1,618 research outputs found
Can targeted cover letters improve participation in health surveys? Results from a randomized controlled trial
Background: Improving response rates in epidemiologic studies is important for the generalizability of the outcome. The aim of this study was to examine whether it can be advantageous for participation to target different versions of the cover letters to different sample subgroups. Methods: A randomized trial was incorporated in a cross-sectional health survey in Denmark (n = 25,000) where a motivational sentence in the cover letter intended to heighten perceptions of relevance of the survey was varied among 11 sample subgroups (treatment groups). Ten different versions of a sentence outlining questionnaire themes were tested: each mentioned three out of five themes: stress, alcohol, sex, sleep problems, and contact with family and friends. An eleventh group, the control group, omitted this sentence. Results: On average, the additional motivational sentence resulted in a significantly lower response rate overall compared to the control group. However, the additional motivational sentence was found to have heterogeneous effects on survey response. Furthermore, the nature of the heterogeneity differed between the versions of the sentence. Specifically, the additional sentence tended to produce a higher response rate among the youngest age group and a lower response rate in the oldest age group compared to the generic letter. The use of alcohol in the motivational sentence tended to have a positive effect on response in the age group 16-24 years, and stress tended to have a positive effect in the age group ≥65 years. On the contrary, sex tended to have a negative effect in the age groups 45-64 years and ≥ 65 years. However, a significant interaction was only found between the use of stress and age group (p = < 0.0001). Conclusion: The findings of significant and heterogeneous effects suggest that there is potential for a targeted approach to improve both response rates and sample composition. The uneven effect of the separate themes across age groups suggests that the selection of themes to be included in the motivational sentence is important for the use of targeted appeals to be successful and warrants further research to better identify which themes works in which contexts, in which subgroups and under which circumstances
Can targeted cover letters improve participation in health surveys? Results from a randomized controlled trial
Background: Improving response rates in epidemiologic studies is important for the generalizability of the outcome. The aim of this study was to examine whether it can be advantageous for participation to target different versions of the cover letters to different sample subgroups. Methods: A randomized trial was incorporated in a cross-sectional health survey in Denmark (n = 25,000) where a motivational sentence in the cover letter intended to heighten perceptions of relevance of the survey was varied among 11 sample subgroups (treatment groups). Ten different versions of a sentence outlining questionnaire themes were tested: each mentioned three out of five themes: stress, alcohol, sex, sleep problems, and contact with family and friends. An eleventh group, the control group, omitted this sentence. Results: On average, the additional motivational sentence resulted in a significantly lower response rate overall compared to the control group. However, the additional motivational sentence was found to have heterogeneous effects on survey response. Furthermore, the nature of the heterogeneity differed between the versions of the sentence. Specifically, the additional sentence tended to produce a higher response rate among the youngest age group and a lower response rate in the oldest age group compared to the generic letter. The use of alcohol in the motivational sentence tended to have a positive effect on response in the age group 16-24 years, and stress tended to have a positive effect in the age group ≥65 years. On the contrary, sex tended to have a negative effect in the age groups 45-64 years and ≥ 65 years. However, a significant interaction was only found between the use of stress and age group (p = < 0.0001). Conclusion: The findings of significant and heterogeneous effects suggest that there is potential for a targeted approach to improve both response rates and sample composition. The uneven effect of the separate themes across age groups suggests that the selection of themes to be included in the motivational sentence is important for the use of targeted appeals to be successful and warrants further research to better identify which themes works in which contexts, in which subgroups and under which circumstances
Patient safety in dentistry: development of a candidate 'never event' list for primary care
Introduction The 'never event' concept is often used in secondary care and refers to an agreed list of patient safety incidents that 'should not happen if the necessary preventative measures are in place'. Such an intervention may raise awareness of patient safety issues and inform team learning and system improvements in primary care dentistry.
Objective To identify and develop a candidate never event list for primary care dentistry.
Methods A literature review, eight workshops with dental practitioners and a modified Delphi with 'expert' groups were used to identify and agree candidate never events.
Results Two-hundred and fifty dental practitioners suggested 507 never events, reduced to 27 distinct possibilities grouped across seven themes. Most frequently occurring themes were: 'checking medical history and prescribing' (119, 23.5%) and 'infection control and decontamination' (71, 14%). 'Experts' endorsed nine candidate never event statements with one graded as 'extreme risk' (failure to check past medical history) and four as 'high risk' (for example, extracting wrong tooth).
Conclusion Consensus on a preliminary list of never events was developed. This is the first known attempt to develop this approach and an important step in determining its value to patient safety. Further work is necessary to develop the utility of this method
Determinants of adults' intention to vaccinate against pandemic swine flu
This article has been made available through the Brunel Open Access Publishing Fund.This article has been made available through the Brunel Open Access Publishing Fund.Background: Vaccination is one of the cornerstones of controlling an influenza pandemic. To optimise vaccination rates in the general population, ways of identifying determinants that influence decisions to have or not to have a vaccination need to be understood. Therefore, this study aimed to predict intention to have a swine influenza
vaccination in an adult population in the UK. An extension of the Theory of Planned Behaviour provided the theoretical framework for the study.
