When Should Potentially False Research Findings Be Considered Acceptable?

Ioannidis estimated that most published research findings are false [1], but he did not indicate when, if at all, potentially false research results may be considered as acceptable to society. We combined our two previously published models [2,3] to calculate the probability above which research findings may become acceptable. A new model indicates that the probability above which research results should be accepted depends on the expected payback from the research (the benefits) and the inadvertent consequences (the harms). This probability may dramatically change depending on our willingness to tolerate error in accepting false research findings. Our acceptance of research findings changes as a function of what we call “acceptable regret,” i.e., our tolerance of making a wrong decision in accepting the research hypothesis. We illustrate our findings by providing a new framework for early stopping rules in clinical research (i.e., when should we accept early findings from a clinical trial indicating the benefits as true?). Obtaining absolute “truth” in research is impossible, and so society has to decide when less-than-perfect results may become acceptable

Specificities of communication and management in healthcare institutions

Prelaskom iz paternalističkog načina komuniciranja u zdravstvu na današnji suradno-partnerski način komuniciranja, značajno su se promijenile pardigme komuniciranja u oblasti zdravstva. Tome su značajno pridonijeli strelovit razvoj medicinske znanosti, informatika i vrlo izražen interes pacijenata za svoje zdravlje. Izgradnja modernih zdravstvenih sustava, specifična struktura rada u zdravstvenim ustanovama kao i proces rada, igraju važnu ulogu. U radu je razmotreno kompleksno funkcioniranje medicinskih timova i njihovih voditelja, uloga timskog rada, odlučivanje, vođenje, izbor vođe… Dijada, temeljni tim liječnika i medicinske sestre, u paternalističkom su modelu komuniciranja imali nadređen odnos prema pacijentu koji je bio pasivan objekt i koji je, bez dublje rasprave, jednosmjerno primao informacije. Danas su medicinari i pacijenti subjekti komunikacije, njihov je odnos ravnopravan, a njihova je komunikacija dvosmjerna. U radu su prikazani povijesni detalji složenog odnosa medicinara i pacijenata te specifičnosti komunikacije, paradigmatski primjeri u komunikaciji. Također je naglašen značaj komunikacije u unutarnjoj i vanjskoj javnosti.With the transition from the paternalistic method of communication in health care, to today\u27s collaborative-partnership way of communication, the paradigms of communication in the field of health care have changed significantly. The rapid development of medical science, informatics, and the very pronounced interest of patients in their health have significantly contributed to this process. Development of modern health systems, the specific structure of work in health institutions as well as the work process play an important role. The paper discusses the complex functioning of medical teams and their leaders, the role of teamwork, decision making, leadership, leader selection… The physician-nurse dya d, in the paternalistic model of communication had a superior relationship to the patient who was a passive object and who received information one-way, without deeper discussion. Today, medics and patients are subjects of communication, their relationship is equal and their communication is two-way. The paper presents historical details of the complex relationship between physicians and patients, as well as the specifics of communication, paradigmatic examples in communication. The importance of communication in the internal and external public was also emphasized

Odrednice stavova prema ženama u vojsci

In recent decades, an increasing number of women are joining the military, which has been historically a male-dominated institution. This study examined attitudes toward women in the military and the factors associated with them. The study was conducted on a random sample of 895 active service members from the Croatian Armed Forces (445 men and 450 women). The study findings indicate a moderately high approval of women in the military, but with the existence of significant gender differences. Men expressed more negative attitudes toward women in the military when compared to women. In addition, the results of the regression analyses indicated that, among men, hostile sexism, satisfaction with professional contacts with women in the military, and professional status were significantly associated with their attitudes toward women in the military. The results also showed that, among women, hostile sexism, frequency of professional contacts with other women, and educational level were significantly associated with their attitudes toward women in the military. The study findings reveal insights into gender relations in the previously unexplored socio-cultural military context, and have implications for research and practice in the Croatian military. However, this study could also contribute to a better understanding of the complexity of gender issues within NATO, and could encourage the development of new theoretical models and cross-cultural research.Posljednjih se desetljeća sve veći broj žena priključuje vojsci, instituciji kojom su povijesno gledano dominirali muškarci. Ovim su istraživanjem ispitane odrednice stavova prema ženama u vojsci, a istraživanje je provedeno na slučajnom uzorku 895 pripadnika djelatnog sastava Hrvatske vojske (445 muškaraca i 450 žena). Nalazi istraživanja ukazuju na umjereno visok stupanj odobravanja žena u vojsci, ali uz postojanje značajnih rodnih razlika. Muškarci su u usporedbi sa ženama izražavali negativnije stavove prema ženama u vojsci. Rezultati regresijskih analiza pokazali su da su među muškarcima hostilni seksizam, zadovoljstvo profesionalnim kontaktima sa ženama u vojsci te profesionalni status značajno povezani s njihovim stavovima prema ženama u vojsci. Rezultati su također pokazali da su kod žena hostilni seksizam, učestalost profesionalnih kontakata s drugim ženama te razina obrazovanja značajno povezani s njihovim stavovima prema ženama u vojsci. Nalazi istraživanja donose uvide u rodne odnose unutar ranije neistraživanog sociokulturnog vojnog konteksta te imaju implikacije za istraživanje i praksu u Hrvatskoj vojsci. Ujedno, mogli bi doprinijeti i boljem razumijevanju složenosti rodnih pitanja unutar NATO-a te potaknuti razvoj novih teorijskih modela i budućih međukulturnih istraživanja

