234 research outputs found
Do treatment preferences for patients with angina change? An 18-month follow-up study.
No full textObjectives To assess whether preferences for patients with angina changed at 18-month follow-up using the Patient Preferences Questionnaire for Angina treatment (PPQA). Background Evidence suggests that patients want information about treatment options. Reliable measurement of patient preferences for treatment is important for empowering patients. Design Postal self-administered questionnaire survey at baseline and follow-up. The preference questionnaire comprised 18 items about the main treatments for angina: medication, angioplasty and coronary artery bypass grafting (CABG). Setting and participants Patients with diagnosed angina from seven participating general practices across England. The sample comprised 222 patients with angina who responded to both baseline and follow-up treatment preference questionnaires. Results Most patients' condition and preferences scores for treatment remained stable over 18 months. An exception was angioplasty preference scores, which indicated more negative attitudes towards this procedure over time. People aged over 75 years least preferred angioplasty. There were no associations between any changes in condition and changes in preferences. However, within-subject agreement could vary by ±5 to 7 points between baseline and follow-up, with stability apparently worst for the medication and best for surgery sub-scales, raising the question of what represents reasonable stability. Conclusion These results suggest preferences are relatively stable, even where there are changes in health, and provide further evidence of the utility (in particular, reliability) of the PPQA. However, this stability in scores did mask some movement in scale scores and in patients' first-ranked treatment choices, showing changing preferences largely from angioplasty to CABG and vice versa, indicating the complexity of preferences
Patient preferences for treatment for angina: an overview of findings from three studies
No full textBackground: Access to cardiac treatments has been documented to vary with patients' age. It is unknown whether these variations reflect patients' treatment preferences. We aimed to investigate patients' preferences for cardiology treatments and develop a Patients' Preferences Questionnaire.Methods: Semi-structured interviews with primary care patients with diagnosed angina with postal follow-up. The resulting Patients' Preferences Questionnaire was tested with newly admitted inpatients with acute coronary syndrome and with patients in primary care.Results: The Patients' Preferences Questionnaire was psychometrically sound. Analyses of preference subscale scores showed that the most positive preference scores were for medication. Angioplasty scored highest at the negative end of the scale. Detailed analyses showed that older people and women were less likely to prefer coronary artery bypass surgery (CABG), reflecting its greater level of invasiveness. Older people (aged over 75 years, compared to people aged under 75 years), but not women, were also more cautious in their strength of preference for angioplasty. More positive attitudes towards CABG surgery, and more negative attitudes towards medication, were associated with greater impact of the condition on life.Conclusions: The research resulted in a psychometrically sound Patients' Preferences Questionnaire. There was some evidence to support the view that older people's weaker preferences for CABG may contribute slightly to variations in the provision of re-vascularization. There was also variation in preferences within age groups, cautioning against the assumption that all or most older people are more reluctant than younger people to undergo invasive procedures
Barnaby Conrad
No full textBlack and white photograph of author and portrait artist Barnaby Conrad, signed for Marriner S. Eccles
Tragedies / By N. Rowe, Esq; ...
No full textVorlageform der Veröffentlichungsangabe: London: Printed for Bernard Lintott between the Temple-Gates, 1714
The Imaginary Reader
No full textAn author has a reader in mind as she writes. Librarians and teachers have actual readers in mind when they choose a book from the shelf. How do we reconcile the two? Hannah Barnaby will examine how authors, teachers, and librarians collaborate to take stories from the imaginary to the actual
What do patients really want? Patients' preferences for treatment for angina
No full textObjective To measure preferences for angina treatments among patients admitted from accident and emergency with acute coronary syndrome.Background Evidence suggests variability in treatment allocations amongst certain socio-demographic groups (e.g. related to age and sex), although it is unclear whether this reflects patient choice, as research on patients' treatment preferences is sparse. Given current policy emphasis on 'patient choice', providers need to anticipate patients' preferences to plan appropriate and acceptable health services.Design Self-administered questionnaire survey.Setting In-patients in a UK hospital.Participants A convenience sample of 53 newly admitted patients with acute coronary syndrome. Exclusion criteria were: a previous cardiologist consultation (including previous revascularization); a clinical judgement of too ill to participate; post-admission death; non-cardiac reasons for chest pain.Main outcome measures Patients' preferences for coronary artery bypass graft (CABG); angioplasty; and two medication alternatives.Results Angioplasty was the preferred treatment (for 80% of respondents), and CABG was second (most preferred by 19%, but second most preferred for 60%). The two least preferred (and least acceptable) treatments were medications. The majority of patients (83%) would 'choose treatment based on the extent of benefits' and 'accept any treatment, no matter how extreme, to return to health'. There were some differences in preference related to age (> 70 years preferred medication to a greater degree than < 70 years) and sex (males preferred CABG surgery more than females).Conclusions There was general preference for procedural interventions over medication, but most patients would accept any treatment, however extreme, to return to former health. There was some evidence of differences in preferences related to age and sex. Furthermore, most patients preferred to have some input into treatment choice (e.g. nearly half wanted to share decision responsibility with their doctor), with only 4% preferring to leave the decision entirely to their doctor. Given these findings, and past findings that suggest there may be variability in treatment allocation according to certain socio-demographic factors, this study suggests a need to develop and use preference measures, and makes a step towards this
