Journal articles on the topic 'Quality control Standards Case studies'
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Tripp, Bridget, Simon Dillon, Sarinnapha Vasunilashorn, Long H. Ngo, Tamara G. Fong, Edward R. Marcantonio, Towia A. Libermann, and Hasan Otu. "METABOLOMICS OF DELIRIUM: A CASE-CONTROL STUDY." Innovation in Aging 3, Supplement_1 (November 2019): S92. http://dx.doi.org/10.1093/geroni/igz038.350.
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Abstract Postoperative delirium complicates 15-50% of major surgery in older adults, resulting in poor patient outcomes and increased healthcare costs. Basic mechanisms of delirium are largely unknown. In this study we implemented a protocol that uses high-throughput metabolomics to explore potential biological mechanisms of delirium. We profiled the plasma metabolome of 10 delirium cases and 10 matched controls from the SAGES cohort of older adults without dementia undergoing major non-cardiac surgery. We used targeted mass spectrometry to measure 302 metabolites (features) preoperatively (PREOP) and on postoperative day 2 (POD2). Metabolomics studies are challenged by inherent technical variability and signal noise. With a small sample and a large feature count, signal noise diminishes statistical power and masks true biological signals. To address these challenges, we implemented quality control sample-based signal correction and normalization to internal standards (ISs). ISs were screened from a pool of 6 potential candidates, resulting in the removal of 3 that failed to perform well, while 3 were retained for our experiments. ISs also enabled successful concatenation of experiments run at different times. Prior to implementing quality control samples and customized ISs, no metabolites were identified as differentially expressed. After implementation, we identified one metabolite that was significantly differentially expressed at PREOP and 17 metabolites that were significantly differentially expressed at POD2 between delirium and controls (BH-corrected p-value < 0.05). In conclusion, integration of quality controls and normalization to internal standards enabled us to detect metabolites associated with postoperative delirium. Such methods should be considered for future metabolomics studies.
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Verhaeghe, Tom. "Systematic internal standard variability and issue resolution: two case studies." Bioanalysis 11, no. 18 (September 2019): 1685–92. http://dx.doi.org/10.4155/bio-2019-0165.
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Two case studies are presented of validated assays where the internal standard showed high variability, and there was a clear response difference between study samples and standards and quality controls. In the first case a co-eluting peak boosted the stable isotope labeled internal standard response in samples from hepatically impaired subjects. In the second case the blank plasma matrix suppressed the structural analog internal standard response. For both assays the issue could be resolved by adapting the chromatographic conditions and re-validating the assay (case 1) or by diluting the study samples with blank plasma (case 2).
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Zhu, Yu Jin, Jian Hua Ren, and Hui Ding. "School Internationalized Operating Model and the Case Study." Advanced Materials Research 219-220 (March 2011): 1215–18. http://dx.doi.org/10.4028/www.scientific.net/amr.219-220.1215.
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School internationalized operating model acts as a kind of school operating model, with the main task of taking the operating approaches of integration, disposition, control and occupation to utilize teaching resources of foreign school into the teaching, education, and management to enhance the efficiency, quality and standards of teaching, education and management of our school. These resources are the curricula, faculty, teaching techniques, education and school management technology of foreign school. Studies have shown that there exist three basic operating models. They are single-campus internationalized operating model; double-campus internationalized operating model and abroad operating model. By implementing the model of internationalized operation and developing internationalized cooperation and communication, school could broaden its version, could promote its operating standard as well as enhance it.
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van der Veer, S. N., K. J. Jager, N. Peek, N. F. de Keizer, and A. Koetsier. "Control Charts in Healthcare Quality Improvement." Methods of Information in Medicine 51, no. 03 (2012): 189–98. http://dx.doi.org/10.3414/me11-01-0055.
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SummaryObjectives: Use of Shewhart control charts in quality improvement (QI) initiatives is increasing. These charts are typically used in one or more phases of the Plan Do Study Act (PDSA) cycle to monitor summaries of process and outcome data, abstracted from clinical information systems, over time. We summarize methodological criteria of Shewhart control charts and investigate adherence of published QI studies to these criteria.Methods: We searched Medline, Embase and CINAHL for studies using Shewhart control charts in QI processes in direct patient care. We extracted methodological criteria for Shewhart control charts, and for the use of these charts in PDSA cycles, from textbooks and methodological literature.Results: We included 34 studies, presenting 64 control charts of which 40 control charts plotted two phases of the PDSA cycle. The criterion to use 10–35 data points in a control chart was least adhered to (48.4% non-adherence). Other criteria were: transformation of the data in case of a skewed distribution (43.7% non adherence), when comparing data from two phases of the PDSA cycle the Plan phase (the first phase) needs to be stable (40.0% non-adherence), using a maximum of four different rules to detect special cause variation (14.1% non-adherence), and setting control limits at three standard deviations from the mean (all control charts adhered).Conclusion: There is room for improvement with regard to the methodological construction of Shewhart control charts used in QI processes. Higher adherence to all methodological criteria will decrease the risk of incorrect conclusions about the process being monitored.
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Chen, Sixing, and Xihong Lin. "Analysis in case–control sequencing association studies with different sequencing depths." Biostatistics 21, no. 3 (December 26, 2018): 577–93. http://dx.doi.org/10.1093/biostatistics/kxy073.
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Summary With the advent of next-generation sequencing, investigators have access to higher quality sequencing data. However, to sequence all samples in a study using next generation sequencing can still be prohibitively expensive. One potential remedy could be to combine next generation sequencing data from cases with publicly available sequencing data for controls, but there could be a systematic difference in quality of sequenced data, such as sequencing depths, between sequenced study cases and publicly available controls. We propose a regression calibration (RC)-based method and a maximum-likelihood method for conducting an association study with such a combined sample by accounting for differential sequencing errors between cases and controls. The methods allow for adjusting for covariates, such as population stratification as confounders. Both methods control type I error and have comparable power to analysis conducted using the true genotype with sufficiently high but different sequencing depths. We show that the RC method allows for analysis using naive variance estimate (closely approximates true variance in practice) and standard software under certain circumstances. We evaluate the performance of the proposed methods using simulation studies and apply our methods to a combined data set of exome sequenced acute lung injury cases and healthy controls from the 1000 Genomes project.
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Tincani, Matt, and Jason Travers. "Publishing Single-Case Research Design Studies That Do Not Demonstrate Experimental Control." Remedial and Special Education 39, no. 2 (April 4, 2017): 118–28. http://dx.doi.org/10.1177/0741932517697447.
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Demonstration of experimental control is considered a hallmark of high-quality single-case research design (SCRD). Studies that fail to demonstrate experimental control may not be published because researchers are unwilling to submit these papers for publication and journals are unlikely to publish negative results (i.e., the file drawer effect). SCRD studies comprise a large proportion of intervention research in special education. Consequently, the existing body of research, comprised mainly of studies that show experimental control, may artificially inflate efficacy of interventions. We discuss how experimental control evolved as the standard for high-quality SCRD; why, in the era of evidence-based practice, rigorous studies that fail to fully demonstrate experimental control are important to include in the body of published intervention research; the role of non-replication studies in discovering intervention boundaries; and considerations for researchers who wish to conduct and appraise studies that fail to yield full experimental control.
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Chan, Kin Wing (Ray), and Andrew Flynn. "Food Production Standards and the Chinese Local State: Exploring New Patterns of Environmental Governance in the Bamboo Shoot Industry in Lin'an." China Quarterly 235 (June 4, 2018): 849–75. http://dx.doi.org/10.1017/s0305741018000802.
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AbstractAlthough current studies into Chinese food supply and quality provide explanations for the causality of food problems, there is limited inquiry into the role of the county government. This is a serious omission for two main reasons: first, because county governments perform a key role in providing support for farmers through agricultural extension services and farmers’ cooperatives, and second, because county-level administrative divisions are central to developing novel instruments to manage supply chain relationships, such as food production standards. We investigate the key players involved in standard making and delivery at the county level. We also analyse how and why the county government engages in standard-setting activities. We use Lin'an's bamboo shoot production industry as a case study to understand how the local state implements “hazard-free,” “green” and “forest food” production standards. The paper concludes that traditional conceptualizations of the local state do not sufficiently address how nature, knowledge of standards and state authority co-produce institutional capacity to control food supply and quality in China. In practice, the local state engages with non-state actors to achieve superficial environmental efforts, such as developing food production standards to throw a “green cloak” over a productivist model.
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Wang, Bin, Junkai Lai, Feifei Jin, Xiwen Liao, Huan Zhu, and Chen Yao. "Clinical Source Data Production and Quality Control in Real-world Studies: Proposal for Development of the eSource Record System." JMIR Research Protocols 11, no. 12 (December 23, 2022): e42754. http://dx.doi.org/10.2196/42754.
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Background An eSource generally includes the direct capture, collection, and storage of electronic data to simplify clinical research. It can improve data quality and patient safety and reduce clinical trial costs. There has been some eSource-related research progress in relatively large projects. However, most of these studies focused on technical explorations to improve interoperability among systems to reuse retrospective data for research. Few studies have explored source data collection and quality control during prospective data collection from a methodological perspective. Objective This study aimed to design a clinical source data collection method that is suitable for real-world studies and meets the data quality standards for clinical research and to improve efficiency when writing electronic medical records (EMRs). Methods On the basis of our group’s previous research experience, TransCelerate BioPharm Inc eSource logical architecture, and relevant regulations and guidelines, we designed a source data collection method and invited relevant stakeholders to optimize it. On the basis of this method, we proposed the eSource record (ESR) system as a solution and invited experts with different roles in the contract research organization company to discuss and design a flowchart for data connection between the ESR and electronic data capture (EDC). Results The ESR method included 5 steps: research project preparation, initial survey collection, in-hospital medical record writing, out-of-hospital follow-up, and electronic case report form (eCRF) traceability. The data connection between the ESR and EDC covered the clinical research process from creating the eCRF to collecting data for the analysis. The intelligent data acquisition function of the ESR will automatically complete the empty eCRF to create an eCRF with values. When the clinical research associate and data manager conduct data verification, they can query the certified copy database through interface traceability and send data queries. The data queries are transmitted to the ESR through the EDC interface. The EDC and EMR systems interoperate through the ESR. The EMR and EDC systems transmit data to the ESR system through the data standards of the Health Level Seven Clinical Document Architecture and the Clinical Data Interchange Standards Consortium operational data model, respectively. When the implemented data standards for a given system are not consistent, the ESR will approach the problem by first automating mappings between standards and then handling extensions or corrections to a given data format through human evaluation. Conclusions The source data collection method proposed in this study will help to realize eSource’s new strategy. The ESR solution is standardized and sustainable. It aims to ensure that research data meet the attributable, legible, contemporaneous, original, accurate, complete, consistent, enduring, and available standards for clinical research data quality and to provide a new model for prospective data collection in real-world studies.
