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Patients’ experience of the quality of care received throughout their continuum of care can be used to direct quality improvement efforts in areas where they are most needed. This study aims to establish validity and reliability of the Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ) – a tool that collects patients’ experience that quantifies aspect of care used to make judgments about quality from the perspective of the Alberta Quality Matrix for Health (AQMH).
The AQMH is a framework that can be used to assess and compare the quality of care in different healthcare settings. The AQMH provides a common language, understanding, and approach to assessing quality. The HAPSQ is one tool that is able to assess quality of care according to five of six AQMH’s dimensions.
This was a prospective methodologic study. Between March and October 2015, a convenience sample of patients presenting with chronic full-thickness rotator cuff tears was recruited prospectively from the University of Calgary Sport Medicine Centre in Calgary, Alberta, Canada. Reliability of the HAPSQ was assessed using test–retest reliability [interclass correlation coefficient (ICC)>0.70]. Validity was assessed through content validity (patient interviews, floor and ceiling effects), criterion validity (percent agreement >70%), and construct validity (hypothesis testing).
Reliability testing was completed on 70 patients; validity testing occurred on 96 patients. The mean duration of symptoms was three years (SD: 5.0, range: 0.1–29). Only out-of-pocket utilization possessed an ICC<0.70. Patients reported that items were relevant and appropriate to measuring quality of care. No floor or ceiling effects were present. Criterion validity was reached for all items assessed. A priori hypotheses were confirmed. The HAPSQ represents an inexpensive, reliable, and valid approach toward collecting clinical information across a patient’s continuum of care.
Five populations of rigid ryegrass (Lolium rigidum Gaudin) from fields across cropping regions in southern Australia were suspected of having resistance to thiocarbamates, chloroacetamides, and sulfonylisoxazoline herbicides. Resistant (R) populations 375-14, 198-15, 16.2, EP162, RAC1, and A18 and two susceptible (S) populations (SLR4 and VLR1) were included in a dose–response study. All suspected R populations expressed resistance to one or all herbicides (thiocarbamates, chloroacetamides, and pyroxasulfone). Population 198-15 exhibited the highest LD50 to triallate (44.7-fold), prosulfocarb (45.7-fold), S-metolachlor (31.5-fold), and metazachlor (27.2-fold) compared with the S populations. Populations 198-15 and 375-14 were also resistant to pyroxasulfone (13.5- and 14.9-fold) compared with the S populations, as was population EP162. This study documents the first case of field-evolved resistance to thiocarbamate, chloroacetamide, and sulfonylisoxazoline herbicides in L. rigidum.
Recent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04–6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.
Landraces (including heritage varieties) are an important agrobiodiversity resource offering considerable value as a buffer against crop failures, as a crop for niche markets, and as a source of diversity for crop genetic improvement activities underpinning future food security. Home gardens are reservoirs of landrace diversity, but some of the accessions held in them are vulnerable or threatened with extinction. Those associated with seed saving networks have added security, for example, ca. 800 varieties are stored in the Heritage Seed Library (HSL) of Garden Organic, UK. In this study, Amplified Fragment Length Polymorphisms-based genetic analysis of accessions held in the HSL was used to (a) demonstrate the range of diversity in the collection, (b) characterize accessions to aid collection management and (c) promote broader use of the collection. In total, 171 accessions were included from six crops: Vicia faba L., Pisum sativum L., Daucus carota L., Cucumis sativus L., Lactuca sativa L. and Brassica oleracea L. var. acephala (DC.) Metzq. Average expected heterozygosity ranged from 0.18 to 0.28 in D. carota; 0.02–0.18 in P. sativum; 0.05–0.18 in L. sativa; 0.15–0.26 in B. oleracea var. acephala; 0.15–0.37 in C. sativus and 0.07–0.36 in V. faba. Genetic diversity and Fst values generally reflected the breeding system and cultivation history of the different crops. Comparisons of the diversity found in heritage varieties with that found in commercial varieties did not show a consistent pattern. Principal coordinates analysis and Unweighted Pair Group Method with Arithmetic Mean cluster analysis were used to identify four potential duplicate accession pairs.
The classification of cultures into a workable number of types for descriptive or interpretative ends has occupied anthropologists since the science was born. Many kinds of data have been selected. Within the last decade Coon's (1948) subdivision of human societies into six levels on the basis of complexity of institutions, and the attempts by Strong (1948), Armillas (1948), Steward (1949), Willey and Phillips (1955) to distinguish developmental periods in the Mesoamerican and Andean archaeological sequences may be cited. Our excuse for attempting yet another formulation is that the current schemes emphasize either ethnographic criteria that are difficult or impossible to detect archaeologically, or unique features of particular cultural configurations rather than general criteria defining more universal patterns. Starting from a point of view different from those heretofore employed, we have tried to develop a classification of cultures that is usable with both ethnographical and archaeological data and that has functional and evolutionary as well as historical and descriptive significance.
A population of rigid ryegrass (Lolium rigidum Gaudin) from a field on the Eyre Peninsula, South Australia, was suspected of resistance to thiocarbamate herbicides. Dose–response studies were conducted on this population (EP162) and two susceptible populations (SLR4 and VLR1). The resistant population exhibited cross-resistance to triallate, prosulfocarb, EPTC, and thiobencarb with higher LD50 to triallate (14.9-fold), prosulfocarb (9.4-fold), EPTC (9.7-fold), and thiobencarb (13.6-fold) compared with the susceptible populations SLR4 and VLR1. The resistant population also displayed resistance to trifluralin, pyroxasulfone, and propyzamide. The LD50 of the resistant population was higher for trifluralin (13.8-fold), pyroxasulfone (8.1-fold), and propyzamide (2.7-fold) compared with the susceptible populations. This study documents the first case of field-evolved resistance to thiocarbamate herbicides in L. rigidum.
