Living with diabetes: quality of care and quality of life

Background: The aim of this research was to characterize the experience of living with diabetes mellitus (DM) and identify patients" opinions of the quality of care received and the results of interventions. Methods: A descriptive, exploratory evaluation study using qualitative methodology was performed. Participants consisted of 40 adult patients diagnosed with DM and followed up in a public hospital in Barcelona, Spain. A semistructured interview and a focus group were used and a thematic content analysis was performed. Results: Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision-making, and the administrative and bureaucratic problems of the health care system. Conclusion: The bureaucratic circuits of the health care system impair patients" quality of life and perceived quality of care. Health professionals should foster patient participation in decision-making. However, this requires not only training and appropriate attitudes, but also adequate staffing and materials.

Evaluation of Photoacoustic Spectroscopy for Quality Control of Cement, TR-409, 1998

This report discusses the feasibility of using infrared photoacoustic spectroscopy (PAS) as a viable technique that can quickly provide information on cement composition prior to use. The PAS technique is of interest because the cost is much lower than for other types of instrumentation used for mineral analysis, it requires virtually no sample preparation, and it can perform multi-component analysis in a matter of minutes. Feasibility of the technique was based on the ability of PAS to identify and quantify sulfate species and major cement matrix components. Strengths and limitations of the technique are presented.

KRAS mutation testing for predicting response to anti-EGFR therapy for colorectal carcinoma: proposal for an European quality assurance program.

Novel therapeutic agents targeting the epidermal growth factor receptor (EGFR) have improved outcomes for patients with colorectal carcinoma. However, these therapies are effective only in a subset of patients. Activating mutations in the KRAS gene are found in 30-40% of colorectal tumors and are associated with poor response to anti-EGFR therapies. Thus, KRAS mutation status can predict which patient may or may not benefit from anti-EGFR therapy. Although many diagnostic tools have been developed for KRAS mutation analysis, validated methods and standardized testing procedures are lacking. This poses a challenge for the optimal use of anti-EGFR therapies in the management of colorectal carcinoma. Here we review the molecular basis of EGFR-targeted therapies and the resistance to treatment conferred by KRAS mutations. We also present guideline recommendations and a proposal for a European quality assurance program to help ensure accuracy and proficiency in KRAS mutation testing across the European Union.

Construcción de un índice de calidad ocupacional (ICO) para el análisis de la inserción profesional de los graduados universitarios = Building an employment quality index (EQI) to analyse graduates’ access to the labour market

En este trabajo se propone la construcción de un índice de calidad ocupacional (ICO) a partir de los datos de la Encuesta de Inserción Laboral de los Graduados de las Universidades Catalanas realizada por la Agencia para la Calidad del Sistema Universitario de Catalunya (AQU), que ha de permitir un mejor análisis de la información que proporciona la encuesta y facilitar su comparación con estudios similares. La encuesta se realiza tres años después de la graduación. En este artículo, se utiliza la segunda encuesta realizada el año 2005 entre 11.456 graduados (52,63%) de la promoción 2001 (AQU, 2005, Serra-Ramoneda, 2007). El índice se ha elaborado a partir de los indicadores objetivos ‘tipo y duración del contrato laboral’, ‘retribución económica’, ‘adecuación entre la formación universitaria y el empleo’ a los que se otorga una puntuación ponderada según las respuestas dadas por los graduados. La suma de las puntuaciones se matiza con un coeficiente derivado del indicador subjetivo ‘satisfacción con el trabajo en general’. A partir de la información proporcionada por el índice, se realiza un análisis comparativo del nivel de calidad ocupacional que han logrado los graduados de áreas de conocimiento, ámbitos de trabajo, ramas de actividad y ubicaciones territoriales del empleo diferentes. Los resultados obtenidos permiten observar que entre los graduados catalanes los siguientes hechos son buenos predictores de la calidad de la ocupación: haber estudiado una carrera que no sea de Humanidades, ser un hombre, haber desempeñado durante la carrera un trabajo relacionado con los estudios, estar ocupado en la construcción, en instituciones financieras o en servicios a empresas, haber tenido algún tipo de movilidad por motivos de trabajo, trabajar fuera de Cataluña y hacerlo en empresas grandes, especialmente con más de 500 trabajadores. Finalmente, se presentan algunas reflexiones y propuestas que pueden resultar de interés para la orientación de los estudiantes y la planificación universitaria

Concrete Pavement Mixture Design and Analysis (MDA): Factors Influencing Drying Shrinkage, TPF-5(205), 2014

This literature review focuses on factors influencing drying shrinkage of concrete. Although the factors are normally interrelated, they can be categorized into three groups: paste quantity, paste quality, and other factors.

