Geometric View of Measurement Errors

The slope of the best fit line from minimizing the sum of the squared oblique errors is the root of a polynomial of degree four. This geometric view of measurement errors is used to give insight into the performance of various slope estimators for the measurement error model including an adjusted fourth moment estimator introduced by Gillard and Iles (2005) to remove the jump discontinuity in the estimator of Copas (1972). The polynomial of degree four is associated with a minimun deviation estimator. A simulation study compares these estimators showing improvement in bias and mean squared error

Nurses’ experiences of clinical commissioning group boards

The following paper is the first in a series of three papers to highlight current practice among governing body nurses, that is, nurses who hold the statutory role of nurse member on clinical commissioning groups in England. In this paper we present findings from a small pilot study into these nurses’ experiences of Clinical Commissioning Groups. Their roles have emerged at a time of organisational change and in a period following extensive criticism of nursing and nurses in the media. We suggest that nurses’ roles and experiences are affected by these contextual ‘events’ and by the emerging structures and diversity of clinical commissioning groups. We argue that governing body nurses’ effectiveness in leading nurses and nursing on clinical commissioning groups may be affected by their relationships with other nurses, especially senior nurses, within clinical commissioning group localities. We suggest that it is timely to evaluate the effectiveness of statutory nurse member roles in influencing decision making on Clinical Commissioning Groups

Are senior nurses on clinical commissioning groups in England inadvertently supporting the devaluation of their profession?: A critical integrative review of the literature

This paper discusses the role of senior nurses who sit on clinical commissioning groups that now plan and procure most health services in England. These nurses are expected to bring a nursing view to all aspects of clinical commissioning group business (National Health Service England 2014a; Olphert 2014). The role is a senior level appointment and requires experience of strategic commissioning. However little is known about how nurses function in these roles. Following Barrientos’ methodology (1998), published policy and literature were analysed to investigate these roles and NHS England’s claim that nursing can influence and advance a nursing perspective in clinical commissioning groups. Drawing on work by Berg et al (2008, 2014) on ‘new public management’ we discuss how nurses on clinical commissioning groups work at the alignment of the interests of biomedicine and managerialism. We propose that the way this nursing role is being implemented might paradoxically offer further evidence of the devaluing of nursing (Latimer 2014) rather than the emergence of a strong professional nursing voice at the level of strategic commissioning

Do governing body and CSU nurses on clinical commissioning groups really lead a nursing agenda? Findings from a 2015 Survey of the Commissioning Nurse Leaders’ Network Membership

Aims This paper presents findings from a 2015 survey of the Commissioning Nurse Leaders’ Network (CNLN) aiming to understand how governing body nurses (GBNs), perceive their influence and leadership on clinical commissioning groups (CCGs). Methods An online survey method was used with a census sample of 238 GBNs and nurses working in CSUs, who were members of the CNLN. The response rate was 40.7% (n=97). Results While most GBNs felt confident in their leadership role, this was less so for non-executive GBNs and nurses in CSUs were much less positive than GBNs about their influence on CCGs. Conclusions Despite GBNs’ satisfaction with their impact on CCGs, there is no reliable evidence of this impact. The purpose of such roles to "represent nursing, and ensure the patient voice is heard” (NHSCC 2016:9) may be a flawed aspiration, conflating nursing leadership and patient voice. Implications for Nursing Management This is the first study to explicitly explore differences between executive and non-executive GBNs and CSUs. Achieving CCG goals, including developing and embedding nursing leadership roles in CCGs, may be threatened if the contributions of GBNs, and other nurses supporting, CCGS, go unrecognised or if GPs or other CCG executive members dominate decision-making

Health information equity: Rebalancing healthcare collections for racial diversity in UK public service contexts

COVID-19 illustrated health disparities experienced by racially minoritised people, with heightened risks faced by Black and South Asian communities lending the issue transparency and urgency. Despite efforts to decolonise medical education, deficits in racial representation in research and resources remain. This study investigates the potential and imperatives for healthcare information services to contribute to health equity through their collections. The literature analysis explores collection management, decolonisation, social justice in librarianship, and Critical Race Theory (CRT) as a framework for change in information contexts. A survey of UK National Health Service (NHS) librarians provides a snapshot of awareness of health information inequity. Semistructured interviews explore information professionals’ experiences of anti-racism in the system. The findings indicate strong engagement with the need for equitable resources but highlight some barriers to success. Opportunities identified include potential for addressing systemic racism in collection policy, capability of information services to influence, or engage in, authorship and publishing to address gaps, and the need for race-based data standards in healthcare. Synthesis of the findings through a framework of CRT tenets illustrates the relevance and utility of CRT as a tool for pursuit of equity in information practice, scholarship, and education

