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Quality indicators

Magdalena M Sakowska, Megan V Thomas, Saxon Connor, Ross Roberts
BACKGROUND: In measuring quality of health-care delivery, digital infrastructure is essential. The aim at this tertiary centre was to create a hospital-wide workflow system that collected data prospectively as part of daily practice. METHODS: In moving towards an electronic health record, a hospital-wide integrated workflow system was introduced in 2013, which electronically managed the perioperative patient journey while simultaneously facilitating surgical audit...
October 21, 2016: ANZ Journal of Surgery
Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi
BACKGROUND: Traditionally, emergency department (ED) physicians rely on their clinical examination to differentiate between cellulitis and abscess when evaluating skin and soft tissue infections (SSTI). Management of an abscess requires incision and drainage, whereas cellulitis generally requires a course of antibiotics. Misdiagnosis often results in unnecessary invasive procedures, sedations (for incision and drainage in pediatric patients), or a return ED visit for failed antibiotic therapy...
October 21, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Benjamin Kearns, Abdullah Pandor, Matt Stevenson, Jean Hamilton, Duncan Chambers, Mark Clowes, John Graham, M Satish Kumar
As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures cabazitaxel (Jevtana(®), Sanofi, UK) to submit evidence for the clinical and cost effectiveness of cabazitaxel for treatment of patients with metastatic hormone-relapsed prostate cancer (mHRPC) previously treated with a docetaxel-containing regimen. The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG)...
October 22, 2016: PharmacoEconomics
Walter Pirker, Regina Katzenschlager
Human gait depends on a complex interplay of major parts of the nervous, musculoskeletal and cardiorespiratory systems. The individual gait pattern is influenced by age, personality, mood and sociocultural factors. The preferred walking speed in older adults is a sensitive marker of general health and survival. Safe walking requires intact cognition and executive control. Gait disorders lead to a loss of personal freedom, falls and injuries and result in a marked reduction in the quality of life. Acute onset of a gait disorder may indicate a cerebrovascular or other acute lesion in the nervous system but also systemic diseases or adverse effects of medication, in particular polypharmacy including sedatives...
October 21, 2016: Wiener Klinische Wochenschrift
A Achtnich, S Rosslenbroich, K Beitzel, A B Imhoff, W Petersen
OBJECTIVE: Arthroscopic assisted suture anchor refixation combined with microfracturing of the femoral ACL insertion zone in cases of acute proximal anterior cruciate ligament (ACL) rupture to restore anatomical and biomechanical properties of the native ACL. INDICATIONS: Acute proximal ACL rupture/avulsion, multiligament injury of the knee CONTRAINDICATIONS: Chronic (>6 weeks) proximal ACL rupture, intraligamentary rupture, as well as previous ACL surgery. SURGICAL TECHNIQUE: Arthroscopic examination of the knee joint, debridement of the femoral insertion zone, examination of the ligament quality by a probe, insertion of a curved lasso through the ACL to place the sutures and use of a drill guide to place the anchor in the middle of the femoral ACL insertion...
October 21, 2016: Operative Orthopädie und Traumatologie
Douglas W Jones, Kirsten Dansey, Allen D Hamdan
Patients with end-stage renal disease (ESRD) who present with critical limb ischemia (CLI) have become an increasingly common and complex treatment problem for vascular surgeons. Dialysis patients have high short-term mortality rates regardless of whether revascularization is pursued. ESRD patients with CLI can be managed with: local wound care, endovascular or surgical revascularization, or amputation. Some patients may heal small foot wounds with local wound care alone, even if distal perfusion is marginal, as long as any infectious process has been controlled...
October 20, 2016: Vascular and Endovascular Surgery
Stephanie Robins, Helena J Barr, Rachel Idelson, Sylvie Lambert, Phyllis Zelkowitz
BACKGROUND: Many men lack knowledge about male infertility, and this may have consequences for their reproductive and general health. Men may prefer to seek health information online, but these sources of information vary in quality. OBJECTIVE: The objective of this study is to determine if online sources of information regarding male infertility are readable, suitable, and of appropriate quality for Internet users in the general population. METHODS: This study used a cross-sectional design to evaluate online sources resulting from search engine queries...
