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Patterns of Energy Imbalance of the Meridians in Patients with Temporomandibular Dysfunction.

Temporomandibular dysfunction (TMD) is a set of changes that affects the muscles of mastication, temporomandibular joint, teeth, and associated periodontal and orofacial structures. According to Traditional Chinese Medicine, the imbalance of energy (Qi) circulating in the acupuncture meridians is always the primary etiologic cause of any physical manifestation. The aim of this study was to describe the patterns of Qi imbalance in patients with TMD by means of an objective measurement. The clinical study was conducted at the Piracicaba Dental School (FOP/Unicamp), in Piracicaba-SP, Brazil. We e…

Variation in optical coherence tomography signal quality as an indicator of retinal nerve fibre layer segmentation error.

PURPOSE: Commercial optical coherence tomography (OCT) systems use global signal quality indices to quantify scan quality. Signal quality ca … thy, 19 glaucoma-suspect and 43 glaucoma subjects. Scans were grouped based on SegE. Quality index (QI) values were computed for each A-scan using software of our own design. Logistic mixed-effects regression modelling was applied to evaluate SS, global mean and SD of QI, and the probability of SegE. RESULTS: The difference between local mean QI in …

The four main domains of the concept of return-on-investment from healthcare quality improvement programmes.

BACKGROUND: This paper synthesizes a series of four studies in the exploration of the concept of Return on Investment (ROI) in relation to healthcare Quality Improvement (QI) programmes (QI-ROI). METHODS: We followed a multi-stage mixed-methods integration approach where four studies were first conducted and reported separately. The four study designs were linked to enable us to build a cohesive understanding of QI-ROI. Collective findings were then analysed and interpreted to identify the main QI-ROI concept domains. Two studies were based on an extensive global interdisciplinary systematic …

A Resident-Led Quality Improvement Initiative to Accelerate Medical Therapy Implementation in Acute Heart Failure: ACCELERATE-HF.

INTRODUCTION: Guideline-directed medical therapy (GDMT) optimization and effective de-congestion are known to improve outcomes in admitted heart failure (HF) patients, yet their implementation is suboptimal. Using an HF decision aid and point-of-care ultrasound (POCUS) at admission, this resident-led quality improvement (QI) initiative aimed to improve GDMT use and reduce HF readmissions. METHODS: This prospective, single-center QI initiative compared resident-performed POCUS and HF decision-aid use (the QI arm) with routine hospital care in admitted HF patients. Assignment to the QI arm was …

The feasibility of a novel national quality improvement programme for tobacco dependency treatment pathways in acute UK hospitals.

INTRODUCTION: The prevalence of smoking remains stubbornly high in the UK despite comprehensive tobacco control measures. A national quality improvement (QI) approach to enhance the treatment of an estimated 1,000,000 annual hospital admissions of tobacco smokers could provide a new opportunity to improve population health and reduce healthcare demand. Barriers to QI include knowledge, costs and competing demands. This study aimed to evaluate the feasibility and effectiveness of a national QI programme hosted by the British Thoracic Society, focused on improving NHS tobacco dependency treatmen…

Quality Indicators for the Diagnosis and Management of Primary Hyperparathyroidism.

IMPORTANCE: Primary hyperparathyroidism (pHPT) is a common endocrine disorder with many diagnostic and treatment challenges. Despite high-quality guidelines, care is variable, and there is low adherence to evidence-based treatment pathways. OBJECTIVE: To develop quality indicators (QIs) to evaluate the diagnosis and treatment of pHPT that could measure, improve, and optimize quality of care and outcomes for patients with this disease. DESIGN, SETTING, AND PARTICIPANTS: This quality improvement study used a guideline-based approach to develop QIs that were ranked by a Canadian 9-member expert…

Relevant factors of leg strength at hospital discharge in patients hospitalized due to acute decompensated heart failure: multi-institutional prospective observational study.

BACKGROUND: Lower leg strength at hospital discharge is strongly associated with poor prognosis in older patients with acute decompensated h … <75 years; n = 142) and older patient group (≥75 years; n = 105). Quadriceps isometric strength (QIS), body mass-corrected QIS (%BM QIS), and change in QIS during hospitalization (QIS ratio) were evaluated in all patients. Physical function in the stable phase was measured by the Performance Measure for Activities of Daily Living-8 (PMADL-8). The …

Virtual adaptation of traditional healthcare quality improvement training in response to COVID-19: a rapid narrative review.