Reward-Processing Behavior in Depressed Participants Relative to Healthy Volunteers: A Systematic Review and Meta-analysis

IMPORTANCE: Dysfunctional reward processing is a leading candidate mechanism for the development of certain depressive symptoms, such as anhedonia. However, to our knowledge, there has not yet been a systematic assessment of whether and to what extent depression is associated with impairments on behavioral reward-processing tasks. OBJECTIVE: To determine whether depression is associated with impairments in reward-processing behavior. DATA SOURCES: The MEDLINE/PubMed, Embase, and PsycInfo databases were searched for studies that investigated reward processing using performance on behavioral tasks by individuals with depression and nondepressed control groups, published between January 1, 1946, and August 16, 2019. STUDY SELECTION: Studies that contained data regarding performance by depressed and healthy control groups on reward-processing tasks were included in the systematic review and meta-analysis. DATA EXTRACTION AND SYNTHESIS: Summary statistics comparing performance between depressed and healthy groups on reward-processing tasks were converted to standardized mean difference (SMD) scores, from which summary effect sizes for overall impairment in reward processing and 4 subcomponent categories were calculated. Study quality, heterogeneity, replicability-index, and publication bias were also assessed. MAIN OUTCOME AND MEASURES: Performance on reward-processing tasks. RESULTS: The final data set comprised 48 case-control studies (1387 healthy control individuals and 1767 individuals with major depressive disorder). The mean age was 37.85 years and 58% of the participants were women. These studies used tasks assessing option valuation (n = 9), reward bias (n = 6), reward response vigor (n = 12), reinforcement learning (n = 20), and grip force (n = 1). Across all tasks, depression was associated with small to medium impairments in reward-processing behavior (SMD = 0.345; 95% CI, 0.209-0.480). When examining reward-processing subcomponent categories, impairment was associated with tasks assessing option valuation (SMD = 0.309; 95% CI, 0.147-0.471), reward bias (SMD = 0.644; 95% CI, 0.270-1.017), and reinforcement learning (SMD = 0.352; 95% CI, 0.115-0.588) but not reward response vigor (SMD = 0.083; 95% CI, −0.144 to 0.309). The medication status of the major depressive disorder sample did not explain any of the variance in the overall effect size. There was significant between-study heterogeneity overall and in all subcomponent categories other than option valuation. Significant publication bias was identified overall and in the reinforcement learning category. CONCLUSIONS AND RELEVANCE: Relative to healthy control individuals, individuals with depression exhibit reward-processing impairments, particularly for tests of reward bias, option valuation, and reinforcement learning. Understanding the neural mechanisms driving these associations may assist in designing novel interventions

Associations between the rate, amount and composition of weight loss as predictors of spontaneous weight regain in adults achieving clinically significant weight loss: a systematic review and meta-regression

Weight regain following weight loss is common although little is known regarding the associations between amount, rate, and composition of weight loss and weight regain. Forty-three studies (52 groups; n = 2379) with longitudinal body composition measurements were identified in which weight loss (≥5%) and subsequent weight regain (≥2%) occurred. Data were synthesized for changes in weight and body composition. Meta-regression models were used to investigate associations between amount, rate, and composition of weight loss and weight regain. Individuals lost 10.9% of their body weight over 13 weeks composed of 19.6% fat-free mass, followed by a regain of 5.4% body weight over 44 weeks composed of 21.6% fat-free mass. Associations between the amount (P < 0.001) and rate (P = 0.049) of weight loss and their interaction (P = 0.042) with weight regain were observed. Fat-free mass (P = 0.017) and fat mass (P < 0.001) loss both predicted weight regain although the effect of fat-free mass was attenuated following adjustment. The amount (P < 0.001), but not the rate of weight loss (P = 0.150), was associated with fat-free mass loss. The amount and rate of weight loss were significant and interacting factors associated with weight regain. Loss of fat-free mass and fat mass explained greater variance in weight regain than weight loss alone