23 research outputs found
The clinical relevance and newsworthiness of NIHR HTA-funded research: a cohort study
No full textObjectiveTo assess the clinical relevance and newsworthiness of the UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme funded reports.Study designRetrospective cohort study.SettingThe cohort included 311 NIHR HTA Programme funded reports publishing in HTA in the period 1 January 2007–31 December 2012. The McMaster Online Rating of Evidence (MORE) system independently identified the clinical relevance and newsworthiness of NIHR HTA publications and non-NIHR HTA publications. The MORE system involves over 4000 physicians rating publications on a scale of relevance (the extent to which articles are relevant to practice) and a scale of newsworthiness (the extent to which articles contain news or something clinicians are unlikely to know).Main outcome measuresThe proportion of reports published in HTA meeting MORE inclusion criteria and mean average relevance and newsworthiness ratings were calculated and compared with publications from the same studies publishing outside HTA and non-NIHR HTA funded publications.Results286/311 (92.0%) of NIHR HTA reports were assessed by MORE, of which 192 (67.1%) passed MORE criteria. The average clinical relevance rating for NIHR HTA reports was 5.48, statistically higher than the 5.32 rating for non-NIHR HTA publications (mean difference=0.16, 95% CI 0.04 to 0.29, p=0.01). Average newsworthiness ratings were similar between NIHR HTA reports and non-NIHR HTA publications (4.75 and 4.70, respectively; mean difference=0.05, 95% CI ?0.18 to 0.07, p=0.402). NIHR HTA-funded original research reports were statistically higher for newsworthiness than reviews (5.05 compared with 4.64) (mean difference=0.41, 95% CI 0.18 to 0.64, p=0.001).ConclusionsFunding research of clinical relevance is important in maximising the value of research investment. The NIHR HTA Programme is successful in funding projects that generate outputs of clinical relevance
An evidence rating service provided valid correlates of the clinical importance of medical articles and journals
No full textObjectives: The objective of this study was to determine reliability and validity of McMaster PLUS measures of scientific merit and clinical importance of articles in medical journals. Study Design and Setting: Analytic survey of peer-reviewed medical journals was carried out. Articles were qualified for inclusion by meeting (1) scientific criteria and (2) a clinical importance rating threshold. Included articles were sent as e-mail alerts to physicians according to their clinical interests. Internal measures included the number of high-quality, clinically important studies published in source journals and response to alerts. For external validation, we correlated internal measures with the Journal Impact Factor (JIF) and citation in DynaMed Plus (DMP). Results: We evaluated 34,232 articles from 57 journals. Inclusion criteria were met by 2,638 articles (7.71%). The number of qualifying articles per journal was correlated with the number of articles with high clinical importance ratings (r 0.96, P < 0.001), article alert clicks (r 0.86, P < 0.001), and DMP citations (r 0.99, P < 0.001). Correlation was lower with the JIF (r 0.68, P < 0.01). Conclusions: Measures of scientific merit and clinical importance of medical journal articles were strongly correlated with each other, less so with JIFs. Journals varied widely by these measures but, generally, few articles were both scientifically sound and clinically important
Increasing the quantity and quality of searching for current best evidence to answer clinical questions: protocol and intervention design of the MacPLUS FS Factorial Randomized Controlled Trials
No full textFinding current best evidence for clinical decisions remains challenging. With 3,000 new studies published every day, no single evidence-based resource provides all answers or is sufficiently updated. McMaster Premium LiteratUre Service--Federated Search (MacPLUS FS) addresses this issue by looking in multiple high quality resources simultaneously and displaying results in a one-page pyramid with the most clinically useful at the top. Yet, additional logistical and educational barriers need to be addressed to enhance point-of-care evidence retrieval. This trial seeks to test three innovative interventions, among clinicians registered to MacPLUS FS, to increase the quantity and quality of searching for current best evidence to answer clinical questions
Interventions for enhancing medication adherence.