Victimization of immigrant children within the high school context
No full textThis study is particularly interested in the micro-level analysis of the relationship between the immigrant assimilation experiences and the likelihood of victimization within the school context. It provides a fuller characterization of the immigrant lived experiences in the United States and how they independently shape the experiences of victimization. The study will contribute to the literature on immigrant children victimization by introducing additional risk factors for examination. The study utilizes the individual-level data from the Children of Immigrants Longitudinal Study (CILS) from the archive of the Inter-University Consortium for Political and Social Research (ICPSR) at the University of Michigan. The CILS dataset captures the adaptation process of the second immigrant generation living in the United States and includes three waves of survey data from 1991 to 2006. Despite the limitations of the study with issues such as sample attrition and demographic restrictions, the findings are still important. The findings conclude that high socio-economic status (SES) people have a much lower victimization risk than low socio-economic status (SES) people and that English proficiency is vital in examining victimization among immigrant youth. Policy implementation should include and not be limited robust diversity training for teachers and administrators alike with an emphasis on inclusion.Ph.D.Includes bibliographical referencesby Carlene Barnab
Cosmological applications of weak gravitational flexion
No full textModern cosmology has reached an important juncture, at which the ability to make measurements of unprecedented
accuracy has led to conclusions that are a fundamental challenge to natural science. The
discovery that, in our current best model, the dynamics of the Universe are completely dominated by unseen
dark matter and dark energy can do little but completely alter the shape of physics research in the 21st
Century. Unfortunately,much of our insight into these phenomenamust come from observations of visible
matter alone; this raises serious problems, as the tracing of dark matter by visible matter is as yet poorly
understood.
Gravitational lensing offers strong prospects for probing the interwoven history of dark and visible matter,
as mass in any form may be detected where it exists untraced by baryons. In this Thesis I describe
advances made in the field of weak gravitational lensing, which constrains the properties of the matter
distribution on cosmological scales using a statistical analysis of the coherent gravitational distortions of
distant galaxy images. I summarize the development of gravitational flexion, a higher order extension to
traditional weak lensing, and describe my work done to bring the study of flexion to a stage where it may be
employed to make accurate cosmological measurements. I show how flexion is sensitive to matter structure
on smaller physical scales than existing lensing techniques and, therefore, promises to shed new light upon
key untested predictions of cosmological models if it can be measured to sufficient accuracy. I discuss the
success of my efforts in this direction, and describe the issues to be encountered in the careful analysis of
this subtle gravitational signal.
This research has involved advances in many areas: the calculation of theoretical flexion predictions, the
refinement of image analysis methods for accurate galaxy shape estimation, and the practical application
of these new flexion techniques to extragalactic imaging data. The culmination of these efforts is a new
maximum likelihood analysis of the galaxy-galaxy lensing signal in the Hubble Space Telescope Galaxy
Evolution from Morphology and SEDs (GEMS) Survey, incorporating improvements and modifications
necessary for the combination of flexion with traditional weak lensing measurements. The results of this
work, and particularly the extent to which measurements of flexion provide extra cosmological insight, are
discussed in detail.
The conclusion is a summary of all that has been learned about the use of flexion as an accurate probe
of cosmology, and a discussion of its prospects for answering some of the many questions that remain
about dark matter. Within the next few year wide-area survey telescopes will begin imaging huge volumes
of deep space, with the measurement of the gravitational lensing signal being given high priority in the
analysis of these data. Within this context, the primary inquiry of this Thesis is the extent to which the
application of flexion measurement techniques will help shed new light upon the unseen, and currently
poorly understood, components of the Universe
Volume The Second. Containing Ulysses. The Royal Convert. Jane Shore.
No full textMit Frontispizen, Zwischentitelblättern und Widmungen in jedem einzelnen StückDie Illustrationen sind Kupferstiche (Frontispize) sowie VignettenVorlageform der Veröffentlichungsangabe: London: Printed for Bernard Lintott between the Temple-Gates, 1714
Volume The First Containing The Ambitious Stepmother. Tamerlane. The Fair Penitent
No full textBandzählung nach Angaben auf dem Zwischentitelblatt bestimmtMit Frontispizen, Zwischentitelblättern und Widmungen in jedem einzelnen StückDie Illustrationen sind Kupferstiche (Frontispize) sowie eine Vignette auf Blatt A, unterzeichnet: "H. Terysson. Fecit."Enthält Widmung an: "To The Right Honourable Edward, Earl of Warwick and Holland ..."Vorlageform der Veröffentlichungsangabe: London: Printed for Bernard Lintott between the Temple-Gates, 1714
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