Psychometric properties of the QoL-ME:A visual and personalized quality of life assessment app for people with severe mental health problems

Background: Quality of Life (QoL) assessment in people with severe mental health problems may benefit from improved personalization and accessibility. Therefore, an innovative, digital, visual, and personalized QoL assessment app for people with severe mental health problems was recently developed: the QoL-ME. The aim of this study was to evaluate the psychometric quality of the QoL-ME by assessing its reliability, validity, and responsiveness. Methods: To examine the reliability of the QoL-ME, the internal consistency of its subscales was assessed using Cronbach's Alpha. Correlations between the QoL-ME and the MANSA were computed to appraise the construct validity of the QoL-ME. Internal responsiveness was evaluated using the standardized response mean and external responsiveness was investigated using hierarchical regression. Results: Cronbach's Alpha's of the subscales of the QoL-ME ranged between 0.5 and 0.84. In accordance with expectations, the language-based core version of the QoL-ME correlated strongly (r = between 0.55 and 0.76) with the MANSA, whilst the picture-based additional modules of the QoL-ME correlated moderately (r = 0.3) with the MANSA. The standardized response mean was 0.23 and the regression model revealed a coefficient β of −0.01. Conclusions: The QoL-ME has adequate psychometric properties. In comparison with similar pictorial instruments, both the QoL-ME's reliability and validity can be considered as sufficient. The results indicate that the responsiveness of the QoL-ME is insufficient. Additional research is needed to evaluate and potentially modify the instrument to improve its responsiveness

Reorganizing and integrating public health, health care, social care and wider public services:A theory-based framework for collaborative adaptive health networks to achieve the triple aim

Forty-one studies were included. Eight components were identified: social forces, resources, finance, relations, regulations, market, leadership, and accountability. Each component consists of three or more subcomponents, providing insight into (1) the (sub)component-specific strategies that accelerate PHM development, (2) the necessary contextual factors and mechanisms for these strategies to be successful and (3) the extracted theories that underlie the (sub)component-specific SCMO configurations. These theories originate from a wide variety of scientific disciplines. We bring these (sub)components together into what we call the Collabroative Adaptive Health Network (CAHN) framework

Pharmacokinetics of amphotericin B after accidental overdose in an adult critically ill patient treated with plasmapheresis: a case report and review of literature

Amphotericin B is a broad-spectrum antifungal agent that is used in the treatment of systemic fungal infections. We describe the case of a 62-year-old female patient with recent aneurysmal subarachnoid hemorrhage who was treated for suspected ventriculitis and a fungal coinfection. Instead of liposomal amphotericin B (L-AmB), 465 mg (5 mg/kg) amphotericin B deoxycholate (DOC) was inadvertently administered, leading to refractory shock with multiple organ failure and requiring mechanical ventilation. Since an overdose of amphotericin B can lead to fatal consequences and has a half-life of 15 days, plasmapheresis was started. The serum concentration decreased from 1.32 µg/mL to 0.62 µg/mL before plasmapheresis, demonstrating a mean half-life of 49 hours. After two plasmapheresis sessions, the serum concentration further dropped to 0.26 µg/mL, demonstrating a mean half-life of 17 hours. In contrast, the third plasmapheresis session had no effect on serum concentration. The patient made a full recovery, potentially facilitated by enhanced amphotericin B elimination through plasmapheresis. Positive outcomes were previously reported in two adult patients treated with plasmapheresis. However, other reports without plasmapheresis described fatal outcomes in adult patients, albeit with a twofold overdose compared to the two patients successfully treated with plasmapheresis. Moreover, plasmapheresis itself carries risks such as hypocalcemia, metabolic alkalosis, and coagulation deficits. Consequently, the role of plasmapheresis in amphotericin B overdose is still debated

Visual and personalized quality of life assessment app for people with severe mental health problems:Qualitative evaluation

Background:  QoL-ME is a digital visual personalized quality of life assessment app for people with severe mental health problems. Research reveals that e-mental health apps frequently suffer from low engagement and fall short of expectations regarding their impact on patients' daily lives. Studies often indicate that e-mental health apps ought to respect the needs and preferences of end users to achieve optimal user engagement. Objective:  The aim of this study was to explore the experiences of users regarding the usability and functionality of QoL-ME and whether the app is actionable and beneficial for patients. Methods:  End users (n=8) of QoL-ME contributed to semistructured interviews. An interview guide was used to direct the interviews. All interviews were audiorecorded and transcribed verbatim. Transcriptions were analyzed and coded thematically. Results:  Analysis revealed 3 main themes: (1) benefit, (2) actionability, and (3) characteristics of the QoL-ME. The first theme reveals that the QoL-ME app was beneficial for the majority of respondents, primarily by prompting them to reflect on their quality of life. The current version is not yet actionable; the actionability of the QoL-ME app may be improved by enabling users to view their scores over time and by supplying practical advice for quality of life improvements. Overall, participants had positive experiences with the usability, design, and content of the app. Conclusions:  The QoL-ME app can be beneficial to users as it provides them with insight into their quality of life and elicits reflection. Incorporating more functionalities that facilitate self-management, such as advice and strategies for improving areas that are lacking, will likely make the app actionable. Patients positively regarded the usability, design, and contents of the QoL-ME app

