Assessment of Clinical Information Quality in Digital Health Technologies: International eDelphi Study.

BACKGROUND: Digital health technologies (DHTs), such as electronic health records and prescribing systems, are transforming health care delivery around the world. The quality of information in DHTs is key to the quality and safety of care. We developed a novel clinical information quality (CLIQ) framework to assess the quality of clinical information in DHTs. OBJECTIVE: This study explored clinicians' perspectives on the relevance, definition, and assessment of information quality dimensions in the CLIQ framework. METHODS: We used a systematic and iterative eDelphi approach to engage clinicians who had information governance roles or personal interest in information governance; the clinicians were recruited through purposive and snowball sampling techniques. Data were collected using semistructured online questionnaires until consensus was reached on the information quality dimensions in the CLIQ framework. Responses on the relevance of the dimensions were summarized to inform decisions on retention of the dimensions according to prespecified rules. Thematic analysis of the free-text responses was used to revise definitions and the assessment of dimensions. RESULTS: Thirty-five clinicians from 10 countries participated in the study, which was concluded after the second round. Consensus was reached on all dimensions and categories in the CLIQ framework: informativeness (accuracy, completeness, interpretability, plausibility, provenance, and relevance), availability (accessibility, portability, security, and timeliness), and usability (conformance, consistency, and maintainability). A new dimension, searchability, was introduced in the availability category to account for the ease of finding needed information in the DHTs. Certain dimensions were renamed, and some definitions were rephrased to improve clarity. CONCLUSIONS: The CLIQ framework reached a high expert consensus and clarity of language relating to the information quality dimensions. The framework can be used by health care managers and institutions as a pragmatic tool for identifying and forestalling information quality problems that could compromise patient safety and quality of care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2021-057430.

Coral growth, survivorship and return-on-effort within nurseries at high-value sites on the Great Barrier Reef.

Coral reefs are deteriorating worldwide prompting reef managers and stakeholders to increasingly explore new management tools. Following back-to-back bleaching in 2016/2017, multi-taxa coral nurseries were established in 2018 for the first time on the Great Barrier Reef (GBR) to aid reef maintenance and restoration at a "high-value" location-Opal Reef-frequented by the tourism industry. Various coral species (n = 11) were propagated within shallow water (ca. 4-7m) platforms installed across two sites characterised by differing environmental exposure-one adjacent to a deep-water channel (Blue Lagoon) and one that was relatively sheltered (RayBan). Growth rates of coral fragments placed onto nurseries were highly variable across taxa but generally higher at Blue Lagoon (2.1-10.8 cm2 month-1 over 12 months) compared to RayBan (0.6-6.6 cm2 month-1 over 9 months). Growth at Blue Lagoon was largely independent of season, except for Acropora tenuis and Acropora hyacinthus, where growth rates were 15-20% higher for December 2018-July 2019 ("warm season") compared to August-December 2018 ("cool season"). Survivorship across all 2,536 nursery fragments was ca. 80-100%, with some species exhibiting higher survivorship at Blue Lagoon (Acropora loripes, Porites cylindrica) and others at RayBan (A. hyacinthus, Montipora hispida). Parallel measurements of growth and survivorship were used to determine relative return-on-effort (RRE) scores as an integrated metric of "success" accounting for life history trade-offs, complementing the mutually exclusive assessment of growth or survivorship. RRE scores within sites (across species) were largely driven by growth, whereas RRE scores between sites were largely driven by survivorship. The initial nursery phase of coral propagation therefore appears useful to supplement coral material naturally available for stewardship of frequently visited Great Barrier Reef tourism (high-value) sites, but further assessment is needed to evaluate how well the growth rates and survival for nursery grown corals translate once material is outplanted.

Don't it make my brown eyes blue: co-witness misinformation about a target's appearance can impair target-absent line-up performance.

Misinformation from another witness has been shown to impair eyewitness reports, but little is known about how it may influence eyewitness identification. In Experiment 1, adult pairs comprising one participant and one experimental confederate viewed a video clip of a staged theft. Half of the participants were then misinformed by the confederate that the thief's accomplice had blue eyes (in fact, they were brown). Next, individual participants described the accomplice and completed a target-absent photographic line-up task comprising blue-eyed members. Misinformed participants were several times more likely than controls to describe the accomplice as having blue eyes, and twice as likely to identify someone from the line-up. In Experiment 2, when line-up members' eye colour was digitally altered from blue to brown, the line-up effect disappeared, suggesting that the increase in identifications in Experiment 1 was not a generalised increase in willingness to choose from the line-up. In Experiment 3, we discounted the possibility that discussion alone could account for the line-up misinformation effect, by subjecting all participants to co-witness discussion.

