Tools for assessing health research partnership outcomes and impacts: a systematic review.

OBJECTIVE: To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts. METHODS: We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist. RESULTS: From 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist. CONCLUSION: This systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.

The association between sociodemographic and clinical characteristics and poor glycaemic control: a longitudinal cohort study.

AIMS: People with diabetes and poor glycaemic control are at higher risk of diabetes-related complications and incur higher healthcare costs. An understanding of the sociodemographic and clinical characteristics associated with poor glycaemic control is needed to overcome the barriers to achieving care goals in this population. METHODS: We used linked administrative and laboratory data to create a provincial cohort of adults with prevalent diabetes, and a measure of HbA1c that occurred at least 1 year following the date of diagnosis. The primary outcome was poor glycaemic control, defined as at least two consecutive HbA1c measurements ≥ 86 mmol/mol (10%), not including the index measurement, spanning a minimum of 90 days. We used multivariable Cox proportional hazards models to evaluate the association between baseline sociodemographic and clinical factors and poor glycaemic control. RESULTS: In this population-based cohort of 169 890 people, younger age was significantly associated with sustained poor glycaemic control, with a hazard ratio (HR) of 3.08, 95% CI (2.79-3.39) for age 18-39 years compared with age ≥ 75 years. Longer duration of diabetes, First Nations status, lower neighbourhood income quintile, history of substance abuse, mood disorder, cardiovascular disease, albuminuria and high LDL cholesterol were also associated with poor glycaemic control. CONCLUSIONS: Although our results may be limited by the observational nature of the study, the large geographically defined sample size, longitudinal design and robust definition of poor glycaemic control are important strengths. These findings demonstrate the complexity associated with poor glycaemic control and indicate a need for tailored interventions.

Continuous-wave Pr³âº:BaY2F8 and Pr³âº:LiYF4 lasers in the cyan-blue spectral region.

We report on the first, to the best of our knowledge, continuous-wave quasi three-level lasers emitting in the cyan-blue spectral range in praseodymium-doped crystalline materials. Applying Pr(3+):BaY2F8 as an active medium, up to 201 mW of output power at 495 nm could be obtained with a slope efficiency of 27% under pumping with an optically pumped semiconductor laser (2ω-OPSL) at 480 nm. In the same pumping scheme using Pr(3+):LiYF4, output powers up to 70 mW were realized at 491 and 500 nm, respectively. With Pr(3+):BaY2F8, diode-pumped laser operation with up to 11% slope efficiency and 44 mW output power was also achieved. In the latter case, detailed investigations on the temperature dependency of the laser output were conducted. Moreover, comparative experiments were carried out for the first time, to the best of our knowledge, with green-emitting Pr(3+):BaY2F8 lasers at 524 and 553 nm both under diode and 2ω-OPSL excitation.

Association between participation in a brief diabetes education programme and glycaemic control in adults with newly diagnosed diabetes.

AIMS: To determine the association between participation in a brief introductory didactic diabetes education programme and change in HbA1c among individuals with newly diagnosed diabetes. METHODS: We identified a population-based cohort of adults newly diagnosed with diabetes between October 2005 and June 2008 in Calgary, Canada, and conducted a retrospective cohort study by linking administrative and laboratory data with programme attendance data. We matched individuals who attended the programme within the first 6 months after diagnosis with those who did not attend, based on their propensity scores. We measured the change in HbA1c between time of diagnosis and 6-18 months later to determine the association between programme participation and change in HbA1c . RESULTS: HbA1c was measured at baseline and follow-up for 7793 individuals, including 803 programme participants. After propensity score matching, programme participation was associated with a significantly greater adjusted mean reduction in HbA1c between baseline and follow-up of 3.3 mmol/mol (95% CI 2.2-4.3) or 0.30% (95% CI 0.20-0.39). There was a significant interaction between baseline HbA1c and programme participation-the difference in adjusted mean reduction in HbA1c associated with programme participation ranged from 2.7 mmol/mol (0.25%) at baseline HbA1c of 53 mmol/mol (7%) to 6.2 mmol/mol (0.56%) at baseline HbA1c of 97 mmol/mol (11%). CONCLUSION: Despite its brevity, participation in a diabetes education programme was associated with an additional reduction in HbA1c in newly diagnosed people that was comparable with that reported in trials of programmes targeted at those with prevalent diabetes.

