PEDro or Cochrane to Assess the Quality of Clinical Trials? A Meta-Epidemiological Study.

OBJECTIVE There is debate on how the methodological quality of clinical trials should be assessed. We compared trials of physical therapy (PT) judged to be of adequate quality based on summary scores from the Physiotherapy Evidence Database (PEDro) scale with trials judged to be of adequate quality by Cochrane Risk of Bias criteria. DESIGN Meta-epidemiological study within Cochrane Database of Systematic Reviews. METHODS Meta-analyses of PT trials were identified in the Cochrane Database of Systematic Reviews. For each trial PeDro and Cochrane assessments were extracted from the PeDro and Cochrane databases. Adequate quality was defined as adequate generation of random sequence, concealment of allocation, and blinding of outcome assessors (Cochrane criteria) or as trials with a PEDro summary score ≥5 or ≥6 points. We combined trials of adequate quality using random-effects meta-analysis. RESULTS Forty-one Cochrane reviews and 353 PT trials were included. All meta-analyses included trials with PEDro scores ≥5, 37 (90.2%) included trials with PEDro scores ≥6 and only 22 (53.7%) meta-analyses included trials of adequate quality according to the Cochrane criteria. Agreement between PeDro and Cochrane was poor for PeDro scores of ≥5 points (kappa = 0.12; 95% CI 0.07 to 0.16) and slight for ≥6 points (kappa 0.24; 95% CI 0.16-0.32). When combining effect sizes of trials deemed to be of adequate quality according to PEDro or Cochrane criteria, we found that a substantial difference in the combined effect size (≥0.15) was evident in 9 (22%) out of the 41 meta-analyses for PEDro cutoff ≥5 and 10 (24%) for cutoff ≥6. CONCLUSIONS The PeDro and Cochrane approaches lead to different sets of trials of adequate quality, and different combined treatment estimates from meta-analyses of these trials. A consistent approach to assessing RoB in trials of physical therapy should be adopted.

An Exploratory Study of Data Quality Management Practices in the ERP Software Systems Context

Quality data are not only relevant for successful Data Warehousing or Business Intelligence applications; they are also a precondition for efficient and effective use of Enterprise Resource Planning (ERP) systems. ERP professionals in all kinds of businesses are concerned with data quality issues, as a survey, conducted by the Institute of Information Systems at the University of Bern, has shown. This paper demonstrates, by using results of this survey, why data quality problems in modern ERP systems can occur and suggests how ERP researchers and practitioners can handle issues around the quality of data in an ERP software Environment.

Impact of a modified dietary plan on the health related quality of life of minority participants in the Women's Healthy Eating and Living (WHEL) Study

Advances in medical technology, in genetics, and in clinical research have led to early detection of cancer, precise diagnosis, and effective treatment modalities. Decline in cancer incidence and mortality due to cancer has led to increased number of long-term survivors. However, the ethnic minority population has not experienced this decline and still continues to carry a disparate proportion of the cancer burden. Majority of the clinical research including survivorship studies have recruited and continue to recruit a convenient sample of middle- to upper-class Caucasian survivors. Thus, minorities are underrepresented in cancer research in terms of both clinical studies and in health related quality of life (HRQOL) studies. ^ Life style and diet have been associated with increased risk of breast cancer. High vegetable low fat diet has been shown to reduce recurrence of breast cancer and early death. The Women's Healthy Eating and Living Study is an ongoing multi-site randomized controlled trial that is evaluating the high-vegetable low fat diet in reducing the recurrence of breast cancer and early death. The purpose of this dissertation was to (1) compare the impact of the modified diet on the HRQOL during the first 12-month period on specific Minorities and matched Caucasians; (2) identify predictors that significantly impact the HRQOL of the study participants; and (3) using the structural equation modeling assess the impact of nutrition on the HRQOL of the intervention group participants. Findings suggest that there are no significant differences in change in HRQOL between Minorities and Caucasians; between Minorities in the intervention group and those in the comparison group; and between women in the intervention group and those in the comparison group. Minority indicator variable and Intervention/Comparison group indicator variable were not found to be good predictors of HRQOL. Although the structural equation models suggested viable representation of the relationship between the antecedent variables, the mediating variables and the two outcome variables, the impact of nutrition was not statistically significant to be included in the model. This dissertation, by analyzing the HRQOL of minorities in the WHEL Study, attempted to add to the knowledge base specific to minority cancer survivors. ^