A regret theory approach to decision curve analysis: A novel method for eliciting decision makers' preferences and decision-making

<p>Abstract</p> <p>Background</p> <p>Decision curve analysis (DCA) has been proposed as an alternative method for evaluation of diagnostic tests, prediction models, and molecular markers. However, DCA is based on expected utility theory, which has been routinely violated by decision makers. Decision-making is governed by intuition (system 1), and analytical, deliberative process (system 2), thus, rational decision-making should reflect both formal principles of rationality and intuition about good decisions. We use the cognitive emotion of regret to serve as a link between systems 1 and 2 and to reformulate DCA.</p> <p>Methods</p> <p>First, we analysed a classic decision tree describing three decision alternatives: treat, do not treat, and treat or no treat based on a predictive model. We then computed the expected regret for each of these alternatives as the difference between the utility of the action taken and the utility of the action that, in retrospect, should have been taken. For any pair of strategies, we measure the difference in net expected regret. Finally, we employ the concept of acceptable regret to identify the circumstances under which a potentially wrong strategy is tolerable to a decision-maker.</p> <p>Results</p> <p>We developed a novel dual visual analog scale to describe the relationship between regret associated with "omissions" (e.g. failure to treat) vs. "commissions" (e.g. treating unnecessary) and decision maker's preferences as expressed in terms of threshold probability. We then proved that the Net Expected Regret Difference, first presented in this paper, is equivalent to net benefits as described in the original DCA. Based on the concept of acceptable regret we identified the circumstances under which a decision maker tolerates a potentially wrong decision and expressed it in terms of probability of disease.</p> <p>Conclusions</p> <p>We present a novel method for eliciting decision maker's preferences and an alternative derivation of DCA based on regret theory. Our approach may be intuitively more appealing to a decision-maker, particularly in those clinical situations when the best management option is the one associated with the least amount of regret (e.g. diagnosis and treatment of advanced cancer, etc).</p

Longitudinal Analysis of Basic Motor and Functional Abilities of Elementary School Pupils

The aim of the research was to conduct a longitudinal study of motor and cardiorespiratory fitness of 5th to 7th grade elementary male and female pupils in the period from 2005 to 2020. The pupils (1649) were divided into 3 generation groups: the older (2005–2009), the middle (2010–2015) and the younger group (2016 – 2020). There is a noticeable decrease in flexibility among all pupils and grades of younger generations. Results indicate poorer performance of younger gener ation of 5th graders in speed and power. The 7th grade female pupils who were tested in the 2015 – 2020 period, showed a significant decline in all motor and cardiorespiratory fitness compared to the other two generation groups, except for upper body power. Every four years, an evaluation of test results should be carried out so that each Physical Education teacher in a particular school can accurately compare and standardise the obtained values

