A systematic review of approaches for continuous quality improvement capacity-building

Context: Continuous quality improvement (CQI) has become prominent in public health settings; yet, little consolidated guidance exists for building CQI capacity of community-based organizations. Objective: To synthesize relevant literature to identify guiding principles and core components critical to building the capacity of organizations to adopt and use CQI. Design: We employed a systematic review approach to assess guiding principles and core components for CQI capacity-building as outlined in the literature. Eligibility Criteria: Studies meeting the following criteria were eligible for review: (1) empirical, peer-reviewed journal article, evaluation study, review, or systematic review; (2) published in 2010 or later; and (3) capacity-building activities were described in enough detail to be replicable. Studies not including human subjects, published in a language other than English, or for which full text was not available were excluded. Study Selection: The initial return of records included 6557 articles, of which 1455 were duplicates. The research team single-screened titles and abstracts of 5102 studies, resulting in the exclusion of 4842 studies. Two hundred sixty-two studies were double-screened during full-text review, yielding a final sample of 61 studies from which data were extracted. Main Outcome Measures: Outcome measures of interest were operationalized descriptions of guiding principles and core components of the CQI capacity-building approach. Results: Results yielded articles from medical education, health care, and public health settings. Findings included guiding principles and core components of CQI capacity-building identified in current practice, as well as infrastructural and contextual elements needed to build CQI capacity. Conclusions: This consolidation of guiding principles and core components for CQI capacity-building is valuable for public health and related workforces. Despite the uneven distribution of articles from health care, medical education, and public health settings, our findings can be used to guide public health organizations in building CQI capacity in a well-informed, systematic manner

Comparison of Shock Response Spectrum for Different Gun Tests

The Soft Catch Gun at Picatinny Arsenal is regularly used for component testing. Most shots contain accelerometers which record accelerations as a function of time. Statistics of accelerometer data indicate that the muzzle exit accelerations are, on average, higher than tactical firings. For that reason, Soft Catch Gun tests with unusually high accelerations may not be scored for Lot Acceptance Tests (LAT) by some customers. The 95/50 Normal Tolerance Limit (NTL) is proposed as a means of determining which test results should be scored. This paper presents comparisons of Shock Response Spectra (SRS) used for the 95/50 scoring criteria. The paper also provides a Discussion Section outlining some concerns with scoring LAT results based on test results outside of the proposed 95/50 criteria

Self-optimization, community stability, and fluctuations in two individual-based models of biological coevolution

We compare and contrast the long-time dynamical properties of two individual-based models of biological coevolution. Selection occurs via multispecies, stochastic population dynamics with reproduction probabilities that depend nonlinearly on the population densities of all species resident in the community. New species are introduced through mutation. Both models are amenable to exact linear stability analysis, and we compare the analytic results with large-scale kinetic Monte Carlo simulations, obtaining the population size as a function of an average interspecies interaction strength. Over time, the models self-optimize through mutation and selection to approximately maximize a community fitness function, subject only to constraints internal to the particular model. If the interspecies interactions are randomly distributed on an interval including positive values, the system evolves toward self-sustaining, mutualistic communities. In contrast, for the predator-prey case the matrix of interactions is antisymmetric, and a nonzero population size must be sustained by an external resource. Time series of the diversity and population size for both models show approximate 1/f noise and power-law distributions for the lifetimes of communities and species. For the mutualistic model, these two lifetime distributions have the same exponent, while their exponents are different for the predator-prey model. The difference is probably due to greater resilience toward mass extinctions in the food-web like communities produced by the predator-prey model.Comment: 26 pages, 12 figures. Discussion of early-time dynamics added. J. Math. Biol., in pres

Qualitative characteristics of meat from confined crossbred heifers fed with lipid sources

Lipids have been used in ruminant feed to replace high amounts of grain for increasing the diet energy density, performance and meat quality. This study evaluated the qualitative characteristics of meat from feedlot heifers fed with sources of lipid supplements. Twenty-one crossbred heifers (1/4Nelore × 1/4Santa Gertrudis × 1/2Braunvieh) were used. Each heifer received 60 % forage with a base of corn silage and 40 % concentrate, resulting in 5.8 % lipid content in the total diet. The following sources of lipids were used: soybeans, protected fat and soybean oil. There were no differences on physical characteristics of meat samples from heifers fed with the lipid sources. Soybeans increased the concentration of linoleic acid, content of polyunsaturated fatty acid and activity of the Δ9-desaturase C16 enzyme in the Longissimus muscle. The use of soybean oil in the diet increased the oleic acid, monounsaturated fatty acid, total cis- and trans-fatty acids (C18:0) and the activity of the Δ9-desaturase C16 enzyme in the subcutaneous fat. Diets with soybean grain had greater deposition of linoleic and linolenic acids than diets with fat protected and greater presence of these essential fatty acids are associated to a better composition and meat quality

Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm

Diagnosis and management of coronary artery disease represents major challenges to our health care system, affecting millions of patients each year. Until recently, the diagnosis of coronary artery disease was possible only through cardiac catheterization and invasive coronary angiography. To avoid the risks of an invasive procedure, stress testing is often employed for an initial assessment of patients with suspected coronary artery disease, serving as a gatekeeper for cardiac catheterization. With the emergence of non-invasive coronary angiography, the question arises if such a strategy is still sensible, particularly, in view of only a modest agreement between stress testing results and the presence of coronary artery disease established by cardiac catheterization. Much data in support of the diagnostic accuracy and prognostic value of non-invasive coronary angiography by computed tomography have emerged within the last few years. These data challenge the role of stress testing as the initial imaging modality in patients with suspected coronary artery disease. This article reviews the clinical utility, limitations, as well as the hazards of stress testing compared with non-invasive coronary artery imaging by computed tomography. Finally, the implications of this review are discussed in relation to clinical practice

Journeys from quantum optics to quantum technology

Sir Peter Knight is a pioneer in quantum optics which has now grown to an important branch of modern physics to study the foundations and applications of quantum physics. He is leading an effort to develop new technologies from quantum mechanics. In this collection of essays, we recall the time we were working with him as a postdoc or a PhD student and look at how the time with him has influenced our research

The present and future of QCD

This White Paper presents an overview of the current status and future perspective of QCD research, based on the community inputs and scientific conclusions from the 2022 Hot and Cold QCD Town Meeting. We present the progress made in the last decade toward a deep understanding of both the fundamental structure of the sub-atomic matter of nucleon and nucleus in cold QCD, and the hot QCD matter in heavy ion collisions. We identify key questions of QCD research and plausible paths to obtaining answers to those questions in the near future, hence defining priorities of our research over the coming decades