Implementing population health managemen

Purpose The purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social care and community services to improve population health and quality of care while reducing costs growth, this study compared four large-scale transformation programs: Greater Manchester Devolution, Vancouver Healthy City Strategy, Gen-H Cincinnati and Gesundes Kinzigtal. Design/methodology/approach Following the realist methodology, this explorative comparative case-study investigated PHM initiatives' key features and participants' experiences of developing such initiatives. A semi-structured interview guideline based on a theoretical framework for PHM guided the interviews with stakeholders (20) from different sectors. Findings Five initial program theories important to the development of PHM were formulated: (1) create trust in a shared vision and understanding of the PHM rationale to establish stakeholders' commitment to the partnership; (2) create shared ownership for achieving the initiative's goals; (3) create shared financial interest that reduces perceived financial risks to provide financial sustainability; (4) create a learning environment to secure initiative's credibility and (5) create citizens' and professionals' awareness of the required attitudes and behaviours. Originality/value The study highlights initial program theories for the implementation of PHM including different strategies and structures underpinning the initiatives. These insights provide a deeper understanding of how large-scale transformation could be developed

Constraints on a Parity-Conserving/Time-Reversal-Non-Conserving Interaction

Time-Reversal-Invariance non-conservation has now been unequivocally demonstrated in a direct measurement at CPLEAR. What about tests of time-reversal-invariance in systems other than the kaon system? Tests of time-reversal-invariance belong to two classes: searches for parity violating (P-odd)/time-reversal-invariance-odd (T-odd) interactions, and for P-even/T-odd interactions (assuming CPT conservation this implies C-conjugation non-conservation). Limits on a P-odd/T-odd interaction follow from measurements of the electric dipole moment of the neutron (with a present upper limit of 6 x 10^-26 e.cm [95% C.L.]). It provides a limit on a P-odd/T-odd pion-nucleon coupling constant which is less than 10^-4 times the weak interaction strength. Experimental limits on a P-even/T-odd interaction are much less stringent. Following the standard approach of describing the nucleon-nucleon interaction in terms of meson exchanges, it can be shown that only charged rho-meson exchange and A_1 meson exchange can lead to a P-even/T-odd interaction. The better constraints stem from measurements of the electric dipole moment of the neutron and from measurements of charge-symmetry breaking in neutron-proton elastic scattering. The latter experiments were executed at TRIUMF (497 and 347 MeV) and at IUCF (183 MeV). Weak decay experiments may provide limits which will possibly be comparable. All other experiments, like gamma decay experiments, detailed balance experiments, polarization - analyzing power difference determinations, and five-fold correlation experiments with polarized incident nucleons and aligned nuclear targets, have been shown to be at least an order of magnitude less sensitive.Comment: 15 pages LaTeX, including 5 PostScript figures. Uses ijmpe1.sty. To appear in International Journal of Modern Physics E (IJMPE). Slight change in short abstrac

Towards a knowledge-rich learning environment in preparatory secondary education

In this case study a novel educational programme for students in preparatory vocational education was studied. The research questions were: (1) Which teaching/learning processes occur in a simulated workplace using the concept of a knowledge-rich workplace? (2) What is the role of models and modelling in the teaching/learning processes? The curriculum project consisted of design and construction tasks. The students were collaboratively involved in the process of designing a tricycle for a real customer. This real-life activity creates opportunities for students to develop and use models, which can be used in more than in one context. The case study explored how the teachers deal with the students' explicit and implicit need for knowledge and skills. The main findings are that teachers more often provide this knowledge, rather than guide the students in reconstructing it, and towards the end of the project, knowledge tended to remain situated

A high-density SNP chip for genotyping great tit (Parus major) populations and its application to studying the genetic architecture of exploration behaviour

High‐density SNP microarrays (“SNP chips”) are a rapid, accurate and efficient method for genotyping several hundred thousand polymorphisms in large numbers of individuals. While SNP chips are routinely used in human genetics and in animal and plant breeding, they are less widely used in evolutionary and ecological research. In this article, we describe the development and application of a high‐density Affymetrix Axiom chip with around 500,000 SNP s, designed to perform genomics studies of great tit (Parus major ) populations. We demonstrate that the per‐SNP genotype error rate is well below 1% and that the chip can also be used to identify structural or copy number variation. The chip is used to explore the genetic architecture of exploration behaviour (EB ), a personality trait that has been widely studied in great tits and other species. No SNP s reached genomewide significance, including at DRD 4 , a candidate gene. However, EB is heritable and appears to have a polygenic architecture. Researchers developing similar SNP chips may note: (i) SNP s previously typed on alternative platforms are more likely to be converted to working assays; (ii) detecting SNP s by more than one pipeline, and in independent data sets, ensures a high proportion of working assays; (iii) allele frequency ascertainment bias is minimized by performing SNP discovery in individuals from multiple populations; and (iv) samples with the lowest call rates tend to also have the greatest genotyping error rates

Parity Violation in Proton-Proton Scattering at 221 MeV

The parity-violating longitudinal analyzing power, Az, has been measured in pp elastic scattering at an incident proton energy of 221 MeV. The result obtained is Az =(0.84 +/- 0.29 (stat.) +/- 0.17 (syst.)) x 10^{-7}. This experiment is unique in that it selects a single parity violating transition amplitude, 3P2-1D2, and consequently directly constrains the weak meson-nucleon coupling constant h^pp_rho When this result is taken together with the existing pp parity violation data, the weak meson-nucleon coupling constants h^pp_rho and h^pp_omega can, for the first time, both be determined.Comment: 8 pages RevTeX4, 3 PostScript figures. Conclusion revised. New information about weak coupling constants adde