478 research outputs found

    Preferred reporting items for studies mapping onto preference-based outcome measures: The MAPS statement

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    'Mapping' onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist, which aims to promote complete and transparent reporting of mapping studies. The primary audiences for the MAPS statement are researchers reporting mapping studies, the funders of the research, and peer reviewers and editors involved in assessing mapping studies for publication. A de novo list of 29 candidate reporting items and accompanying explanations was created by a working group comprised of six health economists and one Delphi methodologist. Following a two-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, a final set of 23 items deemed essential for transparent reporting, and accompanying explanations, was developed. The items are contained in a user friendly 23 item checklist. They are presented numerically and categorised within six sections, namely: (i) title and abstract; (ii) introduction; (iii) methods; (iv) results; (v) discussion; and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document. It is anticipated that the MAPS statement will improve the clarity, transparency and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by eight health economics and quality of life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in five years' time. This statement was published jointly in Applied Health Economics and Health Policy, Health and Quality of Life Outcomes, International Journal of Technology Assessment in Health Care, Journal of Medical Economics, Medical Decision Making, PharmacoEconomics, and Quality of Life Research

    Contextual factors among indiscriminate or larger attacks on food or water supplies, 1946-2015

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    This research updates previous inventories of malicious attacks on food and water to include data from 1946 through mid-2015. A systematic search of news reports, databases and previous inventories of poisoning events was undertaken. Incidents that threatened or were intended to achieve direct harm to humans, and that were either relatively large (number of victims > 4 or indiscriminate in intent or realisation were included. Agents could be chemical, biological or radio-nuclear. Reports of candidate incidents were subjected to systematic inclusion and exclusion criteria as well as validity analysis (not always clearly undertaken in previous inventories of such attacks). We summarise contextual aspects of the attacks that may be important for scenario prioritisation, modelling and defensive preparedness. Opportunity is key to most realised attacks, particularly access to dangerous agents. The most common motives and relative success rate in causing harm were very different between food and water attacks. The likelihood that people were made ill or died also varied by food/water mode, and according to motive and opportunity for delivery of the hazardous agent. Deaths and illness associated with attacks during food manufacture and prior to sale have been fewer than those in some other contexts. Valuable opportunities for food defence improvements are identified in other contexts, especially food prepared in private or community settings

    Speech air flow with and without face masks

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    Face masks slow exhaled air flow and sequester exhaled particles. There are many types of face masks on the market today, each having widely varying fits, filtering, and air redirection characteristics. While particle filtration and flow resistance from masks has been well studied, their effects on speech air flow has not. We built a schlieren system and recorded speech air flow with 14 different face masks, comparing it to mask-less speech. All of the face masks reduced air flow from speech, but some allowed air flow features to reach further than 40 cm from a speaker’s lips and nose within a few seconds, and all the face masks allowed some air to escape above the nose. Evidence from available literature shows that distancing and ventilation in higher-risk indoor environment provide more benefit than wearing a face mask. Our own research shows all the masks we tested provide some additional benefit of restricting air flow from a speaker. However, well-fitted mask specifically designed for the purpose of preventing the spread of disease reduce air flow the most. Future research will study the effects of face masks on speech communication in order to facilitate cost/benefit analysis of mask usage in various environments

    From QASC to QASCIP: successful Australian translational scale-up and spread of a proven intervention in acute stroke using a prospective pre-test/post-test study design

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    Objectives: To embed an evidence-based intervention to manage FEver, hyperglycaemia (Sugar) and Swallowing (the FeSS protocols) in stroke, previously demonstrated in the Quality in Acute Stroke Care (QASC) trial to decrease 90-day death and dependency, into all stroke services in New South Wales (NSW), Australia’s most populous state. Design: Pre-test/post-test prospective study. Setting: 36 NSW stroke services. Methods: Our clinical translational initiative, the QASC Implementation Project (QASCIP), targeted stroke services to embed 3 nurse-led clinical protocols (the FeSS protocols) into routine practice. Clinical champions attended a 1-day multidisciplinary training workshop and received standardised educational resources and ongoing support. Using the National Stroke Foundation audit collection tool and processes, patient data from retrospective medical record self-reported audits for 40 consecutive patients with stroke per site pre-QASCIP (1 July 2012 to 31 December 2012) were compared with prospective self-reported data from 40 consecutive patients with stroke per site post-QASCIP (1 November 2013 to 28 February 2014). Inter-rater reliability was substantial for 10 of 12 variables. Primary outcome measures: Proportion of patients receiving care according to the FeSS protocols pre-QASCIP to post-QASCIP. Results: All 36 (100%) NSW stroke services participated, nominating 100 site champions who attended our educational workshops. The time from start of intervention to completion of post-QASCIP data collection was 8 months. All (n=36, 100%) sites provided medical record audit data for 2144 patients (n=1062 pre-QASCIP; n=1082 post-QASCIP). Pre-QASCIP to post-QASCIP, proportions of patients receiving the 3 targeted clinical behaviours increased significantly: management of fever (pre: 69%; post: 78%; p=0.003), hyperglycaemia (pre: 23%; post: 34%; p=0.0085) and swallowing (pre: 42%; post: 51%; p=0.033). Conclusions: We obtained unprecedented statewide scale-up and spread to all NSW stroke services of a nurse-led intervention previously proven to improve long-term patient outcomes. As clinical leaders search for strategies to improve quality of care, our initiative is replicable and feasible in other acute care settings

