The development of QUADAS : a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews

BACKGROUND: In the era of evidence based medicine, with systematic reviews as its cornerstone, adequate quality assessment tools should be available. There is currently a lack of a systematically developed and evaluated tool for the assessment of diagnostic accuracy studies. The aim of this project was to combine empirical evidence and expert opinion in a formal consensus method to develop a tool to be used in systematic reviews to assess the quality of primary studies of diagnostic accuracy. METHODS: We conducted a Delphi procedure to develop the quality assessment tool by refining an initial list of items. Members of the Delphi panel were experts in the area of diagnostic research. The results of three previously conducted reviews of the diagnostic literature were used to generate a list of potential items for inclusion in the tool and to provide an evidence base upon which to develop the tool. RESULTS: A total of nine experts in the field of diagnostics took part in the Delphi procedure. The Delphi procedure consisted of four rounds, after which agreement was reached on the items to be included in the tool which we have called QUADAS. The initial list of 28 items was reduced to fourteen items in the final tool. Items included covered patient spectrum, reference standard, disease progression bias, verification bias, review bias, clinical review bias, incorporation bias, test execution, study withdrawals, and indeterminate results. The QUADAS tool is presented together with guidelines for scoring each of the items included in the tool. CONCLUSIONS: This project has produced an evidence based quality assessment tool to be used in systematic reviews of diagnostic accuracy studies. Further work to determine the usability and validity of the tool continue

Kendala Adopsi Benih Bersertifikat untuk Usahatani Kentang

EnglishMost potato farmers in Indonesia do not adopt certified potato seed. Relatively expensive price of certified seed is the main reason the farmers apply the seed produced by themselves. In general, prices of potato produced using certified seed and those produced using uncertified seed are relatively equal. The farmers who regularly apply certified seed are those having partnership with the potato processor. High risk of potato seed production discourages the certified seed producers to produce it in sufficient amount for market supply. Less cost of certified seed production and improved potato selling price will enhance farmers\u27 adoption of certified seed. The government needs to empower the farmers to produce quality seed by themselves through informal seed system development rather than they have to depend on commercial certified-seed produced by the formal seed industry. IndonesianAdopsi benih kentang bermutu oleh petani kentang di berbagai daerah relatif rendah. Harga benih kentang bersertifikat yang relatif lebih mahal dibanding benih kentang yang dibuat sendiri oleh petani merupakan alasan utama petani tidak menggunakan benih bersertifikat. Harga kentang yang berasal dari benih buatan sendiri dibanding harga kentang yang berasal dari benih bersertifikat jika dijual ke pasar umum harganya relatif sama. Penggunaan benih kentang bersertifikat dilakukan petani terutama untuk kemitraan dengan prosesor kentang. Risiko tinggi dalam memproduksi benih kentang bersertifikat merupakan disinsentif bagi penangkar benih kentang untuk berproduksi dalam jumlah yang memadai. Kemudahan dalam menangkarkan benih bersertifikat dan membaiknya harga jual kentang akan meningkatkan adopsi petani terhadap benih kentang bersertifikat. Pemerintah juga harus berinisiatif agar petani secara mandiri bisa menghasilkan benih kentang bermutu melalui pengembangan sistem benih informal dan tidak harus bergantung pada benih kentang komersial yang dihasilkan industri benih formal

Aplikasi Quick Count Pada Pemilu Legislatif Dengan Metode Sainte Lague Berbasis Mobile

Pemilu merupakan pesta demokrasi di suatu kota yang diadakan setiap lima tahun sekali, untuk memilih anggota legislatif tingkat kota/kabupaten, DPR Provinsi, DPR RI, DPD maupun presiden. Permasalahan yang sering terjadi dalam Pemilu adalah biasanya perhitungan suara secara manual membutuhkan waktu yang lama, bisa mencapai beberapa minggu atau bahkan lebih dari sebulan. Hal ini dapat menyebabkan kesimpangsiuran dan ketidakpastian informasi siapa yang menang, siapa yang berhak duduk dikursi DPR (dalam pemilu legislatif). Penggunaan handphone dapat dimanfaatkan sebagai media pengiriman data perhitungan suara dari tiap tempat pemungutan suara (TPS) yang tersebar di seluruh Indonesia. Tujuan dari penelitian ini membangun aplikasi quick count pada pemilu legislatif untuk mempercepat perhitungan suara menggunakan metode sainte lague. Hasil dari penelitian aplikasi quick count ini dapat menyampaikan hasil perhitungan suara di setiap TPS tanpa harus menunggu waktu yang terlalu lama dikarenakan setiap relawan dapat langsung mengirimkan hasil perhitungan suara pada setiap penugasannya menggunakan smartphonenya

Exploring differential item functioning in the SF-36 by demographic, clinical, psychological and social factors in an osteoarthritis population

