Criteria and indicators to evaluate quality of care in genitourinary tumour boards.

PURPOSE: Genitourinary (GU) multidisciplinary tumour boards (GUMTBs) are key components of patient care, as they might lead to changes in treatment plan, improved survival, and increased adherence to guidelines. However, there are no guidelines on how GUMTBs should operate or how to assess their quality of performance. METHODS: A systematic literature review was conducted to identify criteria and indicators to evaluate quality in GUMTBs. A scientific committee-comprising 12 GU cancer specialists from seven disciplines-proposed a list of criteria and developed indicators, evaluated in two rounds of Delphi method. Appropriateness and utility of indicators were scored using a 9-point Likert scale. Consensus was defined as at least two-thirds of Delphi respondents selecting a score sub-category that encompassed the median score of the group. RESULTS: Forty-five criteria were selected to evaluate the quality of GUMTBs covering five dimensions: organisation, personnel, protocol and documentation, resources, and interaction with patients. Then, 33 indicators were developed and evaluated in the first round of Delphi, leading to a selection of 26 indicators in two dimensions: function, governance and resources, and GUMTB sessions. In the second round, consensus was reached on the appropriateness of all 26 indicators and on the utility of 24 of them. Index cards for criteria and indicators were developed to be used in clinical practice. CONCLUSIONS: Criteria and indicators were developed to evaluate the quality of GUMTBs, aiming to serve as a guide to improve quality of care and health outcomes in patients with GU cancer.

Biogeochemical assessment of resilient humus formations from virgin and cultivated northern Botswana soils.

Humic matter in virgin and cultivated Vertisols and Arenosols from Pandamatenga (northern Botswana) has been studied by chemical fractionation and visible and infrared derivative spectroscopies. The in vitro soil respiration was also determined. Soils contained <15 g of total C kg(-1) and displayed scant mineralization activity. In Vertisols, cultivation has led to scarce significant changes in humus characteristics, pointing to a noteworthy resilience of the organic matter. Humic acids showed a very dark color, indicating a large concentration of aromatic structures and stable free radicals. Infrared spectra were featureless and alike. This strong structural stability is also suggested by Curie-point pyrolysis of humic acids, which failed to yield substantial amounts of diagnostic products, mainly in the case of Vertisols. Some unexpected similarities between Vertisols and Arenosols indicate that the influence of external factors on the humic acid formation processes prevails on that of the geological substrate. In Pandamatenga soils only small amounts of recalcitrant C and N forms are sequestered; they represent stable pools relatively independent from short- or medium-term climatic changes or management practices.