Temporal Changes In Quality Research Articles

Ecological but Not Biological Traits of European Riverine Invertebrates Respond Consistently to Anthropogenic Impacts

ABSTRACTAimTo determine which riverine invertebrate traits respond consistently to anthropogenic impacts across multiple biogeographic regions.LocationEurope.Time Period1981–2021.Major Taxa StudiedRiverine invertebrates.MethodsWe compiled a database of riverine invertebrate community time series for 673 sites across six European countries spanning six freshwater ecoregions. We compared trait responses to anthropogenic impacts (quantified as changes in ‘ecological quality’) among regions for seven ‘ecological’ traits, which reflect habitat preferences, and nine ‘biological’ traits (e.g., morphology or life history), which represent taxon‐specific attributes that can influence ecosystem processes.ResultsFour ecological traits (current, microhabitat, salinity and trophic preferences) and one biological trait (dispersal mode) responded consistently across regions. These responses were primarily driven by spatial differences among poorer to better quality sites. Responses to temporal changes in quality were comparable but less pronounced.Main ConclusionsConsistent responses to anthropogenic impacts across multiple ecological traits indicate these traits may improve broader scale measurements, comparisons and predictions of community responses. However, we could not use ecological traits to identify the actions of specific stressors because multiple traits always responded as a group. Inconsistent responses across almost all biological traits indicated that these traits may be less predictive of impacts across regions. Predictions of how biological traits, and associated ecosystem processes, respond to anthropogenic impacts may be most effective at regional scales where responses are more consistent.

242 - Temporal changes in quality of the food environment at a weekly market in Tasmania

242 - Temporal changes in quality of the food environment at a weekly market in Tasmania

Effect of Prior Local Therapy on Response to First-line Androgen Receptor Axis Targeted Therapy in Metastatic Castrate-resistant Prostate Cancer: A Secondary Analysis of the COU-AA-302 Trial

BackgroundMen with localized prostate cancer are often treated with local therapy (LT). However, a proportion of these patients will eventually develop recurrence and progression requiring systemic therapy. Whether primary LT affects the response to this subsequent systemic treatment is unclear. ObjectiveWe investigated whether the receipt of prior prostate-directed LT influenced the response to first-line systemic therapy and survival in docetaxel-naïve metastatic castrate-resistant prostate cancer (mCRPC) patients. Design, setting, and participantsThis is an exploratory analysis of the COU-AA-302 trial, a multicentric double-blinded phase 3 randomized controlled trial in which mCRPC patients with no to mild symptoms were randomized to receive abiraterone plus prednisone or placebo plus prednisone. Outcome measurements and statistical analysisWe compared the time-varying effects of first-line abiraterone in patients with and without prior LT using a Cox proportional hazard model. The cut points were chosen using grid search, and were 6 and 36 mo for radiographic progression-free survival (rPFS) and overall survival (OS), respectively. We also investigated whether there was any difference in treatment effect on score change (relative to baseline) in various patient-reported outcomes (measured by Functional Assessment of Cancer Therapy—Prostate [FACT-P]) over time depending on the receipt of prior LT. The adjusted association of prior LT with survival was determined using weighted Cox regression models. Results and limitationsAmong 1053 eligible patients, 64% (n = 669) received prior LT. We did not find any statistically significant heterogeneity of time-dependent treatment effect from abiraterone on rPFS in patients with (hazard ratio [HR]: 0.36 [95% confidence interval: 0.27–0.49] at ≤6 mo; 0.64 [0.49–0.83] at >6 mo) or without (HR: 0.37 [0.26–0.55] at ≤6 mo; 0.72 [0.50–1.03] at >6 mo) prior LT. Similarly, there was no significant heterogeneity in time-dependent treatment effect on OS with (HR: 0.88 [0.71–1.10] at ≤36 mo; 0.76 [0.52–1.11] at >36 mo) or without (0.78 [0.60–1.01] at ≤36 mo; 0.55 [0.30–0.99] at >36 mo) prior LT. We did not find sufficient evidence of a difference in treatment effect from abiraterone on score change over time in prostate cancer subscale (interaction p = 0.4), trial outcome index (interaction p = 0.8), and FACT-P total score (interaction p = 0.6) depending on the receipt of prior LT. Receipt of prior LT was associated with a significant improvement in OS (average HR: 0.72 [0.59–0.89]). ConclusionsThis study demonstrates that the efficacy of first-line abiraterone and prednisone in docetaxel-naïve mCRPC do not vary significantly based on the receipt of prior prostate-directed LT. Further studies are needed to explore the plausible mechanisms of the association of prior LT with superior OS. Patient summaryThis secondary analysis of the COU-AA-302 trial suggests that survival benefits and temporal changes in quality of life with first-line abiraterone in docetaxel-naïve mCRPC do not differ significantly among patients who received versus those who did not receive prior prostate-directed local therapy.