WORK ORGANIZATION AND COMMUNICATION RELATIONS IN A PRESCHOOL INSTITUTION

U ustanovi predškolskoga odgoja i obrazovanja Radost u Splitu provedeno je istraživanje o specifičnostima organizacije rada i ko- munikacijskih relacija opterećenim nedostatkom financija, opre- me, prostora i kadra. Kada je riječ o komunikacijskim odnosima, većina odgojiteljica navodi dobru komunikaciju s djecom, rodite- ljima i kolegicama kao i s ravnateljstvom, a manji broj odgojite- ljica ukazuje na preopterećenost poslom. Kada je riječ o odnosu s djecom (prema skali Megan Tschanen-Moran), najveći broj odgo- jiteljica savjesno i odgovorno obavlja svoj posao unatoč navedenim problemima. Više od dvije trećine odgojiteljica uspostavilo je dnev- nu rutinu u poslu, uspijevaju naučiti djecu slijediti vrtićka pravi- la, motiviraju ih, pružaju im alternativna objašnjenja, pomažu razviti njihovu kreativnost, uspijevaju razviti komunikaciju s prkosnom djecom, imaju strpljenja za svaki njihov upit i njeguju suradno-partnerski odnos s roditeljima. Približno polovina odgo- jiteljica uspijeva se približiti djeci s teškoćama, primiriti nekoliko nemirne djece koja ometaju nastavu, organizirati individualnu nastavu, osigurati alternativnu nastavu, a tek je četvrtina odgo- jiteljica uspjela osigurati programe za nadarenu djecu. Analiza ankete roditelj – dijete – odgojitelj ukazala je na to da je većina roditelja mlađe dobne skupine, oboje je zaposleno, samo je mali broj samohranih roditelja. Kada je riječ o odnosu roditelj – dijete – odgojitelj, najveći broj roditelja odgaja djecu nakon boravka u vrtiću bez pomoći svojih roditelja, manji broj ima pomoć istih, većina stanuje u blizini vrtića, a nešto više od trećine dovozi auto- mobilom dijete u vrtić. Većina je roditelja zadovoljna primanjima na poslu, najviše je nezadovoljnih roditelja iz dobne skupine od 41 do 51 godine. Većina roditelja smatra da su troškovi smještaja realni, većina roditelja svakodnevno obavlja odgojno-obrazovne aktivnosti s djetetom, dnevno više od četiri sata. Većina roditelja nikada tjelesno ne kažnjava dijete, probleme najčešće rješavaju razgovorom. Također većina smatra da odgojiteljica treba omogućiti posjet djetetu kada god žele, upoznati ih s djetetovim aktivnostima, upozoriti ih ako mu nešto ne ide dobro. Svi su roditelji suglasni da odgojiteljica treba upoznati roditelje s napretkom djeteta, ali i to da odgojiteljica čini sve za korist njihova djeteta, kao i to da je komunikacija s odgojiteljicom dobra. Četvrtina anke- tiranih roditelja nije u mogućnosti redovito komunicirati s odgojiteljicama zbog preopterećenosti na poslu. Samo jedna petina roditelja smatra da nije dobro da dijete s teškoćama u razvoju bude u skupini s njihovim djetetom. Samo mali broj roditelja, njih četvero (2,2 %), ima lošu komuni- kaciju s odgojiteljicom, a samo njih šest (3,2 %) smatra da je odgojiteljica nedovoljno angažirana oko djeteta. Analizirajući postavljene hipoteze i rezultate istraživanja, zaključno se može reći da, unatoč brojnim problemima (kadrovi, oprema, prostor, financije...), predškolska ustanova suboptimalno funkcionira glede radnoga procesa i komunikacijskih odnosa, ali da bi svako daljnje narušavanje standarda DPS-a (ukidanje i promjena DPS-a) moglo dovesti do nepovoljnih posljedica za funkcioniranje ustanove.In the institution of preschool education „Radost“ in Split a research has been conducted on the specifics of work organisation and communication relations. Regarding communication relati- onships, most educators pointed out good communication with children, parents, and colleagues as well as with the management, whereas a smaller number of educators indicated the damaged relationship, because of work overload. As regards the relations with children, (according to Me- gan Tschannen-Moran’s scale), the majority of educators conscientiously and responsibly carry out their work despite many problems. More than two-thirds of the educators have established a daily routine at work, manage to teach children to follow kindergarten rules, motivate them, provide alternative explanations, help develop creativity in children, manage to develop communication with defiant children, and they have patience for every request of children, nurture collaborative partner relationship with parents. Approximately half of the educators manage to get closer to children with disabilities, they appease several restless children who interfere with classes, organize individual classes, provide alternative classes, and only a quarter of educators manage to provide programs for gifted children. The analysis of the parent-child-educator survey showed that the parents of the younger age group, where both are employed, are in majority. There is only a small number of single parents. Regarding the parent-child-educator relationship, most parents raise their children after attending kindergarten without the help of their parents, a smaller number uses their help, most live near kindergartens, and slightly more than a third drive their children to kindergarten by car. Most parents are satisfied with their income at work, most dissatisfied parents are in the age group of 41-51. Most parents believe that the cost of accommodation is realistic, most parents perform educational activities with their child every day, for more than 4 hours a day. Most parents never physically punish the child, they usually solve problems by talking. Most parents believe that the educator should allow the parents to visit the child whenever they want, acquaint the parents with the child’s activities, and warn them if something is not going well. All parents agree that the educator should inform the parents about the child’s progress, and also believe that the educator should do everything for the benefit of their child, as well as that communication with the educator is good. A quarter of the surveyed parents are not able to communicate regularly with educators due to work overload. Only one-fifth of parents thinks that it is not good for a child with disabilities to be in a group with their child. Only a small number of parents, 4 (2.2%), have poor communication with the educator, and only 6 (3.2%) believe that the educator is insufficiently engaged around the child. Analyzing the set hypotheses and research results, it can be concluded that, despite many problems (staff, equipment, space, finances ...) preschool is suboptimal in terms of work process and communication relations, but, in the future, any further violation of DPS standards (abolition and change in the DPS) could lead to adverse consequences for the functioning of the institution

