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First, the authors concluded that the morbidly obese patients had an increased risk of early complications including skin necrosis, while others argued that obesity was also associated with greater incidence of late complications [[2]]. The main predictors of length of stay after total knee arthroplasty: patient-related or procedure-related risk factors. [Extracted from the article]

Background: STEM education providers increasingly use complex intervention models to redress persistent under-representation in STEM sectors. These intervention models require robust evaluation to determine their effectiveness. The study examines a complex, sustained intervention intended to build science capital in young people aged 11–15 over 3 years, which drew on science capital theory and related research to inform intervention design and evaluation. When evaluation results differed from those anticipated, process evaluation supported authors to interpret these findings. By outlining challenges faced in the evaluation of a complex, sustained STEM outreach intervention, this paper addresses critique that outreach programmes focus too often on short-term and positive findings. Results: Intervention outcomes were assessed using a quantitative questionnaire adapted from science capital research, issued to pupils at the intervention's baseline (2015), midpoint (2017) and endpoint (2019). Adopting a cohort-based model, the 2015 questionnaire collected a baseline for the Year 7 intervention group (children aged 11–12, N = 464), and established baseline comparator groups for Year 9 (children aged 13–14, N = 556) and Year 11 (children aged 15–16, N = 342). The Year 7 intervention group was re-evaluated again in 2017 when in Year 9 (N = 556), and in 2019 when in Year 11 (N = 349). Analysis explored differences in science capital between the intervention and comparator groups and identified lower composite science capital scores and greater proportions of low- and medium-science capital in the intervention group when compared with the two comparator groups. A rationale for this emerged from the subsequent process evaluation. Conclusions: This study's main contribution is the provision of nuanced insight into the evaluation of STEM interventions for use by others evaluating in similar circumstances, particularly those adopting sustained or complex delivery models. This paper concludes that assessing the effectiveness of complex interventions cannot rely on quantitative evaluation of outcomes alone. Process evaluation can complement quantitative instruments and aid interventions to better understand variability and interpret results. While this study highlights the value of science capital when designing intervention models, it also illustrates the inherent challenges of using an outcome measure of 'building science capital', and quantifying levels over an intervention's course. [ABSTRACT FROM AUTHOR]

Introduction: Involving service users in health service design and delivery is considered important to improve the quality of healthcare because it ensures that the delivery of healthcare is adapted to the needs of the users. Co‐production is a process used to involve service users, but multiple papers have highlighted the need for the mechanisms and values guiding co‐production to be more clearly stated. The aim of this paper was to evaluate the mechanisms and values that guided the co‐production approach of the Stories for Change project, which used Public Narrative as part of the co‐design process to create change in National Health Service maternity services. Methods: This study was conducted using a rapid feedback evaluation approach. Semistructured interviews (n = 16) were the main source of data, six of which were maternity service users, with observations (5 h) and documentary analysis also carried out in parallel. RREAL sheets were used for data analysis to organize data based on key topics of interest. Results: This study identified three broad mechanisms and values underpinning the co‐production approach: creating an open and safe space to share ideas, learning how to tell stories using Public Narrative and having service providers who play a key role in strengthening the health system listen to stories compelling them to action. This study identified the main areas for improvement of the Stories for Change project related to recruitment, the inclusion of participants, the co‐design process, the Skills Session and the Learning Event. Conclusion: Our study provided a deeper understanding of the co‐production approach that addresses the need to uncover the mechanism and values underlying co‐production and co‐design approaches. This study expands on the literature pertaining to the influence of storytelling in creating meaningful change in health care. We propose a co‐design methodology that uses Public Narrative as a model for service user engagement to help inform future healthcare development processes. Patient or Public Contribution: The experiences and perceptions of maternity service users and health professionals informed this evaluation. The project organizers were involved in the manuscript preparation stage by providing feedback, and service users wrote a commentary on the project from the lived experience perspective. [ABSTRACT FROM AUTHOR]

Aim To evaluate an e-prescribing pilot project that took place in a recovery unit in Gloucestershire. Method Nursing and medical staff recorded the time it took to prescribe and administer medication electronically and in paper form. A structured questionnaire was used to assess staff experience and attitudes to e-prescribing after the pilot had ended. Findings It took longer to prescribe and administer medication electronically as compared to using paper prescriptions. Staff identified benefits of e-prescribing, but had a greater number of concerns. Conclusion For e-prescribing to be used safely and for the benefit of patients in the future, the system needs to evolve to meet prescribing needs. Staff will need support and education to switch to this new way of working. [ABSTRACT FROM AUTHOR]

Factors related to the research context, such as inquiry mode, setting, and experimenter contact, may affect participants' comfort with and willingness to disclose certain sexual attitudes or admit to engaging in sensitive sexual behaviors. In this study, 255 female undergraduates (42.7 % non-White) completed a survey containing measures of sexual behavior and attitudes. The level of experimenter contact (high vs. low contact), setting (in lab vs. out of lab), and inquiry mode (pencil-and-paper vs. computer) were manipulated and participants were randomly assigned to conditions. We hypothesized that low-contact, out-of-lab, computer conditions would be associated with more liberal sexual attitudes and higher rates of reported sexual behaviors than high-contact, in-lab, and paper-and-pencil conditions, respectively. Further, we hypothesized that effects would be moderated by race, such that differences would be greater for non-White participants because of concerns that reporting socially undesirable behavior might fuel racial stereotypes. For attitudinal measures, White participants endorsed more liberal attitudes toward sex in high-contact conditions and non-White participants endorsed more liberal attitudes in low-contact conditions. For behavioral measures, non-White participants reported more behaviors on pencil-and-paper surveys than on computers. White participants demonstrated no significant mode-related differences or reported more sexual behaviors in computer conditions than paper-and-pencil conditions. Overall, results suggest that experimenter contact and mode significantly impact sexual self-report and this impact is often moderated by race. [ABSTRACT FROM AUTHOR]

Objective: Professional sport occupies a prominent cultural position in societies across the globe and commercial organisations make use of this to promote their products. The present scoping review explores existing academic literature on the relationship between professional sports clubs and food and drink marketing and considers how this relationship may impact upon the public's health.Design: The scoping review searched six databases. Experts were also consulted. Records written in languages other than English were excluded. We also excluded records relating to mega events (e.g. Olympics, Football World Cup) and alcohol marketing, because of the attention already given to these.Setting: Professional sports clubs.Results: We identified 18 166 titles, reviewed 163 abstracts and read twenty-six full texts. We included six papers in the review. Four were from Australia and New Zealand. The Australasian literature focused largely on the marketing of foods and beverages to children and the potential impact on consumption. Single papers from researchers in Turkey and the USA were identified. The Turkish paper analysed shirt sponsorship in football leagues internationally and showed food and beverage (including alcohol) companies were the most common sponsors. The US paper examined a mixed reaction to a football team named after an energy drink.Conclusions: Commercial relationships between professional sports clubs and Big Food corporations have largely eluded scrutiny in much of the world. The current review highlights the lack of public health research on these relationships. Research exploring the interdependent commercial practices of food and drink companies and professional sports clubs is urgently needed. [ABSTRACT FROM AUTHOR]

