The use of patient feedback by hospital boards of directors: a qualitative study of two NHS hospitals in England

BACKGROUND: Although previous research suggests that different kinds of patient feedback are used in different ways to help improve the quality of hospital care, there have been no studies of the ways in which hospital boards of directors use feedback for this purpose. OBJECTIVES: To examine whether and how boards of directors of hospitals use feedback from patients to formulate strategy and to assure and improve the quality of care. METHODS: We undertook an in-depth qualitative study in two acute hospital National Health Service foundation trusts in England, purposively selected as contrasting examples of the collection of different kinds of patient feedback. We collected and analysed data from interviews with directors and other managers, from observation of board meetings, and from board papers and other documents. RESULTS: The two boards used in-depth qualitative feedback and quantitative feedback from surveys in different ways to help develop strategies, set targets for quality improvement and design specific quality improvement initiatives; but both boards made less subsequent use of any kinds of feedback to monitor their strategies or explicitly to assure the quality of services. DISCUSSION AND CONCLUSIONS: We have identified limitations in the uses of patient feedback by hospital boards that suggest that boards should review their current practice to ensure that they use the different kinds of patient feedback that are available to them more effectively to improve, monitor and assure the quality of care

Acoustic modelling of exhaust devices with nonconforming finite element meshes and transfer matrices

[EN] Transfer matrices are commonly considered in the numerical modelling of the acoustic behaviour associated with exhaust devices in the breathing system of internal combustion engines, such as catalytic converters, particulate filters, perforated mufflers and charge air coolers. In a multidimensional finite element approach, a transfer matrix provides a relationship between the acoustic fields of the nodes located at both sides of a particular region. This approach can be useful, for example, when one-dimensional propagation takes place within the region substituted by the transfer matrix. As shown in recent investigations, the sound attenuation of catalytic converters can be properly predicted if the monolith is replaced by a plane wave four-pole matrix. The finite element discretization is retained for the inlet/outlet and tapered ducts, where multidimensional acoustic fields can exist. In this case, only plane waves are present within the capillary ducts, and three-dimensional propagation is possible in the rest of the catalyst subcomponents. Also, in the acoustic modelling of perforated mufflers using the finite element method, the central passage can be replaced by a transfer matrix relating the pressure difference between both sides of the perforated surface with the acoustic velocity through the perforations. The approaches in the literature that accommodate transfer matrices and finite element models consider conforming meshes at connecting interfaces, therefore leading to a straightforward evaluation of the coupling integrals. With a view to gaining flexibility during the mesh generation process, it is worth developing a more general procedure. This has to be valid for the connection of acoustic subdomains by transfer matrices when the discretizations are nonconforming at the connecting interfaces. In this work, an integration algorithm similar to those considered in the mortar finite element method, is implemented for nonmatching grids in combination with acoustic transfer matrices. A number of numerical test problems related to some relevant exhaust devices are then presented to assess the accuracy and convergence performance of the proposed procedure.Authors gratefully acknowledge the financial support of Ministerio de Ciencia e Innovacion and the European Regional Development Fund by means of the Projects DPI2007-62635 and DPI2010-15412.Denia, F.; Martínez-Casas, J.; Baeza, L.; Fuenmayor, F. (2012). Acoustic modelling of exhaust devices with nonconforming finite element meshes and transfer matrices. Applied Acoustics. 73(8):713-722. https://doi.org/10.1016/j.apacoust.2012.02.003S71372273

Followee recommendation in twitter using fuzzy link prediction.

In social networking sites, it is useful to receive recommendations about whom to contact or follow. These recommendations not only allow to establish connections with people one might already know in real life, but also with people or users that have similar interests or are potentially interesting. We propose an approach that tackles contact (followee) recommendation in Twitter by means of fuzzy logic. This fuzzy approach handles recommendation as a link prediction problem and uses three types of similarity between a pair of users: tweet similarity, followee id similarity, and followee tweet similarity. These similarities are calculated by extracting user profiles. These profiles are, in turn, obtained by considering Twitter as a heterogeneous information network. To test our approach, we crawled a repository of 6,000 users and 2 million tweets, and we measured accuracy by comparing our results with the actual followee lists of the users. These results, which are also compared against the results given by state-of-the-art methods, show a high accuracy. Other advantages of the fuzzy system include a self-explanatory capability and the ability to produce a non-binary friendship value

