1,703 research outputs found
World AIDS Day: together we will stop HIV transmission and conquer AIDS
10.1186/1742-4690-10-129Retrovirology10112
Association of Real-Time Feedback and Cardiopulmonary-Resuscitation Quality Delivered by Ambulance Personnel for Out-of-Hospital Cardiac Arrest.
Background High-quality cardiopulmonary resuscitation (CPR) is associated with improved survival from out-of-hospital cardiac arrest and includes chest compression depth, chest compression rate, and chest compression fraction within international guideline recommendations. Previous studies have demonstrated divergent results of real-time feedback on CPR performance and patient outcomes. This study investigated the association between emergency medical service CPR quality and real-time CPR feedback for out-of-hospital cardiac arrest. Methods and Results This study collected out-of-hospital cardiac arrest data within the Capital Region of Denmark and compared CPR quality delivered by ambulance personnel. Data were collected in 2 consecutive phases from October 2018 to February 2020. Median chest compression depth was 6.0 cm (no feedback) and 5.9 cm (real-time feedback) (P=0.852). Corresponding proportion of guideline-compliant chest compressions for depth was 16.6% and 28.7%, respectively (P<0.001). Median chest compression rate per minute was 111 and 109 (P<0.001), respectively. Corresponding guideline adherence proportion for compression rate was 65.4% compared with 80.4% (P<0.001), respectively. Chest compression fraction was 78.9% compared with 81.9% (P<0.001), respectively. The combination of guideline-compliant chest compression depth and chest compression rate simultaneously was 8.5% (no feedback) versus 18.8% (feedback) (P<0.001). Improvements were not significant for return of spontaneous circulation (odds ratio [OR], 1.08 [95% CI, 0.84-1.39]), sustained return of spontaneous circulation (OR, 1.00 [95% CI, 0.77-1.31]), or survival to hospital discharge (OR, 0.91 [95% CI, 0.64-1.30]). Conclusions Real-time feedback was associated with improved guideline compliance for chest compression depth, rate, and fraction but not return of spontaneous circulation, sustained return of spontaneous circulation, or survival to hospital discharge. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04152252
Choosing party leaders: Anglophone democracies, British parties and the limits of comparative politics
Since 1965, Britain’s major political parties have radically, and repeatedly, changed the ways in which they choose their leaders. Building on a recent comparative study of party leadership selection in the five principal Anglophone (‘Westminster’) parliamentary democracies (Cross and Blais, 2012a), this article first outlines a theoretical framework that purports to explain why the major parties in three of those countries, including Britain, have adopted such reform. It then examines why five major British parties have done so since 1965. It argues that, while Cross and Blais’ study makes a significant contribution to our knowledge and understanding of processes of party leadership selection reform in Anglophone parliamentary democracies, it has limited explanatory power when applied to changes enacted by the major parties in modern and contemporary Britain. Instead, the adoption of such reform in the British context is ultimately best understood and explained by examining both the internal politics and external circumstances of individual parties
Cognition in stroke rehabilitation and recovery research: Consensus-based core recommendations from the second Stroke Recovery and Rehabilitation Roundtable
Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway
Cognition in Stroke Rehabilitation and Recovery Research: Consensus-Based Core Recommendations From the Second Stroke Recovery and Rehabilitation Roundtable
Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway
Do self-reported intentions predict clinicians behaviour: a systematic review.
Background: Implementation research is the scientific study of methods to promote the systematic uptake of
clinical research findings into routine clinical practice. Several interventions have been shown to be effective in
changing health care professionals' behaviour, but heterogeneity within interventions, targeted behaviours, and
study settings make generalisation difficult. Therefore, it is necessary to identify the 'active ingredients' in
professional behaviour change strategies. Theories of human behaviour that feature an individual's "intention" to
do something as the most immediate predictor of their behaviour have proved to be useful in non-clinical
populations. As clinical practice is a form of human behaviour such theories may offer a basis for developing a
scientific rationale for the choice of intervention to use in the implementation of new practice. The aim of this
review was to explore the relationship between intention and behaviour in clinicians and how this compares to
the intention-behaviour relationship in studies of non-clinicians.
Methods: We searched: PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled
Trials, Science/Social science citation index, Current contents (social & behavioural med/clinical med), ISI
conference proceedings, and Index to Theses. The reference lists of all included papers were checked manually.
Studies were eligible for inclusion if they had: examined a clinical behaviour within a clinical context, included
measures of both intention and behaviour, measured behaviour after intention, and explored this relationship
quantitatively. All titles and abstracts retrieved by electronic searching were screened independently by two
reviewers, with disagreements resolved by discussion.
Discussion: Ten studies were found that examined the relationship between intention and clinical behaviours in
1623 health professionals. The proportion of variance in behaviour explained by intention was of a similar
magnitude to that found in the literature relating to non-health professionals. This was more consistently the case
for studies in which intention-behaviour correspondence was good and behaviour was self-reported. Though firm
conclusions are limited by a smaller literature, our findings are consistent with that of the non-health professional
literature. This review, viewed in the context of the larger populations of studies, provides encouragement for
the contention that there is a predictable relationship between the intentions of a health professional and their
subsequent behaviour. However, there remain significant methodological challenges
Stochastic population growth in spatially heterogeneous environments
Classical ecological theory predicts that environmental stochasticity
increases extinction risk by reducing the average per-capita growth rate of
populations. To understand the interactive effects of environmental
stochasticity, spatial heterogeneity, and dispersal on population growth, we
study the following model for population abundances in patches: the
conditional law of given is such that when is small the
conditional mean of is approximately , where and are the abundance and per
capita growth rate in the -th patch respectivly, and is the
dispersal rate from the -th to the -th patch, and the conditional
covariance of and is approximately . We show for such a spatially extended population that if
is the total population abundance, then ,
the vector of patch proportions, converges in law to a random vector
as , and the stochastic growth rate equals the space-time average per-capita growth rate
\sum_i\mu_i\E[Y_\infty^i] experienced by the population minus half of the
space-time average temporal variation \E[\sum_{i,j}\sigma_{ij}Y_\infty^i
Y_\infty^j] experienced by the population. We derive analytic results for the
law of , find which choice of the dispersal mechanism produces an
optimal stochastic growth rate for a freely dispersing population, and
investigate the effect on the stochastic growth rate of constraints on
dispersal rates. Our results provide fundamental insights into "ideal free"
movement in the face of uncertainty, the persistence of coupled sink
populations, the evolution of dispersal rates, and the single large or several
small (SLOSS) debate in conservation biology.Comment: 47 pages, 4 figure
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