A feasibility study for assessing building occupants' indoor air quality expectations compared to nationally recognized standards

Indoor Air Quality (IAQ) can have significant implications for health, productivity, job performance, and operating cost. Professional experience in the field of indoor air quality suggests that high expectations (better than nationally established standards) (American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE)) of workplace indoor air quality lead to increase air quality complaints. To determine whether there is a positive association between expectations and indoor air quality complaints, a one-time descriptive and analytical cross-sectional pilot study was conducted. Area Safety Liaisons (n = 330) at University of Texas Health Science Center – Houston were asked to answer a questionnaire regarding their expectations of four workplace indoor air quality indicators i.e., (temperature, relative humidity, carbon dioxide, and carbon monoxide) and if they experienced and reported indoor air quality problems. A chi-square test for independence was used to evaluate associations among the variables of interest. The response rate was 54% (n = 177). Results did not show significant associations between expectation and indoor air quality. However, a greater proportion of Area Safety Liaisons who expected indoor air quality indicators to be better than the established standard experienced greater indoor air quality problems. Similarly, a slightly higher proportion of Area Liaisons who expected indoor air quality indicators to be better than the standard reported greater indoor air quality complaints. ^ The findings indicated that a greater proportion of Area Safety Liaisons with high expectations (conditions that are beyond what is considered normal and acceptable by ASHRAE) experienced greater indoor air quality discomfort. This result suggests a positive association between high expectations and experienced and reported indoor air quality complaints. Future studies may be able to address whether the frequency of complaints and resulting investigations can be reduced through information and education about what are acceptable conditions.^

International comparison of wait times and quality of care: A pilot study

During the healthcare reform debate in the United States in 2009/2010, many health policy experts expressed a concern that expanding coverage would increase waiting times for patients to obtain care. Many complained that delays in obtaining care in turn would compromise the quality of healthcare in the United States. Using data from The Commonwealth Fund 2010 International Health Policy Survey in Eleven Countries, this study explored the relationship between wait times and quality of care, employing a wait time scale and several quality of care indicators present in the dataset. The impact of wait times on quality was assessed. Increased wait time was expected to reduce quality of care. However, this study found that wait times correlated with better health outcomes for some measures, and had no association with others. Since this is a pilot study and statistical significance was not achieved for any of the correlations, further research is needed to confirm and deepen the findings. However, if future studies confirm this finding, an emphasis on reducing wait times at the expense of other health system level performance variables may be inappropriate. ^

Pilot study assessment of indoor air quality in two dental settings: Particulate matter and volatile organic compounds

Objective: To assess the indoor environment of two different types of dental practices regarding VOCs, PM2.5, and ultrafine particulate concentrations and examine the relationship between specific dental activities and contaminant levels. Method: The indoor environments of two selected dental settings (private practice and community health center) will were assessed in regards to VOCs, PM 2.5, and ultrafine particulate concentrations, as well as other indoor air quality parameters (CO2, CO, temperature, and relative humidity). The sampling duration was four working days for each dental practice. Continuous monitoring and integrated sampling methods were used and number of occupants, frequency, type, and duration of dental procedures or activities recorded. Measurements were compared to indoor air quality standards and guidelines. Results: The private practice had higher CO2, CO, and most VOC concentrations than the community health center, but the community health center had higher PM2.5 and ultrafine PM concentrations. Concentrations of p-dichlorobenzene and PM2.5 exceeded some guidelines. Outdoor concentrations greatly influenced the indoor concentration. There were no significant differences in contaminant levels between the operatory and general area. Indoor concentrations during the working period were not always consistently higher than during the nonworking period. Peaks in particulate matter concentration occurred during root canal and composite procedures.^