The Long Life of Birds: The Rat-Pigeon Comparison Revisited

The most studied comparison of aging and maximum lifespan potential (MLSP) among endotherms involves the 7-fold longevity difference between rats (MLSP 5y) and pigeons (MLSP 35y). A widely accepted theory explaining MLSP differences between species is the oxidative stress theory, which purports that reactive oxygen species (ROS) produced during mitochondrial respiration damage bio-molecules and eventually lead to the breakdown of regulatory systems and consequent death. Previous rat-pigeon studies compared only aspects of the oxidative stress theory and most concluded that the lower mitochondrial superoxide production of pigeons compared to rats was responsible for their much greater longevity. This conclusion is based mainly on data from one tissue (the heart) using one mitochondrial substrate (succinate). Studies on heart mitochondria using pyruvate as a mitochondrial substrate gave contradictory results. We believe the conclusion that birds produce less mitochondrial superoxide than mammals is unwarranted

Nanostructures for imaging, medical diagnostics and therapy

RESEARCHER ID D-9318-2017 (Juan Luis Paris de la Fuente) ORCID 0000-0001-8950-283X (Juan Luis Paris de la Fuente) RESEARCHER ID M-3378-2014 (María Vallet Regí) ORCID 0000-0002-6104-4889 (María Vallet Regí)Depto. de Química en Ciencias FarmacéuticasFac. de FarmaciaTRUEEuropean Research CouncilMinisterio de Economía y Competitividad (MINECO)pu

The Application of DNA Barcodes for the Identification of Marine Crustaceans from the North Sea and Adjacent Regions

During the last years DNA barcoding has become a popular method of choice for molecular specimen identification. Here we present a comprehensive DNA barcode library of various crustacean taxa found in the North Sea, one of the most extensively studied marine regions of the world. Our data set includes 1,332 barcodes covering 205 species, including taxa of the Amphipoda, Copepoda, Decapoda, Isopoda, Thecostraca, and others. This dataset represents the most extensive DNA barcode library of the Crustacea in terms of species number to date. By using the Barcode of Life Data Systems (BOLD), unique BINs were identified for 198 (96.6%) of the analyzed species. Six species were characterized by two BINs (2.9%), and three BINs were found for the amphipod species Gammarus salinus Spooner, 1947 (0.4%). Intraspecific distances with values higher than 2.2% were revealed for 13 species (6.3%). Exceptionally high distances of up to 14.87% between two distinct but monophyletic clusters were found for the parasitic copepod Caligus elongatus Nordmann, 1832, supporting the results of previous studies that indicated the existence of an overlooked sea louse species. In contrast to these high distances, haplotype-sharing was observed for two decapod spider crab species, Macropodia parva Van Noort & Adema, 1985 and Macropodia rostrata (Linnaeus, 1761), underlining the need for a taxonomic revision of both species. Summarizing the results, our study confirms the application of DNA barcodes as highly effective identification system for the analyzed marine crustaceans of the North Sea and represents an important milestone for modern biodiversity assessment studies using barcode sequence

O6-Methylguanine-DNA methyltransferase protein expression by immunohistochemistry in brain and non-brain systemic tumours: systematic review and meta-analysis of correlation with methylation-specific polymerase chain reaction

Background: The DNA repair protein O6-Methylguanine-DNA methyltransferase (MGMT) confers resistance to alkylating agents. Several methods have been applied to its analysis, with methylation-specific polymerase chain reaction (MSP) the most commonly used for promoter methylation study, while immunohistochemistry (IHC) has become the most frequently used for the detection of MGMT protein expression. Agreement on the best and most reliable technique for evaluating MGMT status remains unsettled. The aim of this study was to perform a systematic review and meta-analysis of the correlation between IHC and MSP. Methods A computer-aided search of MEDLINE (1950-October 2009), EBSCO (1966-October 2009) and EMBASE (1974-October 2009) was performed for relevant publications. Studies meeting inclusion criteria were those comparing MGMT protein expression by IHC with MGMT promoter methylation by MSP in the same cohort of patients. Methodological quality was assessed by using the QUADAS and STARD instruments. Previously published guidelines were followed for meta-analysis performance. Results Of 254 studies identified as eligible for full-text review, 52 (20.5%) met the inclusion criteria. The review showed that results of MGMT protein expression by IHC are not in close agreement with those obtained with MSP. Moreover, type of tumour (primary brain tumour vs others) was an independent covariate of accuracy estimates in the meta-regression analysis beyond the cut-off value. Conclusions Protein expression assessed by IHC alone fails to reflect the promoter methylation status of MGMT. Thus, in attempts at clinical diagnosis the two methods seem to select different groups of patients and should not be used interchangeably