No full textPeople who are prescribed self administered medications typically take only about half their prescribed doses. Efforts to assist patients with adherence to medications might improve the benefits of prescribed medications.The primary objective of this review is to assess the effects of interventions intended to enhance patient adherence to prescribed medications for medical conditions, on both medication adherence and clinical outcomes.We updated searches of The Cochrane Library, including CENTRAL (via http://onlinelibrary.wiley.com/cochranelibrary/search/), MEDLINE, EMBASE, PsycINFO (all via Ovid), CINAHL (via EBSCO), and Sociological Abstracts (via ProQuest) on 11 January 2013 with no language restriction. We also reviewed bibliographies in articles on patient adherence, and contacted authors of relevant original and review articles.We included unconfounded RCTs of interventions to improve adherence with prescribed medications, measuring both medication adherence and clinical outcome, with at least 80\% follow-up of each group studied and, for long-term treatments, at least six months follow-up for studies with positive findings at earlier time points.Two review authors independently extracted all data and a third author resolved disagreements. The studies differed widely according to medical condition, patient population, intervention, measures of adherence, and clinical outcomes. Pooling results according to one of these characteristics still leaves highly heterogeneous groups, and we could not justify meta-analysis. Instead, we conducted a qualitative analysis with a focus on the RCTs with the lowest risk of bias for study design and the primary clinical outcome.The present update included 109 new RCTs published since the previous update in January 2007, bringing the total number of RCTs to 182; we found five RCTs from the previous update to be ineligible and excluded them. Studies were heterogeneous for patients, medical problems, treatment regimens, adherence interventions, and adherence and clinical outcome measurements, and most had high risk of bias. The main changes in comparison with the previous update include that we now: 1) report a lack of convincing evidence also specifically among the studies with the lowest risk of bias; 2) do not try to classify studies according to intervention type any more, due to the large heterogeneity; 3) make our database available for collaboration on sub-analyses, in acknowledgement of the need to make collective advancement in this difficult field of research. Of all 182 RCTs, 17 had the lowest risk of bias for study design features and their primary clinical outcome, 11 from the present update and six from the previous update. The RCTs at lowest risk of bias generally involved complex interventions with multiple components, trying to overcome barriers to adherence by means of tailored ongoing support from allied health professionals such as pharmacists, who often delivered intense education, counseling (including motivational interviewing or cognitive behavioral therapy by professionals) or daily treatment support (or both), and sometimes additional support from family or peers. Only five of these RCTs reported improvements in both adherence and clinical outcomes, and no common intervention characteristics were apparent. Even the most effective interventions did not lead to large improvements in adherence or clinical outcomes.Across the body of evidence, effects were inconsistent from study to study, and only a minority of lowest risk of bias RCTs improved both adherence and clinical outcomes. Current methods of improving medication adherence for chronic health problems are mostly complex and not very effective, so that the full benefits of treatment cannot be realized. The research in this field needs advances, including improved design of feasible long-term interventions, objective adherence measures, and sufficient study power to detect improvements in patient-important clinical outcomes. By making our comprehensive database available for sharing we hope to contribute to achieving these advances
Contribuições ao projeto conceitual de sistemas de manipulação e montagem automatizados
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia Elétrica.A presente pesquisa contribui para o projeto conceitual de sistemas de manipulação e montagem automatizados. A abordagem desenvolvida baseia-se na execução simultânea dos projetos da parte física e de controle de forma a obter uma abordagem integrada conferindo economia de tempo e recursos. Objetiva-se com esta abordagem diminuir o ciclo de desenvolvimento de projeto dos sistemas tratados e ao mesmo tempo aumentar a confiabilidade destes, acarretando uma diminuição do esforço de implementação, integração, testes e manutenção. Nesse sentido, ferramentas formais de análise e síntese são utilizadas no processo de projeto, atendendo à nova proposta do presente trabalho. A etapa de descrição funcional, pertencente ao projeto