Person centred care provision and care planning in chronic kidney disease: which outcomes matter? A systematic review and thematic synthesis of qualitative studies. Care planning in CKD: which outcomes matter?

Rationale & Objective: Explore priorities related to outcomes and barriers of adults with chronic kidney disease (CKD) regarding person centred care and care planning.Study design: Systematic review of qualitative studies.Search Strategy & Sources: In July 2018 six bibliographic databases, and reference lists of included articles were searched for qualitative studies that included adults with CKD stages 1-5, not on dialysis or conservative management, without a previous kidney transplantation.Analytical Approach: Three independent reviewers extracted and inductively coded data using thematic synthesis. Reporting quality was assessed using the COREQ and the review reported according to PRISMA and ENTREQ statements.Results: Forty-six studies involving 1493 participants were eligible. The period after diagnosis of CKD is characterized by feelings of uncertainty, social isolation, financial burden, resentment and fear of the unknown. Patients show interest in ways to return to normality and remain in control of their health in order to avoid further deterioration of kidney function. However, necessary information is often unavailable or incomprehensible. Although patients and healthcare professionals share the predominant interest of whether or not dialysis or transplantation is necessary, patients value many more outcomes that are often unrecognized by their healthcare professionals. We identified 4 themes with 6 subthemes that summarize these findings: 'pursuing normality and control' ('pursuing normality'; 'a search for knowledge'); 'prioritizing outcomes' ('reaching kidney failure'; 'experienced health'; 'social life'; 'work and economic productivity'); 'predicting the future'; and 'realising what matters'. Reporting quality was moderate for most included studies.Limitations: Exclusion of non-English articles.Conclusions: The realisation that patients' priorities do not match those of the healthcare professionals, in combination with the prognostic ambiguity, confirms fatalistic perceptions of not being in control when living with CKD. These insights may contribute to greater understanding of patients' perspectives and a more person-centred approach in healthcare prioritization and care planning within CKD care.Clinical epidemiolog

Hyperfine structure of the ground state muonic He-3 atom

On the basis of the perturbation theory in the fine structure constant $\alpha$ and the ratio of the electron to muon masses we calculate one-loop vacuum polarization and electron vertex corrections and the nuclear structure corrections to the hyperfine splitting of the ground state of muonic helium atom $(\mu\ e \ ^3_2He)$. We obtain total result for the ground state hyperfine splitting $\Delta \nu^{hfs}=4166.471$ MHz which improves the previous calculation of Lakdawala and Mohr due to the account of new corrections of orders $\alpha^5$ and $\alpha^6$. The remaining difference between our theoretical result and experimental value of the hyperfine splitting lies in the range of theoretical and experimental errors and requires the subsequent investigation of higher order corrections.Comment: Talk on poster section of XXIV spectroscopy congress, 28 February-5 March 2010, Moscow-Troitsk, Russia, 21 pages, LaTeX, 8 figure

Feasibility and acceptability of e-PROMs data capture and feedback among patients receiving haemodialysis in the Symptom monitoring WIth Feedback Trial (SWIFT) pilot: protocol for a qualitative study in Australia

