1,918 research outputs found
Randomised controlled trials of complex interventions and large-scale transformation of services
Complex interventions and large-scale transformations of services are necessary to meet the health-care challenges of the 21st century. However, the evaluation of these types of interventions is challenging and requires methodological development.
Innovations such as cluster randomised controlled trials, stepped-wedge designs, and non-randomised evaluations provide options to meet the needs of decision-makers. Adoption of theory and logic models can help clarify causal assumptions, and process evaluation can assist in understanding delivery in context. Issues of implementation must also be considered throughout intervention design and evaluation to ensure that results can be scaled for population benefit. Relevance requires evaluations conducted under real-world conditions, which in turn requires a pragmatic attitude to design. The increasing complexity of interventions and evaluations threatens the ability of researchers to meet the needs of decision-makers for rapid results. Improvements in efficiency are thus crucial, with electronic health records offering significant potential
The Allen Telescope Array Twenty-centimeter Survey -- A 700-Square-Degree, Multi-Epoch Radio Dataset -- II: Individual Epoch Transient Statistics
We present our second paper on the Allen Telescope Array Twenty-centimeter
Survey (ATATS), a multi-epoch, ~700 sq. deg. radio image and catalog at 1.4
GHz. The survey is designed to detect rare, bright transients as well as to
commission the ATA's wide-field survey capabilities. ATATS explores the
challenges of multi-epoch transient and variable source surveys in the domain
of dynamic range limits and changing (u,v) coverage.
Here we present images made using data from the individual epochs, as well as
a revised image combining data from all ATATS epochs. The combined image has
RMS noise 3.96 mJy / beam, with a circular beam of 150 arcsec FWHM. The
catalog, generated using a false detection rate algorithm, contains 4984
sources, and is >90% complete to 37.9 mJy. The catalogs generated from snapshot
images of the individual epochs contain between 1170 and 2019 sources over the
564 sq. deg. area in common to all epochs. The 90% completeness limits of the
single epoch catalogs range from 98.6 to 232 mJy.
We compare the catalog generated from the combined image to those from
individual epochs, and from the NRAO VLA Sky Survey (NVSS), a legacy survey at
the same frequency. We are able to place new constraints on the transient
population: fewer than 6e-4 transients / sq. deg., for transients brighter than
350 mJy with characteristic timescales of minutes to days. This strongly rules
out an astronomical origin for the ~1 Jy sources reported by Matsumura et al.
(2009), based on their stated rate of 3.1e-3 / sq. deg.Comment: 28 pages, 12 figures, ApJ accepte
Self-management interventions in patients with long-term conditions: a structured review of approaches to reporting inclusion, assessment, and outcomes in multimorbidity
Background: Multimorbidity has many potential implications for healthcare delivery, but a particularly important impact concerns the validity of trial evidence underpinning clinical guidelines for individual conditions. Objective: To review how authors of published trials of self-management interventions reported inclusion criteria, sample descriptions, and consideration of the impact of multimorbidity on trial outcomes. Methods: We restricted our analysis to a small number of exemplar long-term conditions: type 2 diabetes mellitus, coronary heart disease, and chronic obstructive pulmonary disease. We focussed our search on published Cochrane reviews. Data were extracted from the trials on inclusion/exclusion, sample description, and impact on outcomes. Results: Eleven reviews consisting of 164 unique trials were identified. Sixty percent of trials reported excluding patients with forms of multimorbidity. Reasons for exclusion were poorly described or defined. Reporting of multimorbidity within the trials was poor, with only 35% of trials reporting on multimorbidity in their patient samples. Secondary analyses, exploring the impact of multimorbidity, were very rare. Conclusions: The importance of multimorbidity in trials is only going to become more important over time, but trials often exclude patients with multimorbidity, and reporting of multimorbidity in trials including such patients is generally poor. This limits judgements about the external validity of the results for clinical populations. A consistent approach to the conduct and reporting of secondary analyses of the effects of multimorbidity on outcomes, using current best-practice guidance, could lead to a rapid development of the evidence base. Journal of Comorbidity 2014;4(1):37–4
The effectiveness of self help technologies for emotional problems in adolescents: a systematic review
