2,923 research outputs found

    Book Review

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    Convenient Labelling Technique for Mass Spectrometry - Acid Catalyzed Deuterium and Oxygen-18 Exchange via Gas-liquid Chromatography

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    Mass spectrometry labelling technique - acid catalyzed deuterium and oxygen 18 exchange by gas-liquid chromatograph

    Overstating the evidence - double counting in meta-analysis and related problems

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    Background: The problem of missing studies in meta-analysis has received much attention. Less attention has been paid to the more serious problem of double counting of evidence. Methods: Various problems in overstating the precision of results from meta-analyses are described and illustrated with examples, including papers from leading medical journals. These problems include, but are not limited to, simple double-counting of the same studies, double counting of some aspects of the studies, inappropriate imputation of results, and assigning spurious precision to individual studies. Results: Some suggestions are made as to how the quality and reliability of meta-analysis can be improved. It is proposed that the key to quality in meta-analysis lies in the results being transparent and checkable. Conclusions: Existing quality check lists for meta-analysis do little to encourage an appropriate attitude to combining evidence and to statistical analysis. Journals and other relevant organisations should encourage authors to make data available and make methods explicit. They should also act promptly to withdraw meta-analyses when mistakes are found

    Primary care in Switzerland: evolution of physicians' profile and activities in twenty years (1993-2012).

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    BACKGROUND: According to the Organization for Economic Cooperation and Development, the Swiss healthcare system is one of the most effective in the world. Yet, as other occidental countries, it has to face the increase of chronic diseases frequency and its resulting cost, particularly for primary care (PC). However very few consistent data are available to describe PC features and its evolution over time. The aim of this study is to describe the evolution of the Swiss PC physicians' (PCPs) profile and activities between 1993 and 2012. METHODS: The date come from two independent European surveys carried out in Switzerland respectively in 1993 and 2012. Both surveys were cross-sectional ones and based on representative samples of 200 PCPs, interviewed by questionnaire. RESULTS: In 20 years, PCPs became older (median age 46 vs 56, p < 0.001) and more feminized (7 % vs 22 %, p < 0.001). Nowadays, they more often work in group practices (28 % vs 52 % in 2012, p < 0.001) and are more involved in other paid activities (28 % vs 66 % in 2012, p < 0.001). All the PCPs have a computer in 2012 (78 % in 1993, p < 0.001) and it is mostly used for keeping records of consultations (47 %). The number of daily face-to-face contacts with patients decreased from 31 to 24 but the average length rose from 15 to 20 min (p < 0.001). PCPs provide fewer pediatric and gynecological services but their activity remains globally unchanged in other domains. The frequency of meetings with other disciplines decreased significantly (e.g. once/month face-to-face meets with ambulatory specialists: 78 % vs 23 % in 2012, p < 0.001). The involvement of PCPs in follow-up and treatment of chronic disease globally little differed. In 2012, 8.5 % of the PCPs never performed any chirurgical acts (vs 0 % in 1993, p < 0.001). CONCLUSION: This study showed a substantial evolution of Swiss PC over the last twenty years in terms of socio-demographic, organizational and service provided. The main changes include: feminization and ageing, lower diversity in services provided, fewer but longer consultations. These changes may have important implications for patients' management and will need to be considered for health planning purposes

    Acute Post-Activation Potentiation in NCAA Division II Female Athletes

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    International Journal of Exercise Science 7(3) : 212-219, 2014. Post-activation potentiation (PAP) is a phenomenon in which the power output of a muscle is immediately enhanced after heavy resistance exercise. Whereas the majority of PAP research has examined males, minimal research exists as to how female athletes respond. Therefore, the purpose of this study was to investigate the acute PAP response of back squats on static squat jump (SSJ) performance among NCAA Division II female athletes. Female athletes (n=29) who were current roster members from basketball, softball, and volleyball, performed 3 SSJ prior to 3 repetitions of the back squat exercise at 90% 1RM. After a 5-min rest, athletes once again performed 3 SSJ for maximal height, with peak power calculated using the Sayers equation. There was a significant interaction effect observed between time and team, p=0.022; post-hoc tests indicated that the volleyball team had a significant decrease in power, p=0.008. The main effect for time was not significant, p=0.279, indicating for the group as a whole, there was no evidence of a PAP response. The main effect for team was also nonsignificant, p=0.173, indicating no difference in power outputs by team. Strength and conditioning coaches who work with female athletes should be aware that the successful implementation of PAP complexes within this population appears to be highly individualized. Therefore, the use of PAP complexes in female athletes should consider both the absolute and relative strength of each athlete in conjunction with the length of the rest period when attempting to optimize the PAP response