Quality of Life in Chronic Limb Threatening Ischaemia: Systematic Review and Meta-Analysis

To assess the comparative effectiveness and temporal changes in quality of life (QoL) outcomes after revascularisation, major lower extremity amputation (MLEA), and conservative management (CM) in chronic limb threatening ischaemia (CLTI).

Did medical doctors who order abdominal CT scans during on-call hours truly become worse at clinical reasoning? Yes, they did

ObjectiveTo investigate temporal changes in clinical reasoning quality of physicians who requested abdominal CT scans at a tertiary care center during on-call hours within a 15-year period.MethodsThis retrospective study included 531 patients who underwent abdominal CT at a tertiary care center during on-call hours on 36 randomly sampled unique calendar days in each of the years between 2005 and 2019. Clinical reasoning quality was expressed as a percentage (0–100%), taking into account the degree by which the differential diagnoses on the CT request form matched the CT diagnosis. Temporal changes in the quality of clinical reasoning and number of CT scans were assessed using Mann-Kendall tests. Associations between the quality of clinical reasoning with patient age and gender, requesting department, and time of CT scanning were determined with linear regression analyses.ResultsThe median annual clinical reasoning score was 14.7% (interquartile range: 12.2 to 16.0%; range: 7.7 to 34.6%). The quality of clinical reasoning significantly decreased between 2005 and 2019 (Mann-Kendall Tau of −0.390, p = 0.048), while the number of abdominal CT scans significantly increased (Mann-Kendall tau of 0.790, p < 0.001).ConclusionThe clinical reasoning quality of physicians who request abdominal CT scans during on-call hours has deteriorated over time. Clinical reasoning appears to be worse in younger patients.Key Points• In patients with suspected acute abdominal pathology who are scheduled to undergo CT scanning, referring physicians generally have difficulties in making an accurate pretest (differential) diagnosis.• Clinical reasoning quality of physicians who request acute abdominal CT scans has deteriorated over the years, while the number of CT scans has shown a significant increase.• Clinical reasoning quality appears to be worse in younger patients in this setting.

Temporal changes in self-reported sleep quality, sleep duration and sleep medication use in relation to temporal changes in quality of life and work ability over a 1-year period among Finnish municipal employees.

In this prospective follow-up study, we aimed to examine whether changes in self-reported sleep quality, sleep duration, and sleep medication use are temporally associated with changes in quality of life and work ability in municipal employees when several confounding factors are considered. The study was conducted in Finland among 637 municipal employees (88% women, mean [SD] age 48[10]years) in 2014 and 2015. Information about the participants was collected by self-administered questionnaire and from medical history. Predicting variables were changes in self-reported sleep quality, sleep duration, and sleep medication use. Outcome variables were changes in the EUROHIS-QOL eight-item index and the Work Ability Score. Improved or unchanged sleep quality compared to worse sleep quality were associated with a preferable change in quality of life (both p < 0.001). No change in sleep duration compared to a decrease and no change in sleep medication use compared to increased use were also associated with favourable changes in quality of life. Increased use of sleep medication was associated with a decline in work ability, and the change in Work Ability Score also differed significantly between improved and worsened sleep quality. In this study, changes in sleep were widely associated with changes in quality of life and work ability of municipal employees. Programmes aiming for better sleep health would probably be beneficial both from a health-oriented and an economical point of view. Special attention should be paid to employees with a need for sleep medication.

