2,082 research outputs found
Recommended from our members
The economic impacts of climate change: Evidence from agricultural output and random fluctuations in weather: Comment
In a series of studies employing a variety of approaches, we have found that the potential impact of climate change on US agriculture is likely negative. DeschΓͺnes and Greenstone (2007) report dramatically different results based on regressions of agricultural profits and yields on weather variables. The divergence is explained by (1) missing and incorrect weather and climate data in their study; (2) their use of older climate change projections rather than the more recent and less optimistic projections from the Fourth Assessment Report; and (3) difficulties in their profit measure due to the confounding effects of storage
Health Behavior Change Interventions for Teenage and Young Adult Cancer Survivors: A Systematic Review
PURPOSE: It is important that teenage and young adult (TYA) cancer survivors adopt a healthy lifestyle, since health vulnerabilities associated with their diagnosis and treatment may be exacerbated by poor health behaviors. This review aims to synthesize the current literature on health behavior change interventions created specifically for TYA-aged cancer survivors. METHOD: MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched for studies investigating interventions targeting one or more health behaviors, including: physical activity, diet, smoking cessation, and alcohol consumption. Studies were eligible for review if the study population were defined as TYA cancer survivors and the mean age of the sample was younger than 30 years of age. RESULTS: Twelve studies were identified, of which nine were randomized controlled trials. Physical activity was the most commonly targeted health behavior. Six of the 12 interventions included within this review were successful in changing health behavior. Due to the heterogeneity of intervention characteristics, the relationship between intervention efficacy or outcome and intervention content, delivery mode, or theoretical framework was not discernible. Nevertheless, trends emerged relating to the delivery and content of health behavior interventions designed specifically for TYA cancer survivors. CONCLUSION: More research is required to identify the most effective means of promoting health behavior change among the TYA cancer survivor population. Specifically, future research should focus on providing evidence of the efficiency and feasibility of interventions that use online technologies to facilitate remote intervention delivery and peer support
Letters from Wm. Chas. Roberts, J. B. Fisher, A. H. Throckmorton, Lucien Waggener, J. W. Logan, and A. B. Nelson
Letters of recommendation for O. W. Long
Country differences in the diagnosis and management of coronary heart disease : a comparison between the US, the UK and Germany
Background
The way patients with coronary heart disease (CHD) are treated is partly determined by non-medical factors. There is a solid body of evidence that patient and physician characteristics influence doctors' management decisions. Relatively little is known about the role of structural issues in the decision making process. This study focuses on the question whether doctors' diagnostic and therapeutic decisions are influenced by the health care system in which they take place. This non-medical determinant of medical decision-making was investigated in an international research project in the US, the UK and Germany.
Methods
Videotaped patients within an experimental study design were used. Experienced actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patients of different sex, age and social status. The videotapes were shown to 384 randomly selected primary care physicians in the three countries under study. The sample was stratified on gender and duration of professional experience. Physicians were asked how they would diagnose and manage the patient after watching the video vignette using a questionnaire with standardised and open-ended questions.
Results
Results show only small differences in decision making between British and American physicians in essential aspects of care. About 90% of the UK and US doctors identified CHD as one of the possible diagnoses. Further similarities were found in test ordering and lifestyle advice. Some differences between the US and UK were found in the certainty of the diagnoses, prescribed medications and referral behaviour. There are numerous significant differences between Germany and the other two countries. German physicians would ask fewer questions, they would order fewer tests, prescribe fewer medications and give less lifestyle advice.
