engineering. Provides a taxonomy of different forms of quality maintenance and offers comparative material which may be of interest and relevance to academic readers. (EV)

A review of data quality assessment methods for public health information systems.

PubMed

Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

2014-05-14

High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users' concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process.

The effect of structural empowerment of nurses on quality outcomes in hospitals: a scoping review.

PubMed

Goedhart, Nicole S; van Oostveen, Catharina J; Vermeulen, Hester

2017-04-01

To assess and synthesise studies reporting direct associations between the structural empowerment of frontline nurses and quality outcomes, and to identify gaps in the current literature. The empowerment of nurses seems essential for delivering high-quality patient care. Understanding the relationship between empowerment and quality outcomes would enable nurse managers to make informed choices on improving the quality of care. A scoping review examining the relationship between the structural empowerment of nurses and the quality, effectiveness, safety, efficiency and patient-centredness of care in hospitals. Searching in MEDLINE, CINAHL, Business Source Premier and Embase identified 672 potentially relevant articles. Independent selection, quality assessment, data extraction and analysis were completed. Twelve cross-sectional studies originating from North America were included. These studies showed a variety of quality outcomes and statistics used. All studies reported positive associations between the structural empowerment of nurses, nurse assessed quality of care and patient safety climate, and work and unit effectiveness. Nurses having access to empowering structures positively affects the quality outcomes, i.e. quality, effectiveness, safety, efficiency and patient-centredness of patient care in hospitals. Nurse managers and leaders should ensure empowering work conditions for nurses in order to increase hospitals' quality of patient care. © 2017 John Wiley & Sons Ltd.

A Review of Data Quality Assessment Methods for Public Health Information Systems

PubMed Central

Chen, Hong; Hailey, David; Wang, Ning; Yu, Ping

2014-01-01

High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process. PMID:24830450

Privileged structures: efficient chemical "navigators" toward unexplored biologically relevant chemical spaces.

PubMed

Kim, Jonghoon; Kim, Heejun; Park, Seung Bum

2014-10-22

In the search for new therapeutic agents for currently incurable diseases, attention has turned to traditionally "undruggable" targets, and collections of drug-like small molecules with high diversity and quality have become a prerequisite for new breakthroughs. To generate such collections, the diversity-oriented synthesis (DOS) strategy was developed, which aims to populate new chemical space with drug-like compounds containing a high degree of molecular diversity. The resulting DOS-derived libraries have been of great value for the discovery of various bioactive small molecules and therapeutic agents, and thus DOS has emerged as an essential tool in chemical biology and drug discovery. However, the key challenge has become how to design and synthesize drug-like small-molecule libraries with improved biological relevancy as well as maximum molecular diversity. This Perspective presents the development of privileged substructure-based DOS (pDOS), an efficient strategy for the construction of polyheterocyclic compound libraries with high biological relevancy. We envisioned the specific interaction of drug-like small molecules with certain biopolymers via the incorporation of privileged substructures into polyheterocyclic core skeletons. The importance of privileged substructures such as benzopyran, pyrimidine, and oxopiperazine in rigid skeletons was clearly demonstrated through the discovery of bioactive small molecules and the subsequent identification of appropriate target biomolecule using a method called "fluorescence difference in two-dimensional gel electrophoresis". Focusing on examples of pDOS-derived bioactive compounds with exceptional specificity, we discuss the capability of privileged structures to serve as chemical "navigators" toward biologically relevant chemical spaces. We also provide an outlook on chemical biology research and drug discovery using biologically relevant compound libraries constructed by pDOS, biology-oriented synthesis, or natural product-inspired DOS.

Accelerating research into bio-based FDCA-polyesters by using small scale parallel film reactors.

PubMed

Gruter, Gert-Jan M; Sipos, Laszlo; Adrianus Dam, Matheus

2012-02-01

High Throughput experimentation has been well established as a tool in early stage catalyst development and catalyst and process scale-up today. One of the more challenging areas of catalytic research is polymer catalysis. The main difference with most non-polymer catalytic conversions is the fact that the product is not a well defined molecule and the catalytic performance cannot be easily expressed only in terms of catalyst activity and selectivity. In polymerization reactions, polymer chains are formed that can have various lengths (resulting in a molecular weight distribution rather than a defined molecular weight), that can have different compositions (when random or block co-polymers are produced), that can have cross-linking (often significantly affecting physical properties), that can have different endgroups (often affecting subsequent processing steps) and several other variations. In addition, for polyolefins, mass and heat transfer, oxygen and moisture sensitivity, stereoregularity and many other intrinsic features make relevant high throughput screening in this field an incredible challenge. For polycondensation reactions performed in the melt often the viscosity becomes already high at modest molecular weights, which greatly influences mass transfer of the condensation product (often water or methanol). When reactions become mass transfer limited, catalyst performance comparison is often no longer relevant. This however does not mean that relevant experiments for these application areas cannot be performed on small scale. Relevant catalyst screening experiments for polycondensation reactions can be performed in very efficient small scale parallel equipment. Both transesterification and polycondensation as well as post condensation through solid-stating in parallel equipment have been developed. Next to polymer synthesis, polymer characterization also needs to be accelerated without making concessions to quality in order to draw relevant conclusions.

Do cervical epidural injections provide long-term relief in neck and upper extremity pain? A systematic review.

PubMed

Manchikanti, Laxmaiah; Nampiaparampil, Devi E; Candido, Kenneth D; Bakshi, Sanjay; Grider, Jay S; Falco, Frank J E; Sehgal, Nalini; Hirsch, Joshua A

2015-01-01

The high prevalence of chronic persistent neck pain not only leads to disability but also has a significant economic, societal, and health impact. Among multiple modalities of treatments prescribed in the management of neck and upper extremity pain, surgical, interventional and conservative modalities have been described. Cervical epidural injections are also common modalities of treatments provided in managing neck and upper extremity pain. They are administered by either an interlaminar approach or transforaminal approach. To determine the long-term efficacy of cervical interlaminar and transforaminal epidural injections in the treatment of cervical disc herniation, spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. The literature search was performed from 1966 to October 2014 utilizing data from PubMed, Cochrane Library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references. The evidence was assessed based on best evidence synthesis with Level I to Level V. There were 7 manuscripts meeting inclusion criteria. Of these, 4 assessed the role of interlaminar epidural injections for managing disc herniation or radiculitis, and 3 assessed these injections for managing central spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. There were 4 high quality manuscripts. A qualitative synthesis of evidence showed there is Level II evidence for each etiology category. The evidence is based on one relevant, high quality trial supporting the efficacy of cervical interlaminar epidural injections for each particular etiology. There were no randomized trials available assessing the efficacy of cervical transforaminal epidural injections. Paucity of available literature, specifically conditions other than disc herniation. This systematic review with qualitative best evidence synthesis shows Level II evidence for the efficacy of cervical interlaminar epidural injections with local anesthetic with or without steroids, based on at least one high-quality relevant randomized control trial in each category for disc herniation, discogenic pain without facet joint pain, central spinal stenosis, and post surgery syndrome.

Investing in nursing research in practice settings: a blueprint for building capacity.

PubMed

Jeffs, Lianne; Smith, Orla; Beswick, Susan; Maoine, Maria; Ferris, Ella

2013-12-01

Engaging clinical nurses in practice-based research is a cornerstone of professional nursing practice and a critical element in the delivery of high-quality patient care. Practising staff nurses are well suited to identify the phenomena and issues that are clinically relevant and appropriate for research. In response to the need to invest in and build capacity in nursing research, hospitals have developed creative approaches to spark interest in nursing research and to equip clinical nurses with research competencies. This paper outlines a Canadian hospital's efforts to build research capacity as a key strategy to foster efficacious, safe and cost-effective patient care practices. Within a multi-pronged framework, several strategies are described that collectively resulted in enhanced research and knowledge translation productivity aimed at improving the delivery of safe and high-quality patient care.

Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review.

PubMed

McCaskey, Michael A; Schuster-Amft, Corina; Wirth, Brigitte; Suica, Zorica; de Bruin, Eling D

2014-11-19

Proprioceptive training (PrT) is popularly applied as preventive or rehabilitative exercise method in various sports and rehabilitation settings. Its effect on pain and function is only poorly evaluated. The aim of this systematic review was to summarise and analyse the existing data on the effects of PrT on pain alleviation and functional restoration in patients with chronic (≥ 3 months) neck- or back pain. Relevant electronic databases were searched from their respective inception to February 2014. Randomised controlled trials comparing PrT with conventional therapies or inactive controls in patients with neck- or low back pain were included. Two review authors independently screened articles and assessed risk of bias (RoB). Data extraction was performed by the first author and crosschecked by a second author. Quality of findings was assessed and rated according to GRADE guidelines. Pain and functional status outcomes were extracted and synthesised qualitatively and quantitatively. In total, 18 studies involving 1380 subjects described interventions related to PrT (years 1994-2013). 6 studies focussed on neck-, 12 on low back pain. Three main directions of PrT were identified: Discriminatory perceptive exercises with somatosensory stimuli to the back (pPrT, n=2), multimodal exercises on labile surfaces (mPrT, n=13), or joint repositioning exercise with head-eye coordination (rPrT, n=3). Comparators entailed usual care, home based training, educational therapy, strengthening, stretching and endurance training, or inactive controls. Quality of studies was low and RoB was deemed moderate to high with a high prevalence of unclear sequence generation and group allocation (>60%). Low quality evidence suggests PrT may be more effective than not intervening at all. Low quality evidence suggests that PrT is no more effective than conventional physiotherapy. Low quality evidence suggests PrT is inferior to educational and behavioural approaches. There are few relevant good quality studies on proprioceptive exercises. A descriptive summary of the evidence suggests that there is no consistent benefit in adding PrT to neck- and low back pain rehabilitation and functional restoration.

Preservation of Multiple Mammalian Tissues to Maximize Science Return from Ground Based and Spaceflight Experiments.

PubMed

Choi, Sungshin; Ray, Hami E; Lai, San-Huei; Alwood, Joshua S; Globus, Ruth K

2016-01-01

Even with recent scientific advancements, challenges posed by limited resources and capabilities at the time of sample dissection continue to limit the collection of high quality tissues from experiments that can be conducted only infrequently and at high cost, such as in space. The resources and time it takes to harvest tissues post-euthanasia, and the methods and duration of long duration storage, potentially have negative impacts on sample quantity and quality, thereby limiting the scientific outcome that can be achieved. The goals of this study were to optimize methods for both sample recovery and science return from rodent experiments, with possible relevance to both ground based and spaceflight studies. The first objective was to determine the impacts of tissue harvest time post-euthanasia, preservation methods, and storage duration, focusing on RNA quality and enzyme activities in liver and spleen as indices of sample quality. The second objective was to develop methods that will maximize science return by dissecting multiple tissues after long duration storage in situ at -80°C. Tissues of C57Bl/6J mice were dissected and preserved at various time points post-euthanasia and stored at -80°C for up to 11 months. In some experiments, tissues were recovered from frozen carcasses which had been stored at -80°C up to 7 months. RNA quantity and quality was assessed by measuring RNA Integrity Number (RIN) values using an Agilent Bioanalyzer. Additionally, the quality of tissues was assessed by measuring activities of hepatic enzymes (catalase, glutathione reductase and GAPDH). Fresh tissues were collected up to one hour post-euthanasia, and stored up to 11 months at -80°C, with minimal adverse effects on the RNA quality of either livers or RNAlater-preserved spleens. Liver enzyme activities were similar to those of positive controls, with no significant effect observed at any time point. Tissues dissected from frozen carcasses that had been stored for up to 7 months at -80°C had variable results, depending on the specific tissue analyzed. RNA quality of liver, heart, and kidneys were minimally affected after 6-7 months of storage at -80°C, whereas RNA degradation was evident in tissues such as small intestine, bone, and bone marrow when they were collected from the carcasses frozen for 2.5 months. These results demonstrate that 1) the protocols developed for spaceflight experiments with on-orbit dissections support the retrieval of high quality samples for RNA expression and some protein analyses, despite delayed preservation post-euthanasia or prolonged storage, and 2) many additional tissues for gene expression analysis can be obtained by dissection even following prolonged storage of the tissue in situ at -80°C. These findings have relevance both to high value, ground-based experiments when sample collection capability is severely constrained, and to spaceflight experiments that entail on-orbit sample recovery by astronauts.

Diagnostic relevance of high field MRI in clinical neuroradiology: the advantages and challenges of driving a sports car.

PubMed

Wattjes, Mike P; Barkhof, Frederik

2012-11-01

High field MRI operating at 3 T is increasingly being used in the field of neuroradiology on the grounds that higher magnetic field strength should theoretically lead to a higher diagnostic accuracy in the diagnosis of several disease entities. This Editorial discusses the exhaustive review by Wardlaw and colleagues of research comparing 3 T MRI with 1.5 T MRI in the field of neuroradiology. Interestingly, the authors found no convincing evidence of improved image quality, diagnostic accuracy, or reduced total examination times using 3 T MRI instead of 1.5 T MRI. These findings are highly relevant since a new generation of high field MRI systems operating at 7 T has recently been introduced. • Higher magnetic field strengths do not necessarily lead to a better diagnostic accuracy. • Disadvantages of high field MR systems have to be considered in clinical practice. • Higher field strengths are needed for functional imaging, spectroscopy, etc. • Disappointingly there are few direct comparisons of 1.5 and 3 T MRI. • Whether the next high field MR generation (7 T) will improve diagnostic accuracy has to be investigated.

Blog and Podcast Watch: Pediatric Emergency Medicine.

PubMed

Zaver, Fareen; Hansen, Michael; Leibner, Evan; Little, Andrew; Lin, Michelle

2016-09-01

By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM. The Approved Instructional Resources - Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35) points. An "Honorable Mention" label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians.

Blog and Podcast Watch: Pediatric Emergency Medicine

PubMed Central

Zaver, Fareen; Hansen, Michael; Leibner, Evan; Little, Andrew; Lin, Michelle

2016-01-01

Introduction By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM. Methods The Approved Instructional Resources – Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3–5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ≥26 (out of 35) points. An “Honorable Mention” label is awarded if Board members collectively felt that the posts were valuable and the scores were > 20. Results We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. Conclusion The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. PMID:27625713

A gene-signature progression approach to identifying candidate small-molecule cancer therapeutics with connectivity mapping.

PubMed

Wen, Qing; Kim, Chang-Sik; Hamilton, Peter W; Zhang, Shu-Dong

2016-05-11

Gene expression connectivity mapping has gained much popularity recently with a number of successful applications in biomedical research testifying its utility and promise. Previously methodological research in connectivity mapping mainly focused on two of the key components in the framework, namely, the reference gene expression profiles and the connectivity mapping algorithms. The other key component in this framework, the query gene signature, has been left to users to construct without much consensus on how this should be done, albeit it has been an issue most relevant to end users. As a key input to the connectivity mapping process, gene signature is crucially important in returning biologically meaningful and relevant results. This paper intends to formulate a standardized procedure for constructing high quality gene signatures from a user's perspective. We describe a two-stage process for making quality gene signatures using gene expression data as initial inputs. First, a differential gene expression analysis comparing two distinct biological states; only the genes that have passed stringent statistical criteria are considered in the second stage of the process, which involves ranking genes based on statistical as well as biological significance. We introduce a "gene signature progression" method as a standard procedure in connectivity mapping. Starting from the highest ranked gene, we progressively determine the minimum length of the gene signature that allows connections to the reference profiles (drugs) being established with a preset target false discovery rate. We use a lung cancer dataset and a breast cancer dataset as two case studies to demonstrate how this standardized procedure works, and we show that highly relevant and interesting biological connections are returned. Of particular note is gefitinib, identified as among the candidate therapeutics in our lung cancer case study. Our gene signature was based on gene expression data from Taiwan female non-smoker lung cancer patients, while there is evidence from independent studies that gefitinib is highly effective in treating women, non-smoker or former light smoker, advanced non-small cell lung cancer patients of Asian origin. In summary, we introduced a gene signature progression method into connectivity mapping, which enables a standardized procedure for constructing high quality gene signatures. This progression method is particularly useful when the number of differentially expressed genes identified is large, and when there is a need to prioritize them to be included in the query signature. The results from two case studies demonstrate that the approach we have developed is capable of obtaining pertinent candidate drugs with high precision.

75 FR 20843 - Notice of Workshop To Discuss Policy-Relevant Science to Inform EPA's Integrated Plan for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-21

... Policy-Relevant Science to Inform EPA's Integrated Plan for the Review of the Lead National Ambient Air...-Relevant Science to Inform EPA's Integrated Plan for Review of the National Ambient Air Quality Standards... review focuses on the key policy-relevant issues and considers the most meaningful new science to inform...

Quality of life in patients with Parkinson's disease: development of a questionnaire.

PubMed Central

de Boer, A G; Wijker, W; Speelman, J D; de Haes, J C

1996-01-01

OBJECTIVES--To develop and test a questionnaire for measuring quality of life in patients with Parkinson's disease. METHODS--An item pool was developed based on the experience of patients with Parkinson's disease and of neurologists; medical literature on the problems of patients with Parkinson's disease; and other quality of life questionnaires. To reduce the item pool, 13 patients identified items that were a problem to them and rated their importance. Items which were most often chosen and rated most important were included in the Parkinson's disease quality of life questionnaire (PDQL). The PDQL consists of 37 items. To evaluate the discriminant validity of the PDQL three groups of severity of disease were compared. To test for convergent validity, the scores of the PDQL were tested for correlation with standard indices of quality of life. RESULTS--The PDQL was filled out by 384 patients with Parkinson's disease. It consisted of four subscales: parkinsonian symptoms, systemic symptoms, emotional functioning, and social functioning. The internal-consistency reliability coefficients of the PDQL subscales were high (0.80-0.87). Patients with higher disease severity had significantly lower quality of life on all PDQL subscales (P < 0.05). Almost all PDQL subscales correlated highly (P < 0.001) with the corresponding scales of the standard quality of life indices. CONCLUSION--The PDQL is a relevant, reliable, and valid measure of the quality of life of patients with Parkinson's disease. Images PMID:8676165

Health related quality of life in men with prostate cancer.

PubMed

Penson, David F; Litwin, Mark S; Aaronson, Neil K

2003-05-01

Quality of life is of great concern to patients considering treatment options for prostate cancer. In the absence of clinical trial data clearly demonstrating that a particular treatment is superior to another for localized prostate cancer, in terms of cause specific survival, patients may value quality of life as much as quantity of life. The goal of this review is to familiarize the reader with the methodology of quality of life research and to review the recent literature on quality of life outcomes in prostate cancer. A structured MEDLINE review of literature on health related quality of life in prostate cancer for the years 1995 to 2001 was performed, and was augmented with highly relevant articles from additional selected journals. In the case of advanced or metastatic disease, where the goal of treatment is palliation and symptom-free survival, quality of life often becomes the primary desired outcome. In localized disease all treatments affect health related quality of life, although the impact of each therapy on sexual, urinary and bowel function is unique. Although a highly personal and subjective entity, health related quality of life can be assessed using rigorous and scientifically stringent methods from the field of psychometric test theory. A substantial amount of literature exists regarding the use of established and validated instruments for assessing the impact of prostate cancer and its treatment on health related quality of life. This information is of critical importance when counseling men with newly diagnosed prostate cancer regarding treatment choices and is also helpful in setting appropriate expectations for men with metastatic disease.

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

High-resolution geological mapping at 3D Environments: A case study from the fold-and-thrust belt in northern Taiwan

NASA Astrophysics Data System (ADS)

Chan, Y. C.; Shih, N. C.; Hsieh, Y. C.

2016-12-01

Geologic maps have provided fundamental information for many scientific and engineering applications in human societies. Geologic maps directly influence the reliability of research results or the robustness of engineering projects. In the past, geologic maps were mainly produced by field geologists through direct field investigations and 2D topographic maps. However, the quality of traditional geologic maps was significantly compromised by field conditions, particularly, when the map area is covered by heavy forest canopies. Recent developments in airborne LiDAR technology may virtually remove trees or buildings, thus, providing a useful data set for improving geological mapping. Because high-quality topographic information still needs to be interpreted in terms of geology, there are many fundamental questions regarding how to best apply the data set for high-resolution geological mapping. In this study, we aim to test the quality and reliability of high-resolution geologic maps produced by recent technological methods through an example from the fold-and-thrust belt in northern Taiwan. We performed the geological mapping by applying the LiDAR-derived DEM, self-developed program tools and many layers of relevant information at interactive 3D environments. Our mapping results indicate that the proposed methods will considerably improve the quality and consistency of the geologic maps. The study also shows that in order to gain consistent mapping results, future high-resolution geologic maps should be produced at interactive 3D environments on the basis of existing geologic maps.

Can clinical governance deliver quality improvement in Australian general practice and primary care? A systematic review of the evidence.

PubMed

Phillips, Christine B; Pearce, Christopher M; Hall, Sally; Travaglia, Joanne; de Lusignan, Simon; Love, Tom; Kljakovic, Marjan

2010-11-15

To review the literature on different models of clinical governance and to explore their relevance to Australian primary health care, and their potential contributions on quality and safety. 25 electronic databases, scanning reference lists of articles and consultation with experts in the field. We searched publications in English after 1999, but a search of the German language literature for a specific model type was also undertaken. The grey literature was explored through a hand search of the medical trade press and websites of relevant national and international clearing houses and professional or industry bodies. 11 software packages commonly used in Australian general practice were reviewed for any potential contribution to clinical governance. 19 high-quality studies that assessed outcomes were included. All abstracts were screened by one researcher, and 10% were screened by a second researcher to crosscheck screening quality. Studies were reviewed and coded by four reviewers, with all studies being rated using standard critical appraisal tools such as the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Two researchers reviewed the Australian general practice software. Interviews were conducted with 16 informants representing service, regional primary health care, national and international perspectives. Most evidence supports governance models which use targeted, peer-led feedback on the clinician's own practice. Strategies most used in clinical governance models were audit, performance against indicators, and peer-led reflection on evidence or performance. The evidence base for clinical governance is fragmented, and focuses mainly on process rather than outcomes. Few publications address models that enhance safety, efficiency, sustainability and the economics of primary health care. Locally relevant clinical indicators, the use of computerised medical record systems, regional primary health care organisations that have the capacity to support the uptake of clinical governance at the practice level, and learning from the Aboriginal community-controlled sector will help integrate clinical governance into primary care.

YouTube videos as a source of medical information during the Ebola hemorrhagic fever epidemic.

PubMed

Nagpal, Sajan Jiv Singh; Karimianpour, Ahmadreza; Mukhija, Dhruvika; Mohan, Diwakar; Brateanu, Andrei

2015-01-01

The content and quality of medical information available on video sharing websites such as YouTube is not known. We analyzed the source and quality of medical information about Ebola hemorrhagic fever (EHF) disseminated on YouTube and the video characteristics that influence viewer behavior. An inquiry for the search term 'Ebola' was made on YouTube. The first 100 results were arranged in decreasing order of "relevance" using the default YouTube algorithm. Videos 1-50 and 51-100 were allocated to a high relevance (HR), and a low relevance (LR) video group, respectively. Multivariable logistic regression models were used to assess the predictors of a video being included in the HR vs. LR groups. Fourteen videos were excluded because they were parodies, songs or stand-up comedies (n = 11), not in English (n = 2) or a remaining part of a previous video (n = 1). Two scales, the video information and quality and index and the medical information and content index (MICI) assessed the overall quality, and the medical content of the videos, respectively. There were no videos from hospitals or academic medical centers. Videos in the HR group had a higher median number of views (186,705 vs. 43,796, p < 0.001), more 'likes' (1119 vs. 224, p < 0.001), channel subscriptions (208 vs. 32, p < 0.001), and 'shares' (519 vs. 98, p < 0.001). Multivariable logistic regression showed that only the 'clinical symptoms' component of the MICI scale was associated with a higher likelihood of a video being included in the HR vs. LR group.(OR 1.86, 95 % CI 1.06-3.28, p = 0.03). YouTube videos presenting clinical symptoms of infectious diseases during epidemics are more likely to be included in the HR group and influence viewers behavior.

The writer's guide to education scholarship in emergency medicine: Education innovations (part 3).

PubMed

Hall, Andrew K; Hagel, Carly; Chan, Teresa M; Thoma, Brent; Murnaghan, Aleisha; Bhanji, Farhan

2018-05-01

The scholarly dissemination of innovative medical education practices helps broaden the reach of this type of work, allowing scholarship to have an impact beyond a single institution. There is little guidance in the literature for those seeking to publish program evaluation studies and innovation papers. This study aims to derive a set of evidence-based features of high-quality reports on innovations in emergency medicine (EM) education. We conducted a scoping review and thematic analysis to determine quality markers for medical education innovation reports, with a focus on EM. A search of MEDLINE, EMBASE, ERIC, and Google Scholar was augmented by a hand search of relevant publication guidelines, guidelines for authors, and website submission portals from medical education and EM journals. Study investigators reviewed the selected articles, and a thematic analysis was conducted. Our search strategy identified 14 relevant articles from which 34 quality markers were extracted. These markers were grouped into seven important themes: goals and need for innovation, preparation, innovation development, innovation implementation, evaluation of innovation, evidence of reflective practice, and reporting and dissemination. In addition, multiple outlets for the publication of EM education innovations were identified and compiled. The publication and dissemination of innovations are critical for the EM education community and the training of health professionals. We anticipate that our list of innovation report quality markers will be used by EM education innovators to support the dissemination of novel educational practices.

[Validation and adhesion to GESIDA quality indicators in patients with HIV infection].

PubMed

Riera, Melchor; Esteban, Herminia; Suarez, Ignacio; Palacios, Rosario; Lozano, Fernando; Blanco, Jose R; Valencia, Eulalia; Ocampo, Antonio; Amador, Concha; Frontera, Guillem; vonWichmann-de Miguel, Miguel Angel

2016-01-01

The objective of the study is to validate the relevant GESIDA quality indicators for HIV infection, assessing the reliability, feasibility and adherence to them. The reliability was evaluated using the reproducibility of 6 indicators in peer review, with the second observer being an outsider. The feasibility and measurement of the level of adherence to the 22 indicators was conducted with annual fragmented retrospective collection of information from specific databases or the clinical charts of the nine participating hospitals. Reliability was very high, with interobserver agreement levels higher than 95% in 5 of the 6 indicators. The median time to achieve the indicators ranged between 5 and 600minutes, but could be achieved progressively from specific databases, enabling obtaining them automatically. As regards adherence to the indicators related with the initial evaluation of the patients, instructions and suitability of the guidelines for ART, adherence to ART, follow-up in clinics, and achieve an undetectable HIV by PCR at week 48 of the ART. Indicators of quality related to the prevention of opportunistic infections and control of comorbidities, the standards set were not achieved, and significant heterogeneity was observed between hospitals. The GESIDA quality indicators of HIV infection enabled the relevant indicators to be feasibly and reliably measured, and should be collected in all the units that care for patients with HIV infection. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Land use and land cover changes in Zêzere watershed (Portugal)--Water quality implications.