Issues: Drug consumptions rooms (DCR) and supervised injecting facilities (SIF) are expanding internationally. Previous reviews have not systematically addressed evaluation methodologies.Approach: Results from systematic searches of scientific databases in English until June 2017 were coded for paper type, country and year of publication. For evaluation papers, study outcome, methodology/study design and main indicators of DCR/SIF 'exposure' were recorded.Key Findings: Two hundred and nineteen eligible peer-reviewed papers were published since 1999: the majority from Canada (n = 117 papers), Europe (n = 36) and Australia (n = 32). Fifty-six papers reported evaluation outcomes. Ecological study designs (n = 10) were used to assess the impact on overdose, public nuisance and crime; modelling techniques (n = 6) estimated impact on blood-borne diseases, overdose deaths and costs. Papers using individual-level data included four prospective cohorts (n = 28), cross-sectional surveys (n = 7) and service records (n = 5). Individual-level data were used to assess safer injecting practice, uptake into health and social services and all the other above outcomes except for impact on crime and costs. Four different indicators of DCR/SIF attendance were used to measure service 'exposure'.Implications: Research around DCRs/SIFs has used ecological, modelling, cross-sectional and cohort study designs. Further research could involve systematic inclusion of a control group of people who are eligible but do not access SIFs, validation of self-reported proportion of injections at SIFs or a stepped-wedge or a cluster trial comparing localities.Conclusions: Methodologies appropriate for DCR/SIF evaluation have been established and can be readily replicated from the existing literature. Research on operational aspects, implementation and transferability is also warranted. [ABSTRACT FROM AUTHOR]

Background: E-values are a recently introduced approach to evaluate confounding in observational studies. We aimed to empirically assess the current use of E-values in published literature.Methods: We conducted a systematic literature search for all publications, published up till the end of 2018, which cited at least one of two inceptive E-value papers and presented E-values for original data. For these case publications we identified control publications, matched by journal and issue, where the authors had not calculated E-values.Results: In total, 87 papers presented 516 E-values. Of the 87 papers, 14 concluded that residual confounding likely threatens at least some of the main conclusions. Seven of these 14 named potential uncontrolled confounders. 19 of 87 papers related E-value magnitudes to expected strengths of field-specific confounders. The median E-value was 1.88, 1.82, and 2.02 for the 43, 348, and 125 E-values where confounding was felt likely to affect the results, unlikely to affect the results, or not commented upon, respectively. The 69 case-control publication pairs dealt with effect sizes of similar magnitude. Of 69 control publications, 52 did not comment on unmeasured confounding and 44/69 case publications concluded that confounding was unlikely to affect study conclusions.Conclusions: Few papers using E-values conclude that confounding threatens their results, and their E-values overlap in magnitude with those of papers acknowledging susceptibility to confounding. Facile automation in calculating E-values may compound the already poor handling of confounding. E-values should not be a substitute for careful consideration of potential sources of unmeasured confounding. If used, they should be interpreted in the context of expected confounding in specific fields. [ABSTRACT FROM AUTHOR]

Background: Studies suggest that gender differences in academic medicine exist. Men frequently have better measures of performance such as number of publications, number of citations, remuneration, and funding.Aims: To evaluate whether a gender disparity in authorship exists.Methods: We recorded the gender of first and senior authors of original papers, editorials/reviews from liver-related manuscripts in Gastroenterology, Hepatology, Transplantation, American Journal of Gastroenterology, and Liver Transplantation from January 2014 to 2016.Results: Of 2424 articles reviewed, we excluded 232 (10%) due to inability to determine gender. Among papers analyzed, 72.0% were original and 28.1% reviews/editorials with 65.1% of first authors being male and 34.9% female. Only 20.3% of papers with multiple authors had a female senior author. The proportion of male first and senior authorship between original papers and reviews/editorials was comparable. 72% of original papers had a male as first or senior author, but only 28% females. 71% of review/editorial papers had a male as first or senior author, but only 29% females. When the senior author of an original paper was female, 47.1% of first authors were male and 52.9% female. When the senior author was male, 67.1% of first authors were male and 32.9% female (p < 0.00001).Conclusions: A significant gender difference exists in Hepatology publications. Female authorship mirrors the percentage of female AASLD membership; however, female senior authorship remains disproportionate. In general, funding for male authors is greater. Fewer women are first authors when the senior author is male, highlighting the importance of female mentorship in Hepatology. [ABSTRACT FROM AUTHOR]

Background: The literature on qualitative data analysis mostly concerns analyses pertaining to an individual research question and the organization of data within that research question. Few authors have written about the entire qualitative dataset from which multiple and separate analyses could be conducted and reported. The concept of analytic direction is a strategy that can assist qualitative researchers in deciding which findings to highlight within a dataset. The objectives of this paper were to: 1) describe the importance of analytic direction in qualitative research, and 2) provide a working example of the concept of analytic direction.Methods: A qualitative dataset from one of the author's research programs was selected for review. Ten potential analytic directions were identified after the initial phenomenological analysis was conducted. Three analytic directions based on the same coding template but different content areas of the data were further developed using phenomenological analysis (n = 2) and qualitative description (n = 1) and are the focus of this paper. Development and selection of these three analytic directions was determined partially relying on methodological criteria to promote rigour including a comprehensive examination of the data, the use of multiple analysts, direct quotations to support claims, negative case analysis, and reflexivity.Results: The three analytic directions addressed topics within the scope of the overall research question. Each analytic direction had its own central point or story line and each highlighted a different perspective or voice. The use of an inductive and deductive approach to analysis and how the role of theory was integrated varied in each analytic direction.Conclusions: The concept of analytic direction enables researchers to organize their qualitative datasets in order to tell different and unique "stories". The concept relies upon, and promotes, the conduct of rigourous qualitative research. [ABSTRACT FROM AUTHOR]

This paper proposes an image quality evaluation (IQE) metric by considering gradient, visual saliency, and color information. Visual saliency and gradient information are two types of effective features for quality evaluation research. Different regions within an image are not uniformly important for IQE. Visual saliency can find the most attractive regions to the human visual system in a given image. These attractive image regions are more strongly correlated with image quality results. In addition, the degradation of gradient information is related to the structure distortion which is a very important factor for image quality. However, the two types of features cannot accurately evaluate the color distortion of images. In order to evaluate chromatic distortion, this paper proposes the color similarity which is measured in the YIQ color space. The computation of the proposed method begins with the similarity calculation of local gradient information, visual saliency, and color information. Then, the final quality score is obtained by the standard deviation on each similarity component. The experimental results on five benchmark databases (i.e., CSIQ, IVC, LIVE, TID2013, and TID2008) show that the proposed IQE method performs better than other methods in the correlation with subjective quality judgment. [ABSTRACT FROM AUTHOR]

Aim: To demonstrate how implementing a system‐wide measurement and improvement programme can make the delivery of the Fundamentals of Care visible in practice. Design: Discussion paper. Data Sources: A retrospective evaluation of the experience of implementing a system‐wide peer review programme using the Promoting Action on Research Implementation in Health Services framework. Implications for Nursing: Implementing this programme engages nursing leaders at all levels in fundamental care delivery, evaluation and improvement. It positions nursing leaders as accountable for and champions of fundamental care. Conclusion: The peer review programme offers a solution to the complex challenge of measuring the fundamentals of care in practice. Successful implementations of this programme at two New Zealand inpatient sites have shown positive results in improved care and patient experience. This makes it worthy of consideration for other health organizations. Nursing leadership has proven to be critical to success. The Promoting Action on Research Implementation in Health Services framework highlights the components that assist with successful implementation and assists in presenting a case for change. Impact This paper addressed the problem of the lack of action and dearth of quality, integrated data, visibility of the patient experience and the contribution of nursing leadership in an inpatient setting. Findings indicate that the peer review programme is translatable, modifiable and sensitive to ethnicity and disability. Using the implementation framework to evaluate the process has provided a guide for future implementations. [ABSTRACT FROM AUTHOR]

