232 research outputs found
Developing and evaluating interventions to reduce inappropriate prescribing by general practitioners of antibiotics for upper respiratory tract infections: a randomised controlled trial to compare paper-based and web-based modelling experiments
No full textBackground Much implementation research is focused on full-scale trials with little evidence of preceding modelling work. The Medical Research Council Framework for developing and evaluating complex interventions has argued for more and better theoretical and exploratory work prior to a trial as a means of improving intervention development. Intervention modelling experiments (IMEs) are a way of exploring and refining an intervention before moving to a full-scale trial. They do this by delivering key elements of the intervention in a simulation that approximates clinical practice by, for example, presenting general practitioners (GPs) with a clinical scenario about making a treatment decision. Methods The current proposal will run a full, web-based IME involving 250 GPs that will advance the methodology of IMEs by directly comparing results with an earlier paper-based IME. Moreover, the web-based IME will evaluate an intervention that can be put into a full-scale trial that aims to reduce antibiotic prescribing for upper respiratory tract infections in primary care. The study will also include a trial of email versus postal invitations to participate. Discussion More effective behaviour change interventions are needed and this study will develop one such intervention and a system to model and test future interventions. This system will be applicable to any situation in the National Health Service where behaviour needs to be modified, including interventions aimed directly at the public. Trial registration Current Controlled Trials NCT01206738
Odontophotopsis hammetti Pitts, NEW SPECIES
No full text<i>Odontophotopsis hammetti</i> Pitts, NEW SPECIES <p> <b>Diagnosis of male.</b> This species can be recognized by the hind coxae with longitudinal hirsute carinae along their inner margin, and also having the mandible (Fig. 32) tridentate apically, weakly excised ventrally with the angle of excision obtusely angulate, the dorsal carina complete terminating at moderate tooth, and the apex vertical. Also, this species has a flattened to slightly concave mesosternum similar to other species of <i>Odontophotopsis</i>, but lacks the associated mesosternal processes and has dense plumose setal fringes on the metasoma (Fig. 33).</p> <p> <b>Description of male.</b> <i>Coloration</i> (Figs 32, 33). Body testaceous; flagellum and legs stramineous. Body clothed with dense, erect, brachyplumose, yellowish-white setae. T1 with sparse plumose fringe at distal margin. T2 and S2 with dense fringe of whitish plumose setae. T3–5 and S3–5 each with sparser, but conspicuous fringes of whitish plumose setae.</p> <p> <i>Head.</i> Head rounded to slightly quadrate posteriorly. Mandible (Fig. 32) tridentate, weakly excised beneath, excision obtuse, ventral tooth angulate; dorsal carina complete terminating at moderate tooth; apex vertical; mandible dilated ventrally beyond excision; mandible slightly curving ventrally towards apex. Clypeus depressed below margin of mandible, median area concave; surface of clypeus polished, impunctate, with few erect setae; apex truncate, not bidentate. F1 approximately 0.75X length of F2. Ocelli moderate in size, ocellocular distance approximately 1.25X greatest width of lateral ocellus. Head weakly sculptured with punctures slightly wider than setal bases; interstitial regions glabrous.</p> <p> <i>Mesosoma</i>. Sides and dorsum of pronotum coarsely punctate, dorsum with moderate, shallow punctures, sides with somewhat larger, contiguous punctures. Mesonotum with moderate, contiguous, shallow punctures. Notaulus obsolete on anterior 0.3 of mesonotum. Scutellum coarsely, confluently punctate. Axillae not projecting posteriorly. Dorsum and posterior face of propodeum conspicuously, shallow reticulate, reticulations extending on to sides of propodeum, either remaining reticulate laterally or becoming coarse, punctate-reticulate. Anterolateral area of mesopleuron with moderate, shallow, separated punctures; remainder of mesopleuron with deeper, contiguous to confluent punctures; interstitial areas micropunctate. Metapleuron polished. Mesosternal processes absent, but mesosternum flattened, impunctate; area narrow anteriorly just at midline, widening to mid coxal width posteriorly. Mid coxa edentate. Hind coxa with distinct hirsute carina running longitudinally along inner margin. Metasternum bidentate. Mid femur not swollen. Marginal cell on costa short, 1.25–1.5X length of stigma.