Preliminary Report of Hypoglycemic Response in Obese Metabolic Syndrome Males Treated with Metformin after Weight Loss Intervention

We conducted this study to determine the degree of obesity influence on the hypoglycemic response of growth hormone and cortisol after weight loss of 5%. A total of 45 non-diabetic, male subjects followed in the outpatient endocrinological departments were divided into three groups comprising 15 subjects in each group, based upon body mass index (BMI) to healthy, overweight and obese group. Metformin was administered in the dose of 50 mg daily to the overweight and obese participants. Cortisol was measured at 0, 60 and 120 minutes. Growth hormone (GH) was measured at –15, 0, 30, 60, 90 and 120 minutes.Values of cortisol and GH were compared upon changes in hypothalamo-pituitary-adrenal (HPA) response to insulin induced hypoglycemia initially and after weight loss of 5% for overweight and obese participants.The BMI of the healthy group ranged 20.0–24.5 kg/m2 (median: 22.8); overweight group ranged 25.9–29.7 kg/m2 (median: 28.3); and obese group ranged 30.9–34.6 kg/m2 (median: 32.6). There were no significant differencesof cortisol values among groups at 0 (c²=2.0; p=0.365); 60 (c²=0.754; P=0.686) and at 120 minutes (c²=0.466; p=0.792). The comparisons among groups were significant for differences of GH values at –15 (c²=25.0; p<0.01); 0 (c²=16.2; p<0.01); 30 (c²=16.2; p<0.01); 60 (c²=32.8; p<0.01); 90 (c²=30.2; p<0.01) and at 120 minutes (c²=27.3; p<0.01).Healthy and obese subjects significantly differed in growth hormone response at –15 (Z=4.67; p<0.01); 0 (Z=3.83; p<0.01); 60 (Z=2.78; p=0.05); 90 (Z=4.67; p<0.01) and at 120 minutes (Z=4.23; p<0.01).Changes on the various levels of HPA axis, when it is activated by a stress as it is the case in insulin-induced hypoglycemia correspond to the degree of obesity. Weight loss of 5% was not enough for restoration of a normal stimulated growth hormone release and did not influence on the level of cortisol

What Is the Place of Physical Education among the Teaching Priorities of Primary School Teachers? An Empirical Study on Importance, Qualification and Perceived Teachers’ Competence

The education of children is important because it determines the future of the world. Teachers have a great responsibility for this, which applies to every subject taught. In this regard, teachers usually specialize in a specific area and greatly influence how the subject is taught and how students gain a view of the subject. The present study aimed to investigate teachers’ attitudes about subjects in primary school, with a particular focus on physical education. The sample of participants (N = 111) included Croatian female primary school teachers with a mean age of 47.88 (±8.11 SD) years and a mean teaching experience of 21.83 (±10.24 SD) years. The variable sample consisted of a three-criteria questionnaire for the assessment of classroom subjects: (i) the importance of a subject (importance); (ii) the level of qualifications obtained during study for a subject (qualification); and (iii) the teacher’s competence for teaching (competence). Significant differences were found in the assessment of classroom subjects. The group of core academic subjects has noticeably higher assessments than the group of practical and artistic subjects. The assessment of teachers’ competence in PE teaching is the lowest of all the classroom subjects. Further research of classroom teachers’ attitudes towards the implementation of physical education is advised, with an increased number of participants and the inclusion of new measures

Estimating the mean and variance from the median, range, and the size of a sample

BACKGROUND: Usually the researchers performing meta-analysis of continuous outcomes from clinical trials need their mean value and the variance (or standard deviation) in order to pool data. However, sometimes the published reports of clinical trials only report the median, range and the size of the trial. METHODS: In this article we use simple and elementary inequalities and approximations in order to estimate the mean and the variance for such trials. Our estimation is distribution-free, i.e., it makes no assumption on the distribution of the underlying data. RESULTS: We found two simple formulas that estimate the mean using the values of the median (m), low and high end of the range (a and b, respectively), and n (the sample size). Using simulations, we show that median can be used to estimate mean when the sample size is larger than 25. For smaller samples our new formula, devised in this paper, should be used. We also estimated the variance of an unknown sample using the median, low and high end of the range, and the sample size. Our estimate is performing as the best estimate in our simulations for very small samples (n ≤ 15). For moderately sized samples (15 <n ≤ 70), our simulations show that the formula range/4 is the best estimator for the standard deviation (variance). For large samples (n > 70), the formula range/6 gives the best estimator for the standard deviation (variance). We also include an illustrative example of the potential value of our method using reports from the Cochrane review on the role of erythropoietin in anemia due to malignancy. CONCLUSION: Using these formulas, we hope to help meta-analysts use clinical trials in their analysis even when not all of the information is available and/or reported