Effects of a school-based physical activity program on physical and psychosocial quality of life in elementary school children: a cluster-randomized trial.

The present study tested the effect of a school-based physical activity (PA) program on quality of life (QoL) in 540 elementary school children. First and fifth graders were randomly assigned to a PA program or a no-PA control condition during one academic year. QoL was assessed by the Child Health Questionnaire at baseline and postintervention. Based on mixed linear model analyses, physical QoL in first graders and physical and psychosocial QoL in fifth graders were not affected by the intervention. In first graders, the PA intervention had a positive impact on psychosocial QoL (effect size [d], 0.32; p < .05). Subpopulation analyses revealed that this effect was caused by an effect in urban (effect size [d], 0.38; p < .05) and overweight first graders (effect size [d], 0.45; p < .05). In conclusion, a school-based PA intervention had little effect on QoL in elementary school children.

Basic life support teaching in the second year predraduate medical curriculum: quality of acquisition after 6 months

Purpose of the study: Basic life support (BLS) and automated externaldefibrillation (AED) represent important skills to be acquired duringpregraduate medical training. Since 3 years, our medical school hasintroduced a BLS-AED course (with certification) for all second yearmedical students. Few reports about quality and persistence over timeof BLS-AED learning are available to date in the medical literature.Comprehensive evaluation of students' acquired skills was performedat the end of the 2008 academic year, 6 month after certification.Materials and methods: The students (N = 142) were evaluated duringa 9 minutes «objective structured clinical examination» (OSCE) station.Out of a standardized scenario, they had to recognize a cardiac arrestsituation and start a resuscitation process. Their performance wererecorded on a PC using an Ambuman(TM) mannequin and the AmbuCPR software kit(TM) during a minimum of 8 cycles (30 compressions:2 ventilations each). BLS parameters were systematically checked. Nostudent-rater interactions were allowed during the whole evaluation.Results: Response of the victim was checked by 99% of the students(N = 140), 96% (N = 136) called for an ambulance and/or an AED. Openthe airway and check breathing were done by 96% (N = 137), 92% (N =132) gave 2 rescue breaths. Pulse was checked by 95% (N=135), 100%(N = 142) begun chest compression, 96% (N = 136) within 1 minute.Chest compression rate was 101 ± 18 per minute (mean ± SD), depthcompression 43 ± 8 mm, 97% (N = 138) respected a compressionventilationratio of 30:2.Conclusions: Quality of BLS skills acquisition is maintained during a6-month period after a BLS-AED certification. Main targets of 2005 AHAguidelines were well respected. This analysis represents one of thelargest evaluations of specific BLS teaching efficiency reported. Furtherfollow-up is needed to control the persistence of these skills during alonger time period and noteworthy at the end of the pregraduatemedical curriculum.

Assessment of high hydrostatic pressure and starter culture on the quality properties of low-acid fermented sausages

The addition of starter culture and high pressure processing after ripening improved the microbial quality of low-acid fermented sausages (fuet and chorizo). The use of Lactobacillus sakei CTC6626 and Staphylococcus xylosus CTC6013 as starter culture significantly reduced Enterobacteriaceae and Enterococcus levels in the finished sausages. Moreover, the addition of starter culture produced sausages of similar quality to traditional low-acid fermented sausages. Slightly lower pH values and higher cohesiveness were obtained for both fuet and chorizo with starter culture. Sensory analysis showed no differences between lots of chorizo whereas starter fuet was more acid and gummy. High pressure induced an additional reduction of Enterobacteriaceae in non-starter sausages. An increase of textural properties was observed after pressurization. No other differences were observed between non-treated and pressurized sausages.

