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

Effect of Recycled Waste Polymers, Natural Bitumen and HVS Cut on the Properties of Vacuum Bottom

The neat bitumen, an oil refining by-product, has its own inherent weakness under long-time loading at low and high temperatures. These performance limitations of neat bitumen have led researchers to modify its physical andmechanical properties. According to several studies, polymers can be used to modify the properties of bitumen. Due to much lower production costs and aiming to reduce environmental impacts, recycled waste polymers are preferred as compared with virgin polymers. In this study, the effect of recycled waste polymers including crumb rubber modifier (CRM), polyethylene and latex and non-polymeric materials such as natural bitumen (NB) and heavy vacuum slops (HVS) cut on physical and mechanical properties of vacuum bottom residue (VB) of crude oil distillation was investigat-ed. Based on the results, recycled waste polyethylene and NB can improve the performance grade of VB at high temperatures and CRM, latex and HVS can improve the performance grade of VB at low temperatures. Thus, by designing various blends of these additives with VB, different modified bitumens can be directly obtained from VB without any need to air-blowing process

Systematic review and health risk assessment of arsenic and lead in the fished shrimps from the Persian gulf

The ingestion of heavy metals through contaminated seafood can causes significant outcomes on human health. In recent years, consume fishes and shrimps has increased in Iran, and several study about heavy metals content in fishes and shrimps from Persian Gulf were carried out to check their food safety. The aims of these systematic reviews and meta-analysis was to summarize the evidence on the relation of the intakes of Arsenic (As) and lead (Pb) levels, based on the origin and sub-groups of shrimp species consumed, Hence that we can estimate the risk of oral cancer induced by Pb and As in these groups of shrimp from the persian gulf. We carried out a search of all suitable studies published between 1995 and 2017 in Scopus, Science Direct, PubMed and Web of Science databases. Since the heterogeneity among studied was significant, we used the random effect model (REM) to perform meta-analysis of data. Data were obtained from 9 articles (14 studies), with 511 samples, and it was reported that pooled levels of As and Pb in the muscle shrimps were 1.37 (95 CI: 0.66–2.08 mg/kg d.w.) and 0.58 (95 CI: 0.33–0.82 mg/kg d.w.), respectively. This pooled levels in muscle shrimps were higher than safe dose reported on Food and Agriculture Organization/World Health Organization guidelines (FAO/WHO). The rank order of shrimps species based on As was Panulirus homarus > Penaeus semisulcatus and for the Pb levels was Litopenaeus vannamei > Panulirus homarus > Fenneropenaeus indicus > Metapenaeus affinis. The lowest and highest risk levels of oral cancer, divided by consumers age groups, were respectively 45–54 (6.94E-04) and 15–24 (8.42E-04) for the Pb, and 45–54 (2.87E-01) and 15–24 (3.51E-01) for arsenic. Incremental Lifetime Cancer Risk (ILCR) of Pb and As was higher than 10-4 and 10-3, respectively. All groups (age) of consumers are subject to the cancer risk of due to the consumption of shrimps contaminated by Pb and As, therefore, should be started a control plan for the reduction of the heavy metal bioaccumulation levels in shrimps of the Persian Gulf coupled to a capillary food safety communication. © 2018 Elsevier Lt