Furthermore, the study aimed to correlate the perceived quality of patient-GP communication with the motives inducing individuals to change their doctors.

All people requesting to change their GPs were asked by the office staff to complete a questionnaire.

The study identifies the following main reasons for changing GP: patients perceived the doctor as unwilling to listen to them; patients did not receive the Crenolanib supplier services that they considered useful for their health; and patients perceived the doctor’s disorganization as an obstacle to accessibility.

These findings suggest several actions to improve the doctor-patient relationship, including training for

physicians to develop their communication skills; MI-503 in vivo involving public health operators in helping to understand the rights and obligations of patients and doctors; and a reorganization of the GP’s workload.”
“The essential oil from air dried

buds and roots of Calligonum polygonoides Linn., has been extracted from dry steam distillation and analysed for chemical composition by gas chromatographymass spectrometry. In total, 27 and 10 compounds were analysed qualitatively and quantitatively, accounting for 68.42% and 82.12% total contents of the essential oils of buds and roots, respectively. It contains a complex mixture of terpenoids, hydrocarbons, phenolic compounds, acid derivatives and ketones. The main component of essential oil Histone Methyltransf inhibitor was ethyl homovanillate (11.79%) in buds and drimenol (29.42%) in roots.”
“Background: To examine the effects of a 6 month lifestyle intervention on quality of life, depression, self-efficacy and

eating behavior changes in overweight and obese endometrial cancer survivors.

Methods: Early stage endometrial cancer survivors were randomized to intervention (n = 23) or usual care (n = 22) groups. Chi-square, Student’s t-test and repeated measures analysis of variance were used in intent-to-treat analyses. Outcomes were also examined according to weight loss.

Results: Morbidly obese patients had significantly lower self-efficacy, specifically when feeling physical discomfort. There was a significant improvement for self-efficacy related to social pressure (p = .03) and restraint (p = .02) in the LI group. There was a significant difference for emotional well-being quality of life (p = .02), self-efficacy related to negative emotions (p < .01), food availability (p = .03), and physical discomfort (p = .01) in women who lost weight as compared to women who gained weight. Improvement in restraint was also reported in women who lost weight (p < .01).

Conclusion: This pilot lifestyle intervention had no effect on quality of life or depression but did improve self-efficacy and some eating behaviors.

Trial Registration: http://www.clinicaltrials.

Using the ICECAP, the number of errors detected correlated well between two observers (Spearman rho = 0.984, p < 0.001). Both observers identified all moderate or severe errors similarly and categorised all but 4/139 (2.9%) of the total errors in an identical fashion.

Self-reporting of errors without prompting identified a mean of 24.4% (range 0-50%) of all recorded errors, whereas surgical teams reported a mean of 69.7% (range 50-100%) of errors when ICECAP error-category prompts were used.

Conclusion: The ICECAP tool may be useful for capturing and categorising errors that occur during vascular/endovascular procedures. ICECAP may also have a role as an error recall prompt for self-reporting selleckchem purposes by vascular surgical teams. (C) 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.”
“Background. Percutaneous electrical TPX-0005 price nerve stimulation (PENS) is an electrical neuromodulation technique that has shown its therapeutic potential in various chronic pain conditions over the past few years, but well-blinded controlled studies are lacking.

Patients and Methods. A randomized double-blind sham-controlled crossover trial on 31 patients with chronic pain with surface hyperalgesia to investigate

the efficacy of PENS.

Results. For the active PENS therapies, the median numerical rating scale (NRS) for pain changed from 7.5 (standard deviation [SD] +/- 1) (range 6-10) before therapy to 0.5 (range 0-8.5) after therapy (Z = -4.206, P < 0.0005 [two-tailed]). The mean pain pressure threshold (PPT) measured with the

von Frey aesthesiometer HSP inhibition changed from 202 gm (SD +/- 137 gm) (range 55-800 gm) before therapy to 626 gm (SD +/- 228 gm) (range 45-800 gm) after therapy (Z = -4.373, P < 0.0005 [two-tailed]). There was a statistically significant difference between the changes in NRS for the active (3.9 [+/- 3.2] [0-8]) compared with the sham (0.1 [+/- 0.4] [0-1.5]) therapies, U = 40, Z = -3.484, P < 0.0001 (two-tailed). There was a statistically significant difference between the changes in PPT for the active (310 gm [+/- 267 gm] [0-670 gm]) compared with the sham (8 gm [+/- 4 gm] [0-15 gm]) therapies, U = 48.5, Z = -2.699, P = 0.007 (two-tailed).