High pressure induced changes on sarcoplasmic protein fraction and quality indicators

The combined effect of pressure and mild temperature treatments on bovine sarcoplasmic proteins and quality parameters was assessed. M. longissimus dorsi samples were pressurised in a range of 200–600 MPa and 10–30 °C. High Pressure Processing (HPP) induced a reduction of protein solubility (p < 0.001) compared to non-treated controls (NT), more pronounced above 200 MPa. HPP at pressures higher than 200 MPa induced a strong modification (p < 0.001) of meat colour and a reduction of water holding capacity (WHC). SDS–PAGE analysis demonstrated that HPP significantly modified the composition of the sarcoplasmic protein fraction. The pressurisation temperature mainly affected protein solubility and colour; a smaller effect was observed on protein profiles. Significant correlations (p < 0.001) between sarcoplasmic protein solubility and both expressible moisture (r = −0.78) and colour parameters (r = −0.81 to −0.91) suggest that pressure induced denaturation of sarcoplasmic proteins could influence to some extent WHC and colour modifications of beef. Changes in protein band intensities were also significantly correlated with protein solubility, meat lightness and expressible moisture. These results describe the changes induced by HPP on sarcoplasmic proteins and confirm a relationship between modification of the sarcoplasmic protein fraction and alteration of meat quality characteristics

Surface-enhanced laser desorption/ionisation time-of-flight mass spectrometry: A tool to predict pork quality

Expression of water soluble proteins of fresh pork Longissimus thoracis from 4 pure breed pigs (Duroc, Large White, Landrace, and Piétrain) was studied to identify candidate protein markers for meat quality. Surface-enhanced laser desorption/ionisation time-of-flight mass spectrometry (SELDI-TOF-MS) was used to obtain the soluble protein profiles of Longissimus thoracis muscles. The pure breeds showed differences among the studied meat quality traits (pHu, drip loss, androstenone, marbling, intramuscular fat, texture, and moisture), but no significant differences were detected in sensory analysis. Associations between protein peaks obtained with SELDI-TOF-MS and meat quality traits, mainly water holding capacity, texture and skatole were observed. Of these peaks, a total of 10 peaks from CM10 array and 6 peaks from Q10 array were candidate soluble protein markers for pork loin quality. The developed models explained a limited proportion of the variability, however they point out interesting relationships between protein expression and meat quality

Automated identification of minimal myocardial motion for improved image quality on MR angiography at 3 T

OBJECTIVE: Imaging during a period of minimal myocardial motion is of paramount importance for coronary MR angiography (MRA). The objective of our study was to evaluate the utility of FREEZE, a custom-built automated tool for the identification of the period of minimal myocardial motion, in both a moving phantom at 1.5 T and 10 healthy adults (nine men, one woman; mean age, 24.9 years; age range, 21-32 years) at 3 T. CONCLUSION: Quantitative analysis of the moving phantom showed that dimension measurements approached those obtained in the static phantom when using FREEZE. In vitro, vessel sharpness, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were significantly improved when coronary MRA was performed during the software-prescribed period of minimal myocardial motion (p < 0.05). Consistent with these objective findings, image quality assessments by consensus review also improved significantly when using the automated prescription of the period of minimal myocardial motion. The use of FREEZE improves image quality of coronary MRA. Simultaneously, operator dependence can be minimized while the ease of use is improved.

Abatacept improves health-related quality of life, pain, sleep quality, and daily participation in subjects with juvenile idiopathic arthritis.