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Xu, M., P. J. van Overloop, N. C. van de Giesen, and G. S. Stelling. "Real-time control of combined surface water quantity and quality: polder flushing." Water Science and Technology 61, no. 4 (February 1, 2010): 869–78. http://dx.doi.org/10.2166/wst.2010.847.
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In open water systems, keeping both water depths and water quality at specified values is critical for maintaining a ‘healthy’ water system. Many systems still require manual operation, at least for water quality management. When applying real-time control, both quantity and quality standards need to be met. In this paper, an artificial polder flushing case is studied. Model Predictive Control (MPC) is developed to control the system. In addition to MPC, a ‘forward estimation’ procedure is used to acquire water quality predictions for the simplified model used in MPC optimization. In order to illustrate the advantages of MPC, classical control [Proportional-Integral control (PI)] has been developed for comparison in the test case. The results show that both algorithms are able to control the polder flushing process, but MPC is more efficient in functionality and control flexibility.
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Indah Komsiyah. "Quality Control Management Of Madrasah Education In International Standard." International Journal of Science, Technology & Management 3, no. 1 (January 16, 2022): 265–74. http://dx.doi.org/10.46729/ijstm.v3i1.328.
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Quality control has to design in educational institutions. The purpose of this study was to determine the concept of quality control of education at the International Standard Madrasah Amanatul Ummah Pacet Mojokerto, East Java. This research is qualitative research with a single case study model. The participants involved are 1) kyai, 2) madrasa heads, 3) vice coordinators of Madrasas, 4) ustadzor teachers in Madrasas, 5) students, and 6) alumni. The data collection process is 1) in-depth interviews; 2) participant observation; and 3) documentation studies. Data analysis data used l) data reduction, 2) data display; and 3) conclusion drawing/verification. The finding shows that the quality control process at the International Standard Madrasah Amanatul Ummah includes, 1) monitoring of activity programs is carried out in a coordinated and responsible manner; 2) a series of evaluations carried out intensely; 3) carry out control of order and program implementation continuously; 4) activity report in written form in the form of reporting and verbally in the form of directions; 5) carry out continuous monitoring. While transcendent control is a form of inherent supervision that is embedded in the religious spirit of each person relying on the Substance of the Almighty Creator. The control of improving the quality of education carried out by the Amanatul Ummah International Standard Madrasah is internal and transcendent control.
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Munro, Jordan, and Graham Grove. "Palliative pain: putting the patient back in control of their analgesia." International Journal of Palliative Nursing 28, no. 5 (May 2, 2022): 232–37. http://dx.doi.org/10.12968/ijpn.2022.28.5.232.
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A common reason for admission to palliative care wards is severe cancer-related pain. The delivery of therapy, an essential component in combating pain, is complicated by boundaries imposed by the law and quality use of medicines standards, which patients do not necessarily face in their own homes. These boundaries significantly delay the time until the patient is relieved of pain. Subcutaneous patient-controlled analgesia (PCA), delivered via a continuous ambulatory drug device, offers a potential method of mitigating these boundaries. This case series describes the experiences of the first four patients treated when subcutaneous PCA was introduced to an Australian palliative care ward and offers comments for consideration for future studies and wider implementation of use. It is noted that although PCA was generally effective overall, considerations about the patient's mental state and pain behaviours should be made before deciding to initiate PCA in lieu of nurse-administered breakthroughs.
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Samoylova, I. G. "Optimization of internal quality control system of health care for children needing rehabilitation after neuroinfections." Bulletin of the Russian Military Medical Academy 20, no. 3 (December 15, 2018): 196–98. http://dx.doi.org/10.17816/brmma12351.
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The results of the implementation of a three-tier system of internal quality control of medical care for children in need of rehabilitation after neuroinfections are presented. In 2015, a three-tier internal control system was developed at the clinic of the Children’s Research and Clinical Center for Infectious Diseases. The importance of introducing a new approach was determined by the severity of the patients at this clinic. The severity of the condition of children is due to the effects of neuroinfections. In addition, the quality of medical care is an essential element of improving the health care system in modern conditions. After the introduction of this system, the number of examinations carried out at the first level (heads of clinical departments) increased, at the second level (deputy chief physician for medical work and quality of medical care) decreased. The number of detected defects increased, but the quality factor of medical care turned out to be quite high and fell into the group of «insignificant deviations». The main defects are defects in filling in medical documentation and redundancy in laboratory and instrumental research. The leading position in the structure of defects is occupied by defects in filling in medical documentation with a specific weight of 32,4%. With the introduction of a new quality control system, the average length of stay of a patient in the rehabilitation department came close to the one prescribed in medical and economic standards. Revealed quite a large percentage of diagnostic studies that are not included in the medical and economic standards, that is, additional. This fact indicates the need to revise the medical and economic standards in the direction of expansion, taking into account the need. The third level of the internal control system is designed to assess the corrective actions taken as a result of audits at the first two levels of the internal control system. In general, the three-tier system has certainly improved the quality of care.
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Feng, Ji Hui. "Principle of WaveSonic Logging Tool and Application." Advanced Materials Research 962-965 (June 2014): 856–59. http://dx.doi.org/10.4028/www.scientific.net/amr.962-965.856.
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The configuration and technical specifications of the new type WaveSonic Logging Tool bought by West Drilling Well Logging Company are introduced from Halliburton Company.It shows that the consistency,repeatability and stability of the tool are good,and its specifications fully meet pre-designed requirements and quality control standards. In this paper, WaveSonic logging principles are briefly introduced, applications case studies to porosity, permeability, and oil and water saturation are discussed in details.
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Sche, Josephine Yu Chen. "The establishment of an e-learning program for the master of library science degree at Southern Connecticut State University – case analysis." International Journal of Humanities and Arts Computing 6, no. 1-2 (March 2012): 211–23. http://dx.doi.org/10.3366/ijhac.2012.0050.
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ALA-accredited programs for Master of Library and Information Studies, are offered only in 63 of the total 3000 colleges and universities in the United States and Canada. The professional goals and objectives of the current 2008 Accreditation Standards are highlighted and applied to both traditional on-campus and the newly created eLearning courses for the MLS/MLIS programs. Factors for establishing the MLS eLearning program at SCSU and the methods for quality control and assessment of the MLS online courses are explained.
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Amrina, Uly, and Helmy Firmansyah. "Analysis of Defect and Quality Improvement for O Ring Product Through Applying DMAIC Methodology." Jurnal PASTI 13, no. 2 (November 22, 2019): 136. http://dx.doi.org/10.22441/pasti.2019.v13i2.003.
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To control the quality of a product to meet standards, a reliable measurable technique is needed with the company's business strategy. This research raises case studies identifying quality problems and effective ways of improvement of O Ring products using DMAIC (Define-Measures-Analyse-Improve-Control) quality control methods. Company X found the problem in the form of an average O Ring product defect ratio reaching 1.50% (the company's target is 1.30%). DMAIC is a systematic methodology that focuses on the key factors that control the performance of a process, set it at the best level and keep it at that level. Statistical tools combined with quality principles are applied to each of the DMAIC phases. In the define phase, flowcharts, critical to quality trees, and voice of customer lists are used which produce five types of defects in curing process. In the measure phase, the sigma value combined with pareto diagram are used and shows that the current sigma value is 4,178 with the biggest defect is flow-mark for the O Ring type ZZ00000123. In phase analysis, the root causes of the problem are searched using the why-why analysis and cause-effect diagrams and finds out that the causes are un-sticky rubber tip and unstandardized rubber cutting length. In the improve phase, DOE-based experiments are conducted to get the ideal rubber tip and cutting length conditions. Finally, the work standard is revised in the control phase and monitored by check sheets and control charts. The result of this DMAIC implementation was the O Ring products defect dropped to 0.83% and the sigma value rose to 4,363.Keywords: quality, DMAIC, O Ring, defect, sigma, standard
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Cuenca-Martínez, Ferran, Eva Zapardiel-Sánchez, Enrique Carrasco-González, Roy La Touche, and Luis Suso-Martí. "Assessing anxiety, depression and quality of life in patients with peripheral facial palsy: a systematic review." PeerJ 8 (December 1, 2020): e10449. http://dx.doi.org/10.7717/peerj.10449.
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Objective Peripheral facial palsy (PFP) is predominantly a unilateral disorder of the facial nerve, which can lead to psychological disorders that can result in decreased quality of life. The aim of this systematic review was to assess anxiety, depression and quality of life symptoms associated with PFP. Data sources We searched the Medline, PEDro, CINAHL and Google Scholar databases to conduct this systematic review while following Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. The search was performed by two independent reviewers, and differences between the two reviewers were resolved by consensus. Study Selection The search terms used were derived from the combination of the following MeSH terms: “facial paralysis”, “bell palsy”, “anxiety”, “anxiety disorders”, “depression”, “depressive disorders”, “quality of life” and not MeSH: “facial palsy”, “hemifacial paralysis”, “facial paresis”, “Peripheral Facial Paralysis”, using the combination of different Boolean operators (AND/OR). Data Extraction On November 1st (2019). Data Synthesis In total, 18 cross-sectional articles and two case-control studies were selected. Conclusions The cross-sectional articles showed low methodological quality, while the case-control studies showed acceptable methodological quality. Limited evidence suggests that patients with PFP might have increased levels of anxiety and depressive symptoms. A qualitative analysis also showed limited evidence that quality of life might be diminished in patients with PFP. PROSPERO CRD42020159843.
