The Confidence Database

Understanding how people rate their confidence is critical for the characterization of a wide range of perceptual, memory, motor and cognitive processes. To enable the continued exploration of these processes, we created a large database of confidence studies spanning a broad set of paradigms, participant populations and fields of study. The data from each study are structured in a common, easy-to-use format that can be easily imported and analysed using multiple software packages. Each dataset is accompanied by an explanation regarding the nature of the collected data. At the time of publication, the Confidence Database (which is available at https://osf.io/s46pr/) contained 145 datasets with data from more than 8,700 participants and almost 4 million trials. The database will remain open for new submissions indefinitely and is expected to continue to grow. Here we show the usefulness of this large collection of datasets in four different analyses that provide precise estimations of several foundational confidence-related effects

Hazardous drinking among young adults seeking outpatient mental health services

BACKGROUND: Alcohol use can have a significant negative impact on young adults in mental health treatment. This cross-sectional study examined prevalence and factors associated with hazardous drinking among young adults seeking outpatient mental health services, rate of alcohol use disorders (AUDs), and the relationship between hazardous drinking and other types of substance use. METHODS: Participants were 487 young adults ages 18–25 who completed self-administered computerized screening questions for alcohol and drug use. Alcohol use patterns were assessed and predictors of hazardous drinking (≥5 drinks on one or more occasions in the past year) were identified using logistic regression. RESULTS: Of the 487 participants, 79.8 % endorsed prior-year alcohol use, 52.3 % reported one or more episodes of hazardous drinking in the prior year and 8.2 % were diagnosed with an AUD. Rates of recent and lifetime alcohol, tobacco and marijuana use were significantly greater in those with prior-year hazardous drinking. In logistic regression, prior-year hazardous drinking was associated with lifetime marijuana use (OR 3.30, p < 0.001; 95 % CI 2.05, 5.28), lifetime tobacco use (OR 1.88, p = 0.004; 95 % CI 1.22, 2.90) and older age (OR 1.18 per year, p < 0.001; 95 % CI 1.08, 1.29). CONCLUSIONS: In an outpatient mental health setting, high rates of hazardous drinking were identified, and drinking was associated with history of other substance use. Results highlight patient characteristics associated with hazardous drinking that mental health providers should be aware of in treating young adults, especially older age and greater use of tobacco and marijuana

Fc Effector Function Contributes to the Activity of Human Anti-CTLA-4 Antibodies.

With the use of a mouse model expressing human Fc-gamma receptors (FcγRs), we demonstrated that antibodies with isotypes equivalent to ipilimumab and tremelimumab mediate intra-tumoral regulatory T (Treg) cell depletion in vivo, increasing the CD8+ to Treg cell ratio and promoting tumor rejection. Antibodies with improved FcγR binding profiles drove superior anti-tumor responses and survival. In patients with advanced melanoma, response to ipilimumab was associated with the CD16a-V158F high affinity polymorphism. Such activity only appeared relevant in the context of inflamed tumors, explaining the modest response rates observed in the clinical setting. Our data suggest that the activity of anti-CTLA-4 in inflamed tumors may be improved through enhancement of FcγR binding, whereas poorly infiltrated tumors will likely require combination approaches

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Indigenous Australians and the National Disability Insurance Scheme

If the National Disability Insurance Scheme is to be an effective policy for Indigenous Australians, it needs to take into account their particular needs and aspirations. Overview The National Disability Insurance Scheme (NDIS) is one of the major policy innovations of the early 21st century in Australia, representing a new way of delivering services to people with a disability and those who care for them. It has the potential to transform the lives of hundreds of thousands of people, giving them greater certainty and control over their lives. There is a higher incidence of disability in the Aboriginal and Torres Strait Islander population than in the Australian population more generally, so the NDIS is of particular relevance to Indigenous Australians. However, Indigenous Australians with a disability have a very distinct age, geographic and health profile, which differs from that of the equivalent non-Indigenous population. Furthermore, the conceptualisation of disability and care in many Indigenous communities, particularly in remote areas, may differ markedly in comparison to more settled parts of the country, and there is the added complexity of a unique history of interaction with government. In considering these issues in detail, this Research Monograph provides a resource for policy makers, researchers and service providers who are working in this important policy area. Its major conclusion is that the NDIS, if it is to be an effective policy for Indigenous Australians, needs to take into account their very particular needs and aspirations

Inaugural Report and Operational Guide STARS Inaugural Report and Operational Guide STARS Inaugural Report and Operational Guide