The SF-36 is a very commonly used generic measure of health outcome in osteoarthritis (OA). An important, but frequently overlooked, aspect of validating health outcome measures is to establish if items work in the same way across subgroup of a population. That is, if respondents have the same 'true' level of outcome, does the item give the same score in different subgroups or is it biased towards one subgroup or another. Differential item functioning (DIF) can identify items that may be biased for one group or another and has been applied to measuring patient reported outcomes. Items may show DIF for different conditions and between cultures, however the SF-36 has not been specifically examined in an osteoarthritis population nor in a UK population. Hence, the aim of the study was to apply the DIF method to the SF-36 for a UK OA population. The sample comprised a community sample of 763 people with OA who participated in the Somerset and Avon Survey of Health. The SF-36 was explored for DIF with respect to demographic, social, clinical and psychological factors. Well developed ordinal regression models were used to identify DIF items. Results: DIF items were found by age (6 items), employment status (6 items), social class (2 items), mood (2 items), hip v knee (2 items), social deprivation (1 item) and body mass index (1 item). Although the impact of the DIF items rarely had a significant effect on the conclusions of group comparisons, in most cases there was a significant change in effect size. Overall, the SF-36 performed well with only a small number of DIF items identified, a reassuring finding in view of the frequent use of the SF-36 in OA. Nevertheless, where DIF items were identified it would be advisable to analyse data taking account of DIF items, especially when age effects are the focus of interest

Sociodemographic Characteristics and their Associations with Knowledge, Attitude, and Practice on Leprosy

Background: Garbage has the potential to cause pollution and health problems. Pollution can occur in the air as a result of waste decomposition, can also contaminate water and soil caused by leakage (liquid waste) resulting in various skin diseases. The skin disease are caused by several types of pathogenic microorganism that live and breed in the waste. This study aimed to determine the impact of long residence adjacent to sanitary landfill, distance to landfill, and skin contact with garbage on skin disease symptoms at Putri Cempo final waste disposal, Mojosongo, Surakarta. Subjects and Method: This was an analytic observational study using cross sectional design. This study was conducted in Putri Cempo final waste disposal, Mojosongo, Surakarta, Central Java. A sample of 102 residents living near the Putri Cempo waste disposal were selected for this study. The dependent variable was symptoms of skin disease. The independent variables were duration of residence near the sanitary landfill, house distance to landfill, and skin contact with garbage. The data were collected by questionnaire and analyzed using multiple logistic regression. Results: Residence near the sanitary landfill near ≥ 3 years (OR= 6.00; 95% CI= 1.97 to 18.20; p= 0.002) and house distance to landfill <1 km (OR = 9.50; 95% CI= 3.10 to 28.80; p = 0.001) increased the risk of skin disease symptoms. Indirect contact with waste (OR= 0.68; 95% CI= 0.10 to 2.90; p= 0.605) was associated with decreased skin disease symptoms, but it was statistically insignificant. Conclusion: Residence near the sanitary landfill near ≥ 3 years and house distance to landfill <1 km increase the risk of skin disease symptoms. Keywords: skin disease, symptomp, waste disposal, sanitary landfill, residenc

Methods for the thematic synthesis of qualitative research in systematic reviews

<p>Abstract</p> <p>Background</p> <p>There is a growing recognition of the value of synthesising qualitative research in the evidence base in order to facilitate effective and appropriate health care. In response to this, methods for undertaking these syntheses are currently being developed. Thematic analysis is a method that is often used to analyse data in primary qualitative research. This paper reports on the use of this type of analysis in systematic reviews to bring together and integrate the findings of multiple qualitative studies.</p> <p>Methods</p> <p>We describe thematic synthesis, outline several steps for its conduct and illustrate the process and outcome of this approach using a completed review of health promotion research. Thematic synthesis has three stages: the coding of text 'line-by-line'; the development of 'descriptive themes'; and the generation of 'analytical themes'. While the development of descriptive themes remains 'close' to the primary studies, the analytical themes represent a stage of interpretation whereby the reviewers 'go beyond' the primary studies and generate new interpretive constructs, explanations or hypotheses. The use of computer software can facilitate this method of synthesis; detailed guidance is given on how this can be achieved.</p> <p>Results</p> <p>We used thematic synthesis to combine the studies of children's views and identified key themes to explore in the intervention studies. Most interventions were based in school and often combined learning about health benefits with 'hands-on' experience. The studies of children's views suggested that fruit and vegetables should be treated in different ways, and that messages should not focus on health warnings. Interventions that were in line with these suggestions tended to be more effective. Thematic synthesis enabled us to stay 'close' to the results of the primary studies, synthesising them in a transparent way, and facilitating the explicit production of new concepts and hypotheses.</p> <p>Conclusion</p> <p>We compare thematic synthesis to other methods for the synthesis of qualitative research, discussing issues of context and rigour. Thematic synthesis is presented as a tried and tested method that preserves an explicit and transparent link between conclusions and the text of primary studies; as such it preserves principles that have traditionally been important to systematic reviewing.</p