Conclusion. PENS therapy appears to be effective in providing short-term pain relief in chronic pain conditions. Studies, involving larger sample sizes and longer follow-up are recommended.”
“Objectives: Thrombotic complications are common in vascular surgery patients. Non-O blood types are. associated with an increased risk of thrombo-embolic diseases. The aim of this study is to assess the prognostic implications of non-O vs. 0 blood type regarding 30-day cardiovascular events and long-term mortality after vascular surgery.

“
“To estimate the prevalence of genital tract tuberculosis (TB) among infertile women during laparoscopic evaluation for infertility in a prospective observational study.

A total of 420 infertile women were included. All patients had laparoscopy and all suspicious lesions were biopsied and peritoneal fluids aspirated. Full endometrial curettage followed by histopathological examination was done for specimens. Polymerase chain reaction test (PCR) was performed for all peritoneal fluid selleck chemicals llc samples and tissue biopsy.

Genital tract tuberculosis was diagnosed with laparoscopy

and confirmed by tissue biopsy in 24 patients (5.7%). Visual laparoscopic findings and direct tissue biopsy had the highest sensitivity and specificity (92-94%, respectively) followed by PCR (83-85%) and lastly endometrial biopsy (75-80%) for diagnosis of genital tuberculosis. The incidence of genital tuberculosis was higher among rural patients check details with low socioeconomic and educational levels.

Genital tuberculosis has a role in the etio-pathogenesis of infertility. Laparoscopy and direct tissue biopsy are the gold standards for its diagnosis.”
“The present study has concentrated on finding a new stationary phase in liquid chromatography. To improve the selectivity of monolithic column, a new ionic liquids-based (ILs-based) monolithic column (150 x 4.6 mm i.d.) is synthesized. Characteristic and evaluation of monolithic

column are investigated by field emission-scanning electron microscopy (FE-SEM) and determination of caffeine and theophylline in high performance liquid chromatography (HPLC). FE-SEM images show that this monolithic column has a porosity structure. At the condition of mobile phase was 0.06 mol L(-1) Na(2)HPO(4) (pH 9.0) and flow rate was 0.7 mL min(-1), a good linear relationship was demonstrated when the concentrations of caffeine and theophylline were in the range of 0.1-60.0 mu g mL(-1). These two compounds can obtain better resolution

on the ILs-based monolithic column than non-ILs monolithic column, and the recoveries ranged from 97.40% to 108.00% and the interday and intraday relative standard deviations were less than 5%. The HPLC method, developed in this study, was proved to be acceptable for drugs assay, and this this website ILs-based monolithic column as the stationary phase was a potential tool for future HPLC separation. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 118: 3425-3430, 2010″
“Study Design. Anatomic study.

Objective. The purpose of this study is to determine the effect of the slip amount, slip angle, and disc height on the geometry of the L5 foramen in low-grade, low-dysplasia isthmic L5 spondylolisthesis using a human cadaveric model.

Summary of Background Data. Radicular pain and varying degrees of nerve root dysfunction are present in many adult isthmic spondylolisthesis patients and can be the result of compression of the L5 root within its foramen.

Methods.

(The journal of Neuropsychiatry and Clinical Neurosciences 2011; 23:375-383)”
“A common model used for preclinical research was in vitro human tumor cell culture. An alternative model was the direct implantation of a unique patient’s tumor biopsy specimens into immunodeficient host mice. Published data from PubMed (http://lib-proxy.pnc.edu:2148) and Current Contents Connect databases (http://thomsonreuters.com/products_services/science/science_products/a-z/current_contents_connect) were

reviewed. Prostate cancer (PCa) heterotransplantation was evaluated using histopathology, morphology, cell differentiation, DNA content, tumor marker expression, metastases, tumor Selleck VX-680 kinetics, tumor take rate and tumor vasculature in the first tumor heterotransplant. The heterotransplanted tumor retained the biological properties of the original tumor, such as morphology, degree