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He, Jia-Jun, Shu-Shu Zhao, Hui Zhang, Xia-Ying Liu, Qin Li, and Wen-Xuan Fu. "Emergency Management of Medical Wastewater in Hospitals Specializing in Infectious Diseases: A Case Study of Huoshenshan Hospital, Wuhan, China." International Journal of Environmental Research and Public Health 19, no. 1 (December 30, 2021): 381. http://dx.doi.org/10.3390/ijerph19010381.
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Medical wastewater originating from hospitals specializing in infectious diseases pose a major risk to human and environmental health during pandemics. However, there have been few systematic studies on the management of this type of wastewater management. The function of the Huoshenshan Hospital as a designated emergency field hospital for the treatment of COVID-19 has provided lessons for the management measures of medical wastewater, mainly including: (1) Modern information technology, management schemes, and related standard systems provided the legislative foundation for emergency management of medical wastewater. (2) The three-tier prevention and control medical wastewater management system ensured the discharged wastewater met water quality standards, especially for the leak-proof sealed collection system of the first tier, and the biological and chemical treatment technology of the second tier. (3) The establishment of an effective three-tier medical wastewater quality monitoring accountability system. This system was particularly relevant for ensuring continuous data monitoring and dynamic analysis of characteristic indicators. (4) Information disclosure by government and public supervision promoted successful implementation of medical wastewater management and control measures. Public questionnaires (n = 212) further confirmed the effectiveness of information disclosure. The results of this study can act as methodological reference for the emergency management of wastewater in designated infectious disease hospitals under similar situations.
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Buffoni, Lena, Lennart Ochel, Adrian Pop, Peter Fritzson, Niklas Fors, Görel Hedin, Walid Taha, and Martin Sjölund. "Open Source Languages and Methods for Cyber-Physical System Development: Overview and Case Studies." Electronics 10, no. 8 (April 10, 2021): 902. http://dx.doi.org/10.3390/electronics10080902.
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Industrial cyber-physical system products interleave hardware, software, and communication components. System complexity is increasing simultaneously with increased demands on quality and shortened time-to-market. To effectively support the development of such systems, we present languages and tools for comprehensive integrated model-based development that cover major phases such as requirement analysis, design, implementation, and maintenance. The model-based approach raises the level of abstraction and allows to perform virtual prototyping by simulating and optimizing system models before building physical products. Moreover, open standards and open source implementations enable model portability, tool reuse and a broader deployment. In this paper we present a general overview of the available solutions with focus on Modelica/OpenModelica, Bloqqi, and Acumen. The paper presents contributions to these languages and environments, including symbolic-numeric modeling, requirement verification, code generation, model debugging, design optimization, graphical modeling, and variant handling with traceability, as well a general discussion and conclusions.
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Beyea, M. M., B. W. Tillmann, A. E. Lansavichene, V. Randhawa, K. Van Aarsen, and A. Nagpal. "LO68: Extracorporeal membrane oxygenation in the emergency department for resuscitation of out-of-hospital cardiac arrest patients: a systematic review." CJEM 19, S1 (May 2017): S51. http://dx.doi.org/10.1017/cem.2017.130.
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Introduction: With one person in Canada suffering an out-of-hospital cardiac arrest (OHCA) every 12 minutes and an estimated survival to hospital discharge with good neurologic function ranging from 3 to 16%, OHCA represents a major source of morbidity and mortality. An evolving adjunct for resuscitation of OHCA patients is the use of extracorporeal membrane oxygenation-assisted CPR (ECPR). The purpose of this systematic review is to investigate the survival to hospital discharge with good neurologic recovery in patients suffering from OHCA treated with ECPR compared to those who received standard advanced cardiac life support with conventional CPR (CCPR) alone. Methods: A systematic database search of both MEDLINE & EMBASE was performed up until September 2016 to identify studies with ≥5 patients reporting ECPR use in adults (age ≥16 years) with OHCA. Only studies reporting survival to hospital discharge were included. All identified studies were assessed independently using pre-determined inclusion criteria by two reviewers. Study quality and risk of bias were evaluated using the Newcastle Ottawa regulations assessment scale. Results: Of the 1065 records identified, 54 studies met all inclusion criteria. Inter-rater reliability was high with a kappa statistic of 0.85. The majority of studies were comprised of case series (n=45) of ECPR with 5 to 83 patients/study. Out of the 45 case series, 37 presented neurologic data at hospital discharge and demonstrated a broad range of patients surviving with good neurologic outcome (0 to 71.4%). Only 9 cohort studies with relevant control group (CCPR) were identified (38 to 21750 patients/study). Preliminary analysis demonstrated that 6 cohort studies were sufficient quality to compare ECPR to CCPR. All 6 studies showed significantly increased survival to hospital discharge with good neurologic recovery (ECPR 10.6 to 41.6% vs CCPR 1.5 to 7.7%, respectively). Conclusion: Given the paucity of studies using appropriate comparators to evaluate the impact of ECMO, our confidence in a clinically relevant difference in outcomes compared to current standards of care for OHCA remains weak. Interestingly, a limited number of studies with suitable controls demonstrated a potential benefit associated with ECPR in the management of OHCA in selected patients. In this state of equipoise, high quality RCT data is urgently needed.
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Marlina, Siti, Novrika Silalahi, Septa Dwi Insani, Herri Novita Tarigan, and Friska Ernita Sitorus. "HUBUNGAN STATUS AKREDITASI PUSKESMAS DENGAN MUTU PELAYANAN DI KABUPATEN SIMALUNGUN." Jurnal Penelitian Keperawatan Medik 2, no. 2 (April 30, 2020): 45–53. http://dx.doi.org/10.36656/jpkm.v2i2.239.
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Puskesmas is a health service facility that organizes public health efforts and first-level individual health efforts, with greater emphasis on promotive and preventive efforts, to achieve the highest level of public health in the working area. Puskesmas Accreditation is an acknowledgment given by an independent Accreditation provider established by the Minister after meeting Accreditation standards. The purpose of this study was to determine the relationship between Puskesmas Accreditation Status and Service Quality in Simalungun District. This type of research is analytic to determine the relationship between Puskesmas Accreditation Status and Service Quality in Simalungun District. This study uses a case control study approach (case and control), where independent variables are determined first, then the dependent variable is searched through a questionnaire that has been tested. A sample of 92 people, 46 were sampled for cases (Puskesmas Tiga Dolok) and 46 for controls (puskesmas Huta Bayu) using consecutive sampling techniques. Based on the results of bivariate test studies, that the dimensions of service quality related to the health center accreditation status (p <0.05) are tangibles, reliability, responsiveness, and assurance dimensions. Factors that are not related to the health center accreditation status (p> 0.05) are empathy dimensions. From the multivariate test results, it is known that the most dominant factor on the status of puskesmas accreditation is the quality of service based on the dimensions of responsiveness.
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Marshall, Ashley N., and Kenneth C. Lam. "Research at the Point of Care: Using Electronic Medical Record Systems to Generate Clinically Meaningful Evidence." Journal of Athletic Training 55, no. 2 (February 1, 2020): 205–12. http://dx.doi.org/10.4085/1062-6050-113-19.
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Context Health care leaders have recommended the use of health information technology to improve the quality of patient care. In athletic training, using informatics, such as electronic medical records (EMRs), would support practice-based decisions about patient care. However, athletic trainers (ATs) may lack the knowledge to effectively participate in point-of-care clinical research using EMRs. Objectives To discuss the role of EMRs in athletic training and identify methodologic approaches to conducting clinical research at the point of care. Description The 2020 Commission on Accreditation of Athletic Training Education curricular content standards included the use of an electronic patient record to document care, mitigate error, and support decision making through the collection and use of patient data (Standard 64). Patient data are collected by ATs at the point of care via routine documentation, and these data can be used to answer clinical questions about their practice. Observational or descriptive study designs are ideal for this type of data. Observational research (ie, case-control, cross-sectional, cohort studies) evaluates factors that influence patients' lives in the “real world,” whereas descriptive research (ie, case study or series, descriptive epidemiology studies) identifies characteristics of individuals and groups. If ATs are comprehensively documenting patient care using an EMR, they have the means to participate in observational and descriptive research. Clinical and Research Advantages Using an EMR to its full capacity allows ATs to collect meaningful data at the point of care, conduct practice-based research, and improve health care for the patient and clinician. However, to ensure data quality, these approaches must include routine and comprehensive documentation habits.
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Adams, Emily R., Inge Versteeg, and Mariska M. G. Leeflang. "Systematic Review into Diagnostics for Post-Kala-Azar Dermal Leishmaniasis (PKDL)." Journal of Tropical Medicine 2013 (2013): 1–8. http://dx.doi.org/10.1155/2013/150746.
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Identification of post-kala-azar dermal leishmaniasis (PKDL) is important due to the long and toxic treatment and the fact that PKDL patients may serve as a reservoir for visceral leishmaniasis (VL). We summarized the published literature about the accuracy of diagnostic tests for PKDL. We searched Medline for eligible studies investigating the diagnostic accuracy of any test for PKDL. Study quality was assessed using QUADAS-2. Data were extracted from 21 articles including 43 separate studies. Twenty-seven studies evaluated serological tests (rK39 dipstick, ELISA, DAT, and leishmanin tests), six studies molecular tests, eight microscopy, and two cultures. Only a few of these studies reported a valid estimate of diagnostic accuracy, as most were case-control designs or used a reference standard with low sensitivity. The included studies were very heterogeneous, for example, due to a large variety of reference standards used. Hence, no summary estimates of sensitivity or specificity could be made. We recommend well-designed diagnostic accuracy trials that evaluate, side-by-side, all currently available diagnostics, including clinical symptoms, serological, antigen, molecular, and parasitological tests and possible use of statistical modelling to evaluate diagnostics when there is no suitable gold standard.