We present the first data release of the SkyMapper Southern Survey, a hemispheric survey carried out with the SkyMapper Telescope at Siding Spring Observatory in Australia. Here, we present the survey strategy, data processing, catalogue construction, and database schema. The first data release dataset includes over 66 000 images from the Shallow Survey component, covering an area of 17 200 deg2 in all six SkyMapper passbands uvgriz, while the full area covered by any passband exceeds 20 000 deg2. The catalogues contain over 285 million unique astrophysical objects, complete to roughly 18 mag in all bands. We compare our griz point-source photometry with Pan-STARRS1 first data release and note an RMS scatter of 2%. The internal reproducibility of SkyMapper photometry is on the order of 1%. Astrometric precision is better than 0.2 arcsec based on comparison with Gaia first data release. We describe the end-user database, through which data are presented to the world community, and provide some illustrative science queries.
In the rapidly expanding literature on the ethics of climate engineering, a lot has been made of the fact that stratospheric aerosol injection would for the first time create a world whose climate had been intentionally shaped by deliberate human decisions. Intention has always mattered in ethics. Due to the importance of intention in assigning culpability for harms, one might expect that the moral responsibility for any harms created during an attempt to reconstruct the global climate using stratospheric aerosols would be considerable. This article investigates such an expectation by making a comparison between the culpability for any unintended harms resulting from stratospheric aerosol injection and culpability for the unintended harms already taking place due to carbon emissions. To make this comparison, both types of unintended harms are viewed through the lens of the doctrine of double effect. The conclusion reached goes against what many might expect. The article closes by suggesting that a good way to read this surprising conclusion is that it points toward the continuing moral importance of prioritizing emission reductions.
In-spiraling supermassive black holes should emit gravitational waves, which would produce characteristic distortions in the time of arrival residuals from millisecond pulsars. Multiple national and regional consortia have constructed pulsar timing arrays by precise timing of different sets of millisecond pulsars. An essential aspect of precision timing is the transfer of the times of arrival to a (quasi-)inertial frame, conventionally the solar system barycenter. The barycenter is determined from the knowledge of the planetary masses and orbits, which has been refined over the past 50 years by multiple spacecraft. Within the North American Nanohertz Observatory for Gravitational Waves (NANOGrav), uncertainties on the solar system barycenter are emerging as an important element of the NANOGrav noise budget. We describe what is known about the solar system barycenter, touch upon how uncertainties in it affect gravitational wave studies with pulsar timing arrays, and consider future trends in spacecraft navigation.
The Square Kilometre Array will be an amazing instrument for pulsar astronomy. While the full SKA will be sensitive enough to detect all pulsars in the Galaxy visible from Earth, already with SKA1, pulsar searches will discover enough pulsars to increase the currently known population by a factor of four, no doubt including a range of amazing unknown sources. Real time processing is needed to deal with the 60 PB of pulsar search data collected per day, using a signal processing pipeline required to perform more than 10 POps. Here we present the suggested design of the pulsar search engine for the SKA and discuss challenges and solutions to the pulsar search venture.
The majority of fast radio bursts (FRBs) are poorly localised, hindering their potential scientific yield as galactic, intergalactic, and cosmological probes. LOFT-e, a digital backend for the U.K.’s e-MERLIN seven-telescope interferometer will provide commensal search and real-time detection of FRBs, taking full advantage of its field of view (FoV), sensitivity, and observation time. Upon burst detection, LOFT-e will store raw data offline, enabling the sub-arcsecond localisation provided by e-MERLIN and expanding the pool of localised FRBs. The high-time resolution backend will additionally introduce pulsar observing capabilities to e-MERLIN.
Phased Array Feed (PAF) technology is the next major advancement in radio astronomy in terms of combining high sensitivity and large field of view. The Focal L-band Array for the Green Bank Telescope (FLAG) is one of the most sensitive PAFs developed so far. It consists of 19 dual-polarization elements mounted on a prime focus dewar resulting in seven beams on the sky. Its unprecedented system temperature of ~17 K will lead to a 3 fold increase in pulsar survey speeds as compared to contemporary single pixel feeds. Early science observations were conducted in a recently concluded commissioning phase of the FLAG where we clearly demonstrated its science capabilities. We observed a selection of normal and millisecond pulsars and detected giant pulses from PSR B1937+21.
We observed single pulses from PSR J0034-0721 (B0031-07) simultaneously at the MWA (185 MHz) and the GMRT (610 MHz). Correlation analyses reveal that the phase difference of the average profiles at the two frequencies differs from the phase difference observed between individual subpulses, indicating that the individual emission columns above the pulsar’s rotating carousel of sparks do not evolve in frequency in the same way that the global magnetosphere does. This hints at a possible departure from the dipolar field geometry in this pulsar’s emission region. Moreover, the discrepancy depends on the drift mode, suggestive of a way to constrain the emission heights associated with each drift mode.
PSR J0337+1715 is a millisecond radio pulsar in a hierarchical stellar triple system with two white dwarfs. This system is a unique and excellent laboratory in which to test the strong equivalence principle (SEP) of general relativity. An initial SEP-violation test was performed using direct 3-body numerical integration of the orbit in order to model the more than 25000 pulse times of arrival (TOAs) from three radio telescopes: Arecibo, Green Bank and Westerbork. In this work I present our efforts to quantify the effects of systematics in the TOAs and timing residuals, which limit the precision of an SEP test. In particular, we apply Fourier-based techniques to the timing residuals in order to isolate the effects of systematics that can masquerade as an SEP violation.