OBJECTIVE: To assess health-related quality of life (HRQOL) in abatacept-treated children/adolescents with juvenile idiopathic arthritis (JIA). METHODS: In this phase III, double-blind, placebo-controlled trial, subjects with active polyarticular course JIA and an inadequate response/intolerance to ≥1 disease-modifying antirheumatic drug (including biologics) received abatacept 10 mg/kg plus methotrexate (MTX) during the 4-month open-label period (period A). Subjects achieving the American College of Rheumatology Pediatric 30 criteria for improvement (defined "responders") were randomized to abatacept or placebo (plus MTX) in the 6-month double-blind withdrawal period (period B). HRQOL assessments included 15 Child Health Questionnaire (CHQ) health concepts plus the physical (PhS) and psychosocial summary scores (PsS), pain (100-mm visual analog scale), the Children's Sleep Habits Questionnaire, and a daily activity participation questionnaire. RESULTS: A total of 190 subjects from period A and 122 from period B were eligible for analysis. In period A, there were substantial improvements across all of the CHQ domains (greatest improvement was in pain/discomfort) and the PhS (8.3 units) and PsS (4.3 units) with abatacept. At the end of period B, abatacept-treated subjects had greater improvements versus placebo in all domains (except behavior) and both summary scores. Similar improvement patterns were seen with pain and sleep. For participation in daily activities, an additional 2.6 school days/month and 2.3 parents' usual activity days/month were gained in period A responders with abatacept, and further gains were made in period B (1.9 versus 0.9 [P = 0.033] and 0.2 versus -1.3 [P = 0.109] school days/month and parents' usual activity days/month, respectively, in abatacept- versus placebo-treated subjects). CONCLUSION: Improvements in HRQOL were observed with abatacept, providing real-life tangible benefits to children with JIA and their parents/caregivers.

Heterosis in crosses among white grain maize populations with high quality protein

The objective of this work was to investigate heterosis and its components in 16 white grain maize populations presenting high quality protein. These populations were divided according to grain type in order to establish different heterosis groups. The crosses were carried out according to a partial diallel cross design among flint and dent populations. Seven agronomic traits were evaluated in three environments while four leaf diseases and incidence of corn stunt were evaluated in one. Least square procedure was applied to the normal equation X'Xbeta = X'Y, to estimate the model effects and their respective sum of squares. Among the heterosis components, in diallel analysis, significance for average heterosis in grain yield, number of days to female flowering and to all evaluated diseases was detected. Specific heterosis was significant for days to female flowering and resistance to Puccinia polysora. Results concerned to grain yield trait indicate that populations with superior performance in dent group, no matter what flint population group is used in crosses, tend to generate superior intervarietal hybrids. In decreasing order of preference, the dent type populations CMS 476, ZQP/B 103 and ZQP/B 101 and the flint type CMS 461, CMS 460, ZQP/B 104 and ZQP/B 102 are recommended to form composites.

EEG signal analysis via a cleaning procedure based on multivariate empirical mode decomposition

Artifacts are present in most of the electroencephalography (EEG) recordings, making it difficult to interpret or analyze the data. In this paper a cleaning procedure based on a multivariate extension of empirical mode decomposition is used to improve the quality of the data. This is achieved by applying the cleaning method to raw EEG data. Then, a synchrony measure is applied on the raw and the clean data in order to compare the improvement of the classification rate. Two classifiers are used, linear discriminant analysis and neural networks. For both cases, the classification rate is improved about 20%.

A randomised controlled clinical trial and gait analysis of fixed- and mobile-bearing total knee replacements with a five-year follow-up.

This study compared the outcome of total knee replacement (TKR) in adult patients with fixed- and mobile-bearing prostheses during the first post-operative year and at five years' follow-up, using gait parameters as a new objective measure. This double-blind randomised controlled clinical trial included 55 patients with mobile-bearing (n = 26) and fixed-bearing (n = 29) prostheses of the same design, evaluated pre-operatively and post-operatively at six weeks, three months, six months, one year and five years. Each participant undertook two walking trials of 30 m and completed the EuroQol questionnaire, Western Ontario and McMaster Universities osteoarthritis index, Knee Society score, and visual analogue scales for pain and stiffness. Gait analysis was performed using five miniature angular rate sensors mounted on the trunk (sacrum), each thigh and calf. The study population was divided into two groups according to age (≤ 70 years versus > 70 years). Improvements in most gait parameters at five years' follow-up were greater for fixed-bearing TKRs in older patients (> 70 years), and greater for mobile-bearing TKRs in younger patients (≤ 70 years). These findings should be confirmed by an extended age controlled study, as the ideal choice of prosthesis might depend on the age of the patient at the time of surgery.