Dietary and lifestyle quality indices with/without physical activity and markers of insulin resistance in European adolescents: the HELENA study

Resistencia a la insulina en adolescentes

Estudio y análisis para la elaboración de un modelo de certificado de calidad cinegética en España = Study and analysis for the development of a model of hunting quality certificate in Spain

Con esta tesis doctoral se pretende elaborar un modelo de Certificado de Calidad Cinegética independiente, de adhesión voluntaria y aplicable a todo tipo de espacios cinegéticos, de forma que posteriormente pueda convertirse en una metodología que sea empleada como instrumento válido de medición de la Calidad Cinegética y normalizada a través de una familia de Normas aprobadas por un organismo de normalización reconocido a nivel nacional o internacional. En primer lugar, se procedió a la realización de un riguroso y exhaustivo estudio de justificación siguiendo la metodología propuesta por la Norma UNE 66172:2003 IN, Directrices para la justificación y desarrollo de sistemas de gestión (equivalente a la Norma Internacional GUIA ISO/IEC 72:2001). A continuación, se procedió a la identificación y desarrollo de los parámetros de Ordenación Cinegética comunes a cualquier espacio cinegético en España y a la conceptualización de la Calidad Cinegética. Finalmente, se desarrolló un modelo estructurado en nueve Criterios y treinta y cuatro Indicadores de Calidad Cinegética, y un proyecto de familia de Normas para la Certificación de la Calidad Cinegética. ABSTRACT This doctoral thesis aims to produce a model of Hunting Quality Certificate independent, of voluntary adherence and applicable to all types of hunting areas, so that later it can become a methodology to be used as a valid instrument for measuring Hunting Quality and standardized through a family of standards approved by an organization of standardization recognized at a national or an international level. First, we proceeded to carry out a rigorous and comprehensive justification study following the methodology proposed by the UNE 66172: 2003 IN, Guidelines for the justification and development of management systems standards (equivalent to the International Standard GUIA ISO / IEC 72: 2001). Then, we proceeded to the identification and development of Hunting Management parameters common to any hunting area in Spain and the conceptualization of Hunting Quality. Finally, a model structured into nine Criteria and thirty-four Indicators of Hunting Quality and a draft of a family of standards for Hunting Quality Certification were developed.

Soundscape quality analysis by fuzzy logic: A field study in Cordoba, Argentina

This research studies urban soundscapes through the comparative analysis of twelve public open spaces in the city of Córdoba (Argentina), taken as case studies. The work aims to examine selection of indicators and assessment tools intended to characterize soundscape quality. The field study was carried out through surveys and acoustic and psychoacoustic indicators, that are used together to objectively describe the sound quality of urban spaces. The study shows that, while there is a relationship of these indicators with the sound quality of the spaces, this is not linear. Their relative importance or influence depends on the interrelations occurring between the parameters studied. A model analyzing and correlating the parameters with the sound quality, based on the postulates of fuzzy logic, was applied as a tool of analysis, and it was seen to achieve a very close approximation to the subjective or perceptual response of the inhabitants. This close match between the model results and the perceptual response of the users confirms the fuzzy model as an effective tool for the study, not only of soundscapes, but also for those situations in which objective parameters must be related to the perceptual response of users.

Quality Management, Environmental Management and Organizational Design in the Hotel Industry: A Qualitative Study

The purpose of this paper is twofold. First, the paper analyzes the relationship between quality management and environmental management and their effects on hotel performance. Second, the article examines the relationship between these two management systems and organizational design. The paper uses an exploratory, qualitative approach based on interviews with managers and experts in the hotel industry. Based on a content analysis of interviews, the results lead to several propositions. Specifically, quality and environmental management influence hotel performance through mediating variables. Moreover, the implementation of quality management facilitates the implementation of environmental management. Furthermore, the implementation of these two management systems is associated with an increase of formalization and decentralization. The paper contributes to the analysis of quality management, environmental management, organizational design and performance in a joint manner, which has not been attempted before in the hotel industry. In addition, it helps extend the findings about these links in manufacturing and service organizations to the hotel industry.