Implementation outcome instruments for use in physical healthcare settings: a systematic review

BACKGROUND: Implementation research aims to facilitate the timely and routine implementation and sustainment of evidence-based interventions and services. A glaring gap in this endeavour is the capability of researchers, healthcare practitioners and managers to quantitatively evaluate implementation efforts using psychometrically sound instruments. To encourage and support the use of precise and accurate implementation outcome measures, this systematic review aimed to identify and appraise studies that assess the measurement properties of quantitative implementation outcome instruments used in physical healthcare settings. METHOD: The following data sources were searched from inception to March 2019, with no language restrictions: MEDLINE, EMBASE, PsycINFO, HMIC, CINAHL and the Cochrane library. Studies that evaluated the measurement properties of implementation outcome instruments in physical healthcare settings were eligible for inclusion. Proctor et al.'s taxonomy of implementation outcomes was used to guide the inclusion of implementation outcomes: acceptability, appropriateness, feasibility, adoption, penetration, implementation cost and sustainability. Methodological quality of the included studies was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Psychometric quality of the included instruments was assessed using the Contemporary Psychometrics checklist (ConPsy). Usability was determined by number of items per instrument. RESULTS: Fifty-eight publications reporting on the measurement properties of 55 implementation outcome instruments (65 scales) were identified. The majority of instruments assessed acceptability (n = 33), followed by appropriateness (n = 7), adoption (n = 4), feasibility (n = 4), penetration (n = 4) and sustainability (n = 3) of evidence-based practice. The methodological quality of individual scales was low, with few studies rated as 'excellent' for reliability (6/62) and validity (7/63), and both studies that assessed responsiveness rated as 'poor' (2/2). The psychometric quality of the scales was also low, with 12/65 scales scoring 7 or more out of 22, indicating greater psychometric strength. Six scales (6/65) rated as 'excellent' for usability. CONCLUSION: Investigators assessing implementation outcomes quantitatively should select instruments based on their methodological and psychometric quality to promote consistent and comparable implementation evaluations. Rather than developing ad hoc instruments, we encourage further psychometric testing of instruments with promising methodological and psychometric evidence. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2017 CRD42017065348

Chronischer Stress Und Bewegungsmangel Reduzieren Baro-Afferente Signalübermittlung

peer reviewedChronischer Stress und Bewegungsmangel spielen eine wesentliche Rolle bei Interozeption. Kardiale Interozeption geht wiederum auf die Verarbeitung von baro-afferenten Signalen zurück. Um den Einfluss von Sport, sowie psychosozialem Stress auf die Verarbeitung baro-afferenter Signalverarbeitung zu untersuchen, rekrutierten wir 185 gesunde Teilnehmer (M: 22.82 Jahre; Geschlecht: 57.3 % weiblich). Den Teilnehmern wurden 14 akustische Schreckreize in der frühen (R-Zacke +230 ms) und späten (R +530 ms) kardialen Phase dargeboten, jeweils vor und nach einem sozial-evaluativen Kaltwasser-Stresstest (SEKWT), oder einer Kontrollbedingung. Chronischer Stress wurde mittels Trierer Inventar für Chronischen Stress (TICS), körperliche Aktivität mittels eines Items zu absolvierten Sporteinheiten in Stunden pro Woche erfasst. Weder die SEKWT-Gruppe (n = 115) (Md = 57.93, n = 63; Md = 55.83, n = 51; z = -1.229, p = .219) noch die Kontroll-Gruppe (Md = 25.27, n = 22; Md = 25.68, n = 28; z = -.787, p = .431) zeigten unterschiedliche Schreckreaktionen in der frühen gegenüber der späten kardialen Phase („kardiale Modulation der Schreckreaktion“/KMS). Signifikante Korrelationen zeigten sich zwischen dem KMS-Effekt und den TICS-Subskalen „Erfolgsdruck“ (r = .216, p = .005) und „Chronische Besorgnis“ (r = .156, p = .041). Eine Regressionsanalyse zeigte eine signifikante Interaktion zwischen erhöhter körperlicher Aktivität und dem KMS-Effekt in der SEKWT-Gruppe (F(1,113) = 5.257, p = .024) mit einer Varianzaufklärung von R2 = .044. Akuter Stress hat offenbar keinen Einfluss auf baro-afferente Signalverarbeitung. Chronischer Stress und verminderte körperliche Aktivität hingegen kann baro-afferente Signalübermittlung verringern, was ein Mechanismus der Symptomentstehung bei bestimmten Stress-bezogenen Erkrankungen sein könnte

Synthesis and coordination of a neutral phosphaguanidine and comparison of its basicity with a guanidine

