Psychometric properties of the Dutch version of the Evidence-Based Practice Attitude Scale (EBPAS).

BackgroundThe Evidence-Based Practice Attitude Scale (EBPAS) was developed in the United States to assess attitudes of mental health and welfare professionals toward evidence-based interventions. Although the EBPAS has been translated in different languages and is being used in several countries, all research on the psychometric properties of the EBPAS within youth care has been carried out in the United States. The purpose of this study was to investigate the psychometric properties of the Dutch version of the EBPAS.MethodsAfter translation into Dutch, the Dutch version of the EBPAS was examined in a diverse sample of 270 youth care professionals working in five institutions in the Netherlands. We examined the factor structure with both exploratory and confirmatory factor analyses and the internal consistency reliability. We also conducted multiple linear regression analyses to examine the association of EBPAS scores with professionals' characteristics. It was hypothesized that responses to the EBPAS items could be explained by one general factor plus four specific factors, good to excellent internal consistency reliability would be found, and EBPAS scores would vary by age, sex, and educational level.ResultsThe exploratory factor analysis suggested a four-factor solution according to the hypothesized dimensions: Requirements, Appeal, Openness, and Divergence. Cronbach's alphas ranged from 0.67 to 0.89, and the overall scale alpha was 0.72. The confirmatory factor analyses confirmed the factor structure and suggested that the lower order EBPAS factors are indicators of a higher order construct. However, Divergence was not significantly correlated with any of the subscales or the total score. The confirmatory bifactor analysis endorsed that variance was explained both by a general attitude towards evidence-based interventions and by four specific factors. The regression analyses showed an association between EBPAS scores and youth care professionals' age, sex, and educational level.ConclusionsThe present study provides strong support for a structure with a general factor plus four specific factors and internal consistency reliability of the Dutch version of the EBPAS in a diverse sample of youth care professionals. Hence, the factor structure and reliability of the original version of the EBPAS seem generalizable to the Dutch version of the EBPAS

\u27Traffic-light\u27 nutrition labelling and \u27junk-food\u27 tax : a modelled comparison of cost-effectiveness for obesity prevention

Introduction: Cost-effectiveness analyses are important tools in efforts to prioritise interventions for obesity prevention.Modelling facilitates evaluation of multiple scenarios with varying assumptions. This study compares the cost-effectiveness ofconservative scenarios for two commonly proposed policy-based interventions: front-of-pack &lsquo;traffic-light&rsquo; nutrition labelling(traffic-light labelling) and a tax on unhealthy foods (&lsquo;junk-food&rsquo; tax).Methods: For traffic-light labelling, estimates of changes in energy intake were based on an assumed 10% shift in consumptiontowards healthier options in four food categories (breakfast cereals, pastries, sausages and preprepared meals) in 10% of adults. For the &lsquo;junk-food&rsquo; tax, price elasticities were used to estimate a change in energy intake in response to a 10% price increase in seven food categories (including soft drinks, confectionery and snack foods). Changes in population weight and body mass index by sex were then estimated based on these changes in population energy intake, along with subsequent impacts on disability-adjusted life years (DALYs). Associated resource use was measured and costed using pathway analysis, based on a health sector perspective (with some industry costs included). Costs and health outcomes were discounted at 3%. The cost-effectiveness of each intervention was modelled for the 2003 Australian adult population.Results: Both interventions resulted in reduced mean weight (traffic-light labelling: 1.3 kg (95% uncertainty interval (UI): 1.2;1.4); &lsquo;junk-food&rsquo; tax: 1.6 kg (95% UI: 1.5; 1.7)); and DALYs averted (traffic-light labelling: 45 100 (95% UI: 37 700; 60 100);&lsquo;junk-food&rsquo; tax: 559 000 (95% UI: 459 500; 676 000)). Cost outlays were AUD81 million (95% UI: 44.7; 108.0) for traffic-lightlabelling and AUD18 million (95% UI: 14.4; 21.6) for &lsquo;junk-food&rsquo; tax. Cost-effectiveness analysis showed both interventions were&lsquo;dominant&rsquo; (effective and cost-saving).Conclusion: Policy-based population-wide interventions such as traffic-light nutrition labelling and taxes on unhealthy foods arelikely to offer excellent &lsquo;value for money&rsquo; as obesity prevention measures.<br /

Dynamics of Locally Coupled Oscillators with Next-Nearest-Neighbor Interaction

A theoretical description of decentralized dynamics within linearly coupled, one-dimensional oscillators (agents) with up to next-nearest-neighbor interaction is given. Conditions for stability of such system are presented. Our results indicate that the stable systems have response that grow at least linearly in the system size. We give criteria when this is the case. The dynamics of these systems can be described with traveling waves with strong damping in the high frequencies. Depending on the system parameters, two types of solutions have been found: damped oscillations and reflectionless waves. The latter is a novel result and a feature of systems with at least next-nearest-neighbor interactions. Analytical predictions are tested in numerical simulations

Clinical implications of food-drug interactions with small-molecule kinase inhibitors

During the past two decades, small-molecule kinase inhibitors have proven to be valuable in the treatment of solid and haematological tumours. However, because of their oral administration, the intrapatient and interpatient exposure to small-molecule kinase inhibitors (SMKIs) is highly variable and is affected by many factors, such as concomitant use of food and herbs. Food-drug interactions are capable of altering the systemic bioavailability and pharmacokinetics of these drugs. The most important mechanisms underlying food-drug interactions are gastrointestinal drug absorption and hepatic metabolism through cytochrome P450 isoenzymes. As food-drug interactions can lead to therapy failure or severe toxicity, knowledge of these interactions is essential. This Review provides a comprehensive overview of published studies involving food-drug interactions and herb-drug interactions for all registered SMKIs up to Oct 1, 2019. We critically discuss US Food and Drug Administration (FDA) and European Medicines Agency (EMA) guidelines concerning food-drug interactions and offer clear recommendations for their management in clinical practice

Classical stability of U(1)_A domain walls in dense matter QCD

It was recently shown that there exists metastable U(1)_A domain wall configurations in high-density QCD (\mu >> 1 GeV). In the following we will assess the stability of such non-trivial field configurations at intermediate densities (\mu < 1 GeV). The existence of such configurations at intermediate densities could have interesting consequences for the physics of neutron stars with high core density.Comment: 13 pages, 2 Postscript figures, typos correcte