For reasons of human health and sustainability, there is a growing interest in the potential of integrated nature-based interventions in healthcare. However, it is not clear which quality criteria underlie these interventions. Here, we develop a study protocol for a scoping review to explore potential quality criteria relating to the design, implementation and evaluation of nature-based interventions in healthcare institutions. The literature search will be conducted in PubMed, MEDLINE, Web of Science and Scopus, focusing on studies published in English between January 2005 and April 2023. The Joanna Briggs Institute Scoping Review methodology and Preferred Reporting Items for Systematic Reviews with extension for scoping reviews will be used. Search terms were developed stepwise and in consultation with the interdisciplinary research team and the project steering group. Two researchers will perform the screening of the papers independently. Using descriptive content analysis, identified quality criteria will be classified according to the applied theoretical frameworks, outcomes, levels (institutional, professional and patient) and the domains of biodiversity, human health or intervention processes. Ultimately, this descriptive work will result in a set of quality indicators and a prototype nature-based intervention quality assessment framework, which will be presented to the project steering group and multi-stakeholder assembly for further refinement.

To implement effective stewardship in food animal production, it is essential that producers and veterinarians are aware of preventive interventions to reduce illness in livestock. Systematic reviews and meta-analyses (SR/MA) provide transparent, replicable, and quality-assessed overviews. At present, it is unknown how many SR/MA evaluate preventive antibiotic use or management practices aimed at reducing disease risk in animal agriculture. Further, the quality of existing reviews is unknown. Our aim was to identify reviews investigating these topics and to provide an assessment of their quality. Thirty-eight relevant reviews were identified. Quality assessment was based on the AMSTAR 2 framework for the critical appraisal of systematic reviews. The quality of most of the reviews captured was classified as critically low (84.2%, n = 32/38), and only a small percentage of the evaluated reviews did not contain critical weaknesses (7.9%, n = 3/38). Particularly, a small number of reviews reported the development of an a priori protocol (15.8%, n = 6/38), and few reviews stated that key review steps were conducted in duplicate (study selection/screening: 26.3%, n = 10/38; data extraction: 15.8%, n = 6/38). The development of high-quality reviews summarizing evidence on approaches to antibiotic reduction is essential, and thus greater adherence to quality conduct guidelines for synthesis research is crucial.

Introduction: Depending on the time and day of initial Emergency Department (ED) presentation, some patients may require a return to the ED the following day for ultrasound examination. Return visits for ultrasound may be time and resource intensive for both patients and the ED. Qualitative experience suggests that a percentage of return ultrasounds could be performed at a non-ED facility. Our objective was to undertake a retrospective audit of return for ultrasound usage, patterns and outcomes at 2 academic EDs. Methods: A retrospective review of all adult patients returning to the ED for ultrasound at both LHSC ED sites in 2016 was undertaken. Each chart was independently reviewed by two emergency medicine consultants. Charts were assessed for day and time of initial presentation and return, type of ultrasound ordered, and length of ED stay on initial presentation and return visit. Opinion based questions were considered by reviewers, including urgency of diagnosis clarification required, if symptoms were still present on return, and if any medical or surgical treatment or follow up was arranged based on ultrasound results. Agreement between reviewers was assessed. Results: After eliminating charts for which the return visit was not for a scheduled ultrasound examination, 328 patient charts were reviewed. 63% of patients were female and median [IQR] age was 40 years [27-56]. Abdomen/pelvis represented 50% of the ultrasounds; renal 24%; venous Doppler 15.9%. Symptoms were still present and documented in 79% of cases. 22% of cases required a medical intervention and 9% an immediate surgical intervention. 11% of patients were admitted to hospital on their return visit. Outpatient follow-up based on US results was initiated in 29% of cases. Median [IQR] combined LOS was 479.5 minutes [358.5-621.75]. Agreement between reviewers for opinion based questions was poor (63%-96%). Conclusion: Ideally, formal ultrasound should be available on a 24 hour basis for ED patients in order to avoid return visits. A percentage of return for ultrasound examinations do not result in any significant change in treatment. Emergency departments should consider the development of pathways to avoid return visits for follow up ultrasound when possible. The low incidence of surgical treatment in those returning for US suggests that this population could be served in a non-hospital setting. Further research is required to support this conclusion.