conceitual, é analisada através de diversos modelos encontrados na literatura, resultando na identificação do poder de representação e das limitações de uso. Um modelo de descrição funcional analisado, a rede Canal Agência, é selecionado em função de sua adequação aos objetivos do presente trabalho. Tal modelo possibilita um tratamento coerente da descrição funcional com o modelo comportamental empregado. Este modelo, oriundo da área de sistemas a eventos discretos, baseado em autômatos e linguagens controláveis, é usado para propiciar um processo automático de síntese de supervisores, ao invés dos usuais procedimentos manuais ou heurísticos. Além desta vantagem, o procedimento de síntese de controladores tem a grande conveniência de ser baseado no modelo da dinâmica do sistema em malha aberta e na especificação do comportamento desejado. Esta abordagem insere a perspectiva comportamental do sistema. Seguindo os fundamentos do presente trabalho consegue-se estabelecer uma metodologia adequada para sistemas de manipulação e montagem automatizados, inserindo conceitos e necessidades próprias
Project Unité
No full textA three-volume catalogue produced for a group exhibition in 1993 at Le Corbusier's Unité d'Habitation housing complex in Firminy, France. In volume 1, Loach details the architect's execution of several commissions for Firminy; Koolhaas applies Dali's paranoid-critical method to Le Corbusier while examining both men's reaction to Manhattan; a statistical analysis looks at present-day Unité occupants. Illustrations, project descriptions, artists' statements and essays by the 44 international exhibiting artists comprise volume 2 and 3. Bibl. 5 p
Sexual Orientation Self-Concept Ambiguity and Alcohol Use Disorder Symptomology: The Roles of Motivated Psychological Distancing and Drinking to Cope
No full textThe Behavioural Effects of Perspective-Taking: The Influence of Group Membership and Stereotype Threat
No full textPerspective-taking induced self-other overlap in cognitive representations has been lauded as a mechanism which promotes social bonds. The application of self (perspective-taker) to other (target of perspective-taking) leads to reduced stereotyping and prejudice, while the application of other to self increases the stereotypical behaviour of the perspective-taker (in line with the target stereotype). However, three experiments presented in this thesis suggest that this is not always the case when perspective-taker and target belong to different stereotyped groups.
Focusing on the stereotype of women and maths, Experiment 1 found that perspective-taking when the perspective-taker and target belonged to different stereotyped groups did not result in behaviour consistent with the target-stereotype. Furthermore, evidence of behavioural contrast was found. Experiment 2 further examined the behavioural effects of perspective-taking when the perspective-taker was negatively stereotyped and the target was positively stereotyped; consistent with the first experiment, contrast effects were found following perspective-taking. Given the findings of the first two experiments, hypotheses regarding the outcome of an intervention designed to reduce stereotype threat using perspective-taking were revised (Experiment 3). Findings of Experiment 3 were consistent with Experiments 1 and 2, in that perspective-taking when the target was positively stereotyped did not reduce stereotype threat for women (negatively stereotyped). The findings of the three experiments were interpreted in line with the prime-to-behaviour literature, and specifically, behavioural contrast effects following priming with exemplars
Comparative frequency of Coagulation Factor II and Coagulation Factor V Alleles among new-born and senior citizens
No full textResistance to activated protein C is one of the most common inherited disorders associated with hereditary thrombophilia. A missense mutation in the gene coding for coagulation factor V (CF V Leiden) and which renders this procoagulant factor resistant to inactivation by activated protein C results in an inherited risk for venous thrombosis. Recently, another mutation has been identified in the prothrombin gene (CF II G20210A) which was also associated with increased risk for venous thrombosis. In this study, we sought to establish the frequency of the two alleles in a random sample of Maltese newborn and compare these with the frequencies of the same alleles among senior citizens and patients with clinical thrombophilia. The control population of 554 newborn samples processed for the same point mutations gave 13 (2.3%) who were CF V Leiden heterozygotes and 7 (2.7%) who were CF II G20210A heterozygotes. Neither homozygotes nor trans-heterozygotes (i.e. CF V Leden and CF II2 0210A heterozygotes) were observed. The 348 senior citizens gave 9 (2.6%) CF V Leiden heterozygotes and 8 (2.4%) CF II G20210A heterozygotes. Neither homozygotes nor trans-heterozygotes (i.e. CF V Leden and CF II20210A heterozygotes) were observed. The 328 patients referred to the Laboratory of Molecular Genetics, University of Malta, with clinical thrombosis gave 23 (7.01%) CF V Leiden heterozygotes and 24 (7.31%) CF II G20210A heterozygous. One patient was found to be trans-heterozygous for the two mutations. The data suggested that although CF V G1691A and CF II G20210A may increase risk for thrombophilia, they do not impact on the survival of the carriers, but the transheterozygozity may also confer increased risk. The high allele frequency may be best explained by positive natural selection.peer-reviewe
