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Several principled measures of contextuality have been proposed for general systems of random variables (i.e. inconsistently connected systems). One such measure is based on quasi-couplings using negative probabilities (here denoted by [Formula: see text], Dzhafarov & Kujala, 2016 Quantum interaction). Dzhafarov & Kujala (Dzhafarov & Kujala 2019 Phil. Trans. R. Soc. A 377, 20190149. (doi:10.1098/rsta.2019.0149)) introduced a measure of contextuality, [Formula: see text], that naturally generalizes to a measure of non-contextuality. Dzhafarov & Kujala (Dzhafarov & Kujala 2019 Phil. Trans. R. Soc. A 377, 20190149. (doi:10.1098/rsta.2019.0149)) additionally conjectured that in the class of cyclic systems these two measures are proportional. Here we prove that conjecture is correct. Recently, Cervantes (Cervantes 2023 J. Math. Psychol. 112, 102726. (doi:10.1016/j.jmp.2022.102726)) showed the proportionality of [Formula: see text] and the Contextual Fraction measure introduced by Abramsky & Brandenburger (Abramsky & Brandenburger 2011 New J. Phys. 13, 113036. (doi:10.1088/1367-2630/13/11/113036)). The present proof completes the description of the interrelations of all contextuality measures proposed within or translated into the Contextuality-by-Default framework so far as they pertain to cyclic systems. This article is part of the theme issue 'Quantum contextuality, causality and freedom of choice'.
RESUMO
BACKGROUND: Audit and Feedback (A&F) is one of the most common strategies used to improve quality in healthcare. However, there is still lack of awareness regarding the enabling factors and barriers that could influence its effectiveness. The aim of this study was to develop a questionnaire to measure the knowledge, attitudes and behaviors of general practitioners (GPs) regarding A&F. The study was performed in the context of the EASY-NET program (project code NET-2016-02364191). METHODS: The survey was developed according to two steps. Firstly, a scoping review was performed in order to map the literature on the existing similar instruments with the aim of identifying the sub-domains and possible items to include in a preliminary version of the questionnaire. In the second phase, the questionnaire was reviewed by a multidisciplinary group of experts and administrated to a convenience sample in a pilot survey. RESULTS: Ten papers were included in the scoping review. The survey target and development methodology were heterogenous among the studies. The knowledge, attitudes and behaviors domains were assessed in six, nine and seven studies, respectively. In the first step, 126 pertinent items were extracted and categorized as follows: 8 investigated knowledge, 93 investigated attitudes, and 25 investigated behaviors. Then, 2 sub-domains were identified for knowledge, 14 for attitudes and 7 for behavior. Based on these results, a first version of the survey was developed via consensus among two authors and then revised by the multidisciplinary group of experts in the field of A&F. The final version of the survey included 36 items: 8 in the knowledge domain, 19 in the attitudes domain and 9 in the behaviors domain. The results of the pilot study among 15 GPs suggested a good acceptability and item relevance and accuracy, with positive answers totaling 100% and 93.3% in the proposed questions. CONCLUSIONS: The methodology used has shown to be a good strategy for the development of the survey. The survey will be administrated before and after the implementation of an A&F intervention to assess both baseline characteristics and changes after the intervention.
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BACKGROUND: The aim of this study was to evaluate the effects of heart failure guideline implementation in the Pordenone province area, by using the regional health system databases. METHODS: We created the provincial registry of hospitalization for heart failure and we defined a set of indicators to assess the adequate use of the hospital facility, the correct use of diagnostic instruments, the appropriate use of medications, the in-hospital, 6-month and 1-year mortality rates. RESULTS: Up to December 31, 2002, 2977 subjects, living in the Pordenone province area, were hospitalized for heart failure (10.4 for 1000 inhabitants). Repeated hospitalizations in the years have percentage values oscillating at around 20%. The average length of hospitalization appeared declining, ranging from 11.1 days in 2000 to 10.3 days in 2002. The in-hospital death rate varied between 16-17%. The cumulative death rate within 6 months (33.2%) and 1 year (41.0%) of hospitalization resulted rather high, also considering the patients' advanced mean age (79 years). The percentage of patients who underwent an echocardiogram as outpatients in the previous year increased from 5.7% in 2000 to 13.1% in 2002. As for therapy, an increase in the percentage of patients treated with ACE-inhibitors (from 44.6 to 50.2%), sartans (from 8.2 to 11.7%), beta-blockers (from 11.7 to 16.7%) and diuretics (from 66.4 to 68.5%) was evident from 2000 to 2001. A mild reduction in the percentage of patients treated with digitalis (from 35.0 to 33.8%) and with calcium antagonists (from 22.4 to 20.9%) was also noted. CONCLUSIONS: The results of this study show that it is possible to use some indicators in evaluating the effects of guideline implementation in heart failure, by using the regional health system data. The final goal is to gradually involve all the professionals in the different phases of the natural course of heart failure patients, particularly the general practitioners.