Executive Summary This report serves as a summary of the inaugural year&apos;s activity and impact, whilst also acting as an operational guide for subsequent years. STARS is a unique differentiated development pilot that aimed to identify the needs of, and offer support to, high achieving level 2 students at the University of Surrey. No comparable schemes in the UK and European literature could be identified. The STARS scheme targeted students entering level 2 who had achieved an average of over 70% in level 1 (n=502). Over 82% of the eligible students invited became affiliated with the scheme. Their needs were identified through a process of heuristic research. The data show that high achieving students have discernibly different needs. Subsequently, the multidisciplinary STARS team delivered bespoke developmental activities (covering perfectionism, resilience, team work and advanced communication skills) in response to this data. All of the students who participated in the evaluation process wanted STARS to continue in 2013 and 98% of students thought it was important that the University continues to recognise and support its high-achievers. Students reported improvements in motivation, development in academic and non-academic competencies and increased academic self-efficacy from participating in STARS. In addition to the short-term reported impact, the scheme may also affect longer term aspirations. In November 2011, at the beginning of the scheme, 25% of the students reported they were considering PGT study; by the end of the academic session, this had risen to 69%. The scheme therefore represents a potentially potent set of simple interventions which may have the effect of increasing both aspiration and also possibly loyalty to the institution which has recognised them individually and invested in them personally. Further research would of course be valuable to examine the extent of correlation and any possible causative relationship; as well as whether the intentions translated into actions in the students&apos; futures, and the proportion of those who remained with their UG institution. There are clear advantages to the institution to be gained by continuing to support this high achieving population throughout their level 2 and 3 experience. Mary Dickinson July 2012 STARS Inaugural Report and Operational Guide STARS Inaugural Report and Operational Guide Rationale STARS, a differentiated development initiative, originated from a commitment to improve inclusivity of provision; ensuring that the University offers quality support for all students. Developing exceptional students is in every institution&apos;s interest, as &quot;the attitudes and accomplishments of the most talented students help to improve an institution&apos;s academic atmosphere and differentiate a university from its peer institutions&quot; (Rinn and Plucker, 2004: p.54). Historically in terms of &apos;additional&apos; (co-curricular) academic provision there has been a tendency to concentrate on students who are under-performing. However, a differentiated learning pilot argued that bright students &quot;should have equal entitlement to be developed to his or her full potential&quot; (Assinder, 2007, p4). Therefore, STARS was an attempt to address these needs, and thereby contribute to the University&apos;s drive to increase the proportion of &apos;good&apos; degrees. The University believes its focus on &quot;personal development and professional attitude&quot; (University of Surrey, 2012, p. 20) is one core reason for its excellent graduate employability. In addition to the professional training year that many undergraduate students complete, skills development is embedded within the academic programmes. Professional and personal development planning is featured across the curriculum and the University has provided specific skills development opportunities for all students since 2007 in SPLASH: the &quot;Student Personal Learning and Study Hub&quot;. The University Strategy 2007-2017 identifies, as a key strategic challenge for the institution the need to: &apos;Improve the student experience in both the quality of learning and teaching and the non-academic student experience&apos;. Level 2 students were selected for two reasons. Firstly, the UK first year and final year experience have been well researched in recent years (e.g. The hypothesis of this project was that high-achieving students will respond positively to improvements in the affective aspect of their learning experience www.surrey.ac.uk/library/splash 4 STARS Inaugural Report and Operational Guide Method STARS targeted students entering level 2 who had achieved an average of over 70% at level 1 (n=502). A virtual tutorial outlining the STARS objectives was distributed to all eligible students, along with joining instructions. To join the scheme students needed to register with the STARS virtual community, hosted on the social networking platform Ning 1 . Research suggests that when students feel they have shared experiences that social networking can be valuable. Social networking services may also benefit learners by allowing them to enter new networks of collaborative learning, often based on interests and affinities not catered for in their immediate educational environment…students will invest time and energy in building relationships around shared interests and knowledge communities (Selwyn, 2008, p.20). The forum created a virtual &quot;place&quot; where STARS students could feel a sense of &quot;belonging&quot; (Salmon, 2002, p.26) to the new group. The forum allowed collaboration and interaction which was encouraged using activities and prompt questions by the moderators. It also acted as a point of provision for learning development materials and self-help study guides, as well as acting as a conduit to all the generic study skills materials currently offered. Clarke confirms that such e-content creates opportunities for formal and informal learning via peer support (Clarke, 2004 pp.6-17), highlighting the engagement that occurs between staff, as well as between peers and resources. Ning has a very intuitive interface, and as it is similar to Facebook it was easily used by most students. It also links well with other common resources/formats (YouTube, Flickr etc). It allows good moderator control, but allows students space for creativity. Essentially, Ning had all of the functionality needed for the STARS programme: blogs, forums, groups, email, and event management. Over 400 students of the 502 who were eligible chose to sign up to Ning. The STARS Team A review of the literature (summarised in In anticipation of multi-disciplinary input being required (as per US data) the core team comprised of learning development specialists from SPLASH, working in an integrated way with experienced counselling staff (from Student Services). In addition to the initial team, the following were also consulted and were involved in design and delivery;