INTRODUCTION: People receiving haemodialysis experience a high symptom burden and impaired quality of life. The use of patient-reported outcome measures (PROMs) is increasing in nephrology care, however their acceptability, utility and impacts are not well understood. METHODS AND ANALYSIS: We describe a protocol for a qualitative study to evaluate the feasibility and acceptability of electronic-PROMs (e-PROMs) data capture and feedback in haemodialysis following the pilot Symptom monitoring WIth Feedback Trial (SWIFT). SWIFT involves linkage of e-PROMs data, including symptoms and health-related quality of life, to the Australia and New Zealand Dialysis and Transplant Registry with feedback to patients' treating nephrologists and nurse unit managers. Focus groups and semistructured interviews will be conducted with nephrologists (n=15), dialysis nurses (n=24) and patients receiving haemodialysis (n=24) from six dialysis units in Australia. Question topics will include the technical and clinical feasibility and acceptability of e-PROMs reporting and feedback (including the barriers and enablers to uptake) and perceived impact on patient care and outcomes. Transcripts will be analysed thematically and guided by Normalisation Process Theory. ETHICS AND DISSEMINATION: Ethics approval was obtained from the relevant hospital Human Research Ethics Committees (HREC/18/CALHN/481; HREC/MML/54599). The findings from the SWIFT pilot and qualitative evaluation will inform the implementation of the SWIFT main trial, and more broadly, the use of e-PROMs in clinical settings and registries. TRIAL REGISTRATION NUMBER: ANZCTRN12618001976279.Emily Duncanson, Paul N Bennett, Andrea Viecelli, Kathryn Dansie, William Handke, Allison Ton

A meta-review demonstrates improved reporting quality of qualitative reviews following the publication of COREQ- and ENTREQ-checklists, regardless of modest uptake

Background Reviews of qualitative studies allow for deeper understanding of concepts and findings beyond the single qualitative studies. Concerns on study reporting quality led to the publication of the COREQ-guidelines for qualitative studies in 2007, followed by the ENTREQ-guidelines for qualitative reviews in 2012. The aim of this meta-review is to: 1) investigate the uptake of the COREQ- and ENTREQ- checklists in qualitative reviews; and 2) compare the quality of reporting of the primary qualitative studies included within these reviews prior- and post COREQ-publication. Methods Reviews were searched on 02-Sept-2020 and categorized as (1) COREQ- or (2) ENTREQ-using, (3) using both, or (4) non-COREQ/ENTREQ. Proportions of usage were calculated over time. COREQ-scores of the primary studies included in these reviews were compared prior- and post COREQ-publication using T-test with Bonferroni correction. Results 1.695 qualitative reviews were included (222 COREQ, 369 ENTREQ, 62 both COREQ/ENTREQ and 1.042 non-COREQ/ENTREQ), spanning 12 years (2007-2019) demonstrating an exponential publication rate. The uptake of the ENTREQ in reviews is higher than the COREQ (respectively 28% and 17%), and increases over time. COREQ-scores could be extracted from 139 reviews (including 2.775 appraisals). Reporting quality improved following the COREQ-publication with 13 of the 32 signalling questions showing improvement; the average total score increased from 15.15 to 17.74 (p-value < 0.001). Conclusion The number of qualitative reviews increased exponentially, but the uptake of the COREQ and ENTREQ was modest overall. Primary qualitative studies show a positive trend in reporting quality, which may have been facilitated by the publication of the COREQ.Clinical epidemiolog

Replacement times of a spectrum of elements in the North Atlantic based on thorium supply

The measurable supply of 232Th to the ocean can be used to derive the supply of other elements, which is more difficult to quantify directly. The measured inventory of an element divided by the derived supply yields a replacement time estimate, which in special circumstances is related to a residence time. As a proof of concept, Th‐based supply rates imply a range in the replacement times of the rare earth elements (REEs) in the North Atlantic that is consistent with the chemical reactivity of REEs related to their ionic charge density. Similar estimates of replacement times for the bioactive trace elements (Fe, Mn, Zn, Cd, Cu and Co), ranging from \u3c5 years to \u3e50,000 years, demonstrate the broad range of elemental reactivity in the ocean. Here, we discuss how variations in source composition, fractional solubility ratios or non‐continental sources such as hydrothermal vents lead to uncertainties in Th‐based replacement time estimates. We show that the constraints on oceanic replacement time provided by the Th‐based calculations are broadly applicable in predicting how elements are distributed in the ocean and for some elements, such as Fe, may inform us on how the carbon cycle may be impacted by trace element supply and removal