PubMed

Meneses, B M; Reis, R; Vale, M J; Saraiva, R

2015-09-15

To understand the relations between land use allocation and water quality preservation within a watershed is essential to assure sustainable development. The land use and land cover (LUC) within Zêzere River watershed registered relevant changes in the last decades. These land use and land cover changes (LUCCs) have impacts in water quality, mainly in surface water degradation caused by surface runoff from artificial and agricultural areas, forest fires and burnt areas, and caused by sewage discharges from agroindustry and urban sprawl. In this context, the impact of LUCCs in the quality of surface water of the Zêzere watershed is evaluated, considering the changes for different types of LUC and establishing their possible correlations to the most relevant water quality changes. The results indicate that the loss of coniferous forest and the increase of transitional woodland-shrub are related to increased water's pH; while the growth in artificial surfaces and pastures leads mainly to the increase of soluble salts and fecal coliform concentration. These particular findings within the Zêzere watershed, show the relevance of addressing water quality impact driven from land use and should therefore be taken into account within the planning process in order to prevent water stress, namely within watersheds integrating drinking water catchments. Copyright © 2015 Elsevier B.V. All rights reserved.

Quality and Certification of Electronic Health Records

PubMed Central

Hoerbst, A.; Ammenwerth, E.

2010-01-01

Background Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. PMID:23616834

Is there a difference between child self-ratings and parent proxy-ratings of the quality of life of children with a diagnosis of attention-deficit hyperactivity disorder (ADHD)? A systematic review of the literature.

PubMed

Galloway, Helen; Newman, Emily

2017-03-01

There are contemporary indicators that parent proxy-ratings and child self-ratings of a child's quality of life (QoL) are not interchangeable. This review examines dual informant studies to assess parent-child agreement on the QoL of children with attention-deficit/hyperactivity disorder. A systematic search of four major databases (PsycINFO, MEDLINE, EMBASE and Cochrane databases) was completed, and related peer-reviewed journals were hand-searched. Studies which reported quantitative QoL ratings for matched parent and child dyads were screened in accordance with relevant inclusion and exclusion criteria. Key findings were extracted from thirteen relevant studies, which were rated for conformity to the recommendations of an adapted version of the STROBE statement guidelines for observational studies. In the majority of studies reviewed, children rated their QoL more highly than their parents. There was some evidence for greater agreement on the physical health domain than psychosocial domains.

RNA Surveillance: Molecular Approaches in Transcript Quality Control and their Implications in Clinical Diseases

PubMed Central

Moraes, Karen CM

2010-01-01

Production of mature mRNAs that encode functional proteins involves highly complex pathways of synthesis, processing and surveillance. At numerous steps during the maturation process, the mRNA transcript undergoes scrutiny by cellular quality control machinery. This extensive RNA surveillance ensures that only correctly processed mature mRNAs are translated and precludes production of aberrant transcripts that could encode mutant or possibly deleterious proteins. Recent advances in elucidating the molecular mechanisms of mRNA processing have demonstrated the existence of an integrated network of events, and have revealed that a variety of human diseases are caused by disturbances in the well-coordinated molecular equilibrium of these events. From a medical perspective, both loss and gain of function are relevant, and a considerable number of different diseases exemplify the importance of the mechanistic function of RNA surveillance in a cell. Here, mechanistic hallmarks of mRNA processing steps are reviewed, highlighting the medical relevance of their deregulation and how the understanding of such mechanisms can contribute to the development of therapeutic strategies. PMID:19829759

Clinically relevant determinants of body composition, function and nutritional status as mortality predictors in lung cancer patients.

PubMed

Kovarik, Miroslav; Hronek, Miloslav; Zadak, Zdenek

2014-04-01

Lung cancer belongs to the type of tumors with a relatively high frequency of malnutrition, sarcopenia and cachexia, severe metabolic syndromes related to impairment of physical function and quality of life, resistance to therapy and short survival. Inexpensive and accessible methods of evaluating changes in body composition, physical function and nutrition status are for this reason of great importance for clinical practice to enable the early identification, monitoring, preventing and treatment of these nutritional deficiencies. This could lead to improved outcomes in the quality of life, physical performance and survival of patients with lung cancer. The aim of this article is to summarize the recent knowledge for the use of such methods, their predictability for patient outcomes and an association with other clinically relevant parameters, specifically with lung cancer patients, because such an article collectively describing their practical application in clinical practice is lacking. The interest of this article is in the use of anthropometry, handgrip dynamometry, bioelectrical impedance analysis derived phase angle and nutritional screening questionnaires in lung cancer patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Practice-Based Evidence in Community Guide Systematic Reviews.

PubMed

Vaidya, Namita; Thota, Anilkrishna B; Proia, Krista K; Jamieson, Sara; Mercer, Shawna L; Elder, Randy W; Yoon, Paula; Kaufmann, Rachel; Zaza, Stephanie

2017-03-01

To assess the relative contributions and quality of practice-based evidence (PBE) and research-based evidence (RBE) in The Guide to Community Preventive Services (The Community Guide). We developed operational definitions for PBE and RBE in which the main distinguishing feature was whether allocation of participants to intervention and comparison conditions was under the control of researchers (RBE) or not (PBE). We conceptualized a continuum between RBE and PBE. We then categorized 3656 studies in 202 reviews completed since The Community Guide began in 1996. Fifty-four percent of studies were PBE and 46% RBE. Community-based and policy reviews had more PBE. Health care system and programmatic reviews had more RBE. The majority of both PBE and RBE studies were of high quality according to Community Guide scoring methods. The inclusion of substantial PBE in Community Guide reviews suggests that evidence of adequate rigor to inform practice is being produced. This should increase stakeholders' confidence that The Community Guide provides recommendations with real-world relevance. Limitations in some PBE studies suggest a need for strengthening practice-relevant designs and external validity reporting standards.

Education for All in South Africa: Developing a National System for Quality Assurance.

ERIC Educational Resources Information Center

Smith, William J.; Ngoma-Maema, Wendy Yolisa

2003-01-01

Draws on international research, policy, and practice relevant to quality assurance systems to analyze the development of a national framework for educational quality assurance in South Africa. Describes an emerging framework for quality assurance that encompasses evaluation of student achievement, quality audits and reviews, program and service…

Systematic review of communication partner training in aphasia: methodological quality.

PubMed

Cherney, Leora R; Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey

2013-10-01

Twenty-three studies identified from a previous systematic review examining the effects of communication partner training on persons with aphasia and their communication partners were evaluated for methodological quality. Two reviewers rated the studies on defined methodological quality criteria relevant to each study design. There were 11 group studies, seven single-subject participant design studies, and five qualitative studies. Quality scores were derived for each study. The mean inter-rater reliability of scores for each study design ranged from 85-93%, with Cohen's Kappa indicating substantial agreement between raters. Methodological quality of research on communication partner training in aphasia was highly varied. Overall, group studies employed the least rigorous methodology as compared to single subject and qualitative research. Only two of 11 group studies complied with more than half of the quality criteria. No group studies reported therapist blinding and only one group study reported participant blinding. Across all types of studies, the criterion of treatment fidelity was most commonly omitted. Failure to explicitly report certain methodological quality criteria may account for low ratings. Using methodological rating scales specific to the type of study design may help improve the methodological quality of aphasia treatment studies, including those on communication partner training.

Spatial Data Quality Control Procedure applied to the Okavango Basin Information System

NASA Astrophysics Data System (ADS)

Butchart-Kuhlmann, Daniel

2014-05-01

Spatial data is a powerful form of information, capable of providing information of great interest and tremendous use to a variety of users. However, much like other data representing the 'real world', precision and accuracy must be high for the results of data analysis to be deemed reliable and thus applicable to real world projects and undertakings. The spatial data quality control (QC) procedure presented here was developed as the topic of a Master's thesis, in the sphere of and using data from the Okavango Basin Information System (OBIS), itself a part of The Future Okavango (TFO) project. The aim of the QC procedure was to form the basis of a method through which to determine the quality of spatial data relevant for application to hydrological, solute, and erosion transport modelling using the Jena Adaptable Modelling System (JAMS). As such, the quality of all data present in OBIS classified under the topics of elevation, geoscientific information, or inland waters, was evaluated. Since the initial data quality has been evaluated, efforts are underway to correct the errors found, thus improving the quality of the dataset.

The impact of working memory and the “process of process modelling” on model quality: Investigating experienced versus inexperienced modellers

NASA Astrophysics Data System (ADS)

Martini, Markus; Pinggera, Jakob; Neurauter, Manuel; Sachse, Pierre; Furtner, Marco R.; Weber, Barbara

2016-05-01

A process model (PM) represents the graphical depiction of a business process, for instance, the entire process from online ordering a book until the parcel is delivered to the customer. Knowledge about relevant factors for creating PMs of high quality is lacking. The present study investigated the role of cognitive processes as well as modelling processes in creating a PM in experienced and inexperienced modellers. Specifically, two working memory (WM) functions (holding and processing of information and relational integration) and three process of process modelling phases (comprehension, modelling, and reconciliation) were related to PM quality. Our results show that the WM function of relational integration was positively related to PM quality in both modelling groups. The ratio of comprehension phases was negatively related to PM quality in inexperienced modellers and the ratio of reconciliation phases was positively related to PM quality in experienced modellers. Our research reveals central cognitive mechanisms in process modelling and has potential practical implications for the development of modelling software and teaching the craft of process modelling.

Quality of life in small-scaled homelike nursing homes: an 8-month controlled trial.

PubMed

Kok, Jeroen S; Nielen, Marjan M A; Scherder, Erik J A

2018-02-27

Quality of life is a clinical highly relevant outcome for residents with dementia. The question arises whether small scaled homelike facilities are associated with better quality of life than regular larger scale nursing homes do. A sample of 145 residents living in a large scale care facility were followed over 8 months. Half of the sample (N = 77) subsequently moved to a small scaled facility. Quality of life aspects were measured with the QUALIDEM and GIP before and after relocation. We found a significant Group x Time interaction on measures of anxiety meaning that residents who moved to small scale units became less anxious than residents who stayed on the regular care large-scale units. No significant differences were found on other aspects of quality of life. This study demonstrates that residents who move from a large scale facility to a small scale environment can improve an aspect of quality of life by showing a reduction in anxiety. Current Controlled Trials ISRCTN11151241 . registration date: 21-06-2017. Retrospectively registered.

The impact of working memory and the “process of process modelling” on model quality: Investigating experienced versus inexperienced modellers

PubMed Central

Martini, Markus; Pinggera, Jakob; Neurauter, Manuel; Sachse, Pierre; Furtner, Marco R.; Weber, Barbara

2016-01-01

A process model (PM) represents the graphical depiction of a business process, for instance, the entire process from online ordering a book until the parcel is delivered to the customer. Knowledge about relevant factors for creating PMs of high quality is lacking. The present study investigated the role of cognitive processes as well as modelling processes in creating a PM in experienced and inexperienced modellers. Specifically, two working memory (WM) functions (holding and processing of information and relational integration) and three process of process modelling phases (comprehension, modelling, and reconciliation) were related to PM quality. Our results show that the WM function of relational integration was positively related to PM quality in both modelling groups. The ratio of comprehension phases was negatively related to PM quality in inexperienced modellers and the ratio of reconciliation phases was positively related to PM quality in experienced modellers. Our research reveals central cognitive mechanisms in process modelling and has potential practical implications for the development of modelling software and teaching the craft of process modelling. PMID:27157858

The impact of working memory and the "process of process modelling" on model quality: Investigating experienced versus inexperienced modellers.

PubMed

Martini, Markus; Pinggera, Jakob; Neurauter, Manuel; Sachse, Pierre; Furtner, Marco R; Weber, Barbara

2016-05-09

A process model (PM) represents the graphical depiction of a business process, for instance, the entire process from online ordering a book until the parcel is delivered to the customer. Knowledge about relevant factors for creating PMs of high quality is lacking. The present study investigated the role of cognitive processes as well as modelling processes in creating a PM in experienced and inexperienced modellers. Specifically, two working memory (WM) functions (holding and processing of information and relational integration) and three process of process modelling phases (comprehension, modelling, and reconciliation) were related to PM quality. Our results show that the WM function of relational integration was positively related to PM quality in both modelling groups. The ratio of comprehension phases was negatively related to PM quality in inexperienced modellers and the ratio of reconciliation phases was positively related to PM quality in experienced modellers. Our research reveals central cognitive mechanisms in process modelling and has potential practical implications for the development of modelling software and teaching the craft of process modelling.

DCAA Audits: Widespread Problems with Audit Quality Require Significant Reform

DTIC Science & Technology

2009-09-01

is included in appendix III. DOD contract management continues to be a high- risk area for the government.17 With hundreds of billions of taxpayer...Defense Contract Management : DOD’s Lack of Adherence to Key Contracting Principles on Iraq Oil Contract Put Government Interests at Risk , GAO-07-839...in the Federal Government68 require federal agency managers to identify and assess relevant risks the agency faces from external and internal

Healthier Students Are Better Learners: High-Quality, Strategically Planned, and Effectively Coordinated School Health Programs Must Be a Fundamental Mission of Schools to Help Close the Achievement Gap

ERIC Educational Resources Information Center

Basch, Charles E.

2011-01-01

Objective: To discuss implications for educational policy and practice relevant to closing the achievement gap based on the literature review and synthesis presented in 7 articles of the October 2011 special issue of the "Journal of School Health". Methods: Implications for closing the achievement gap are drawn from analyses of current literature.…

Beef quality attributes: A systematic review of consumer perspectives.

PubMed

Henchion, Maeve M; McCarthy, Mary; Resconi, Virginia C

2017-06-01

Informed by quality theory, this systematic literature review seeks to determine the relative importance of beef quality attributes from a consumer perspective, considering search, experience and credence quality attributes. While little change is anticipated in consumer ranking of search and experience attributes in the future, movement is expected in terms of ranking within the credence category and also in terms of the ranking of credence attributes overall. This highlights an opportunity for quality assurance schemes (QAS) to become more consumer focused through including a wider range of credence attributes. To capitalise on this opportunity, the meat industry should actively anticipate new relevant credence attributes and researchers need to develop new or better methods to measure them. This review attempts to identify the most relevant quality attributes in beef that may be considered in future iterations of QAS, to increase consumer satisfaction and, potentially, to increase returns to industry. Copyright © 2017 Elsevier Ltd. All rights reserved.

Population exposure to hazardous air quality due to the 2015 fires in Equatorial Asia.

PubMed

Crippa, P; Castruccio, S; Archer-Nicholls, S; Lebron, G B; Kuwata, M; Thota, A; Sumin, S; Butt, E; Wiedinmyer, C; Spracklen, D V

2016-11-16

Vegetation and peatland fires cause poor air quality and thousands of premature deaths across densely populated regions in Equatorial Asia. Strong El-Niño and positive Indian Ocean Dipole conditions are associated with an increase in the frequency and intensity of wildfires in Indonesia and Borneo, enhancing population exposure to hazardous concentrations of smoke and air pollutants. Here we investigate the impact on air quality and population exposure of wildfires in Equatorial Asia during Fall 2015, which were the largest over the past two decades. We performed high-resolution simulations using the Weather Research and Forecasting model with Chemistry based on a new fire emission product. The model captures the spatio-temporal variability of extreme pollution episodes relative to space- and ground-based observations and allows for identification of pollution sources and transport over Equatorial Asia. We calculate that high particulate matter concentrations from fires during Fall 2015 were responsible for persistent exposure of 69 million people to unhealthy air quality conditions. Short-term exposure to this pollution may have caused 11,880 (6,153-17,270) excess mortalities. Results from this research provide decision-relevant information to policy makers regarding the impact of land use changes and human driven deforestation on fire frequency and population exposure to degraded air quality.

Population exposure to hazardous air quality due to the 2015 fires in Equatorial Asia

PubMed Central

Crippa, P.; Castruccio, S.; Archer-Nicholls, S.; Lebron, G. B.; Kuwata, M.; Thota, A.; Sumin, S.; Butt, E.; Wiedinmyer, C.; Spracklen, D. V.

2016-01-01

Vegetation and peatland fires cause poor air quality and thousands of premature deaths across densely populated regions in Equatorial Asia. Strong El-Niño and positive Indian Ocean Dipole conditions are associated with an increase in the frequency and intensity of wildfires in Indonesia and Borneo, enhancing population exposure to hazardous concentrations of smoke and air pollutants. Here we investigate the impact on air quality and population exposure of wildfires in Equatorial Asia during Fall 2015, which were the largest over the past two decades. We performed high-resolution simulations using the Weather Research and Forecasting model with Chemistry based on a new fire emission product. The model captures the spatio-temporal variability of extreme pollution episodes relative to space- and ground-based observations and allows for identification of pollution sources and transport over Equatorial Asia. We calculate that high particulate matter concentrations from fires during Fall 2015 were responsible for persistent exposure of 69 million people to unhealthy air quality conditions. Short-term exposure to this pollution may have caused 11,880 (6,153–17,270) excess mortalities. Results from this research provide decision-relevant information to policy makers regarding the impact of land use changes and human driven deforestation on fire frequency and population exposure to degraded air quality. PMID:27848989

Assessment of efficiency of functioning the infocommunication systems a special purpose in the conditions of violation quality of relevance information

NASA Astrophysics Data System (ADS)

Parinov, A. V.; Korotkikh, L. P.; Desyatov, D. B.; Stepanov, L. V.

2018-03-01

The uniqueness of information processing mechanisms in special-purpose infocommunication systems and the increased interest of intruders lead to an increase in the relevance of the problems associated with their protection. The paper considers the issues of building risk-models for the violation of the relevance and value of information in infocommunication systems for special purposes. Also, special attention is paid to the connection between the qualities of relevance and the value of information obtained as a result of the operation of infocommunication systems for special purposes. Analytical expressions for the risk and damage function in the time range in special-purpose infocommunication systems are obtained, which can serve as a mathematical basis for risk assessment. Further, an analytical expression is obtained to assess the chance of obtaining up-to-date information in the operation of infocommunication systems up to the time the information quality is violated. An analytical expression for estimating the chance can be used to calculate the effectiveness of a special-purpose infocommunication system.

Phenology and Cover of Plant Growth Forms Predict Herbivore Habitat Selection in a High Latitude Ecosystem

PubMed Central

Fauchald, Per; Langeland, Knut; Ims, Rolf A.; Yoccoz, Nigel G.; Bråthen, Kari Anne

2014-01-01

The spatial and temporal distribution of forage quality is among the most central factors affecting herbivore habitat selection. Yet, for high latitude areas, forage quantity has been found to be more important than quality. Studies on large ungulate foraging patterns are faced with methodological challenges in both assessing animal movements at the scale of forage distribution, and in assessing forage quality with relevant metrics. Here we use first-passage time analyses to assess how reindeer movements relate to forage quality and quantity measured as the phenology and cover of growth forms along reindeer tracks. The study was conducted in a high latitude ecosystem dominated by low-palatable growth forms. We found that the scale of reindeer movement was season dependent, with more extensive area use as the summer season advanced. Small-scale movement in the early season was related to selection for younger stages of phenology and for higher abundances of generally phenologically advanced palatable growth forms (grasses and deciduous shrubs). Also there was a clear selection for later phenological stages of the most dominant, yet generally phenologically slow and low-palatable growth form (evergreen shrubs). As the summer season advanced only quantity was important, with selection for higher quantities of one palatable growth form and avoidance of a low palatable growth form. We conclude that both forage quality and quantity are significant predictors to habitat selection by a large herbivore at high latitude. The early season selectivity reflected that among dominating low palatability growth forms there were palatable phenological stages and palatable growth forms available, causing herbivores to be selective in their habitat use. The diminishing selectivity and the increasing scale of movement as the season developed suggest a response by reindeer to homogenized forage availability of low quality. PMID:24972188

Phenology and cover of plant growth forms predict herbivore habitat selection in a high latitude ecosystem.

PubMed

Iversen, Marianne; Fauchald, Per; Langeland, Knut; Ims, Rolf A; Yoccoz, Nigel G; Bråthen, Kari Anne

2014-01-01

The spatial and temporal distribution of forage quality is among the most central factors affecting herbivore habitat selection. Yet, for high latitude areas, forage quantity has been found to be more important than quality. Studies on large ungulate foraging patterns are faced with methodological challenges in both assessing animal movements at the scale of forage distribution, and in assessing forage quality with relevant metrics. Here we use first-passage time analyses to assess how reindeer movements relate to forage quality and quantity measured as the phenology and cover of growth forms along reindeer tracks. The study was conducted in a high latitude ecosystem dominated by low-palatable growth forms. We found that the scale of reindeer movement was season dependent, with more extensive area use as the summer season advanced. Small-scale movement in the early season was related to selection for younger stages of phenology and for higher abundances of generally phenologically advanced palatable growth forms (grasses and deciduous shrubs). Also there was a clear selection for later phenological stages of the most dominant, yet generally phenologically slow and low-palatable growth form (evergreen shrubs). As the summer season advanced only quantity was important, with selection for higher quantities of one palatable growth form and avoidance of a low palatable growth form. We conclude that both forage quality and quantity are significant predictors to habitat selection by a large herbivore at high latitude. The early season selectivity reflected that among dominating low palatability growth forms there were palatable phenological stages and palatable growth forms available, causing herbivores to be selective in their habitat use. The diminishing selectivity and the increasing scale of movement as the season developed suggest a response by reindeer to homogenized forage availability of low quality.

A cloud-based framework for large-scale traditional Chinese medical record retrieval.

PubMed

Liu, Lijun; Liu, Li; Fu, Xiaodong; Huang, Qingsong; Zhang, Xianwen; Zhang, Yin

2018-01-01

Electronic medical records are increasingly common in medical practice. The secondary use of medical records has become increasingly important. It relies on the ability to retrieve the complete information about desired patient populations. How to effectively and accurately retrieve relevant medical records from large- scale medical big data is becoming a big challenge. Therefore, we propose an efficient and robust framework based on cloud for large-scale Traditional Chinese Medical Records (TCMRs) retrieval. We propose a parallel index building method and build a distributed search cluster, the former is used to improve the performance of index building, and the latter is used to provide high concurrent online TCMRs retrieval. Then, a real-time multi-indexing model is proposed to ensure the latest relevant TCMRs are indexed and retrieved in real-time, and a semantics-based query expansion method and a multi- factor ranking model are proposed to improve retrieval quality. Third, we implement a template-based visualization method for displaying medical reports. The proposed parallel indexing method and distributed search cluster can improve the performance of index building and provide high concurrent online TCMRs retrieval. The multi-indexing model can ensure the latest relevant TCMRs are indexed and retrieved in real-time. The semantics expansion method and the multi-factor ranking model can enhance retrieval quality. The template-based visualization method can enhance the availability and universality, where the medical reports are displayed via friendly web interface. In conclusion, compared with the current medical record retrieval systems, our system provides some advantages that are useful in improving the secondary use of large-scale traditional Chinese medical records in cloud environment. The proposed system is more easily integrated with existing clinical systems and be used in various scenarios. Copyright © 2017. Published by Elsevier Inc.

Development of Performance Dashboards in Healthcare Sector: Key Practical Issues.

PubMed

Ghazisaeidi, Marjan; Safdari, Reza; Torabi, Mashallah; Mirzaee, Mahboobeh; Farzi, Jebraeil; Goodini, Azadeh

2015-10-01

Static nature of performance reporting systems in health care sector has resulted in inconsistent, incomparable, time consuming, and static performance reports that are not able to transparently reflect a round picture of performance and effectively support healthcare managers' decision makings. So, the healthcare sector needs interactive performance management tools such as performance dashboards to measure, monitor, and manage performance more effectively. The aim of this article was to identify key issues that need to be addressed for developing high-quality performance dashboards in healthcare sector. A literature review was established to search electronic research databases, e-journals collections, and printed journals, books, dissertations, and theses for relevant articles. The search strategy interchangeably used the terms of "dashboard", "performance measurement system", and "executive information system" with the term of "design" combined with operator "AND". Search results (n=250) were adjusted for duplications, screened based on their abstract relevancy and full-text availability (n=147) and then assessed for eligibility (n=40). Eligible articles were included if they had explicitly focused on dashboards, performance measurement systems or executive information systems design. Finally, 28 relevant articles included in the study. Creating high-quality performance dashboards requires addressing both performance measurement and executive information systems design issues. Covering these two fields, identified contents were categorized to four main domains: KPIs development, Data Sources and data generation, Integration of dashboards to source systems, and Information presentation issues. This study implies the main steps to develop dashboards for the purpose of performance management. Performance dashboards developed on performance measurement and executive information systems principles and supported by proper back-end infrastructure will result in creation of dynamic reports that help healthcare managers to consistently measure the performance, continuously detect outliers, deeply analyze causes of poor performance, and effectively plan for the future.

YouTube Videos on Botulinum Toxin A for Wrinkles: A Useful Resource for Patient Education.

PubMed

Wong, Katharine; Doong, Judy; Trang, Trinh; Joo, Sarah; Chien, Anna L

2017-12-01

Patients interested in botulinum toxin type A (BTX-A) for wrinkles search for videos on YouTube, but little is known about the quality and reliability of the content. The authors examined the quality, reliability, content, and target audience of YouTube videos on BTX for wrinkles. In this cross-sectional study, the term "Botox" was searched on YouTube. Sixty relevant videos in English were independently categorized by 2 reviewers as useful informational, misleading informational, useful patient view, or misleading patient view. Disagreements were settled by a third reviewer. Videos were rated on the Global Quality Scale (GQS) (1 = poor, 5 = excellent). Sixty-three percent of the BTX YouTube videos were useful informational (GQS = 4.4 ± 0.7), 33% as useful patient view (GQS = 3.21 ± 1.2), 2% as misleading informational (GQS = 1), and 2% as misleading patient view (GQS = 2.5). The large number of useful videos, high reliability, and the wide range of content covered suggests that those who search for antiwrinkle BTX videos on YouTube are likely to view high-quality content. This suggests that YouTube may be a good source of videos to recommend for patients interested in BTX.

Can high quality overcome consumer resistance to restricted provider access? Evidence from a health plan choice experiment.