We examine trends in words/terms published in Health & Place between 1995 and 2018. Terms used have diversified over this period, including a decline in 'health' overall, as well as greater usage of 'diet', 'alcohol' and 'depression'. There was a noticeable increase in using 'neighbourhood' to describe context. Topic modelling reveals that papers are increasingly concerned with specific aspects of place (e.g. the built environment). Our findings emphasise that Health & Place has matured into the leading outlet for examining the geographical dimensions of health with important and enduring insights that continue to inform research and policy. [ABSTRACT FROM AUTHOR]

Background: The study purpose was to compare the effectiveness of monthly or quarterly peer reminder knowledge translation interventions, with monthly or quarterly paper-based reminders, to sustain a mobility innovation, the sit-to-stand activity.Method: A cluster RCT using a stratified 2 × 2 factorial design was conducted in 24 Canadian residential care facilities with 416 residents and 54 peer reminder care aides. The 1-year intervention included two intensities of reminders (high: socially based peer reminders delivered by volunteer care aides to other care aides; low: paper-based reminders posted in residents' rooms), at two frequencies (monthly; every 3 months). Intervention fidelity was assessed using questionnaires and observations. Monthly sustainability rate of the sit-to-stand activity was calculated as the percentage of opportunities that residents successfully completed the activity in 30 days. Residents' sustainability rates were analyzed using a linear mixed model that mirrored the clustered repeated-measures factorial trial design. The model included a random intercept to account for clustering within sites. An unstructured covariance structure characterized the interdependence of repeated measures over time.Results: Twenty-four sites were randomized. One site was excluded because of falsifying data, leaving 23 sites and 349 residents for intention-to-treat analysis. Paper reminders were implemented with high fidelity across all arms (91.5% per protocol), while the peer reminders were implemented with moderate fidelity in the monthly group (81.0% per protocol) and poor fidelity in the quarterly group (51.7% per protocol). At month 1, mean sustainability ranged from 40.7 to 47.2 per 100 opportunities, across the four intervention arms (p = 0.43). Mean rate of sustainability in the high intensity, high frequency group diverged after randomization, yielding statistically significant differences among the groups at 4 months which persisted for the remainder of the trial. After 12 months, the mean sustainability in the high intensity, high frequency group was approximately twice that of the other three groups combined (64.1 versus 37.8 per 100 opportunities, p < 0.001).Conclusions: A monthly peer reminder intervention was more effective than a quarterly peer reminder intervention, a monthly paper-based reminder intervention, and a quarterly paper-based reminder intervention, in supporting care aides to sustain a mobility innovation in residential care facilities over 1 year.Trial Registration: ClinicalTrials.gov , NCT01746459. Registered 11 December 2012: https://clinicaltrials.gov/ct2/show/NCT01746459 . [ABSTRACT FROM AUTHOR]

Background: Previous systematic reviews have examined the effectiveness of interventions for frequent presenters to the Emergency Department (ED) but not the costs and cost-effectiveness of such interventions.Method: A systematic literature review was conducted which screened the following databases: Pubmed, Medline, Embase, Cochrane and Econlit. An inclusion and exclusion criteria were developed following PRISMA guidelines. A narrative review methodology was adopted due to the heterogeneity of the reporting of the costs across the studies.Results: One thousand three hundred eighty-nine papers were found and 16 were included in the review. All of the interventions were variations of a case management approach. Apart from one study which had mixed results, all of the papers reported a decrease in ED use and costs. There were no cost effectiveness studies.Conclusion: The majority of interventions for frequent presenters to the ED were found to decrease ED use and cost. Future research should be undertaken to examine the cost effectiveness of these interventions. [ABSTRACT FROM AUTHOR]

Background: Data-driven process analysis is an important area that relies on software support. Process variant analysis is a sort of analysis technique in which analysts compare executed process variants, a.k.a. process cohorts. This comparison can help to identify insights for improving processes. There are a few software supports to enable process cohort comparison based on the frequencies of process activities and performance metrics. These metrics are effective in cohort analysis, but they cannot support cohort comparison based on the probability of transitions among states, which is an important enabler for cohort analysis in healthcare.Results: This paper defines an approach to compare process cohorts using Markov models. The approach is formalized, and it is implemented as an open-source python library, named dfgcompare. This library can be used by other researchers to compare process cohorts. The implementation is also used to compare caregivers' behavior when prescribing drugs in the Stockholm Region. The result shows that the approach enables the comparison of process cohorts in practice.Conclusions: We conclude that dfgcompare supports identifying differences among process cohorts. [ABSTRACT FROM AUTHOR]

The incidence of many hormone-dependent diseases, including testicular cancer, has sharply increased in all high-income countries during the 20th century. This is not fully explained by established risk factors. Concurrent, increasing exposure to antiandrogenic environmental endocrine disrupting chemicals (EDCs) in fetal life may partially explain this trend. This systematic review assessed available evidence regarding the association between environmental EDC exposure and risk of testicular cancer (seminomas and nonseminomas). Following PRISMA guidelines, a search of English peer-reviewed literature published prior to December 14, 2020 in the databases PubMed and Embase® was performed. Among the 279 identified records, 19 were eligible for quality assessment and 10 for further meta-analysis. The completeness of reporting was high across papers, but over 50% were considered subject to potential risk of bias. Mean age at diagnosis was 31.9 years. None considered effects of EDC multipollutant mixtures. The meta-analyses showed that maternal exposure to combined EDCs was associated with a higher risk of testicular cancer in male offspring [summary risk ratios: 2.16, (95% CI:1.78-2.62), 1.93 (95% CI:1.49-2.48), and 2.78 (95% CI:2.27-3.41) for all, seminoma, and nonseminoma, respectively]. Similarly, high maternal exposures to grouped organochlorines and organohalogens were associated with higher risk of seminoma and nonseminoma in the offspring. Summary estimates related to postnatal adult male EDC exposures were inconsistent. Maternal, but not postnatal adult male, EDC exposures were consistently associated with a higher risk of testicular cancer, particularly risk of nonseminomas. However, the quality of studies was mixed, and considering the fields complexity, more prospective studies of prenatal EDC multipollutant mixture exposures and testicular cancer are needed. [ABSTRACT FROM AUTHOR]

Background: In recent years, with the development of artificial intelligence, the use of deep learning technology for clinical information extraction has become a new trend. Clinical Event Detection (CED) as its subtask has attracted the attention from academia and industry. However, directly applying the advancements in deep learning to CED task often yields unsatisfactory results. The main reasons are due to the following two points: (1) A great number of obscure professional terms in the electronic medical record leads to poor recognition performance of model. (2) The scarcity of datasets required for the task leads to poor model robustness. Therefore, it is urgent to solve these two problems to improve model performance.Methods: This paper proposes a combining data augmentation and domain information with TENER Model for Clinical Event Detection.Results: We use two evaluation metrics to compare the overall performance of the proposed model with the existing model on the 2012 i2b2 challenge dataset. Experimental results demonstrate that our proposed model achieves the best F1-score of 80.26%, type accuracy of 93% and Span F1-score of 90.33%, and outperforms the state-of-the-art approaches.Conclusions: This paper proposes a multi-granularity information fusion encoder-decoder framework, which applies the TENER model to the CED task for the first time. It uses the pre-trained language model (BioBERT) to generate word-level features, solving the problem of a great number of obscure professional terms in the electronic medical record lead to poor recognition performance of model. In addition, this paper proposes a new data augmentation method for sequence labeling tasks, solving the problem of the scarcity of datasets required for the task leads to poor model robustness. [ABSTRACT FROM AUTHOR]