A phosphaguanidine [Me2NC(PPh2)=NiPr], the analogous guanidine [Me2NC(NPh2)=NiPr], and their hydrochloride (HCl) salts were prepared to study the influence of substituting a phosphorus atom for a nitrogen atom on the basicity of the two compounds and the bonding in their conjugate acids. The pKa values of both HCl salts were measured in acetonitrile by NMR titration. Surprisingly, the substitution of P for N has essentially no effect on basicity even though the geometry at that atom is changed. The presence of phenyl substituents in the protonated guanidine reduces the resonance in the CN3 core, whereas poor orbital overlap between P and C reduces the resonance in the N2CP core of the protonated phosphaguanidine. The neutral phosphaguanidine binds to a Cu(I) halide through both the Nimine and the P, which suggested that the basic N atom on the bound ligand may have little utility as a Brønsted base. Fortunately, however, a Cu(I) halide complex of the protonated phosphaguanidine is stable. Thus, the tendency of the basic N to bind to metals does not proscribe it serving as a metal-proximate Brønsted base.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Pädiatrische versorgungskonzepte in Europa

To promote children’s health in Europe, the World Health Organization (WHO) developed the European child and adolescent health strategy 2015–2020, which is supported and will be implemented by all Member States (MS). In order to measure the implementation of the strategy at country level, the WHO regional office carried out a survey in 2016, involving 48 out of 53 countries (91%). Findings from the survey will be available in a forthcoming WHO report and on the WHO website. This article presents selected results about health systems, mental and sexual and reproductive health. The primary care of children and adolescents in Europe illustrates a variety of care models, yet the majority of MS incorporate a system in which children are treated by both pediatricians and general practitioners. The survey also shows that many countries, including Germany, do not have pediatric essential drug lists or pediatric formulations of all essential drugs. Key data on mental health of adolescents derived from the Health Behaviour in School-aged Children (HBSC) study, included in WHO Europe monitoring profiles of child health, has led to exemplary national actions. Access to sexual and reproductive health services continues to be a problem in many countries. A legal abortion without parental consent for adolescents under the age of 18 is only possible in less than half (48%) of the countries surveyed. This article compares the German case with that of other European countries and provides policy directions for the main childhood and youth health indicators in Europe as well as where they can be tracked. The ultimate aim is to support political dialogue, recognizing pediatricians as advocates for children, to make relevant recommendations for improving child and adolescent health

Pediatric treatment concepts in Europe

To promote children’s health in Europe, the World Health Organization (WHO) developed the European child and adolescent health strategy 2015–2020, which is supported and will be implemented by all Member States (MS). In order to measure the implementation of the strategy at country level, the WHO regional office carried out a survey in 2016, involving 48 out of 53 countries (91%). Findings from the survey will be available in a forthcoming WHO report and on the WHO website. This article presents selected results about health systems, mental and sexual and reproductive health. The primary care of children and adolescents in Europe illustrates a variety of care models, yet the majority of MS incorporate a system in which children are treated by both pediatricians and general practitioners. The survey also shows that many countries, including Germany, do not have pediatric essential drug lists or pediatric formulations of all essential drugs. Key data on mental health of adolescents derived from the Health Behaviour in School-aged Children (HBSC) study, included in WHO Europe monitoring profiles of child health, has led to exemplary national actions. Access to sexual and reproductive health services continues to be a problem in many countries. A legal abortion without parental consent for adolescents under the age of 18 is only possible in less than half (48%) of the countries surveyed. This article compares the German case with that of other European countries and provides policy directions for the main childhood and youth health indicators in Europe as well as where they can be tracked. The ultimate aim is to support political dialogue, recognizing pediatricians as advocates for children, to make relevant recommendations for improving child and adolescent health.PostprintPeer reviewe

Situation of child and adolescent health in Europe

To promote child health in Europe, the World Health Organization Regional Office for Europe developed the child and adolescent health strategy (2015–2020), which was adopted by all Member States of the WHO European Region. The strategy’s implementation was monitored through country profiles compiling existing health data and a survey sent to all 53 European ministries of health. Responses from 48 countries are described graphically, quantitatively and qualitatively. This report helps to review achievements and address gaps in realizing the full potential for the health and well-being of children and adolescents

Situation of child and adolescent health in Europe

To promote child health in Europe, the World Health Organization Regional Office for Europe developed the child and adolescent health strategy (2015–2020), which was adopted by all Member States of the WHO European Region. The strategy’s implementation was monitored through country profiles compiling existing health data and a survey sent to all 53 European ministries of health. Responses from 48 countries are described graphically, quantitatively and qualitatively. This report helps to review achievements and address gaps in realizing the full potential for the health and well-being of children and adolescents