Methods: Three hundred and sixty two adults from the UK, who were not in vaccination priority groups, completed either an online (n = 306) or pen and paper (n = 56) questionnaire. Data were collected from 30th October 2009, just after swine flu vaccination became available in the UK, and concluded on 31st December 2009. The main outcome of interest was future swine flu vaccination intentions.
Results: The extended Theory of Planned Behaviour predicted 60% of adults’ intention to have a swine flu vaccination with attitude, subjective norm, perceived control, anticipating feelings of regret (the impact of missing a vaccination opportunity), intention to have a seasonal vaccine this year, one perceived barrier: “I cannot be bothered to get a swine flu vaccination” and two perceived benefits: “vaccination decreases my chance of getting swine flu or its complications” and “if I get vaccinated for swine flu, I will decrease the frequency of having to consult my doctor,” being significant predictors of intention. Black British were less likely to intend to have a vaccination compared to Asian or White respondents.
Conclusions: Theoretical frameworks which identify determinants that influence decisions to have a pandemic influenza vaccination are useful. The implications of this research are discussed with a view to maximising any future pandemic influenza vaccination uptake using theoretically-driven applications.This article is available through the Brunel Open Access Publishing Fund
A viscoelastic deadly fluid in carnivorous pitcher plants
Background : The carnivorous plants of the genus Nepenthes, widely
distributed in the Asian tropics, rely mostly on nutrients derived from
arthropods trapped in their pitcher-shaped leaves and digested by their
enzymatic fluid. The genus exhibits a great diversity of prey and pitcher forms
and its mechanism of trapping has long intrigued scientists. The slippery inner
surfaces of the pitchers, which can be waxy or highly wettable, have so far
been considered as the key trapping devices. However, the occurrence of species
lacking such epidermal specializations but still effective at trapping insects
suggests the possible implication of other mechanisms. Methodology/Principal
Findings : Using a combination of insect bioassays, high-speed video and
rheological measurements, we show that the digestive fluid of Nepenthes
rafflesiana is highly viscoelastic and that this physical property is crucial
for the retention of insects in its traps. Trapping efficiency is shown to
remain strong even when the fluid is highly diluted by water, as long as the
elastic relaxation time of the fluid is higher than the typical time scale of
insect movements. Conclusions/Significance : This finding challenges the common
classification of Nepenthes pitchers as simple passive traps and is of great
adaptive significance for these tropical plants, which are often submitted to
high rainfalls and variations in fluid concentration. The viscoelastic trap
constitutes a cryptic but potentially widespread adaptation of Nepenthes
species and could be a homologous trait shared through common ancestry with the
sundew (Drosera) flypaper plants. Such large production of a highly
viscoelastic biopolymer fluid in permanent pools is nevertheless unique in the
plant kingdom and suggests novel applications for pest control
Structural and magnetic phase diagram of CeFeAsO1-xFx and its relationship to high-temperature superconductivity
We use neutron scattering to study the structural and magnetic phase
transitions in the iron pnictides CeFeAsO1-xFx as the system is tuned from a
semimetal to a high-transition-temperature (high-Tc) superconductor through
Fluorine (F) doping x. In the undoped state, CeFeAsO develops a structural
lattice distortion followed by a stripe like commensurate antiferromagnetic
order with decreasing temperature. With increasing Fluorine doping, the
structural phase transition decreases gradually while the antiferromagnetic
order is suppressed before the appearance of superconductivity, resulting an
electronic phase diagram remarkably similar to that of the high-Tc copper
oxides. Comparison of the structural evolution of CeFeAsO1-xFx with other
Fe-based superconductors reveals that the effective electronic band width
decreases systematically for materials with higher Tc. The results suggest that
electron correlation effects are important for the mechanism of high-Tc
superconductivity in these Fe pnictides.Comment: 19 pages, 5 figure
A Comparison of Red Fluorescent Proteins to Model DNA Vaccine Expression by Whole Animal In Vivo Imaging
DNA vaccines can be manufactured cheaply, easily and rapidly and have performed well in pre-clinical animal studies. However, clinical trials have so far been disappointing, failing to evoke a strong immune response, possibly due to poor antigen expression. To improve antigen expression, improved technology to monitor DNA vaccine transfection efficiency is required. In the current study, we compared plasmid encoded tdTomato, mCherry, Katushka, tdKatushka2 and luciferase as reporter proteins for whole animal in vivo imaging. The intramuscular, subcutaneous and tattooing routes were compared and electroporation was used to enhance expression. We observed that overall, fluorescent proteins were not a good tool to assess expression from DNA plasmids, with a highly heterogeneous response between animals. Of the proteins used, intramuscular delivery of DNA encoding either tdTomato or luciferase gave the clearest signal, with some Katushka and tdKatushka2 signal observed. Subcutaneous delivery was weakly visible and nothing was observed following DNA tattooing. DNA encoding haemagglutinin was used to determine whether immune responses mirrored visible expression levels. A protective immune response against H1N1 influenza was induced by all routes, even after a single dose of DNA, though qualitative differences were observed, with tattooing leading to high antibody responses and subcutaneous DNA leading to high CD8 responses. We conclude that of the reporter proteins used, expression from DNA plasmids can best be assessed using tdTomato or luciferase. But, the disconnect between visible expression level and immunogenicity suggests that in vivo whole animal imaging of fluorescent proteins has limited utility for predicting DNA vaccine efficacy