BACKGROUND: Information and communication technology are playing a major role in ensuring continuity of healthcare services during the COVID-19 pandemic. The pandemic has also disrupted healthcare quality improvement (QI) training and education for healthcare professionals and there is a need to rethink the way QI training and education is delivered. The purpose of this rapid evidence review is to quickly, but comprehensively collate studies to identify what works and what does not in delivering QI training and education using distance learning modalities. METHODS: Three healthcare databases …

Integrating Training in Quality Improvement and Health Equity in Graduate Medical Education: Two Curricula for the Price of One.

A recent call to address health care disparities has come from the Accreditation Council for Graduate Medical Education's (ACGME's) Clinical Learning Environment Review (CLER) program. The CLER program aspires that faculty and residents will identify the disparities among the patient populations they serve and engage in quality improvement (QI) activities designed to address them. In this Perspective, the authors provide a framework for integrating QI and health equity principles in graduate medical education to meet these ACGME expectations. The authors illustrate their four-step framework by…

International Comparison of Quality Indicators for Adults Hospitalized for Heart Failure: A Systematic Review.

BACKGROUND: There is limited international agreement on defining care quality for the millions of people hospitalized with heart failure worldwide. Our objective was to compare and measure agreement across existing internationally published quality indicators (QIs) for the care of adults hospitalized for heart failure. METHODS: Systematic review and evidence gap map of internationally published articles reporting on QIs for adults hospitalized for heart failure, using PubMed, MEDLINE, EMBASE, and TRIP from inception to July 18, 2022. Narrative synthesis and descriptive statistics characterize…

Quality Indicators for Bladder Cancer Services: A Collaborative Review.

CONTEXT: There is a lack of accepted consensus on what should constitute appropriate quality-of-care indicators for bladder cancer. OBJECTIVE: To evaluate the optimal management of bladder cancer and propose quality indicators (QIs). EVIDENCE ACQUISITION: A systematic review was performed to identify literature on current optimal management and potential quality indicators for both non-muscle-invasive (NMIBC) and muscle-invasive (MIBC) bladder cancer. A panel of experts was convened to select a recommended list of QIs. EVIDENCE SYNTHESIS: For NMIBC, preoperative QIs include tobacco cessatio…

Improving Rates of Delayed Cord Clamping in Ethiopian Hospitals: A Virtual Quality Collaborative.

OBJECTIVE: Although curricula to teach quality improvement (QI) methodology exist for global settings, ongoing mentorship and support to implement QI practices have not been well established. Leveraging the ECHO methodology, we taught a basic QI curriculum and established a learning community to improve a chosen gap in essential newborn care, delayed cord clamping (DCC). METHODS: The Ethiopian Neonatal Quality Improvement (EN-QI) Project was conducted from February 2021 to January 2022 across 8 delivery centers selected by the Ethiopian Pediatrics Society. Each site set a SMART (Specific-Meas…

Association Between Adherence to Quality Indicators and 7-Day In-Hospital Mortality After Acute Ischemic Stroke.

BACKGROUND AND PURPOSE: Quality indicators (QI) are an accepted tool to measure performance of hospitals in routine care. We investigated the association between quality of acute stroke care defined by overall adherence to evidence-based QI and early outcome in German acute care hospitals. METHODS: Patients with ischemic stroke admitted to one of the hospitals cooperating within the ADSR (German Stroke Register Study Group) were analyzed. The ADSR is a voluntary network of 9 regional stroke registers monitoring quality of acute stroke care across 736 hospitals in Germany. Quality of stroke ca…

Показатели качества консенсуса для мониторинга множественного склероза.