PubMed

Harris, Katherine M

2002-06-01

To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents "extremely satisfied with results of care" had the greatest impact on plan choice while the proportion of network doctors "affiliated with university medical centers" had the least. Other consumer and expert assessed measures had more comparable effects. Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of quality required for consumers to accept access restrictions may be so high as to be unattainable. The results provide empirical support for the current focus of decision support efforts on consumer assessed quality measures. At the same time, however, the results suggest that consumers would also value quality measures based on expert assessments. This finding is relevant given the lack of comparative quality information based on expert judgment and research suggesting that consumers have apprehensions about their ability to meaningfully interpret performance-based quality measures.

Whatever? The effect of social exclusion on adopting persuasive messages.

PubMed

Pfundmair, Michaela; Aydin, Nilüfer; Frey, Dieter

2017-01-01

The aversive state of social exclusion can result in a broad range of cognitive deficits. Being unable or unmotivated to process relevant information, we assumed that social exclusion would also affect the success of persuasive attempts. We hypothesized that socially excluded people would adopt attitudes regardless of persuasion quality. In three studies using different manipulations of social exclusion and persuasion, we showed that participants who were socially excluded adopted persuasive messages regardless of argument quality. In contrast, this undifferentiated response was not shown by socially included participants who were more persuaded by high- compared to low-quality arguments. In Study 3, we moreover revealed that this pattern could only be replicated in reliable situations-that is, when the communicator appeared credible. These findings support the assumption that social exclusion can lead to reduced processing of information.

Methodological Quality of National Guidelines for Pediatric Inpatient Conditions

PubMed Central

Hester, Gabrielle; Nelson, Katherine; Mahant, Sanjay; Eresuma, Emily; Keren, Ron; Srivastava, Rajendu

2014-01-01

Background Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings (PRIS) network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children’s hospitals. The methodological quality of guidelines for priority conditions is unknown. Objective To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. Design We searched sources including PubMed for national guidelines published 2002–2012. Guidelines specific to one organism, test or treatment, or institution were excluded. Guidelines were rated by two raters using a validated tool (AGREE II) with an overall rating on a 7-point scale (7–highest). Inter-rater reliability was measured with a weighted kappa coefficient. Results 17 guidelines met inclusion criteria for 13 conditions, 7 conditions yielded no relevant national guidelines. The highest methodological quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5 and 6.5 respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3 respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78–0.87). Conclusions We identified a group of moderate to high methodological quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives. PMID:24677729

Experiments in the EMRP project KEY-VOCs: Adsorption/desorption effects of VOCs in different tubing materials and preparation and analysis of a zero gas

NASA Astrophysics Data System (ADS)

Englert, Jennifer; Claude, Anja; Kubistin, Dagmar; Tensing, Erasmus; Michl, Katja; Plass-Duelmer, Christian

2017-04-01

Atmospheric chemistry and composition are influenced by volatile organic compounds (VOCs) emitted from natural and anthropogenic sources. Due to their toxicity and their crucial role in ozone and aerosol formation VOCs impact air quality and climate change and high quality observations are demanded. The European Metrology Research Programme (EMRP) project KEY-VOCs has targeted the improvement of VOC measurement capabilities with the focus on VOCs relevant for indoor air as well as for air quality and climate monitoring programmes. One major uncertainty is the influence of surface effects of the measurement devices. By developing a test system the adsorption/desorption effects of certain VOCs can be systematically examined. Different tubing materials e.g. stainless steel and PFA were analysed with the oxygenated VOC methanol and results of these experiments will be presented. In air quality monitoring very low levels of VOCs have to be measured. Purified air or nitrogen is widely used as a zero gas to characterize measurement systems and procedures as well as for instrument calibration. A high quality zero gas is an important contributor to the quality of the measurements and generally achieved by using state-of-the-art purification technologies. The efficiency of several air purifiers was assessed and the results have been analysed.

Ultra-High Q Acoustic Resonance in Superfluid ^4He

NASA Astrophysics Data System (ADS)

De Lorenzo, L. A.; Schwab, K. C.

2017-02-01

We report the measurement of the acoustic quality factor of a gram-scale, kilohertz-frequency superfluid resonator, detected through the parametric coupling to a superconducting niobium microwave cavity. For temperatures between 400 mK and 50 mK, we observe a T^{-4} temperature dependence of the quality factor, consistent with a 3-phonon dissipation mechanism. We observe Q factors up to 1.4× 10^8, consistent with the dissipation due to dilute ^3He impurities, and expect that significant further improvements are possible. These experiments are relevant to exploring quantum behavior and decoherence of massive macroscopic objects, the laboratory detection of continuous gravitational waves from pulsars, and the probing of possible limits to physical length scales.

Rationale behind the near-ideal catalysis of Candida antarctica lipase A (CAL-A) for highly concentrating ω-3 polyunsaturated fatty acids into monoacylglycerols.

PubMed

He, Yongjin; Li, Jingbo; Kodali, Sitharam; Chen, Bilian; Guo, Zheng

2017-03-15

Dramatic decline in the quality and quantity of ω-3 PUFAs from marine resource demands new environmental-friendly technology to produce high quality ω-3 PUFAs concentrates in a better bioavailable form. Accordingly this work demonstrated an exceptionally highly efficient non-aqueous approach that non-regiospecific and non ω-3 PUFAs preferential Candida antarctica lipase A (CAL-A), functioning as a near-ideal biocatalyst, is capable to directly concentrate ω-3 PUFAs from 20% to 30% in oils to up to >90% in monoacylglycerols form through one step reaction. The rationale behind the experimental observation is justified and the catalytic property and specificity of an ideal enzyme tackling this task are defined. High selectivity and efficiency, excellent reusability of biocatalyst, general applicability for concentrating ω-3 PUFAs from both fish and microalgae oils, simple process for product recovery (e.g. by short path distillation), make this novel approach a highly industrially relevant and with potential application in food and drug industries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social Support Moderates the Relationship between Sleep and Inflammation in a Population at High Risk for Developing Cardiovascular Disease

PubMed Central

Tomfohr, Lianne M.; Edwards, Kate M.; Madsen, Joshua W.; Mills, Paul J.

2015-01-01

Poor sleep and low social support have each been associated with mortality and morbidity from chronic illness and a small body of research suggests that the two interact to influence systemic inflammation, whereby good social relationships may buffer the relationship between poor sleep and increased inflammation. The current study investigated interactions between sleep and social support in the prediction of inflammation in a clinical population (prehypertensive and hypertensive individuals) at high risk for the development of cardiovascular disease. Using a standardized subjective measure of sleep quality, we found that social support moderated the association between sleep and circulating levels of both IL-6 and CRP, such that poor sleep appeared to confer a risk of increased inflammation only in those participants who also reported low social support. In women, the same relationship was observed for TNF-α. These results extend previous findings into a clinical population and also demonstrate that sleep quality and social support interact in the prediction of two previously uninvestigated clinically relevant inflammatory markers (CRP and TNF-α). High levels of perceived social support may compensate for the negative health impact of poor sleep quality and vice versa. PMID:26402487

Single-Subject Evaluation: A Tool for Quality Assurance.

ERIC Educational Resources Information Center

Nuehring, Elane M.; Pascone, Anne B.

1986-01-01

The use of single-subject designs in peer review, in utilization review, and in other quality-assurance audits is encouraged. Presents an overview of the methodologies of single-subject designs and quality assurance, and provides examples of cases in which single-subject techniques furnished relevant quality assurance documentation. (Author/ABB)

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...

YouTube provides irrelevant information for the diagnosis and treatment of hip arthritis.

PubMed

Koller, Ulrich; Waldstein, Wenzel; Schatz, Klaus-Dieter; Windhager, Reinhard

2016-10-01

YouTube is increasingly becoming a key source for people to satisfy the need for additional information concerning their medical condition. This study analyses the completeness of accurate information found on YouTube pertaining to hip arthritis. The present study analyzed 133 YouTube videos using the search terms: hip arthritis, hip arthritis symptoms, hip arthritis diagnosis, hip arthritis treatment and hip replacement. Two quality assessment checklists with a scale of 0 to 12 points were developed to evaluate available video content for the diagnosis and the treatment of hip arthritis. Videos were grouped into poor quality (grade 0-3), moderate quality (grade 4-7) and excellent quality (grade 8-12), respectively. Three independent observers assessed all videos using the new grading system and independently scored all videos. Discrepancies regarding the categories were clarified by consensus discussion. For intra-observer reliabilities, grading was performed at two occasions separated by four weeks. Eighty-four percent (n = 112) had a poor diagnostic information quality, 14% (n = 19) a moderate quality and only 2% (n = 2) an excellent quality, respectively. In 86% (n = 114), videos provided poor treatment information quality. Eleven percent (n = 15) of videos had a moderate quality and only 3% (n = 4) an excellent quality, respectively. The present study demonstrates that YouTube is a poor source for accurate information pertaining to the diagnosis and treatment of hip arthritis. These finding are of high relevance for clinicians as videos are going to become the primary source of information for patients. Therefore, high quality educational videos are needed to further guide patients on the way from the diagnosis of hip arthritis to its proper treatment.

Association between somatic symptom burden and health-related quality of life in people with chronic low back pain.

PubMed

Fujii, Tomoko; Oka, Hiroyuki; Katsuhira, Junji; Tonosu, Juichi; Kasahara, Satoshi; Tanaka, Sakae; Matsudaira, Ko

2018-01-01

Depression is a relevant risk factor for low back pain and is associated with the outcomes of low back pain. Depression also often overlaps with somatisation. As previous studies have suggested that somatisation or a higher somatic symptom burden has a role in the outcomes of low back pain, the aim of the present cross-sectional study was to examine whether somatic symptom burden was associated with health-related quality of life in individuals with chronic low back pain independent of depression. We analyzed internet survey data on physical and mental health in Japanese adults aged 20-64 years with chronic low back pain (n = 3,100). Health-related quality of life was assessed using the EuroQol five dimensions (EQ-5D) questionnaire. Somatic symptom burden and depression were assessed using the Somatic Symptom Scale-8 (SSS-8) and the Patient Health Questionnaire-2 (PHQ-2), respectively. SSS-8 score was categorized as no to minimal (0-3), low (4-7), medium (8-11), high (12-15), and very high (16-32). The association between SSS-8 and EQ-5D was examined using linear regression models, adjusting for depression and other covariates, including age, sex, BMI, smoking, marital status, education, exercise, employment, and the number of comorbid diseases. A higher somatic symptom burden was significantly associated with a lower health-related quality of life independent of depression and the number of comorbid diseases (regression coefficient = 0.040 for SSS-8 high vs. very high and 0.218 for non to minimal vs. very high, p trend <0.0001). In conclusion, somatic symptom burden might be important for the health-related quality of life of individuals with chronic low back pain.

A Conceptual Analysis of Quality in Quality Function Deployment-Based Contexts of Higher Education

ERIC Educational Resources Information Center

Matorera, Douglas

2015-01-01

The purpose of this paper is to assess and evaluate how higher education institutions (HEIs) using Quality Function Deployment draw out the relevancy and potential of the model in shaping their concept of "Quality" and how that Quality can be assured in higher education institutions' (HEIs') programmes. An intensive literature review was…

Improving couples' quality of life through a Web-based prostate cancer education intervention.

PubMed

Song, Lixin; Rini, Christine; Deal, Allison M; Nielsen, Matthew E; Chang, Hao; Kinneer, Patty; Teal, Randall; Johnson, David C; Dunn, Mary W; Mark, Barbara; Palmer, Mary H

2015-03-01

To evaluate the feasibility and acceptability of a newly developed web-based, couple-oriented intervention called Prostate Cancer Education and Resources for Couples (PERC). Quantitative, qualitative, mixed-methods approach. Oncology outpatient clinics at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center at UNC–Chapel Hill. 26 patients with localized prostate cancer (PCa) and their partners. Pre- and postpilot quantitative assessments and a postpilot qualitative interview were conducted. General and PCa-specific symptoms, quality of life, psychosocial factors, PERC’s ease of use, and web activities. Improvement was shown in some PCa-specific and general symptoms (small effect sizes for patients and small-to-medium effect sizes for partners), overall quality of life, and physical and social domains of quality of life for patients (small effect sizes). Web activity data indicated high PERC use. Qualitative and quantitative analyses indicated that participants found PERC easy to use and understand,as well as engaging, of high quality, and relevant. Overall, participants were satisfied with PERC and reported that PERC improved their knowledge about symptom management and communication as a couple. PERC was a feasible, acceptable method of reducing the side effects of PCa treatment–related symptoms and improving quality of life. PERC has the potential to reduce the negative impacts of symptoms and enhance quality of life for patients with localized PCa and their partners, particularly for those who live in rural areas and have limited access to post-treatment supportive care.

Re-Interpreting Relevant Learning: An Evaluative Framework for Secondary Education in a Global Language

ERIC Educational Resources Information Center

Barrett, Angeline M.; Bainton, David

2016-01-01

The 2030 education goal privileges "relevant learning outcomes" as the evaluative space for quality improvement. Whilst the goal was designed for global level monitoring, its influence cuts across different scales. Implementation of the goal involves reinterpreting "relevant learning" at the local level. One way that small…

An ecological alternative to Snodgrass & Vanderwart: 360 high quality colour images with norms for seven psycholinguistic variables.

PubMed

Moreno-Martínez, Francisco Javier; Montoro, Pedro R

2012-01-01

This work presents a new set of 360 high quality colour images belonging to 23 semantic subcategories. Two hundred and thirty-six Spanish speakers named the items and also provided data from seven relevant psycholinguistic variables: age of acquisition, familiarity, manipulability, name agreement, typicality and visual complexity. Furthermore, we also present lexical frequency data derived from Internet search hits. Apart from the high number of variables evaluated, knowing that it affects the processing of stimuli, this new set presents important advantages over other similar image corpi: (a) this corpus presents a broad number of subcategories and images; for example, this will permit researchers to select stimuli of appropriate difficulty as required, (e.g., to deal with problems derived from ceiling effects); (b) the fact of using coloured stimuli provides a more realistic, ecologically-valid, representation of real life objects. In sum, this set of stimuli provides a useful tool for research on visual object- and word-processing, both in neurological patients and in healthy controls.

Atomic Scale Understanding of Poly-Si/SiO2/c-Si Passivated Contacts: Passivation Degradation Due to Metallization

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

Aguiar, Jeffery A.; Young, David; Lee, Benjamin

2016-11-21

The key attributes for achieving high efficiency crystalline silicon solar cells include class leading developments in the ability to approach the theoretical limits of silicon solar technology (29.4% efficiency). The push for high efficiency devices is further compounded with the clear need for passivation to reduce recombination at the metal contacts. At the same time there is stringent requirement to retain the same material device quality, surface passivation, and performance characteristics following subsequent processing. The development of passivated silicon cell structures that retain active front and rear surface passivation and overall material cell quality is therefore a relevant and activemore » area of development. To address the potential outcomes of metallization on passivated silicon stack, we report on some common microstructural features of degradation due to metallization for a series of silicon device stacks. A fundamental materials understanding of the metallization process on retaining high-efficiency passivated Si devices is therefore gained over these series of results.« less

Characterization of Extracellular Vesicles by Size-Exclusion High-Performance Liquid Chromatography (HPLC).

PubMed

Huang, Tao; He, Jiang

2017-01-01

Extracellular vesicles (EVs) have recently attracted substantial attention due to the potential diagnostic and therapeutic relevance. Although a variety of techniques have been used to isolate and analyze EVs, it is still far away from satisfaction. Size-exclusion chromatography (SEC), which separates subjects by size, has been widely applied in protein purification and analysis. The purpose of this chapter is to show the applications of size-exclusion high-performance liquid chromatography (HPLC) as methods for EV characterization of impurities or contaminants of small size, and thus for quality assay for the purity of the samples of EVs.

Planning and Execution for an Autonomous Aerobot

NASA Technical Reports Server (NTRS)

Gaines, Daniel M.; Estlin, Tara A.; Schaffer, Steven R.; Chouinard, Caroline M.

2010-01-01

The Aerial Onboard Autonomous Science Investigation System (AerOASIS) system provides autonomous planning and execution capabilities for aerial vehicles (see figure). The system is capable of generating high-quality operations plans that integrate observation requests from ground planning teams, as well as opportunistic science events detected onboard the vehicle while respecting mission and resource constraints. AerOASIS allows an airborne planetary exploration vehicle to summarize and prioritize the most scientifically relevant data; identify and select high-value science sites for additional investigation; and dynamically plan, schedule, and monitor the various science activities being performed, even during extended communications blackout periods with Earth.

The Internet and patient education--resources and their reliability: focus on a select urologic topic.

PubMed

Sacchetti, P; Zvara, P; Plante, M K

1999-06-01

The information revolution triggered by the rapid growth of the Internet has allowed healthcare providers and patients to access a rapidly expanding volume of information. To address the quality of this information, a survey of the data on a single urology-related topic available on the Internet was performed. The search on the World Wide Web (Web) was performed using the search engine HotBot and search directory Yahoo. The Web pages were assessed according to their relevancy to the topic chosen. Relevance rates were derived from the number of relevant sites divided by the total number of sites found. Relevant sites were subsequently ranked for quality on the basis of their accuracy, comprehensiveness, and objectivity. HotBot was then subsequently divided by domain, with each assessed separately. Yahoo was analyzed in its entirety. The resources were then compared for relevance and quality of information. When using the keyword "Viagra," HotBot responded with 15,109 hits. Yahoo presented 51 hits under the category, "Health: Pharmacy: Drugs and Medications: Specific Drugs and Medications: Viagra (Sildenafil)." The relevance rate for the first 50 hits in the search engine HotBot was 0.08. The relevance rates for the edu and org domains found by HotBot were 0.22 and 0.24, respectively; those for com and net were both 0.10. The relevance rate for the search directory Yahoo was 0.20. For relevant sites, the quality of the information presented was significantly higher in the Yahoo and in the HotBot domains hosted by nonprofit organizations when compared with HotBot in general and with its commercially oriented domains. HotBot overall was found to contain seven excellent sites, of which only three were found within Yahoo. Although the medical information available on the Web has proliferated at a remarkable rate, the number of Web sites providing complete, nonbiased information continues to represent only a small portion of the total. We have shown that the search directory Yahoo reduced the number of irrelevant sites significantly, but at the same time, some very valuable information available in HotBot was missing. At present, it may be useful to conduct searches within Yahoo followed by a review of both the edu and org HotBot domains.

Systematic review of studies of staffing and quality in nursing homes.

PubMed

Bostick, Jane E; Rantz, Marilyn J; Flesner, Marcia K; Riggs, C Jo

2006-07-01

To evaluate a range of staffing measures and data sources for long-term use in public reporting of staffing as a quality measure in nursing homes. Eighty-seven research articles and government documents published from 1975 to 2003 were reviewed and summarized. Relevant content was extracted and organized around 3 themes: staffing measures, quality measures, and risk adjustment variables. Data sources for staffing information were also identified. There is a proven association between higher total staffing levels (especially licensed staff) and improved quality of care. Studies also indicate a significant relationship between high turnover and poor resident outcomes. Functional ability, pressure ulcers, and weight loss are the most sensitive quality indicators linked to staffing. The best national data sources for staffing and quality include the Minimum Data Set (MDS) and On-line Survey and Certification Automated Records (OSCAR). However, the accuracy of this self-reported information requires further reliability and validity testing. A nationwide instrument needs to be developed to accurately measure staff turnover. Large-scale studies using payroll data to measure staff retention and its impact on resident outcomes are recommended. Future research should use the most nurse-sensitive quality indicators such as pressure ulcers, functional status, and weight loss.

Quality of care and variability in lung cancer management across Belgian hospitals: a population-based study using routinely available data.

PubMed

Vrijens, France; De Gendt, Cindy; Verleye, Leen; Robays, Jo; Schillemans, Viki; Camberlin, Cécile; Stordeur, Sabine; Dubois, Cécile; Van Eycken, Elisabeth; Wauters, Isabelle; Van Meerbeeck, Jan P

2018-05-01

To evaluate the quality of care for all patients diagnosed with lung cancer in Belgium based on a set of evidence-based quality indicators and to study the variability of care between hospitals. A retrospective study based on linked data from the cancer registry, insurance claims and vital status for all patients diagnosed with lung cancer between 2010 and 2011. Evidence-based quality indicators were identified from a systematic literature search. A specific algorithm to attribute patients to a centre was developed, and funnel plots were used to assess variability of care between centres. None. The proportion of patients who received appropriate care as defined by the indicator. Secondary outcome included the variability of care between centres. Twenty indicators were measured for a total of 12 839 patients. Good results were achieved for 60-day post-surgical mortality (3.9%), histopathological confirmation of diagnosis (93%) and for the use of PET-CT before treatment with curative intent (94%). Areas to be improved include the reporting of staging information to the Belgian Cancer Registry (80%), the use of brain imaging for clinical stage III patients eligible for curative treatment (79%), and the time between diagnosis and start of first active treatment (median 20 days). High variability between centres was observed for several indicators. Twenty-three indicators were found relevant but could not be measured. This study highlights the feasibility to develop a multidisciplinary set of quality indicators using population-based data. The main advantage of this approach is that not additional registration is required, but the non-measurability of many relevant indicators is a hamper. It allows however to easily point to areas of large variability in care.

"A manager in the minds of doctors:" a comparison of new modes of control in European hospitals.

PubMed

Kuhlmann, Ellen; Burau, Viola; Correia, Tiago; Lewandowski, Roman; Lionis, Christos; Noordegraaf, Mirko; Repullo, Jose

2013-07-02

Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals. The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources. The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) 'integrated' control with high levels of coordination and coherent patterns for cost and quality controls; (2) 'partly integrated' control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) 'fragmented' control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management. Our comparison highlights how organisations matter and brings the crucial relevance of 'coordination' of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective.

The gut microbiota and the liver: implications for clinical practice.

PubMed

Quigley, Eamonn M; Monsour, Howard P

2013-11-01

While a central role for the microbiota in the precipitation of infectious and non-infectious complications of liver disease has been long established, evidence for a more fundamental role in the etiology of several liver diseases continues to accumulate. However, though progress is rapidly occurring in this area, the definitive delineation of the precise relevance of changes in the microbiota to various forms and stages of liver disease is still far from complete. While high quality clinical evidence supports the use of antibiotic therapy, in the management of hepatic encephalopathy, spontaneous bacterial peritonitis and other infectious complications, how these interventions impact on the microbiota and microbiota-host interactions has not been clearly defined. Although probiotics and even, perhaps, fecal transplantation hold promise in the management of liver disease, and the potential impact of probiotics is supported by a considerable amount of laboratory data, high-quality clinical evidence is scanty.

Social sensing of floods in the UK.

PubMed

Arthur, Rudy; Boulton, Chris A; Shotton, Humphrey; Williams, Hywel T P

2018-01-01

"Social sensing" is a form of crowd-sourcing that involves systematic analysis of digital communications to detect real-world events. Here we consider the use of social sensing for observing natural hazards. In particular, we present a case study that uses data from a popular social media platform (Twitter) to detect and locate flood events in the UK. In order to improve data quality we apply a number of filters (timezone, simple text filters and a naive Bayes 'relevance' filter) to the data. We then use place names in the user profile and message text to infer the location of the tweets. These two steps remove most of the irrelevant tweets and yield orders of magnitude more located tweets than we have by relying on geo-tagged data. We demonstrate that high resolution social sensing of floods is feasible and we can produce high-quality historical and real-time maps of floods using Twitter.

Integrity management of offshore structures and its implication on computation of structural action effects and resistance

NASA Astrophysics Data System (ADS)

Moan, T.

2017-12-01

An overview of integrity management of offshore structures, with emphasis on the oil and gas energy sector, is given. Based on relevant accident experiences and means to control the associated risks, accidents are categorized from a technical-physical as well as human and organizational point of view. Structural risk relates to extreme actions as well as structural degradation. Risk mitigation measures, including adequate design criteria, inspection, repair and maintenance as well as quality assurance and control of engineering processes, are briefly outlined. The current status of risk and reliability methodology to aid decisions in the integrity management is briefly reviewed. Finally, the need to balance the uncertainties in data, methods and computational efforts and the cautious use and quality assurance and control in applying high fidelity methods to avoid human errors, is emphasized, and with a plea to develop both high fidelity as well as efficient, simplified methods for design.

Thermal and non-thermal preservation techniques of tiger nuts' beverage "horchata de chufa". Implications for food safety, nutritional and quality properties.

PubMed

Roselló-Soto, Elena; Poojary, Mahesha M; Barba, Francisco J; Koubaa, Mohamed; Lorenzo, Jose M; Mañes, Jordi; Moltó, Juan Carlos

2018-03-01

"Horchata de chufa" is a traditional Spanish beverage produced from tiger nuts (Cyperus esculentus L.). Due to its richness in nutritional compounds, it is highly perishable and its conservation by pasteurization and/or adding preservatives is required. Although efficient, conventional thermal treatment for pasteurization induces changes in the nutritional and sensory properties. Replacing conventional pasteurization by non-thermal technologies such as pulsed electric fields, ultraviolet, and high pressure, combined with moderate temperatures (<40°C) allows a reduction of energy consumption, along with the preservation of the most thermo-sensitive molecules. Accordingly, this review deals with the description of the most relevant non-thermal technologies applied to preserve "horchata" beverage in order to extend the shelf life and inactivate pathogenic microorganisms as well as to preserve the nutritional and quality properties of this food beverage. Copyright © 2017 Elsevier Ltd. All rights reserved.

A set of high quality colour images with Spanish norms for seven relevant psycholinguistic variables: the Nombela naming test.

PubMed

Moreno-Martinez, Francisco Javier; Montoro, Pedro R; Laws, Keith R

2011-05-01

This paper presents a new corpus of 140 high quality colour images belonging to 14 subcategories and covering a range of naming difficulty. One hundred and six Spanish speakers named the items and provided data for several psycholinguistic variables: age of acquisition, familiarity, manipulability, name agreement, typicality and visual complexity. Furthermore, we also present lexical frequency data derived internet search hits. Apart from the large number of variables evaluated, these stimuli present an important advantage with respect to other comparable image corpora in so far as naming performance in healthy individuals is less prone to ceiling effect problems. Reliability and validity indexes showed that our items display similar psycholinguistic characteristics to those of other corpora. In sum, this set of ecologically valid stimuli provides a useful tool for scientists engaged in cognitive and neuroscience-based research.

Global environmental change research: empowering developing countries.

