Concordance between decision analysis and matching systematic review of randomized controlled trials in assessment of treatment comparisons: a systematic review

BACKGROUND: Systematic review (SR) of randomized controlled trials (RCT) is the gold standard for informing treatment choice. Decision analyses (DA) also play an important role in informing health care decisions. It is unknown how often the results of DA and matching SR of RCTs are in concordance. We assessed whether the results of DA are in concordance with SR of RCTs matched on patient population, intervention, control, and outcomes. METHODS: We searched PubMed up to 2008 for DAs comparing at least two interventions followed by matching SRs of RCTs. Data were extracted on patient population, intervention, control, and outcomes from DAs and matching SRs of RCTs. Data extraction from DAs was done by one reviewer and from SR of RCTs by two independent reviewers. RESULTS: We identified 28 DAs representing 37 comparisons for which we found matching SR of RCTs. Results of the DAs and SRs of RCTs were in concordance in 73% (27/37) of cases. The sensitivity analyses conducted in either DA or SR of RCTs did not impact the concordance. Use of single (4/37) versus multiple data source (33/37) in design of DA model was statistically significantly associated with concordance between DA and SR of RCTs. CONCLUSIONS: Our findings illustrate the high concordance of current DA models compared with SR of RCTs. It is shown previously that there is 50% concordance between DA and matching single RCT. Our study showing the concordance of 73% between DA and matching SR of RCTs underlines the importance of totality of evidence (i.e. SR of RCTs) in the design of DA models and in general medical decision-making

Optical Properties of High-Frequency Radio Sources from the Australia Telescope 20 GHz (AT20G) Survey

Our current understanding of radio-loud AGN comes predominantly from studies at frequencies of 5 GHz and below. With the recent completion of the Australia Telescope 20 GHz (AT20G) survey, we can now gain insight into the high-frequency radio properties of AGN. This paper presents supplementary information on the AT20G sources in the form of optical counterparts and redshifts. Optical counterparts were identified using the SuperCOSMOS database and redshifts were found from either the 6dF Galaxy survey or the literature. We also report 144 new redshifts. For AT20G sources outside the Galactic plane, 78.5% have optical identifications and 30.9% have redshift information. The optical identification rate also increases with increasing flux density. Targets which had optical spectra available were examined to obtain a spectral classification. There appear to be two distinct AT20G populations; the high luminosity quasars that are generally associated with point-source optical counterparts and exhibit strong emission lines in the optical spectrum, and the lower luminosity radio galaxies that are generally associated with passive galaxies in both the optical images and spectroscopic properties. It is suggested that these different populations can be associated with different accretion modes (cold-mode or hot-mode). We find that the cold-mode sources have a steeper spectral index and produce more luminous radio lobes, but generally reside in smaller host galaxies than their hot-mode counterparts. This can be attributed to the fact that they are accreting material more efficiently. Lastly, we compare the AT20G survey with the S-cubed semi-empirical (S3-SEX) models and conclude that the S3-SEX models need refining to correctly model the compact cores of AGN. The AT20G survey provides the ideal sample to do this.Comment: Accepted for publication in MNRA

Evaluating the Effects of the Teen Outreach Program on Positive Youth Development Constructs

Introduction: The Teen Outreach Program (TOP) is a positive youth development (PYD) program that seeks to reduce the risk of adolescent pregnancy, school dropout, and course failure. As TOP has not been evaluated for its impact on PYD constructs, our purpose was to assess this potential. Methods: A pair-matched, cluster randomized controlled trial to evaluate TOP among youth in 26 high schools was conducted in 2013-2014. Youth (N=3740) were surveyed at baseline and immediately following program completion. A linear mixed effects model compared scores of the Lerner’s Five Cs measure of PYD between treatment and control youth and by race/ethnicity and gender subgroups. Results: After a multiple comparison adjustment, no statistically significant results were observed. Conclusions: Despite the lack of statistically significant findings, the current study can provide insight for future evaluations of TOP regarding adaptation and evaluation of core components, implementation, PYD impacts, and sexual and reproductive health outcomes

A successful search for intervening 21 cm HI absorption in galaxies at 0.4 < z <1.0 with the Australian Square Kilometre Array Pathfinder (ASKAP)