of differentiation, pathology, secretory activity, expression of tumor markers and human vasculature. Human PCa heterotransplants have considerable experimental advantages over cell culture following xenotransplantation.”
“Twist boundaries in the deep-UV nonlinear optical crystal KBe(2)BO(3)F(2) (KBBF) are studied through first-principles calculations. It was found that the optical qualities and the capability for second-harmonic generation (SHG) in KBBF obtained from the different single-crystal growth methods are very different. These properties are associated with the presence of defects. Our studies demonstrate that the (0001) twist boundaries in KBBF are easily formed due to the quite https://www.selleckchem.com/products/CAL-101.html weak interaction between the in-plane layers. These grain boundaries have very small influences on the modifications of the UV optical absorption

edge and the refractive indices in KBBF. However, the SHG conversion efficiency in KBBF can be significantly deteriorated as the (0001) twist boundaries occur, so it is necessary to eliminate these twist boundaries during the single-crystal growth processes. Our theoretical results are consistent with experimental observations. (C) 2011 American Institute of Physics. [doi:10.1063/1.3569836]“
“Hashimoto’s encephalopathy, first described in 1966, is still CYT387 JAK/STAT inhibitor problematic in terms of its pathophysiology, diagnosis, and treatment. The syndrome is more common in women, and is associated with autoimmune antithyroid antibodies. Presentation varies considerably; there may be episodes of cerebral ischemia, seizure, or psychosis, or there may be depression, cognitive decline, and periods of fluctuating consciousness. Because the symptoms respond so well to immunosuppressive treatment, prompt diagnosis and management are important. Here, the authors present a representative case report, along with a comprehensive review of current literature.

“
“To evaluate long-term clinical results of lumbar total disc replacement (TDR) compared with posterior lumbar fusion.

This prospective randomized High Content Screening controlled trial comprised 152 patients; 80 were randomized to TDR and 72 to fusion. All patients had chronic low back pain (CLBP) and

had not responded to nonsurgical treatment. Primary outcome measure was global assessment of back pain (GA), secondary outcome measures were back and leg pain, Oswestry Disability Index (ODI), EQ5D, and SF-36. All measures were collected from SweSpine (Swedish national register for spinal surgery) at 1, 2, and 5 years. Follow-up rate at 5 years was 99.3 %.

Both groups showed clinical improvement at 5-year follow-up. For GA, 38 % (30/80) in the TDR group were totally pain free vs. 15 % (11/71) in the fusion group (p < 0.003). Back pain and improvement selleckchem of back pain

were better in the TDR group: VAS back pain at 5 years 23 +/- A 29 vs. 31 +/- A 27, p = 0.009, and VAS improvement of back pain at 5 years 40 +/- A 32 vs. 28 +/- A 32, p = 0.022. ODI and improvement in ODI were also better in the TDR group: ODI at 5 years 17 +/- A 19 vs. 23 + 17, p = 0.02 and ODI improvement at 5 years 25 +/- A 18 vs. 18 +/- A 19 (p = 0.02). There was no difference in complications and reoperations between the two groups.

Global assessment of low back pain differed between the two surgical groups at all follow-up occasions. Significant differences between groups concerning back pain, pain improvement, and ODI were present at 1 year and disappeared at 2 years, but reappeared at the 5-year follow-up.”
“An acidic polygalacturonase (PG) from Aspergillus kawachii was produced by solid state fermentation employing a polyurethane foam support. The conditions used for the production of acidic PG were particle size of support (0.6 or 500 mm(3)) and fermentation time. From the factors CT99021 studied, 3 the particle size had important influence on enzyme production. The best conditions for acidic PG production were 0.6 turn particle size, 18 hr at 30 degrees C and initial pH

of 5.0. In addition, pectin was extracted from citrus pomaces (grapefruit, lime, and tangerine) by acidic PG at 50 degrees C for 24 hr with citric acid solution. Infrared spectroscopy showed that lime pomace had more high-methoxylated (65%) endogenous pectin than was obtained than from grapefruit or tangerine pomaces. The enzymatically extracted pectin yield in dry basis (d.b.) for grapefruit and lime pectins were 6.95 and 4.25%, respectively. The citric acid solution alone also contributed to pectin extraction from citrus pomaces (7-9%, d.b.). Limited pectin extraction by acidic PG from tangerine pomace was most likely due to the presence of low-methoxylated endogenous pectin. The enzymatic method for pectin extraction using acidic PG from A. kawachii is a promising technique for releasing highly polymerized pectic substances from high-methoxylated lime or grapefruit pomaces.

