Transect sampling strategies for semi-detailed characterization of inland valley systems

For the semi-detailed characterization of inland valleys systems in the Ivory Coast, transect sampling was used to describe valley morphology, soils, and land use characteristics. Initially, for each valley one transect with a width of 200 to 400 m was proposed. More recently, use of a larger number of transects has been suggested. However, there is no statistical basis for either the number of transects to be described or their optimal width. Two sets of aerial photographs (1979, scale 1:50 000, and 1996, scale 1:20 000) of the Boundiali key area were processed and the results digitized. Using GIS, sets of transects with different width were made, and used for the determination of the sample size for estimating the land use ratio and the valley bottom ratio at valley system level with given confidence intervals. These results were validated with data from the field and with sets of pre-selected transects. The calculated sample size is based on simple random sampling and depends on both transect width and variability in the study area. For the characterization of inland valleys with reasonable confidence intervals, the sample size for random sampling is too large for the semi-detailed characterization method. Smaller samples of transects selected on the basis of sub-recent aerial photographs gave comparable results for land cover characteristics estimation as the larger samples for random sampling. There is scope for reducing sample size by formalizing criteria for transect placement on the basis of the earlier aerial photographs

Transect sampling strategies for semi-detailed characterization of inland valley systems

For the semi-detailed characterization of inland valleys systems in the Ivory Coast, transect sampling was used to describe valley morphology, soils, and land use characteristics. Initially, for each valley one transect with a width of 200 to 400 m was proposed. More recently, use of a larger number of transects has been suggested. However, there is no statistical basis for either the number of transects to be described or their optimal width. Two sets of aerial photographs (1979, scale 1:50 000, and 1996, scale 1:20 000) of the Boundiali key area were processed and the results digitized. Using GIS, sets of transects with different width were made, and used for the determination of the sample size for estimating the land use ratio and the valley bottom ratio at valley system level with given confidence intervals. These results were validated with data from the field and with sets of pre-selected transects. The calculated sample size is based on simple random sampling and depends on both transect width and variability in the study area. For the characterization of inland valleys with reasonable confidence intervals, the sample size for random sampling is too large for the semi-detailed characterization method. Smaller samples of transects selected on the basis of sub-recent aerial photographs gave comparable results for land cover characteristics estimation as the larger samples for random sampling. There is scope for reducing sample size by formalizing criteria for transect placement on the basis of the earlier aerial photographs

Plasma levels of nitric oxide related amino acids in demented subjects with Down syndrome are related to neopterin concentrations

Subjects with Down syndrome (DS) have abnormalities in virtually all aspects of the immune system and almost all will be affected with Alzheimer’s disease (AD). It is thought that nitric oxide (NO) is involved in the pathophysiology of AD. In the present study, including a total of 401 elderly DS subjects, the spectrum of plasma amino acids and neopterin was investigated and related to development of AD. Concentrations of nearly all amino acids in DS subjects differed significantly from those of healthy controls. Neopterin was increased in DS subjects, especially in dementia. The production of NO as reflected by an increased citrulline/arginine ratio (Cit/Arg ratio) was enhanced during development of clinical dementia. Neopterin concentrations correlated to the Cit/Arg ratio only in the group of prevalent demented subjects (ρ = 0.48, P = 0.006). The results of this study are suggestive for an increase in oxidative processes in DS subjects with AD

How are "teaching the teachers" courses in evidence based medicine evaluated? A systematic review

Background Teaching of evidence-based medicine (EBM) has become widespread in medical education. Teaching the teachers (TTT) courses address the increased teaching demand and the need to improve effectiveness of EBM teaching. We conducted a systematic review of assessment tools for EBM TTT courses. To summarise and appraise existing assessment methods for teaching the teachers courses in EBM by a systematic review. Methods We searched PubMed, BioMed, EmBase, Cochrane and Eric databases without language restrictions and included articles that assessed its participants. Study selection and data extraction were conducted independently by two reviewers. Results Of 1230 potentially relevant studies, five papers met the selection criteria. There were no specific assessment tools for evaluating effectiveness of EBM TTT courses. Some of the material available might be useful in initiating the development of such an assessment tool. Conclusion There is a need for the development of educationally sound assessment tools for teaching the teachers courses in EBM, without which it would be impossible to ascertain if such courses have the desired effect