We have used the Australian Square Kilometre Array Pathfinder (ASKAP) radio telescope to search for intervening 21 cm neutral hydrogen (HI) absorption along the line of sight to 53 bright radio continuum sources. Our observations are sensitive to HI column densities typical of Damped Lyman Alpha absorbers (DLAs) in cool gas with an HI spin temperature below about 300-500 K. The six-dish Boolardy Engineering Test Array (BETA) and twelve-antenna Early Science array (ASKAP-12) covered a frequency range corresponding to redshift $0.4<z<1.0$ and $0.37<z<0.77$ respectively for the HI line. Fifty of the 53 radio sources observed have reliable optical redshifts, giving a total redshift path $\Delta z$ = 21.37. This was a spectroscopically-untargeted survey, with no prior assumptions about the location of the lines in redshift space. Four intervening HI lines were detected, two of them new. In each case, the estimated HI column density lies above the DLA limit for HI spin temperatures above 50-80 K, and we estimate a DLA number density at redshift $z\sim0.6$ of $n(z)=0.19\substack{+0.15 \\ -0.09}$. This value lies somewhat above the general trend of $n(z)$ with redshift seen in optical DLA studies. Although the current sample is small, it represents an important proof of concept for the much larger 21cm First Large Absorption Survey in HI (FLASH) project to be carried out with the full 36-antenna ASKAP telescope, probing a total redshift path $\Delta z\sim\,50,000$.Comment: 21 pages, 11 figures. Accepted for publication in MNRA

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Exploring Young Women’s Choice to Initiate Use of Long-acting Reversible Contraception: A Mixed Methods Approach

Background: The United States has the highest rate of unintended pregnancy compared to any other developed country. Unintended pregnancy is associated with negative health outcomes for both parents and children. It is estimated that government expenditures for unintended pregnancy total $21 billion each year. Women ages 18-25 years old have the highest rate of unintended pregnancy. This age group is categorized as emerging adulthood, and this is a unique developmental period in a person’s life. Given the high rate of unintended pregnancies and the associated negative outcomes, increasing the use of more reliable methods of birth control is a public health priority. Long-acting reversible contraception (LARC) are the most effective reversible forms of contraception available. However, the use of LARC among young women is low, with only 5% of those ages 15-24 using this method. Additionally, among women who use LARC, 89% use the IUD and only 11% use the implant. By understanding factors that influence LARC initiation, use of these highly effective methods can be increased and subsequently the rate of unintended pregnancy could be decreased. Purpose: The purpose of this study was to advance our understanding of key factors in LARC initiation and why women chose one LARC method over another. The objectives were as follows: 1) Determine if interpersonal and intrapersonal differences exist between IUD users and implant users; and 2) Explore how participants chose either the IUD or the implant. Methods: A mixed method study was conducted among 18-25 year old, nulliparous women who were currently using LARC. Phase I consisted of a quantitative survey administered online to 226 participants. Phase II involved conducting in-depth, semi-structured interviews with a subset of participants (N=30) from Phase I to further explore important factors in LARC initiation. This study was guided by Social Cognitive Theory. Phase I data were analyzed using MANOVA or chi-square tests, and Phase II interviews were analyzed using the Applied Thematic Analysis approach. Results: Quantitative results indicated that Hispanic women and participants who were younger were more likely to use the implant compared to the IUD. Women using the IUD more often reported that their friends were influential in their choice compared to implant users. The most common and trusted sources of information for participants was their health care provider or the internet. In the qualitative phase, the majority of women reported that using a previous method of contraception inconsistently (outcome expectations) was an important motivator in considering LARC. They then sought out health information (knowledge) on LARC from their provider and the internet. They also sought — either through their social network and/or social media — to hear the experiences of other women who had used these methods (observational learning). Upon making the decision to use LARC, women then intentionally set a goal of using LARC and used behavioral skills and self-efficacy to overcome barriers and achieve LARC initiation. Most women experienced barriers to LARC insertion, e.g. health insurance issues, health care providers engaging in non-evidence based practice behaviors, and an unusually long delay between the consultation appointment and the insertion appointment. Participants discussed choosing one LARC method over the other due to an aversion to the location of placement, insertion procedure, and/or some other characteristic specific to the implant or IUD. Conclusion: This study found that key factors in LARC initiation were outcome expectations, reinforcement, knowledge, observational learning, behavioral skills, intentions, self-efficacy, and opportunities and barriers. Targeting these key factors in future interventions can lead to an increase in LARC use among young women, thereby leading to a decrease in unintended pregnancy. Furthermore, addressing policy and practice barriers to LARC initiation will allow women easier access to these highly effective methods, which will also ultimately lead to a decrease in the rate of unintended pregnancy

The spatial and temporal distribution of volcanoes in Japan

Japan is located on the westem edge of the Pacific plate, in one of the most dynamic areas on Earth, with approximately 80 active volcanoes and considerable tectonic activity. The Japanese Nuclear Waste Management Organisation (NUMO) will construct a deep geological repository for high level nuclear waste somewhere in Japan. Potential hazard posed by a new volcanic event occurring and disrupting this facility during its operational lifetime need to be thoroughly assessed.EThOS - Electronic Theses Online ServiceGBUnited Kingdo