The role of women's identification with math and academic major in women's susceptibility to stereotype threat and stereotype lift
No full text2015 Spring.Includes bibliographical references.A stereotype threat (ST) occurs when individuals underperform in a domain, for example in math, as a result of exposure to a relevant negative stereotype. Women engaged in math-intensive tasks can experience ST when negative stereotypes about women's math ability are made salient, via for example, test instructions that allege superior math performance by men. Evidence regarding the role of ST test instructions on women's math performances has been mixed (e.g., Bell, Spencer, Iserman, & Logel, 2003; Schmader, 2002). While prior studies found that women underperform in ST conditions that emphasize the validity of a math test (i.e., when a math test is presented as indicative of math ability), no study has included a condition in which the validity of a math test is downplayed (i.e., "test not indicative of math ability" conditions). Studies examining conditions alleging men's superiority in math (i.e., "men perform better than women" conditions) have not included conditions that presented a math test as indicative of math ability (Cadinu, Maass, Frigerio, Impagliazzo, & Latinotti, 2003; Johnson, Bernard-Brak, Saxon, & Johnson, 2012). Additionally, it is unclear which women are most vulnerable to math ST conditions. While ST is found to have greater impact on women who are highly identified with math relative to women with low identification with math (e.g., Aronson, Quinn, & Spencer, 1999), there is also evidence that women in math-intensive majors (e.g., engineering) have lower susceptibility to math ST than women not in math-intensive majors (e.g., psychology) (Crisp, Bache, & Maitner, 2009; Croizet et al., 2004). Furthermore, the roles of identification with math and academic major have been researched independently. The present study examines the roles of women's identification with mathematics and college majors on their susceptibility to math underperformance under two ST conditions, one related to the validity of the math test and the other involving comparisons in math performance between women and men. Women (n = 847), of whom 231 were in math-intensive majors and 616 were not in math-intensive majors at a large Mountain West state university, completed the Identification with Math Scale and reported their college majors five to seven days before completing a mathematics test. They were then randomly assigned to one of six math ST conditions in a 2 (Validity of Math Test Variable: test indicative of math ability, test not indicative of math ability) × 3 (Women-Men Math Performance Differences Variable: men perform better than women, no mention of differences in math performance, or women perform better than men) factorial design experiment. It was hypothesized that women in the "men perform better than women" condition would underperform relative to women in the "no mention of differences in math performance" condition. It was also hypothesized that women high in identification with math who were assigned to the "test indicative of math ability" condition would experience greater math underperformance than women in the "test not indicative of math ability" condition. A significant interaction between the Women-Men Math Performance Differences Variable and the Identification with Math Variable was found. Women high in identification with math in the "men perform better than women" condition scored significantly lower than women in the "no mention of differences in math performance" condition. No such difference in performance was observed for women low in identification with math. Women in the "women perform better than men" condition performed better than women in other conditions regardless of their identification with math. This study's findings suggest that women who strongly identify with math may be especially vulnerable to ST, consistent with past findings (e.g., Steinberg, Okun, & Aiken, 2012). In support of findings from past studies (e.g., Johnson et al., 2012), this study also demonstrates that to do well in math tests women may benefit from exposure to information explicitly contradicting female math incompetence stereotypes. Current study's findings have implications for intervention programs with highly math-identified women
