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

Two Earth-sized planets orbiting Kepler-20

Since the discovery of the first extrasolar giant planets around Sun-like stars, evolving observational capabilities have brought us closer to the detection of true Earth analogues. The size of an exoplanet can be determined when it periodically passes in front of (transits) its parent star, causing a decrease in starlight proportional to its radius. The smallest exoplanet hitherto discovered has a radius 1.42 times that of the Earth's radius (R Earth), and hence has 2.9 times its volume. Here we report the discovery of two planets, one Earth-sized (1.03R Earth) and the other smaller than the Earth (0.87R Earth), orbiting the star Kepler-20, which is already known to host three other, larger, transiting planets. The gravitational pull of the new planets on the parent star is too small to measure with current instrumentation. We apply a statistical method to show that the likelihood of the planetary interpretation of the transit signals is more than three orders of magnitude larger than that of the alternative hypothesis that the signals result from an eclipsing binary star. Theoretical considerations imply that these planets are rocky, with a composition of iron and silicate. The outer planet could have developed a thick water vapour atmosphere.Comment: Letter to Nature; Received 8 November; accepted 13 December 2011; Published online 20 December 201

Three monthly coral Sr/Ca records from the Chagos Archipelago covering the period of 1950-1995 A.D.: reproducibility and implications for quantitative reconstructions of sea surface temperature variations

In order to assess the fidelity of coral Sr/Ca for quantitative reconstructions of sea surface temperature variations, we have generated three monthly Sr/Ca time series from Porites corals from the lagoon of Peros Banhos (71°E, 5°S, Chagos Archipelago). We find that all three coral Sr/Ca time series are well correlated with instrumental records of sea surface temperature (SST) and air temperature. However, the intrinsic variance of the single-core Sr/Ca time series differs from core to core, limiting their use for quantitative estimates of past temperature variations. Averaging the single-core data improves the correlation with instrumental temperature (r > 0.7) and allows accurate estimates of interannual temperature variations (~0.35°C or better). All Sr/Ca time series indicate a shift towards warmer temperatures in the mid-1970s, which coincides with the most recent regime shift in the Pacific Ocean. However, the magnitude of the warming inferred from coral Sr/Ca differs from core to core and ranges from 0.26 to 0.75°C. The composite Sr/Ca record from Peros Banhos clearly captures the major climatic signals in the Indo-Pacific Ocean, i.e. the El Niño–southern oscillation and the Pacific decadal oscillation. Moreover, composite Sr/Ca is highly correlated with tropical mean temperatures (r = 0.7), suggesting that coral Sr/Ca time series from the tropical Indian Ocean will contribute to multi-proxy reconstructions of tropical mean temperatures

The stellar halo of the Galaxy

Stellar halos may hold some of the best preserved fossils of the formation history of galaxies. They are a natural product of the merging processes that probably take place during the assembly of a galaxy, and hence may well be the most ubiquitous component of galaxies, independently of their Hubble type. This review focuses on our current understanding of the spatial structure, the kinematics and chemistry of halo stars in the Milky Way. In recent years, we have experienced a change in paradigm thanks to the discovery of large amounts of substructure, especially in the outer halo. I discuss the implications of the currently available observational constraints and fold them into several possible formation scenarios. Unraveling the formation of the Galactic halo will be possible in the near future through a combination of large wide field photometric and spectroscopic surveys, and especially in the era of Gaia.Comment: 46 pages, 16 figures. References updated and some minor changes. Full-resolution version available at http://www.astro.rug.nl/~ahelmi/stellar-halo-review.pd

Colposcopy attendance and deprivation: A retrospective analysis of 27 193 women in the NHS Cervical Screening Programme

This study is funded by a grant from the UK Department of Health (no. 106/0001). ED and NM are supported by the Policy Research Unit in Cancer Awareness, Screening, and Early Diagnosis. The Policy Research Unit receives funding for a research programme from the Department of Health Policy Research Programme. It is a collaboration between researchers from seven institutions (Queen Mary University of London, University College London, King’s College London, London School of Hygiene and Tropical Medicine, Hull York Medical School, Durham University and Peninsula Medical School)

Global health education: a pilot in trans-disciplinary, digital instruction

Background: The development of new global health academic programs provides unique opportunities to create innovative educational approaches within and across universities. Recent evidence suggests that digital media technologies may provide feasible and cost-effective alternatives to traditional classroom instruction; yet, many emerging global health academic programs lag behind in the utilization of modern technologies. Objective: We created an inter-departmental University of Southern California (USC) collaboration to develop and implement a course focused on digital media and global health. Design: Course curriculum was based on core tenants of modern education: multi-disciplinary, technologically advanced, learner-centered, and professional application of knowledge. Student and university evaluations were reviewed to qualitatively assess course satisfaction and educational outcomes. Results: ‘New Media for Global Health’ ran for 18 weeks in the Spring 2012 semester with N=41 students (56.1% global health and 43.9% digital studies students). The course resulted in a number of high quality global health-related digital media products available at http://iml420.wordpress.com/. Challenges confronted at USC included administrative challenges related to co-teaching and frustration from students conditioned to a rigid system of teacher-led learning within a specific discipline. Quantitative and qualitative course evaluations reflected positive feedback for the course instructors and mixed reviews for the organization of the course. Conclusion: The development of innovative educational programs in global health requires on-going experimentation and information sharing across departments and universities. Digital media technologies may have implications for future efforts to improve global health education

Diagnostic test accuracy of remote, multidomain cognitive assessment (telephone and video call) for dementia

Copyright \ua9 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.Objectives: This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows:. Our main objective is to assess the test accuracy of any multidomain cognitive test delivered remotely for the diagnosis of any form of dementia. Our review will not be limited to a particular healthcare setting or a particular threshold score of index test. Secondary objectives To describe the degree of agreement between a remotely delivered cognitive test and the same or a closely related test delivered in-person when neither is assessed against a clinical dementia reference standard. To identify the quality and quantity of the research evidence describing test accuracy of remote testing. To identify sources of heterogeneity in the test accuracy described. To identify gaps in the evidence where further research is required. Investigation of sources of heterogeneity Heterogeneity is often seen in clinical test accuracy reviews (Deeks 2001). Important potential sources of heterogeneity will include the case-mix of the population being assessed; clinical setting; person performing the assessment; platform used to administer the test (e.g. standard telephone versus video call); threshold scores used to define test positivity; and the quality of the included papers. We will collect data on all of these factors, and if data allow will explore their effect using subgroup and sensitivity analyses as appropriate

Listeria monocytogenes in Milk Products

peer-reviewedMilk and milk products are frequently identified as vectors for transmission of Listeria monocytogenes. Milk can be contaminated at farm level either by indirect external contamination from the farm environment or less frequently by direct contamination of the milk from infection in the animal. Pasteurisation of milk will kill L. monocytogenes, but post-pasteurisation contamination, consumption of unpasteurised milk and manufacture of unpasteurised milk products can lead to milk being the cause of outbreaks of listeriosis. Therefore, there is a concern that L. monocytogenes in milk could lead to a public health risk. To protect against this risk, there is a need for awareness surrounding the issues, hygienic practices to reduce the risk and adequate sampling and analysis to verify that the risk is controlled. This review will highlight the issues surrounding L. monocytogenes in milk and milk products, including possible control measures. It will therefore create awareness about L. monocytogenes, contributing to protection of public health

Cytokine preconditioning of engineered cartilage provides protection against interleukin-1 insult

Research reported in this publication was supported in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health under Award Number R01AR60361, R01AR061988, P41EB002520). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. ART was supported by a National Science Foundation Graduate Fellowship