Quality of Qualitative Research in the Health Sciences : Analysis of the Common Criteria Present in 58 Assessment Guidelines by Expert Users

The number of qualitative research methods has grown substantially over the last twenty years, both in social sciences and, more recently, in the health sciences. This growth came with questions on the quality criteria needed to evaluate this work, and numerous guidelines were published. The latters include many discrepancies though, both in their vocabulary and construction. Many expert evaluators decry the absence of consensual and reliable evaluation tools. The authors present the results of an evaluation of 58 existing guidelines in 4 major health science fields (medicine and epidemiology; nursing and health education; social sciences and public health; psychology / psychiatry, research methods and organization) by expert users (article reviewers, experts allocating funds, editors, etc.). The results propose a toolbox containing 12 consensual criteria with the definitions given by expert users. They also indicate in which disciplinary field each type of criteria is known to be more or less essential. Nevertheless, the authors highlight the limitations of the criteria comparability, as soon as one focuses on their specific definitions. They conclude that each criterion in the toolbox must be explained to come to broader consensus and identify definitions that are consensual to all the fields examined and easily operational.

L'immanence - ou l'opinion à la question. Autour de Qu'est-ce que la philosophie?

Nous nous attachons, dans une lecture centrée sur Qu'est-ce que la philosophie? de Deleuze et Guattari, à cerner la compréhension des auteurs du propre de la philosophie. Nous montrons la centralité de la nécessité de se distinguer d'avec l'opinion dans l'élaboration du concept de concept et l'importance du plan d'immanence en tant qu'il n'est pas un concept mais le tracé, toujours se faisant, des rapports de composition entre les concepts.

Le raisonnement clinique de l'infirmier (ère) expert(e) lors de l'évaluation de la douleur chez les patients ventilés, sédatés et non communicants aux soins intensifs

Problématique : La douleur aux soins intensifs adultes est un problème majeur auquel l'équipe soignante est confrontée quotidiennement. Elle nécessite un traitement adéquat et, pour ce faire, une évaluation systématique et précise est requise. Les patients hospitalisés aux soins intensifs sont vulnérables de par leurs pathologies et les multiples stimulations douloureuses auxquelles ils sont exposés. L'évaluation de la douleur est rendue complexe par le fait qu'ils ne peuvent pas la communiquer verbalement. L'utilisation d'échelles d'évaluation de la douleur est recommandée, mais les scores obtenus doivent être interprétés et contextualisés. Evaluer la douleur chez ce type de patient demande aux infirmières des connaissances et compétences élevées, à même d'être mobilisées lors d'un processus complexe lié au raisonnement clinique. But : l'objectif de cette étude descriptive observationnelle est de décrire les indicateurs influençant le raisonnement clinique de l'infirmière1 experte lors de l'évaluation de la douleur chez les patients ventilés, sédatés et non communicants aux soins intensifs. Les résultats produisent une meilleure compréhension de l'évaluation et de la gestion de la douleur en pratique et, finalement, participent à l'amélioration de la qualité de son évaluation et de sa gestion. Méthode : un échantillon de convenance de sept infirmières expertes travaillant dans une unité de soins intensifs d'un hôpital universitaire de Suisse Romande a été constitué pour cette étude. Les données ont été récoltées en situation réelle lors de l'évaluation de la douleur de sept patients en utilisant la méthode du think aloud, par une observation non participative et par un entretien semistructuré. Les données ont été analysées en utilisant une méthode d'analyse de contenu déductive sur la base d'un modèle de raisonnement clinique, comprenant les suivantes: le contexte, la situation du patient, la génération d'hypothèses, les actions infirmières et l'évaluation de l'action. Résultats : la moyenne d'expérience des infirmières participantes est de 15 ans (ÉT 4.5) en soins et de 7.85 ans (ÉT 3.1) en soins intensifs. Sept patients étaient ventilés, sédatés et non communicants ayant une moyenne de score APACHE II2 de 19. Les résultats montrent que les infirmières se basent principalement sur des indicateurs physiologiques pour évaluer la douleur. Elles cherchent à prévenir la douleur pour le patient. Elles se réfèrent régulièrement à des situations déjà vécues (pattern). Elles mobilisent leurs connaissances pour pondérer l'agitation liée à la douleur ou à d'autres causes en générant des hypothèses, puis réalisent un test antalgique pour confirmer ou infirmer l'hypothèse retenue. Conclusion : le contexte clinique joue un rôle important dans le raisonnement clinique de l'infirmière et la gestion de la douleur. Pour faciliter cette tâche, l'évaluation de la douleur doit être combinée avec l'évaluation de la situation clinique du patient et du niveau de sédation des patients de soins intensifs.