October 21, 2016: Interactive Journal of Medical Research
David M Cykert, Joni S Williams, Rebekah J Walker, Kimberly S Davis, Leonard E Egede
AIMS: Discrimination is linked to negative health outcomes, but little research has investigated how the cumulative effect of discrimination impacts perceptions of care. This study investigated the influence of cumulative perceived discrimination on quality of care, patient-centeredness, and dissatisfaction with care in adults with type 2 diabetes. METHODS: Six hundred two patients from two primary care clinics in Charleston, SC. Linear regression models assessed associations between perceived discrimination and quality of care, patient-centered care, and dissatisfaction with care...
September 30, 2016: Journal of Diabetes and its Complications
Eric L Scholten, Roy Semaan, Peter Illei, Christopher Mallow, Sixto Arias, David Feller-Kopman, Karen Oakjones-Burgess, Bernice Frimpong, Ricardo Ortiz, Hans Lee, Lonny Yarmus
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of thoracic structures is a commonly performed tissue sampling technique. The usage of an inner-stylet in the EBUS needle has never been rigorously evaluated, and may be unnecessary. METHODS: In a prospective randomized single blinded controlled clinical trial, patients with a clinical indication for EBUS-TBNA underwent lymph node sampling using both with-stylet and without-stylet techniques...
October 18, 2016: Chest
Razegheh Akhbarizadeh, Farid Moore, Behnam Keshavarzi, Alireza Moeinpour
Marine pollutants are becoming a growing concern due to their ecological consequences. This study investigates the potential risk posed by microplastics and toxic elements in coastal sediments of Khark Island, the main oil export hub of Iran. Principal component biplots exhibited a significant positive correlation between microplastic quantities (ranging in shape and color) and concentration of heavy metals with industrial activity. Source identification of the heavy metals indicated both natural and anthropogenic origin...
October 18, 2016: Environmental Pollution
Fabíola Araújo, José Filho, Aldebaro Klautau
Voice imitation basically consists in estimating a synthesizer input parameters to mimic a target speech signal. This is a difficult inverse problem because the mapping is time-varying, non-linear and from many to one. It typically requires considerable amount of time to be done manually. This work presents a system based on a genetic algorithm (GA) to automatically estimate the input parameters of the Klatt and HLSyn formant synthesizers using an analysis-by-synthesis process. Results are presented for natural (human-generated) speech for three male speakers...
October 18, 2016: Bio Systems
Valentina Longobardi, Angela Salzano, Giuseppe Campanile, Raffaele Marrone, Francesco Palumbo, Milena Vitiello, Gianluigi Zullo, Bianca Gasparrini
The aim of this study was to evaluate the effect of carnitine supplementation of semen extender on fertility parameters of frozen-thawed buffalo sperm. Buffalo semen was cryopreserved in BioXcell containing 0 (control group), 2.5 and 7.5-mM carnitine. After thawing, viability, motility, membrane integrity and capacitation status (assessed by localization of phosphotyrosine-containing proteins and chlortetracycline, chlortetracycline assay) were evaluated. Furthermore, total antioxidant capacity, reactive oxygen species (ROS) and lipid peroxidation levels, as well as adenosine triphosphate (ATP) content and phospholipids concentration were assessed...
September 20, 2016: Theriogenology
Seokjin Suh, Xiangpeng Meng, Sanghoon Ko
The objective of this study was to develop different-sized chitosan nanoparticles as CO2-based food quality indicators. Chitosan nanoparticles were fabricated with different sizes (small, 300nm; medium, 500nm; and large, 1000nm) by ionic gelation. To investigate the performance of chitosan nanoparticles as CO2 indicators, they were suspended in aqueous solution at pH 8.0. Changes in the pH and absorbance of the suspension were measured over time, the absorbance at the transition appearance time being calculated using the inverse-Hill function...
December 1, 2016: Talanta
Yanan Zhang, Loong-Tak Lim
Colorimetric CO2 indicators were prepared by printing pH dyes (M-cresol purple or phenol red, tetrabutylammonium hydroxide, ethylcellulose, 1:2 ethanol:1-butanol solvent), using a commercially available thermal inkjet printer, on either cellulose paper or plastic transparency film. Indicators inks printed on the papers had higher sensitivity to CO2, greater color change, and more producible than those printed on plastic film. Varying the print intensities of the two pH dyes resulted in multiplexed indicators with tunable sensitivity and expanded detection concentration range towards CO2...