This paper analyzes a UK-based psychoeducational intervention for users of online child sexual exploitation material (CSEM). It is founded on 17 months of anthropological research in group programs with 81 participants and 15 staff. The article argues that group exercises help participants reframe knowledge about their offending, and ultimately reinforce the theoretical concept of discipline (Foucault) toward internal and external surveillance, normalization, and decreased risk. The paper first discusses factors participants believed contributed to offending. It then analyzes the program and participants' experiences, focusing on exercises about the mind (fantasy), Internet usage (disclosure and relationships), needs met by offending (Good Lives and true needs), and planning for the future (relapse prevention). Critical is that participants are encouraged to reengage offline lives and enact discipline on and to the online world. Thus, the article ends with an anthropologically-minded discussion about digital norms, online morality, and implications for Internet offender psychoeducational practice. [ABSTRACT FROM AUTHOR]

Background: Over 90% of the 50,000 deaf children in the UK have hearing parents, many of whom were not expecting a deaf child and may require specialist support. Deaf children can experience poorer long-term outcomes than hearing children across a range of domains. After early detection by the Universal Newborn Hearing Screening Programme, parents in the UK receive support from Qualified Teachers of the Deaf and audiologists but resources are tight and intervention support can vary by locality. There are challenges faced due to a lack of clarity around what specific parenting support interventions are most helpful.Methods: The aim of this research was to complete a systematic scoping review of the evidence to identify early support interventions for parents of deaf infants. From 5577 identified records, 54 met inclusion criteria. Two reviewers screened papers through three rounds before completing data extraction and quality assessment.Results: Identified parent support interventions included both group and individual sessions in various settings (including online). They were led by a range of professionals and targeted various outcomes. Internationally there were only five randomised controlled trials. Other designs included non-randomised comparison groups, pre / post and other designs e.g. longitudinal, qualitative and case studies. Quality assessment showed few high quality studies with most having some concerns over risk of bias.Conclusion: Interventions commonly focused on infant language and communication followed by parental knowledge and skills; parent wellbeing and empowerment; and parent/child relationship. There were no interventions that focused specifically on parent support to understand or nurture child socio-emotional development despite this being a well-established area of poor outcome for deaf children. There were few UK studies and research generally was not of high quality. Many studies were not recent and so not in the context of recent healthcare advances. Further research in this area is urgently needed to help develop evidence based early interventions. [ABSTRACT FROM AUTHOR]

This paper determines the assessment of publications submitted to the UK research evaluation carried out in 2014, the REF, which would have resulted if they had been assessed with the bibliometric algorithm used by the Italian evaluation agency, ANVUR, for its evaluation of the research of Italian universities. We find extremely high correlations between the two assessment approaches. [ABSTRACT FROM AUTHOR]

This research examines the differential effect of research-writing teaching innovation on proposal and dissertation completion rates at the Turfloop Graduate School of Leadership (TGSL). The method combined a review with a longitudinal quantitative secondary data design. The data on proposal and dissertation completion rates were compared using a t-test statistics. Findings show that at an alpha level of 0.05, a significant difference (at P<0.05) exists in the proposal and dissertation completion rates between the pre-innovation teaching period and within the innovation teaching period – with improved completion rate occurring during the teaching innovation period. Results also depict a mean difference in research methodology pass marks (albeit insignificance). Based on the findings, the paper contributes by developing an agency-based inclusive framework for teaching dissertation research writing. This framework provides an agenda for further research on teacher and student agency, and hence inclusive teaching of academic writing. [ABSTRACT FROM AUTHOR]

Time-Sensitive Networking (TSN) is a set of Ethernet standards aimed to improve determinism in packet delivery for converged networks. The main goal is to provide mechanisms that enable low and predictable transmission latency and high availability for demanding applications such as real-time audio/video streaming, automotive, and industrial control. To provide the required guarantees, TSN integrates different traffic shaping mechanisms including 802.1Qbv, 802.1Qch, and 802.1Qcr, allowing for the coexistence of different traffic classes with different priorities on the same network. Achieving the required quality of service (QoS) level needs proper selection and configuration of shaping mechanisms, which is difficult due to the diversity in the requirements of the coexisting streams under the presence of potential end-system-induced jitter. This paper discusses the suitability of the TSN traffic shaping mechanisms for the different traffic types, analyzes the TSN network configuration problem, i.e., finds the optimal path and shaper configurations for all TSN elements in the network to provide the required QoS, discusses the goals, constraints, and challenges of time-aware scheduling, and elaborates on the evaluation criteria of both the network-wide schedules and the scheduling algorithms that derive the configurations to present a common ground for comparison between the different approaches. Finally, we analyze the evolution of the scheduling task, identify shortcomings, and suggest future research directions. [ABSTRACT FROM AUTHOR]

Background: A robust evidence base is required to assist healthcare commissioners and providers in selecting effective and sustainable approaches to improve cancer diagnosis and treatment. Such evidence can be difficult to build, given the fast-paced and highly pressured nature of healthcare delivery, the absence of incentives, and the presence of barriers in conducting pragmatic yet robust research evaluations. Cancer Research UK (CRUK) has played an active part in building the evidence base through its funding of programmes to identify, evaluate and scale-up innovative approaches across the UK. The aim of this paper is to describe and explain the research design and intended approach and activities for two cancer services improvement projects in Scotland funded by CRUK. Methods: A hybrid effectiveness-implementation study design will assess both the efficiency of the new pathways and their implementation strategies, with the aim of generating knowledge for scale-up. A range of implementation, service and clinical outcomes will be assessed as determined by the projects' Theories of Change (ToCs). A naturalistic case study approach will enable in-depth exploration of context and process, and the collection and synthesis of data from multiple sources including routine datasets, patient and staff surveys, in-depth interviews and observational and other data. The evaluations are informed throughout by a patient/public representatives' group, and by small group discussions with volunteer cancer patients. Discussion: Our approach has been designed to provide a holistic understanding of how (well) the improvement projects work (in relation to their anticipated outcomes), and how they interact with their wider contexts. The evaluations will help identify barriers, facilitators, and unanticipated consequences that can impact scalability, sustainability and spread. By opting for a pragmatic, participatory evaluation research design, we hope to inform strategies for scaling up successful innovations while addressing challenges in a targeted manner. [ABSTRACT FROM AUTHOR]