    Universities and community-based research in developing countries: community voice and educational provision in rural Tanzania

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    The main focus of recent research on the community engagement role of universities has been in developed countries, generally in towns and cities and usually conducted from the perspectives of universities rather than the communities with which they engage. The purpose of this paper is to investigate the community engagement role of universities in the rural areas of developing countries, and its potential for strengthening the voice of rural communities. The particular focus is on the provision of primary and secondary education. The paper is based on the assumption that in order for community members to have both the capacity and the confidence to engage in political discourse for improving educational capacity and quality, they need the opportunity to become involved and well-versed in the options available, beyond their own experience. Particular attention is given in the paper to community-based research (CBR). CBR is explored from the perspectives of community members and local leaders in the government-community partnerships which have responsibility for the provision of primary and secondary education in rural Tanzania. The historical and policy background of the partnerships, together with findings from two case studies, provide the context for the paper

    New directions for lifelong learning using network technologies

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    Please refer only to original source: Koper, R., Tattersall, C. (2004). New directions for lifelong learning using network technologies. British Journal of Educational Technology, 35 (6), 689-700.The requirements placed on learning technologies to support lifelong learning differ considerably from those placed on technologies to support particular fragments of a learning lifetime. The time scales involved in lifelong learning, together with its multi-institutional and episodic nature are not reflected in today’s mainstream learning technologies and their associated architectures. The article presents an integrated model and architecture to serve as the basis for the realization of networked learning technologies serving the specific needs and characteristics of lifelong learners. The integrative model is called a “Learning Network” (LN) and its requirements and architecture are explored, together with the ways in which its application can help in reducing barriers to lifelong learning

    From Lurker to Active Participant

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    The original publication is available from www.springerlink.com. Sloep, P. B., & Kester, L. (2009). From Lurker to Active Participant. In R. Koper (Ed)., Learning Network Services for Professional Development (pp. 17-26). Berlin, Germany: Springer Verlag.In this chapter we will specifically go into the question of how prospective Learning Network users may be convinced of these benefits, for that is likely to be the necessary condition for their active participation in any Learning Network. Their question would be ‘Why should I participate?’, this chapter inventories an-swers to that question, which are then translated into a few guidelines for those contemplating to set up a particular, topic-bound Learning Network. Two kinds of answer are distinguished. Proximate answers, which affect the decision to partici-pate here and now; and ultimate answers, which motivate participation, but only in the long run, after the decision to participate has already been taken. Both are im-portant, the former to persuade people to participate, the latter to persuade people to keep participating. Before going into them, we’ll introduce a concrete example to add some realism to the discussion.The work on this publication has been sponsored in part by the TENCompetence Integrated Project that is funded by the European Commission's 6th Framework Programme, priority IST/Technology Enhanced Learning. Contract 027087 [http://www.tencompetence.org

    Mapping the disease-specific LupusQoL to the SF-6D

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    Purpose To derive a mapping algorithm to predict SF-6D utility scores from the non-preference-based LupusQoL and test the performance of the developed algorithm on a separate independent validation data set. Method LupusQoL and SF-6D data were collected from 320 patients with systemic lupus erythematosus (SLE) attending routine rheumatology outpatient appointments at seven centres in the UK. Ordinary least squares (OLS) regression was used to estimate models of increasing complexity in order to predict individuals’ SF-6D utility scores from their responses to the LupusQoL questionnaire. Model performance was judged on predictive ability through the size and pattern of prediction errors generated. The performance of the selected model was externally validated on an independent data set containing 113 female SLE patients who had again completed both the LupusQoL and SF-36 questionnaires. Results Four of the eight LupusQoL domains (physical health, pain, emotional health, and fatigue) were selected as dependent variables in the final model. Overall model fit was good, with R2 0.7219, MAE 0.0557, and RMSE 0.0706 when applied to the estimation data set, and R2 0.7431, MAE 0.0528, and RMSE 0.0663 when applied to the validation sample. Conclusion This study provides a method by which health state utility values can be estimated from patient responses to the non-preference-based LupusQoL, generalisable beyond the data set upon which it was estimated. Despite concerns over the use of OLS to develop mapping algorithms, we find this method to be suitable in this case due to the normality of the SF-6D data

    A European lens upon adult and lifelong learning in Asia

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    In this article, we seek to assess the extent to which adult and lifelong learning policies and practices in Asia have distinctiveness by comparison to those found in western societies, through an analysis of inter-governmental, national and regional policies in the field. We also inform our study through the analysis of the work of organisations with an international remit with a specific focus on Asia and Europe. In one case, the Asia–Europe Meeting Lifelong Learning (ASEM LLL) Hub has a specific function of bringing together researchers in Asia and Europe. In another, the PASCAL Observatory has had a particular focus on one aspect of lifelong learning, that of learning cities, with a concentration in its work on Asia and Europe. We focus on learning city development as a particular case of distinction in the field. We seek to identify the extent to which developments in the field in Asia have influenced and have been influenced by practices elsewhere in world, especially in Europe, and undertake our analysis using theories of societal learning/the learning society, learning communities and life-deep learning. We complement our analysis through assessment of material contained in three dominant journals in the field, the International Journal of Lifelong Education, the International Review of Education and Adult Education Quarterly, each edited in the west
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