Towards actionable international comparisons of health system performance: expert revision of the OECD framework and quality indicators.

OBJECTIVE: To review and update the conceptual framework, indicator content and research priorities of the Organisation for Economic Cooperation and Development's (OECD) Health Care Quality Indicators (HCQI) project, after a decade of collaborative work. DESIGN: A structured assessment was carried out using a modified Delphi approach, followed by a consensus meeting, to assess the suite of HCQI for international comparisons, agree on revisions to the original framework and set priorities for research and development. SETTING: International group of countries participating to OECD projects. PARTICIPANTS: Members of the OECD HCQI expert group. RESULTS: A reference matrix, based on a revised performance framework, was used to map and assess all seventy HCQI routinely calculated by the OECD expert group. A total of 21 indicators were agreed to be excluded, due to the following concerns: (i) relevance, (ii) international comparability, particularly where heterogeneous coding practices might induce bias, (iii) feasibility, when the number of countries able to report was limited and the added value did not justify sustained effort and (iv) actionability, for indicators that were unlikely to improve on the basis of targeted policy interventions. CONCLUSIONS: The revised OECD framework for HCQI represents a new milestone of a long-standing international collaboration among a group of countries committed to building common ground for performance measurement. The expert group believes that the continuation of this work is paramount to provide decision makers with a validated toolbox to directly act on quality improvement strategies.

Learning journalistic opinion genres using CLIL methodology

The Faculty of Business and Communication recently started an internationalization process that, in two year’s time, will allow all undergraduate students (studying Journalism, Audiovisual Communication, Advertising and Public Relations, Business and Marketing) to take 25% of their subjects in English using CLIL methodology. Currently, Journalism is the degree course with the greatest percentage of CLIL subjects, for example Current Affairs Workshop, a subject dedicated to analyzing current news using opinion genres. Moreover, because of the lack of other subjects offered in English, ERASMUS students have to take some journalism subjects in order to complete their international passport, and one of the classes they choose is the Current Affairs Workshop. The aim of this paper is to explore how CLIL methodology can be useful for learning journalistic opinion genres (chat-shows, discussions and debates) in a subject where Catalan Communication students –with different levels of English- share their knowledge with European students of other social disciplines. Students work in multidisciplinary groups in which they develop real radio and TV programs, adopting all the roles (moderator, technician, producer and participants), analyzing daily newspapers and other sources to create content, based on current affairs. This paper is based on the participant observation of the lecturers of the subject, who have designed different activities related to journalistic genres, where students can develop their skills according to the role they play in every assignment. Examples of successful lessons will be given, in addition to the results of the course: both positive and negative. Although the objective of the course is to examine professional routines related to opinion genres, and students are not directly graded on their level of English, the Catalan students come to appreciate how they finally overcome their fear of working in a foreign language. This is a basic result of their experience.

¿Por qué los estudiantes participan poco en la gestión de la universidad? La opinión del profesorado = Why do students participate so little in the management of the university? The opinion of the teaching staff

El artículo invita a reflexionar sobre la participación de los estudiantes en la gestión y el gobierno de la universidad a partir de una investigación. Se centra en la opinión y percepción que el profesorado implicado directamente en la gestión de la docencia tiene sobre esta participación. Se aportan datos relevantes que ayudan a disponer de una visión más completa de un fenóneno complejo y multidimensional como es la participación estudiantil. Sus interpretaciones nos ofrecen información significativa que contribuye a comprender algunas de las causas de la baja participación y nos orienta hacia las posibles estrategias a emprender para intentar invertir esta tendencia

Bias in dissemination of clinical research findings: structured OPEN framework of what, who and why, based on literature review and expert consensus.