13; 95% CI: -18.44 to -3.82) and moderate evidence 2 RCTs, N = 102) that exercises are more effective for functional status on short-term follow-up (WMD: -6.50; 95% CI: AP24534 in vivo -9.26 to -3.74). None of the studies reported that exercises increased the reoperation rate. We also found low quality evidence (2 RCTs, N = 103) that high intensity exercises are slightly more effective

than low intensity exercise programs for pain in the short-term (WMD: -10.67; 95% CI: -17.04 to -4.30) and moderate evidence (2 RCTs, N = 103) that they are more effective for functional status in the short-term (standardized mean difference [SMD] -0.77; 95% CI: -1.17 to -0.36). Finally, we found low quality evidence (3 RCTs, N = 95) that there were no significant differences between supervised and home exercises for short-term

pain relief (SMD: -1.12; 95% CI: -2.77-0.53) or functional status find more (3 RCT, N = 95; SMD -1.17; 95% CI: -2.63-0.28).

Conclusion. Exercise programs starting 4 to 6 weeks postsurgery seem to lead to a faster decrease in pain and disability than no treatment. High intensity exercise programs seem to lead to a faster decrease in pain and disability than low intensity programs. There were no significant differences between supervised and home exercises for pain relief, disability, or global perceived effect. There is no evidence that active programs increase the reoperation rate after first-time lumbar surgery.”
“Background and aim: To evaluate the prevalence of subclinical cardiovascular (CV) abnormalities in systemic lupus erythematosus (SLE) stratified according to SLE-related organ damage using the Systemic Lupus International Collaborating Clinics (SLICC) damage index.

Methods 4EGI-1 clinical trial and results: We selected SLE patients without clinically

overt CV events (n = 45, 56% with SLICC. = 0, 44% with SLICC = 1-4). CV evaluation was performed using cardiac and vascular echo-Doppler techniques. Post-ischemic flow-mediated dilation (FMD) over nitroglycerine-mediated dilation (NMD) of the brachial artery < 0.70 defined endothelial dysfunction.

The prevalence of preclinical CV abnormalities (CVAbn, including at least one of the following-carotid atherosclerosis, Left ventricular (LV) hypertrophy, low arterial compliance, LV watt motion abnormalities, aortic regurgitation, FMD/NMD < 0.70)-was 64% (16/25) in patients with SLICC = 0 and 80% (16/20) in those with SLICC > 0 (p = not significant (NS)). In particular, the prevalence of carotid atherosclerosis (28% vs. 16%), of LV hypertrophy (12% vs. 6%) and of LV watt motion abnormalities (15% vs. 12%), of low global arterial compliance (18% vs. 10%), prevalence of aortic regurgitation (30% vs. 18%) and/or aortic valve fibrosclerosis (10% vs. 8%), FMD < 10% (14 +/- 5% vs. 14% +/- 6) and prevalence of FMD/NMD < 0.70 (53% vs.

5%). Prevalence of clinically relevant POP was 21%. Multivariate analysis demonstrated significantly higher odds ratios on the report of vaginal bulging, parity a parts per thousand yen2 and a mother with POP. The receiver operating characteristic curve showed areas under the curve of 0.672 and 0.640.

The prevalence of POP at or beyond the hymen could be estimated in a general female population using our prediction model with 17 questions and our POP score chart with eight questions.”
“Magnetization and Mossbauer spectroscopy measurements are performed at low temperature under high field, on

nanoparticles with a nickel ferrite core and a maghemite shell. These nanoparticles present finite size and surface effects, together with exchange anisotropy. Selleckchem 5-Fluoracil High field magnetization brings the evidences of a monodomain ordered core and surface spins freezing in disorder at low temperature. Mossbauer spectra at 4.2 K present an extra contribution from the disordered surface which is field dependent. Field and size dependences of this latter show a progressive spin alignment along the ferrite core which is size dependent. The weak surface pinning condition of the nanoparticles

confirms that the spin disorder is localized in the external shell. The underfield decrease in the mean canting angle in the superficial shell is then directly related to the unidirectional exchange anisotropy through the interface between the ordered core and the disordered shell. The obtained anisotropy Z-IETD-FMK cost field H(Ea) scales as the inverse of the nanoparticle diameter, validating its interfacial origin. The associated anisotropy constant K(Ea) equals 2.5 x 10(-4) J/m(2). (C) 2009

American Institute qf Physics. [doi: 10.1063/1.3245326]“
“The aim of the study was to determine whether successful incontinence pessary fitting or pessary size can be predicted by specific POPQ measurements in women without EPZ004777 clinical trial advanced pelvic organ prolapse.