Abstract Background Adolescence is a transition period that involves physiological, psychological, and social changes. Emotional problems such as symptoms of anxiety and depression may develop due to these changes. Although many of these problems may not meet diagnostic thresholds, they may develop into more severe disorders and may impact on functioning. However, there are barriers that may make it difficult for adolescents to receive help from health professionals for such problems, one of which is the limited availability of formal psychological therapy. One way of increasing access to help for such problems is through self help technology (i.e. delivery of psychological help through information technology or paper based formats). Although there is a significant evidence base concerning self help in adults, the evidence base is much weaker in adolescents. This study aims to examine the effectiveness of self help technology for the treatment of emotional problems in adolescents by conducting a systematic review of randomized and quasi-experimental evidence. Methods Five major electronic databases were searched: Medline, PsycInfo, Embase, Cochrane Controlled Trials Register and CINAHL. In addition, nine journals were handsearched and the reference lists of all studies were examined for any additional studies. Fourteen studies were identified. Effect sizes were calculated across 3 outcome measures: attitude towards self (e.g. self esteem); social cognition (e.g. self efficacy); and emotional symptoms (i.e. depression and anxiety symptoms). Results Meta analysis showed small, non-significant effect size for attitude towards self (ES = -0.14, 95% CI = -0.72 to 0.43), a medium, non-significant effect size for social cognition (ES = -0.49, 95% CI = -1.23 to 0.25) and a medium, non-significant effect size for emotional symptoms (ES = -0.47, 95% CI = -1.00 to 0.07). However, these findings must be considered preliminary, because of the small number of studies, their heterogeneity, and the relatively poor quality of the studies. Conclusion At present, the adoption of self help technology for adolescents with emotional problems in routine clinical practice cannot be recommended. There is a need to conduct high quality randomised trials in clearly defined populations to further develop the evidence base before implementation.</p
Interview with Harold Bower
Harold Bower gives a history of the Kokosing River area.https://digital.kenyon.edu/lak_interviews/1022/thumbnail.jp
The effect of using social pressure in cover letters to improve retention in a longitudinal health study: an embedded randomised controlled retention trial
BackgroundRetention of participants in cohort studies is important for validity. One way to promote retention is by sending a persuasive cover letter with surveys. The study aimed to compare the effectiveness of a covering letter containing social pressure with a standard covering letter on retention in a health cohort study. Social pressure involves persuading people to behave in a certain way by the promise that their actions will be made know to others. We implemented a mild form of social pressure, where the recipient was told that information about whether they responded to the current survey would be noted by the research team and printed on future correspondence from the research team to the recipient.MethodsThe design was an embedded randomised controlled retention trial, conducted between July 2015 and April 2016 in Salford, UK. Participants in the host health cohort study were eligible. They received either: (1) a covering letter with two consecutive surveys (sent six and twelve months after recruitment), containing a social pressure intervention; or (2) a matching letter without the social pressure text. The primary outcome was retention in the host study, defined as return of both surveys. Randomisation was computer-generated, with stratification by household size. Participants were blinded to group assignment. Researchers were blinded for outcome ascertainment.ResultsAdults (n = 4447) aged over 65 years, with a long-term condition and enrolled in the host study, were randomly allocated to receive a social pressure covering letter (n = 2223) or control (n = 2224). All 4447 participants were included in the analysis. Both questionnaires were returned by 1577 participants (71%) sent the social pressure letters and 1511 (68%) sent control letters, a risk difference of 3 percentage points (adjusted odds ratio = 1.16 (95% confidence interval = 1.02–1.33)).ConclusionA mild form of social pressure made a small but significant improvement in retention of older adults in a health cohort study. Investigation of social pressure across other research contexts and stronger social pressure messages is warranted
Identification of stable endogenous reference genes for real-time PCR in the human fetal gonad using an external standard technique
Peer reviewedPostprin
Identifying Psychosocial Interventions That Improve Both Physical and Mental Health in Patients With Diabetes: A systematic review and meta-analysis
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