Множественный склероз (МС) как хроническое, дегенеративное аутоиммунное заболевание центральной нервной системы имеет продольный и разнородный курс с увеличением вариантов лечения и профилей рисков, требующих постоянного мониторинга растущего числа параметров. Несмотря на руководящие принципы лечения, отсутствуют стратегические и индивидуализированные пути мониторинга, включая соответствующие показатели качества (КИ). Для решения этой проблемы мы систематически разрабатывали транспарентные, отслеживаемые и измеримые КИ для мониторинга НР. С помощью обзора литературы, дискуссий экспертов и форм

Совпадение в аннотации оригинала
Multiple sclerosis (MS) as a chronic, degenerative autoimmune disease of the central nervous system has a longitudinal and heterogeneous cou … lack of strategic and individualised monitoring pathways, including respective quality indicators (QIs). To address this, we systematically developed transparent, traceable, and measurable QIs for MS monitoring. Through literature review, expert discussions, and consensus-building, existing QIs were identified and refined. In a two-stage online Delp …

Revisiting Turkish Esophageal Atresia Regisrty data for quality indicators.

AIM: The Turkish Esophageal Atresia Registry (TEAR) data were revisited using quality indicators (QIs) to evaluate quality care provided to patients with esophageal atresia (EA). METHODS: Among 36 centers registering data in the TEAR database, only those treating more than four patients per year were included. Based on predefined QIs, each center was assessed for structural, procedural and outcome indicators. Mean percentages were calculated for each QI. Centers with a lower-than-mean percentage for adverse outcomes were determined as 'meeting' that QI, while those with higher percentage were…

Quality Indicators to Monitor Home Care Services for the Older Population: A Scoping Review.

OBJECTIVES: To identify and synthesize publicly available quality indicators (QIs) routinely used to monitor and assess the quality and safety of home care services for the older population. DESIGN: A scoping literature review following the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). SETTING AND PARTICIPANTS: Older people aged ≥65 years old receiving home care services. METHODS: Academic and gray literature searches were conducted to identify publicly available QIs routinely used at the population level and reported since 201…

Quality Indicators for the Diagnosis and Management of Menière's Disease.

OBJECTIVE: Menière's disease (MD) is a clinical disorder that often provides challenges in diagnosis and management. High-quality evidence to guide care providers is sparse, which can result in significant practice variations. Quality indicators (QIs) are one method that can be used to standardize and measure accepted care practices to improve healthcare quality and patient outcomes. Here, we developed practical, high-yield QIs that serve to measure and inform the quality of care provided to patients with MD. STUDY DESIGN: Modified RAND Corporation University of California, Los Angeles approp…

Mortality in Staphylococcus aureus bacteraemia remains high despite adherence to quality indicators: secondary analysis of a prospective cohort study.

OBJECTIVES: To evaluate the association between compliance with previously published quality indicators (QIs) for the management of Staphylococcus aureus bacteraemia (SAB) and 30-day mortality. METHODS: We conducted a post hoc analysis of all adult patients with SAB who were hospitalized at a Spanish university hospital between 2013 and 2018. We evaluated the compliance with 7 QIs of SAB management (i.e., Infectious Diseases consultation, follow-up blood cultures, early source control, echocardiography, early cloxacillin or cefazolin, vancomycin monitoring, and appropriate treatment duration)…

Cost-Effectiveness of Increased Use of Dual Antiplatelet Therapy After High-Risk Transient Ischemic Attack or Minor Stroke.

BACKGROUND: Rates of dual antiplatelet therapy (DAPT) after high-risk transient ischemic attack or minor ischemic stroke (TIAMIS) are suboptimal. We performed a cost-effectiveness analysis to characterize the parameters of a quality improvement (QI) intervention designed to increase DAPT use after TIAMIS. METHODS AND RESULTS: We constructed a decision tree model that compared current national rates of DAPT use after TIAMIS with rates after implementing a theoretical QI intervention designed to increase appropriate DAPT use. The base case assumed that a QI intervention increased the rate of DA…

Exploration of Constitutional Bias and Associated Factors in Patients with Recurrent and Metastatic Gastric Cancer, and the Therapeutic Effect of Yiqi Wenyang Jiedu Prescription: A one-arm study.

OBJECTIVE: This study was conducted to elucidate the distribution characteristics of predominant unbalanced constitutions and TCM syndrome elements in patients with recurrent and metastatic gastric cancer. This study was also undertaken to analyze the potential relationship between the body constitutions of patients, syndrome elements, and biological indicators, as well as to investigate the effect of Yiqi Wenyang Jiedu prescription (YWJP) on symptoms and biological indicators before and after treatment. RESULT: Yang-deficiency and Qi-deficiency were identified as prevalent imbalanced constit…