PubMed

Nobre, Carlos A; Lahsen, Myanna; Ometto, Jean P H B

2008-09-01

This paper discusses ways to reconcile the United Nations Millennium Development Goals with environmental sustainability at the national and international levels. The authors argue that development and better use of sustainability relevant knowledge is key, and that this requires capacity building globally, and especially in the less developed regions of the world. Also essential is stronger integration of high-quality knowledge creation and technology--and policy--development, including, importantly, the creation of centers of excellence in developing regions which effectively use and produce applications-directed high quality research and bring it to bear on decision making and practices related to environmental change and sustainable management of natural resources. The authors argue that Southern centers of excellence are a necessary first step for bottom-up societal transformation towards sustainability, and that such centers must help design innovative ways to assess and place value on ecosystem services.

High-quality de novo assembly of the apple genome and methylome dynamics of early fruit development.

PubMed

Daccord, Nicolas; Celton, Jean-Marc; Linsmith, Gareth; Becker, Claude; Choisne, Nathalie; Schijlen, Elio; van de Geest, Henri; Bianco, Luca; Micheletti, Diego; Velasco, Riccardo; Di Pierro, Erica Adele; Gouzy, Jérôme; Rees, D Jasper G; Guérif, Philippe; Muranty, Hélène; Durel, Charles-Eric; Laurens, François; Lespinasse, Yves; Gaillard, Sylvain; Aubourg, Sébastien; Quesneville, Hadi; Weigel, Detlef; van de Weg, Eric; Troggio, Michela; Bucher, Etienne

2017-07-01

Using the latest sequencing and optical mapping technologies, we have produced a high-quality de novo assembly of the apple (Malus domestica Borkh.) genome. Repeat sequences, which represented over half of the assembly, provided an unprecedented opportunity to investigate the uncharacterized regions of a tree genome; we identified a new hyper-repetitive retrotransposon sequence that was over-represented in heterochromatic regions and estimated that a major burst of different transposable elements (TEs) occurred 21 million years ago. Notably, the timing of this TE burst coincided with the uplift of the Tian Shan mountains, which is thought to be the center of the location where the apple originated, suggesting that TEs and associated processes may have contributed to the diversification of the apple ancestor and possibly to its divergence from pear. Finally, genome-wide DNA methylation data suggest that epigenetic marks may contribute to agronomically relevant aspects, such as apple fruit development.

The impact of personal resources and their goal relevance on satisfaction with food-related life among the elderly.

PubMed

Dean, Moira; Grunert, Klaus G; Raats, Monique M; Nielsen, Niels Asger; Lumbers, Margaret

2008-01-01

The study explored how actual resources, perceived levels of different types of resources and goal relevance of these resources affect older people's satisfaction with food-related life using a survey in eight European countries, where 3291 participants above 65 years of age and living in their own homes took part. Satisfaction with food-related life was measured using Satisfaction With Food-related Life (SWFL) scale developed by Grunert, Raats, Dean, Nielsen, Lumbers and The Food in Later Life Team. [(2007). A measure of satisfaction with food-related life. Appetite, 49, 486-493]. Results showed that older people rated the resources that they believed to have plentiful of as being highly relevant to achieve their goals. The individuals who rated the relevance and their level of different resources as high were also more satisfied with their food-related quality of life. Further, satisfaction with food-related life, as was expected, was predicted by income, health measures and living circumstances. However, the study also showed that perceived levels of other resources such as support of family and friends, food knowledge, storage facilities also added to the individuals' satisfaction with food-related life. In addition, the congruence between perceived level and relevance of a resource was also shown to add to people's satisfaction with food-related life, implying that older people's satisfaction with food-related life depends not only on the level of resources they think they have but also on their goals and how important they think these resources are to achieving their goals.

Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome.

PubMed

Franik, Sebastian; Eltrop, Stephanie M; Kremer, Jan Am; Kiesel, Ludwig; Farquhar, Cindy

2018-05-24

Polycystic ovary syndrome (PCOS) is the most common cause of infrequent periods (oligomenorrhoea) and absence of periods (amenorrhoea). It affects about 4% to 8% of women worldwide and often leads to anovulatory subfertility. Aromatase inhibitors (AIs) are a class of drugs that were introduced for ovulation induction in 2001. Since about 2001 clinical trials have reached differing conclusions as to whether the AI letrozole is at least as effective as the first-line treatment clomiphene citrate (CC). To evaluate the effectiveness and safety of aromatase inhibitors for subfertile women with anovulatory PCOS for ovulation induction followed by timed intercourse or intrauterine insemination (IUI). We searched the following sources from inception to November 2017 to identify relevant randomised controlled trials (RCTs): the Cochrane Gynaecology and Fertility Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, Pubmed, LILACS, Web of Knowledge, the World Health Organization (WHO) clinical trials register and Clinicaltrials.gov. We also searched the references of relevant articles. We did not restrict the searches by language or publication status. We included all RCTs of AIs used alone or with other medical therapies for ovulation induction in women of reproductive age with anovulatory PCOS. Two review authors independently selected trials, extracted the data and assessed risks of bias. We pooled studies where appropriate using a fixed-effect model to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for most outcomes, and risk differences (RDs) for ovarian hyperstimulation syndrome (OHSS). The primary outcomes were live birth and OHSS. Secondary outcomes were clinical pregnancy, miscarriage and multiple pregnancy. We assessed the quality of the evidence for each comparison using GRADE methods. This is a substantive update of a previous review. We identified 16 additional studies for the 2018 update. We include 42 RCTs (7935 women). The aromatase inhibitor letrozole was used in all studies.Letrozole compared to clomiphene citrate (CC) with or without adjuncts followed by timed intercourseLive birth rates were higher with letrozole (with or without adjuncts) compared to clomiphene citrate (with our without adjuncts) followed by timed intercourse (OR 1.68, 95% CI 1.42 to 1.99; 2954 participants; 13 studies; I 2 = 0%; number needed to treat for an additional beneficial outcome (NNTB) = 10; moderate-quality evidence). There is high-quality evidence that OHSS rates are similar with letrozole or clomiphene citrate (0.5% in both arms: risk difference (RD) -0.00, 95% CI -0.01 to 0.00; 2536 participants; 12 studies; I 2 = 0%; high-quality evidence). There is evidence for a higher pregnancy rate in favour of letrozole (OR 1.56, 95% CI 1.37 to 1.78; 4629 participants; 25 studies; I 2 = 1%; NNTB = 10; moderate-quality evidence). There is little or no difference between treatment groups in the rate of miscarriage by pregnancy (20% with CC versus 19% with letrozole; OR 0.94, 95% CI 0.70 to 1.26; 1210 participants; 18 studies; I 2 = 0%; high-quality evidence) and multiple pregnancy rate (1.7% with CC versus 1.3% with letrozole; OR 0.69, 95% CI 0.41 to 1.16; 3579 participants; 17 studies; I 2 = 0%; high-quality evidence). However, a funnel plot showed mild asymmetry, indicating that some studies in favour of clomiphene might be missing.Letrozole compared to laparoscopic ovarian drillingThere is low-quality evidence that live birth rates are similar with letrozole or laparoscopic ovarian drilling (OR 1.38, 95% CI 0.95 to 2.02; 548 participants; 3 studies; I 2 = 23%; low-quality evidence). There is insufficient evidence for a difference in OHSS rates (RD 0.00, 95% CI -0.01 to 0.01; 260 participants; 1 study; low-quality evidence). There is low-quality evidence that pregnancy rates are similar (OR 1.28, 95% CI 0.94 to 1.74; 774 participants; 5 studies; I 2 = 0%; moderate-quality evidence). There is insufficient evidence for a difference in miscarriage rate by pregnancy (OR 0.66, 95% CI 0.30 to 1.43; 240 participants; 5 studies; I 2 = 0%; moderate-quality evidence), or multiple pregnancies (OR 3.00, 95% CI 0.12 to 74.90; 548 participants; 3 studies; I 2 = 0%; low-quality evidence).Additional comparisons were made for Letrozole versus placebo, Selective oestrogen receptor modulators (SERMS) followed by intrauterine insemination (IUI), follicle stimulating hormone (FSH), Anastrozole, as well as dosage and administration protocols. There is insufficient evidence for a difference in either group of treatment due to a limited number of studies. Hence more research is necessary. Letrozole appears to improve live birth and pregnancy rates in subfertile women with anovulatory polycystic ovary syndrome, compared to clomiphene citrate. There is high-quality evidence that OHSS rates are similar with letrozole or clomiphene citrate. There is high-quality evidence of no difference in miscarriage rates or multiple pregnancy rates. There is low-quality evidence of no difference in live birth and pregnancy rates between letrozole and laparoscopic ovarian drilling, although there were few relevant studies. For the 2018 update, we added good-quality trials, upgrading the quality of the evidence.

Human factors and safety in emergency medicine

NASA Technical Reports Server (NTRS)

Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

1994-01-01

A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

Top studies relevant to primary care practice.

PubMed

Perry, Danielle; Kolber, Michael R; Korownyk, Christina; Lindblad, Adrienne J; Ramji, Jamil; Ton, Joey; Allan, G Michael

2018-04-01

To summarize 10 high-quality studies from 2017 that have strong relevance to primary care practice. Study selection involved routine literature surveillance by a group of primary care health professionals. This included screening abstracts of important journals and Evidence Alerts, as well as searching the American College of Physicians Journal Club. Topics of the 2017 articles include whether treating subclinical hypothyroidism improves outcomes or symptoms; whether evolocumab reduces cardiovascular disease as well as low-density lipoprotein levels; whether lifestyle interventions reduce medication use in patients with diabetes; whether vitamin D prevents cardiovascular disease, cancer, or upper respiratory tract infections; whether canagliflozin reduces clinical events in patients with diabetes; how corticosteroid injections affect knee osteoarthritis; whether drained abscesses benefit from antibiotic treatment; whether patients with diabetes benefit from bariatric surgery; whether exenatide reduces clinical events in patients with diabetes; and whether tympanostomy tubes affect outcomes in recurrent acute otitis media or chronic otitis media. We provide brief summaries, context where needed, and final recommendations for 10 studies with potential effects on primary care. We also briefly review 5 "runner-up" studies. Research from 2017 produced several high-quality studies in diabetes management. These have demonstrated benefit for alternative therapies and offered evidence not previously available. This year's selection of studies also provided information on a variety of conditions and therapies that are, or might become, more common in primary care settings. Copyright© the College of Family Physicians of Canada.

Nature-assisted therapy: systematic review of controlled and observational studies.

PubMed

Annerstedt, Matilda; Währborg, Peter

2011-06-01

Nature's potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.

A methodological approach to identify external factors for indicator-based risk adjustment illustrated by a cataract surgery register

PubMed Central

2014-01-01

Background Risk adjustment is crucial for comparison of outcome in medical care. Knowledge of the external factors that impact measured outcome but that cannot be influenced by the physician is a prerequisite for this adjustment. To date, a universal and reproducible method for identification of the relevant external factors has not been published. The selection of external factors in current quality assurance programmes is mainly based on expert opinion. We propose and demonstrate a methodology for identification of external factors requiring risk adjustment of outcome indicators and we apply it to a cataract surgery register. Methods Defined test criteria to determine the relevance for risk adjustment are “clinical relevance” and “statistical significance”. Clinical relevance of the association is presumed when observed success rates of the indicator in the presence and absence of the external factor exceed a pre-specified range of 10%. Statistical significance of the association between the external factor and outcome indicators is assessed by univariate stratification and multivariate logistic regression adjustment. The cataract surgery register was set up as part of a German multi-centre register trial for out-patient cataract surgery in three high-volume surgical sites. A total of 14,924 patient follow-ups have been documented since 2005. Eight external factors potentially relevant for risk adjustment were related to the outcome indicators “refractive accuracy” and “visual rehabilitation” 2–5 weeks after surgery. Results The clinical relevance criterion confirmed 2 (“refractive accuracy”) and 5 (“visual rehabilitation”) external factors. The significance criterion was verified in two ways. Univariate and multivariate analyses revealed almost identical external factors: 4 were related to “refractive accuracy” and 7 (6) to “visual rehabilitation”. Two (“refractive accuracy”) and 5 (“visual rehabilitation”) factors conformed to both criteria and were therefore relevant for risk adjustment. Conclusion In a practical application, the proposed method to identify relevant external factors for risk adjustment for comparison of outcome in healthcare proved to be feasible and comprehensive. The method can also be adapted to other quality assurance programmes. However, the cut-off score for clinical relevance needs to be individually assessed when applying the proposed method to other indications or indicators. PMID:24965949

Drifts in ADCC-related quality attributes of Herceptin®: Impact on development of a trastuzumab biosimilar.

PubMed

Kim, Seokkyun; Song, Jinsu; Park, Seungkyu; Ham, Sunyoung; Paek, Kyungyeol; Kang, Minjung; Chae, Yunjung; Seo, Heewon; Kim, Hyung-Chan; Flores, Michael

A biosimilar product needs to demonstrate biosimilarity to the originator reference product, and the quality profile of the latter should be monitored throughout the period of the biosimilar's development to match the quality attributes of the 2 products that relate to efficacy and safety. For the development of a biosimilar version of trastuzumab, the reference product, Herceptin®, was extensively characterized for the main physicochemical and biologic properties by standard or state-of-the-art analytical methods, using multiple lots expiring between March 2015 and December 2019. For lots with expiry dates up to July 2018, a high degree of consistency was observed for all the tested properties. However, among the lots expiring in August 2018 or later, a downward drift was observed in %afucose (G0+G1+G2). Furthermore, the upward drift of %high mannose (M5+M6) was observed in the lots with expiry dates from June 2019 to December 2019. As a result, the combination of %afucose and %high mannose showed 2 marked drifts in the lots with expiry dates from August 2018 to December 2019, which was supported by the similar trend of biologic data, such as FcγRIIIa binding and antibody-dependent cell-mediated cytotoxicity (ADCC) activity. Considering that ADCC is one of the clinically relevant mechanisms of action for trastuzumab, the levels of %afucose and %high mannose should be tightly monitored as critical quality attributes for biosimilar development of trastuzumab.

Drifts in ADCC-related quality attributes of Herceptin®: Impact on development of a trastuzumab biosimilar

PubMed Central

Kim, Seokkyun; Song, Jinsu; Park, Seungkyu; Ham, Sunyoung; Paek, Kyungyeol; Kang, Minjung; Chae, Yunjung; Seo, Heewon; Kim, Hyung-Chan; Flores, Michael

2017-01-01

ABSTRACT A biosimilar product needs to demonstrate biosimilarity to the originator reference product, and the quality profile of the latter should be monitored throughout the period of the biosimilar's development to match the quality attributes of the 2 products that relate to efficacy and safety. For the development of a biosimilar version of trastuzumab, the reference product, Herceptin®, was extensively characterized for the main physicochemical and biologic properties by standard or state-of-the-art analytical methods, using multiple lots expiring between March 2015 and December 2019. For lots with expiry dates up to July 2018, a high degree of consistency was observed for all the tested properties. However, among the lots expiring in August 2018 or later, a downward drift was observed in %afucose (G0+G1+G2). Furthermore, the upward drift of %high mannose (M5+M6) was observed in the lots with expiry dates from June 2019 to December 2019. As a result, the combination of %afucose and %high mannose showed 2 marked drifts in the lots with expiry dates from August 2018 to December 2019, which was supported by the similar trend of biologic data, such as FcγRIIIa binding and antibody-dependent cell-mediated cytotoxicity (ADCC) activity. Considering that ADCC is one of the clinically relevant mechanisms of action for trastuzumab, the levels of %afucose and %high mannose should be tightly monitored as critical quality attributes for biosimilar development of trastuzumab. PMID:28296619

An optimized high quality male DNA extraction from spermatophores in open thelycum shrimp species.

PubMed

Planella, Laia; Heras, Sandra; Vera, Manuel; García-Marín, José-Luis; Roldán, María Inés

2017-09-01

The crucial step of most of the current genetic studies is the extraction of DNA of sufficient quantity and quality. Several genomic DNA isolation methods have been described to successfully obtain male DNA from shrimp species. However, all current protocols require invasive handling methods with males for DNA isolation. Using Aristeus antennatus as a model we tested a reliable non-invasive differential DNA extraction method to male DNA isolation from spermatophores attached to female thelycum. The present protocol provides high quality and quantity DNA for polymerase chain reaction amplification and male genotyping. This new approach could be useful to experimental shrimp culture to select sires with relevant genetic patterns for selective breeding programs. More importantly, it can be applied to identify the mating pairs and male structure in wild populations of species as A. antennatus, where males are often difficult to capture. Our method could be also valuable for biological studies on other spermatophore-using species, such as myriapods, arachnids and insects. © 2016 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Prevalence of Back Pain in Sports: A Systematic Review of the Literature.

PubMed

Trompeter, Katharina; Fett, Daniela; Platen, Petra

2017-06-01

Back pain is a frequent health problem in the general population. The epidemiology of back pain in the general population is well researched, but detailed data on the prevalence and risk factors of back pain in athletes are rare. The primary objective was to review articles about back pain in athletes to provide an overview of its prevalence in different sports and compare its prevalence among various types of sports and the general population. A comprehensive search of articles published through May 2015 was conducted. Two independent reviewers searched six databases from inception (PubMed ® , Embase, MEDLINE ® , Cochrane Library, PsycINFO and PSYNDEX), using specifically developed search strategies, for relevant epidemiological research on back pain in 14- to 40-year-old athletes of Olympic disciplines. The reviewers independently evaluated the methodological quality of reviewed articles meeting the inclusion criteria to identify potential sources of bias. Relevant data were extracted from each study. Forty-three articles were judged to meet the inclusion criteria and were included in the assessment of methodological quality. Of these, 25 were assessed to be of high quality. Lifetime prevalence and point prevalence were the most commonly researched episodes and the lower back was the most common localization of pain. In the high-quality studies, lifetime prevalence of low back pain in athletes was 1-94%, (highest prevalence in rowing and cross-country skiing), and point prevalence of low back pain was 18-65% (lowest prevalence in basketball and highest prevalence in rowing). The methodological heterogeneity of the included studies showed a wide range of prevalence rates and did not enable a detailed comparison of data among different sports, within one discipline, or versus the general population. Based on the results of this review, however, it seems obvious that back pain requires further study in some sports.

Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.

PubMed

Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool

2018-01-16

Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

Knowledge management systems success in healthcare: Leadership matters.

PubMed

Ali, Nor'ashikin; Tretiakov, Alexei; Whiddett, Dick; Hunter, Inga

2017-01-01

To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations. A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand. Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives. Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessment of spatial and physical neighborhood characteristics that influence sound quality and herewith well-being and health

PubMed Central

Devilee, Jeroen; van Kempen, Elise; Swart, Wim; van Kamp, Irene; Ameling, Caroline

2017-01-01

Environmental noise and health studies seldom address the positive effect of environments with high acoustic quality. Sound quality, in turn, is influenced by a large number of factors, including the spatial–physical characteristics of a neighborhood. In general, these characteristics cannot be retrieved from existing databases. In this article, we describe the design of an audit instrument and demonstrate its value for gathering information about these characteristics of neighborhoods. The audit instrument used was derived from research in other fields than environmental health. The instrument was tested in 33 neighborhoods in the Dutch cities of Amsterdam, Rotterdam, and Arnhem. In these neighborhoods, more or less homogeneous subareas were identified that were subject of the audit. The results show that the audit approach is suitable to gather neighborhood data that are relevant for the sound quality of neighborhoods. Together with survey data, they provide information that could further the field of soundscape and health. Several suggestions for improvement of the audit instrument were made. PMID:28615546

How to Assess Quality of Research in Iran, From Input to Impact? Introduction of Peer-Based Research Evaluation Model in Iran.

PubMed

Ebadifar, Asghar; Baradaran Eftekhari, Monir; Owlia, Parviz; Habibi, Elham; Ghalenoee, Elham; Bagheri, Mohammad Reza; Falahat, Katayoun; Eltemasi, Masoumeh; Sobhani, Zahra; Akhondzadeh, Shahin

2017-11-01

Research evaluation is a systematic and objective process to measure relevance, efficiency and effectiveness of research activities, and peer review is one of the most important tools for assessing quality of research. The aim of this study was introducing research evaluation indicators based on peer reviewing. This study was implemented in 4 stages. A list of objective-oriented evaluation indicators were designed in 4 axes, including; governance and leadership, structure, knowledge production and research impact. The top 10% medical sciences research centers (RCs) were evaluated based on peer review. Adequate equipment and laboratory instruments, high quality research publication and national or international cooperation were the main strengths in medical sciences RCs and the most important weaknesses included failure to adhere to strategic plans, parallel actions in similar fields, problems in manpower recruitment, knowledge translation & exchange (KTE) in service providers and policy makers' levels. Peer review evaluation can improve the quality of research.

Inline roasting hyphenated with gas chromatography-mass spectrometry as an innovative approach for assessment of cocoa fermentation quality and aroma formation potential.

PubMed

Van Durme, Jim; Ingels, Isabel; De Winne, Ann

2016-08-15

Today, the cocoa industry is in great need of faster and robust analytical techniques to objectively assess incoming cocoa quality. In this work, inline roasting hyphenated with a cooled injection system coupled to a gas chromatograph-mass spectrometer (ILR-CIS-GC-MS) has been explored for the first time to assess fermentation quality and/or overall aroma formation potential of cocoa. This innovative approach resulted in the in-situ formation of relevant cocoa aroma compounds. After comparison with data obtained by headspace solid phase micro extraction (HS-SPME-GC-MS) on conventional roasted cocoa beans, ILR-CIS-GC-MS data on unroasted cocoa beans showed similar formation trends of important cocoa aroma markers as a function of fermentation quality. The latter approach only requires small aliquots of unroasted cocoa beans, can be automatated, requires no sample preparation, needs relatively short analytical times (<1h) and is highly reproducible. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Water Quality Monitoring Programme for Schools and Communities

ERIC Educational Resources Information Center

Spellerberg, Ian; Ward, Jonet; Smith, Fiona

2004-01-01

A water quality monitoring programme for schools is described. The purpose of the programme is to introduce school children to the concept of reporting on the "state of the environment" by raising the awareness of water quality issues and providing skills to monitor water quality. The programme is assessed and its relevance in the…

[Animal drugs quality status and reason analysis].

PubMed

Ding, Qing; Qiu, Ya-jing; Fang, Ke-hui; Hu, Hao-bin; Wu, Yue

2015-11-01

In order to reaction the quality present situation, problems on the current quality of animal sources of drugs are summed up by using test data analysis, literature search and marketing research. This paper can also help the improvement of the quality management, the revision of the relevant department policy system and the improvement of standards.

Benchmarking Potential Factors Leading to Education Quality: A Study of Cambodian Higher Education

ERIC Educational Resources Information Center

Chen, Ching-Yaw; Sok, Phyra; Sok, Keomony

2007-01-01

Purpose: To study the quality in higher education in Cambodia and explore the potential factors leading to quality in Cambodian higher education. Design/methodology/approach: Five main factors that were deemed relevant in providing quality in Cambodian higher education were proposed: academic curriculum and extra-curricular activities, teachers'…

Analysis Supporting Factors and Constraints LPMP Performance in Improving the Quality of Education in Jambi Province

ERIC Educational Resources Information Center

Rosadi, Kemas Imron

2015-01-01

Development of education in Indonesia is based on three aspects, namely equity and expansion, quality and relevance, as well as good governance. Quality education is influenced by several factors related to quality education managerial leaders, limited funds, facilities, educational facilities, media, learning resources, tools and training…

Minimum Volume Discussion in the Treatment of Colon and Rectal Cancer: A Review of the Current Status and Relevance of Surgeon and Hospital Volume regarding Result Quality and the Impact on Health Economics.

PubMed

Link, Karl-Heinrich; Coy, Peter; Roitman, Mark; Link, Carola; Kornmann, Marko; Staib, Ludger

2017-05-01

To answer the question whether minimum caseloads need to be stipulated in the German S3 (or any other) guidelines for colorectal cancer, we analyzed the current representative literature. The question is important regarding medical quality as well as health economics and policy. A literature research was conducted in PubMed for papers concerning 'colon cancer' (CC), 'rectal cancer' (RC), and 'colorectal cancer' (CRC), with 'results', 'quality', and 'mortality' between the years 2000 and 2016 being relevant factors. We graded the recommendations as 'pro', 'maybe', or 'contra' in terms of a significant correlation between hospital volume (HV) or surgeon volume (SV) and treatment quality. We also listed the recommended numbers suggested for HV or SV as minimum caseloads and calculated and discussed the socio-economic impact of setting minimum caseloads for CRC. The correlations of caseloads of hospitals or surgeons turned out to be highly controversial concerning the influence of HV or SV on short- and long-term surgical treatment quality of CRC. Specialized statisticians made the point that the reports in the literature might not use the optimal biometrical analytical/reporting methods. A Dutch analysis showed that if a decision towards minimum caseloads, e.g. >50 for CRC resections, would be made, this would exclude a lot of hospitals with proven good treatment quality and include hospitals with a treatment quality below average. Our economic analysis envisioned that a yearly loss of EUR <830,000 might ensue for hospitals with volumes <50 per year. Caseload (HV, SV) definitely is an inconsistent surrogate parameter for treatment quality in the surgery of CC, RC, or CRC. If used at all, the lowest tolerable numbers but the highest demands for structural, process and result quality in the surgical/interdisciplinary treatment of CC and RC must be imposed and independently controlled. Hospitals fulfilling these demands should be medically and socio-economically preferred concerning the treatment of CC and RC patients.

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…

Quality of Life Assessment for Physical Activity and Health Promotion: Further Psychometrics and Comparison of Measures

ERIC Educational Resources Information Center

Gill, Diane L.; Reifsteck, Erin J.; Adams, Melanie M.; Shang, Ya-Ting

2015-01-01

Despite the clear relationship between physical activity and quality of life, few sound, relevant quality of life measures exist. Gill and colleagues developed a 32-item quality of life survey, and provided initial psychometric evidence. This study further examined that quality of life survey in comparison with the widely used short form (SF-36)…

Temperature determines size and direction of effects of elevated CO2 and nitrogen form on yield quantity and quality of Chinese cabbage.

PubMed

Reich, M; van den Meerakker, A N; Parmar, S; Hawkesford, M J; De Kok, L J

2016-01-01

Rising atmospheric CO2 concentrations (e[CO2 ]) are presumed to have a significant impact on plant growth and yield and also on mineral nutrient composition, and therefore, on nutritional quality of crops and vegetables. To assess the relevance of these effects in future agroecosystems it is important to understand how e[CO2 ] interacts with other environmental factors. In the present study, we examined the interactive effects of e[CO2 ] with temperature and the form in which nitrogen is supplied (nitrate or ammonium nitrate) on growth, amino acid content and mineral nutrient composition of Chinese cabbage (Brassica pekinensis Rupr.), a crop characterised by its high nutritional value and increasing relevance for human nutrition in many developing countries. Higher temperature, ammonium nitrate and e[CO2 ] had a positive impact on net photosynthesis and growth. A stimulating effect of e[CO2 ] on growth was only observed if the temperature was high (21/18 °C, day/night), and an interaction of e[CO2 ] with N form was only observed if the temperature was ambient (15/12 °C, day/night). Mineral nutrient composition was affected in a complex manner by all three factors and their interaction. These results demonstrate how much the effect of e[CO2 ] on mineral quality of crops depends on other environmental factors. Changes in temperature, adapting N fertilisation and the oxidation state of N have the potential to counteract the mineral depletion caused by e[CO2 ]. © 2015 German Botanical Society and The Royal Botanical Society of the Netherlands.