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Vesali, Farzad, Habibollah Molatefi, Mohammad A. Rezvani, Bijan Moaveni, and Markus Hecht. "New control approaches to improve contact quality in the conventional spans and overlap section in a high-speed catenary system." Proceedings of the Institution of Mechanical Engineers, Part F: Journal of Rail and Rapid Transit 233, no. 9 (January 10, 2019): 988–99. http://dx.doi.org/10.1177/0954409718822861.
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Continuous and quality contact between the pantograph and the catenary system is one of the major challenges for increasing the speed of electric trains. Compared to other studies, this paper has considered the catenary system as the main system and has assumed the pantograph as an excitation factor. Based on this, a controller has been applied on the contact wire, once at the last span and another time near the contact point of the pantograph. Results were compared with the conventional controllers that exert control force on a collector's head. Based on this, two different objectives were considered for the controller including ‘improvement of contact quality’ and ‘minimisation of the vertical velocity of the overlap point’. For this purpose, a full analytical model of the catenary system was presented and was verified using the relevant standards, and then three types of linear quadratic optimal controllers were added to the model with the two objectives mentioned above. The results of the study show that if the model aims to reduce the overlap point vertical velocity, contact quality will be improved. However, in case it aims to enhance contact quality, the velocity of the overlap point will not necessarily be reduced. Moreover, the contact point controller aiming at reducing the overlap point velocity outperforms other controllers and makes 71% improvement in contact quality in comparison with the no-controller case.
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Alwi, Alwi, M. Rimawan, and Aliah Pratiwi. "ANALISIS PENERAPAN STANDAR AKUNTANSI DAN SISTIM PENGENDALIAN INTERNAL TERHADAP KUALITAS LAPORAN KEUANGAN." INVOICE : JURNAL ILMU AKUNTANSI 2, no. 2 (September 28, 2020): 79–89. http://dx.doi.org/10.26618/inv.v2i2.4112.
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This study aims to analyze the effect of the adoption of Government Accounting Standards and Internal Control Systems on the Quality of Financial Statements of case studies conducted at the Regional Government Work Unit in Bima City Government. The research instrument used was a questionnaire with a Likert scale. The population and sample in this study is the Regional Work Unit as an accounting entity in the Bima City government area. The sampling method in this study uses a purposive sampling method with the Quota Sampling approach with each SKPD there are 3 respondents sampled namely the Head of Finance, Section Head as reviewer of the financial statements that have been prepared and Accounting Section Staff in charge of directly compiling financial statements. Data analysis techniques used in this study are the Validity Test, Reliability Test, Classical Assumption Test (Normality, Multicollinearity, Autokoerlasi) and Hypothesis Test with Multiple Linear Regression Test. The results of the analysis conducted in this study indicate that there is a positive influence on the application of Government Accounting Standards and Internal Control Systems to the Quality of Financial Statements in the Regional Government Work Unit of the City of Bima.
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Nolen, Sharon L., and W. Fred Dimmick. "Epa's Control Technology Approach to Assisting States and Regions with Air Toxics Problems: Five Case Studies." Toxicology and Industrial Health 6, no. 5 (October 1990): 257–67. http://dx.doi.org/10.1177/074823379000600520.
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The Environmental Protection Agency (EPA) announced in June 1985 a new strategy to reduce public exposure to toxic air pollutants in the ambient air. Over the next 5–8 years, the strategy called for State and Local authorities to take on more of the lead regulatory role, with the Agency providing technical and financial assistance to their efforts. The shift in emphasis and responsibility from the Federal level to State and Local air toxics programs and the need to transfer expertise from the Federal level to the appropriate State or Local level prompted EPA's Office of Research and Development (ORD) and EPA's Office of Air Quality Planning and Standards (OAQPS) to develop and implement an innovative technical assistance program. This program is called the Control Technology Center (CTC). It has since been expanded to include technical assistance in the area of control of air toxics, particulate matter, and volatile organic compounds (VOCs); emission measurements; and other areas where expertise is available to ORD and OAQPS. During the CTC's first year of operation, operating guidelines were developed and three categories of technical assistance were established. These categories are telephone HOTLINE calls, direct engineering assistance, and technical guidance projects. The CTC HOTLINE is a special telephone number which State and Local Agencies can call for easy access to EPA personnel who can provide prompt assistance in a variety of ways including discussions, references to pertinent literature, and referrals to other EPA personnel. In some cases, a HOTLINE call will require more in-depth engineering analysis indicating a need for direct engineering assistance. These projects tend to be short-term (2 to 3 months) and specific in nature. In some cases, several agencies may indicate a need for information on the same source, or a group of Agencies may make a joint request. In these cases, the CTC Steering Committee, a group who advises the CTC managers, may decide that a technical guidance project is indicated. Technical guidance projects are longer-term and are intended to be of broad interest, useful to many agencies. This paper discusses the development of the CTC, experience to date with its operation, and future plans. In addition, five CTC projects are discussed to illustrate the assistance provided.
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Nguyen, Thanh Cong. "Research to Evaluate the Quality of Passenger Bus Body Frame, Assuring the Passive Safety in the Design Process." Applied Mechanics and Materials 889 (March 2019): 440–47. http://dx.doi.org/10.4028/www.scientific.net/amm.889.440.
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At present, we are aiming to improve the localization rate and cost reduction in Vietnam, the bus manufacturing units have made their own chassis on the basis of appropriate selection. Passenger bus body frame design is an important process to ensure the suitability and quality of the product before the manufacturing. According to the governmental regulations, the vehicle manufacturing sector in Vietnam must comply with a design approval process and type approval test. Designs must be approved by the competent authority prior to the commencement of manufacturing. There are some applicable regulations in Vietnam such as the standard QCVN 09:2015/BGTVT and QCVN 10:2015/BGTVT on the standards for passenger buses to ensure technical safety and environmental protection. However, there is no specific regulation on the evaluation of bus durability to ensure the passive safety of such vehicles. During the design process, it is possible to calculate the durability accurately that determines the quality of the passenger bus body frame. It could enable automobile manufacturers as well as the competent authorities of design quality approval to control the bus body frame quality, resulting in the improvment of the pruduct, the competitiveness of the product and reducing the production cost. This presentation is the result of structural studies which calculated the deformation of the passenger bus body frame in frontal crash in accordance with the standard ECE R33 and the case of flipping in accordance with the standard ECE R66 for the 46-seat passenger bus, manufactured in Vietnam by Ansys/LS-Dyna software. Accordingly, this evaluation was implemented to assess the quality of the passenger bus body frame in the design process. The result shows that the passenger bus body frame meets the requirement of durability and passive safety in accordance with the calculated standards.
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Papastamatiou, D., N. Skarpelis, and A. Argyraki. "AIR QUALITY IN MINING AREAS: THE CASE OF STRATONI, CHALKIDIKI, GREECE." Bulletin of the Geological Society of Greece 43, no. 5 (July 31, 2017): 2510. http://dx.doi.org/10.12681/bgsg.11657.
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Air quality sampling tests are conducted on a 24h basis by “HELLENIC GOLD S.A.” in the Stratoni mining settlement. The settlement is located in the neighbourhood of a flotation plant where galena and sphalerite concentrates are produced after crushing and processing of Pb-Ag-Zn sulfide ore. Old piles of mineral waste occur close to the settlement. The mineralogy of mineral dust collected on filters of 3 air samplers from August to December 2008 was studied. Elemental analysis of mineral dust collected from January to December 2008 was conducted. The purpose of the study was to determine levels of air pollution, type of mineral particles as well as potential sources. Measurements of air quality included PM10. Statistical analysis of the collected data included tests to determine the control on daily particle concentration and mineralogy of fluctuations of temperature, humidity, wind direction and wind speed. Air quality was better than during 1998-2000. Air quality was typically at its worse during hot summer days when wind speed was high. The concentration of PM10 particulate matter was quite low when compared to International Air Quality Standards regulations, indicating that levels of air pollution in the area do not pose human health hazards.
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CISSE, Mody, Ousmane DEMBELE, Nah TRAORE, Seydou Moussa COULIBALY, B. Moussa CISSE, Niélé Ousmane TRAORE, Niaboula DEMBELE, et al. "Analysis of the Physico-Chemical Conformity of Antibiotics: Case of Amoxicillin 500 mg Capsule at the National Health Laboratory Distributed in Health Structures in Mali." Journal of Drug Delivery and Therapeutics 12, no. 5-S (October 15, 2022): 100–105. http://dx.doi.org/10.22270/jddt.v12i5-s.5641.
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Introduction: Amoxicillin belongs to the family of β-lactams and is one of the mostly used in hospitals for the management of bacterial infections especially in Mali. It has a broad spectrum of activity from the group of aminopenicillins or aminobenzylpenicillins (group A penicillins). Microbiological and physico-chemical control has evolved with the development of biotechnology. All bacterial species or germs are affected by the phenomenon of resistance to antibacterials, which often poses real therapeutic problems. Based on previous studies in Mali, amoxicillin is still recommended in pharmacies and university hospitals to treat bacterial infections. It sometimes happens that patients are not satisfied with this amoxicillin-based prescription in our teaching hospitals. The objective of this study was to control the physico-chemical quality of amoxicillin 500 mg in capsule form.
Methodology: This is a physico-chemical study of amoxicillin capsules dosed at 500 mg received at the National Health Laboratory in Bamako. We analyzed 10 batches of five (5) boxes (10 platelets/box) of amoxicillin. We used either HPLC, or TLC or Dissolu-test to control the quality of amoxicillin capsules for the presence of the active principle and to ensure fake amoxicillin capsules were not distributed. We used as reference, the standards contained in the pharmacopoeias in use.
Results: The results of the physicochemical tests revealed that the samples analyzed complied with the standards of the Pharmacopoeias in use: The weight of our capsules was between 0.5g and 0.6g. All the tested samples were compliant with a disintegration time of 15 minutes at 37°C ±2°C. The peaks of standard amoxicillin and that of the tested samples appeared at substantially equal retention times, i.e. at 3.249 min and 3.248 min. respectively.