</p> <p> <i>Metasoma</i>. First metasomal segment broad, nodose. Pygidium elongate and ovate, polished to weakly granulate along posterior margin, not strongly margined; S2 with felt line tuft-like, 0.2X length of tergal felt line. Hypopygium elongate and ovate. Genitalia (Fig. 64) with paramere acicular; cuspis elongate, approximately 0.5X free length of paramere, and cylindrical in lateral view, with moderate basal pit.</p> <p> <i>Female.</i> Unknown.</p> <p> <i>Length.</i> 11–13 mm.</p> <p> <b>Material examined.</b> Holotype: <b>California</b>, <i>Riverside Co</i>., Deep Canyon, 11.Nov.1963, coll. E. Schlinger (UCRC). Paratypes: <b>California</b>, <i>Riverside Co</i>., Deep Canyon: 1 male, 25. Sep.1969, 1 male, 26.Sep– 6. Oct.1969, 1 male, 9. Oct.1963, 2 males, 11.Nov.1963 (UCRC, EMUS).</p> <p> <b>Distribution.</b> Currently known only from Deep Canyon, but will presumably be found throughout at least the western Sonoran Desert.</p> <p> <b>Etymology.</b> Named after Samuel Dashiell Hammett (1894–1961), who was a well-known American author of hardboiled detective novels and short stories, and creator of the famous protagonist, Sam Spade.</p> <p> <b>Remarks.</b> Although this species lacks mesosternal processes, it clearly belongs in <i>Odontophotopsis</i> due the characteristic genitalia and overall appearance of the species (i.e., density of plumose setae, weakly punctate head, etc.). Furthermore, the species has the mesosternum broadly, but weakly concave and impunctate similar to other <i>Odontophotopsis</i> having mesosternal processes, but unlike <i>Sphaeropthalma</i>, which have the mesosternum punctate and convex on either side of the midline. The species belongs in the <i>O. parva</i> species-group, based on mandibular morphology and the bidentate metasternum. This is the only species in this species-group that lacks a densely granulate pygidium. However, recent phylogenetic analyses of <i>Odontophotopsis</i> (Pitts <i>et al.</i> 2010) suggest this species-group is paraphyletic with respect to the <i>O. tapajos</i> species-group. Some of these species lack developed mesosternal processes and all lack a granulate pygidium.</p>Published as part of <i>Pitts, James P., Wilson, Joseph S., Williams, Kevin A. & Boehme, Nicole F., 2010, Nocturnal velvet ant males (Hymenoptera: Mutillidae) of Deep Canyon, California including four new species and a fifth new species from Owens Lake Valley, California, pp. 1-34 in Zootaxa 2553</i> on page 9, DOI: <a href="http://zenodo.org/record/196847">10.5281/zenodo.196847</a>
From 'ICDAS' to 'cariescare international': the 20-year journey building international consensus to take caries evidence into clinical practice
No full textEste documento traza el viaje de colaboración de 20 años realizado por equipos internacionales de investigadores, educadores y profesionales de la odontología. Tras el desarrollo inicial del Sistema Internacional de Evaluación y Detección de Caries (ICDAS) en 2002, el Sistema Internacional de Clasificación y Manejo de Caries (ICCMS) se desarrolló en colaboración entre 2010-2017 con varias organizaciones de investigación y práctica dental, e influenciado por la mejor evidencia juzgada a través de Metodología SIGN, el Tratado de Minamata del PNUMA (y la eliminación progresiva de las amalgamas dentales vinculadas), tres laboratorios de políticas dentales y un movimiento internacional en odontología operativa para avanzar hacia la odontología mínimamente invasiva. La Federación Dental Mundial de la FDI publicitó y abogó por el ICCMS en 2019, cuando se publicó la Guía de consenso 'CariesCare International' y el sistema de manejo de caries 4D para ayudar a poner en práctica el ICCMS. Este sistema, que está diseñado para ayudar a los médicos a brindar una atención óptima de la caries a los pacientes, ahora se está adaptando internacionalmente para su uso pospandémico en el estudio 'Caries OUT'. También se está utilizando como un vehículo para implementar la actualización Brindar una mejor