Study Question: Are there temporal trends of sperm concentration (SC) and total sperm count (TSC) in Chinese healthy males from 1981 to 2019?Summary Answer: Our result indicated a temporal decrease in SC and TSC among 327 373 healthy Chinese men in the recent four decades.What Is Known Already: A review of 61 papers reported a temporal decline in SC and TSC from 1938 to 1990. This trend was later confirmed by a systematic review of 185 published papers from 1981 to 2013. However, the majority of the included individuals were from western countries. In China, whether SC and TSC have declined remains controversial.Study Design, Size, Duration: This systematic review of published articles used data extracted from Pubmed, Science Direct, Embase, China-National-Knowledge-Infrastructure (CNKI) and Wanfang Data to assess changes in SC and TSC in China from 1981 to 2019.Participants/materials, Setting, Methods: A total of 111 studies including 327 373 individuals who provided semen samples from 1981 to 2019 were extracted for the present analysis. Study selection and data extraction were performed by two independent researchers. The trends in SC and TSC were analysed using liner-regression and meta-regression before and after adjusting for potential covariates. Moreover, subgroups, categorised based on geographic region, fertility status or recruitment source, were also analysed.Main Results and the Role Of Chance: SC declined significantly (slope liner-regression = -0.748 million/ml/year; P = 0.005; slope meta-regression = -0.824 million/ml/year; P < 0.001) between 1981 and 2019 in China. Trends for TSC was similar to that for SC (slope liner-regression = -2.073 million/year; P = 0.032; slope meta-regression = -2.188 million/year; P = 0.003). In subgroup meta-regression analyses, males with definite fertility had continuous declines in SC (slope northern group=-2.268, P = 0.009; slope southern group=-1.014, P = 0.009) and TSC (slope northern group=-9.675, P = 0.010; slope southern group=-3.215, P = 0.042). However, in the unselected group, where fertility status was unknown, the obvious downward trend in SC was only seen in males from Northern regions (slope = -0.836, P = 0.003). Another subgroup analysis demonstrated that obvious decreases in SC (slope = -1.432, P < 0.001) and TSC (slope=-4.315, P = 0.001) were only seen in volunteer groups but not in pre-pregnancy examination groups and other recruitment groups. The results changed minimally in multiple sensitivity analyses.Limitations, Reasons For Caution: The validity of the meta-analysis results was limited mainly by the quality of the included studies. Additionally, our study spanned many decades and the recommended criteria for some semen parameter assessments have significantly changed, which may bring about some unavoidable bias. Moreover, the data remain insufficient especially in some provinces of China.Wider Implications Of the Findings: The present study is the first study to report significant decreases in SC and TSC in 327 373 healthy Chinese men between 1981 and 2019, indicating a serious reproductive health warning. Further studies on the causes of the declines are urgently needed.Study Funding/competing Interest(s): D.Z. is supported by the National Natural Science Funding of China, Natural Science Funding of Shaanxi Province, Science Funding of Health Department, Shaanxi Province, Fundamental Research Funds for the Central University and the Project of Independent Innovative Experiment for Postgraduates in Medicine in Xi'an Jiaotong University. The authors have no conflicts of interests to declare.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Burn injuries are severe problems for human. Accurate segmentation for burn wounds in patient surface can improve the calculation precision of %TBSA (total burn surface area), which is helpful in determining treatment plan. Recently, deep learning methods have been used to automatically segment wounds. However, owing to the difficulty of collecting relevant images as training data, those methods cannot often achieve fine segmentation. A burn image-generating framework is proposed in this paper to generate burn image datasets with annotations automatically. Those datasets can be used to increase segmentation accuracy and save the time of annotating. This paper brings forward an advanced burn image generation framework called Burn-GAN. The framework consists of four parts: Generating burn wounds based on the mainstream Style-GAN network; Fusing wounds with human skins by Color Adjusted Seamless Cloning (CASC); Simulating real burn scene in three-dimensional space; Acquiring annotated dataset through three-dimensional and local burn coordinates transformation. Using this framework, a large variety of burn image datasets can be obtained. Finally, standard metrics like precision, Pixel Accuracy (PA) and Dice Coefficient (DC) were utilized to assess the framework. With nonsaturating loss with R2 regularization (NSLR2) and CASC, the segmentation network gains the best results. The framework achieved precision at 90.75%, PA at 96.88% and improved the DC from 84.5 to 89.3%. A burn data-generating framework have been built to improve the segmentation network, which can automatically segment burn images with higher accuracy and less time than traditional methods. [ABSTRACT FROM AUTHOR]

Aims: Most patients who receive implantable cardioverter defibrillators (ICDs) for primary prevention do not receive therapy during the lifespan of the ICD, whilst up to 50% of sudden cardiac death (SCD) occur in individuals who are considered low risk by conventional criteria. Machine learning offers a novel approach to risk stratification for ICD assignment.Methods and Results: Systematic search was performed in MEDLINE, Embase, Emcare, CINAHL, Cochrane Library, OpenGrey, MedrXiv, arXiv, Scopus, and Web of Science. Studies modelling SCD risk prediction within days to years using machine learning were eligible for inclusion. Transparency and quality of reporting (TRIPOD) and risk of bias (PROBAST) were assessed. A total of 4356 studies were screened with 11 meeting the inclusion criteria with heterogeneous populations, methods, and outcome measures preventing meta-analysis. The study size ranged from 122 to 124 097 participants. Input data sources included demographic, clinical, electrocardiogram, electrophysiological, imaging, and genetic data ranging from 4 to 72 variables per model. The most common outcome metric reported was the area under the receiver operator characteristic (n = 7) ranging between 0.71 and 0.96. In six studies comparing machine learning models and regression, machine learning improved performance in five. No studies adhered to a reporting standard. Five of the papers were at high risk of bias.Conclusion: Machine learning for SCD prediction has been under-applied and incorrectly implemented but is ripe for future investigation. It may have some incremental utility in predicting SCD over traditional models. The development of reporting standards for machine learning is required to improve the quality of evidence reporting in the field. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate a new prenatal education program evaluation tool, the UpStart Parent Survey – Prenatal, in terms of: (a) reliability and validity; (b) sensitivity to change over time; (c) whether results differed for mothers versus fathers; and (d) whether results differed when using an electronic tablet‐computer versus a paper survey. Design and Sample: Psychometric study. Participants were 277 expectant mothers (n = 161) and fathers (n = 106) enrolled in Childbirth Essentials, a 6‐week prenatal education program. Measures: The UpStart Parent Survey – Prenatal is a retrospective pretest/posttest survey with three scales: Parenting Knowledge, Parenting Experience, and Program Satisfaction, and three open‐ended questions. Results: The UpStart Parent Survey – Prenatal is sensitive to change and demonstrated significant positive differences in parenting knowledge and parenting experience. There was no difference in results whether the survey was completed by mothers or fathers. Results were similar whether paper or electronic formats were used. The survey was easy to complete. Conclusion: The UpStart Parent Survey – Prenatal holds promise as a reliable and valid evaluation tool to capture outcomes of brief prenatal education programs that target the general population of expectant parents. [ABSTRACT FROM AUTHOR]

Background: The past two decades have seen a large increase in investment in global public health research. There is a need for increased coordination and accountability, particularly in understanding where funding is being allocated and who has capacity to perform research. In this paper, we aim to assess global, regional, national and sub-national capacity for public health research and how it is changing over time in different parts of the world.Methods: To allow comparisons of regions, countries and universities/research institutes over time, we relied on Web of Science(TM) database and used Hirsch (h) index based on 5-year-periods (h5). We defined articles relevant to public health research with 98% specificity using the combination of search terms relevant to public health, epidemiology or meta-analysis. Based on those selected papers, we computed h5 for each country of the world and their main universities/research institutes for these 5-year time periods: 1996-2000, 2001-2005 and 2006-2010. We computed h5 with a 3-year-window after each time period, to allow citations from more recent years to accumulate. Among the papers contributing to h5-core, we explored a topic/disease under investigation, "instrument" of health research used (eg, descriptive, discovery, development or delivery research); and universities/research institutes contributing to h5-core.Results: Globally, the majority of public health research has been conducted in North America and Europe, but other regions (particularly Eastern Mediterranean and South-East Asia) are showing greater improvement rate and are rapidly gaining capacity. Moreover, several African nations performed particularly well when their research output is adjusted by their gross domestic product (GDP). In the regions gaining capacity, universities are contributing more substantially to the h-core publications than other research institutions. In all regions of the world, the topics of articles in h-core are shifting from communicable to non-communicable diseases (NCDs). There is also a trend of reduction in "discovery" research and increase in "delivery" research.Conclusion: Funding agencies and research policy makers should recognise nations where public health research capacity is increasing. These countries are worthy of increased investment in order to further increase the production of high quality local research and continue to develop their research capacity. Similarly, universities that contribute substantially to national research capacity should be recognised and supported. Biomedical journals should also take notice to ensure equity in peer-review process and provide researchers from all countries an equal opportunity to publish high-quality research and reduce financial barriers to accessing these journals. [ABSTRACT FROM AUTHOR]