Conclusion
Although all physicians in the three countries under study were presented exactly the same patient, some disparities in the diagnostic and patient management decisions were evident. Since other possible influences on doctors treatment decisions are controlled within the experimental design, characteristics of the health care system seem to be a crucial factor within the decision making process
Unusual exanthema combined with cerebral vasculitis in pneumococcal meningitis: a case report
<p>Abstract</p> <p>Introduction</p> <p>Bacterial meningitis is a complex, rapidly progressive disease in which neurological injury is caused in part by the causative organism and in part by the host's own inflammatory responses.</p> <p>Case presentation</p> <p>We present the case of a two-year-old Greek girl with pneumococcal meningitis and an atypical curvilinear-like skin eruption, chronologically associated with cerebral vasculitis. A diffusion-weighted MRI scan showed lesions with restricted diffusion, reflecting local areas of immunologically mediated necrotizing vasculitis.</p> <p>Conclusions</p> <p>Atypical presentations of bacterial meningitis may occur, and they can be accompanied by serious unexpected complications.</p
Combining estimates of interest in prognostic modelling studies after multiple imputation: current practice and guidelines
Background: Multiple imputation (MI) provides an effective approach to handle missing covariate
data within prognostic modelling studies, as it can properly account for the missing data
uncertainty. The multiply imputed datasets are each analysed using standard prognostic modelling
techniques to obtain the estimates of interest. The estimates from each imputed dataset are then
combined into one overall estimate and variance, incorporating both the within and between
imputation variability. Rubin's rules for combining these multiply imputed estimates are based on
asymptotic theory. The resulting combined estimates may be more accurate if the posterior
distribution of the population parameter of interest is better approximated by the normal
distribution. However, the normality assumption may not be appropriate for all the parameters of
interest when analysing prognostic modelling studies, such as predicted survival probabilities and
model performance measures.
Methods: Guidelines for combining the estimates of interest when analysing prognostic modelling
studies are provided. A literature review is performed to identify current practice for combining
such estimates in prognostic modelling studies.
Results: Methods for combining all reported estimates after MI were not well reported in the
current literature. Rubin's rules without applying any transformations were the standard approach
used, when any method was stated.
Conclusion: The proposed simple guidelines for combining estimates after MI may lead to a wider
and more appropriate use of MI in future prognostic modelling studies
Genome landscapes and bacteriophage codon usage
Across all kingdoms of biological life, protein-coding genes exhibit unequal
usage of synonmous codons. Although alternative theories abound, translational
selection has been accepted as an important mechanism that shapes the patterns
of codon usage in prokaryotes and simple eukaryotes. Here we analyze patterns
of codon usage across 74 diverse bacteriophages that infect E. coli, P.
aeruginosa and L. lactis as their primary host. We introduce the concept of a
`genome landscape,' which helps reveal non-trivial, long-range patterns in
codon usage across a genome. We develop a series of randomization tests that
allow us to interrogate the significance of one aspect of codon usage, such a
GC content, while controlling for another aspect, such as adaptation to
host-preferred codons. We find that 33 phage genomes exhibit highly non-random
patterns in their GC3-content, use of host-preferred codons, or both. We show
that the head and tail proteins of these phages exhibit significant bias
towards host-preferred codons, relative to the non-structural phage proteins.
Our results support the hypothesis of translational selection on viral genes
for host-preferred codons, over a broad range of bacteriophages.Comment: 9 Color Figures, 5 Tables, 53 Reference
Hierarchical information clustering by means of topologically embedded graphs
We introduce a graph-theoretic approach to extract clusters and hierarchies
in complex data-sets in an unsupervised and deterministic manner, without the
use of any prior information. This is achieved by building topologically
embedded networks containing the subset of most significant links and analyzing
the network structure. For a planar embedding, this method provides both the
intra-cluster hierarchy, which describes the way clusters are composed, and the
inter-cluster hierarchy which describes how clusters gather together. We
discuss performance, robustness and reliability of this method by first
investigating several artificial data-sets, finding that it can outperform
significantly other established approaches. Then we show that our method can
successfully differentiate meaningful clusters and hierarchies in a variety of
real data-sets. In particular, we find that the application to gene expression
patterns of lymphoma samples uncovers biologically significant groups of genes
which play key-roles in diagnosis, prognosis and treatment of some of the most
relevant human lymphoid malignancies.Comment: 33 Pages, 18 Figures, 5 Table
- β¦