OBJECTIVE: The aim of this study is to review highly cited articles that focus on non-publication of studies, and to develop a consistent and comprehensive approach to defining (non-) dissemination of research findings. SETTING: We performed a scoping review of definitions of the term 'publication bias' in highly cited publications. PARTICIPANTS: Ideas and experiences of a core group of authors were collected in a draft document, which was complemented by the findings from our literature search. INTERVENTIONS: The draft document including findings from the literature search was circulated to an international group of experts and revised until no additional ideas emerged and consensus was reached. PRIMARY OUTCOMES: We propose a new approach to the comprehensive conceptualisation of (non-) dissemination of research. SECONDARY OUTCOMES: Our 'What, Who and Why?' approach includes issues that need to be considered when disseminating research findings (What?), the different players who should assume responsibility during the various stages of conducting a clinical trial and disseminating clinical trial documents (Who?), and motivations that might lead the various players to disseminate findings selectively, thereby introducing bias in the dissemination process (Why?). CONCLUSIONS: Our comprehensive framework of (non-) dissemination of research findings, based on the results of a scoping literature search and expert consensus will facilitate the development of future policies and guidelines regarding the multifaceted issue of selective publication, historically referred to as 'publication bias'.

The environmental effects of changing speed limits: a quantile regression approach

Two speed management policies were implemented in the metropolitan area of Barcelona aimed at reducing air pollution concentration levels. In 2008, the maximum speed limit was reduced to 80 km/h and, in 2009, a variable speed system was introduced on some metropolitan motorways. This paper evaluates whether such policies have been successful in promoting cleaner air, not only in terms of mean pollutant levels but also during high and low pollution episodes. We use a quantile regression approach for fixed effect panel data. We find that the variable speed system improves air quality with regard to the two pollutants considered here, being most effective when nitrogen oxide levels are not too low and when particulate matter concentrations are below extremely high levels. However, reducing the maximum speed limit from 120/100 km/h to 80 km/h has no effect – or even a slightly increasing effect –on the two pollutants, depending on the pollution scenario. Length: 32 pages

Le raisonnement clinique de l'infirmier(ère) expert(e) lors de l'évaluation de la douleur chez l'enfant ventilé et non communicant, sous analgésie et sédation, aux soins intensifs de pédiatrie

Dans le contexte des soins intensifs pédiatriques, la douleur est une préoccupation majeure et quotidienne pour l'équipe soignante. Les patients sont vulnérables de par leur condition et les multiples stimulations douloureuses auxquelles ils sont exposés. En dépit des données probantes démontrant l'importance d'une évaluation de la douleur, le traitement de celle-ci reste non optimal dans cette population vulnérable. Une douleur inadéquatement traitée peut causer de nombreuses complications à moyen et à long terme. L'évaluation de la douleur chez le patient ventilé et non communicant représente un défi important, rendu complexe par l'utilisation concomitante de médicaments sédatifs et analgésiques qui peuvent masquer ou altérer les comportements de la douleur. Il existe des outils d'évaluation adaptés à cette population vulnérable, mais l'interprétation des scores reste difficile. L'évaluation de la douleur demande aux infirmières des connaissances et compétences élevées à même d'être mobilisées lors d'un processus complexe lié au raisonnement clinique. Le but de cette étude descriptive et observationnelle est de déterminer les indicateurs utilisés par les infirmières expertes des soins intensifs de pédiatrie lors de l'évaluation de la douleur chez le patient ventilé et non communicant, sous analgésie et sédation. Un échantillon de convenance de dix infirmières expertes travaillant dans une unité de soins intensifs pédiatriques d'un hôpital universitaire de Suisse romande a participé à cette étude. Les données ont été récoltées par l'enregistrement de la verbalisation du raisonnement clinique au lit du patient, complété par une observation non participante et un entretien semi-structuré. Le développement d'un cadre théorique constitué d'un modèle de raisonnement clinique expert et d'une modélisation du décodage de la douleur a permis de réaliser une analyse de contenu des enregistrements. Les résultats montrent une utilisation importante des indicateurs physiologiques, en lien avec la stabilité clinique du patient qui est un critère essentiel pour la prise de décision lors de la gestion de la douleur. La difficulté à discriminer l'agitation résultant de la douleur ou d'autres causes est également omniprésente. Les expertes anticipent et préviennent la survenue de la douleur en s'appuyant sur leurs connaissances et les situations de patient déjà rencontrées. Le contexte clinique influence de manière prépondérante le raisonnement clinique et les indicateurs utilisés lors de l'évaluation et la gestion de la douleur. Celle-ci doit être évaluée de manière combinée avec la stabilité clinique du patient et son niveau de sédation. De futures recherches sont nécessaires pour confirmer ces résultats réalisés avec un échantillon de petite taille et un devis observationnel.