Recent trends in multimedia technologies indicate the need for richer imaging modalities to increase user engagement with the content. Among other alternatives, point clouds denote a viable solution that offers an immersive content representation, as witnessed by current activities in JPEG and MPEG standardization committees. As a result of such efforts, MPEG is at the final stages of drafting an emerging standard for point cloud compression, which we consider as the state-of-the-art. In this study, the entire set of encoders that have been developed in the MPEG committee are assessed through an extensive and rigorous analysis of quality. We initially focus on the assessment of encoding configurations that have been defined by experts in MPEG for their core experiments. Then, two additional experiments are designed and carried to address some of the identified limitations of current approach. As part of the study, state-of-the-art objective quality metrics are benchmarked to assess their capability to predict visual quality of point clouds under a wide range of radically different compression artifacts. To carry the subjective evaluation experiments, a web-based renderer is developed and described. The subjective and objective quality scores along with the rendering software are made publicly available, to facilitate and promote research on the field.

There has been quite a considerable amount of debate over the last decade about the importance of quality assessment in the field of LTC provision in Portugal, framed by the discourse on social investment. In a context of limited resources, care providers are pressured to demonstrate creation of value. Quality assessment becomes one of the paths to demonstrate worthiness. This, however, has not translated into standardised protocols of evaluation of impacts and quality in particular. The question has been asked why is that? In this article we contribute to answering this question by looking at the discourses of stakeholders on the topic of social investment and quality in LTC. Overall there is a discourse that acknowledges the importance of assessing investments and quality as a reliable proxy to measure return on investments, although there is a general difficulty in translating social investment and the quest for quality into specific examples and tools.

Guideline methods to develop recommendations dedicate most effort around organising discovery and corroboration knowledge following the evidence-based medicine (EBM) framework. Guidelines typically use a single dimension of information, and generally discard contextual evidence and formal expert knowledge and consumer's experiences in the process. In recognition of the limitations of guidelines in complex cases, complex interventions and systems research, there has been significant effort to develop new tools, guides, resources and structures to use alongside EBM methods of guideline development. In addition to these advances, a new framework based on the philosophy of science is required. Guidelines should be defined as implementation decision support tools for improving the decision-making process in real-world practice and not only as a procedure to optimise the knowledge base of scientific discovery and corroboration. A shift from the model of the EBM pyramid of corroboration of evidence to the use of broader multi-domain perspective graphically depicted as ‘Greek temple’ could be considered. This model takes into account the different stages of scientific knowledge (discovery, corroboration and implementation), the sources of knowledge relevant to guideline development (experimental, observational, contextual, expert-based and experiential); their underlying inference mechanisms (deduction, induction, abduction, means-end inferences) and a more precise definition of evidence and related terms. The applicability of this broader approach is presented for the development of the Canadian Consensus Guidelines for the Primary Care of People with Developmental Disabilities.

Objectives: Although consideration of ethical issues is recognized as a crucial part of health technology assessment, ethics analysis for HTA is generally perceived as methodologically underdeveloped in comparison to other HTA domains. The aim of our study is (i) to verify existing tools for quality assessment of ethics analyses for HTA, (ii) to consider some arguments for and against the need for quality assessment tools for ethics analyses for HTA, and (iii) to propose a preliminary set of criteria that could be used for assessing the quality of ethics analyses for HTA.

Methods: We systematically reviewed the literature, reviewed HTA organizations’ Web sites, and solicited views from thirty-two experts in the field of ethics for HTA.

Results: The database and HTA agency Web site searches yielded 420 references (413 from databases, seven from HTA Web sites). No formal instruments for assessing the quality of ethics analyses for HTA purposes were identified. Thirty-two experts in the field of ethics for HTA from ten countries, who were brought together at two workshops held in Edmonton (Canada) and Cologne (Germany) confirmed the findings from the literature.

Conclusions: Generating a quality assessment tool for ethics analyses in HTA would confer considerable benefits, including methodological alignment with other areas of HTA, increase in transparency and transferability of ethics analyses, and provision of common language between the various participants in the HTA process. We propose key characteristics of quality assessment tools for this purpose, which can be applied to ethics analyses for HTA purposes.