December 1, 2016: Talanta
Paibul Suriyawongpaisal, Wichai Aekplakorn, Samrit Srithamrongsawat, Chaisit Srithongchai, Orawan Prasitsiriphon, Rassamee Tansirisithikul
BACKGROUND: Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk of delayed treatment leading to avoidable disability or death. METHODS: Using mixed-methods approach to draw evidence from multiple sources (over 40,000 records of administrative dataset of Thai emergency medical services, in-depth interviews, telephone survey of users and documentary review), we are were able to shed light on the existence of copayment and its related factors in the Thai healthcare system despite the presence of universal health coverage since 2001...
October 21, 2016: BMC Health Services Research
Richard Kalisa, Stephen Rulisa, Thomas van den Akker, Jos van Roosmalen
BACKGROUND: The WHO Maternal Near Miss (MNM) approach was developed to evaluate and improve quality of obstetric care worldwide. This study aimed to study the incidence of MNM and quality of care at a district hospital in rural Rwanda by applying this approach. METHODS: A facility based, prospective cohort study conducted at a district hospital in rural Rwanda between June 2013 and December 2014. Subjects were followed from time of admission to discharge or death...
October 21, 2016: BMC Pregnancy and Childbirth
Shengnan Zhai, Genying Li, Youwei Sun, Jianmin Song, Jihu Li, Guoqi Song, Yulian Li, Hongqing Ling, Zhonghu He, Xianchun Xia
BACKGROUND: Phytoene synthase 1 (PSY1) is the most important regulatory enzyme in carotenoid biosynthesis, whereas its function is hardly known in common wheat. The aims of the present study were to investigate Psy1 function and genetic regulation using reverse genetics approaches. RESULTS: Transcript levels of Psy1 in RNAi transgenic lines were decreased by 54-76 % and yellow pigment content (YPC) was reduced by 26-35 % compared with controls, confirming the impact of Psy1 on carotenoid accumulation...
October 21, 2016: BMC Plant Biology
Kate Ablett, Andrew R Thompson
Childhood skin conditions can affect the quality of life of children, adolescents, and families. As such, paediatric dermatological conditions have been the focus of a number of qualitative studies and there is now a need to integrate the findings. A meta-ethnography was carried out with the existing 12 studies, which included nine studies examining parental experiences and three studies of child experiences. Meta-ethnographic analysis of the studies identified themes focused on the child's sense of stigmatisation and the challenges for families that arose from this...
October 18, 2016: Body Image
A P M Suzanne Giesbers, Roel L J Schouteten, Erik Poutsma, Beatrice I J M van der Heijden, Theo van Achterberg
BACKGROUND: Providing nursing teams with feedback on quality measurements is used as a quality improvement instrument in healthcare organizations worldwide. Previous research indicated contradictory results regarding the effect of such feedback on both nurses' well-being and performance. OBJECTIVES: Building on the Job Demands-Resources model this study explores: (1) whether and how nurses' perceptions of feedback on quality measurements (as a burdening job demand or rather as an intrinsically or extrinsically motivating job resource) are respectively related to nurses' well-being and performance; and (2) whether and how team reflection influences nurses' perceptions...
October 11, 2016: International Journal of Nursing Studies
Abidelfatah M Nasser, Neta-Lee Benisti, Naomi Ofer, Sivan Hovers, Yeshayahu Nitzan
Advanced wastewater treatment processes are applied to prevent the environmental dissemination of pathogenic microorganisms. Giardia lamblia causes a severe disease called giardiasis, and is highly prevalent in untreated wastewater worldwide. Monitoring the microbial quality of wastewater effluents is usually based on testing for the levels of indicator microorganisms in the effluents. This study was conducted to compare the suitability of fecal coliforms, F+ coliphages and sulfide reducing clostridia (SRC) as indicators for the reduction of Giardia cysts in two full-scale wastewater treatment plants...
October 21, 2016: Journal of Environmental Science and Health. Part A, Toxic/hazardous Substances & Environmental Engineering
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