Gender differences of mental health consumers accessing integrated primary and behavioral care.

Persons with severe mental illness and addiction are at higher risk for early morbidity and mortality than the general population, and are less likely to receive primary care and preventive health services. Primary and behavioral integrated care programs aim to reduce these health disparities by providing comprehensive health and wellness services. Gender in particular may play a significant role in individuals' engagement and outcomes in such programs. Hence, this study examines the salient characteristics of behavioral health consumers accessing an integrated care program at a large community mental health center. Baseline gender differences in consumer demographics, substance use, psychological distress and functioning, physical health indicators, and risk factors for serious medical conditions are examined. Our results demonstrate that key gender differences exist and may warrant distinct treatment needs for men and women receiving integrated care.

The biocontrol agent Bacillus sp. CHEP5 primes the defense response against Cercospora sojina.

Glycine max (soybean) production can be dramatically affected by frogeye leaf spot (FLS) caused by Cercospora sojina Hara. The inoculation of biocontrol agents may be an alternative strategy for C. sojina control. The native biocontrol bacterium Bacillus sp. CHEP5 reduced the severity of FLS in soybean by inducing systemic resistance. We suggest that the defense response was primed since the expression of the defense related gene GmAOS was enhanced in induced plants treated with both methyl jasmonate and C. sojina. Furthermore, as GmAOS is related to jasmonic acid biosynthesis, we assume that this phytohormone is involved in induced systemic resistance signaling defense pathway in soybean against C. sojina.

Induction of defence response in peanut elicited by Bacillus sp. CHEP5: A biological strategy for control of smut disease caused by Thecaphora frezzii in the field.

Peanut is susceptible to many diseases; among them, peanut smut disease caused by Thecaphora frezzii is the most damaging, causing yield losses of 30%. Fungicide treatment is not effective to control this disease. In this scenario, biological control would be an alternative to diminish the disease. Systemic resistance induced by a biotic agent is known to be effective against a broad spectrum of pathogens. In this study we evaluated the effect of different inoculation strategies of Bacillus sp. CHEP5, a peanut native strain, on peanut smut incidence and severity in field experiments. Peroxidase activity and accumulation of phenolic compounds were measured as changes associated with induced defensive traits. After three consecutive field trials, we found that Bacillus sp. CHEP5 inoculation protects peanut from T. frezzii because incidence and severity were reduced in two field trials. Furthermore, bacterial inoculation in the furrow followed by foliar application around the date of peg development would be the best strategy to control the disease. In addition, a correlation was found between increase in plant phenolic content and decrease in smut disease parameters. Thereafter, we concluded that Bacillus sp. CHEP5 may reduce smut as a result of plant defence response induction.

Income of living kidney donors and the income difference between living kidney donors and their recipients in the United States.

Disincentives for living kidney donation are common but are poorly understood. We studied 54 483 living donor kidney transplants in the United States between 2000 and 2009, limiting to those with valid zip code data to allow determination of median household income by linkage to the 2000 U.S. Census. We then determined the income and income difference of donors and recipients. The median household income in donors and recipients was $46 334 ±$17 350 and $46 439 ±$17 743, respectively. Donation-related expenses consume ≥ 1 month's income in 76% of donors. The mean ± standard deviation income difference between recipients and donors in transplants involving a wealthier recipient was $22 760 ± 14 792 and in 90% of transplants the difference was <$40 000 dollars. The findings suggest that the capacity for donors to absorb the financial consequences of donation, or of recipients to reimburse allowable expenses, is limited. There were few transplants with a large difference in recipient and donor income, suggesting that the scope and value of any payment between donors and recipients is likely to be small. We conclude that most donors and recipients have similar modest incomes, suggesting that the costs of donation are a significant burden in the majority of living donor transplants.

Chronic ozone exposure preferentially modifies root rather than foliar metabolism of date palm (Phoenix dactylifera) saplings.