In a multicenter study, women with stress urinary incontinence (SUI) and POPQ stage a parts per thousand currency sign2 were randomized to three treatment arms: (1) incontinence pessary, (2) behavioral therapy, or (3) both. This study evaluates incontinence pessary size, POPQ measures, and successful fitting in the 266 women assigned to treatment arms 1 and 3.

Two hundred thirty-five women (92%) were successfully fitted with an incontinence ring (n = 122) or dish (n = 113). Hysterectomy, genital hiatus (GH), and GH/total vaginal length (TVL) ratios did not predict unsuccessful fitting (p > 0.05). However, mean TVL was greater in women successfully fitted (9.6 vs. 8.8 cm, p < 0.01). Final pessary diameter was not predicted by TVL, point D, or point C (p > 0.05).

The vast majority of women with SUI can be successfully fitted with an incontinence pessary, but specific POPQ measures were not helpful in determining incontinence pessary size.

This treatment also offers a tool to understand the processes involved in budbreak. A genomics approach is presented here to increase our understanding of budbreak in kiwifruit. Most genes identified following HC application appear to be associated with responses to stress, but a number of genes appear to be associated with the reactivation of growth. Three patterns of gene expression were identified: Profile 1, an HC-induced transient activation; Profile 2, an HC-induced transient activation followed by a growth-related

activation; and Profile 3, HC- and growth-repressed. One group of genes that was rapidly up-regulated in response to HC was the glutathione S-transferase (GST) class of genes, which have been associated with stress YH25448 cost and signalling. Previous budbreak studies, in three other species, also report up-regulated GST expression. Phylogenetic

analysis of these GSTs showed that they clustered into two sub-clades, suggesting a strong correlation between their expression and budbreak across species.”
“Study Design. Morphology comparisons between the pedicle and pedicle rib unit in the immature spine were conducted through computed tomographic scans.

Objective. To establish reference data 3-deazaneplanocin A ic50 concerning the dimensions of the pedicle rib unit for normal children.

Summary of Background Data. Until recently, studies on extrapedicular fixation were mostly based on adults. No published study has assessed the morphology of the pedicle rib unit in the normal immature population. Establishment of the basic morphometric characteristics may be beneficial in treating immature patients with spinal disorders.

Methods. Measurements were carried out on the chest computed

tomography scans Tyrosine Kinase Inhibitor Library purchase of the immature Chinese patients without any spinal disorder findings. The width, chord length, and transverse angle of the pedicle rib unit were obtained and compared with the corresponding pedicle index. Difference between sex groups was measured, and significant statistical correlations were carefully studied to determine potentially important clinical relationships.

Results. The mean values and the standard deviations obtained for each thoracic segment were determined. The width, chord length, and transverse angle of the pedicle rib unit were significantly larger than corresponding pedicle measurements at all levels. Significant difference for measurements between sexes was found at some segments. Compared with the sex, age seemed to have a more significant effect on the measurements. Linear pedicle and pedicle rib unit dimensions had good correlations with age, whereas the transverse angle seemed to change little with age.

Conclusion. Compared with the dimensions of the immature pedicle, the significantly larger size of the corresponding pedicle rib unit provides a more ample space, which accommodates screws with larger diameters.

Children and families should be advised to eat a diet high in fruits, vegetables, whole grains, low-fat or nonfat dairy products, beans, fish, and lean meats, while limiting sugar, fast food, and highly processed foods. Children should engage in at least 60 minutes per day of moderate to vigorous physical activity, and screen time (e.g., television, computer, video games) should be limited to no more than one to two hours of quality programming daily. Most school-aged children require 11 hours of

sleep per night. Decreased sleep is associated with EGFR inhibitor behavioral issues, decreased concentration at school, and obesity. Children should brush their teeth twice per day with a toothpaste containing fluoride. Unintentional injury is the leading Selleck HDAC inhibitor cause of death in this age group in the United States, and families should be counseled on traffic, water, sports, and firearm safety. Because high-risk behaviors may start in early adolescence, many experts recommend screening for tobacco, alcohol, and drug use beginning at 11 years of age. Sexually active adolescents

should be counseled on protecting against sexually transmitted infections, and should be screened for these infections if indicated. (Am Fam Physician. 2011;83(6):689-694. Copyright (C) 2011 American Academy of Family Physicians.)”
“Study design: By analyzing a large number of surgical selleck compound patients, we identified the roles of wedge-shaped changes in related surgeries.