guía de salud oral sobre la caries, como parte del marco de atención médica oral de intervención mínima en el Reino Unido.This paper charts the 20-year collaborative journey made by international teams of dental researchers, educators and practitioners. Following the initial development of the International Caries Detection and Assessment System (ICDAS) in 2002, the International Caries Classification and Management System (ICCMS) was collaboratively developed between 2010-2017 with several dental research and practice organisations, and influenced by best evidence judged via SIGN methodology, the UNEP Minamata Treaty (and linked phasing down of dental amalgam), three Dental Policy Labs and an international movement in operative dentistry to move towards minimally invasive dentistry. The FDI World Dental Federation publicised and advocated the ICCMS in 2019, when the 'CariesCare International' Consensus Guide and 4D caries management system was published to aid the delivery of ICCMS into practice. This system, which is designed to help practitioners deliver optimal caries care for patients, is now being adapted internationally for post-pandemic use in the 'Caries OUT' study. It is also being used as a vehicle for implementing the updated Delivering better oral health guidance on caries, as part of the minimum intervention oral healthcare delivery framework in the UK
Email invitations to general practitioners were as effective as postal invitations and were more efficient.
No full textObjective: To evaluate which of two invitation methods, email or post, was most effective at recruiting general practitioners to an online trial. Study design and setting: Randomised controlled trial. Participants were general practitioners in Scotland, UK. Results: 270 general practitioners were recruited. Using email did not improve recruitment (risk difference = 0.7% (95% confidence interval -2.7% to 4.1%)). Email was, however, simpler to use and cheaper, costing £3.20 per recruit compared to £15.69 for postal invitations. Reminders increased recruitment by around 4% for each reminder sent for both invitation methods. Conclusions: In the Scottish context, inviting general practitioners to take part in an online trial by email does not adversely affect recruitment and is logistically easier and cheaper than using postal invitations
Paper-based and web-based intervention modeling experiments identified the same predictors of general practitioners' antibiotic-prescribing behavior
No full textCopyright © 2014 Elsevier Inc. All rights reserved.Peer reviewe
Description of the implementation of best practices for caries management in Colombia
No full textEl Sistema Internacional de Clasificación y Manejo de Caries (ICCMS™) presenta recomendaciones sobre salud oral que tienen el fin de mantener y preservar la estructura dental. Está conformado por 4 elementos 4D): D1-Determinar (Riesgo de caries a nivel del paciente); D2-Detectar y valorar (Clasificación de lesiones y valoración de su actividad, valoración de riesgo a nivel intraoral); D3Decida (Toma de decisiones: Plan personalizado de atención (a nivel del paciente y del diente) y D4Desarrolle las acciones (Intervenciones apropiadas a nivel dental y del paciente para la prevención, control y manejo).
Estos elementos representan la mejor evidencia al momento. Adicionalmente, cuando se tratan de comprender los comportamientos de los dentistas, el modelo COM-B permite identificar la Capacidad, Oportunidad y Motivación para llevar a cabo comportamientos de diagnóstico y manejo de caries dental.
Identificar los determinantes que influyen en la adopción e implementación de las mejores prácticas de caries dental en los odontólogos de la práctica clínica y en los docentes de Facultades de Odontología de Colombia.
Con el aval ético, académicos expertos en Cariología moderna y miembros de ICDAS diseñaron una encuesta para odontólogos de la práctica clínica y de la docencia clínica basado en el modelo COM-B, con preguntas para identificar la Capacidad, Oportunidad y Motivación para realizar los comportamientos de diagnóstico y manejo de caries dental. La encuesta, luego de ser sujeta a un proceso de validación aparente y de contenido, y de análisis de consistencia interna de las escalas a partir de un estudio piloto, fue enviada para ser respondida a clínicos y docentes en Colombia.