Temporal changes in quality of life amongst European atrial fibrillation patients: relationship to all-cause mortality. A report from the ESC-EHRA EORP-AF General Long-Term Registry

Abstract Background Atrial fibrillation (AF) significantly impacts on patients' quality of life (QoL). An impaired QoL has been associated with worse outcomes even in AF patients, but contemporary data in a large-scale pan-European population are limited. Purpose We aimed to assess temporal changes in AF patients' QoL across 2 years follow-up observation, and the relationship of QoL changes with all-cause death. Methods We analyzed patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. The EQ-5D-5L questionnaire was used to assess QoL. A Health Utility Score (HUS), indicating the overall health state (1 equals perfect health), was derived. Differences throughout the follow-up (Baseline, 1-Y FU, 2-Y FU) observation were assessed. The study outcome was all-cause mortality. Results Out of a total of 11906 patients, 8097 (73.0%) were available for this analysis. Mean (SD) age was 69.1 (11.5) years; 60.8% males; median CHA2DS2-VASc and HASBLED scores were 3 (IQR 2–4) and 1 (1–2), respectively. The mean (SD) HUS at baseline was 0.815 (0.200) and 0.834 (0.196), 0.829 (0.195) at 1-year follow-up and 2-year follow-up, respectively (p&amp;lt;0.0001 for changes over time). Patients with a higher CHA2DS2-VASc score (CHA2DS2-VASc 6–9) reported a significant reduction in the quality of life, compared to the other CHA2DS2-VASc strata, with a mean (SD) HUS decreasing from 0.754 (0.214) at baseline to 0.727 (0.238) at 2-year follow-up (F=6.538, p&amp;lt;0.0001) (Figure). Multivariate analysis demonstrated that age [−0.001 (95% CI [−0.002, −0.121]) and coronary artery disease (CAD) [−0.016 (95% CI [−0.029, −0.004] were independently inversely associated with increasing QoL. Positive changes in HUS over time were inversely associated with an increase in the risk of all-cause death, even after adjusting for chronic kidney disease, liver disease, chronic obstructive pulmonary disease, oral anticoagulants and type of AF (OR:0.24, 95% CI: 0.13–0.45 for increasing HUS difference, as a continuous variable). Conclusions In a contemporary European-wide cohort of AF patients, significant temporal changes in QoL were found. Patients at higher stroke risk according to CHA2DS2-VASc score showed a significant reduction in the QoL. Age and CAD were independently associated with changes in QoL. A greater reduction in HUS (i.e. worsening QoL) over time was associated with a higher risk of all-cause death. Temporal changes in HUS Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Since the start of EORP, several companies have supported the programme with unrestricted grants

Predictors of changes in quality of life in head and neck cancer patients: a prospective study over a 6-month period.

Patients with head and neck cancer experience multiple complaints during treatment which also affect quality of life. The present study assessed predictors of temporal changes in quality of life over a 6-month period among patients treated for head and neck cancer. Patients completed questionnaires at the beginning (t1) and end (t2) of their hospital stay and 3 (t3) and 6months (t4) thereafter. Quality of life was evaluated using EORTC QLQ-C30 and QLQ-H&N35. Descriptive statistics were computed across measurement points for different domains of quality of life; predictors were identified using general linear models. Eighty-three patients (mean age: 58, SD = 11, 20.5% female) participated. Quality of life decreased during treatment and slowly recovered thereafter. From t1 to t4, there were adverse changes that patients consider to be relevant in physical and role functioning, fatigue, dyspnea, insomnia, loss of appetite, financial difficulties, problems with senses and teeth, limited mouth opening, mouth dryness, social eating, coughing, and sticky saliva. Temporal changes in global quality of life between t1 and t2 were predicted by tumor stage (B = - 5.6, p = 0.04) and well-being (B = 0.8, p = 0.04); radiotherapy was a predictor of temporal changes in physical functioning (B = - 12.5, p = 0.03). Quality of life decreases during treatment, half a year after hospital stay there are still restrictions in some areas. A special focus should be given on head and neck cancer patient's quality of life in the aftercare.

Evaluation of the impact of the voucher and accreditation approach on improving reproductive health behaviors and status in Kenya