    Emergence of long-range order in BaTiO3 from local symmetry-breaking distortions

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    By using a symmetry motivated basis to evaluate local distortions against pair distribution function data (PDF), we show without prior bias, that the off-centre Ti displacements in the archetypal ferroelectric BaTiO3 are zone centred and rhombohedral-like in nature across its known ferroelectric and paraelectric phases. With our newly-gained insight we construct a simple Monte Carlo (MC) model which captures our main experimental findings and demonstrate how the rich crystallographic phase diagram of BaTiO3 emerges from correlations of local symmetry-breaking distortions alone. Our results strongly support the order-disorder picture for these phase transitions, but can also be reconciled with the soft-mode theory of BaTiO3 that is supported by some spectroscopic techniques.Comment: 5 pages, 3 figure

    Harold Jeffreys's Theory of Probability Revisited

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    Published exactly seventy years ago, Jeffreys's Theory of Probability (1939) has had a unique impact on the Bayesian community and is now considered to be one of the main classics in Bayesian Statistics as well as the initiator of the objective Bayes school. In particular, its advances on the derivation of noninformative priors as well as on the scaling of Bayes factors have had a lasting impact on the field. However, the book reflects the characteristics of the time, especially in terms of mathematical rigor. In this paper we point out the fundamental aspects of this reference work, especially the thorough coverage of testing problems and the construction of both estimation and testing noninformative priors based on functional divergences. Our major aim here is to help modern readers in navigating in this difficult text and in concentrating on passages that are still relevant today.Comment: This paper commented in: [arXiv:1001.2967], [arXiv:1001.2968], [arXiv:1001.2970], [arXiv:1001.2975], [arXiv:1001.2985], [arXiv:1001.3073]. Rejoinder in [arXiv:0909.1008]. Published in at http://dx.doi.org/10.1214/09-STS284 the Statistical Science (http://www.imstat.org/sts/) by the Institute of Mathematical Statistics (http://www.imstat.org

    Understanding Variation in Sets of N-of-1 Trials.

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    A recent paper in this journal by Chen and Chen has used computer simulations to examine a number of approaches to analysing sets of n-of-1 trials. We have examined such designs using a more theoretical approach based on considering the purpose of analysis and the structure as regards randomisation that the design uses. We show that different purposes require different analyses and that these in turn may produce quite different results. Our approach to incorporating the randomisation employed when the purpose is to test a null hypothesis of strict equality of the treatment makes use of Nelder's theory of general balance. However, where the purpose is to make inferences about the effects for individual patients, we show that a mixed model is needed. There are strong parallels to the difference between fixed and random effects meta-analyses and these are discussed

    « C’est normal qu’on mollisse ou qu’on vieillisse » : faut-il aborder le déclin fonctionnel avec les personnes âgées en médecine de famille ?