Shear Wave Splitting Analysis to Estimate Fracture Orientation and Frequency Dependent Anisotropy
Shear wave splitting is a well-known method for indication of orientation, radius, and length of fractures in subsurface layers. In this paper, a three component near offset VSP data acquired from a fractured sandstone reservoir in southern part of Iran was used to analyse shear wave splitting and frequency-dependent anisotropy assessment. Polarization angle obtained by performing rotation on radial and transverse components of VSP data was used to determine the direction of polarization of fast shear wave which corresponds to direction of fractures. It was shown that correct implementation of shear wave splitting analysis can be used for determination of fracture direction. During frequency- dependent anisotropy analysis, it was found that the time delays in shear- waves decrease as the frequency increases. It was clearly demonstrated throughout this study that anisotropy may have an inverse relationship with frequency. The analysis presented in this paper complements the studied conducted by other researchers in this field of research
Mapping children's presence in the neighbourhood
Within the work of Gert Biesta, public spaces are considered as the main fields where processes of civic learning can take place. Learning is always “in place and time”. Place matters, not only as a spatial background or set of conditions , but as a pedagogical process in itself. So in order to facilitate processes of civic learning we need to understand how spaces function as a co-educator in its own right.. In my PhD I studied how the neighbourhood can be understood as a co-educator. The processes through which children are socialised into a given order are not universal, nor neutral. One might state that children grow up into very different orders. The neighbourhood is an important factor into these diversified socialisation processes, but the neighbourhood is also made by its residents and users themselves, including children. This emphasises that socialisation is a relational process and not a functional oneway introduction of children into a prescribed social ordeIn this contribution, a methodological framework will be developed for understanding and studying the neighbourhood of children as a co-educator. The basis of this framework is formed by the synergy between spatial, social and personal dimensions of the neighbourhood
Development and Evaluation of a Palliative Medicine Curriculum for Third-Year Medical Students
Abstract Objective: To assess the impact, retention, and magnitude of effect of a required didactic and experiential palliative care curriculum on third-year medical students' knowledge, confidence, and concerns about end-of-life care, over time and in comparison to benchmark data from a national study of internal medicine residents and faculty. Design: Prospective study of third-year medical students prior to and immediately after course completion, with a follow-up assessment in the fourth year, and in comparison to benchmark data from a large national study. Setting: Internal Medicine Clerkship in a public accredited medical school. Participants: Five hundred ninety-three third-year medical students, from July 2002 to December 2007. Main outcome measures: Pre- and postinstruction performance on: knowledge, confidence (self-assessed competence), and concerns (attitudes) about end-of-life care measures, validated in a national study of internal medicine residents and faculty. Medical student's reflective written comments were qualitatively assessed. Intervention: Required 32-hour didactic and experiential curriculum, including home hospice visits and inpatient hospice care, with content drawn from the AMA-sponsored Education for Physicians on End-of-life Care (EPEC) Project. Results: Analysis of 487 paired t tests shows significant improvements, with 23% improvement in knowledge (F1,486=881, p<0.001), 56% improvement in self-reported competence (F1,486=2,804, p<0.001), and 29% decrease in self-reported concern (F1,486=208, p<0.001). Retesting medical students in the fourth year showed a further 5% increase in confidence (p<0.0002), 13% increase in allaying concerns (p<0.0001), but a 6% drop in knowledge. The curriculum's effect size on M3 students' knowledge (0.56) exceeded that of a national cross-sectional study comparing residents at progressive training levels (0.18) Themes identified in students' reflective comments included perceived relevance, humanism, and effectiveness of methods used to teach and assess palliative care education. Conclusions: We conclude that required structured didactic and experiential palliative care during the clinical clerkship year of medical student education shows significant and largely sustained effects indicating students are better prepared than a national sample of residents and attending physicians.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98455/1/jpm%2E2010%2E0502.pd
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