Genetically Determined Height and Risk of Non-hodgkin Lymphoma

Although the evidence is not consistent, epidemiologic studies have suggested that taller adult height may be associated with an increased risk of some non-Hodgkin lymphoma (NHL) subtypes. Height is largely determined by genetic factors, but how these genetic factors may contribute to NHL risk is unknown. We investigated the relationship between genetic determinants of height and NHL risk using data from eight genome-wide association studies (GWAS) comprising 10,629 NHL cases, including 3,857 diffuse large B-cell lymphoma (DLBCL), 2,847 follicular lymphoma (FL), 3,100 chronic lymphocytic leukemia (CLL), and 825 marginal zone lymphoma (MZL) cases, and 9,505 controls of European ancestry. We evaluated genetically predicted height by constructing polygenic risk scores using 833 height-associated SNPs. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for association between genetically determined height and the risk of four NHL subtypes in each GWAS and then used fixed-effect meta-analysis to combine subtype results across studies. We found suggestive evidence between taller genetically determined height and increased CLL risk (OR = 1.08, 95% CI = 1.00\u20131.17, p = 0.049), which was slightly stronger among women (OR = 1.15, 95% CI: 1.01\u20131.31, p = 0.036). No significant associations were observed with DLBCL, FL, or MZL. Our findings suggest that there may be some shared genetic factors between CLL and height, but other endogenous or environmental factors may underlie reported epidemiologic height associations with other subtypes

Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Globally, the number of patients undergoing maintenance dialysis is increasing, yet throughout the world there is significant variability in the practice of initiating dialysis. Factors such as availability of resources, reasons for starting dialysis, timing of dialysis initiation, patient education and preparedness, dialysis modality and access, as well as varied \u201ccountry-specific\u201d factors significantly affect patient experiences and outcomes. As the burden of end-stage kidney disease (ESKD) has increased globally, there has also been a growing recognition of the importance of patient involvement in determining the goals of care and decisions regarding treatment. In January 2018, KDIGO (Kidney Disease: Improving Global Outcomes) convened a Controversies Conference focused on dialysis initiation, including modality choice, access, and prescription. Here we present a summary of the conference discussions, including identified knowledge gaps, areas of controversy, and priorities for research. A major novel theme represented during the conference was the need to move away from a \u201cone-size-fits-all\u201d approach to dialysis and provide more individualized care that incorporates patient goals and preferences while still maintaining best practices for quality and safety. Identifying and including patient-centered goals that can be validated as quality indicators in the context of diverse health care systems to achieve equity of outcomes will require alignment of goals and incentives between patients, providers, regulators, and payers that will vary across health care jurisdictions

Population change of Common Buzzards Buteo buteo in central southern England between 2011 and 2016

Capsule: Distance sampling identified an increase in estimated population size of Common Buzzards Buteo buteo in central southern England between 2011 and 2016 of more than 50%. The rate of population growth slowed in later years. Aims: To assess the utility of a targeted distance sampling protocol to derive seasonal and annual population estimates for Common Buzzards across an area of southern England. Methods: We used a line transect survey methodology and multiple covariate distance sampling to assess population density and abundance of Common Buzzards in spring and autumn between 2011 and 2016 across a 2600 km2 area of central southern England. Results: Estimated population size increased by more than 50%, from approximately 2900 to 4500 individuals, across the period in a trend similar to that shown by Breeding Bird Survey data. Discussion: A slowing of the growth in population size of Common Buzzards in central southern England suggests that the species may be approaching carrying capacity in this area. These results also suggest that currently employed broad scale survey methodologies adequately reflect the general population trends for this species. Our data provide the first published estimates of the Common Buzzard population in central southern England derived from direct empirical assessment

Seasonal acclimatization to temperature in cardueline finches

1. Seasonal variation in body constituents and utilization of lipid, protein, and carbohydrate during cold stress in American goldfinches were studied to determine relations of these functions to the pronounced seasonal shift in thermogenic capacity documented in a previous study (Dawson and Carey, 1976).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47119/1/360_2004_Article_BF00686746.pd