Performance measurement part II: A guide to developing dermatology performance measures.

Throughout the 21st century, national and local governments, private health sectors, health insurance companies, healthcare professionals, labor unions, and consumers have been striving to develop an effective approach to evaluate, report, and improve the quality of healthcare. As medicine improves and health systems grow to meet patient needs, the performance measurement system of care effectiveness must also evolve. Continual efforts should be undertaken to effectively measure quality of care to create a more informed public, improve health outcomes, and reduce healthcare costs.

Performance measurement part I: Foundational knowledge for measure development.

As medicine is moving toward performance and outcome-based payment and is transitioning away from productivity-based systems, value is now being appraised in healthcare through "performance measures." Over the past few decades, assessment of clinical performance in health care has been essential in ensuring safe and cost-effective patient care. The Centers for Medicare & Medicaid Services is further driving this change with measurable, outcomes-based national payer incentive payment systems.

Color-Encoded Links Improve Homophily Perception in Node-Link Diagrams.

Node-link diagrams enable visual assessment of homophily when viewers can identify and evaluate the relative number of intra-cluster and inter-cluster links. Our online experiment shows that a new design with link type encoded edge color leads to more accurate perception of homophily than a design with same-color edges.

Lollipops Help Align Visual and Statistical Fit Estimates in Scatterplots With Nonlinear Models.

Scatterplots overlayed with a nonlinear model enable visual estimation of model-data fit. Although statistical fit is calculated using vertical distances, viewers' subjective fit is often based on shortest distances. Our results suggest that adding vertical lines ("lollipops") supports more accurate fit estimation in the steep area of model curves (https://osf.

Participatory Development of a Modular Advance Care Planning Program in Pediatric Palliative Care (MAPPS).

Context: Decision-making in pediatric palliative care concerns mainly children without decision-making capacity. It has to balance the child's best interests, parental responsibility and the impact on the family system.

Objectives: Advance care planning (ACP) supports decision making about future medical care.

Optimized procedures for testing plasma metanephrines in patients on hemodialysis.

Diagnosis of pheochromocytomas and paragangliomas in patients receiving hemodialysis is troublesome. The aim of the study was to establish optimal conditions for blood sampling for mass spectrometric measurements of normetanephrine, metanephrine and 3-methoxytyramine in patients on hemodialysis and specific reference intervals for plasma metanephrines under the most optimal sampling conditions. Blood was sampled before and near the end of dialysis, including different sampling sites in 170 patients on hemodialysis.

Visual Model Fit Estimation in Scatterplots: Influence of Amount and Decentering of Noise.

Scatterplots with a model enable visual estimation of model-data fit. In Experiment 1 (N = 62) we quantified the influence of noise-level on subjective misfit and found a negatively accelerated relationship. Experiment 2 showed that decentering of noise only mildly reduced fit ratings.

Visual Model Fit Estimation in Scatterplots and Distribution of Attention.

Scatterplots are ubiquitous data graphs and can be used to depict how well data fit to a quantitative theory. We investigated which information is used for such estimates. In Experiment 1 ( = 25), we tested the influence of slope and noise on perceived fit between a linear model and data points.

Acute effects of supplemental oxygen therapy using different nasal cannulas on walking capacity in patients with idiopathic pulmonary fibrosis: a randomised crossover trial.

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Identifying key elements for paediatric advance care planning with parents, healthcare providers and stakeholders: A qualitative study.

Background: Although international guidelines recommend discussions about goals of care and treatment options for children with severe and life-limiting conditions, there are still few structured models of paediatric advance care planning.

Aim: The study aimed at identifying key components of paediatric advance care planning through direct discussions with all involved parties.

Design: The study had a qualitative design with a participatory approach.

Solvent effects on the crystal structure of silver pentacyanocyclopentadienide: supramolecular isomerism and solvent coordination.

Several coordination polymers of silver(i)-pentacyanocyclopentadienide (PCC) were studied by X-ray diffraction to examine the effects of different solvents on supramolecular isomerism of the PCC-ligand. While alcohols yield supramolecular isomers of [Ag(PCC)] without coordination of solvent molecules, less polar solvents show coordinate binding. The influence of solvent polarity can be observed by a gradual change in the lattice structure featuring distinct motifs.

Image noise reduction technology allows significant reduction of radiation dosage in cardiac device implantation procedures.

