eHealth and the use of individually tailored information:a systematic review

Tailored messages are those that specifically target individuals following an assessment of their unique characteristics. This systematic review assesses the evidence regarding the effectiveness of tailoring within eHealth interventions aimed at chronic disease management. OVID Medline/Embase databases were searched for randomised control trials, controlled clinical, trials, before -after studies, and time series analyses from inception - May 2014. Objectively measured clinical processes/outcomes were considered. Twenty-two papers were eligible for inclusion: 6/22 used fully tailored messaging and 16/22 used partially tailored messages. Two studies isolated tailoring as the active component. The remainder compared intervention with standard care. In all, 12/16 studies measuring clinical processes and 2/6 studies reporting clinical outcomes showed improvements, regardless of target group. Study quality was low and design did not allow for identification of interventions’ active component. Heterogeneity precluded meta-analysis. This review has demonstrated that there is a lack of evidence to suggest that tailoring within an eHealth context confers benefit over non-tailored eHealth interventions. </jats:p

Covariance of cross-correlations: towards efficient measures for large-scale structure

We study the covariance of the cross-power spectrum of different tracers for the large-scale structure. We develop the counts-in-cells framework for the multi-tracer approach, and use this to derive expressions for the full non-Gaussian covariance matrix. We show, that for the usual auto-power statistic, besides the off-diagonal covariance generated through gravitational mode-coupling, the discreteness of the tracers and their associated sampling distribution can generate strong off-diagonal covariance, and that this becomes the dominant source of covariance as k>>k_f=2 pi/L. On comparison with the derived expressions for the cross-power covariance, we show that the off-diagonal terms can be suppressed, if one cross-correlates a high tracer-density sample with a low one. Taking the effective estimator efficiency to be proportional to the signal-to-noise ratio (SN), we show that, to probe clustering as a function of physical properties of the sample, i.e. cluster mass or galaxy luminosity, then the cross-power approach can out perform the auto-power one by factors of a few. We confront the theory with measurements of the mass-mass, halo-mass, and halo-halo power spectra from a large ensemble of N-body simulations. We show that there is a significant SN advantage to be gained from using the cross-power approach when studying the bias of rare haloes. The analysis is repeated in configuration space and again SN improvement is found. We estimate the covariance matrix for these samples, and find strong off-diagonal contributions. The covariance depends on halo mass, with higher mass samples having stronger covariance. In agreement with theory, we show that the covariance is suppressed for the cross-power. This work points the way towards improved estimators for clustering studies.Comment: Several significant improvements to the earlier version: for instance it is shown more clearly how shot noise corrections may generate off-diagonal covariance in the power spectrum. Original version submitted to MNRAS on 18th September 2008. This version 18 pages, 7 figure

Decision Support for Diabetes in Scotland:Implementation and Evaluation of a Clinical Decision Support System

Background: Automated clinical decision support systems (CDSS) are associated with improvements in health care delivery to those with long-term conditions, including diabetes. A CDSS was introduced to two Scottish regions (combined diabetes population ~30 000) via a national diabetes electronic health record. This study aims to describe users’ reactions to the CDSS and to quantify impact on clinical processes and outcomes over two improvement cycles: December 2013 to February 2014 and August 2014 to November 2014. Methods: Feedback was sought via patient questionnaires, health care professional (HCP) focus groups, and questionnaires. Multivariable regression was used to analyze HCP SCI-Diabetes usage (with respect to CDSS message presence/absence) and case-control comparison of clinical processes/outcomes. Cases were patients whose HCP received a CDSS messages during the study period. Closely matched controls were selected from regions outside the study, following similar clinical practice (without CDSS). Clinical process measures were screening rates for diabetes-related complications. Clinical outcomes included HbA1c at 1 year. Results: The CDSS had no adverse impact on consultations. HCPs were generally positive toward CDSS and used it within normal clinical workflow. CDSS messages were generated for 5692 cases, matched to 10 667 controls. Following clinic, the probability of patients being appropriately screened for complications more than doubled for most measures. Mean HbA1c improved in cases and controls but more so in cases (–2.3 mmol/mol [–0.2%] versus –1.1 [–0.1%], P = .003). Discussion and Conclusions: The CDSS was well received; associated with improved efficiencies in working practices; and large improvements in guideline adherence. These evidence-based, early interventions can significantly reduce costly and devastating complications. </jats:sec

How well are Australian infants and children aged 4 to 5 years doing?

This report presents an analysis of the data from the first wave of the Longitudinal Study of Australian Children (LSAC) to explore the wellbeing of over 10,000 Australian infants and children. This report presents an analysis of the data from the first wave of the Longitudinal Study of Australian Children (LSAC) to explore the wellbeing of 5,107 children in the infant cohort of the study and the 4,983 children, aged 4 to 5 years, in the child cohort. Wave 1 of LSAC includes measures of multiple aspects of children\u27s early development. These developmental measures are summarised in the LSAC Outcome Index, a composite measure which includes an overall index as well as three separate domain scores, tapping physical development, social and emotional functioning, and learning and cognitive development. This report explores five specific aspects of infants\u27 and children\u27s experiences, exposures and environments in relation to their Outcome Index scores: * key sociodemographic characteristics covering the child, mother, family and neighbourhood * non-parental care experiences * child health—prenatal and postnatal experiences and exposures * maternal physical and mental health * the early educational experiences of the child cohort in the home and out-of-home contexts. This paper is by Melissa Wake, Ann Sanson, Donna Berthelsen, Pollyanna Hardy, Sebastian Misson, Katherine Smith, Judy Ungerer and the LSAC Research Consortium