Objectives: To illustrate the relevance of vertebral wedge-shaped changes in X-ray imaging at supine and standing positions in patients with percutaneous kyphoplasty as well as the postoperative effect.

Setting: All patient data were collected from a hospital in China.

Methods: Between June 2006 and May 2010, 77 surgical patients (9 men and 68 women) with wedge-shaped compression fractures were retrospectively analyzed. Patients were divided into group A (Delta WR >=

2.5%) and group B (Delta WR < 2.5%) according to the dynamic changes in the percentage of vertebral body wedge-shaped variable ratio (WR) at supine and standing positions. The intensity of back pain in different positions pre- and postoperatively was evaluated with a visual analog pain scale (VAS).

Results: The WRs in both standing and supine positions were significantly reduced by kyphoplasty in both groups A and B. In agreement with the improvement in WRs, the VAS was significantly decreased in three positions for patients in group A and in turning over and standing position for patients in group B. With respect to Delta WR changes, group B revealed significantly lower values compared with group A preoperatively (P < 0.001), but there was no significant difference between groups A and B postoperatively and at 1-month follow-up (P = 0.179 and P = 0.558, respectively).

5mm implant with a 3.8 mm abutment (Experimental Design, ED). All the different experimental groups were discretized to over 60000 elements and 100000

nodes, and 130N vertical (axial) and 90N horizontal loads were applied on the coronal portion of the abutment. Von Mises stresses were evaluated and maximum and minimum values were acquired for each implant-abutment configuration.

Results: The load-induced Von Mises stress (maximum to minumum ranges) on the implant ranged from 150 MPa to 58 Pa (SCD); 45 MPa to 55 Pa (WCD); 190 MPa to 64 Pa (ED). The Von Mises stress on the abutment ranged from 150 MPa to 52 MPa GSK461364 price (SCD); 70 MPa to 55 MPa (WCD), and 85 MPa to 42 MPa respectively (ED). The maximum stresses transmitted from the implant-abutment system to the cortical and trabecular bone were 67 Pa and 52 MPa (SCD); 54 Pa and 27 MPa (WCD); 64 Pa and 42 MPa (ED), respectively. When the implant body was evaluated for stresses, a substantial decrease in their levels were observed at the threaded implant region due to the diametral

mismatch between implant and abutment for the ED configuration.

Conclusion: BMS-754807 price The platform switching configuration led to not only to a relative decrease in stress levels compared to narrow and wide standard configurations, but also to a notable stress field shift from bone towards the implant system, potentially resulting in lower crestal bone overloading.”
“An 11-year-old female felt discomfort in her head, and left hemispheric syndrome occurred shortly thereafter. At presentation, her National Institutes of Health stroke scale (NIHSS)

score was 13, and a magnetic resonance imaging scan revealed acute brain infarction in the left thalamus. She was immediately treated with the intravenous administration of tissue plasminogen activator (IV t-PA) followed by edaravone, a free radical scavenger. Two hours buy Thiazovivin after IV t-PA, her symptoms dramatically resolved and her NIHSS score decreased to 5. No adverse events were observed. She was the youngest patient treated with IV t-PA in Japan, and would be the youngest treated in most developed countries. An optimal treatment for stroke in children has not been established, and this case highlights the urgent need to examine the safety and efficacy of IV t-PA and edaravone therapy for ischemic stroke in children.”
“Public disclosure is increasingly a requirement of accrediting agencies and governments. There are few published empirical evaluations of disclosure interventions that inform evidence-based implementation or policy. This study investigated the practices associated with the public disclosure of healthcare accreditation information, in addition to multi-stakeholder perceptions of key challenges and opportunities for improvement. We conducted a mixed methods study comprising analysis of disclosure practices by accreditation agencies, and 47 semi-structured individual or group interviews involving 258 people.