Five year follow-up comparing tension-free vaginal tape and colposuspension.

Burch colposuspension has been the procedure of choice for stress urinary incontinence, more recently the tension-free vaginal tape (TVT) has been used. A retrospective study on all TVT's and colposupensions was performed. The present clinical condition was assessed using the Bristol Female Lower Urinary Tract Symptoms and Short-Form 12 questionnaires. The median operating time was 50-59 minutes for TVT and 70-79 minutes for colposupension. The median number of day's hospitalization was 3 and 10 respectively. The overall success rate was 88.5% and 92% respectively. No significant difference in subjective outcome was noted at more than 5 years after surgery between the two procedures for either the BFLUTS or SF-12.

Communicating with families about post-mortems: practice guidance.

In January 2001 the Chief Medical Officer announced the Public Inquiry (Redfern Report) into post-mortem practice at Alder Hey Hospital in Liverpool. It was expected that this inquiry report would influence post-mortem practice in general and communication with parents in particular and in May 2003 a code of practice for clinical staff was produced by the Department of Health (DH) (2003a). This article discusses the code of practice Families and Post Mortems and explores the relevance of these recommendations to neonatal and children's nurses.

Negative affect and binge eating in overweight women.

OBJECTIVES: Binge eating among overweight women is associated with adverse physical and psychological consequences, and is known to occur in response to negative affect. This study sought to examine the role played by individual differences in coping style in the relationship between negative affect and binge eating. METHOD: Overweight women (N = 105) completed a battery of questionnaires that assessed their binge eating severity, negative affect, and dispositional coping style. RESULTS: Women with higher levels of negative affect had more severe binge eating problems than those who generally experienced a low level of affective distress. Among those who were low in negative affect, however, those who tended to use the dysfunctional strategy of disengagement to cope with stress reported more severe binge eating than those who reported they were less likely to employ this coping style. CONCLUSIONS: The findings from this study emphasize the complexity and multicausality of affect-related binge eating in overweight women. Prospective studies are required to establish the role of negative affect and coping style in the onset and progression of recurrent binge eating among overweight individuals.

Developing mouse Sertoli cells in vitro: effects on developing ovaries in co-culture and production of anti-Müllerian hormone.

Previous work in our laboratory showed that pre-Sertoli cells adopt an epithelial phenotype when cultured in the presence of reconstituted basement membrane (RBM), and so cultures were established with and without this substrate. Biological activity of isolated developing mouse Sertoli cells maintained in vitro was assessed in the current study by utilising a co-culture approach, to determine whether the cells were capable of affecting ovarian differentiation. Developing Sertoli cells isolated at embryonic day (E) 12.5 exerted a deleterious effect on E12.5 ovaries in co-culture, inducing a loss of germ cells. However, when cells were isolated a day later and co-cultured with E13.5 ovaries (after entry to meiosis has begun), germ cells survived and showed evidence of meiosis, although ovigerous cords in co-cultures were masculinized compared to those of control cultured ovaries. Thus, both stages examined showed biological effects; cultured pre-Sertoli cells explanted at E12.5 showed a negative effect on female germ cells, whereas those explanted at E13.5 masculinized ovigerous cords. The functional status of isolated developing mouse Sertoli cells in vitro was further assessed by immunocytochemistry to investigate the expression of anti-Müllerian hormone, an early product of pre-Sertoli cells. Positive immunostaining was seen in developing Sertoli cells in vitro, particularly where cells had been explanted to an RBM substrate, demonstrating that good epithelial morphology is associated with improved function. Our culture system is therefore well suited for investigating factors produced by developing Sertoli cells, their role in influencing testicular morphogenesis and their potential to perturb ovarian differentiation. We believe that this in vitro approach provides a more physiological assessment compared with the knockout mouse model, where global effects of genes with housekeeping functions can compromise overall development.