What is the value and impact of quality and safety teams? A scoping review

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to conduct a scoping review of the literature about the establishment and impact of quality and safety team initiatives in acute care.</p> <p>Methods</p> <p>Studies were identified through electronic searches of Medline, Embase, CINAHL, PsycINFO, ABI Inform, Cochrane databases. Grey literature and bibliographies were also searched. Qualitative or quantitative studies that occurred in acute care, describing how quality and safety teams were established or implemented, the impact of teams, or the barriers and/or facilitators of teams were included. Two reviewers independently extracted data on study design, sample, interventions, and outcomes. Quality assessment of full text articles was done independently by two reviewers. Studies were categorized according to dimensions of quality.</p> <p>Results</p> <p>Of 6,674 articles identified, 99 were included in the study. The heterogeneity of studies and results reported precluded quantitative data analyses. Findings revealed limited information about attributes of successful and unsuccessful team initiatives, barriers and facilitators to team initiatives, unique or combined contribution of selected interventions, or how to effectively establish these teams.</p> <p>Conclusions</p> <p>Not unlike systematic reviews of quality improvement collaboratives, this broad review revealed that while teams reported a number of positive results, there are many methodological issues. This study is unique in utilizing traditional quality assessment and more novel methods of quality assessment and reporting of results (SQUIRE) to appraise studies. Rigorous design, evaluation, and reporting of quality and safety team initiatives are required.</p

Summary and Recommendations from Working Group 1: model uncertainty representations in convection-permitting / shorter lead-time / limited-area ensembles

WG3 discussed both the pros and cons of existing schemes as Working group 1 considered the treatment of model uncertainty (MU) in high-resolution ensembles, at grid spacings of order 1-5 km. These systems are often run for regional weather forecasting, perhaps over a single country, and for lead times of up to 5 days. Looking ahead, ECMWF’s strategy seeks to deliver global medium-range ensemble forecasts with 3-4 km grid spacings by 2030. It is questionable for what grid spacing we should dispense with a deep convection parameterization, but it will be either switched off or damped in these systems, such that deep convection can be assumed to be dominated by explicit motions. One of the problems with limited-area ensemble systems at this scale is that spread depends not only on the modelling system itself but also on the variability inherited from the large-scale boundary conditions. There is often thought to be a lack of spread in our high-resolution EPS (ensemble prediction systems), but this could reflect a lack of diversity on larger scales. The relative importance of lateral-boundary diversity and the model uncertainty mechanisms is regime dependent. The lateral boundaries will generally be more important in midlatitude winter but less so for summertime convection in relatively weak synoptic flow

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Genome-wide association study reveals genetic risk underlying Parkinson's disease.

We performed a genome-wide association study (GWAS) in 1,713 individuals of European ancestry with Parkinson's disease (PD) and 3,978 controls. After replication in 3,361 cases and 4,573 controls, we observed two strong association signals, one in the gene encoding alpha-synuclein (SNCA; rs2736990, OR = 1.23, P = 2.24 x 10(-16)) and another at the MAPT locus (rs393152, OR = 0.77, P = 1.95 x 10(-16)). We exchanged data with colleagues performing a GWAS in Japanese PD cases. Association to PD at SNCA was replicated in the Japanese GWAS, confirming this as a major risk locus across populations. We replicated the effect of a new locus detected in the Japanese cohort (PARK16, rs823128, OR = 0.66, P = 7.29 x 10(-8)) and provide supporting evidence that common variation around LRRK2 modulates risk for PD (rs1491923, OR = 1.14, P = 1.55 x 10(-5)). These data demonstrate an unequivocal role for common genetic variants in the etiology of typical PD and suggest population-specific genetic heterogeneity in this disease