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    Pour répondre au vieillissement de la population, des initiatives de dépistage et de prise en charge des problèmes de santé liés à l’âge sont mises en place, notamment en médecine de famille. Les résultats préliminaires d’une étude qualitative suggèrent que les personnes âgées sont ambivalentes face à la notion d’anticipation des problèmes, tendent à les banaliser et à être réticentes à en parler spontanément à leur médecin. Cependant, elles trouvent pertinent que ce dernier aborde le sujet avec des questions spécifiques, ceci permettant d’initier une discussion sur des problématiques sensibles. Les possibilités de prise en charge des syndromes gériatriques et du déclin fonctionnel semblent peu connues des patient-e-s. Le dépistage permet donc d’aborder ces problématiques et d’informer les patient-e-s au sujet de solutions existantes. [Among the health strategies to respond to the aging of the population, initiatives for the screening and management of age-related health issues are implemented, including in family medicine. Preliminary results of a qualitative study suggest that elderly people are ambivalent about anticipating age-related issues, tend to trivialize them and to be reluctant to discuss them spontaneously with their doctors. However, they find relevant that their family doctor brings up the topic with specific questions, because that allows initiating a discussion about some of these sensitive issue. It appears that the awareness of the existing management of geriatric syndromes and functional decline possibilities is rather low. A screening initiative is therefore an opportunity to address these different issues and to inform patients about existing solutions.]]]> fre oai:serval.unil.ch:BIB_7917561D1F2C 2022-05-07T01:20:55Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_7917561D1F2C Good and Bad Days: Fluctuations in the Burden of Informal Dementia Caregivers, an Experience Sampling Study. info:doi:10.1097/NNR.0000000000000243 info:eu-repo/semantics/altIdentifier/doi/10.1097/NNR.0000000000000243 info:eu-repo/semantics/altIdentifier/pmid/29095373 Pihet, S. Moses Passini, C. Eicher, M. info:eu-repo/semantics/article article 2017 Nursing research, vol. 66, no. 6, pp. 421-431 info:eu-repo/semantics/altIdentifier/eissn/1538-9847 urn:issn:0029-6562 <![CDATA[Informal dementia caregivers (IDCs) are often confronted with important fluctuations in care-related burden, commonly described as "good and bad days." These fluctuations are overlooked by traditional questionnaires focusing on the average experience. The experience sampling method (ESM) is based on the repeated collection of data in everyday life, thereby allowing the description of day-to-day fluctuations in IDC burden, and the identification of their correlates. ESM studies are still scarce among IDCs, with none focusing on day-to-day fluctuations in burden. This ESM study aimed to examine day-to-day fluctuations in the burden of IDCs and test their associations with six moment-to-moment predictors. Primary IDCs (N = 26, median age = 68 years, 77% women, 73% spouses) volunteered to answer questions about their daily burdens, patients' memories and behavioral problems (MBP), caregivers' MBP-related distress, psychological distress, self-efficacy and positive affects, and relationship quality; volunteers did this every evening for 2 weeks on a touchpad, resulting in 206 measures. Data were analyzed with multilevel linear regression. Day-to-day fluctuations covered about two thirds of the total variance for most study variables. All six predictors had a significant bivariate relation with daily burden, explaining 15%-32% of its fluctuations, with significant differences between caregivers in the strength of these relations. The best multivariate model explained 51% of the day-to-day fluctuations in burden. It included caregiver MBP-related distress, psychological distress, and relationship quality. This innovative study of IDC burden shows that day-to-day fluctuations are an important part of caregivers' real-life experiences and that half of this variability is predicted by currently understudied factors. Inviting caregivers to monitor clinical outcomes daily over 1 or 2 weeks could help tailor interventions to their individual needs and also empower them

    Development of a monitoring instrument to assess the performance of the Swiss primary care system.

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    The Swiss health system is customer-driven with fee-for-service paiement scheme and universal coverage. It is highly performing but expensive and health information systems are scarcely implemented. The Swiss Primary Care Active Monitoring (SPAM) program aims to develop an instrument able to describe the performance and effectiveness of the Swiss PC system. Based on a Literature review we developed a conceptual framework and selected indicators according to their ability to reflect the Swiss PC system. A two round modified RAND method with 24 inter-/national experts took place to select primary/secondary indicators (validity, clarity, agreement). A limited set of priority indicators was selected (importance, priority) in a third round. A conceptual framework covering three domains (structure, process, outcome) subdivided into twelve sections (funding, access, organisation/ workflow of resources, (Para-)Medical training, management of knowledge, clinical-/interpersonal care, health status, satisfaction of PC providers/ consumers, equity) was generated. 365 indicators were pre-selected and 335 were finally retained. 56 were kept as priority indicators.- Among the remaining, 199 were identified as primary and 80 as secondary indicators. All domains and sections are represented. The development of the SPAM program allowed the construction of a consensual instrument in a traditionally unregulated health system through a modified RAND method. The selected 56 priority indicators render the SPAM instrument a comprehensive tool supporting a better understanding of the Swiss PC system's performance and effectiveness as well as in identifying potential ways to improve quality of care. Further challenges will be to update indicators regularly and to assess validity and sensitivity-to-change over time
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