Background: In 1962, Methods of Information in Medicine ( MIM ) began to publish papers on the methodology and scientific fundamentals of organizing, representing, and analyzing data, information, and knowledge in biomedicine and health care. Considered a companion journal, Applied Clinical Informatics ( ACI ) was launched in 2009 with a mission to establish a platform that allows sharing of knowledge between clinical medicine and health IT specialists as well as to bridge gaps between visionary design and successful and pragmatic deployment of clinical information systems. Both journals are official journals of the International Medical Informatics Association.Objectives: As a follow-up to prior work, we set out to explore congruencies and interdependencies in publications of ACI and MIM. The objectives were to describe the major topics discussed in articles published in ACI in 2014 and to determine if there was evidence that theory in 2014 MIM publications was informed by practice described in ACI publications in any year. We also set out to describe lessons learned in the context of bridging informatics practice and theory and offer opinions on how ACI editorial policies could evolve to foster and improve such bridging.Methods: We conducted a retrospective observational study and reviewed all articles published in ACI during the calendar year 2014 (Volume 5) for their main theme, conclusions, and key words. We then reviewed the citations of all MIM papers from 2014 to determine if there were references to ACI articles from any year. Lessons learned in the context of bridging informatics practice and theory and opinions on ACI editorial policies were developed by consensus among the two authors.Results: A total of 70 articles were published in ACI in 2014. Clinical decision support, clinical documentation, usability, Meaningful Use, health information exchange, patient portals, and clinical research informatics emerged as major themes. Only one MIM article from 2014 cited an ACI article. There are several lessons learned including the possibility that there may not be direct links between MIM theory and ACI practice articles. ACI editorial policies will continue to evolve to reflect the breadth and depth of the practice of clinical informatics and articles received for publication. Efforts to encourage bridging of informatics practice and theory may be considered by the ACI editors.Conclusions: The lack of direct links from informatics theory-based papers published in MIM in 2014 to papers published in ACI continues as was described for papers published during 2012 to 2013 in the two companion journals. Thus, there is little evidence that theory in MIM has been informed by practice in ACI. [ABSTRACT FROM AUTHOR]

Background: Interest in collecting Patient Reported Outcomes using electronic methods such as mobile phones has increased in recent years. However there is debate about the level of measurement equivalence between the traditional paper and newer electronic modes. Information about the acceptability of the electronic versions to respondents is also required. The aim of this study is to compare the equivalence of delivering a widely used generic measure of health status (EQ-5D-5L) across two administration modes (paper and mobile phone).Methods: Respondents from a research cohort of people in South Yorkshire were identified, and randomly allocated to one of two administration modes (paper vs. mobile phone) based on stratifications for age and gender (and across a range of self-reported health conditions). A parallel group design was used where each respondent only completed EQ-5D-5L using one of the modes. In total, 70 respondents completed the measure in the mobile phone arm, and 66 completed the standard paper version. Follow up usability questions were also included to assess the acceptability of the mobile version of EQ-5D-5L. Measurement equivalence was compared at the dimension, utility score and visual analogue scale level using chi square analysis and ANOVA, and by comparing mean differences to an estimated minimally important difference value.Results: Response rates were higher in the mobile arm. The mean EQ-5D-5L utility and VAS scores, and the frequency of respondents endorsing individual EQ-5D-5L dimension response levels did not significantly differ across the administration modes. The majority of the mobile arm agreed that the mobile version of EQ-5D-5L was easy to complete, and that the phone was easy to use, and that they would complete mobile health measures again.Conclusions: Completing health status measures such as EQ-5D using mobile phones produces equivalent results to more traditional methods, but with added benefits (for example lessening the burden of data entry). Respondents are positive towards completing questionnaires using these methods. The results provide evidence that electronic measures are valid for use to collect data in a range of settings including clinical trials, routine care, and in health diary settings. [ABSTRACT FROM AUTHOR]

Background: Effective web-assisted tobacco interventions (WATIs) have been underutilized by smokers; moreover, despite practice guideline recommendations, clinical teams do not routinely refer smokers to WATIs. Our goal was to test a clinical practice innovation, an ePortal designed to change practice and patient behavior. Our hypotheses were that the integrated system would result in increased smoker referrals, with an automated follow-up system resulting in more smoker registrations and finally augmentations of the WATI would result in more smokers quitting at 6 months.Methods: Practice ePortal Implementation Trial: Practices (n = 174) were randomized to an online practice ePortal with an "e-referral tool" to the WATI (e-referred smokers received automated email reminders from the practice) and with practice feedback reports with patient tracking and practice-to-patient secure messaging versus comparison (a paper "referral prescription"). Implementation success was measured by the number of smokers referred and smokers registering. Clinical Effectiveness Trial: To estimate the effectiveness of the WATI components on 6-month smoking cessation, registered smokers were randomized into three groups: a state-of-the-art tailored WATI control [control], the WATI enhanced with proactive, pushed tailored email motivational messaging (messaging), and the WATI with messaging further enhanced with personal secure messaging with a tobacco treatment specialist and an online support group (personalized).Results: Practice ePortal Trial results: A total of 4789 smokers were referred. The mean smokers referred per practice was not statistically different by group (ePortal 24.89 (SD 22.29) versus comparison 30.15 (SD 25.45), p = 0.15). The e-referral portal implementation program resulted in nearly triple the rate of smoker registration (31 % of all smokers referred registered online) versus comparison (11 %, p < 0.001). Clinical Effectiveness Trial results: Active smokers randomized to the personalized group had a 6-month cessation rate of 25.2 %, compared with the messaging group (26.7 %) and the control (17 %). Next, when using an inverse probability weighted selection model to account for attrition, those randomized to the two groups that received motivational messaging (messaging or personalized) were more likely to quit than those in the control (p = 0.04).Conclusions: Among all smokers referred, the e-referral resulted in nearly threefold greater registrants (31 %) than paper (11 %). The practice ePortal smokers received multiple reminders (increasing registration opportunities), and the practices could track patient progress. The result was more smokers registering and, thus, more cessation opportunities. Combining the proactive referral and the WATI resulted in higher rates of smoking cessation.Trial Registration: Web-delivered Provider Intervention for Tobacco Control (QUIT-PRIMO) - a randomized controlled trial: NCT00797628 . [ABSTRACT FROM AUTHOR]