Conclusion: Our work aimed to assess the quality of antibiotics used in Mali with the analytical means available at the LNS. All the batches of amoxicillin analyzed have not presented any cases of non-compliance so they can be distributed in health structures. This type of study should be extended to the other pharmaceutical forms of amoxicillin in the form of powders to be reconstituted dispensed in health centers in Mali.
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Pereira, Luísa Gomes, Paulo Fernandez, Sandra Mourato, Jorge Matos, Cedric Mayer, and Fábio Marques. "Quality Control of Outsourced LiDAR Data Acquired with a UAV: A Case Study." Remote Sensing 13, no. 3 (January 26, 2021): 419. http://dx.doi.org/10.3390/rs13030419.
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Over the last few decades, we witnessed a revolution in acquiring very high resolution and accurate geo-information. One of the reasons was the advances in photonics and LiDAR, which had a remarkable impact in applications requiring information with high accuracy and/or elevated completeness, such as flood modelling, forestry, construction, and mining. Also, miniaturization within electronics played an important role as it allowed smaller and lighter aerial cameras and LiDAR systems to be carried by unmanned aerial vehicles (UAV). While the use of aerial imagery acquired with UAV is becoming a standard procedure in geo-information extraction for several applications, the use of LiDAR for this purpose is still in its infancy. In several countries, companies have started to commercialize products derived from LiDAR data acquired using a UAV but not always with the necessary expertise and experience. The LIDAR-derived products’ price has become very attractive, but their quality must meet the contracted specifications. Few studies have reported on the quality of outsourced LiDAR data acquired with UAV and the problems that need to be handled during production. There can be significant differences between the planning and execution of a commercial project and a research field campaign, particularly concerning the size of the surveyed area, the volume of the acquired data, and the strip processing. This work addresses the quality control of LiDAR UAV data through outsourcing to develop a modelling-based flood forecast and alert system. The contracted company used the Phoenix Scout-16 from Phoenix LiDAR Systems, carrying a Velodyne VLP-16 and mounted on a DJI Matrice 600 PRO Hexacopter for an area of 560 ha along a flood-prone area of the Águeda River in Central Portugal.
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Brando, Sabrina, and Jon Coe. "Confronting Back-of-House Traditions: Primates as a Case Study." Journal of Zoological and Botanical Gardens 3, no. 3 (July 26, 2022): 366–97. http://dx.doi.org/10.3390/jzbg3030029.
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This review commentary focuses on traditional management practices and facility design with suggested improvements in non-public primate management areas, often called “back-of-house”, (henceforth BOH) in zoos, sanctuaries, and research facilities. Progress has been made toward improving animal quality of life in larger, more naturalistic, and enriched indoor and outdoor display areas. However, the quality of life in BOH areas has improved little in comparison. Basic management, regulatory, structural, and spatial BOH environments are lagging, especially in the developing world, and animals may be confined in less enriching spaces for substantial periods of the 24 h day. We reviewed traditional management policy and practice, as well as newer training, enrichment, and welfare policies and actions, and suggested alternatives for structural environments and spatial environments. The suggestions included using more animal-friendly construction materials and animal–computer interaction, providing greater control of the ambient environment and choice of access to multiple areas by the animals themselves, and designing for optimal animal wellbeing at all times, including when caregivers are no longer present. Case studies focused on primates were included. We concluded by suggesting a new, integrated design model based not upon rote standards and old models but building on empirical foundations while embracing empathy and innovation.
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Hughes, John G., George Lewith, Hugh MacPherson, Claudia M. Witt, Mike Cummings, and Peter Fisher. "Assessment of the quality of reporting in studies of acupuncture for patients with cancer using the STRICTA guidelines." Acupuncture in Medicine 37, no. 4 (June 12, 2019): 223–27. http://dx.doi.org/10.1136/acupmed-2017-011592.
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Introduction: There has been a burgeoning of research evaluating acupuncture for various symptoms of cancer and the side-effects associated with its treatment. A systematic review was conducted to examine the quality of reporting in published studies of acupuncture in cancer according to the STRICTA (STandards for Reporting Interventions in Clinical Trials of Acupuncture) guidelines. Methods: Systematic review of published research of acupuncture for symptoms of cancer and the side-effects associated with its treatment. Databases searched were: Medline, CINAHL, Cochrane (all databases), Scopus, and PubMed from their inception to December 2014. Clinical trials, pilot/feasibility studies, observational studies, and case studies were included. Only full journal papers published in English were included. The quality of reporting was evaluated using STRICTA guidelines. Each included paper was assessed by two independent reviewers, with disagreements adjudicated by a third reviewer. Results: 88 papers were identified which met the inclusion criteria. The median number of STRICTA items reported in trials with a control or comparator arm (n=47) was 14 out of 17 (range 8 to 17, IQR 4). For studies without a control or comparator arm the median was 11 out of a possible 15 (range 5 to 15, IQR 3). Key weaknesses in reporting included details of other components of treatments, and details of the acupuncturist administering treatments. Conclusions: Despite the widespread use of the STRICTA guidelines in acupuncture research, adherence remains poor for a few specific items. Further research is required to explore the reasons why authors fail to report those items, and to develop strategies to improve the adherence to the guidelines.
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Chen, Yan-Jiao, Gabriel Shimizu Bassi, and Yong-Qing Yang. "Classic Chinese Acupuncture versus Different Types of Control Groups for the Treatment of Chronic Pain: Review of Randomized Controlled Trials (2000–2018)." Evidence-Based Complementary and Alternative Medicine 2019 (December 4, 2019): 1–15. http://dx.doi.org/10.1155/2019/6283912.
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Objective. To review the effectiveness of classic Chinese acupuncture in the treatment of chronic pain by comparing treatment groups with different types of control groups in accordance with the newly published guidelines for systematic reviews. Methods. We searched EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials databases from 2000 to 2018. We included randomized controlled trials that included acupuncture as the sole treatment or as an adjunctive treatment for chronic pain. The outcome was pain intensity measured by the visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale, 11-point numeric rating scale (NRS), and other tools. Two researchers conducted the study selection, data extraction, and quality assessment processes independently. Disagreements were solved by discussion and reanalysis of the data. The quality of all included studies was evaluated using the CBNG (the Cochrane Back and Neck Group) and the STRICTA (Standards for Reporting Interventions in Controlled Trials of Acupuncture) checklists. Results. Sixty-one studies were fully analyzed and ranked based on the newest STRICTA and CBNG standards. We found good evidence that receiving acupuncture is better than not receiving treatment or being placed on a waiting list and reasonable evidence that it is better than conventional or usual care. Limited evidence was found regarding placebo treatments that involve the expectation of needling (real or fake). Conclusion. Sham acupuncture may not be appropriate as a control intervention for assessing the effectiveness of acupuncture. Acupuncture effectiveness in controlling chronic pain is still limited due to the low quality of the studies published.
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Frimodt-Møller, Katrine Emilie, Jens Richardt Møllegaard Jepsen, Ulla Feldt-Rasmussen, and Jesper Krogh. "Hippocampal Volume, Cognitive Functions, Depression, Anxiety, and Quality of Life in Patients With Cushing Syndrome." Journal of Clinical Endocrinology & Metabolism 104, no. 10 (June 19, 2019): 4563–77. http://dx.doi.org/10.1210/jc.2019-00749.
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Abstract Context Cushing syndrome (CS) is associated with hippocampal atrophy and psychopathology. Objective The primary objective of this systematic review was to assess hippocampal volume (HV) in patients with CS. The secondary objectives were to assess patients’ cognitive functioning, depressive and anxiety symptoms, and quality of life. Data Sources PubMed, Embase, Cochrane, LILACs, and Scopus databases were searched for relevant studies until 1 May 2019. Study Selection Case-control studies comparing patients with CS with healthy control subjects, or studies assessing patients with CS before and after surgery were included. The initial search resulted in 18 studies fulfilling the inclusion criteria. Data Extraction Data extraction regarding all outcomes was performed independently by two reviewers. Quality assessment was assessed with the Newcastle-Ottawa Scale for case-control studies. Data Synthesis Meta-analysis was performed using a random effect model. The right-side HV in patients with CS was reduced by a standard mean difference of 0.68 (95% CI, −1.12 to −0.24; P = 0.002; I2 = 0%) compared with healthy control subjects, but with no increase in HV after surgery. Patients had more depressive symptoms, impaired cognitive functions, and reduced health-related QoL (HRQoL), which all responded favorably to surgery. The data did not support the presence of anxiety in patients with CS. Conclusion An overall reduction of HV in patients with CS was not suggested by the study findings. However, most cognitive domains were significantly affected and responded favorably to surgery. Depressive symptoms and reduced HRQoL were present in patients with CS and improved after surgery.
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Parvin, C. A. "New insight into the comparative power of quality-control rules that use control observations within a single analytical run." Clinical Chemistry 39, no. 3 (March 1, 1993): 440–47. http://dx.doi.org/10.1093/clinchem/39.3.440.
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Abstract The error detection characteristics of quality-control (QC) rules that use control observations within a single analytical run are investigated. Unlike the evaluation of QC rules that span multiple analytical runs, most of the fundamental results regarding the performance of QC rules applied within a single analytical run can be obtained from statistical theory, without the need for simulation studies. The case of two control observations per run is investigated for ease of graphical display, but the conclusions can be extended to more than two control observations per run. Results are summarized in a graphical format that offers many interesting insights into the relations among the various QC rules. The graphs provide heuristic support to the theoretical conclusions that no QC rule is best under all error conditions, but the multirule that combines the mean rule and a within-run standard deviation rule offers an attractive compromise.
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Drevno, Ann. "Policy tools for agricultural nonpoint source water pollution control in the U.S. and E.U." Management of Environmental Quality: An International Journal 27, no. 2 (March 14, 2016): 106–23. http://dx.doi.org/10.1108/meq-12-2014-0177.