In their natural environment, date palms are exposed to chronic atmospheric ozone (O3) concentrations from local and remote sources. In order to elucidate the consequences of this exposure, date palm saplings were treated with ambient, 1.5 and 2.0 times ambient O3 for three months in a free-air controlled exposure facility. Chronic O3 exposure reduced carbohydrate contents in leaves and roots, but this effect was much stronger in roots. Still, sucrose contents of both organs were maintained at elevated O3, though at different steady states. Reduced availability of carbohydrate for the Tricarboxylic acid cycle (TCA cycle) may be responsible for the observed reduced foliar contents of several amino acids, whereas malic acid accumulation in the roots indicates a reduced use of TCA cycle intermediates. Carbohydrate deficiency in roots, but not in leaves caused oxidative stress upon chronic O3 exposure, as indicated by enhanced malonedialdehyde, H2O2 and oxidized glutathione contents despite elevated glutathione reductase activity. Reduced levels of phenolics and flavonoids in the roots resulted from decreased production and, therefore, do not indicate oxidative stress compensation by secondary compounds. These results show that roots of date palms are highly susceptible to chronic O3 exposure as a consequence of carbohydrate deficiency.

Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes.

Individual studies indicate that kidney transplantation is associated with lower mortality and improved quality of life compared with chronic dialysis treatment. We did a systematic review to summarize the benefits of transplantation, aiming to identify characteristics associated with especially large or small relative benefit. Results were not pooled because of expected diversity inherent to observational studies. Risk of bias was assessed using the Downs and Black checklist and items related to time-to-event analysis techniques. MEDLINE and EMBASE were searched up to February 2010. Cohort studies comparing adult chronic dialysis patients with kidney transplantation recipients for clinical outcomes were selected. We identified 110 eligible studies with a total of 1 922 300 participants. Most studies found significantly lower mortality associated with transplantation, and the relative magnitude of the benefit seemed to increase over time (p < 0.001). Most studies also found that the risk of cardiovascular events was significantly reduced among transplant recipients. Quality of life was significantly and substantially better among transplant recipients. Despite increases in the age and comorbidity of contemporary transplant recipients, the relative benefits of transplantation seem to be increasing over time. These findings validate current attempts to increase the number of people worldwide that benefit from kidney transplantation.

Absolute frequency spectroscopy of CO2 lines at around 2.09 µm by combined use of an Er:fiber comb and a Ho:YLF amplifier.

The low-frequency tail of an octave-spanning supercontinuum (SC) generated by an Er:fiber comb is enhanced by a multipass Ho:YLF amplifier and used in a sum-frequency-generation scheme to obtain absolute referencing of a single-mode Tm-Ho:YAG laser tunable around 2.09 µm. By tuning the comb repetition frequency, the probing laser is scanned across the absorption lines of a CO(2) gas sample and highly accurate absorption profiles are measured. This approach can be readily scaled to any wavelength above ~2 µm.

Spectroscopic properties and upconversion in Pr3+:YF3 nanoparticles.

The synthesis and spectroscopic investigation of Pr(3+):YF(3) nanoparticles with nominal concentration between 0.05% and 5 at% Pr(3+) are reported. Pr(3+) emission in the visible range of the spectrum is investigated at room temperature and at 10 K as well as time resolved spectroscopy as a function of Pr(3+) concentration. The upconverted emission from the orange to the blue region is observed and the time-resolved spectroscopy of the visible emissions is discussed as a function of the doping level. A careful analysis of the decays permits identification of the main energy-transfer mechanisms that determine the population of the excited levels at various times during the decay.

Interaction among Arachis hypogaea L. (peanut) and beneficial soil microorganisms: how much is it known?

The leguminous crop Arachis hypogaea L. (peanut) is originally from South America and then was disseminated to tropical and subtropical regions. The dissemination of the crop resulted in peanut plants establishing a symbiotic nitrogen-fixing relationship with a wide diversity of indigenous soil bacteria. We present in this review, advances on the molecular basis for the crack-entry infection process involved in the peanut-rhizobia interaction, the diversity of rhizobial and fungal antagonistic bacteria associated with peanut plants, the effect of abiotic and biotic stresses on this interaction and the response of peanut to inoculation.

CW and femtosecond operation of a diode-pumped Yb:BaY(2)F(8) laser.

We report for the first time on laser action of a diode-pumped Yb:BaY(2)F(8) crystal. Both CW and femtosecond operations have been demonstrated at room-temperature conditions. A maximum output power of 0.56 W, a slope efficiency of 34%, and a tunability range from 1013 to 1067 nm have been obtained in CW regime. Transform-limited pulse trains with a minimum duration of 275 fs, an average power of 40 mW, and a repetition rate of 83 MHz have been achieved in a passive mode-locked regime using a semiconductor saturable absorber mirror.

Efficient in-band pumped Ho:LuLiF(4) 2 microm laser.