AbtsractBackgroundAlternatives to the traditional 'supply-side' approach to financing service delivery are being explored. These strategies are termed results-based finance, demand-side health financing or output-based aid which includes a range of interventions that channel government or donor subsidies to the user rather than the provider. Initial pilot assessments of reproductive health voucher programs suggest that, they can increase access and use, reducing inequities and enhancing program efficiency and service quality. However, there is a paucity of evidence describing how the programs function in different settings, for various reproductive health services. Population Council, funded by the Bill and Melinda Gates Foundation, intends to generate evidence around the 'voucher and accreditation' approaches to improving the reproductive health of low income women in Kenya.Methods/DesignA quasi-experimental study will investigate the impact of the voucher approach on improving reproductive health behaviors, reproductive health status and reducing inequities at the population level; and assessing the effect of vouchers on increasing access to, and quality of, and reducing inequities in the use of selected reproductive health services. The study comprises of four populations: facilities, providers, women of reproductive health age using facilities and women and men who have been pregnant and/or used family planning within the previous 12 months. The study will be carried out in samples of health facilities - public, private and faith-based in: three districts; Kisumu, Kiambu, Kitui and two informal settlements in Nairobi which are accredited to provide maternal and newborn health and family planning services to women holding vouchers for the services; and compared with a matched sample of non-accredited facilities. Health facility assessments (HFA) will be conducted at two stages to track temporal changes in quality of care and utilization. Facility inventories, structured observations, and client exit interviews will be used to collect comparable data across facilities. Health providers will also be interviewed and observed providing care. A population survey of about 3000 respondents will also be carried out in areas where vouchers are distributed and similar locations where vouchers are not distributed.

Temporal Changes in Quality of Life (QoL) of Patients With Primary Brain Tumors: Raw QoL Data From a Randomized Trial as Reference for Future Studies

Temporal Changes in Quality of Life (QoL) of Patients With Primary Brain Tumors: Raw QoL Data From a Randomized Trial as Reference for Future Studies

Assessment of source-sink theory for predicting demographic rates among habitats that exhibit temporal changes in quality

Within the framework of Pulliam's source-sink model we tested predictions of habitat-specific demography on a "closed" population of muskrats (Ondatra zibethicus L.) occupying three contiguous habitats that exhibited temporal changes in quality and quantity. We were able to distinguish between dispersal among habitats and mortality within each habitat, and induce temporal variation in operational-habitat availability and suitability by manipulating water level. Temporal variation in population size and density among habitats supported the source-sink model and was primarily associated with habitat-specific survival rates. For example, the mean annual over-winter mortality rate of individuals in the principal source habitat (0.87) was less than in the sink habitat (0.94), and subsequently the mean annual finite rate of increase (λ) was positive in the source habitat (λ = 1.41) and negative in the sink habitat (λ = 0.90). The high recruitment rate of juveniles in the prime habitat during autumn was also associated with significant emigration of juveniles from this habitat. Emigration of adults among habitats provided support for the role of spacing behaviour in regulating the breeding density of muskrats in prime habitat. However, in contrast to the assumption of source-sink theory, year-to-year variation in survival rate in the more marginal habitats appeared to be explained more by temporal changes in habitat suitability than by density. Significant emigration of juveniles from the sink habitat was not predicted and was largely dependent on current habitat conditions. In addition, the mean annual emigration rate was lowest in the principal source habitat (0.30) and highest in the more marginal habitats (0.62). Failure to detect directional emigration from prime to marginal habitats in the spring, as predicted by the source-sink model, was likely due to declining local population size. In environments where spatial differences in habitat quality are not static, and annual change in local population size is largely independent of density, current source-sink models must be modified to better predict individual dispersal strategies.

Assessment of source-sink theory for predicting demographic rates among habitats that exhibit temporal changes in quality

Assessment of source-sink theory for predicting demographic rates among habitats that exhibit temporal changes in quality

Saratoga Springs and Early Hydrogeochemistry in the United States

AbstractThe earliest quantitative chemical analysis of ground water from the United States was probably made during 1807. The largest number of early analyses were of water from various mineral springs in and near the towns of Ballston and Saratoga Springs, New York. Although most of the scientific and economic interest at the time centered on the reported health benefits from the water, some of the earliest reports describing the springs contained rudimentary yet scientifically based hydrogeochemical explanations for the dissolved constitutents in the water. One motivation for the early analytical work was the desire to concoct a dry mixture of chemicals that would duplicate the mineral water when mixed with ordinary drinking water. The use of a powder would simplify distribution and bypass dealing with owners of the springs. Early analyses of water from Congress Spring published by different individuals between 1817 and 1856 are similar, and if allowance is made for minor temporal changes in quality, the results would be considered useful even by modern standards.

On the Evolutionary Stability of Dispersal to Sink Habitats

On the Evolutionary Stability of Dispersal to Sink Habitats