Performance improvement for optimization of the non-linear geometric fitting problem in manufacturing metrology

NASA Astrophysics Data System (ADS)

Moroni, Giovanni; Syam, Wahyudin P.; Petrò, Stefano

2014-08-01

Product quality is a main concern today in manufacturing; it drives competition between companies. To ensure high quality, a dimensional inspection to verify the geometric properties of a product must be carried out. High-speed non-contact scanners help with this task, by both speeding up acquisition speed and increasing accuracy through a more complete description of the surface. The algorithms for the management of the measurement data play a critical role in ensuring both the measurement accuracy and speed of the device. One of the most fundamental parts of the algorithm is the procedure for fitting the substitute geometry to a cloud of points. This article addresses this challenge. Three relevant geometries are selected as case studies: a non-linear least-squares fitting of a circle, sphere and cylinder. These geometries are chosen in consideration of their common use in practice; for example the sphere is often adopted as a reference artifact for performance verification of a coordinate measuring machine (CMM) and a cylinder is the most relevant geometry for a pin-hole relation as an assembly feature to construct a complete functioning product. In this article, an improvement of the initial point guess for the Levenberg-Marquardt (LM) algorithm by employing a chaos optimization (CO) method is proposed. This causes a performance improvement in the optimization of a non-linear function fitting the three geometries. The results show that, with this combination, a higher quality of fitting results a smaller norm of the residuals can be obtained while preserving the computational cost. Fitting an ‘incomplete-point-cloud’, which is a situation where the point cloud does not cover a complete feature e.g. from half of the total part surface, is also investigated. Finally, a case study of fitting a hemisphere is presented.

Citation of prior research has increased in introduction and discussion sections with time: A survey of clinical trials in physiotherapy.

PubMed

Hoderlein, Xenia; Moseley, Anne M; Elkins, Mark R

2017-08-01

Many clinical trials are reported without reference to the existing relevant high-quality research. This study aimed to investigate the extent to which authors of reports of clinical trials of physiotherapy interventions try to use high-quality clinical research to (1) help justify the need for the trial in the introduction and (2) help interpret the trial's results in the discussion. Data were extracted from 221 clinical trials that were randomly selected from the Physiotherapy Evidence Database: 70 published in 2001 (10% sample) and 151 published in 2015 (10% sample). The Physiotherapy Evidence Database score (which rates methodological quality and completeness of reporting) for each trial was also downloaded. Overall 41% of trial reports cited a systematic review or the results of a search for other evidence in the introduction section: 20% for 2001 and 50% for 2015 (relative risk = 2.3, 95% confidence interval = 1.5-3.8). For the discussion section, only 1 of 221 trials integrated the results of the trial into an existing meta-analysis, but citation of a relevant systematic review did increase from 17% in 2001 to 34% in 2015. There was no relationship between citation of existing research and the total Physiotherapy Evidence Database score. Published reports of clinical trials of physiotherapy interventions increasingly cite a systematic review or the results of a search for other evidence in the introduction, but integration with existing research in the discussion section is very rare. To encourage the use of existing research, stronger recommendations to refer to existing systematic reviews (where available) could be incorporated into reporting checklists and journal editorial guidelines.

Pain, Fatigue, and Psychological Impact on Health-Related Quality of Life in Childhood-Onset Lupus.

PubMed

Jones, Jordan T; Cunningham, Natoshia; Kashikar-Zuck, SusmitA; Brunner, Hermine I

2016-01-01

To evaluate pain, fatigue, and psychological functioning of childhood-onset systemic lupus erythematosus (SLE) patients and examine how these factors impact health-related quality of life (HRQOL). At a tertiary rheumatology clinic, 60 childhood-onset SLE patients completed the following: a visual analog scale (VAS) of pain intensity (0-10), the Pediatric Quality of Life (PedsQL) multidimensional fatigue scale, Pain Coping Questionnaire, Pain Catastrophizing Scale (PCS), Children's Depression Inventory I (CDI-I), the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire, and the PedsQL generic core (GC) scale and rheumatology module (RM). Sociodemographics and multiple disease activity indicators were recorded. Fatigue was present in 65% of the patients. Clinically relevant pain (pain-VAS >3), anxiety (SCARED ≥25), and depressive symptoms (CDI-I >12) were observed in 40%, 37%, and 30% of the patients, respectively; 22% had high catastrophizing (PCS ≥26). On average, the PedsQL-GC and -RM scores for childhood-onset SLE were lower than in healthy norms. Reduced PedsQL-GC and -RM scores were highly correlated with greater levels of fatigue, anxiety, and depressive symptoms (Pearson's r > 0.65), but had weak correlation with disease activity (Pearson's r < 0.25). Regression analysis demonstrated HRQOL was most impacted by fatigue, pain, and anxiety when evaluating all factors concurrently (P < 0.001). Childhood-onset SLE is associated with decreased HRQOL, and psychological aspects of health contribute substantially to low HRQOL, whereas measures of childhood-onset SLE activity seem less relevant. Fatigue, pain, mood, and anxiety symptoms are present in a large subgroup of patients and need medical attention to achieve optimal health outcomes. © 2016, American College of Rheumatology.

[Meta-analysis of diagnostic capability of frequency-doubling technology (FDT) for primary glaucoma].

PubMed

Liu, Ting; He, Xiang-ge

2006-05-01

To evaluate the overall diagnostic capabilities of frequency-doubling technology (FDT) in patients of primary glaucoma, with standard automated perimetry (SAP) and/or optic disc appearance as the gold standard. A comprehensive electric search in MEDLINE, EMBASE, Cochrane Library, BIOSIS, Previews, HMIC, IPA, OVID, CNKI, CBMdisc, VIP information, CMCC, CCPD, SSreader and 21dmedia and a manual search in related textbooks, journals, congress articles and their references were performed to identify relevant English and Chinese language articles. Criteria for adaptability were established according to validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests. Quality of the included articles was assessed and relevant materials were extracted for studying. Statistical analysis was performed with Meta Test version 0.6 software. Heterogeneity of the included articles was tested, which was used to select appropriate effect model to calculate pooled weighted sensitivity and specificity. Summary Receiver Operating Characteristic (SROC) curve was established and the area under the curve (AUC) was calculated. Finally, sensitivity analysis was performed. Fifteen English articles (21 studies) of 206 retrieved articles were included in the present study, with a total of 3172 patients. The reported sensitivity of FDT ranged from 0.51 to 1.00, and specificity from 0.58 to 1.00. The pooled weighted sensitivity and specificity for FDT with 95% confidence intervals (95% CI) after correction for standard error were 0.86 (0.80 - 0.90), 0.87 (0.81 - 0.91), respectively. The AUC of SROC was 93.01%. Sensitivity analysis demonstrated no disproportionate influences of individual study. The included articles are of good quality and FDT can be a highly efficient diagnostic test for primary glaucoma based on Meta-analysis. However, a high quality perspective study is still required for further analysis.

[Definition of low threshold volumes for quality assurance: conceptual and methodological issues involved in the definition and evaluation of thresholds for volume outcome relations in clinical care].

PubMed

Wetzel, Hermann

2006-01-01

In a large number of mostly retrospective association studies, a statistical relationship between volume and quality of health care has been reported. However, the relevance of these results is frequently limited by methodological shortcomings. In this article, criteria for the evidence and definition of thresholds for volume-outcome relations are proposed, e.g. the specification of relevant outcomes for quality indicators, analysis of volume as a continuous variable with an adequate case-mix and risk adjustment, accounting for cluster effects and considering mathematical models for the derivation of cut-off values. Moreover, volume thresholds are regarded as surrogate parameters for the indirect classification of the quality of care, whose diagnostic validity and effectiveness in improving health care quality need to be evaluated in prospective studies.

Method for Examination and Documentation of Basic Information and Metadata from Published Reports Relevant to the Study of Stormwater Runoff Quality

USGS Publications Warehouse

Dionne, Shannon G.; Granato, Gregory E.; Tana, Cameron K.

1999-01-01

A readily accessible archive of information that is valid, current, and technically defensible is needed to make informed highway-planning, design, and management decisions. The National Highway Runoff Water-Quality Data and Methodology Synthesis (NDAMS) is a cataloging and assessment of the documentation of information relevant to highway-runoff water quality available in published reports. The report review process is based on the NDAMS review sheet, which was designed by the USGS with input from the FHWA, State transportation agencies, and the regulatory community. The report-review process is designed to determine the technical merit of the existing literature in terms of current requirements for data documentation, data quality, quality assurance and quality control (QA/QC), and technical issues that may affect the use of historical data. To facilitate the review process, the NDAMS review sheet is divided into 12 sections: (1) administrative review information, (2) investigation and report information, (3) temporal information, (4) location information (5) water-quality-monitoring information, (6) sample-handling methods, (7) constituent information, (8) sampling focus and matrix, (9) flow monitoring methods, (10) field QA/QC, (11) laboratory, and (12) uncertainty/error analysis. This report describes the NDAMS report reviews and metadata documentation methods and provides an overview of the approach and of the quality-assurance and quality-control program used to implement the review process. Detailed information, including a glossary of relevant terms, a copy of the report-review sheets, and reportreview instructions are completely documented in a series of three appendixes included with this report. Therefore the reviews are repeatable and the methods can be used by transportation research organizations to catalog new reports as they are published.

[Quality Indicators of Primary Health Care Facilities in Austria].

PubMed

Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

2017-07-11

Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

User benefits and funding strategies. [technology assessment and economic analysis of the space shuttles and NASA Programs

NASA Technical Reports Server (NTRS)

Archer, J. L.; Beauchamp, N. A.; Day, C. F.

1975-01-01

The justification, economic and technological benefits of NASA Space Programs (aside from pure scientific objectives), in improving the quality of life in the United States is discussed and outlined. Specifically, a three-step, systematic method is described for selecting relevant and highly beneficial payloads and instruments for the Interim Upper Stage (IUS) that will be used with the space shuttle until the space tug becomes available. Viable Government and private industry cost-sharing strategies which would maximize the number of IUS payloads, and the benefits obtainable under a limited NASA budget were also determined. Charts are shown which list the payload instruments, and their relevance in contributing to such areas as earth resources management, agriculture, weather forecasting, and many others.

Nanosecond laser scribing of CIGS thin film solar cell based on ITO bottom contact

NASA Astrophysics Data System (ADS)

Kuk, Seungkuk; Wang, Zhen; Fu, Shi; Zhang, Tao; Yu, Yi Yin; Choi, JaeMyung; Jeong, Jeung-hyun; Hwang, David J.

2018-03-01

Cu(In,Ga)Se2 (CIGS) thin films, a promising photovoltaic architecture, have mainly relied on Molybdenum for the bottom contact. However, the opaque nature of Molybdenum (Mo) poses limitations in module level fabrication by laser scribing as a preferred method for interconnect. We examined the P1, P2, and P3 laser scribing processes on CIGS photovoltaic architecture on the indium tin oxide (ITO) bottom contact with a cost-effective nanosecond pulsed laser of 532 nm wavelength. Laser illuminated from the substrate side, enabled by the transparent bottom contact, facilitated selective laser energy deposition onto relevant interfaces towards high-quality scribing. Parametric tuning procedures are described in conjunction with experimental and numerical investigation of relevant mechanisms, and preliminary mini-module fabrication results are also presented.

Barriers and Facilitators to Safe Food Handling among Consumers: A Systematic Review and Thematic Synthesis of Qualitative Research Studies

PubMed Central

Young, Ian; Waddell, Lisa

2016-01-01

Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers’ perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11), moderate (11), and low (9). Overarching analytical themes included: 1) safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2) most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3) consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed. PMID:27907161

Responding to a Relevance Imperative in School Science and Mathematics: Humanising the Curriculum through Story

ERIC Educational Resources Information Center

Darby-Hobbs, Linda

2013-01-01

There has been a recent push to reframe curriculum and pedagogy in ways that make school more meaningful and relevant to students' lives and perceived needs. This "relevance imperative" is evident in contemporary rhetoric surrounding quality education, and particularly in relation to the junior secondary years where student disengagement with…

Bringing Relevance to Elearning--A Gender Perspective

ERIC Educational Resources Information Center

Wallace, Ann; Panteli, Niki

2018-01-01

In this paper, we discuss the importance of relevance in the provision of eLearning for the pursuit of higher education (HE). In particular, we argue how the extant literature focuses on quality and security in the design of eLearning platforms, but pays scant attention to how relevant the platform and the programme contents are to the needs of…

Grading the quality of evidence and the strength of recommendations in clinical dentistry: a critical review of 2 prominent approaches.

PubMed

Faggion, Clovis Mariano

2010-06-01

The objective of this article was to critically review 2 prominent approaches used to grade the quality of evidence and the strength of recommendations. Every year much information becomes available as a result of publication of scientific papers, and clinicians should be able to assess current evidence so they, along with their patients, can make the most appropriate clinical decisions. This is particularly important when there is little or no high-quality evidence available about the subject of interest. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and the Strength of Recommendation Taxonomy (SORT) were evaluated. Strengths and weaknesses of these 2 systems are discussed, mainly on the basis of their relevance to clinical dentistry. The conclusion was that use of a system for grading the quality of evidence and the strength of recommendations is urgently required because of the great heterogeneity of the quality and type of evidence relating to many dental procedures. Use of such a system will enable clinicians and their patients to make more informed decisions.

Statistical issues in reporting quality data: small samples and casemix variation.

PubMed

Zaslavsky, A M

2001-12-01

To present two key statistical issues that arise in analysis and reporting of quality data. Casemix variation is relevant to quality reporting when the units being measured have differing distributions of patient characteristics that also affect the quality outcome. When this is the case, adjustment using stratification or regression may be appropriate. Such adjustments may be controversial when the patient characteristic does not have an obvious relationship to the outcome. Stratified reporting poses problems for sample size and reporting format, but may be useful when casemix effects vary across units. Although there are no absolute standards of reliability, high reliabilities (interunit F > or = 10 or reliability > or = 0.9) are desirable for distinguishing above- and below-average units. When small or unequal sample sizes complicate reporting, precision may be improved using indirect estimation techniques that incorporate auxiliary information, and 'shrinkage' estimation can help to summarize the strength of evidence about units with small samples. With broader understanding of casemix adjustment and methods for analyzing small samples, quality data can be analysed and reported more accurately.

How to do (or not to do)… Measuring health worker motivation in surveys in low- and middle-income countries

PubMed Central

Borghi, J; Lohmann, J; Dale, E; Meheus, F; Goudge, J; Oboirien, K; Kuwawenaruwa, A

2018-01-01

Abstract A health system’s ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings. Increasing policy and researcher attention is directed towards understanding what drives health worker motivation and how different policy interventions affect motivation, as motivation is key to performance and quality of care outcomes. As a result, there is growing interest among researchers in measuring motivation within health worker surveys. However, there is currently limited guidance on how to conceptualize and approach measurement and how to validate or analyse motivation data collected from health worker surveys, resulting in inconsistent and sometimes poor quality measures. This paper begins by discussing how motivation can be conceptualized, then sets out the steps in developing questions to measure motivation within health worker surveys and in ensuring data quality through validity and reliability tests. The paper also discusses analysis of the resulting motivation measure/s. This paper aims to promote high quality research that will generate policy relevant and useful evidence. PMID:29165641

High power disk lasers: advances and applications

NASA Astrophysics Data System (ADS)

Havrilla, David; Holzer, Marco

2011-02-01

Though the genesis of the disk laser concept dates to the early 90's, the disk laser continues to demonstrate the flexibility and the certain future of a breakthrough technology. On-going increases in power per disk, and improvements in beam quality and efficiency continue to validate the genius of the disk laser concept. As of today, the disk principle has not reached any fundamental limits regarding output power per disk or beam quality, and offers numerous advantages over other high power resonator concepts, especially over monolithic architectures. With well over 1000 high power disk lasers installations, the disk laser has proven to be a robust and reliable industrial tool. With advancements in running cost, investment cost and footprint, manufacturers continue to implement disk laser technology with more vigor than ever. This paper will explain important details of the TruDisk laser series and process relevant features of the system, like pump diode arrangement, resonator design and integrated beam guidance. In addition, advances in applications in the thick sheet area and very cost efficient high productivity applications like remote welding, remote cutting and cutting of thin sheets will be discussed.

Method for extracting relevant electrical parameters from graphene field-effect transistors using a physical model

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

Boscá, A., E-mail: alberto.bosca@upm.es; Dpto. de Ingeniería Electrónica, E.T.S.I. de Telecomunicación, Universidad Politécnica de Madrid, Madrid 28040; Pedrós, J.

2015-01-28

Due to its intrinsic high mobility, graphene has proved to be a suitable material for high-speed electronics, where graphene field-effect transistor (GFET) has shown excellent properties. In this work, we present a method for extracting relevant electrical parameters from GFET devices using a simple electrical characterization and a model fitting. With experimental data from the device output characteristics, the method allows to calculate parameters such as the mobility, the contact resistance, and the fixed charge. Differentiated electron and hole mobilities and direct connection with intrinsic material properties are some of the key aspects of this method. Moreover, the method outputmore » values can be correlated with several issues during key fabrication steps such as the graphene growth and transfer, the lithographic steps, or the metalization processes, providing a flexible tool for quality control in GFET fabrication, as well as a valuable feedback for improving the material-growth process.« less

Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis

PubMed Central

O'Brien, Kelly K; Solomon, Patricia; Trentham, Barry; MacLachlan, Duncan; MacDermid, Joy; Tynan, Anne-Marie; Baxter, Larry; Casey, Alan; Chegwidden, William; Robinson, Greg; Tran, Todd; Wu, Janet; Zack, Elisse

2014-01-01

Objective Our aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV. Design We conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence on rehabilitation interventions for common comorbidities experienced by older adults with HIV. Methods We included highly relevant HIV-specific research addressing rehabilitation and ageing (stream A) and high-quality evidence on the effectiveness of rehabilitation interventions for common comorbidities experienced by older adults ageing with HIV (stream B). We extracted and synthesised relevant data from the evidence to draft evidence-informed recommendations for rehabilitation. Draft recommendations were refined based on people living with HIV (PLHIV) and clinician experience, values and preferences, reviewed by an interprofessional team for Grading of Recommendations Assessment, Development, and Evaluation (GRADE) (quality) rating and revision and then circulated to PLHIV and clinicians for external endorsement and final refinement. We then devised overarching recommendations to broadly guide rehabilitation with older adults living with HIV. Results This synthesis yielded 8 overarching and 52 specific recommendations. Thirty-six specific recommendations were derived from 108 moderate-level or high-level research articles (meta-analyses and systematic reviews) that described the effectiveness of rehabilitation interventions for comorbidities that may be experienced by older adults with HIV. Recommendations addressed rehabilitation interventions across eight health conditions: bone and joint disorders, cancer, stroke, cardiovascular disease, mental health challenges, cognitive impairments, chronic obstructive pulmonary disease and diabetes. Sixteen specific recommendations were derived from 42 research articles specific to rehabilitation with older adults with HIV. The quality of evidence from which these recommendations were derived was either low or very low, consisting primarily of narrative reviews or descriptive studies with small sample sizes. Recommendations addressed approaches to rehabilitation assessment and interventions, and contextual factors to consider for rehabilitation with older adults living with HIV. Conclusions These evidence-informed recommendations provide a guide for rehabilitation with older adults living with HIV. PMID:24833687

Automatic evidence quality prediction to support evidence-based decision making.

PubMed

Sarker, Abeed; Mollá, Diego; Paris, Cécile

2015-06-01

Evidence-based medicine practice requires practitioners to obtain the best available medical evidence, and appraise the quality of the evidence when making clinical decisions. Primarily due to the plethora of electronically available data from the medical literature, the manual appraisal of the quality of evidence is a time-consuming process. We present a fully automatic approach for predicting the quality of medical evidence in order to aid practitioners at point-of-care. Our approach extracts relevant information from medical article abstracts and utilises data from a specialised corpus to apply supervised machine learning for the prediction of the quality grades. Following an in-depth analysis of the usefulness of features (e.g., publication types of articles), they are extracted from the text via rule-based approaches and from the meta-data associated with the articles, and then applied in the supervised classification model. We propose the use of a highly scalable and portable approach using a sequence of high precision classifiers, and introduce a simple evaluation metric called average error distance (AED) that simplifies the comparison of systems. We also perform elaborate human evaluations to compare the performance of our system against human judgments. We test and evaluate our approaches on a publicly available, specialised, annotated corpus containing 1132 evidence-based recommendations. Our rule-based approach performs exceptionally well at the automatic extraction of publication types of articles, with F-scores of up to 0.99 for high-quality publication types. For evidence quality classification, our approach obtains an accuracy of 63.84% and an AED of 0.271. The human evaluations show that the performance of our system, in terms of AED and accuracy, is comparable to the performance of humans on the same data. The experiments suggest that our structured text classification framework achieves evaluation results comparable to those of human performance. Our overall classification approach and evaluation technique are also highly portable and can be used for various evidence grading scales. Copyright © 2015 Elsevier B.V. All rights reserved.

Opening the black box of ethics policy work: evaluating a covert practice.

PubMed

Frolic, Andrea; Drolet, Katherine; Bryanton, Kim; Caron, Carole; Cupido, Cynthia; Flaherty, Barb; Fung, Sylvia; McCall, Lori

2012-01-01

Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the "black box" of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We also describe the development and application of an evaluation strategy to assess the quality of ethics policy review work, and to enable continuous improvement of ethics policy review processes. Given the potential for policy work to impact entire patient populations and organizational systems, it is imperative that HECs and ethicists develop clearer roles, responsibilities, procedural standards, and evaluation methods to ensure the delivery of consistent, relevant, and high-quality ethics policy reviews.

Non-caloric sweeteners, sweetness modulators, and sweetener enhancers.

PubMed

DuBois, Grant E; Prakash, Indra

2012-01-01

For a new sweetness technology to realize strong commercial success, it must be safe, exhibit good taste quality, be sufficiently soluble and stable in food and beverage systems, and be cost effective and patentable. Assessments of the commercial promise of eight synthetic and eight natural non-caloric sweeteners are made relevant to these metrics. High-potency (HP) non-caloric sweeteners, both synthetic and natural, are generally limited in taste quality by (a) low maximal sweetness response, (b) "off" tastes, (c) slow-onset sweet tastes that linger, and (d) sweet tastes that adapt or desensitize the gustatory system. Formulation approaches to address these limitations are discussed. Enhancement of the normal sucrose sensory response by action of a sweetener receptor positive allosteric modulator (PAM) has been achieved with very significant calorie reduction and with retention of the taste quality of sucrose. Research on PAM discovery over the past decade is summarized.

Localized analysis of paint-coat drying using dynamic speckle interferometry

NASA Astrophysics Data System (ADS)

Sierra-Sosa, Daniel; Tebaldi, Myrian; Grumel, Eduardo; Rabal, Hector; Elmaghraby, Adel

2018-07-01

The paint-coating is part of several industrial processes, including the automotive industry, architectural coatings, machinery and appliances. These paint-coatings must comply with high quality standards, for this reason evaluation techniques from paint-coatings are in constant development. One important factor from the paint-coating process is the drying, as it has influence on the quality of final results. In this work we present an assessment technique based on the optical dynamic speckle interferometry, this technique allows for the temporal activity evaluation of the paint-coating drying process, providing localized information from drying. This localized information is relevant in order to address the drying homogeneity, optimal drying, and quality control. The technique relies in the definition of a new temporal history of the speckle patterns to obtain the local activity; this information is then clustered to provide a convenient indicative of different drying process stages. The experimental results presented were validated using the gravimetric drying curves

Why research-informed teaching in engineering education? A review of the evidence

NASA Astrophysics Data System (ADS)

Bubou, Gordon Monday; Offor, Ibebietei Temple; Bappa, Abubakar Saddiq

2017-05-01

Challenges of today's engineering education (EE) are emergent, necessitating calls for its reformation to empower future engineers function optimally as innovative leaders, in both local and international contexts. These challenges: keeping pace with technological dynamism; high attrition; and most importantly, quality teaching/learning require multifaceted approaches. But how can EE respond to the growing demand for relevant teaching? What can we do for engineering faculties to leverage on quality teaching? How do we embed quality teaching in EE? Scholarship of teaching and learning is advocated as one viable approach. It uses evidence-based teaching (EBT) strategies, and research-informed evidence to guide educational decisions regarding teaching and learning. We review the theories underpinning EBT, the scientific evidence on which it is based, and innovative instructional strategies that enhance active learning. Some of these issues have been discussed already, largely through developing countries lens. Nevertheless, linkages to equivalent global perspectives are presented here.

Water quality guidelines for the Great Barrier Reef World Heritage Area: a basis for development and preliminary values.

PubMed

Moss, Andrew; Brodie, Jon; Furnas, Miles

2005-01-01

The Australian and New Zealand Guidelines for Fresh and Marine Water Quality (ANZECC Guidelines) provide default national guideline values for a wide range of indicators of relevance to the protection of the ecological condition of natural waters. However, the ANZECC Guidelines also place a strong emphasis on the need to develop more locally relevant guidelines. Using a structured framework, this paper explores indicators and regional data sets that can be used to develop more locally relevant guidelines for the Great Barrier Reef World Heritage Area (GBRWHA). The paper focuses on the water quality impacts of adjacent catchments on the GBRWHA with the key stressors addressed being nutrients, sediments and agricultural chemicals. Indicators relevant to these stressors are discussed including both physico-chemical pressure indicators and biological condition indicators. Where adequate data sets are available, guideline values are proposed. Generally, data were much more readily available for physico-chemical pressure indicators than for biological condition indicators. Specifically, guideline values are proposed for the major nutrients nitrogen (N) and phosphorus (P) and for chlorophyll-a. More limited guidelines are proposed for sediment related indicators. For most agricultural chemicals, the ANZECC Guidelines are likely to remain the default of choice for some time but it is noted that there is data in the literature that could be used to develop more locally relevant guidelines.