Harmonising evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries

BACKGROUND: We developed and evaluated the outcomes of an e-learning course for evidence based medicine (EBM) training in postgraduate medical education in different languages and settings across five European countries. METHODS: We measured changes in knowledge and attitudes with well-developed assessment tools before and after administration of the course. The course consisted of five e-learning modules covering acquisition (formulating a question and search of the literature), appraisal, application and implementation of findings from systematic reviews of therapeutic interventions, each with interactive audio-visual learning materials of 15 to 20 minutes duration. The modules were prepared in English, Spanish, German and Hungarian. The course was delivered to 101 students from different specialties in Germany (psychiatrists), Hungary (mixture of specialties), Spain (general medical practitioners), Switzerland (obstetricians-gynaecologists) and the UK (obstetricians-gynaecologists). We analysed changes in scores across modules and countries. RESULTS: On average across all countries, knowledge scores significantly improved from pre- to post-course for all five modules (p < 0.001). The improvements in scores were on average 1.87 points (14% of total score) for module 1, 1.81 points (26% of total score) for module 2, 1.9 points (11% of total score) for module 3, 1.9 points (12% of total score) for module 4 and 1.14 points (14% of total score) for module 5. In the country specific analysis, knowledge gain was not significant for module 4 in Spain, Switzerland and the UK, for module 3 in Spain and Switzerland and for module 2 in Spain. Compared to pre-course assessment, after completing the course participants felt more confident that they can assess research evidence and that the healthcare system in their country should have its own programme of research about clinical effectiveness. CONCLUSION: E-learning in EBM can be harmonised for effective teaching and learning in different languages, educational settings and clinical specialties, paving the way for development of an international e-EBM course

What is out there? A typology of land restoration projects in Latin America and the Caribbean

Abstract Restoring degraded lands is high on the international agenda and the number of restoration projects in Latin America and the Caribbean (LAC) has increased considerably over the past decades. However, the variety of approaches used have not been systematically documented and analyzed. We aimed to develop a restoration typology as a function of the geographical and socio-economical setting, planning, timeframe, finances, implementation, monitoring and potential impact, which will help to discern broad patterns and identify gaps in project implementation in LAC. We categorized 97 restoration projects using Multiple Correspondence Analysis and a Hierarchical Clustering on Principal Components. Three main restoration types emerged from the clustering, with the main defining variables being: (1) project area under restoration, (2) amount of funding received, (3) source of funding and (4) monitoring efforts. The first type are large-scale projects, which receive high amounts of funding provided by international donors, and with a well-established monitoring plan; the second type are projects financed with private money, typically lacking a sound monitoring program; and the third type represents small projects with low amounts of funding, financed with public funds from national governments, often with a rudimentary monitoring plan. The typology enables a comparative analysis of the status and trends of restoration activities across Latin America. We conclude that, despite growing awareness and recognition that integrated approaches are needed to revert complex and interconnected socio-economic and environmental issues like land degradation, the socio-economic dimension remains underexposed in the majority of restoration projects, whereas monitoring is still regarded as an extra cost instead of a necessary investment

The effectiveness of a clinically integrated e-learning course in evidence-based medicine: A cluster randomised controlled trial

BACKGROUND: To evaluate the educational effects of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduates compared to a traditional lecture-based course of equivalent content. METHODS: We conducted a cluster randomised controlled trial in the Netherlands and the UK involving postgraduate trainees in six obstetrics and gynaecology departments. Outcomes (knowledge gain and change in attitude towards EBM) were compared between the clinically integrated e-learning course (intervention) and the traditional lecture based course (control). We measured change from pre- to post-intervention scores using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). RESULTS: There were six clusters involving teaching of 61 postgraduate trainees (28 in the intervention and 33 in the control group). The intervention group achieved slightly higher scores for knowledge gain compared to the control, but these results were not statistically significant (difference in knowledge gain: 3.5 points, 95% CI -2.7 to 9.8, p = 0.27). The attitudinal changes were similar for both groups. CONCLUSION: A clinically integrated e-learning course was at least as effective as a traditional lecture based course and was well accepted. Being less costly than traditional teaching and allowing for more independent learning through materials that can be easily updated, there is a place for incorporating e-learning into postgraduate EBM curricula that offer on-the-job training for just-in-time learning. TRIAL REGISTRATION: Trial registration number: ACTRN12609000022268

Markers of early changes in cognition across cohorts of adults with Down syndrome at risk of Alzheimer's disease.

IntroductionDown syndrome (DS), a genetic variant of early onset Alzheimer's disease (AD), lacks a suitable outcome measure for prevention trials targeting pre-dementia stages.MethodsWe used cognitive test data collected in several longitudinal aging studies internationally from 312 participants with DS without dementia to identify composites that were sensitive to change over time. We then conducted additional analyses to provide support for the utility of the composites. The composites were presented to an expert panel to determine the most optimal cognitive battery based on predetermined criteria.ResultsThere were common cognitive domains across site composites, which were sensitive to early decline. The final composite consisted of memory, language/executive functioning, selective attention, orientation, and praxis tests.DiscussionWe have identified a composite that is sensitive to early decline and thus may have utility as an outcome measure in trials to prevent or delay symptoms of AD in DS