190 research outputs found
Standardised description of health and social care: A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs)
Background:
Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be comparable across regions and countries to allow benchmarking and organizational learning, and for research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a classification of adult mental health services that was later adapted for the assessment of health and social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its impact in health policy and decision-making.
Method:
We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (1997–2018).
Results:
Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning. The classification has been translated into eight languages and has been used by seven international research networks. Since 2000, it has originated 11 instruments for health system research with extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585 catchment areas in 34 countries for description of services delivery at local, regional and national levels.
Conclusions:
The ESMS/DESDE system provides a common terminology, a classification of care services, and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It facilitates comparisons across and within countries for evidence-informed planning
Standardised description of health and social care:A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs)
Background: Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be
comparable across regions and countries to allow benchmarking and organizational learning, and for
research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a
classification of adult mental health services that was later adapted for the assessment of health and
social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the
study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its
impact in health policy and decision-making.
Method: We conducted a systematic review following the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines (1997–2018).
Results: Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning.
The classification has been translated into eight languages and has been used by seven international
research networks. Since 2000, it has originated 11 instruments for health system research with
extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585
catchment areas in 34 countries for description of services delivery at local, regional and national levels.
Conclusions: The ESMS/DESDE system provides a common terminology, a classification of care services,
and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It
facilitates comparisons across and within countries for evidence-informed plannin
Corrosion Inhibition of Sodium Silicate with Nanosilica as Coating in Pre-Corroded Steel
This study was conducted to investigate the potential of using sodium silicate with nanosilica as a treatment to inhibit the progress of corrosion in steel specimens that are already corroded. Steel specimens measuring 16 mm in diameter and 4 mm in thickness were prepared and subjected to pre-corrosion by immersion to 3.5% NaCl solution. Two sets of specimens were then dip-coated with sodium silicate containing nanosilica. One set was coated with 1% nanosilica, and the other was coated with 2.5% nanosilica. The coated specimens were then subjected to Complex Impedance Spectroscopy (CIS) at 20 Hz to 20 MHz frequency range. Compared with the sodium silicate coating with 1% nanosilica, the sodium silicate coating with 2.5% nanosilica had a larger semi-circle curve in the Nyquist plot. Similarly, the sodium silicate coating with 2.5% nanosilica also showed larger magnitudes of impedance at the low-frequency region and larger phase angles at the high-frequency regions in the Bode plot. These results imply that the sodium silicate coating with 2.5% nanosilica coating demonstrated better capacitive behavior. In addition, equivalent circuit modelling results also showed that the sodium silicate coating with 2.5% nanosilica had higher coating resistance and lower coating capacitance as compared to the sodium silicate coating with 1% nanosilica. Doi: 10.28991/cej-2021-03091761 Full Text: PD
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Improved Reflectance and Stability of Mo/Si Multilayers
Commercial EUV lithographic systems require multilayers with higher reflectance and better stability then that published to date. Interface-engineered Mo/Si multilayers with 70% reflectance at 13.5 nm wavelength (peak width of 0.545 nm) and 71% at 12.7 nm wavelength (peak width of 0.49 nm) were developed. These results were achieved with 50 bilayers. These new multilayers consist of Mo and Si layers separated by thin boron carbide layers. Depositing boron carbide on interfaces leads to reduction in silicide formation on the Mo-on-Si interfaces. Bilayer contraction is reduced by 30% implying that there is less intermixing of Mo and Si to form silicide. As a result the Mo-on-Si interfaces are sharper in interface-engineered multilayers than in standard Mo/Si multilayers. The optimum boron carbide thicknesses have been determined and appear to be different for Mo-on-Si and Si-on-Mo interfaces. The best results were obtained with 0.4 nm thick boron carbide layer on the Mo-on-Si interface and 0.25 nm thick boron carbide layer on the Si-on-Mo interface. Increase in reflectance is consistent with multilayers with sharper and smoother interfaces. A significant improvement in oxidation resistance of EUV multilayers has been achieved with ruthenium terminated Mo/Si multilayers. The best capping layer design consists of a Ru layer separated from the last Si layer by a boron carbide layer. This design achieves high reflectance and the best oxidation resistance in a water vapor (i.e. oxidation) environment. Electron beam exposures of 4.5 hours in the presence of 5x10{sup -7} torr water vapor partial pressure show no measurable reflectance loss and no increase in the oxide thickness of Ru terminated multilayers. Longer exposures in different environments are necessary to test lifetime stability of many years
Beyond buzz-pollination – departures from an adaptive plateau lead to new pollination syndromes
Knowledge and attitudes of primary health care physicians and nurses with regard to population screening for colorectal cancer in Balearic Islands and Barcelona