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Purpose – In the USA and Europe, agricultural nonpoint source (NPS) pollution continues to be among the chief impediments to achieving water quality standards. While the implementation of technology-based water pollution control tools has resulted in evident point source pollution abatement, NPSs continue to threaten surface water and groundwater. The purpose of this paper is to draw from environmental policy literature to identify regulatory tools and management approaches that specifically target agricultural NPS pollution and the factors that drive or impede their implementation and enforcement. This paper utilizes the policy tool framework to help characterize the widespread policy problem, distinguishing its unique set of hurdles from other environmental problems. Design/methodology/approach – Discussion of agricultural NPS pollution management approaches is based on a thorough review of relevant environmental policy and environmental economic literature as well as case studies from the USA and Europe. Analysis is based on the policy tool framework. Findings – This study finds that controlling numerous diffuse sources of agricultural pollution requires an integrated approach that utilizes river basin management and a mix of policy instruments. Additionally, findings suggest that transitioning from voluntary mechanisms to more effective instruments based on measurable water quality performance relies predominantly on three factors: first, more robust quality monitoring data and models; second, local participation; and third, political will. Originality/value – This research provides important information for regional and national policymakers in areas where there is increasing pollution and regulatory mandates. Identifying conditions of effective water quality policy is applicable and will be of direct use to agencies charged with pollution control.
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Krajcsák, Zoltán. "Successes of quality management systems through self-evaluation and commitment in different organizational cultures." Management Decision 56, no. 7 (July 9, 2018): 1467–84. http://dx.doi.org/10.1108/md-09-2017-0870.
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Purpose The purpose of this paper is to create a theoretical framework that shows how the specialties of the organizational culture relate to the success of quality management systems’ (QMSs) application. In addition to these variables, the dependent variables of employees’ self-evaluation and some dimensions of commitment are also analyzed. Design/methodology/approach Unsuccessful organizational implementations of ISO 9000, total quality management (TQM) and Six Sigma are presented in case studies. These conclusions are utilized to retrieve individual and organizational barriers to the variables considered in each culture. Findings The characteristics of adhocracy determine self-efficacy and professional commitment. Through high levels of these variables, Six Sigma can be suggested for adhocracies. The clan culture is characterized by a high level of affective commitment and self-esteem, which support the TQM together with the internal focus dimension of the culture. The market culture is characterized by a high level of continuance commitment and neuroticism, which support ISO 9000 standards together with the control dimension of the culture. Research limitations/implications The limitation of the findings comes from the small sample size. The model presented is partly based on case studies; therefore, further research studies need to support or refute it. Practical implications In the practical use of the results, QMSs can be selected more targeted, reducing the risk of failing quality improvement strategies. Social implications Increasing and aligning quality and commitment in organizations supports the strengthening of individual and social well-being. Originality/value The study attempts to determine the most appropriate QMSs for organizational cultures in a complex way by analyzing the relationships between multiple organizational and individual variables.
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Hategeka, Celestin, Hinda Ruton, Mohammad Karamouzian, Larry D. Lynd, and Michael R. Law. "Use of interrupted time series methods in the evaluation of health system quality improvement interventions: a methodological systematic review." BMJ Global Health 5, no. 10 (October 2020): e003567. http://dx.doi.org/10.1136/bmjgh-2020-003567.
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BackgroundWhen randomisation is not possible, interrupted time series (ITS) design has increasingly been advocated as a more robust design to evaluating health system quality improvement (QI) interventions given its ability to control for common biases in healthcare QI. However, there is a potential risk of producing misleading results when this rather robust design is not used appropriately. We performed a methodological systematic review of the literature to investigate the extent to which the use of ITS has followed best practice standards and recommendations in the evaluation of QI interventions.MethodsWe searched multiple databases from inception to June 2018 to identify QI intervention studies that were evaluated using ITS. There was no restriction on date, language and participants. Data were synthesised narratively using appropriate descriptive statistics. The risk of bias for ITS studies was assessed using the Cochrane Effective Practice and Organisation of Care standard criteria. The systematic review protocol was registered in PROSPERO (registration number: CRD42018094427).ResultsOf 4061 potential studies and 2028 unique records screened for inclusion, 120 eligible studies assessed eight QI strategies and were from 25 countries. Most studies were published since 2010 (86.7%), reported data using monthly interval (71.4%), used ITS without a control (81%) and modelled data using segmented regression (62.5%). Autocorrelation was considered in 55% of studies, seasonality in 20.8% and non-stationarity in 8.3%. Only 49.2% of studies specified the ITS impact model. The risk of bias was high or very high in 72.5% of included studies and did not change significantly over time.ConclusionsThe use of ITS in the evaluation of health system QI interventions has increased considerably over the past decade. However, variations in methodological considerations and reporting of ITS in QI remain a concern, warranting a need to develop and reinforce formal reporting guidelines to improve its application in the evaluation of health system QI interventions.
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Leung, Alexander A., Christopher J. Symonds, Gregory L. Hundemer, Paul E. Ronksley, Diane L. Lorenzetti, Janice L. Pasieka, Adrian Harvey, and Gregory A. Kline. "Performance of Confirmatory Tests for Diagnosing Primary Aldosteronism: a Systematic Review and Meta-Analysis." Hypertension 79, no. 8 (August 2022): 1835–44. http://dx.doi.org/10.1161/hypertensionaha.122.19377.
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Background: Confirmatory tests are recommended for diagnosing primary aldosteronism, but the supporting evidence is unclear. Methods: We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials. Studies evaluating any guideline-recommended confirmatory test (ie, saline infusion test, salt loading test, fludrocortisone suppression test, and captopril challenge test), compared with a reference standard were included. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the risk of bias. Meta-analyses were conducted using hierarchical summary receiver operating characteristic models. Results: Fifty-five studies were included, comprising 26 studies (3654 participants) for the recumbent saline infusion test, 4 studies (633 participants) for the seated saline infusion test, 2 studies (99 participants) for the salt loading test, 7 studies (386 participants) for the fludrocortisone suppression test, and 25 studies (2585 participants) for the captopril challenge test. Risk of bias was high, affecting more than half of studies, and across all domains. Studies with case-control sampling overestimated accuracy by 7-fold (relative diagnostic odds ratio, 7.26 [95% CI, 2.46–21.43]) and partial verification or use of inconsistent reference standards overestimated accuracy by 5-fold (5.12 [95% CI, 1.48–17.77]). There were large variations in how confirmatory tests were conducted, interpreted, and verified. Under most scenarios, confirmatory testing resulted in an excess of missed cases. The certainty of evidence underlying each test (Grading of Recommendations, Assessment, Development, and Evaluations) was very low. Conclusions: Recommendations for confirmatory testing in patients with abnormal screening tests and high probability features of primary aldosteronism are based on very low-quality evidence and their routine use should be reconsidered.
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Laesser, Céline Isabelle, Paul Cumming, Emilie Reber, Zeno Stanga, Taulant Muka, and Lia Bally. "Management of Glucose Control in Noncritically Ill, Hospitalized Patients Receiving Parenteral and/or Enteral Nutrition: A Systematic Review." Journal of Clinical Medicine 8, no. 7 (June 28, 2019): 935. http://dx.doi.org/10.3390/jcm8070935.
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Hyperglycemia is a common occurrence in hospitalized patients receiving parenteral and/or enteral nutrition. Although there are several approaches to manage hyperglycemia, there is no consensus on the best practice. We systematically searched PubMed, Embase, Cochrane Central, and ClinicalTrials.gov to identify records (published or registered between April 1999 and April 2019) investigating strategies to manage glucose control in adults receiving parenteral and/or enteral nutrition whilst hospitalized in noncritical care units. A total of 15 completed studies comprising 1170 patients were identified, of which 11 were clinical trials and four observational studies. Diabetes management strategies entailed adaptations of nutritional regimens in four studies, while the remainder assessed different insulin regimens and administration routes. Diabetes-specific nutritional regimens that reduced glycemic excursions, as well as algorithm-driven insulin delivery approaches that allowed for flexible glucose-responsive insulin dosing, were both effective in improving glycemic control. However, the assessed studies were, in general, of limited quality, and we see a clear need for future rigorous studies to establish standards of care for patients with hyperglycemia receiving nutrition support.
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Meinert, Edward, Abrar Alturkistani, Kimberley A. Foley, David Brindley, and Josip Car. "Examining Cost Measurements in Production and Delivery of Three Case Studies Using E-Learning for Applied Health Sciences: Cross-Case Synthesis." Journal of Medical Internet Research 21, no. 6 (June 4, 2019): e13574. http://dx.doi.org/10.2196/13574.
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Background The World Health Report (2006) by the World Health Organization conveys that a significant increase is needed in global health care resourcing to meet the current and future demand for health professionals. Electronic learning (e-Learning) presents a possible opportunity to change and optimize training by providing a scalable means for instruction, thus reducing the costs for training health professionals and providing patient education. Research literature often suggests that a benefit of e-Learning is its cost-effectiveness compared with face-to-face instruction, yet there is limited evidence with respect to the comparison of design and production costs with other forms of instruction or the establishment of standards pertaining to budgeting for these costs. Objective To determine the potential cost favorability of e-Learning in contrast to other forms of learning, there must first be an understanding of the components and elements for building an e-Learning course. Without first taking this step, studies lack the essential financial accounting rigor for course planning and have an inconsistent basis for comparison. This study aimed to (1) establish standard ingredients for the cost of e-Learning course production and (2) determine the variance instructional design has on the production costs of e-Learning courses. Methods This study made use of a cross-case method among 3 case studies using mixed methods, including horizontal budget variance calculation and qualitative interpretation of responses from course designers for budget variance using total quality management themes. The different implementation-specific aspects of these cases were used to establish common principles in the composition of budgets in the production and delivery of an applied health professional e-Learning course. Results A total of 2 case studies reported significant negative budget variances caused by issues surrounding underreporting of personnel costs, inaccurate resource task estimation, lack of contingency planning, challenges in third-party resource management, and the need to update health-related materials that became outdated during course production. The third study reported a positive budget variance because of the cost efficiency derived from previous implementation, the strong working relationship of the course project team, and the use of iterative project management methods. Conclusions This research suggests that the delivery costs of an e-Learning course could be underestimated or underreported and identifies factors that could be used to better control budgets. Through consistent management of factors affecting the cost of course production, further research could be undertaken using standard economic evaluation methods to evaluate the advantages of using e-Learning.