Halo-model Analysis of the Clustering of Photometrically Selected Galaxies from SDSS

We measure the angular 2-point correlation functions of galaxies in a volume limited, photometrically selected galaxy sample from the fifth data release of the Sloan Digital Sky Survey. We split the sample both by luminosity and galaxy type and use a halo-model analysis to find halo-occupation distributions that can simultaneously model the clustering of all, early-, and late-type galaxies in a given sample. Our results for the full galaxy sample are generally consistent with previous results using the SDSS spectroscopic sample, taking the differences between the median redshifts of the photometric and spectroscopic samples into account. We find that our early- and late- type measurements cannot be fit by a model that allows early- and late-type galaxies to be well-mixed within halos. Instead, we introduce a new model that segregates early- and late-type galaxies into separate halos to the maximum allowed extent. We determine that, in all cases, it provides a good fit to our data and thus provides a new statistical description of the manner in which early- and late-type galaxies occupy halos.Comment: Accepted to MNRAS 11 pages, 6 figure

Phylogenetic relationships of Indian caecilians (Amphibia: Gymnophiona) inferred from mitochondrial rRNA gene sequences

India has a diverse caecilian fauna, including representatives of three of the six currently recognized families, the Caeciliidae, Ichthyophiidae, the endemic Uraeotyphlidae, but previous molecular phylogenetic studies of caecilians have not included sequences for any Indian caecilians. Partial 12S and 16S mitochondrial gene sequences were obtained for a single representative of each of the caecilian families found in India and aligned against previously reported sequences for 13 caecilian species. The resulting alignment (16 taxa, 1200 sites, of which 288 cannot be aligned unambiguously) was analyzed using parsimony, maximum-likelihood, and distance methods. As judged by bootstrap proportions, decay indices, and leaf stabilities, well-supported relationships of the Indian caecilians are recovered from the alignment. The data (1) corroborate the hypothesis, based on morphology, that the Uraeotyphlidae and Ichthyophiidae are sister taxa, (2) recover a monophyletic Ichthyophiidae, including Indian and South East Asian representatives, and (3) place the Indian caeciliid Gegeneophis ramaswamii as the sister group of the caeciliid caecilians of the Seychelles. Rough estimates of divergence times suggest an origin of the Uraeotyphlidae and Ichthyophiidae while India was isolated from Laurasia and Africa and are most consistent with an Indian origin of these families and subsequent dispersal of ichthyophiids into South East Asia

XMM-Newton Surveys of the Canada-France Redshift Survey Fields - III: The Environments of X-ray Selected AGN at 0.4<z<0.6

The environmental properties of a sample of 31 hard X-ray selected AGN are investigated, from scales of 500 kpc down to 30 kpc, and are compared to a control sample of inactive galaxies. The AGN all lie in the redshift range 0.4<z<0.6. The accretion luminosity-density of the Universe peaks close to this redshift range, and the AGN in the sample have X-ray luminosities close to the knee in the hard X-ray luminosity function, making them representative of the population which dominated this important phase of energy conversion. Using both the spatial clustering amplitude and near neighbour counts it is found that the AGN have environments that are indistinguishable from normal, inactive galaxies over the same redshift range and with similar optical properties. Typically, the environments are of sub-cluster richness, in contrast to similar studies of high-z quasars, which are often found in clusters with comparable richness to the Abell R>=0 clusters. It is suggested that minor mergers with low mass companions is a likely candidate for the mechanism by which these modest luminosity AGN are fuelled.Comment: 12 pages, 6 figures, accepted by MNRA

The Dark Matter Haloes and Host Galaxies of MgII Absorbers at z~1

Strong foreground absorption features from singly-ionized Magnesium (Mg II) are commonly observed in the spectra of quasars and are presumed to probe a wide range of galactic environments. To date, measurements of the average dark matter halo masses of intervening Mg II absorbers by way of large-scale cross-correlations with luminous galaxies have been limited to z<0.7. In this work we cross-correlate 21 strong (W{\lambda}2796>0.6 {\deg}A) Mg II absorption systems detected in quasar spectra from the Sloan Digital Sky Survey Data Release 7 with ~32,000 spectroscopically confirmed galaxies at 0.7<z<1.45 from the DEEP2 galaxy redshift survey. We measure dark matter (DM) halo biases of b_G=1.44\pm0.02 and b_A=1.49\pm0.45 for the DEEP2 galaxies and Mg II absorbers, respectively, indicating that their clustering amplitudes are roughly consistent. Haloes with the bias we measure for the Mg II absorbers have a corresponding mass of 1.8(+4.2/-1.6) \times 10^12h-1M_sun, although the actual mean absorber halo mass will depend on the precise distribution of absorbers within DM haloes. This mass estimate is consistent with observations at z=0.6, suggesting that the halo masses of typical Mg II absorbers do not significantly evolve from z~1. We additionally measure the average W{\lambda}2796>0.6 \AA gas covering fraction to be f =0.5 within 60 h-1kpc around the DEEP2 galaxies, and we find an absence of coincident strong Mg II absorption beyond a projected separation of ~40 h-1kpc. Although the star-forming z>1 DEEP2 galaxies are known to exhibit ubiquitous blueshifted Mg II absorption, we find no direct evidence in our small sample linking W{\lambda}2796>0.6 \AA absorbers to galaxies with ongoing star formation.Comment: 12 pages, 5 figures, Accepted to MNRA