The interobserver-validated relevance of intervertebral spacer materials in MRI artifacting

PubMed Central

Heidrich, G.; Bruening, T.; Krefft, S.; Buchhorn, G.; Klinger, H.M.

2006-01-01

Intervertebral spacers for anterior spine fusion are made of different materials, such as titanium, carbon or cobalt-chrome, which can affect the post-fusion MRI scans. Implant-related susceptibility artifacts can decrease the quality of MRI scans, thwarting proper evaluation. This cadaver study aimed to demonstrate the extent that implant-related MRI artifacting affects the post-fusion evaluation of intervertebral spacers. In a cadaveric porcine spine, we evaluated the post-implantation MRI scans of three intervertebral spacers that differed in shape, material, surface qualities and implantation technique. A spacer made of human cortical bone was used as a control. The median sagittal MRI slice was divided into 12 regions of interest (ROI). No significant differences were found on 15 different MRI sequences read independently by an interobserver-validated team of specialists (P>0.05). Artifact-affected image quality was rated on a score of 0-1-2. A maximum score of 24 points (100%) was possible. Turbo spin echo sequences produced the best scores for all spacers and the control. Only the control achieved a score of 100%. The carbon, titanium and cobalt-chrome spacers scored 83.3, 62.5 and 50%, respectively. Our scoring system allowed us to create an implant-related ranking of MRI scan quality in reference to the control that was independent of artifact dimensions. The carbon spacer had the lowest percentage of susceptibility artifacts. Even with turbo spin echo sequences, the susceptibility artifacts produced by the metallic spacers showed a high degree of variability. Despite optimum sequencing, implant design and material are relevant factors in MRI artifacting. PMID:16463200

Recurrent vulvovaginal candidiasis: A review of guideline recommendations.

PubMed

Matheson, Alexia; Mazza, Danielle

2017-04-01

Recurrent vulvovaginal candidiasis (VVC) is a difficult-to-manage condition that affects 5-8% of women of reproductive age. Current treatment regimes have high relapse rates, resulting in poor quality of life for the women affected. To compare the quality and content of current guidelines concerned with recurrent VVC and to develop a summary of recommendations to assist in the management of women with this condition. Relevant clinical guidelines were identified through a search of several databases (MEDLINE, SCOPUS and The Cochrane Library) and relevant websites. Five guidelines were identified. Each guideline was assessed for quality using the AGREE II instrument. Guideline recommendations were extracted, compared and contrasted. The identified guidelines were of mixed quality. This is not related to the level of evidence supporting them but is because of poor stakeholder involvement, applicability and lack of clarity concerning editorial independence. Current international guidelines for recurrent VVC are consistent in terms of their definition of the condition, diagnostic techniques and utilising induction and maintenance therapy as the treatment of choice. However, the regimen suggested by most guidelines (fluconazole weekly for six months) is not particularly effective; only 42.9% of patients are disease free after 12 months. An alternative regimen put forward by one of the guidelines cites a 77% cure rate after 12 months. Most guidelines lacked specific recommendations for the induction part of induction and maintenance treatment. The current most recommended treatment of recurrent VVC is sub-optimal. Studies performed on a larger scale are required to identify more effective treatments. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Practice Guideline Recommendations on Perioperative Fasting: A Systematic Review.

PubMed

Lambert, Eva; Carey, Sharon

2016-11-01

Traditionally, perioperative fasting consisted of being nil by mouth (NBM) from midnight before surgery and fasting postoperatively until recovery of bowel function. These outdated practices persist despite emerging evidence revealing that excessive fasting results in negative outcomes and delayed recovery. Various evidence-based, multimodal, enhanced recovery protocols incorporating minimized perioperative fasting have arisen to improve patient outcomes and streamline recovery, but implementation remains limited. This article aims to review current fasting guidelines, assess their quality, summarize relevant recommendations, and identify gaps in evidence. A systematic literature search of Medline and CINAHL and a manual search of relevant websites identified guidelines containing suitable grading systems and fasting recommendations. Guideline quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Grading systems were standardized to the American Society for Parenteral and Enteral Nutrition format and recommendations summarized based on grading and guideline quality. Nineteen guidelines were included. Rigor of development scores ranged from 29%-95%, with only 8 guidelines explicitly declaring the use of systematic methodology. Applicability scores were lowest, averaging 32%. Ten recommendation types were extracted and summarized. Strong and consistent evidence exists for the minimization of perioperative fasting, for a 2-hour preoperative fast after clear fluids, and for early recommencement of oral food and fluid intake postoperatively. This article presents several high-level recommendations ready for immediate implementation, while poorly graded and inconsistent recommendations reveal key areas for future research. Meanwhile, guideline quality requires improvement, especially regarding rigor of development and applicability, through systematic methodology, reporting transparency, and implementation strategies. © 2015 American Society for Parenteral and Enteral Nutrition.

The Assessment of Marital Quality: A Reevaluation.

ERIC Educational Resources Information Center

Fincham, Frank D.; Bradbury, Thomas N.

1987-01-01

Examines problem of marital quality not being defined or readily distinguishable from other relevant constructs such as communication. Explores implications of treating marital quality as the global evaluation of one's marriage, for the association between empirical and conceptual dependence, the interpretation of responses to self-report…

Analytical considerations and dimensionless analysis for a description of particle interactions in high pressure processes

NASA Astrophysics Data System (ADS)

Rauh, Cornelia; Delgado, Antonio

2010-12-01

High pressures of up to several hundreds of MPa are utilized in a wide range of applications in chemical, bio-, and food engineering, aiming at selective control of (bio-)chemical reactions. Non-uniformity of process conditions may threaten the safety and quality of the resulting products because processing conditions such as pressure, temperature, and treatment history are crucial for the course of (bio-)chemical reactions. Therefore, thermofluid-dynamical phenomena during the high pressure process have to be examined, and numerical tools to predict process uniformity and to optimize the processes have to be developed. Recently applied mathematical models and numerical simulations of laboratory and industrial scale high pressure processes investigating the mentioned crucial phenomena are based on continuum balancing models of thermofluid dynamics. Nevertheless, biological systems are complex fluids containing the relevant (bio-)chemical compounds (enzymes and microorganisms). These compounds are particles that interact with the surrounding medium and between each other. This contribution deals with thermofluid-dynamical interactions of the relevant particulate (bio-)chemical compounds (enzymes and microorganisms) with the surrounding fluid. By consideration of characteristic time and length scales and particle forces, the motion of the (bio-)chemical compounds is characterized.

Impact of PubMed search filters on the retrieval of evidence by physicians.

PubMed

Shariff, Salimah Z; Sontrop, Jessica M; Haynes, R Brian; Iansavichus, Arthur V; McKibbon, K Ann; Wilczynski, Nancy L; Weir, Matthew A; Speechley, Mark R; Thind, Amardeep; Garg, Amit X

2012-02-21

Physicians face challenges when searching PubMed for research evidence, and they may miss relevant articles while retrieving too many nonrelevant articles. We investigated whether the use of search filters in PubMed improves searching by physicians. We asked a random sample of Canadian nephrologists to answer unique clinical questions derived from 100 systematic reviews of renal therapy. Physicians provided the search terms that they would type into PubMed to locate articles to answer these questions. We entered the physician-provided search terms into PubMed and applied two types of search filters alone or in combination: a methods-based filter designed to identify high-quality studies about treatment (clinical queries "therapy") and a topic-based filter designed to identify studies with renal content. We evaluated the comprehensiveness (proportion of relevant articles found) and efficiency (ratio of relevant to nonrelevant articles) of the filtered and nonfiltered searches. Primary studies included in the systematic reviews served as the reference standard for relevant articles. The average physician-provided search terms retrieved 46% of the relevant articles, while 6% of the retrieved articles were relevant (corrected) (the ratio of relevant to nonrelevant articles was 1:16). The use of both filters together produced a marked improvement in efficiency, resulting in a ratio of relevant to nonrelevant articles of 1:5 (16 percentage point improvement; 99% confidence interval 9% to 22%; p < 0.003) with no substantive change in comprehensiveness (44% of relevant articles found; p = 0.55). The use of PubMed search filters improves the efficiency of physician searches. Improved search performance may enhance the transfer of research into practice and improve patient care.

Seasonal-scale Observational Data Analysis and Atmospheric Phenomenology for the Cold Land Processes Experiment

NASA Technical Reports Server (NTRS)

Poulos, Gregory S.; Stamus, Peter A.; Snook, John S.

2005-01-01

The Cold Land Processes Experiment (CLPX) experiment emphasized the development of a strong synergism between process-oriented understanding, land surface models and microwave remote sensing. Our work sought to investigate which topographically- generated atmospheric phenomena are most relevant to the CLPX MSA's for the purpose of evaluating their climatic importance to net local moisture fluxes and snow transport through the use of high-resolution data assimilation/atmospheric numerical modeling techniques. Our task was to create three long-term, scientific quality atmospheric datasets for quantitative analysis (for all CLPX researchers) and provide a summary of the meteorologically-relevant phenomena of the three MSAs (see Figure) over northern Colorado. Our efforts required the ingest of a variety of CLPX datasets and the execution an atmospheric and land surface data assimilation system based on the Navier-Stokes equations (the Local Analysis and Prediction System, LAPS, and an atmospheric numerical weather prediction model, as required) at topographically- relevant grid spacing (approx. 500 m). The resulting dataset will be analyzed by the CLPX community as a part of their larger research goals to determine the relative influence of various atmospheric phenomena on processes relevant to CLPX scientific goals.

Hypothesis driven drug design: improving quality and effectiveness of the design-make-test-analyse cycle.

PubMed

Plowright, Alleyn T; Johnstone, Craig; Kihlberg, Jan; Pettersson, Jonas; Robb, Graeme; Thompson, Richard A

2012-01-01

In drug discovery, the central process of constructing and testing hypotheses, carefully conducting experiments and analysing the associated data for new findings and information is known as the design-make-test-analyse cycle. Each step relies heavily on the inputs and outputs of the other three components. In this article we report our efforts to improve and integrate all parts to enable smooth and rapid flow of high quality ideas. Key improvements include enhancing multi-disciplinary input into 'Design', increasing the use of knowledge and reducing cycle times in 'Make', providing parallel sets of relevant data within ten working days in 'Test' and maximising the learning in 'Analyse'. Copyright © 2011 Elsevier Ltd. All rights reserved.

Exploring the nutrient inputs and cycles in Tampa Bay and coastal watersheds using MODIS images and data mining

NASA Astrophysics Data System (ADS)

Chang, Ni-Bin; Xuan, Zhemin

2011-09-01

Excessive nutrients, which may be represented as Total Nitrogen (TN) and Total Phosphorus (TP) levels, in natural water systems have proven to cause high levels of algae production. The process of phytoplankton growth which consumes the excess TN and TP in a water body can also be related to the changing water quality levels, such as Dissolved Oxygen (DO), chlorophyll-a, and turbidity, associated with their changes in absorbance of natural radiation. This paper explores spatiotemporal nutrient patterns in Tampa Bay, Florida with the aid of Moderate Resolution Imaging Spectroradiometer or MODIS images and Genetic Programming (GP) models that are deigned to link those relevant water quality parameters in aquatic environments.

Light scattering techniques for the characterization of optical components

NASA Astrophysics Data System (ADS)

Hauptvogel, M.; Schröder, S.; Herffurth, T.; Trost, M.; von Finck, A.; Duparré, A.; Weigel, T.

2017-11-01

The rapid developments in optical technologies generate increasingly higher and sometimes completely new demands on the quality of materials, surfaces, components, and systems. Examples for such driving applications are the steadily shrinking feature sizes in semiconductor lithography, nanostructured functional surfaces for consumer optics, and advanced optical systems for astronomy and space applications. The reduction of surface defects as well as the minimization of roughness and other scatter-relevant irregularities are essential factors in all these areas of application. Quality-monitoring for analysing and improving those properties must ensure that even minimal defects and roughness values can be detected reliably. Light scattering methods have a high potential for a non-contact, rapid, efficient, and sensitive determination of roughness, surface structures, and defects.

Getting sports injury prevention on to public health agendas - addressing the shortfalls in current information sources.

PubMed

Finch, Caroline F

2012-01-01

Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantification of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.

Patient-reported outcomes in randomised controlled trials of colorectal cancer: an analysis determining the availability of robust data to inform clinical decision-making

PubMed Central

Whale, Katie; Fish, Daniel; Fayers, Peter; Cafaro, Valentina; Pusic, Andrea; Blazeby, Jane M.; Efficace, Fabio

2016-01-01

Purpose Randomised controlled trials (RCTs) are the most robust study design measuring outcomes of colorectal cancer (CRC) treatments, but to influence clinical practice trial design and reporting of patient-reported outcomes (PROs) must be of high quality. Objectives of this study were as follows: to examine the quality of PRO reporting in RCTs of CRC treatment; to assess the availability of robust data to inform clinical decision-making; and to investigate whether quality of reporting improved over time. Methods A systematic review from January 2004–February 2012 identified RCTs of CRC treatment describing PROs. Relevant abstracts were screened and manuscripts obtained. Methodological quality was assessed using International Society for Quality of Life Research—patient-reported outcome reporting standards. Changes in reporting quality over time were established by comparison with previous data, and risk of bias was assessed with the Cochrane risk of bias tool. Results Sixty-six RCTs were identified, seven studies (10 %) reported survival benefit favouring the experimental treatment, 35 trials (53 %) identified differences in PROs between treatment groups, and the clinical significance of these differences was discussed in 19 studies (29 %). The most commonly reported treatment type was chemotherapy (n = 45; 68 %). Improvements over time in key methodological issues including the documentation of missing data and the discussion of the clinical significance of PROs were found. Thirteen trials (20 %) had high-quality reporting. Conclusions Whilst improvements in PRO quality reporting over time were found, several recent studies still fail to robustly inform clinical practice. Quality of PRO reporting must continue to improve to maximise the clinical impact of PRO findings. PMID:25910987

Does Internal Quality Management Contribute to More Control or to Improvement of Higher Education?: A Survey on Faculty's Perceptions

ERIC Educational Resources Information Center

Kleijnen, Jan; Dolmans, Diana; Willems, Jos; van Hout, Hans

2011-01-01

Purpose: The purpose of this paper is to explore faculty's perceptions of quality management activities (QMA) within their departments, attention being paid to relevant quality aspects and whether quality management contributes to control or improvement of higher education. Furthermore, it examines differences between departments and relationships…

A preclinical Talbot-Lau prototype for x-ray dark-field imaging of human-sized objects.

PubMed

Hauke, C; Bartl, P; Leghissa, M; Ritschl, L; Sutter, S M; Weber, T; Zeidler, J; Freudenberger, J; Mertelmeier, T; Radicke, M; Michel, T; Anton, G; Meinel, F G; Baehr, A; Auweter, S; Bondesson, D; Gaass, T; Dinkel, J; Reiser, M; Hellbach, K

2018-06-01

Talbot-Lau x-ray interferometry provides information about the scattering and refractive properties of an object - in addition to the object's attenuation features. Until recently, this method was ineligible for imaging human-sized objects as it is challenging to adapt Talbot-Lau interferometers (TLIs) to the relevant x-ray energy ranges. In this work, we present a preclinical Talbot-Lau prototype capable of imaging human-sized objects with proper image quality at clinically acceptable dose levels. The TLI is designed to match a setup of clinical relevance as closely as possible. The system provides a scan range of 120 × 30 cm 2 by using a scanning beam geometry. Its ultimate load is 100 kg. High aspect ratios and fine grid periods of the gratings ensure a reasonable setup length and clinically relevant image quality. The system is installed in a university hospital and is, therefore, exposed to the external influences of a clinical environment. To demonstrate the system's capabilities, a full-body scan of a euthanized pig was performed. In addition, freshly excised porcine lungs with an extrinsically provoked pneumothorax were mounted into a human thorax phantom and examined with the prototype. Both examination sequences resulted in clinically relevant image quality - even in the case of a skin entrance air kerma of only 0.3 mGy which is in the range of human thoracic imaging. The presented case of a pneumothorax and a reader study showed that the prototype's dark-field images provide added value for pulmonary diagnosis. We demonstrated that a dedicated design of a Talbot-Lau interferometer can be applied to medical imaging by constructing a preclinical Talbot-Lau prototype. We experienced that the system is feasible for imaging human-sized objects and the phase-stepping approach is suitable for clinical practice. Hence, we conclude that Talbot-Lau x-ray imaging has potential for clinical use and enhances the diagnostic power of medical x-ray imaging. © 2018 American Association of Physicists in Medicine.

Development of the European Organisation for Research and Treatment of Cancer quality of life questionnaire module for older people with cancer: The EORTC QLQ-ELD15.

PubMed

Johnson, Colin; Fitzsimmons, Deborah; Gilbert, Jacqueline; Arrarras, Juan-Ignacio; Hammerlid, Eva; Bredart, Anne; Ozmen, Mahir; Dilektasli, Evren; Coolbrandt, Anne; Kenis, Cindy; Young, Teresa; Chow, Edward; Venkitaraman, Ramachandran; Howse, Frances; George, Steve; O'Connor, Steve; Yadegarfar, Ghasem

2010-08-01

There is a lack of instruments that focus on the specific health-related quality of life (HRQOL) issues that affect older people with cancer. The aim of this study was to develop a HRQOL questionnaire module to supplement the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire, the EORTC QLQ-C30 for older (>70years) patients with cancer. Phases 1-3 were conducted in seven countries following modified EORTC Quality of Life Group guidelines for module development. Phase 1: potentially relevant issues were identified by a systematic literature review, a questionnaire survey of 17 multi-disciplinary health professionals and two rounds of qualitative interviews. The first round included 9 patients aged >70. The second round was a comparative series of interviews with 49 patients >70years with a range of cancer diagnoses and 40 patients aged 50-69years matched for gender and disease site. In Phase 2 the issues were formulated into a long provisional item list. This was administered in Phase 3 together with the QLQ-C30 to two further groups of cancer patients aged >70 (n=97) or 50-69years (n=85) to determine the importance, relevance and acceptability of each item. Redundant and duplicate items were removed; issues specific to the older group were selected for the final questionnaire. In Phase 1, 75 issues were identified. These were reduced in Phase 2 to create a 45 item provisional list. Phase 3 testing of the provisional list led to the selection of 15 items with good range of response, high scores of importance and relevance in the older patients. This resulted in the EORTC QLQ-ELD15, containing five conceptually coherent scales (functional independence, relationships with family and friends, worries about the future, autonomy and burden of illness). The EORTC QLQ-ELD15 in combination with the EORTC QLQ-C30 is ready for large-scale validation studies, and will assess HRQOL issues of most relevance and concern for older people with cancer across a wide range of cancer sites and treatment stages. Copyright 2010 Elsevier Ltd. All rights reserved.

Obstructive sleep apnea syndrome and sleep quality in hypertensive patients.

PubMed

Bacci, Marcelo Rodrigues; Emboz, Jonathan Naim Mora; Alves, Beatriz da Costa Aguiar; Veiga, Glaucia Luciano da; Murad, Neif; Meneghini, Adriano; Chagas, Antonio Carlos P; Fonseca, Fernando Luiz Affonso

2017-12-01

Obstructive sleep apnea and hypopnea syndrome (OSAHS) is one of the developmental factors of high blood pressure (HBP), a relevant global public health problem. OSAHS is characterized by the reduction or complete cessation of respiratory airflow due to intermittent airway collapse. Additionally, significant changes in sleep rhythm and pattern are observed in these patients. To evaluate the association between OSAHS and sleep quality in essential and resistant hypertensives. A cross-sectional, observational study evaluated 43 hypertensive patients treated at the outpatient clinics of the Faculdade de Medicina do ABC (FMABC) who were medicated with two or more antihypertensive drugs and divided into nonresistant or resistant to treatment. Group I (using up to two antihypertensive agents - 60.47% of the sample) presented mean systolic blood pressure (SBP) of 127.5±6.4 mmHg, mean diastolic blood pressure (DBP) of 79.6±5.2 mmHg, mean body mass index (BMI) of 27.2±5.3 kg/m2 and mean age of 51.2±15.1 years. Group II (using more than two antihypertensive drugs - 37.2% of the sample) presented mean SBP of 132.1±9.3 mmHg, mean DBP of 84.5±5.8 mmHg, mean BMI of 27.2±7.2 kg/m2 and mean age of 55.5±13.4 years. The patients presented low quality of sleep/sleep disorder evaluated by the Pittsburgh Sleep Quality Index (PSQI), which represents a preponderant factor for OSAHS. Patients at high risk for OSAHS had poor sleep quality and high levels of DBP, suggesting a causal relation between these parameters. However, they did not present a higher prevalence of resistant high blood pressure (RHBP).

Consumer Quality Index Chronic Skin Disease (CQI-CSD): a new instrument to measure quality of care from the patient's perspective.

PubMed

van Cranenburgh, O D; Krol, M W; Hendriks, M C P; de Rie, M A; Smets, E M A; de Korte, J; Sprangers, M A G

2015-10-01

Assessing quality of care from the patient's perspective is considered to be highly relevant. As a standardized instrument in dermatology was lacking, we developed a patient experience questionnaire regarding chronic skin disease care: the Consumer Quality Index Chronic Skin Disease (CQI-CSD). (i) To evaluate the dimensional structure of the CQI-CSD, (ii) to assess its ability to distinguish between hospitals according to patients' experiences with quality of care, (iii) to explore patients' experiences with dermatological care and priorities for quality improvement according to the patients, and (iv) to optimize the questionnaire based on psychometric results and stakeholders' input. In a cross-sectional study 5647 adult patients who received dermatological care in the past 12 months in 20 hospitals were randomly selected and invited to fill out the questionnaire. Overall 1160 of 3989 eligible respondents (29% response rate, 30-87 per hospital) were included for analysis. The CQI-CSD comprised seven scales with high internal consistency (Cronbach's α = 0·74-0·92). The instrument's discriminative power was limited. Patients were positive about the care provided by nurses and doctors, but the provision of information by healthcare providers, accessibility of care and patient involvement could be improved. We optimized the CQI-CSD, resulting in a revised questionnaire containing 65 items. In conclusion, the CQI-CSD is a useful instrument to measure patient experiences with dermatological care. © 2015 British Association of Dermatologists.

Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions.

PubMed

Bustamante Madsen, Lizell; Eddleston, Michael; Schultz Hansen, Kristian; Konradsen, Flemming

2018-03-01

Death following self-harm constitutes a major global public health challenge and there is an urgent need for governments to implement cost-effective, national suicide prevention strategies. To conduct a systematic review and quality appraisal of the economic evaluations of interventions aimed at preventing suicidal behavior. A systematic literature search was performed in several literature databases to identify relevant articles published from 2003 to 2016. Drummond's 10-item appraisal tool was used to assess the methodological quality of the included studies. In total, 25 documents encompassing 30 economic evaluations were included in the review. Of the identified evaluations, 10 studies were found to be of poor quality, 14 were of average quality, and six studies were considered of good quality. The majority of evaluations found the interventions to be cost-effective. Several limitations were identified and discussed in the article. A notable few economic evaluations were identified. The studies were diverse, primarily set in high-income countries, and often based on modeling, emphasizing the need for more primary research into the topic. The discussion of suicide and self-harm prevention should be as nuanced as possible, including health economics along with cultural, social, and political aspects.

Examples of subjective image quality enhancement in multimedia

NASA Astrophysics Data System (ADS)

Klíma, Miloš; Pazderák, Jiří; Fliegel, Karel

2007-09-01

The subjective image quality is an important issue in all multimedia imaging systems with a significant impact onto QoS (Quality of Service). For long time the image fidelity criterion was widely applied in technical systems esp. in both television and image source compression fields but the optimization of subjective perception quality and fidelity approach (such as the minimum of MSE) are very different. The paper presents an experimental testing of three different digital techniques for the subjective image quality enhancement - color saturation, edge enhancement, denoising operators and noise addition - well known from both the digital photography and video. The evaluation has been done for extensive operator parameterization and the results are summarized and discussed. It has been demonstrated that there are relevant types of image corrections improving to some extent the subjective perception of the image. The above mentioned techniques have been tested for five image tests with significantly different image characteristics (fine details, large saturated color areas, high color contrast, easy-to-remember colors etc.). The experimental results show the way to optimized use of image enhancing operators. Finally the concept of impressiveness as a new possible expression of subjective quality improvement is presented and discussed.

[Method for the quality assessment of data collection processes in epidemiological studies].

PubMed

Schöne, G; Damerow, S; Hölling, H; Houben, R; Gabrys, L

2017-10-01

For a quantitative evaluation of primary data collection processes in epidemiological surveys based on accompaniments and observations (in the field), there is no description of test criteria and methodologies in relevant literature and thus no known application in practice. Therefore, methods need to be developed and existing procedures adapted. The aim was to identify quality-relevant developments within quality dimensions by means of inspection points (quality indicators) during the process of data collection. As a result we seek to implement and establish a methodology for the assessment of overall survey quality supplementary to standardized data analyses. Monitors detect deviations from standard primary data collection during site visits by applying standardized checklists. Quantitative results - overall and for each dimension - are obtained by numerical calculation of quality indicators. Score results are categorized and color coded. This visual prioritization indicates necessity for intervention. The results obtained give clues regarding the current quality of data collection. This allows for the identification of such sections where interventions for quality improvement are needed. In addition, process quality development can be shown over time on an intercomparable basis. This methodology for the evaluation of data collection quality can identify deviations from norms, focalize quality analyses and help trace causes for significant deviations.

Optimizing Hearing Loss Prevention and Treatment, Rehabilitation and Re - Integration of Soldiers with Hearing Impairment

DTIC Science & Technology

2016-10-01

for whom hearing loss is more often associated with middle ear disease , but is also relevant to assess the aeration system of the ear in with ...being, the ability to cope with post-traumatic stress and the overall quality of life. Modern Militaries have highly trained and experienced specialists...impaired in that environment. In the case of evaluating the impact of noise-induced hearing loss, this would mean finding trained operators with all

Hearing Aid–Related Standards and Test Systems

PubMed Central

Ravn, Gert; Preves, David

2015-01-01

Many documents describe standardized methods and standard equipment requirements in the field of audiology and hearing aids. These standards will ensure a uniform level and a high quality of both the methods and equipment used in audiological work. The standards create the basis for measuring performance in a reproducible manner and independent from how and when and by whom parameters have been measured. This article explains, and focuses on, relevant acoustic and electromagnetic compatibility parameters and describes several test systems available. PMID:27516709

Review of Available Water-Quality Data for the Southern Colorado Plateau Network and Characterization of Water Quality in Five Selected Park Units in Arizona, Colorado, New Mexico, and Utah, 1925 to 2004

USGS Publications Warehouse

Brown, Juliane B.

2008-01-01

Historical water-quality data in the National Park Service Southern Colorado Plateau Network have been collected irregularly and with little followup interpretation, restricting the value of the data. To help address these issues, to inform future water-quality monitoring planning efforts, and to address relevant National Park Service Inventory and Monitoring Program objectives, the U.S. Geological Survey, in cooperation with the National Park Service, compiled, reviewed, and summarized available historical water-quality data for 19 park units in the Southern Colorado Plateau Network. The data are described in terms of availability by major water-quality classes, park unit, site type, and selected identified water sources. The report also describes the geology, water resources, water-quality issues, data gaps, and water-quality standard exceedances identified in five of the park units determined to be of high priority. The five park units are Bandelier National Monument in New Mexico, Canyon de Chelly National Monument in Arizona, Chaco Culture National Historical Park in New Mexico, Glen Canyon National Recreation Area in Arizona and Utah, and Mesa Verde National Park in Colorado. Statistical summaries of water-quality characteristics are presented and considerations for future water-quality monitoring are provided for these five park units.

Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

PubMed

Cole, Donald C; Robson, Lynda S; Lemieux-Charles, Louise; McGuire, Wendy; Sicotte, Claude; Champagne, Francois

2005-01-01

Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

Information presentation format moderates the unconscious-thought effect: The role of recollection.

PubMed

Abadie, Marlène; Waroquier, Laurent; Terrier, Patrice

2016-09-01

The unconscious-thought effect occurs when distraction improves complex decision-making. In two experiments using the unconscious-thought paradigm, we investigated the effect of presentation format of decision information (i) on memory for decision-relevant information and (ii) on the quality of decisions made after distraction, conscious deliberation or immediately. We used the process-dissociation procedure to measure recollection and familiarity. The two studies showed that presenting information blocked per criterion led participants to recollect more decision-relevant details compared to a presentation by option. Moreover, a Bayesian meta-analysis of the two studies provided strong evidence that conscious deliberation resulted in better decisions when the information was presented blocked per criterion and substantial evidence that distraction improved decision quality when the information was presented blocked per option. Finally, Study 2 revealed that the recollection of decision-relevant details mediated the effect of presentation format on decision quality in the deliberation condition. This suggests that recollection contributes to conscious deliberation efficacy.

Outcome measures for clinical rehabilitation trials: impairment, function, quality of life, or value?

PubMed

Wade, Derick T

2003-10-01

Choosing outcome measures in rehabilitation research depends on the standard research skills of clear thinking, attention to detail, and minimizing the amount of data collected. In rehabilitation, outcome is more difficult to measure because (1) usually several outcomes are relevant, (2) relevant outcomes are affected by multiple factors in addition to treatment, and (3) even good measures rarely reflect the specific interest of any individual patient or member of the rehabilitation team, leading to some dissent. Measurement of general quality of life is not possible because there is little agreement as to the nature of the construct; moreover, measurement of relevant aspects of quality of life would probably give similar results. Cost in terms of resources can be estimated, but there is no validated or even widely accepted method of relating this to benefit in a fair, open, and rational way. Outcome is best measured at the level of behavior (activities), with other measures being used to aid interpretation.

[How significant are customer surveys in the rehabilitation of patients with mental illness?].

PubMed

Queri, S; Spörrle, M

2008-12-01

In Germany, customer surveys in the field of rehabilitation meanwhile are of high political relevance - particularly since the Deutsche Rentenversicherung (German Pension Insurance) has defined customer judgements as a significant outcome parameter. Both the theoretical conceptualization and the empirical data available suggest that customer satisfaction is a construct widely dependent on subjective factors, which has only little reference to the reality of treatment. In the Herzogsägmühle Rehabilitation Centre a detailed customer survey (rehabilitants with mental illness) was carried out for the first time in 2007 in the framework of internal quality management. Data analysis was to yield new knowledge concerning the validity of subjective patient-related outcome parameters as well as relative to the content dimensioning regarding satisfaction and quality judgments in this specific sample. A Centre-specific questionnaire was constructed taking into account existing empirical data and theoretical considerations concerning the relevant content dimensions of customer satisfaction. Forty-six mostly male rehabilitants with an average age of 25 were interviewed. The majority of the interviewees had been diagnosed as having a schizophrenic or an affective disorder. The data obtained was submitted to a predominantly explorative data analysis, also testing various hypotheses. The results show that the rehabilitants' judgements are differentiated and that the expected positive bias was restricted to a few areas. Also it could be shown that treatment satisfaction and quality evaluations present different content dimensions. While satisfaction depends on the evaluation of treatment efficacy, the quality judgement is dependent on evaluation of the professional skills of the staff involved. CONCLUSION/CONSEQUENCES: In particular the quality judgments of the rehabilitants are important in both internal and external (by the cost carriers) quality management assurance. Both theoretical considerations and empirical findings on the subject of patient satisfaction suggest that surveys should be embedded in a comprehensive evaluation concept in the framework of effectiveness research. It is therefore projected to validate the patient judgements given at the Rehabilitation Centre on objective, treatment-related outcome parameters.

Data Quality Monitoring and Noise Analysis at the EUREF Permanent Network

NASA Astrophysics Data System (ADS)

Kenyeres, A.; Bruyninx, C.

2004-12-01

The EUREF Permanent Network (EPN) includes now more then 150 GNSS stations of different quality and different observation history. The greatest portion of the sites is settled on the tectonically stable parts of Eurasia, where only mm-level yearly displacements are expected. In order to extract the relevant geophysical information, sophisticated analysis tools and stable, long term observations are necessary. As the EPN is operational since 1996, it offers the potential to estimate high quality velocities associated with reliable uncertainties. In order to support this work, a set of efficient and demonstrative tools have been developed to monitor the data and station quality. The periodically upgraded results are displayed on the website of the EPN Central Bureau (CB) (www.epncb.oma.be) in terms of sky plots, graphs of observation percentage, cycle slips and multipath. The different quality plots are indirectly used for the interpretation of the time series. Sudden changes or unusual variation in the time series (beyond the obvious equipment change) often correlates with changes in the environment mirrored by the quality plots. These graphs are vital for the proper interpretation and the understanding of the real processes. Knowing the nuisance factors, we can generate cleaner time series. We are presenting relevant examples of this work. Two kinds of time series plots are displayed at the EPN CB website: raw and improved time series. They are cumulative solutions of the weekly EPN SINEX files using the minimum constraint approach. Within the improved time series the outliers and offsets are already taken into account. We will also present preliminary results of a detailed noise analysis of the EPN time series. The target of this work is twofold: on one side we aim at computing more realistic velocity estimates of the EPN stations and on the other side the information about the station noise characteristics will support the removal and proper interpretation of site-specific phenomena .

Twenty years of meta-analyses in orthopaedic surgery: has quality kept up with quantity?

PubMed

Dijkman, Bernadette G; Abouali, Jihad A K; Kooistra, Bauke W; Conter, Henry J; Poolman, Rudolf W; Kulkarni, Abhaya V; Tornetta, Paul; Bhandari, Mohit

2010-01-01

As the number of studies in the literature is increasing, orthopaedic surgeons highly depend on meta-analyses as their primary source of scientific evidence. The objectives of this review were to assess the scientific quality and number of published meta-analyses on orthopaedics-related topics over time. We conducted, in duplicate and independently, a systematic review of published meta-analyses in orthopaedics in the years 2005 and 2008 and compared them with a previous systematic review of meta-analyses from 1969 to 1999. A search of electronic databases (MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews) was performed to identify meta-analyses published in 2005 and 2008. We searched bibliographies and contacted content experts to identify additional relevant studies. Two investigators independently assessed the quality of the studies, using the Oxman and Guyatt index, and abstracted relevant data. We included forty-five and forty-four meta-analyses from 2005 and 2008, respectively. While the number of meta-analyses increased fivefold from 1999 to 2008, the mean quality score did not change significantly over time (p = 0.067). In the later years, a significantly lower proportion of meta-analyses had methodological flaws (56% in 2005 and 68% in 2008) compared with meta-analyses published prior to 2000 (88%) (p = 0.006). In 2005 and 2008, respectively, 18% and 30% of the meta-analyses had major to extensive flaws in their methodology. Studies from 2008 with positive conclusions used and described appropriate criteria for the validity assessment less often than did those with negative results. The use of random-effects and fixed-effects models as pooling methods became more popular toward 2008. Although the methodological quality of orthopaedic meta-analyses has increased in the past twenty years, a substantial proportion continues to show major to extensive flaws. As the number of published meta-analyses is increasing, a routine checklist for scientific quality should be used in the peer-review process to ensure methodological standards for publication.

EVALUATING AND USING AIR QUALITY MODELS

EPA Science Inventory

Grid-based models are being used to assess the magnitude of the pollution problem and to design emission control strategies to achieve compliance with the relevant air quality standards in the United States.

Clients’ perceptions of the quality of care in Mexico City’s public-sector legal abortion program

PubMed Central

Becker, Davida; Díaz-Olavarrieta, Claudia; Juárez, Clara; García, Sandra G.; Sanhueza, Patricio; Harper, Cynthia C.

2014-01-01

Context In 2007 the Mexico City legislature made the groundbreaking decision to legalize first trimester abortion. Limited research has been conducted to understand clients’ perceptions of the abortion services available in public sector facilities. Methods We measured clients’ perceptions of quality of care at three public sector sites in Mexico City in 2009 (n=402). We assessed six domains of quality of care (client-staff interaction, information provision, technical competence, post-abortion contraceptive services, accessibility, and the facility environment), and conducted ordinal logistic regression analysis to identify which domains were important to women for their overall evaluation of care. We measured the association of overall service evaluation with socio-demographic factors and abortion-visit characteristics, in addition to specific quality of care domains. Results Clients reported a high quality of care for abortion services with an overall mean rating of 8.8 out of 10. Multivariable analysis showed that important domains for high evaluation included client perception of doctor as technically skilled (p<0.05), comfort with doctor (p<0.001), perception of confidentiality (p<.01), perception that receptionist was respectful (p<.05) and counseling on self-care at home following the abortion and post-abortion emotions (p<0.05 and p<0.01). Other relevant domains for high evaluation were convenient site hours (p<0.01), waiting time (p<0.001) and clean facility (p<0.05). Nulliparous women rated their care less favorably than parous women (p<0.05). Conclusions Our findings highlight important domains of service quality to women’s overall evaluations of abortion care in Mexico City. Strategies to improve clients’ service experiences should focus on improving counseling, service accessibility and waiting time. PMID:22227626

Can High Quality Overcome Consumer Resistance to Restricted Provider Access? Evidence from a Health Plan Choice Experiment

PubMed Central

Harris, Katherine M

2002-01-01

Objective To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. Data Sources and Setting A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. Study Design An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. Principal Findings The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents “extremely satisfied with results of care” had the greatest impact on plan choice while the proportion of network doctors “affiliated with university medical centers” had the least. Other consumer and expert assessed measures had more comparable effects. Conclusions Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of quality required for consumers to accept access restrictions may be so high as to be unattainable. The results provide empirical support for the current focus of decision support efforts on consumer assessed quality measures. At the same time, however, the results suggest that consumers would also value quality measures based on expert assessments. This finding is relevant given the lack of comparative quality information based on expert judgment and research suggesting that consumers have apprehensions about their ability to meaningfully interpret performance-based quality measures. PMID:12132595

A Systematic Review of Community Interventions to Improve Aboriginal Child Passenger Safety

PubMed Central

Oudie, Eugenia; Desapriya, Ediriweera; Turcotte, Kate; Pike, Ian

2014-01-01

We evaluated evidence of community interventions to improve Aboriginal child passenger safety (CPS) in terms of its scientific merit and cultural relevance. We included studies if they reported interventions to improve CPS in Aboriginal communities, compared at least pre- and postintervention conditions, and evaluated rates and severity of child passenger injuries, child restraint use, or knowledge of CPS. We also appraised quality and cultural relevance of studies. Study quality was associated with community participation and cultural relevance. Strong evidence showed that multicomponent interventions tailored to each community improves CPS. Interventions in Aboriginal communities should incorporate Aboriginal views of health, involve the community, and be multicomponent and tailored to the community’s circumstances and culture. PMID:24754652

Minimum Volume Discussion in the Treatment of Colon and Rectal Cancer: A Review of the Current Status and Relevance of Surgeon and Hospital Volume regarding Result Quality and the Impact on Health Economics

PubMed Central

Link, Karl-Heinrich; Coy, Peter; Roitman, Mark; Link, Carola; Kornmann, Marko; Staib, Ludger

2017-01-01

Background To answer the question whether minimum caseloads need to be stipulated in the German S3 (or any other) guidelines for colorectal cancer, we analyzed the current representative literature. The question is important regarding medical quality as well as health economics and policy. Methods A literature research was conducted in PubMed for papers concerning ‘colon cancer’ (CC), ‘rectal cancer’ (RC), and ‘colorectal cancer’ (CRC), with ‘results', ‘quality’, and ‘mortality’ between the years 2000 and 2016 being relevant factors. We graded the recommendations as ‘pro’, ‘maybe’, or ‘contra’ in terms of a significant correlation between hospital volume (HV) or surgeon volume (SV) and treatment quality. We also listed the recommended numbers suggested for HV or SV as minimum caseloads and calculated and discussed the socio-economic impact of setting minimum caseloads for CRC. Results The correlations of caseloads of hospitals or surgeons turned out to be highly controversial concerning the influence of HV or SV on short- and long-term surgical treatment quality of CRC. Specialized statisticians made the point that the reports in the literature might not use the optimal biometrical analytical/reporting methods. A Dutch analysis showed that if a decision towards minimum caseloads, e.g. >50 for CRC resections, would be made, this would exclude a lot of hospitals with proven good treatment quality and include hospitals with a treatment quality below average. Our economic analysis envisioned that a yearly loss of EUR <830,000 might ensue for hospitals with volumes <50 per year. Conclusions Caseload (HV, SV) definitely is an inconsistent surrogate parameter for treatment quality in the surgery of CC, RC, or CRC. If used at all, the lowest tolerable numbers but the highest demands for structural, process and result quality in the surgical/interdisciplinary treatment of CC and RC must be imposed and independently controlled. Hospitals fulfilling these demands should be medically and socio-economically preferred concerning the treatment of CC and RC patients. PMID:28560230

Integrated Management of Residential Indoor Air Quality: A Call for Stakeholders in a Changing Climate.

PubMed

Levasseur, Marie-Eve; Poulin, Patrick; Campagna, Céline; Leclerc, Jean-Marc

2017-11-25

A paradigm change in the management of environmental health issues has been observed in recent years: instead of managing specific risks individually, a holistic vision of environmental problems would assure sustainable solutions. However, concrete actions that could help translate these recommendations into interventions are lacking. This review presents the relevance of using an integrated indoor air quality management approach to ensure occupant health and comfort. At the nexus of three basic concepts (reducing contaminants at the source, improving ventilation, and, when relevant, purifying the indoor air), this approach can help maintain and improve indoor air quality and limit exposure to several contaminants. Its application is particularly relevant in a climate change context since the evolving outdoor conditions have to be taken into account during building construction and renovation. The measures presented through this approach target public health players, building managers, owners, occupants, and professionals involved in building design, construction, renovation, and maintenance. The findings of this review will help the various stakeholders initiate a strategic reflection on the importance of indoor air quality and climate change issues for existing and future buildings. Several new avenues and recommendations are presented to set the path for future research activities.

Integrated Management of Residential Indoor Air Quality: A Call for Stakeholders in a Changing Climate

PubMed Central

Levasseur, Marie-Eve; Poulin, Patrick; Campagna, Céline; Leclerc, Jean-Marc

2017-01-01

A paradigm change in the management of environmental health issues has been observed in recent years: instead of managing specific risks individually, a holistic vision of environmental problems would assure sustainable solutions. However, concrete actions that could help translate these recommendations into interventions are lacking. This review presents the relevance of using an integrated indoor air quality management approach to ensure occupant health and comfort. At the nexus of three basic concepts (reducing contaminants at the source, improving ventilation, and, when relevant, purifying the indoor air), this approach can help maintain and improve indoor air quality and limit exposure to several contaminants. Its application is particularly relevant in a climate change context since the evolving outdoor conditions have to be taken into account during building construction and renovation. The measures presented through this approach target public health players, building managers, owners, occupants, and professionals involved in building design, construction, renovation, and maintenance. The findings of this review will help the various stakeholders initiate a strategic reflection on the importance of indoor air quality and climate change issues for existing and future buildings. Several new avenues and recommendations are presented to set the path for future research activities. PMID:29186831

An inventory and evaluation of biological investigations that relate to stream-water quality in the upper Illinois River basin of Illinois, Indiana, and Wisconsin

USGS Publications Warehouse

Steffeck, D.W.; Striegl, Robert G.

1989-01-01

Results of studies of the aquatic biology of the upper Illinois River basin provide a historical data source from which inferences can be made about changes in the quality of water in the main stem river and its tributaries. The results of biological investigations that have been conducted throughout the basin since 1900 are summarized and their relevance to stream-water-quality assessment is described, particularly their relevance to the upper Illinois River basin pilot project for the National Water Quality Assessment program. Four general categories of biological investigations were identified: Populations and community structure, chemical concentrations in tissue, organism health, and toxicity measurements. Biological investigations were identified by their location in the basin and by their relevance to each general investigation category. The most abundant literature was in the populations and community structure category. Tissue data were limited to polychlorinated biphenyls, organochlorine pesticides, dioxin, and several metals. The most cited measure of organism health was a condition factor for fish that associates body length with weight or body depth. Toxicity measurements included bioassays and the Ames Tests. The bioassays included several testing methods and test organism. (USGS)

A chemical application method with underwater dissection to improve anatomic identification of cadaveric foot and ankle structures in podiatric education.

PubMed

Dilandro, Anthony C; Chappell, Todd M; Panchani, Prakash N; Kozlowski, Piotr B; Tubbs, R Shane; Khan, Khurram H; D'Antoni, Anthony V

2013-01-01

Many cadaver-based anatomy courses and surgical workshops use prosections to help podiatry students and residents learn clinically relevant anatomy. The quality of these prosections is variable and dependent upon the methods used to prepare them. These methods have not been adequately described in the literature, and few studies describe the use of chemicals to prepare prosections of the cadaveric foot and ankle. Recognizing the need for better teaching prosections in podiatric education, we developed a chemical application method with underwater dissection to better preserve anatomic structures of the cadaveric foot and ankle. We used inexpensive chemicals before, during, and after each step, which ultimately resulted in high-quality prosections that improved identification of anatomic structures relevant to the practice of podiatric medicine. Careful preservation of clinically important nerves, vessels, muscles, ligaments, and joints was achieved with these prosections. Although this method required additional preparation time, the resultant prosections have been repeatedly used for several years to facilitate learning among podiatry students and residents, and they have held up well. This method can be used by educators to teach podiatry students throughout their medical training and even into residency.

Breaking the mould without breaking the system: the development and pilot of a clinical dashboard at The Prince Charles Hospital.

PubMed

Clark, Kevin W; Whiting, Elizabeth; Rowland, Jeffrey; Thompson, Leah E; Missenden, Ian; Schellein, Gerhard

2013-06-01

There is a vast array of clinical and quality data available within healthcare organisations. The availability of this data in a timely and easy to visualise way is an essential component of high-performing healthcare teams. It is recognised that good quality information is a driver of performance for clinical teams and helps ensure best possible care for patients. In 2012 the Internal Medicine Program at The Prince Charles Hospital developed a clinical dashboard that displays locally relevant information alongside relevant hospital and statewide metrics that inform daily clinical decision making. The data reported on the clinical dashboard is driven from data sourced from the electronic patient journey board in real time as well as other Queensland Health data sources. This provides clinicians with easy access to a wealth of local unit data presented in a simple graphical format that is being captured locally and arranged on a single screen so the information can be monitored at a glance. Local unit data informs daily decisions that identify and confirm patient flow problems, assist to identify root causes and enable evaluation of patient flow solutions.

[Marketing orientation in rehabilitation--exemplified by image analysis of a rehabilitation clinic for addictions].

PubMed

Altenhöner, T; Schönhoff, T; Wehmeier, D

2001-06-01

This article presents the findings of an image analysis carried out for a rehabilitation clinic for addictive diseases. The cross-sectional study was designed as an anonymous survey sent to relevant (regional) referral agencies (n = 90), e.g. counselling services for addictive diseases. The study covers the clinic's actual and ideal image, discriminating frequency of referrals, diagnostic categories, region, and type of institution. Results concerning the real profile indicate that on average the dimensions cooperation, communication with regard to personal contact, and reputation of the clinic were more critically judged than the issues information, communication with regard to discharge reports, standards of quality, and consideration of patients' needs. Cooperation, communication with regard to personal contact, and quality standards turned out to be the most important criteria from the referring agencies' perspective (ideal profile). A statistical comparison between those with high and low assignment rates suggested that customers rated the clinic more favourably than non-customers. Thus, it seems that the clinic's image has considerable influence on referral decisions. Particularly interesting is the additional finding that the referring institutions perceive pension insurers' directives to be of secondary relevance.

Compressed ultrasound video image-quality evaluation using a Likert scale and Kappa statistical analysis

NASA Astrophysics Data System (ADS)

Stewart, Brent K.; Carter, Stephen J.; Langer, Steven G.; Andrew, Rex K.

1998-06-01

Experiments using NASA's Advanced Communications Technology Satellite were conducted to provide an estimate of the compressed video quality required for preservation of clinically relevant features for the detection of trauma. Bandwidth rates of 128, 256 and 384 kbps were used. A five point Likert scale (1 equals no useful information and 5 equals good diagnostic quality) was used for a subjective preference questionnaire to evaluate the quality of the compressed ultrasound imagery at the three compression rates for several anatomical regions of interest. At 384 kbps the Likert scores (mean plus or minus SD) were abdomen (4.45 plus or minus 0.71), carotid artery (4.70 plus or minus 0.36), kidney (5.0 plus or minus 0.0), liver (4.67 plus or minus 0.58) and thyroid (4.03 plus or minus 0.74). Due to the volatile nature of the H.320 compressed digital video stream, no statistically significant results can be derived through this methodology. As the MPEG standard has at its roots many of the same intraframe and motion vector compression algorithms as the H.261 (such as that used in the previous ACTS/AMT experiments), we are using the MPEG compressed video sequences to best gauge what minimum bandwidths are necessary for preservation of clinically relevant features for the detection of trauma. We have been using an MPEG codec board to collect losslessly compressed video clips from high quality S- VHS tapes and through direct digitization of S-video. Due to the large number of videoclips and questions to be presented to the radiologists and for ease of application, we have developed a web browser interface for this video visual perception study. Due to the large numbers of observations required to reach statistical significance in most ROC studies, Kappa statistical analysis is used to analyze the degree of agreement between observers and between viewing assessment. If the degree of agreement amongst readers is high, then there is a possibility that the ratings (i.e., average Likert score at each bandwidth) do in fact reflect the dimension they are purported to reflect (video quality versus bandwidth). It is then possible to make intelligent choice of bandwidth for streaming compressed video and compressed videoclips.

[Quality of care indicators for the care of human immunodeficiency virus-infected individuals, adapted to the pediatric age].

PubMed

Soler-Palacín, Pere; Provens, Ana Clara; Martín-Nalda, Andrea; Espiau, María; Fernández-Polo, Aurora; Figueras, Concepció

2014-03-01

Since infection with human immunodeficiency virus (HIV) was first described, there have been many advances in its diagnosis, monitoring and treatment. However, few contributions are related to the area of health care quality. In this sense, the Spanish Study Group on AIDS (GESIDA) has developed a set of quality care indicators for adult patients living with HIV infection that includes a total of 66 indicators, 22 of which are considered to be relevant. Standards were calculated for each of them in order to reflect the level of the quality of care offered to these patients. Similar documents for pediatric patients are currently lacking. Preparation of a set of quality care indicators applicable to pediatric patients based on the GESIDA document and the Spanish Guidelines for monitoring of pediatric patients infected with HIV. Each indicator was analysed with respect to the required standards in all patients under 18 years of age followed-up in our Unit, with the aim of evaluating the quality of care provided. A total of 61 indicators were collected (51 from the GESIDA document and 10 from currently available pediatric guidelines), 30 of which were considered to be relevant. An overall compliance of 81%-83% was obtained when assessing the relevant indicators. The availability of health care quality standards is essential for the care of pediatric HIV-infected patients. The assessment of these indicators in our Unit yielded satisfactory results. Copyright © 2012 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Teaching Quality in Math Class: The Development of a Scale and the Analysis of Its Relationship with Engagement and Achievement

PubMed Central

Leon, Jaime; Medina-Garrido, Elena; Núñez, Juan L.

2017-01-01

Math achievement and engagement declines in secondary education; therefore, educators are faced with the challenge of engaging students to avoid school failure. Within self-determination theory, we address the need to assess comprehensively student perceptions of teaching quality that predict engagement and achievement. In study one we tested, in a sample of 548 high school students, a preliminary version of a scale to assess nine factors: teaching for relevance, acknowledge negative feelings, participation encouragement, controlling language, optimal challenge, focus on the process, class structure, positive feedback, and caring. In the second study, we analyzed the scale’s reliability and validity in a sample of 1555 high school students. The scale showed evidence of reliability, and with regard to criterion validity, at the classroom level, teaching quality was a predictor of behavioral engagement, and higher grades were observed in classes where students, as a whole, displayed more behavioral engagement. At the within level, behavioral engagement was associated with achievement. We not only provide a reliable and valid method to assess teaching quality, but also a method to design interventions, these could be designed based on the scale items to encourage students to persist and display more engagement on school duties, which in turn bolsters student achievement. PMID:28701964

Drinking Water Quality Guidelines across Canadian Provinces and Territories: Jurisdictional Variation in the Context of Decentralized Water Governance

PubMed Central

Dunn, Gemma; Bakker, Karen; Harris, Leila

2014-01-01

This article presents the first comprehensive review and analysis of the uptake of the Canadian Drinking Water Quality Guidelines (CDWQG) across Canada’s 13 provinces and territories. This review is significant given that Canada’s approach to drinking water governance is: (i) highly decentralized and (ii) discretionary. Canada is (along with Australia) only one of two Organization for Economic Cooperation and Development (OECD) member states that does not comply with the World Health Organization’s (WHO) recommendation that all countries have national, legally binding drinking water quality standards. Our review identifies key differences in the regulatory approaches to drinking water quality across Canada’s 13 jurisdictions. Only 16 of the 94 CDWQG are consistently applied across all 13 jurisdictions; five jurisdictions use voluntary guidelines, whereas eight use mandatory standards. The analysis explores three questions of central importance for water managers and public health officials: (i) should standards be uniform or variable; (ii) should compliance be voluntary or legally binding; and (iii) should regulation and oversight be harmonized or delegated? We conclude with recommendations for further research, with particular reference to the relevance of our findings given the high degree of variability in drinking water management and oversight capacity between urban and rural areas in Canada. PMID:24776725

Drinking Water Quality Guidelines across Canadian provinces and territories: jurisdictional variation in the context of decentralized water governance.