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Wu, Huiqun, Huan Wu, Lili Shi, Xinlu Yuan, Ying Yin, Mingjie Yuan, Yushan Zhou, Qianwen Hu, Kui Jiang, and Jiancheng Dong. "The Association of Haptoglobin Gene Variants and Retinopathy in Type 2 Diabetic Patients: A Meta-Analysis." Journal of Diabetes Research 2017 (2017): 1–10. http://dx.doi.org/10.1155/2017/2195059.
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Aims/Introduction. To collectively evaluate the association between haptoglobin (Hp) gene variants and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).Methods. A comprehensive literature review was performed for eligible studies. After inclusion and exclusion selection as well as quality assessment, those studies meeting quality standards were included. In this study, diabetic patients with retinopathy were selected as the case group and those ones without DR were treated as the control group. The recessive model, allele model, additive model, heterozygote model, and homozygote model were utilized to investigate the association of three Hp gene variants and DR. Subgroup analysis on different severity of DR including nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) was also conducted.Results. Six trials from different regions were finally included. A total of 1145 subjects containing 564 T2DM patients with retinopathy were included. The recessive model, allele model, additive model, and homozygote model results showed that Hp gene variants were not associated with DR, NPDR, and PDR. However, the heterozygote model indicated the association of Hp gene variants with DR.Conclusions. No association was found between the Hp gene variants and PDR and NPDR. More studies are required to verify these findings.
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Chatzievangelou, Damianos, Jacopo Aguzzi, Martin Scherwath, and Laurenz Thomsen. "Quality Control and Pre-Analysis Treatment of the Environmental Datasets Collected by an Internet Operated Deep-Sea Crawler during Its Entire 7-Year Long Deployment (2009–2016)." Sensors 20, no. 10 (May 25, 2020): 2991. http://dx.doi.org/10.3390/s20102991.
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Deep-sea environmental datasets are ever-increasing in size and diversity, as technological advances lead monitoring studies towards long-term, high-frequency data acquisition protocols. This study presents examples of pre-analysis data treatment steps applied to the environmental time series collected by the Internet Operated Deep-sea Crawler “Wally” during a 7-year deployment (2009–2016) in the Barkley Canyon methane hydrates site, off Vancouver Island (BC, Canada). Pressure, temperature, electrical conductivity, flow, turbidity, and chlorophyll data were subjected to different standardizing, normalizing, and de-trending methods on a case-by-case basis, depending on the nature of the treated variable and the range and scale of the values provided by each of the different sensors. The final pressure, temperature, and electrical conductivity (transformed to practical salinity) datasets are ready for use. On the other hand, in the cases of flow, turbidity, and chlorophyll, further in-depth processing, in tandem with data describing the movement and position of the crawler, will be needed in order to filter out all possible effects of the latter. Our work evidences challenges and solutions in multiparametric data acquisition and quality control and ensures that a big step is taken so that the available environmental data meet high quality standards and facilitate the production of reliable scientific results.
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Mohammed, Ruqayah, and Miklas Scholz. "Quality Control and Homogeneity Analysis of Precipitation Time Series in the Climatic Region of Iraq." Atmosphere 14, no. 2 (January 17, 2023): 197. http://dx.doi.org/10.3390/atmos14020197.
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Non-climatic reasons, such as station replacement and changing the measurement device and calculation method, may make climate data unrepresentative of the actual variation of the regional climate. Data quality control and homogenization tests for climate data are critical. Thus, this study aims to evaluate the quality and homogeneity level of precipitation time series in arid and semi-arid climatic zones and specify the breakpoint in the datasets. The proposed methodology has been used to conduct arid and semi-arid representative case studies comprising 40 annual precipitation series for Iraq between 1979 and 2014. A Box-Cox transformation has been used to adjust the non-normally distributed datasets. Outliers have been censored by truncating extreme values. The results of the outliers indicate that they may be caused more by climate variability than by human-induced reasons. Homogeneity adjustments have been developed by applying these four homogeneity tests: Pettitt’s test, the Standard Normal Homogeneity method, Buishand’s test, and von Neumann’s check. Approximately 40% of the series (i.e., 16 stations out of 40) were homogeneous. Each homogeneity test was evaluated separately, and non-homogeneous stations were identified. Then, the series was classified into three groups that were assigned the labels “useful,” “doubtful”, and “suspect.” The results indicated that twenty-one stations were associated with the class ‘suspect’, three of the stations belonged to the class ‘doubtful’, and sixteen locations were within the class ‘useful’. Furthermore, the data analysis indicated no influence of the outliers on the results of the homogeneity tests. Accordingly, the study recommends further research on homogeneity tests that can be applied without considering outlier tests for similar case studies.
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GENSICHEN, J., M. BEYER, C. MUTH, F. M. GERLACH, M. VON KORFF, and J. ORMEL. "Case management to improve major depression in primary health care: a systematic review." Psychological Medicine 36, no. 1 (August 1, 2005): 7–14. http://dx.doi.org/10.1017/s0033291705005568.
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Background. Deficits in the care of depression lead to poor medication adherence, which increases the risk of an unfavourable outcome for this care. This review evaluates effects on symptoms and medication adherence of case management in primary health care.Method. A systematic literature search was performed. The quality of the studies was rated according to the Cochrane Effective Practice and Organization of Care Group (EPOC) criteria. To conduct a subgroup analysis interventions were classified as either ‘standard’ or ‘complex’ case management.Results. Thirteen studies met the inclusion criteria. In a meta-analysis we calculated a standard mean difference/effect size on symptom severity after 6–12 months of −0·40 (95% CI −0·60 to –0·20). Patients in the intervention groups were more likely to achieve remission after 6–12 months [relative risk (RR) 1·39, 95% CI 1·30–1·48]. The relative risk for clinical response was 1·82 (95% CI 1·68–2·05). Patients in intervention groups had better medication adherence than the control group (RR 1·5, 95% CI 1·28–1·86). We found heterogeneous results when assessing effects of different types of intervention.Conclusions. We conclude that case management improves management of major depression in primary health-care settings.
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Melsens, K., M. C. Leone, S. Paolino, M. Cutolo, D. Elewaut, R. Gerli, I. Peene, and V. Smith. "THU0278 NAILFOLD CAPILLAROSCOPY IN SJÖGREN’S SYNDROME: A SYSTEMATIC LITERATURE REVIEW AND STANDARDISED INTERPRETATION." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 365.2–366. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1687.
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Background:Sjögren Syndrome (SS) is a rheumatic connective tissue disease in which vascular involvement (e.g. Raynaud’s phenomenon) may occur. No systematic review exists elucidating on the role of nailfold capillaroscopy in SS.Objectives:To give a standardised overview of capillaroscopic changes and clinical associations in SS.Methods:The literature was searched through in three databases by two reviewers. All published original studies which assess patients with SS by capillaroscopy were revised. A quality assessment was applied, based on sample size, population description, presence of a control group, presence of instrumental specifications and/or standardly applied capillaroscopic methodology, presence of clear descriptions of capillaroscopic parameters and based on the used statistical analysis. The capillaroscopic findings were described in a EULAR consented standardised way (1). Significant associations of capillaroscopic parameters in SS-patients with clinical and laboratory variables were also reported.Results:The literature search resulted in 826 hits. Based on title and abstract screening 519 original studies were retained and of these, 12 full texts described an assessment by nailfold capillaroscopy in SS. Six studies (four case-control studies and two case-series) were retained after performing a critical quality assessment (fig 1). EULAR standardised description (table 1) attested conclusive results for capillary ‘morphology’, suggesting a not higher prevalence of abnormal shapes in SS than in healthy (2,3). Concerning clinical associations, capillary density was associated with Raynaud in two studies and with interstitial lung disease in one study (2-4). No association between serologic features (anti-nuclear antibodies, anti-SSA, anti-SSB and anti-RF) and capillaroscopic parameters were found (2,5).Table 1.Standardised description of capillaroscopic characteristics in Sjögren’s Syndrome vs Healthy Legend. Only studies mentioning p-values were considered in this table. *Tektonidou et al. did not report differences between healthy controls and the SS group as a whole, but rather reported differences between healthy controls and subgroups of patients with/without Raynaud’s and with/without centromere antibodies.AssessmentParameterSignificantNot significantConclusionQuantitativeDensity1 study [2]1 study [3]Not conclusiveDimensionDilationGiant0 studies0 studies0 studies1 study [2]Not conclusiveNormal morphologyHairpin shapedTortuosityCrossing0 studies0 studies0 studies0 studies1 study [3]1 study [3]Not conclusiveAbnormal morphology0 studies2 studies [2,3]Equal absence of abnormal morphology in SS vs healthy controlsHaemorrhages0 studies2 studies [2,3]Not conclusive*Semi quantitative0 studies0 studiesNo dataQualitativeNormalNon specific abnormalitiesScleroderma pattern0 studies0 studies0 studies1 study [3]1 study [3]0 studiesNot conclusive*Not conclusive*No dataConclusion:A small number of studies have investigated the role of nailfold capillaroscopy in SS. Prospective follow up studies with standard evaluation and capillaroscopy in SS are warranted.References:[1]Smith et al Autoimmun Rev 2020, DOI: 10.1016/j.autrev.2020.102458[2]Capobianco et al Clin Exp Rheumatol 2005;23(6):789-94[3]Tektonidou et al Rheumatology (Oxford, England) 1999;38(9):826-30[4]Cakmakci et al Tuberk Torakx 2015;63:22-30[5]Corominas et al Rheumatol Int 2016;36(3):365-9Disclosure of Interests:Karin Melsens: None declared, Maria C. Leone: None declared, Sabrina Paolino: None declared, Maurizio Cutolo Grant/research support from: Bristol-Myers Squibb, Actelion, Celgene, Consultant of: Bristol-Myers Squibb, Speakers bureau: Sigma-Alpha, Dirk Elewaut: None declared, Roberto Gerli: None declared, Isabelle Peene: None declared, Vanessa Smith Grant/research support from: The affiliated company received grants from Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer Ingelheim Pharma GmbH & Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH & Co, Speakers bureau: Actelion Pharmaceuticals Ltd, Boehringer-Ingelheim Pharma GmbH & Co and UCB Biopharma Sprl
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Kirgizov, K., G. Muftakhova, G. Serik, S. Kogan, S. Varfolomeeva, and A. Rumyantsev. "National Childhood Cancer Plan Prepared by the National Center of Pediatric Hematology, Oncology and Immunology and the National Society of Pediatric Hematologists and Oncologists as a New Successful Strategy." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 166s. http://dx.doi.org/10.1200/jgo.18.78000.