Background: Health systems are facing unprecedented socioeconomic pressures as well as the need to cope with the ongoing strain brought about by the COVID-19 pandemic. In response, the reconfiguration of health systems to encourage greater collaboration and integration has been promoted with a variety of collaborative shapes and forms being encouraged and developed. Despite this continued interest, evidence for success of these various arrangements is lacking, with the links between collaboration and improved performance often remaining uncertain. To date, many examinations of collaborations have been undertaken, but use of realist methodology may shed additional light on how and why collaboration works, and whom it benefits.Methods: This paper seeks to test initial context-mechanism-outcome configurations (CMOCs) of interorganisational collaboration with the view to producing a refined realist theory. This phase of the realist synthesis used case study and evaluation literature; combined with supplementary systematic searches. These searches were screened for rigour and relevance, after which CMOCs were extracted from included literature and compared against existing ones for refinement, refutation, or affirmation. We also identified demi-regularities to better explain how these CMOCs were interlinked.Results: Fifty-one papers were included, from which 338 CMOCs were identified, where many were analogous. This resulted in new mechanisms such as 'risk threshold' and refinement of many others, including trust, confidence, and faith, into more well-defined constructs. Refinement and addition of CMOCs enabled the creation of a 'web of causality' depicting how contextual factors form CMOC chains which generate outputs of collaborative behaviour. Core characteristics of collaborations, such as whether they were mandated or cross-sector, were explored for their proposed impact according to the theory.Conclusion: The formulation of this refined realist theory allows for greater understanding of how and why collaborations work and can serve to inform both future work in this area and the implementation of these arrangements. Future work should delve deeper into collaborative subtypes and the underlying drivers of collaborative performance.Review Registration: This review is part of a larger realist synthesis, registered at PROSPERO with ID CRD42019149009 . [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify and meta-analyse the neuroimaging data and hence synthesise a brain map showing the neural correlates of watching food commercials.Design: Published studies were retrieved and included into the analysis if they evaluated brain responses to food commercials with functional MRI and reported results based on whole-brain analysis in standard brain coordinates.Setting: No additional restriction was placed on the search, such as the publication year and age of participants.Participants: Seven papers that composed of a total of 442 participants fulfilled the inclusion criteria. All of them recruited children or adolescents.Results: Food commercials caused larger brain responses than nonfood counterparts in the cuneus on both hemispheres, which played a role in dietary self-control and modulation of food craving. Other brain regions involved in food commercials processing included the left culmen, left middle occipital gyrus and the right superior parietal lobule, which could be related to reward, emotional responses and habit formation.Conclusion: These neural correlates may help explain the food choice and eating behaviours of children and adolescents that might be relevant to the development of obesity. [ABSTRACT FROM AUTHOR]

Learners are not stakeholders in their own education. Adhering to the quantitative gold standard in English as a Second Language (ESL) deprives the learner from having a voice in their learning process. This paper addresses voicelessness and ventriloquism in ESL, ventriloquism referring to the act of voicing the thoughts of another person, in this case the system overriding the learners' experiences. This article addresses this problem, aligning itself with the Platinum standard while challenging the quantitative gold standard in ESL research. This paper offers resonance and semantic reliability as evaluative measures in educational research taken from literary criticism. The notion of resonance has been addressed in the literature on qualitative research since the dawn of the narrative turn; I address how resonance can be used in educational research. [ABSTRACT FROM AUTHOR]

The social contributions of research activities have become more and more important in the rapidly changing innovation environment. Despite the fact that industrial commercialization of research results constitutes one of the most essential drivers for innovation and competitiveness, most generally used social impact evaluation criteria do not include clear metrics involving research commercialization possibilities. In a similar manner, principles regarding sustainable development have been largely omitted from the impact criteria. This paper considers the "broader impacts criteria" (BIC) model developed for social impact evaluation in the National Science Foundation in United States. We propose extensions to the BIC criteria related to commercialization and sustainable development viewpoints on impact evaluation. This paper also considers a newly introduced extension to BIC, called "inclusionimmediacy criteria" (IIC). Based on it, we propose an extended version of the model that aims to additionally evaluate the impact of research fromcommercialization point of view. [ABSTRACT FROM AUTHOR]

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In a companion paper, we showed how local hospital leaders could assess systems and identify key safety concerns and targets for system improvement. In the present paper, we consider how these leaders might implement practical, low-cost interventions to improve safety. Our focus is on making immediate safety improvements both to directly improve patient care and as a foundation for advancing care in the longer-term. We describe a 'portfolio' approach to safety improvement in four broad categories: prioritising critical processes, such as checking drug doses; strengthening the overall system of care, for example, by introducing multiprofessional handovers; control of known risks, such as only using continuous positive airway pressure when appropriate conditions are met; and enhancing detection and response to hazardous situations, such as introducing brief team meetings to identify and respond to immediate threats and challenges. Local clinical leaders and managers face numerous challenges in delivering safe care but, if given sufficient support, they are nevertheless in a position to bring about major improvements. Skills in improving safety and quality should be recognised as equivalent to any other form of (sub)specialty training and as an essential element of any senior clinical or management role. National professional organisations need to promote appropriate education and provide coaching, mentorship and support to local leaders. [ABSTRACT FROM AUTHOR]

In the context of the new era, the distinctive function of BD (big data) analysis and prediction also introduces a new way of thinking to university IPE (ideological and political education), broadens the domain of university IPE, and enhances the curricular offerings of IPE universities. In order to enhance the intelligence and personalization of the intelligent teaching system, this paper describes in detail the design and implementation processes for each component of the system. It also uses the association mining rule algorithm of data mining. To maintain population diversity, a population initialization method and a neighborhood-based search operator are used, both of which are based on a thorough consideration of the characteristics of complex networks. The neighborhood search strategy enhances the local search capability of the TLBO (Teaching-Learning Based Optimization) algorithm. The optimized TLBO algorithm presented in this paper achieves the highest average modularity value of 0.5238 through testing on real-world data sets. The outcomes demonstrate that the algorithm performs well and is successful in identifying problems in the community. [ABSTRACT FROM AUTHOR]

Yan'an is one of the "two holy places" of the Chinese nation and the Chinese revolution and is one of the first cities of historical and cultural significance and an outstanding tourist city in China, as announced by the state council. The evaluation of the effectiveness of environmental conservation is one of the very important elements of the conservation of Yan'an's architectural heritage. However, the existing evaluation methods cannot provide new solutions for decision-making, the meaning of the comprehensive evaluation function is unclear, the naming clarity is low, there is less quantitative data and more qualitative components, and the results are not easily convincing. This paper proposes a method for evaluating the practical effects of environmental class measures in the conservation of Yan'an's architectural heritage based on recurrent neural networks. The recurrent neural network makes full use of the memory function in the network, considers the causal relationship of the actual effect, and efficiently evaluates the existing measures. In comparison with factor analysis and hierarchical analysis, this paper has greater applicability in evaluating the practical effects of environmental measures in the conservation of Yan'an's architectural heritage and is basically consistent with the results of the theoretical analysis. It provides a scientific basis for the construction and implementation of environmental measures for the architectural heritage of Yan'an. [ABSTRACT FROM AUTHOR]