Background: Novel x-ray systems with real-time image noise reduction technology (INRT) to reduce radiation dose during fluoroscopy and cine acquisition have become available. This study evaluated the reduction of radiation dose in device implantation with INRT.

Methods: Radiation dose data from 132 consecutive new device implantation procedures (102 pacemaker [PM] or implantable cardioverter defibrillator [ICD] and 30 cardiac resynchronization therapy [CRT] devices) performed between January 2015 and December 2015 on an angiography system with INRT (Allura ClarityIQ) were collected.

Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study.

Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues.

Reducing Radiation Dose in Coronary Angiography and Angioplasty Using Image Noise Reduction Technology.

This study sought to quantitatively evaluate the reduction of radiation dose in coronary angiography and angioplasty with the use of image noise reduction technology in a routine clinical setting. Radiation dose data from consecutive 605 coronary procedures (397 consecutive coronary angiograms and 208 consecutive coronary interventions) performed from October 2014 to April 2015 on a coronary angiography system with noise reduction technology (Allura Clarity IQ) were collected. For comparison, radiation dose data from consecutive 695 coronary procedures (435 coronary angiograms and 260 coronary interventions) performed on a conventional coronary angiography system from October 2013 to April 2014 were evaluated.

Microwave Cooking Practices in Minnesota Food Service Establishments.

Uneven cooking due to consumer use of microwave ovens to cook food products that have been prepared but are not ready to eat has been a documented risk factor in several foodborne disease outbreaks. However, the use of microwave ovens in restaurants and other food service establishments has not been well documented. The aim of this study was to describe the types of food service establishments that use microwave ovens, how these ovens are used, types of foods heated or cooked in these ovens, types of microwave ovens used in food service establishments, and the level of compliance with U.

Quantitative data analysis to determine best food cooling practices in U.S. restaurants.

Data collected by the Centers for Disease Control and Prevention (CDC) show that improper cooling practices contributed to more than 500 foodborne illness outbreaks associated with restaurants or delis in the United States between 1998 and 2008. CDC's Environmental Health Specialists Network (EHS-Net) personnel collected data in approximately 50 randomly selected restaurants in nine EHS-Net sites in 2009 to 2010 and measured the temperatures of cooling food at the beginning and the end of the observation period. Those beginning and ending points were used to estimate cooling rates.

Managerial practices regarding workers working while ill.

Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S.

Restaurant manager and worker food safety certification and knowledge.

Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training.

Food worker experiences with and beliefs about working while ill.

Transmission of foodborne pathogens from ill food workers to diners in restaurants is an important cause of foodborne illness outbreaks. The U.S.

Handling practices of fresh leafy greens in restaurants: receiving and training.

Multiple foodborne illness outbreaks have been associated with the consumption of fresh produce. Investigations have indicated that microbial contamination throughout the farm-to-fork continuum often contributed to these outbreaks. Researchers have hypothesized that handling practices for leafy greens in restaurants may support contamination by and proliferation and amplification of pathogens that cause foodborne illness outbreaks.

Restaurant food cooling practices.

Improper food cooling practices are a significant cause of foodborne illness, yet little is known about restaurant food cooling practices. This study was conducted to examine food cooling practices in restaurants. Specifically, the study assesses the frequency with which restaurants meet U.

Recordkeeping practices of beef grinding activities at retail establishments.

Ground beef has been implicated as a transmission vehicle in foodborne outbreaks of infection with pathogens such as Escherichia coli O157:H7 and Salmonella. During outbreak investigations, traceback of contaminated beef to the producing facility is often unsuccessful because of inadequate recordkeeping at retail establishments that grind beef products. We conducted a survey in three states participating in the Environmental Health Specialists Network to describe beef grinding and recordkeeping practices at retail establishments.

Tomato handling practices in restaurants.

In recent years, multiple outbreaks of Salmonella infection have been associated with fresh tomatoes. Investigations have indicated that tomato contamination likely occurred early in the farm-to-consumer chain, although tomato consumption occurred mostly in restaurants. Researchers have hypothesized that tomato handling practices in restaurants may contribute to these outbreaks.

Factors related to food worker hand hygiene practices.

To identify factors related to food worker hand hygiene practices, we collected (i) observational data on food worker (n = 321) hand hygiene practices (hand washing and glove use) and (ii) observational and interview data on factors related to hygiene behavior, such as worker activity, restaurant characteristics, worker food safety training, and the physical and social environment. Results indicated that hand washing and glove use were more likely to occur in conjunction with food preparation than with other activities (e.g.