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Background and context: More than 4000 cases of pediatric cancer registered in Russia annually. Overall survival for pediatric cancer is about 80% and improved from 10% during last 25 years. Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology (Center) and the National Society of Pediatric Hematologists and Oncologists (NSPHO) played a major role in this movement. Aim: Build new childhood cancer control plan based on close collaboration of 86 centers and departments of pediatric oncology. Strategy/Tactics: Plan is based on close collaboration between leading Center and NSPHO (representative of all centers) and supported by the government and the Ministry of Health. Plan developed as the result of analysis of strengths, weaknesses, threats and possible opportunities. Strengths: unique standards (guidelines and protocols) for pediatric cancer for all country with the financial governmental support, strong society (NSPHO), availability of modern technologies and rapid improvement of rehabilitation for children with cancer. Weaknesses: absence of national pediatric cancer registry, lack of high quality oncology nursing, comparable low publication activity. Opportunities: building of the national pediatric cancer registry, increasing of number of multicenter studies, implementation of the new technologies (cellular and gene therapy) and active educational activities based on international collaboration. Program/Policy process: Dmitry Rogachev Center in charge of pediatric hematology, oncology and immunology for Russia and NSPHO is key society. Strategy: scientific analysis and continuous improving of standards (guidelines and protocols) based on multicenter studies; building the morphologically-based national pediatric hematology/oncology registry; continuous development of professional standards for education and quality control; capacity building; scientific and educational activities (national meetings, schools for healthcare professionals, regional educational programs, Russian CME accreditation, outreach programs). Outcomes: Sixty guidelines were prepared, this work is continuing. Morphologic study for more than 13,000 children was made in Dmitry Rogachev Center (all suspicious cases controlled). New standards prepared and discussed. National telemedicine network formed (consulting, case registration, database updates, etc.). More than 5000 cases were consulted through this system in 2017. CME educational seminars (on/off-line) organized. About 12 regions of Russia visited annually with preparation of the report with proposals for improvement of regional service for children with cancer. What was learned: Success is based on close collaboration between Center, Society and Government (all aspects of pediatric cancer control from diagnostics to education covered). This experience could be implemented in the countries with post-Soviet model of healthcare.
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Silva, Daniela, Lara Ferriani, and Maria Carmen Viana. "Depression, anthropometric parameters, and body image in adults: a systematic review." Revista da Associação Médica Brasileira 65, no. 5 (May 2019): 731–38. http://dx.doi.org/10.1590/1806-9282.65.5.731.
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SUMMARY OBJECTIVE: To evaluate the association between depression, anthropometric parameters and body image in adults through a systematic review of the literature. METHOD: Medline, Lilacs and PsycInfo databases were searched by two independent reviewers up to August 2018, without language restriction, including cross-sectional, case-control, and cohort studies in adults (18-65 years), of both genders. The quality of the studies was assessed using the Newcastle-Ottawa Scale instrument. The PRISMA standards were adopted for the conduct of this review, whose protocol is registered in PROSPERO, number CRD42018105248. RESULTS: The search resulted in 1,770 articles; however, a total of 5 articles were included in this review, whose designs were transversal. Quality scores ranged from 8 to 9 points. The association between depression, anthropometric parameters, and body image was found in all included studies, regardless of the different statistical methods employed. Women perceived their body larger than it really was by idealizing a lean body, whereas in men the perception of being underweight or dissatisfaction was observed by idealizing a larger body, both conditions were associated with the presence of depression or depressive symptoms and body mass index in the same time. CONCLUSION: Depression, anthropometric parameters and body image were associated. It is necessary to conduct other studies, especially longitudinal studies to elucidate the relationship among depression, weight, body image, and other associated factors.
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Borgese, Laura, Giuseppe Tomasoni, Filippo Marciano, Annalisa Zacco, Fabjola Bilo, Elena Stefana, Paola Cocca, et al. "Definition of an Indoor Air Sampling Strategy for SARS-CoV-2 Detection and Risk Management: Case Study in Kindergartens." International Journal of Environmental Research and Public Health 19, no. 12 (June 16, 2022): 7406. http://dx.doi.org/10.3390/ijerph19127406.
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In the last two years, the world has been overwhelmed by SARS-CoV-2. One of the most important ways to prevent the spread of the virus is the control of indoor conditions: from surface hygiene to ventilation. Regarding the indoor environments, monitoring the presence of the virus in the indoor air seems to be promising, since there is strong evidence that airborne transmission through infected droplets and aerosols is its dominant transmission route. So far, few studies report the successful detection of SARS-CoV-2 in the air; moreover, the lack of a standard guideline for air monitoring reduces the uniformity of the results and their usefulness in the management of the risk of virus transmission. In this work, starting from a critical analysis of the existing standards and guidelines for indoor air quality, we define a strategy to set-up indoor air sampling plans for the detection of SARS-CoV-2. The strategy is then tested through a case study conducted in two kindergartens in the metropolitan city of Milan, in Italy, involving a total of 290 children and 47 teachers from 19 classrooms. The results proved its completeness, effectiveness, and suitability as a key tool in the airborne SARS-CoV-2 infection risk management process. Future research directions are then identified and discussed.
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Ribeiro, Ivana Leao, Ximena Gálvez González, Diego Lara Torres, Luz Alejandra Lorca, Snehil Dixit, Nicolás Yáñez Benavides, and Francisco Ortega Gonzalez. "Signs of Central Hypersensitivity, Stress, and Anxiety following Treatment for Breast Cancer: A Case Control Study." International Journal of Breast Cancer 2021 (October 18, 2021): 1–9. http://dx.doi.org/10.1155/2021/5691584.
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Background. With treatment for breast cancer, women treated may present significant sensory abnormalities in the upper extremity. However, there are no conclusive studies that have evaluated pressure pain thresholds (PPT) in the shoulder of postoperated women for breast cancer. The aim of this study was to compare PPT in the shoulder, stress, anxiety, depression symptoms, and quality of sleep among postoperated women for breast cancer (PO group) and asymptomatic women of shoulder pain (control group). Methods. 40 women participated ( n = 20 , PO group, age: average ± standard deviation , 49.2 ± 8.3 years; body mass index (BMI): 27.5 ± 3.0 kg/cm2; surgery time: 22.2 ± 34.4 months; n = 20 , control group, 46.9 ± 8.1 years; BMI: 26.8 ± 3.5 kg/cm2). The PPT was evaluated with a digital algometer at 32 points in the shoulder region and one control point in the tibialis anterior. Stress, anxiety, and depression were evaluated with the Depression, Anxiety and Stress Scale 21 (DASS-21) and the quality of sleep by the Pittsburgh Sleep Quality Index. Results. Significant differences were observed over 1.5 kgf/cm2 in 33 points evaluated ( p < 0.01 ) with a small to high effect size (Cliff’s delta range = 0.16 ; 0.92) and higher levels of anxiety and stress in the PO group (anxiety: median [first; third quartile], 5[3; 12.5]; stress: 9.7 ± 4.7 (7.8; 11.8)) in comparison with the control group (anxiety: 2.5[1; 4.8]; stress: 6.7 ± 3.31 (5.2; 8.3), ( p < 0.05 )). No significant differences were found between the groups in depression and sleep quality ( p > 0.05 ). Conclusion. Postoperated women for breast cancer present hyperalgesia in the shoulder anterior and posterior region, low PPT in the tibialis anterior, and higher levels of stress and anxiety compared to the control group.
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Manchikanti, Laxmaiah. "Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 4: Observational Studies." Pain Physician 1;12, no. 1;1 (January 14, 2009): 73–108. http://dx.doi.org/10.36076/ppj.2009/12/73.
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Evidence-based medicine (EBM) stresses the examination of evidence from clinical research and describes it as a shift in medical paradigms, in contrast to intuition, unsystematic clinical experience, and pathophysiologic rationale. While the importance of randomized trials has been created by the concept of the hierarchy of evidence in guiding therapy, much of the medical research is observational. There is competition, contrast, and a feeling of inferiority and uselessness for observational studies, created by a lack of understanding of medical research. However, observational studies and randomized clinical trials (RCTs) can be viewed as the steps of observation and experimentation that form the basis of the scientific methodology. Further, rational healthcare practices require knowledge about the etiology and pathogenesis, diagnosis, prognosis, and treatment of disorders. The reporting of observational research is often not detailed and clear enough with insufficient quality and poor reporting, which hampers the assessment of strengths and weaknesses of the study and the generalizability of the mixed results. Thus, design, implementation, and reporting of observational studies is crucial. The biased interpretation of results from observational studies, either in favor of or opposed to a treatment, and lack of proper understanding of observational studies, leads to a poor appraisal of the quality. Similar to the Consolidated Standards of Reporting Trials (CONSORT) statement for the reporting of randomized trials, the Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) statement was developed with recommendations to improve the quality of reporting observational studies. The STROBE statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Multiple types of observational studies are conducted; however, 3 types have been highlighted in the STROBE document and also in the present review, which include cohort studies, case-controlled studies, and cross-sectional studies. This comprehensive review provides an introduction and rationale, types, design, and reporting of observational studies; outcomes assessment and data presentation and analysis; statistical analysis, results, and a discussion of observational studies. Key words: Observational studies, cohort studies, case control studies, cross-sectional studies, allocation bias, sample size, Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE)