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Realist evaluation

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https://www.readbyqxmd.com/read/28736809/dose-evaluation-of-grid-therapy-using-a-6-mv-flattening-filter-free-fff-photon-beam-a-monte-carlo-study
#1
Immaculada Martínez-Rovira, Josep Puxeu, Yolanda Prezado
PURPOSE: Spatially fractionated radiotherapy is a strategy to overcome the main limitation of radiotherapy, i.e., the restrained normal tissue tolerances. A well-known example is Grid Therapy, which is currently performed at some hospitals using megavoltage photon beams delivered by Linacs. Grid Therapy has been successfully used in the management of bulky abdominal tumors with low toxicity. The aim of this work is to evaluate whether an improvement in therapeutic index in Grid Therapy can be obtained by implementing it in a flattening filter-free (FFF) Linac...
July 24, 2017: Medical Physics
https://www.readbyqxmd.com/read/28736455/using-kaizen-to-improve-employee-well-being-results-from-two-organizational-intervention-studies
#2
Ulrica von Thiele Schwarz, Karina M Nielsen, Terese Stenfors-Hayes, Henna Hasson
Participatory intervention approaches that are embedded in existing organizational structures may improve the efficiency and effectiveness of organizational interventions, but concrete tools are lacking. In the present article, we use a realist evaluation approach to explore the role of kaizen, a lean tool for participatory continuous improvement, in improving employee well-being in two cluster-randomized, controlled participatory intervention studies. Case 1 is from the Danish Postal Service, where kaizen boards were used to implement action plans...
August 2017: Human Relations; Studies Towards the Integration of the Social Sciences
https://www.readbyqxmd.com/read/28735790/patient-specific-finite-element-analysis-of-fiber-post-and-ferrule-design
#3
Monise de Paula Rodrigues, Priscilla Barbosa Ferreira Soares, Andréa Dollores Correia Miranda Valdivia, Roberto Sales Pessoa, Crisnicaw Veríssimo, Antheunis Versluis, Carlos José Soares
INTRODUCTION: A ferrule on anterior endodontic-treated teeth has been evaluated using clinical trials, in vitro tests, and finite element analysis (FEA). The patient-specific FEA with a nonuniform ferrule and nonlinear contact biting load associated with clinical validation can be used to predict failure. METHODS: A patient was selected with both maxillary central incisors with different ferrule designs who received endodontic treatment and restoration using a fiber post, composite core, and computer aided design and computer aided manufacturing lithium disilicate ceramic crowns...
July 20, 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28734964/removing-user-fees-for-health-services-a-multi-epistemological-perspective-on-access-inequities-in-senegal
#4
Philipa Mladovsky, Maymouna Ba
Plan Sésame (PS) is a user fee exemption policy launched in 2006 to provide free access to health services to Senegalese citizens aged 60 and over. Analysis of a large household survey evaluating PS echoes findings of other studies showing that user fee removal can be highly inequitable. 34 semi-structured interviews and 19 focus group discussions with people aged 60 and over were conducted in four regions in Senegal (Dakar, Diourbel, Matam and Tambacounda) over a period of six months during 2012. They were analysed to identify underlying causes of exclusion from/inclusion in PS and triangulated with the household survey...
July 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28734112/fused-multivariate-empirical-mode-decomposition-memd-and-inverse-solution-method-for-eeg-source-localization
#5
Pegah Khosropanah, Abdul Rahman Ramli, Kheng Seang Lim, Mohammad Hamiruce Marhaban, Anvarjon Ahmedov
EEG source localization is determining possible cortical sources of brain activities with scalp EEG. Generally, every step of the data processing sequence affects the accuracy of EEG source localization. In this paper, we introduce a fused multivariate empirical mode decomposing (MEMD) and inverse solution algorithm with an embedded unsupervised eye blink remover in order to localize the epileptogenic zone accurately. For this purpose, we constructed realistic forward models using MRI and boundary element method (BEM) for each patient to obtain results that are more realistic...
July 22, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28731928/serious-game-versus-online-course-for-pretraining-medical-students-before-a-simulation-based-mastery-learning-course-on-cardiopulmonary-resuscitation-a-randomised-controlled-study
#6
David Drummond, Paul Delval, Sonia Abdenouri, Jennifer Truchot, Pierre-François Ceccaldi, Patrick Plaisance, Alice Hadchouel, Antoine Tesnière
BACKGROUND: Although both recorded lectures and serious games have been used to pretrain health professionals before simulation training on cardiopulmonary resuscitation, they have never been compared. OBJECTIVE: The aim of this study was to compare an online course and a serious game for pretraining medical students before simulation-based mastery learning on the management of sudden cardiac arrest. DESIGN: A randomised controlled trial. Participants were pretrained using the online course or the serious game on day 1 and day 7...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28730744/improving-hospital-discharge-arrangements-for-people-who-are-homeless-a-realist-synthesis-of-the-intermediate-care-literature
#7
REVIEW
Michelle Cornes, Martin Whiteford, Jill Manthorpe, Joanne Neale, Richard Byng, Nigel Hewett, Michael Clark, Alan Kilmister, James Fuller, Robert Aldridge, Michela Tinelli
This review presents a realist synthesis of "what works and why" in intermediate care for people who are homeless. The overall aim was to update an earlier synthesis of intermediate care by capturing new evidence from a recent UK government funding initiative (the "Homeless Hospital Discharge Fund"). The initiative made resources available to the charitable sector to enable partnership working with the National Health Service (NHS) in order to improve hospital discharge arrangements for people who are homeless...
July 20, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28728584/professionals-perception-of-intimate-partner-violence-in-young-people-a-qualitative-study-in-northern-spain
#8
Amaia Maquibar, Carmen Vives-Cases, Anna-Karin Hurtig, Isabel Goicolea
BACKGROUND: Intimate partner violence (IPV) is a public health problem with devastating effects on young women's health. These negative effects increase when the exposure to IPV lasts for a long time and exposure at an early age increases the risk of adult IPV. Despite efforts made in the last few decades, data show little progress has been made towards its reduction. Thus, the aim of the study reported here is to explore professionals' perceptions regarding intimate partner violence (IPV) among young people, focusing on the characteristics of the phenomenon and their perceptions about existing programmes and campaigns aimed at addressing it...
July 20, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28728205/-predictability-of-postoperative-pain-and-satisfaction-how-precise-are-we-and-what-is-the-role-of-professional-experience
#9
Ulf Krister Hofmann, Cosima Dobler, Marco Gesicki, Torsten Kluba, Sebastian Scheidt
Background The indication for surgery is justified by an expected improvement for the patient. To evaluate the probability and extent of individual postoperative patient benefit, the surgeon needs to elaborate numerous parameters of potential relevance for the outcome beyond his key competence, that is the technical dimension of the operation. Despite the highest medical standards, individual postoperative satisfaction with surgery is highly variable, even in cases with a technically good result. The aim of the present study was to investigate the individual predictability of postoperative pain and satisfaction in patients with elective musculoskeletal surgery...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28721493/modelling-of-lesions-associated-with-functional-mitral-regurgitation-in-an-ex-vivo-platform
#10
Michal Jaworek, Federico Lucherini, Claudia Romagnoni, Guido Gelpi, Monica Contino, Paolo Romitelli, Carlo Antona, Gianfranco B Fiore, Riccardo Vismara
Functional mitral regurgitation (FMR) is a complex pathology involving valvular and subvalvular structures reconfiguration, and its treatment is considered challenging. There is a lack of experimental models allowing for reliable preclinical FMR treatments' evaluation in a realistic setting. A novel approach to simulate FMR was developed and incorporated into an ex vivo passive beating heart platform. FMR was obtained by dilating the mitral annulus (MA) mainly in the antero-posterior direction and displacing the papillary muscles (PMs) apically and laterally by ad hoc designed and 3D printed dilation and displacing devices...
July 18, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28720915/evaluation-of-the-use-of-a-virtual-patient-on-student-competence-and-confidence-in-performing-simulated-clinic-visits
#11
Catherine A Taglieri, Steven J Crosby, Kristin Zimmerman, Tulip Schneider, Dhiren K Patel
Objective. To assess the effect of incorporating virtual patient activities in a pharmacy skills lab on student competence and confidence when conducting real-time comprehensive clinic visits with mock patients. Methods. Students were randomly assigned to a control or intervention group. The control group completed the clinic visit prior to completing virtual patient activities. The intervention group completed the virtual patient activities prior to the clinic visit. Student proficiency was evaluated in the mock lab...
June 2017: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28715332/current-source-density-estimation-enhances-the-performance-of-motor-imagery-related-brain-computer-interface
#12
Dheeraj Rathee, Haider Raza, Girijesh Prasad, Hubert Cecotti
The objective is to evaluate the impact of EEG referencing schemes and spherical surface Laplacian (SSL) methods on the classification performance of motor-imagery (MI) related brain-computer interface systems. Two EEG referencing schemes: common referencing, common average referencing (CAR) and three surface Laplacian methods: current source density (CSD), finite difference method, and SSL using realistic head model, were implemented separately for pre-processing of the EEG signals recorded at the scalp. A combination of filter bank common spatial filter for features extraction and support vector machine for classification was used for both pairwise binary classifications and four-class classification of MI tasks...
July 13, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28715130/average-glandular-dose-coefficients-for-pendant-geometry-breast-ct-using-realistic-breast-phantoms
#13
Andrew M Hernandez, John M Boone
PURPOSE: To design volume-specific breast phantoms from breast CT (bCT) data sets and estimate the associated normalized mean glandular dose coefficients for breast CT using Monte Carlo methods. METHODS: A large cohort of bCT data sets (N=215) was used to evaluate breast volume into quintiles (plus the top 5%). The average radius profile was then determined for each of the six volume-specific groups and used to both fabricate physical phantoms and generate mathematical phantoms (V1-V6; "V" denotes classification by volume)...