A Hierarchical Approach for Multi-task Logistic Regression

Peer-reviewed

Opinion Mining

In this thesis we study the field of opinion mining by giving a comprehensive review of the available research that has been done in this topic. Also using this available knowledge we present a case study of a multilevel opinion mining system for a student organization's sales management system. We describe the field of opinion mining by discussing its historical roots, its motivations and applications as well as the different scientific approaches that have been used to solve this challenging problem of mining opinions. To deal with this huge subfield of natural language processing, we first give an abstraction of the problem of opinion mining and describe the theoretical frameworks that are available for dealing with appraisal language. Then we discuss the relation between opinion mining and computational linguistics which is a crucial pre-processing step for the accuracy of the subsequent steps of opinion mining. The second part of our thesis deals with the semantics of opinions where we describe the different ways used to collect lists of opinion words as well as the methods and techniques available for extracting knowledge from opinions present in unstructured textual data. In the part about collecting lists of opinion words we describe manual, semi manual and automatic ways to do so and give a review of the available lists that are used as gold standards in opinion mining research. For the methods and techniques of opinion mining we divide the task into three levels that are the document, sentence and feature level. The techniques that are presented in the document and sentence level are divided into supervised and unsupervised approaches that are used to determine the subjectivity and polarity of texts and sentences at these levels of analysis. At the feature level we give a description of the techniques available for finding the opinion targets, the polarity of the opinions about these opinion targets and the opinion holders. Also at the feature level we discuss the various ways to summarize and visualize the results of this level of analysis. In the third part of our thesis we present a case study of a sales management system that uses free form text and that can benefit from an opinion mining system. Using the knowledge gathered in the review of this field we provide a theoretical multi level opinion mining system (MLOM) that can perform most of the tasks needed from an opinion mining system. Based on the previous research we give some hints that many of the laborious market research tasks that are done by the sales force, which uses this sales management system, can improve their insight about their partners and by that increase the quality of their sales services and their overall results.

Improving the effectiveness of supply chain development work – an expert role perspective

This study focuses to the intersection of three sets of activities in a company: expert work, development work and supply chain management, SCM. Experts and expert work represent a set of individuals whose efficiency and impact this study is intended to improve, while development work defines the set of organizational activities to focus on. SCM as an expertise area acts as the platform on which this study is built. The study has two aims. Firstly, it aims to derive a model helping an SCM expert to increase the effectiveness of expert work in development tasks by understanding the encountered organizational situations and processes better, reflecting his/her past and future actions to organizational processes and selecting and adjusting the processes and contents of his/her work accordingly. Secondly, it aims to develop applicable approaches and methods to understand, evaluate and manage the organizational processes and situations in development work. The integrative model on approaches and methods to improve the effectiveness of development processes is split to two aggregate dimensions: technical performance of the developed solution and consumption of resources of the development process. Six potential approaches and methods aiming at helping in the management of organizational dimensions are presented in enclosed publications. The approaches focus on three subtasks of development work: decision making, implementation and change, and knowledge accumulation. The approaches and methods have been tested in case studies representing typical development processes in the area of supply chain management. As a result, four suggestions are presented. Firstly, SCM experts are advised to consider the SCM development work to be consisting of development processes. Secondly, inside these processes they should identify and evaluate the risk of difficult decision-making related to organizational factors. Thirdly, they are prompted for an active role in implementation and change, supporting the implementation through whole process. Finally, the development should be seen in a holistic view, taking into account the stage of knowledge and organizational issues related to it, and adopt a knowledge development strategy.