El banco de ítems estuvo compuesto por 79 preguntas, 34 para diagnóstico y 45 para manejo. A partir de los análisis de correlación de Spearman se encontró que los comportamientos de diagnóstico correlacionaron más con la escala de Oportunidad referida a recursos, mientras que los de manejo estuvieron más relacionados con la Capacidad y la Oportunidad relativa a la importancia.
Los hallazgos enseñan que el modelo COM-B es ventajoso para explicar la implementación de los comportamientos de diagnóstico y manejo de caries dental de acuerdo al ICCMS™. La Oportunidad con el acceso a recursos ayuda a explicar los comportamientos de diagnóstico, mientras que la Capacidad es la que más explica la variabilidad en el manejo de caries dental. La motivación en términos de la remuneración debería mejorarse.Magíster en Ciencias OdontológicasMaestríaThe International Caries Classification and Management System (ICCMS™) delivers recommendations for dental health with the aim of maintaining and preserving tooth structure. It is comprised of four elements (4Ds): D1-Determine (caries risk at patient level); Detect and assess (lesion classification and activity assessment, risk assessment at intraoral level); D3-Decide (decision making: personalized care plan (patient and tooth level) and D4-Do (appropriate interventions at dental and patient level for prevention, control and management). These elements represent the best evidence recommendations at the moment. In addition, when trying to understand dentists’ behaviors, the COM-B model is a useful framework that allows the identification of the Capability, Opportunity and Motivation to conduct dental caries diagnosis and management Behaviours.
To identify the determinants that may be influencing the adoption and implementation of the best practices of dental caries in clinical practice by dentists and teachers from dental faculties in Colombia.
With ethics approval, modern Cariology academic experts and ICDAS members designed a survey for clinicians and teachers based on the COM-B model with questions that identified the Capability, Opportunity, and Motivation to perform caries diagnosis and management behaviours. After the questionnaire items were subjected to face and content validation, and a pilot study was performed to evaluate the internal consistency reliability of the scales, the survey was sent to be completed by clinicians and teachers from Colombia.
The item pool was composed of 79 questions, with 34 belonging to the caries diagnosis dimension and the other 45 to the caries management dimension. Spearman correlation analysis showed that the diagnosis behaviours correlated the most with Opportunity in terms of resources, while caries had the highest correlations with Capability and Opportunity related to importance.
The findings show that the COM-B model is an advantageous framework in explaining caries diagnosis and management behaviours aligned with ICCMS™ recommendations. Opportunity related to the access of resources was the highest explanatory variable of diagnosis behaviours while Capability explained the most variability in management behaviours. Additionally, motivation in terms of remuneration needs to be improved
Mind as Machine: Can Computational Processes Be Regarded As Explanatory of Mental Processes?
No full textThe aim of the thesis is to evaluate recent work in artificial intelligence (AI). It is argued that such evaluation can be philosophically interesting, and examples are given of areas of the philosophy of AI where insufficient concentration on the actual results of AI has led to missed opportunities for the two disciplines — philosophy and AI — to benefit from cross-fertilization. The particular topic of the thesis is the use of AI techniques in psychological explanation. The claim is that such techniques can be of value in psychology, and the strategy of proof is to exhibit an area where this is the case. The field of model-based knowledge-based system (KBS) development is outlined; a type of model called a conceptual model will be shown to be psychologically explanatory of the expertise that it models. A group of major philosophies of explanation are examined, and it is discovered that such philosophies are too restrictive and prescriptive to be of much value in evaluating many areas of science; they fail to apply to scientific explanation generally. The importance of having sympathetic yardsticks for the evaluation of explanatory practices in arbitrary fields is defended, and a series of such yardsticks is suggested. The practice of providing information processing models in psychology is discussed. A particular type of model, a psychological competence model, is defined, and its use in psychological explanation defended. It is then shown that conceptual models used in model-based KBS development are psychological competence models. It follows therefore that such models are explanatory of the expertise they model. Furthermore, since KBSs developed using conceptual models share many structural characteristics with their conceptual models, it follows that a limited class of those systems are also explanatory of expertise. This constitutes an existence proof that computational processes can be explanatory of mental processes
The shape of the future of dental education for dental caries- and how we get there: Introduction to the ACFF Caries Workshop
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