Introduction / Innovation Concept: In 2008, the Accreditation Council for Graduate Medical Education endorsed a change such that EM residency programs can decrease their synchronous conference experiences by up to 20% in exchange for asynchronous learning - Individualized Interactive Instruction (III). Identifying quality online resources that would also fulfill III’s reporting criteria (program director monitoring, evaluation component, faculty oversight, program effectiveness) is challenging. Using crowdsourced expertise, the Approved Instructional Resources (AIR) series from Academic Life in Emergency Medicine (ALiEM) was created in 2014 to provide a credible method to identify quality educational blogs and podcasts. The identified resources, however, focused on basic content with limited utility for more senior residents. We thus created the AIR-Pro series in 2015, aimed to cover more advanced concepts. Methods: The AIR-Pro series is a continuously building curriculum covering a new subject area every 2 months. For each area, 6 EM Chief Residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by 8 reviewers from the AIR-Pro Board (faculty and chief residents at various institutions). The scoring instrument contains 5 measurement outcomes (7-point Likert scale): recency, accuracy, educational utility, evidence based, and references. The AIR-Pro Approved label is given to posts with a score of ≥28 (out of 35) points and these are featured in the blog posting. For scores of 26-27, an Honorable Mention label is given if Board members collectively felt that they were valuable. For each AIR-Pro subject area, a multiple choice quiz is written based on the featured posts. Educator dashboard access of the Google Drive quizzes is given to program directors for monitoring. If approved by their program director, EM residents receive official III credit upon completion of each quiz. Curriculum, Tool, or Material: As of Jan 1, 2016, there have been 2 modules published on ALiEM with 1,220 (Cardiovascular) and 1,059 (Trauma) pageviews worldwide. Although early in development, 21 different institutions are using the AIR-Pro Series with over 150 residents completed the cardiovascular and trauma quizzes. We anticipate more because the original AIR Series has over 73 programs using it for III credit. Conclusion: The AIR-Pro series is a novel, objective, crowdsourced approach towards identifying quality, educational, social media content for the advanced EM resident.

Biodynamic (BD) agriculture became the subject of research efforts during the past decades, whereas a part of the scientific community looks at the BD method with skepticism and marks it as dogmatic. Nevertheless, as explored in this review, a fair share of the available peer-reviewed research results of controlled field experiments as well as case studies show effects of BD preparations on yield, soil quality and biodiversity. Moreover, BD preparations express a positive environmental impact in terms of energy use and efficiency. However, the underlying natural science mechanistic principle of BD preparations is still under investigation. In addition, quality determination methods, based on holistic approaches, are increasingly being investigated and recognized. BD farming strives, as manifested in several publications, to positively impact cultural landscape design as well. Summarized data showed that further research is needed and thus encouraged in the field of food quality comparison/determination, food safety, environmental performance (e.g., footprints), and on the effects of BD farming practices on farm animals.

Objective: We studied the influence of the methodologic quality of individual trials on the outcome of a landmark meta-analysis on thrombolytic therapy in acute myocardial infarction. From each study we extracted the number of patients in both groups who died in hospital or during follow-up. Methodologic quality was assessed using the Delphi list. We first recalculated pooled odds ratios (ORs) and 95% confidence intervals (CIs), on the studies found and compared them with the original results of Yusuf et al. Next we incorporated the results of quality assessment in five different ways in the calculation of the pooled ORs: a) component analysis; b) visual plot; c) quality score as a threshold score; d) quality score as a weighting factor; and e) cumulative pooling.

Results and Conclusion: No correlation between quality scores and ORs was found. Studies with a proper description of the different quality components provided an estimate close to the true treatment effect. No major differences were found between the results of the five different methods of incorporating the quality scores into the final conclusion.

On the basis of investigations with samples from a fertilization trial started in 1980, some parameters of food storage ability are evaluated. Microbial infestation of the product during incubation seems to be the most reliable parameter, but the circumstances of infestation and the optimal test conditions are unknown. There are no reliable correlations among the results of degradation tests, storage tests under optimal conditions, and chemical contents of the product. The concept of product vitality (a product-oriented quality referring to a product full of vigor) is based on results of degradation tests. Ultimately, however, food quality standards are based on human priorities (human-oriented). Therefore, not only product characteristics, but also social, psychological, and environmental criteria should be considered.