<p>Abstract</p> <p>Background</p> <p>Primary health care (PHC) professionals play a key role in population screening of colorectal cancer. The purposes of the study are: to assess knowledge and attitudes among PHC professionals with regard to colorectal cancer screening, as well as the factors that determine their support for such screening.</p> <p>Methods</p> <p>Questionnaire-based survey of PHC physicians and nurses in the Balearic Islands and in a part of the metropolitan area of Barcelona.</p> <p>Results</p> <p>We collected 1,219 questionnaires. About 84% of all professionals believe that screening for colorectal cancer by fecal occult blood test (FOBT) is effective. Around 68% would recommend to their clients a colorectal cancer screening program based on FOBT and colonoscopy. About 31% are reluctant or do not know. Professionals perceive the fear of undergoing a colonoscopy as the main obstacle in getting patients to participate, and the invasive nature of this test is the main reason behind their resistance to this program. The main barriers to support the screening program among PHC professionals are lack of knowledge (nurses) and lack of time (physicians). On multivariate analysis, the factors associated with reluctance to recommend colorectal cancer screening were: believing that FOBT has poor sensitivity and is complicated; that colonoscopy is an invasive procedure; that a lack of perceived benefit could discourage client participation; that only a minority of clients would participate; thinking that clients are fed up with screening tests and being unaware if they should be offered something to ensure their participation in the programme.</p> <p>Conclusions</p> <p>Two in every three PHC professionals would support a population screening program for colorectal cancer screening. Factors associated with reluctance to recommend it were related with screening tests characteristics as sensitivity and complexity of FOBT, and also invasive feature of colonoscopy. Other factors were related with patients' believes.</p
Tumor-associated microbiome features of metastatic colorectal cancer and clinical implications
BackgroundColon microbiome composition contributes to the pathogenesis of colorectal cancer (CRC) and prognosis. We analyzed 16S rRNA sequencing data from tumor samples of patients with metastatic CRC and determined the clinical implications.Materials and methodsWe enrolled 133 patients with metastatic CRC at St. Vincent Hospital in Korea. The V3-V4 regions of the 16S rRNA gene from the tumor DNA were amplified, sequenced on an Illumina MiSeq, and analyzed using the DADA2 package.ResultsAfter excluding samples that retained <5% of the total reads after merging, 120 samples were analyzed. The median age of patients was 63 years (range, 34–82 years), and 76 patients (63.3%) were male. The primary cancer sites were the right colon (27.5%), left colon (30.8%), and rectum (41.7%). All subjects received 5-fluouracil-based systemic chemotherapy. After removing genera with <1% of the total reads in each patient, 523 genera were identified. Rectal origin, high CEA level (≥10 ng/mL), and presence of lung metastasis showed higher richness. Survival analysis revealed that the presence of Prevotella (p = 0.052), Fusobacterium (p = 0.002), Selenomonas (p<0.001), Fretibacterium (p = 0.001), Porphyromonas (p = 0.007), Peptostreptococcus (p = 0.002), and Leptotrichia (p = 0.003) were associated with short overall survival (OS, <24 months), while the presence of Sphingomonas was associated with long OS (p = 0.070). From the multivariate analysis, the presence of Selenomonas (hazard ratio [HR], 6.35; 95% confidence interval [CI], 2.38–16.97; p<0.001) was associated with poor prognosis along with high CEA level.ConclusionTumor microbiome features may be useful prognostic biomarkers for metastatic CRC
Serum adiponectin level is not only decreased in metabolic syndrome but also in borderline metabolic abnormalities
Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries
Background
Process evaluation is increasingly recognized as an important component of effective implementation research and yet, there has been surprisingly little work to understand what constitutes best practice. Researchers use different methodologies describing causal pathways and understanding barriers and facilitators to implementation of interventions in diverse contexts and settings. We report on challenges and lessons learned from undertaking process evaluation of seven hypertension intervention trials funded through the Global Alliance of Chronic Diseases (GACD).
Methods
Preliminary data collected from the GACD hypertension teams in 2015 were used to inform a template for data collection. Case study themes included: (1) description of the intervention, (2) objectives of the process evaluation, (3) methods including theoretical basis, (4) main findings of the study and the process evaluation, (5) implications for the project, policy and research practice and (6) lessons for future process evaluations. The information was summarized and reported descriptively and narratively and key lessons were identified.
Results
The case studies were from low- and middle-income countries and Indigenous communities in Canada. They were implementation research projects with intervention arm. Six theoretical approaches were used but most comprised of mixed-methods approaches. Each of the process evaluations generated findings on whether interventions were implemented with fidelity, the extent of capacity building, contextual factors and the extent to which relationships between researchers and community impacted on intervention implementation. The most important learning was that although process evaluation is time consuming, it enhances understanding of factors affecting implementation of complex interventions. The research highlighted the need to initiate process evaluations early on in the project, to help guide design of the intervention; and the importance of effective communication between researchers responsible for trial implementation, process evaluation and outcome evaluation.
Conclusion
This research demonstrates the important role of process evaluation in understanding implementation process of complex interventions. This can help to highlight a broad range of system requirements such as new policies and capacity building to support implementation. Process evaluation is crucial in understanding contextual factors that may impact intervention implementation which is important in considering whether or not the intervention can be translated to other contexts
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