The water environment is one of the basic elements that constitute the environment. It is an important place for the survival and development of human society, and it is also the most seriously disturbed and damaged area by humans. The pollution and destruction of water environment has become one of the major environmental problems in the world today. The essence of urban water space landscape design under the concept of integrating people's ecological design is the ecological landscape design of urban water spaces, while the development of ecological landscape design in the field of urban water space landscape design is still in its infancy, and the interpretation of its concept is also different. The ecological design of the landscape reflects a new dream of human beings, a new aesthetics and value: the true cooperative and fraternal relationship between man and nature. At present, the ecological design of urban water space landscape has not put forward a more accurate concept, clear principles and standards, and a complete and systematic theoretical basis, which requires further research, discussion, and continuous practice by this generation of designers to improve it. To this end, this paper proposed a research method on the integration of water environment governance in urban and rural spaces with natural ecological landscape design. This paper mainly talked about the status quo of water environment and its network sensor algorithm research and analyzed its coverage area one by one. Then, the water quality extraction is introduced in detail. And finally, the data analysis of the Beijing river waters, the analyzer rainfall, water quality, and so on are carried out in the experimental part. It could be seen from the experimental results that there were currently 22 reclaimed water plants in six urban areas of Beijing, with a daily water treatment capacity of 4.08 million cubic meters and a sewage treatment rate of 98%. As of 2016, 440 million cubic meters of reclaimed water has been reused. With the commissioning of the new reclaimed water system, the proportion of reclaimed water in the river and lake environment will continue to increase. [ABSTRACT FROM AUTHOR]

Introducing systems thinking concepts in the programme evaluation field has been mostly aimed at supporting the practice of evaluation, rather than towards making theoretical advancements in the evaluation field. This paper introduces ideas and principles from systems thinking at the theoretical and practical levels in the programme evaluation field as applied to a peace‐building programme called the Hermes Programme in Colombia. This document demonstrates how systems thinking concepts and tools were used in the practice of evaluation. We show the theoretical development of the proposed evaluation and explain how its stages were carried out in evaluating the Hermes Programme. This paper also illustrates the benefits of using systems thinking in evaluation. [ABSTRACT FROM AUTHOR]

There are diverse perceptions about the primary purpose of evaluation. In interprofessional education (IPE), there has been a perceived focus on evaluating against the outcome of improved collaborative practice and quality of care. This paper presents an exploration of the nature and purpose of evaluation methods commonly utilized in the IPE literature with its focus on outcomes-based evaluation and particularly the Kirkpatrick framework. It categorises recent evaluations of pre-qualification (pre-certification) IPE interventions. Of the 90 studies included, most evaluated soon after the educational intervention, only five specifically referred to an evaluation framework and the most frequently used tool was the RIPLS. There was a noteworthy reliance on students' self-rated perceptions of their attitudes towards collaborative practice collected through surveys, focus groups and interviews. There appears to be a need to reconsider the type of evaluation required. In conclusion, this paper offers recommendations for evaluation practice that is moving towards realist approaches; describes the longer term effects of interventions on attitudes and behaviour; develops and validates data collection tools including direct observation of practice and more comprehensively engages with all stakeholders to ensure that evaluation activities are not only focused on improving IPE but also on enhancing our understanding of interprofessional practice. [ABSTRACT FROM AUTHOR]

Aim: Documentation is a critical element in the function of the nursing team, and cannot be separated from high-quality, patient-centered care. The aim of this study was to compare the quality of nursing documentation in electronic and paper-based systems.Method: A retrospective descriptive study was designed to compare the quality of nursing documentation in electronic health records (EHR) versus paper-based documentation systems before and after the application of the electronic system.Results: Analysis of data found a significant difference in the quality of nursing documentation in the two hospitals both before and after the implementation of an EHR system (p < 0.001).Quality of nursing documentation in the electronic system was significantly better than that of paper-based documentation systems.Conclusion: Vocal-electronic systems help to improve quality of nursing documentation, suggesting this aspect may be essential to implementing a successful system in local settings. [ABSTRACT FROM AUTHOR]

The need for developing effective telehealth tools for dysphagia management is high not only for people who live in rural areas, but also for individuals with mobility/access limitations. We aimed to develop an electronic case History Tool/form (thereafter, e-HiT) for dysphagia, and compare its effectiveness with its paper-based version (PBV) on completion time, completeness, independence, and patient perceptions/satisfaction. Secondarily, we examined associations between the aforementioned variables and predictor variables, such as age, cognition, and computer/internet use. Forty adults who expressed concerns with eating/swallowing participated. To compare both versions, a randomized, controlled two-period crossover design was used. In Visit 1, Group A completed the e-HiT and Group B completed the PBV. In Visit 2, Group A completed the PBV and Group B completed the e-HiT. A satisfaction survey was completed post visits. There were no statistically significant differences for completion time (p = 0.743), completeness (p = 0.486), and independence (p = 0.738). Patient perception/satisfaction was significantly higher with the e-HiT (p = 0.004). In addition, a significant association was found between completion time and age (p = 0.0063). Our results indicate that completing the e-HiT is as time efficient as completing the PBV and that both forms elicit the same amount of information with no or minimal support. Also, completion of the e-HiT yielded significantly higher satisfaction responses. This is the first study documenting the effectiveness of the e-HiT for outpatients with dysphagia, providing evidence that the first step of a swallowing assessment-case history completion-can be effectively completed via telehealth by individuals with reliable internet connection and basic computer literacy skills. [ABSTRACT FROM AUTHOR]

Purpose Complexity received increasing attention from researchers in integration and evaluation studies. Complex adaptive systems are the most prominent formulation of complexity used in programme evaluations. However, there remain significant theoretical and conceptual barriers to using complexity as an explanatory model in social sciences, and thus in applying it successfully in integration and evaluation studies. The paper aims to discuss these issues.Design/methodology/approach Discussion paper outlining the potential uses and risks of complexity theory for studying integration programmes in health and social care and programme evaluations in general. The paper proceeds by synthesising the work of various critics and proponents of complexity theory in the social sciences and evaluation theory.Findings Complexity offers opportunities and risks to social scientists working in programme evaluations and integration studies. The opportunities are defined by additional modelling and verification/falsification of possible cause and effect links in programme settings. The risks, on the other hand, are twofold. Social scientists may use complexity as a shorthand for as yet insufficient understanding of the contexts under examination, or they mistake it for an explanatory device without testing its potential to explain. The second risk emerges as a result of the nature of complexity and its role in natural sciences. Assigning complexity an explanatory role may prevent further investigation of a given setting that may reveal that complexity is insufficient to understand what is going on.Originality/value Researchers should make clear how they have operationalised and measured the various features of the complexity model to allow robust verification of the evidence. Scholars should also assume that complexity as defined by the natural sciences is philosophically and epistemologically problematic when transferred into the realm of social sciences that largely operate with concepts informed by the paradigm of understanding social behaviour. [ABSTRACT FROM AUTHOR]

To undertake a literature search and critical appraisal of best available evidence to answer the clinical question: Does the addition of clonidine (I) to standard treatment with an opioid (C) improve outcomes (O) in infants with Neonatal Abstinence Syndrome? A search of both comprehensive (MedLine and Embase) and pre-filtered databases (Dynamed, UpToDate and TRIP), utilising Boolean Operators to combine search terms appropriately. Three relevant studies were identified. One paper describing the outcomes of a randomised controlled trial by Agthe et al. (2009) most accurately answered the clinical question posed. This paper was critically appraised, and evidence applied to the clinical scenario. The use of clonidine as an adjunct to opioid in the management of infants with NAS reduces the total number of treatment days and dose of opioid required to control symptoms. However, there is a higher risk of rebound in symptoms post-cessation of opioid and clinicians need to account for this in their discharge planning. More large scale, multi-centre high-quality research is needed to clarify the role of clonidine in the treatment of NAS: as monotherapy versus adjunct, the optimal dose and longer-term impact on neurodevelopment. [ABSTRACT FROM AUTHOR]

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