An efficient Ho:LuLiF(4) laser in-band pumped by a cladding-pumped Tm-doped silica fiber laser operating at 1937 nm is reported. At low-cavity output coupling, the Ho:LuLiF(4) laser yielded 5.1 W of output at a wavelength of 2066 nm for 8.0 W of absorbed pump power with a slope efficiency of 70%. At high-cavity output coupling, the lasing wavelength shifted to 2053 nm and the laser produced an output power of 5.4 W with a slope efficiency of 76%. The beam propagation factor (M(2)) was measured to be approximately 1.1 at the maximum output power confirming fundamental transverse mode (TEM(oo)) operation. The influence of resonator design on laser performance is discussed, along with prospects for further power scaling and improvement of the laser efficiency.

Practice pattern variation in oral glucocorticoid therapy after the induction of response in proliferative lupus nephritis.

Glucocorticoids are standard therapy for induction of response in proliferative lupus nephritis. However, the optimal duration of glucocorticoid therapy is uncertain. We surveyed physicians who treat lupus nephritis regarding their use of glucocorticoids in proliferative lupus nephritis after induction of response and regarding factors associated with different practice patterns. We administered a questionnaire of standardized cases assessing glucocorticoid use after induction of response to specialists with expertise in proliferative lupus nephritis. We examined the association between continuation of glucocorticoids and patient and physician characteristics. Of 90 invited participants, 72 (80%) responded. A total of 24 (33%) respondents attempted to discontinue glucocorticoids in all scenarios, 21 (29%) continued glucocorticoids in all scenarios, and 27 (38%) attempted to discontinue in some scenarios but not others. Responses varied according to the physician group (p < 0.001) and by years in practice (p < 0.001). Of those who discontinued glucocorticoids in selected scenarios, 15/27 (55%) were influenced by the characteristics of the induction of response, 16/27 (59%) by past lupus history, and 9/27 (33%) by the tolerance and use of immunosuppression. We conclude that glucocorticoid therapy after induction of response in proliferative lupus nephritis is varied. This variability likely represents clinical equipoise. A randomized trial evaluating the effect of glucocorticoid use after induction of response is warranted.

Chronic kidney disease among Aboriginal people living in Canada.

AIMS: Chronic kidney disease (CKD) poses a significant health burden on Aboriginal communities around the world. High rates of diabetes among Aboriginal Canadians are an important contributing factor to the rising rates of CKD in this population, and diabetes has been the leading cause of kidney failure among Aboriginal patients initiating dialysis in Canada for the last decade. This paper will describe access to, quality of, and outcomes associated with the renal care of Aboriginal people living in Canada. RESULTS: Research shows that rates of CKD are higher among Aboriginal people residing in Canada, and that despite remote residence location, use of peritoneal dialysis is substantially lower than in white patients. Similarly, although mortality rates among Canadian hemodialysis patients are similar for Aboriginals and for whites, Aboriginal patients have substantially reduced access to kidney transplantation. CONCLUSIONS: A concerted effort to lower rates of CKD in this population is needed. Changes in healthcare policy that successfully translate into healthcare provider and patient level improvements in access to and the quality of care will be needed to significantly reduce the risk of CKD and progression to kidney failure.

The pregnancy rate and live birth rate in kidney transplant recipients.

Fertility is one of the potential benefits for women undergoing kidney transplantation; however, population-based information about the likelihood of pregnancy and successful fetal outcome is not available. In this observational study of 16 195 female kidney transplant recipients aged 15-45 years in the United States between 1990 and 2003, we determined the pregnancy rate and live birth rate using Medicare claims data from the first three posttransplant years. The pregnancy rate was 33 per thousand female transplant recipients between 1990 and 2003 and progressively declined from 59 in 1990 to 20 in 2000. The live birth rate between 1990 and 2003 was 19 per thousand female transplant recipients and declined in parallel with the pregnancy rate. Despite a decrease in therapeutic abortions over time, the proportion of pregnancies resulting in fetal loss (45.6%) remained constant during the study due to an increase in spontaneous abortions and other causes of fetal loss. The pregnancy rate in kidney transplant recipients was markedly lower and declined more rapidly than reported in the general American population during the same period. The live birth rate was substantially lower than reported in voluntary registries of transplant recipients, and the proportion of pregnancies resulting in unexpected fetal loss increased over time.