PubMed

Dunn, Gemma; Bakker, Karen; Harris, Leila

2014-04-25

This article presents the first comprehensive review and analysis of the uptake of the Canadian Drinking Water Quality Guidelines (CDWQG) across Canada's 13 provinces and territories. This review is significant given that Canada's approach to drinking water governance is: (i) highly decentralized and (ii) discretionary. Canada is (along with Australia) only one of two Organization for Economic Cooperation and Development (OECD) member states that does not comply with the World Health Organization's (WHO) recommendation that all countries have national, legally binding drinking water quality standards. Our review identifies key differences in the regulatory approaches to drinking water quality across Canada's 13 jurisdictions. Only 16 of the 94 CDWQG are consistently applied across all 13 jurisdictions; five jurisdictions use voluntary guidelines, whereas eight use mandatory standards. The analysis explores three questions of central importance for water managers and public health officials: (i) should standards be uniform or variable; (ii) should compliance be voluntary or legally binding; and (iii) should regulation and oversight be harmonized or delegated? We conclude with recommendations for further research, with particular reference to the relevance of our findings given the high degree of variability in drinking water management and oversight capacity between urban and rural areas in Canada.

Teaching Quality in Math Class: The Development of a Scale and the Analysis of Its Relationship with Engagement and Achievement.

PubMed

Leon, Jaime; Medina-Garrido, Elena; Núñez, Juan L

2017-01-01

Math achievement and engagement declines in secondary education; therefore, educators are faced with the challenge of engaging students to avoid school failure. Within self-determination theory, we address the need to assess comprehensively student perceptions of teaching quality that predict engagement and achievement. In study one we tested, in a sample of 548 high school students, a preliminary version of a scale to assess nine factors: teaching for relevance, acknowledge negative feelings, participation encouragement, controlling language, optimal challenge, focus on the process, class structure, positive feedback, and caring. In the second study, we analyzed the scale's reliability and validity in a sample of 1555 high school students. The scale showed evidence of reliability, and with regard to criterion validity, at the classroom level, teaching quality was a predictor of behavioral engagement, and higher grades were observed in classes where students, as a whole, displayed more behavioral engagement. At the within level, behavioral engagement was associated with achievement. We not only provide a reliable and valid method to assess teaching quality, but also a method to design interventions, these could be designed based on the scale items to encourage students to persist and display more engagement on school duties, which in turn bolsters student achievement.

Do psychological interventions reduce depression in hemodialysis patients?: A meta-analysis of randomized controlled trials following PRISMA.

PubMed

Xing, Lu; Chen, Ruiqi; Diao, Yongshu; Qian, Jiahui; You, Chao; Jiang, Xiaolian

2016-08-01

Depression is highly prevalent in hemodialysis patients and results in poor patient outcomes. Although psychological interventions are being developed and used for these patients, there is uncertainty regarding the effectiveness of these interventions. The purpose of this meta-analysis is to evaluate the effects of psychological interventions on depression treatment in hemodialysis patients. All randomized controlled trials (RCTs) relevant to the depression treatment of hemodialysis patients through psychological interventions were retrieved from the following databases: Embase, Pubmed, PsycINFO, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. The reference lists of identified RCTs were also screened. The Cochrane risk of bias tool was used to evaluate the quality of the studies, RevMan (5.3) was used to analyze the data, and the evidence quality of the combined results was evaluated using GRADE (3.6.1). Eight RCTs were included. The combined results showed that psychological interventions significantly reduced the scores of the Beck Depression Inventory (P<0.001) and interdialysis weight gain (P<0.001). However, due to the high heterogeneity, effect size combinations of sleep quality and quality of life were not performed. Psychological interventions may reduce the degree of depression and improve fluid intake restriction adherence. More rigorously designed research is needed.

Insufficient documentation for clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis, based on a systematic review and meta-analysis.

PubMed

Winther, Kristian Hillert; Wichman, Johanna Eva Märta; Bonnema, Steen Joop; Hegedüs, Laszlo

2017-02-01

By a systematic review and meta-analysis to investigate clinically relevant effects of selenium supplementation in patients with chronic autoimmune thyroiditis. Controlled trials in adults (≥18 years) with autoimmune thyroiditis, comparing selenium with or without levothyroxine substitution, versus placebo and/or levothyroxine substitution, were eligible for inclusion. Identified outcomes were serum thyrotropin (thyroid stimulating hormone) levels in LT4-untreated patients, thyroid ultrasound and health-related quality of life. Eleven publications, covering nine controlled trials, were included in the systematic review. Random effects model meta-analyses were performed in weighted mean difference for thyroid stimulating hormone, ultrasound and health-related quality of life. Quality of evidence was assessed per outcome, using GRADE. Meta-analyses showed no change in thyroid stimulating hormone, or improvements in health-related quality of life or thyroid echogenicity (ultrasound), between levothyroxine substitution-untreated patients assigned to selenium supplementation or placebo. Three trials found some improvement in wellbeing in patients receiving levothyroxine substitution, but could not be synthesized in a meta-analysis. The quality of evidence ranged from very low to low for thyroid stimulating hormone as well as ultrasound outcomes, and low to moderate for health-related quality of life, and was generally downgraded due to small sample sizes. We found no effect of selenium supplementation on thyroid stimulating hormone, health-related quality of life or thyroid ultrasound, in levothyroxine substitution-untreated individuals, and sporadic evaluation of clinically relevant outcomes in levothyroxine substitution-treated patients. Future well-powered RCTs, evaluating e.g. disease progression or health-related quality of life, are warranted before determining the relevance of selenium supplementation in autoimmune thyroiditis.

INTEGRATED CHEMICAL INFORMATION TECHNOLOGIES ...

EPA Pesticide Factsheets

A central regulatory mandate of the Environmental Protection Agency, spanning many Program Offices and issues, is to assess the potential health and environmental risks of large numbers of chemicals released into the environment, often in the absence of relevant test data. Models for predicting potential adverse effects of chemicals based primarily on chemical structure play a central role in prioritization and screening strategies yet are highly dependent and conditional upon the data used for developing such models. Hence, limits on data quantity, quality, and availability are considered by many to be the largest hurdles to improving prediction models in diverse areas of toxicology. Generation of new toxicity data for additional chemicals and endpoints, development of new high-throughput, mechanistically relevant bioassays, and increased generation of genomics and proteomics data that can clarify relevant mechanisms will all play important roles in improving future SAR prediction models. The potential for much greater immediate gains, across large domains of chemical and toxicity space, comes from maximizing the ability to mine and model useful information from existing toxicity data, data that represent huge past investment in research and testing expenditures. In addition, the ability to place newer “omics” data, data that potentially span many possible domains of toxicological effects, in the broader context of historical data is the means for opti

The 2010 California Research at the Nexus of Air Quality and Climate Change (CalNex) field study

NASA Astrophysics Data System (ADS)

Ryerson, T. B.; Andrews, A. E.; Angevine, W. M.; Bates, T. S.; Brock, C. A.; Cairns, B.; Cohen, R. C.; Cooper, O. R.; de Gouw, J. A.; Fehsenfeld, F. C.; Ferrare, R. A.; Fischer, M. L.; Flagan, R. C.; Goldstein, A. H.; Hair, J. W.; Hardesty, R. M.; Hostetler, C. A.; Jimenez, J. L.; Langford, A. O.; McCauley, E.; McKeen, S. A.; Molina, L. T.; Nenes, A.; Oltmans, S. J.; Parrish, D. D.; Pederson, J. R.; Pierce, R. B.; Prather, K.; Quinn, P. K.; Seinfeld, J. H.; Senff, C. J.; Sorooshian, A.; Stutz, J.; Surratt, J. D.; Trainer, M.; Volkamer, R.; Williams, E. J.; Wofsy, S. C.

2013-06-01

The California Research at the Nexus of Air Quality and Climate Change (CalNex) field study was conducted throughout California in May, June, and July of 2010. The study was organized to address issues simultaneously relevant to atmospheric pollution and climate change, including (1) emission inventory assessment, (2) atmospheric transport and dispersion, (3) atmospheric chemical processing, and (4) cloud-aerosol interactions and aerosol radiative effects. Measurements from networks of ground sites, a research ship, tall towers, balloon-borne ozonesondes, multiple aircraft, and satellites provided in situ and remotely sensed data on trace pollutant and greenhouse gas concentrations, aerosol chemical composition and microphysical properties, cloud microphysics, and meteorological parameters. This overview report provides operational information for the variety of sites, platforms, and measurements, their joint deployment strategy, and summarizes findings that have resulted from the collaborative analyses of the CalNex field study. Climate-relevant findings from CalNex include that leakage from natural gas infrastructure may account for the excess of observed methane over emission estimates in Los Angeles. Air-quality relevant findings include the following: mobile fleet VOC significantly declines, and NOx emissions continue to have an impact on ozone in the Los Angeles basin; the relative contributions of diesel and gasoline emission to secondary organic aerosol are not fully understood; and nighttime NO3 chemistry contributes significantly to secondary organic aerosol mass in the San Joaquin Valley. Findings simultaneously relevant to climate and air quality include the following: marine vessel emissions changes due to fuel sulfur and speed controls result in a net warming effect but have substantial positive impacts on local air quality.

Impact of nutrition interventions on pediatric mortality and nutrition outcomes in humanitarian emergencies: A systematic review.

PubMed

Balhara, Kamna S; Silvestri, David M; Tyler Winders, W; Selvam, Anand; Kivlehan, Sean M; Becker, Torben K; Levine, Adam C

2017-12-01

Malnutrition contributes to paediatric morbidity and mortality in disasters and complex emergencies, but summary data describing specific nutritional interventions in these settings are lacking. This systematic review aimed to characterise such interventions and their effects on paediatric mortality, anthropometric measures and serum markers of nutrition. A systematic search of OVID MEDLINE, Cochrane Library and relevant grey literature was conducted. We included all randomised controlled trials and observational controlled studies evaluating effectiveness of nutritional intervention(s) on defined health outcomes in children and adolescents (0-18 years) within a disaster or complex emergency. We extracted study characteristics, interventions and outcomes data. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. A total of 31 studies met inclusion criteria. Most were conducted in Africa (17), during periods of conflict or hunger gaps (14), and evaluated micronutrient supplementation (14) or selective feeding (10). Overall study quality was low, with only two high and four moderate quality studies. High- and medium-quality studies demonstrated positive impact of fortified spreads, ready-to-use therapeutic foods, micronutrient supplementation, and food and cash transfers. In disasters and complex emergencies, high variability and low quality of controlled studies on paediatric malnutrition limit meaningful data aggregation. If existing research gaps are to be addressed, the inherent unpredictability of humanitarian emergencies and ethical considerations regarding controls may warrant a paradigm shift in what constitutes adequate methods. Periodic hunger gaps may offer a generalisable opportunity for robust trials, but consensus on meaningful nutritional endpoints is needed. © 2017 John Wiley & Sons Ltd.

Archive data base and handling system for the Orbiter flying qualities experiment program

NASA Technical Reports Server (NTRS)

Myers, T. T.; Dimarco, R.; Magdaleno, R. E.; Aponso, B. L.

1986-01-01

The OFQ archives data base and handling system assembled as part of the Orbiter Flying Qualities (OFQ) research of the Orbiter Experiments Program (EOX) are described. The purpose of the OFQ archives is to preserve and document shuttle flight data relevant to vehicle dynamics, flight control, and flying qualities in a form that permits maximum use for qualified users. In their complete form, the OFQ archives contain descriptive text (general information about the flight, signal descriptions and units) as well as numerical time history data. Since the shuttle program is so complex, the official data base contains thousands of signals and very complex entries are required to obtain data. The OFQ archives are intended to provide flight phase oriented data subsets with relevant signals which are easily identified for flying qualities research.

40 CFR 93.152 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... official charged with direct responsibility for management of an area designated as Class I under the Act... 301(d) of the Act and which implements the relevant requirements of the Act. Areawide air quality... which uses an air quality dispersion model to determine the effects of emissions on air quality. Cause...

Developing Quality Assurance Culture for Sustainable University Education in Nigeria

ERIC Educational Resources Information Center

Ibara, Emmanuel Chisa

2015-01-01

The relevance of any university education depends on quality parameters that should be specified, adhered to and sustained. The development of quality assurance culture in Nigerian university education is imperative, considering the fact that globalization, mobility of labour, competition and the quest for best practices have subjected…

Does the EUA Institutional Evaluation Programme Contribute to Quality Improvement?

ERIC Educational Resources Information Center

Tavares, Diana Amado; Rosa, Maria Joao; Amaral, Alberto

2010-01-01

Purpose: This paper aims to reflect on the relevance of the Institutional Evaluation Programme (IEP) of the European University Association (EUA) to universities' quality improvement. It aims to analyse IEP follow-up reports to determine whether the programme contributes to the development of a quality improvement culture.…

Dynamic Evaluation of a Regional Air Quality Model: Assessing the Emissions-Induced Weekly Ozone Cycle

EPA Science Inventory

Air quality models are used to predict changes in pollutant concentrations resulting from envisioned emission control policies. Recognizing the need to assess the credibility of air quality models in a policy-relevant context, we perform a dynamic evaluation of the community Mult...

Relationship between Parents and Peer Influences on Qualities of Adolescent Friendship

ERIC Educational Resources Information Center

Obiunu, Jude J.

2015-01-01

The study investigated the relationship between parents and peer influences on the qualities of adolescent friendship. Relevant literature in the field of adolescent friendship qualities and parental interaction were investigated. The problem of the study is the increasing incidences of emotional, imbalance among young people that manifest in…

Large-Scale Interlaboratory Study to Develop, Analytically Validate and Apply Highly Multiplexed, Quantitative Peptide Assays to Measure Cancer-Relevant Proteins in Plasma*

PubMed Central

Abbatiello, Susan E.; Schilling, Birgit; Mani, D. R.; Zimmerman, Lisa J.; Hall, Steven C.; MacLean, Brendan; Albertolle, Matthew; Allen, Simon; Burgess, Michael; Cusack, Michael P.; Gosh, Mousumi; Hedrick, Victoria; Held, Jason M.; Inerowicz, H. Dorota; Jackson, Angela; Keshishian, Hasmik; Kinsinger, Christopher R.; Lyssand, John; Makowski, Lee; Mesri, Mehdi; Rodriguez, Henry; Rudnick, Paul; Sadowski, Pawel; Sedransk, Nell; Shaddox, Kent; Skates, Stephen J.; Kuhn, Eric; Smith, Derek; Whiteaker, Jeffery R.; Whitwell, Corbin; Zhang, Shucha; Borchers, Christoph H.; Fisher, Susan J.; Gibson, Bradford W.; Liebler, Daniel C.; MacCoss, Michael J.; Neubert, Thomas A.; Paulovich, Amanda G.; Regnier, Fred E.; Tempst, Paul; Carr, Steven A.

2015-01-01

There is an increasing need in biology and clinical medicine to robustly and reliably measure tens to hundreds of peptides and proteins in clinical and biological samples with high sensitivity, specificity, reproducibility, and repeatability. Previously, we demonstrated that LC-MRM-MS with isotope dilution has suitable performance for quantitative measurements of small numbers of relatively abundant proteins in human plasma and that the resulting assays can be transferred across laboratories while maintaining high reproducibility and quantitative precision. Here, we significantly extend that earlier work, demonstrating that 11 laboratories using 14 LC-MS systems can develop, determine analytical figures of merit, and apply highly multiplexed MRM-MS assays targeting 125 peptides derived from 27 cancer-relevant proteins and seven control proteins to precisely and reproducibly measure the analytes in human plasma. To ensure consistent generation of high quality data, we incorporated a system suitability protocol (SSP) into our experimental design. The SSP enabled real-time monitoring of LC-MRM-MS performance during assay development and implementation, facilitating early detection and correction of chromatographic and instrumental problems. Low to subnanogram/ml sensitivity for proteins in plasma was achieved by one-step immunoaffinity depletion of 14 abundant plasma proteins prior to analysis. Median intra- and interlaboratory reproducibility was <20%, sufficient for most biological studies and candidate protein biomarker verification. Digestion recovery of peptides was assessed and quantitative accuracy improved using heavy-isotope-labeled versions of the proteins as internal standards. Using the highly multiplexed assay, participating laboratories were able to precisely and reproducibly determine the levels of a series of analytes in blinded samples used to simulate an interlaboratory clinical study of patient samples. Our study further establishes that LC-MRM-MS using stable isotope dilution, with appropriate attention to analytical validation and appropriate quality control measures, enables sensitive, specific, reproducible, and quantitative measurements of proteins and peptides in complex biological matrices such as plasma. PMID:25693799

BTS guide to good statistical practice

DOT National Transportation Integrated Search

2002-09-01

Quality of data has many faces. Primarily, it has to be relevant to its users. Relevance is : an outcome that is achieved through a series of steps starting with a planning process that : link user needs to data requirements. It continues through acq...

[Evaluation of the quality of medical care in primary care patients with metabolic syndrome].

PubMed

Modrego Navarro, Angel; Ramírez Espinosa, Manuel; Fustero Fernández, Mariví; Tarraga López, Pedro Juan; Bastida Calvo, José Carlos; Torras Tohà, Núria

2009-08-01

As there is a high prevalence of metabolic syndrome (MS) in the overweight population, their cardiovascular risk is also high and the review system in Spain appears to be inadequate. The present study was carried out to evaluate the quality of the medical care of these patients. Epidemiological, cross-sectional and multicenter study. A total of 138 primary care general practitioners from all over Spain included outpatients of both sexes, > 18 years old, with body mass index > or = 25 and with biochemical data from the last 6 months for fasting glucose, triglycerides, HDL-c and blood pressure. Self-evaluation, retrospective, internal and with data processing. Principal determinations: Degree of compliance of 12 evaluation criteria and description of MS factors. A total of 2,280 patients were analysed. MS prevalence was 53.2%. Biochemical data were significantly higher in patients with MS and the most prevalent risk factors were: triglycerides > 150 (49.6%), systolic blood pressure > 140 (40.8%), fasting glucose > or = 126 (38.4%). Poor compliance of a few but relevant criteria was responsible for a high percentage of errors in the medical care quality. Introduction of improvement activities in patients with MS in primary care is essential in the management and prevention of cardiovascular complications.

Problem solving, loneliness, depression levels and associated factors in high school adolescents.

PubMed

Sahin, Ummugulsum; Adana, Filiz

2016-01-01

To determine problem solving, loneliness, depression levels and associated factors in high school adolescents. This cross-sectional study was conducted in a city west of Turkey (Bursa) in a public high school and the population was 774 and the sampling was 394 students. Students to be included in the study were selected using the multiple sampling method. A personal Information Form with 23 questions, Problem Solving Inventory (PSI), Loneliness Scale (UCLA), Beck Depression Inventory (BDI) were used as data collection tools in the study. Basic statistical analyses, t-test, Kruskall Wallis-H, One Way Anova and Pearson Correlation test were used to evaluate the data. Necessary permissions were obtained from the relevant institution, students, parents and the ethical committee. The study found significant differences between "problem solving level" and family type, health assessment, life quality and mothers', fathers' siblings' closeness level; between "loneliness level" and gender, family income, health assessment, life quality and mothers', fathers', siblings' closeness level; between "depression level" and life quality, family income, fathers' closeness level. Unfavorable socio-economic and cultural conditions can have an effect on the problem solving, loneliness and depression levels of adolescents. Providing structured education to adolescents at risk under school mental health nursing practices is recommended.

Engineering and biotechnological aspects for the manufacturing of high quality fried potato products.

PubMed

Reimerdes, Ernst H; Franke, Knut

2006-04-01

Fried potato products have become very popular foods over the last decades. High quality standards have been established for these products by the food industry including uniform brown color and crispness. During frying, Maillard reactions takes place which contribute to color and taste development in these products. However, safety aspects are also influenced by these reactions, e.g., acrylamide formation. Maintaining high safety standards as well as the expected quality requires systematic research based on an integrated approach including all relevant variables, e.g., raw material properties, processing conditions and equipment concepts. Selected results of these investigations are presented and discussed, regarding influence of composition, e.g., precursor levels for Maillard reactions, treatment of raw materials and addition of reactants to frying fat. It has been demonstrated that a combined treatment of the potato sticks by coating of product surfaces and partial pre-drying can be successfully applied to produce well-browned French fries with lower acrylamide contents. Reductions up to 75% could be reached compared to samples without treatment. Furthermore, addition of a water/oil emulsion containing glutamine in the aqueous phase has been shown to influence Maillard reactions at the product surface, resulting in lower acrylamide contents at the same state of browning.

Are consumer-directed home care beneficiaries satisfied? Evidence from Washington state.

PubMed

Wiener, Joshua M; Anderson, Wayne L; Khatutsky, Galina

2007-12-01

This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study, we developed an 8-item Satisfaction With Paid Personal Assistance Scale as the measure of satisfaction. In predicting satisfaction with personal assistance services, we estimated an ordinary least squares regression model that was right-censored to account for the large percentage of respondents who were highly satisfied with their care. Among the older population, but not younger people with disabilities, beneficiaries receiving consumer-directed services were more satisfied than individuals receiving agency-directed care. There was no evidence that quality of care was less with consumer-directed services. In addition, overall satisfaction levels with paid home care were very high. This study supports the premise that consumer satisfaction, an important measure of quality, in consumer-directed home care is not inferior to that in agency-directed care. The positive effect of consumer direction for older people underlines the fact that this service option is relevant for this population. In addition, this research provides evidence that home- and community-based services are of high quality, at least on one dimension.

Quality Measurement Recommendations Relevant to Clinical Guidelines in Germany and the United Kingdom: (What) Can We Learn From Each Other?

PubMed Central

Petzold, Thomas; Deckert, Stefanie; Williamson, Paula R.; Schmitt, Jochen

2018-01-01

We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted. In Germany, no explicit methodological guidance exists, but 3 different approaches are used. For NICE, a general approach is used for the derivation of quality indicators out of quality standards. Quality indicators were defined in 34 out of 87 CGs (39%) in Germany and for 58 out of 133 (43%) NICE CGs. Statements regarding measurement properties of instruments for quality indicator assessment were missing in German and NICE documents. Thirteen pairs of CGs (32%) have associated quality indicators. Thirty-four quality indicators refer to the same aspect of the quality of care, which corresponds to 27% of the German and 7% of NICE quality indicators. The development of a standardized and internationally accepted methodology for the derivation of quality indicators relevant to CGs is needed to measure and compare quality of care in health care systems. PMID:29591538

Student-Teacher Relationships As a Protective Factor for School Adjustment during the Transition from Middle to High School

PubMed Central

Longobardi, Claudio; Prino, Laura E.; Marengo, Davide; Settanni, Michele

2016-01-01

A robust body of research has identified school transitions during adolescence, and in particular the transition from middle to high school, as one of the riskiest phases for school failure, being characterized by significant social, emotional and behavioral changes. This transition is critical even with respect to academic achievement: in Italy, the highest frequency of school dropout can be observed in the 9th and 10th grades, partly as a consequence of poor adjustment to the new school context. The impact of students' relationships with their teachers may be particularly relevant during critical developmental periods. Indeed, student-teacher relationships have been widely recognized as protective factors in school adjustment and, in case of negative relationships, also as a factor that increases the risk of maladjustment. Positive and affective student-teacher relationships may play an important role in students' adaptation to the school environment, favoring both academic achievement and adaptive behaviors. The aim of this study was to investigate the effects of the quality of teacher-student relationships, as perceived by pupils, on academic achievement, and problem and prosocial behaviors during the relevant school transition. The sample consisted of 122 students (55% female). We employed a self-report questionnaire to collect information on: demographic characteristics, quality of the relationship with teachers, problem and prosocial behaviors, and academic achievement. Students filled in the questionnaires twice: once during the 8th grade and 1 year later, during their first year of high school (9th grade). Regression analyses indicated that both average and varying levels of closeness with teachers significantly predicted changes in academic achievement: A perceived increase in closeness in 9th grade, as well as a higher mean closeness level, was associated with an increase in academic achievement. In turn, an increase in the level of perceived conflict with teachers significantly predicted an increase in conduct problems and hyperactive behaviors. This study supports the significance of student-teacher relationships as a protective factor during students' transition to high-school. Our findings also highlight the importance of relationship quality in preventing students' risk of school failure. PMID:28066305

Student-Teacher Relationships As a Protective Factor for School Adjustment during the Transition from Middle to High School.

PubMed

Longobardi, Claudio; Prino, Laura E; Marengo, Davide; Settanni, Michele

2016-01-01

A robust body of research has identified school transitions during adolescence, and in particular the transition from middle to high school, as one of the riskiest phases for school failure, being characterized by significant social, emotional and behavioral changes. This transition is critical even with respect to academic achievement: in Italy, the highest frequency of school dropout can be observed in the 9th and 10th grades, partly as a consequence of poor adjustment to the new school context. The impact of students' relationships with their teachers may be particularly relevant during critical developmental periods. Indeed, student-teacher relationships have been widely recognized as protective factors in school adjustment and, in case of negative relationships, also as a factor that increases the risk of maladjustment. Positive and affective student-teacher relationships may play an important role in students' adaptation to the school environment, favoring both academic achievement and adaptive behaviors. The aim of this study was to investigate the effects of the quality of teacher-student relationships, as perceived by pupils, on academic achievement, and problem and prosocial behaviors during the relevant school transition. The sample consisted of 122 students (55% female). We employed a self-report questionnaire to collect information on: demographic characteristics, quality of the relationship with teachers, problem and prosocial behaviors, and academic achievement. Students filled in the questionnaires twice: once during the 8th grade and 1 year later, during their first year of high school (9th grade). Regression analyses indicated that both average and varying levels of closeness with teachers significantly predicted changes in academic achievement: A perceived increase in closeness in 9th grade, as well as a higher mean closeness level, was associated with an increase in academic achievement. In turn, an increase in the level of perceived conflict with teachers significantly predicted an increase in conduct problems and hyperactive behaviors. This study supports the significance of student-teacher relationships as a protective factor during students' transition to high-school. Our findings also highlight the importance of relationship quality in preventing students' risk of school failure.