Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review

<p>Abstract</p> <p>Background</p> <p>The standardisation of the assessment methodology and case definition represents a major precondition for the comparison of study results and the conduction of meta-analyses. International guidelines provide recommendations for the standardisation of falls methodology; however, injurious falls have not been targeted. The aim of the present article was to review systematically the range of case definitions and methods used to measure and report on injurious falls in randomised controlled trials (RCTs) on fall prevention.</p> <p>Methods</p> <p>An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls".</p> <p>Results</p> <p>The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes.</p> <p>Conclusions</p> <p>No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review.</p

Effective self-regulated science learning through multimedia-enriched skeleton concept maps

This study combines work on concept mapping with scripted collaborative learning. Purpose: The objective was to examine the effects of self-regulated science learning through scripting students’ argumentative interactions during collaborative ‘multimedia-enriched skeleton concept mapping’ on meaningful science learning and retention. Programme description: Each concept in the enriched skeleton concept map (ESCoM) contained annotated multimedia-rich content (pictures, text, animations or video clips) that elaborated the concept, and an embedded collaboration script to guide students’ interactions. Sample: The study was performed in a Biomolecules course on the Bachelor of Applied Science program in the Netherlands. All first-year students (N=93, 31 women, 62 men, aged 17–33 years) took part in this study. Design and methods: The design used a control group who received the regular course and an experimental group working together in dyads on an ESCoM under the guidance of collaboration scripts. In order to investigate meaningful understanding and retention, a retention test was administered a month after the final exam. Results: Analysis of covariance demonstrated a significant experimental effect on the Biomolecules exam scores between the experimental group and the control, and the difference between the groups on the retention test also reached statistical significance. Conclusions: Scripted collaborative multimedia ESCoM mapping resulted in meaningful understanding and retention of the conceptual structure of the domain, the concepts, and their relations. Not only was scripted collaborative multimedia ESCoM mapping more effective than the traditional teaching approach, it was also more efficient in requiring far less teacher guidance

Cogena, a novel tool for co-expressed gene-set enrichment analysis, applied to drug repositioning and drug mode of action discovery

This work was supported by the portfolio of translational research of the National Institutes for Health Research Cardiovascular Biomedical Research Unit at Barts, the UK Medical Research Council (JID-2015-0339), Major Research Plan of The National Natural Science Foundation of China [grant number U1435222], Plan for Innovative Graduate Student at NUDT [grant number B140202], Plan for interdisciplinary joint PhD students at NUDT and China Scholarship Council [to ZJ]

Timolol and Epinephrine: A Clinical Study of Ocular Interactions

• In a crossover design study, we assessed effects on intraocular pressure, pupillary diameter, pulse rate, and blood pressure over six hours of one drop of 0.5% timolol maleate and 2% epinephrine hydrochloride in one eye. Both eyes of each patient had been pretreated for one week with twice-daily applications of epinephrine or timolol, respectively. In random sequence, 20 patients (40 eyes) participated in both phases of the study. Pretreatment with timolol significantly reduced the ocular hypotensive effect of epinephrine (from 15.3% to 4.6%); epinephrine pretreatment did not affect the pressure reduction of timolol. Pretreatment with timolol enhanced the mydriatic effect of epinephrine (from 35.8% to 71.9% pupillary dilation); pretreatment with epinephrine resulted in an apparent mydriatic effect for timolol

Association of Lp(a) (Lipoprotein[a]) and Hypertension in Primary Prevention of Cardiovascular Disease: The MESA

BackgroundThis study explored the longitudinal relationship of Lp(a) (lipoprotein[a]) and hypertension to cardiovascular outcomes in a large multiethnic cohort free of baseline cardiovascular disease.MethodsIndividuals from the MESA (Multi-Ethnic Study of Atherosclerosis; N=6674) were grouped as follows: group 1: Lp(a) &lt;50 mg/dL and no hypertension; group 2: Lp(a) ≥50 mg/dL and no hypertension; group 3: Lp(a) &lt;50 mg/dL and hypertension; and group 4: Lp(a) ≥50 mg/dL and hypertension. Kaplan-Meier curves and multivariable Cox proportional hazard models were used to assess the relationship of Lp(a) and hypertension with time to cardiovascular disease events.ResultsMean follow-up time was 13.9 (5.0) years and 809 participants experienced a cardiovascular disease event. A statistically significant interaction was found between Log[Lp(a)] and hypertension status (P=0.091). Compared with the reference group (Lp[a] &lt;50 mg/dL and no hypertension), those with Lp[a] ≥50 mg/dL and no hypertension had no increased risk for cardiovascular disease events (hazard ratio, 1.09 [95% CI, 0.79-1.50]). However, those with Lp(a) &lt;50 mg/dL and hypertension or Lp(a) ≥50 mg/dL and hypertension demonstrated a statistically significant increase in risk compared to the reference group (hazard ratio, 1.66 [95% CI, 1.39-1.98]) and (hazard ratio, 2.07 [95% CI, 1.63-2.62]), respectively. Among those with hypertension, Lp(a) was associated with a significant increase in cardiovascular disease risk (hazard ratio, 1.24 [95% CI, 1.01-1.53]).ConclusionsAlthough the major contribution to cardiovascular risk was hypertension, elevated Lp(a) significantly modified the association of hypertension with cardiovascular disease. More research is needed to understand mechanistic links among Lp(a), hypertension, and cardiovascular disease

Closing the gaps in opioid use disorder research, policy and practice: conference proceedings

Abstract Drug overdose deaths involving opioids have surged in recent years and the economic cost of the opioid epidemic is estimated to be over $500 billion annually. In the midst of calls for declaring a national emergency, health policy decision makers are considering the best ways to allocate resources to curb the epidemic. On June 9, 2017, 116 invited health researchers, clinicians, policymakers, health system leaders, and other stakeholders met at the University of Pennsylvania to discuss approaches to address the gaps in evidence-based substance use disorder policy and practice, with an emphasis on the opioid epidemic. The conference was sponsored by the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH), a NIDA-funded National Center of Excellence, and hosted by the Leonard Davis Institute of Health Economics of the University of Pennsylvania. The conference aims were to: (1) foster new relationships between researchers and policymakers through a collaborative work process and (2) generate evidence-based policy recommendations to address the opioid epidemic. The conference concluded with an interactive work session during which attendees self-identified as researchers or policymakers and were divided equally among 13 tables. These groups met to develop and present policy recommendations based on an opioid use disorder case study. Thirteen policy recommendations emerged across four themes: (1) quality of treatment, (2) continuity of care, (3) opioid prescribing and pain management, and (4) consumer engagement. This conference serves as a proposed model to develop equitable, working relationships among researchers, clinicians, and policymakers