July 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28714853/unveiling-the-development-of-intracranial-injury-using-dynamic-brain-eit-an-evaluation-of-current-reconstruction-algorithms
#14
Haoting Li, Rongqing Chen, Canhua Xu, Benyuan Liu, Mengxing Tang, Lin Yang, Xiuzhen Dong, Feng Fu
Dynamic brain EIT is a promising technique for continuous monitoring the development of cerebral injury. While there are many reconstruction algorithms available to brain EIT, there is still a lack of study to compare their performance in the context of dynamic brain monitoring. To address the problem, we develop a framework for evaluating different current algorithms with their ability to correctly identify small intracranial conductivity changes. Firstly, a simulation 3D head phantom with realistic layered structure and impedance distribution were developed...
July 17, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28710852/mixture-toxicity-in-the-marine-environment-model-development-and-evidence-for-synergism-at-environmental-concentrations
#15
David Deruytter, Jan M Baert, Nancy Nevejan, Karel A C DE Schamphelaere, Colin R Janssen
Little is known about the effect of metal mixtures on marine organisms, especially when exposed to environmentally realistic concentrations. This information is, however, required to evaluate the need to include mixtures in future environmental risk assessment (ERA) procedures. Here, the effect of Cu-Ni binary mixtures on Mytilus edulis larval development was assessed using a full factorial design that included environmentally relevant metal concentrations and ratios. The reproducibility of the results was assessed by repeating this experiment 5 times...
July 15, 2017: Environmental Toxicology and Chemistry
https://www.readbyqxmd.com/read/28709600/challenges-in-conducting-clinical-trials-in-nephrology-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#16
Colin Baigent, William G Herrington, Josef Coresh, Martin J Landray, Adeera Levin, Vlado Perkovic, Marc A Pfeffer, Peter Rossing, Michael Walsh, Christoph Wanner, David C Wheeler, Wolfgang C Winkelmayer, John J V McMurray
Despite the high costs of treatment of people with kidney disease and associated comorbid conditions, the amount of reliable information available to guide the care of such patients is very limited. Some treatments have been assessed in randomized trials, but most such trials have been too small to detect treatment effects of a magnitude that would be realistic to achieve with a single intervention. Therefore, KDIGO convened an international, multidisciplinary controversies conference titled "Challenges in the Conduct of Clinical Trials in Nephrology" to identify the key barriers to conducting trials in patients with kidney disease...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28708840/index-extraction-for-electromagnetic-field-evaluation-of-high-power-wireless-charging-system
#17
SangWook Park
This paper presents the precise dosimetry for highly resonant wireless power transfer (HR-WPT) system using an anatomically realistic human voxel model. The dosimetry for the HR-WPT system designed to operate at 13.56 MHz frequency, which one of the ISM band frequency band, is conducted in the various distances between the human model and the system, and in the condition of alignment and misalignment between transmitting and receiving circuits. The specific absorption rates in the human body are computed by the two-step approach; in the first step, the field generated by the HR-WPT system is calculated and in the second step the specific absorption rates are computed with the scattered field finite-difference time-domain method regarding the fields obtained in the first step as the incident fields...
2017: PloS One
https://www.readbyqxmd.com/read/28707555/long-term-effects-of-silver-nanoparticles-in-caco-2-cells
#18
Laura Vila, Ricard Marcos, Alba Hernández
The high success of silver nanoparticles (AgNPs), mainly associated with their proved antimicrobial properties, has led to an increasing spread in our close environment. Although many studies have been carried out to detect potential toxicity of AgNPs, most of them have been developed under unrealistic exposure conditions. In terms of human risk, the evaluation of long-term exposures to sub-toxic doses of NPs remains a challenge. Here we have determined different transformation-related end-points under a scenario of 6 weeks long-term exposure to low non-cytotoxic AgNPs concentrations (0...
July 14, 2017: Nanotoxicology
https://www.readbyqxmd.com/read/28706173/-development-and-evaluation-of-a-self-reflection-program-for-intensive-care-unit-nurses-who-have-experienced-the-death-of-pediatric-patients
#19
Hyun Ju Kang, Kyung Sook Bang
PURPOSE: This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness. METHODS: The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program...
June 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28705402/-development-of-an-objective-structured-clinical-examination-osce-for-evaluating-clinical-competence-in-vascular-medicine
#20
J Risse, T Busato, V Dufrost, M Perri, S Zuily, D Wahl
OBJECTIVES: Vascular medicine is now a clinical specialty in France. During their studies, students will acquire clinical reasoning in addition to technical skills. An Objective Structured Clinical Examination (OSCE) is considered as the gold standard for evaluating clinical competence. Our main objective was to evaluate the feasibility and acceptability of OSCE for the evaluation of students, secondarily their performance. METHODS: Three representative clinical cases of the specialty were developed...
May 2017: J Med Vasc
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