THE EFFECTIVENESS OF LEARNING MODULE TO TRAIN CRITICAL THINKING SKILL

The limited material and students’ low thinking skill on science in grade eighth of SMPN 1 Paringin inspire the researcher to compose learning material in the form of module. This research aims to evaluate the quality of Natural Science learning module in grade 8. The research model uses Tessmer model which covers 1) self evaluation, 2) expert review, 3) one-to-one, 4) small group, and 5) field test. The research is conducted in SMPN 1 Paringin academic year 2016/2017. The module effectiveness data covers cognitive learning result, critical thinking skill, good attitude, social skill, and students’ responses. The research result shows that the developed module is effective. The effectiveness is based on some parameters, they are; 1) students’ cognitive learning result is beyond classical accomplishment, 2) students’ critical thinking skill is very good, 3) students’ attitude covering honesty and responsibility is averagely very good, 4) students’ social skill covering cooperation and contributing idea is averagely very good, 5) students’ responses are generally good.  Article visualizations

Andre gevinstrealiseringsrapport med anbefalinger. Nasjonalt velferdsteknologiprogram

Stortinget etablerte gjennom RNB 2013 (Helse- og omsorgsdepartementet, 2013) «Nasjonalt program for utvikling og implementering av velferdsteknolog 2014-2020». Den nasjonale satsingen har som hovedmålsetning å møte kommunenes informasjons- og kunnskapsbehov for å tilrettelegge for bred bruk av velferdsteknologiske løsninger. Det nasjonale programmet presenterer her den andre gevinstrapporten fra utprøvinger av trygghets- og mestringsteknologi som er foretatt av utviklingskommunene. Kommunene har høstet mange nye erfaringer i året som har gått og resultatene som fremkommer er entydige; velferdsteknologi gir betydelig gevinst. Resultatene gir grunnlag for anbefalinger om nye teknologiområder som du kan lese om i denne rapporten, i tillegg til flere erfaringer fra tidligere anbefalte løsninger. Utviklingskommunene i det nasjonale programmet har lagt ned et imponerende arbeid: Fra det første tilskuddet ble gitt i 2013 og frem til i dag har kommunene tatt kvantesprang i prosjektstyring, tjenesteutvikling, evaluerings- og dokumentasjonsarbeid, bestillerkompetanse og generell kunnskap om velferdsteknologi. Disse kommunene besitter nå en verdifull kompetanse om muligheter og nytteverdi for sluttbruker, pårørende og tjenesten som helhet. Denne kunnskapen vil gjøre veien lettere for andre kommuner som vil i gang med velferdsteknologi, når stafettpinnen nå går videre. Helsesektoren er i konstant endring - både behov og muligheter utvikler seg.Kommuner som ser muligheter i teknologien og legger om måten de leverer helse- og omsorgstjenester på står bedre rustet til å møte fremtidens utfordringer

Andre gevinstrealiseringsrapport med anbefalinger. Nasjonalt velferdsteknologiprogram

Stortinget etablerte gjennom RNB 2013 (Helse- og omsorgsdepartementet, 2013) «Nasjonalt program for utvikling og implementering av velferdsteknolog 2014-2020». Den nasjonale satsingen har som hovedmålsetning å møte kommunenes informasjons- og kunnskapsbehov for å tilrettelegge for bred bruk av velferdsteknologiske løsninger. Det nasjonale programmet presenterer her den andre gevinstrapporten fra utprøvinger av trygghets- og mestringsteknologi som er foretatt av utviklingskommunene. Kommunene har høstet mange nye erfaringer i året som har gått og resultatene som fremkommer er entydige; velferdsteknologi gir betydelig gevinst. Resultatene gir grunnlag for anbefalinger om nye teknologiområder som du kan lese om i denne rapporten, i tillegg til flere erfaringer fra tidligere anbefalte løsninger. Utviklingskommunene i det nasjonale programmet har lagt ned et imponerende arbeid: Fra det første tilskuddet ble gitt i 2013 og frem til i dag har kommunene tatt kvantesprang i prosjektstyring, tjenesteutvikling, evaluerings- og dokumentasjonsarbeid, bestillerkompetanse og generell kunnskap om velferdsteknologi. Disse kommunene besitter nå en verdifull kompetanse om muligheter og nytteverdi for sluttbruker, pårørende og tjenesten som helhet. Denne kunnskapen vil gjøre veien lettere for andre kommuner som vil i gang med velferdsteknologi, når stafettpinnen nå går videre. Helsesektoren er i konstant endring - både behov og muligheter utvikler seg.Kommuner som ser muligheter i teknologien og legger om måten de leverer helse- og omsorgstjenester på står bedre rustet til å møte fremtidens utfordringer