577 research outputs found

    Preferred roles in treatment decision making among patients with cancer: A pooled analysis of studies using the control preferences scale

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    OBJECTIVES: To collect normative data, assess differences between demographic groups, and indirectly compare US and Canadian medical systems relative to patient expectations of involvement in cancer treatment decision making. STUDY DESIGN: Meta-analysis. METHODS: Individual patient data were compiled across 6 clinical studies among 3491 patients with cancer who completed the 2-item Control Preferences Scale indicating the roles they preferred versus actually experienced in treatment decision making. RESULTS: The roles in treatment decision making that patients preferred were 26% active, 49% collaborative, and 25% passive. The roles that patients reported actually experiencing were 30% active, 34% collaborative, and 36% passive. Roughly 61% of patients reported having their preferred role; only 6% experienced extreme discordance between their preferred versus actual roles. More men than women (66% vs 60%, P = .001) and more US patients than Canadian patients (84% vs 54%, P <.001) reported concordance between their preferred versus actual roles. More Canadian patients than US patients preferred and actually experienced (42% vs 18%, P <.001) passive roles. More women than men reported taking a passive role (40% vs 24%, P <.001). Older patients preferred and were more likely than younger patients to assume a passive role. CONCLUSIONS: Roughly half of the studied patients with cancer indicated that they preferred to have a collaborative relationship with physicians. Although most patients had the decision-making role they preferred, about 40% experienced discordance. This highlights the need for incorporation of individualized patient communication styles into treatment plans

    Evolutionary Epidemiology of Drug-Resistance in Space

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    The spread of drug-resistant parasites erodes the efficacy of therapeutic treatments against many infectious diseases and is a major threat of the 21st century. The evolution of drug-resistance depends, among other things, on how the treatments are administered at the population level. “Resistance management” consists of finding optimal treatment strategies that both reduce the consequence of an infection at the individual host level, and limit the spread of drug-resistance in the pathogen population. Several studies have focused on the effect of mixing different treatments, or of alternating them in time. Here, we analyze another strategy, where the use of the drug varies spatially: there are places where no one receives any treatment. We find that such a spatial heterogeneity can totally prevent the rise of drug-resistance, provided that the size of treated patches is below a critical threshold. The range of parasite dispersal, the relative costs and benefits of being drug-resistant compared to being drug-sensitive, and the duration of an infection with drug-resistant parasites are the main factors determining the value of this threshold. Our analysis thus provides some general guidance regarding the optimal spatial use of drugs to prevent or limit the evolution of drug-resistance

    Cumulative advantage in collective action groups: How competition for group members alters the provision of public goods

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    Research on collective action problems and the provision of public goods has yielded an array of important insights into why people sacrifice for their groups, but ignores the processes that bring people into those groups in the first place. The literature is also silent on the fact that groups providing similar public goods often compete with one another to attract new members. We extend the reach of theories of collective action problems to bring them to bear on these interrelated issues. Results from four experiments support our predictions about when group members compete to attract new adherents by sacrificing more for group goals. Further, we find that prospective members join more productive groups at much higher rates and then contribute to them at high levels. These processes give way to cumulative advantage, whereby initially productive groups continually attract new members. Thus competition for members can yield large inequalities in the size and success of collective action groups

    NGO assessment study report (Yellow Book)

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    http://sci.esa.int/science-e/www/object/index.cfm?fobjectid=49839#The NGO (New Gravitational wave Observatory) concept results from the reformulation of the LISA mission into a European-led mission. This report, the so-called Yellow Book, contains the results of ESA's assessment study (Phase 0/A) of the candidate L-class Cosmic Vision mission NGO

    Chemisch modifizierte Oligonucleotide als Sonden und Agentien

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    Is Consistently Unfair Better than Sporadically Fair? An Investigation of Justice Variability and Stress

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    Measurement of the double-differential inclusive jet cross section in proton-proton collisions at s\sqrt{s} = 5.02 TeV

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    International audienceThe inclusive jet cross section is measured as a function of jet transverse momentum pTp_\mathrm{T} and rapidity yy. The measurement is performed using proton-proton collision data at s\sqrt{s} = 5.02 TeV, recorded by the CMS experiment at the LHC, corresponding to an integrated luminosity of 27.4 pb1^{-1}. The jets are reconstructed with the anti-kTk_\mathrm{T} algorithm using a distance parameter of RR = 0.4, within the rapidity interval y\lvert y\rvert<\lt 2, and across the kinematic range 0.06 <\ltpTp_\mathrm{T}<\lt 1 TeV. The jet cross section is unfolded from detector to particle level using the determined jet response and resolution. The results are compared to predictions of perturbative quantum chromodynamics, calculated at both next-to-leading order and next-to-next-to-leading order. The predictions are corrected for nonperturbative effects, and presented for a variety of parton distribution functions and choices of the renormalization/factorization scales and the strong coupling αS\alpha_\mathrm{S}
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