84 research outputs found
Self-interest bias in the COVID-19 pandemic: A cross-cultural comparison between the United States and China
In the global crisis of the COVID-19 pandemic, many countries attempt to enforce new social norms to prevent the further spread of the coronavirus. A key to the success of these measures is the individual adherence to norms that are collectively beneficial to contain the spread of the pandemic. However, individuals’ self-interest bias (i.e., the prevalent tendency to license own but not others’ self-serving acts or norm violations) can pose a challenge to the success of such measures. The current research examines COVID-19-related self-interest bias from a cross-cultural perspective. Two studies (N = 1,558) sampled from the United States and China consistently revealed that participants from the United States evaluated their own self-serving acts (exploiting test kits in Study 1; social gathering and sneezing without covering the mouth in public in Study 2) as more acceptable than identical deeds of others, while such self-interest bias did not emerge among Chinese participants. Cultural underpinnings of independent versus interdependent self-construal may influence the extent to which individuals apply self-interest bias to justifications of their own self-serving behaviors during the pandemic
Has primary care antimicrobial use really been increasing? Comparison of changes in different prescribing measures for a complete geographic population 1995-2014
Objectives To elucidate how population trends in total antimicrobials dispensed in the community translate into individual exposure. Methods Retrospective, population-based observational study of all antimicrobial prescribing in a Scottish region in financial years 1995, 2000 and 2005–14. Analysis of temporal changes in all antimicrobials and specific antimicrobials measured in: WHO DDD per 1000 population; prescriptions per 1000 population; proportion of population with ≥1 prescription; mean number of prescriptions per person receiving any; mean DDD per prescription. Results Antimicrobial DDD increased between 1995 and 2014, from 5651 to 6987 per 1000 population [difference 1336 (95% CI 1309–1363)]. Prescriptions per 1000 fell (from 821 to 667, difference –154, –151 to –157), as did the proportion prescribed any antimicrobial [from 39.3% to 30.8% (–8.5, –8.4 to –8.6)]. Rising mean DDD per prescription, from 6.88 in 1995 to 10.47 in 2014 (3.59, 3.55–3.63), drove rising total DDD. In the under-5s, every measure fell over time (68.2% fall in DDD per 1000; 60.7% fall in prescriptions per 1000). Among 5–64 year olds, prescriptions per 1000 were lowest in 2014 but among older people, despite a reduction since 2010, the 2014 rate was still higher than in 2000. Trends in individual antimicrobials provide some explanation for overall trends. Conclusions Rising antimicrobial volumes up to 2011 were mainly due to rising DDD per prescription. Trends in dispensed drug volumes do not readily translate into information on individual exposure, which is more relevant for adverse consequences including emergence of resistance.PostprintPeer reviewe
Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans
BACKGROUND The Australian Government Department of Veterans’ Affairs (DVA) funds an ongoing health promotion based program to improve use of medicines and related health services, which implements interventions that include audit and feedback in the form of patient-specific feedback generated from administrative claims records. We aimed to determine changes in medicine use as a result of the program. METHODS The program provides targeted patient-specific feedback to medical practitioners. The feedback is supported with educational material developed by a clinical panel, subject to peer review and overseen by a national editorial committee. Veterans who meet target criteria also receive educational brochures. The program is supported by a national call centre and ongoing national consultation. Segmented regression analyses (interrupted time series) were undertaken to assess changes in medication use in targeted veterans pre and post each intervention. RESULTS 12 interventions were included; three to increase medicine use, seven which aimed to reduce use, and two which had combination of messages to change use. All programs that aimed to increase medicine use were effective, with relative effect sizes at the time of the intervention ranging from 1% to 8%. Mixed results were seen with programs aiming to reduce inappropriate medicine use. Highly specific programs were effective, with relative effect sizes at the time of the intervention of 10% decline in use of NSAIDs in high risk groups and 14% decline in use of antipsychotics in dementia. Interventions targeting combinations of medicines, including medicine interactions and potentially inappropriate medicines in the elderly did not change practice significantly. Interventions with combinations of messages targeting multiple components of practice had an impact on one component, but not all components targeted. CONCLUSIONS The Veterans’ MATES program showed positive practice change over time, with interventions increasing use of appropriate medicines where under-use was evident and reduced use of inappropriate medicines when single medicines were targeted. Combinations of messages were less effective, suggesting specific messages focusing on single medicines are required to maximise effect. The program provides a model that could be replicated in other settings.Elizabeth E Roughead, Lisa M Kalisch Ellett, Emmae N Ramsay, Nicole L Pratt, John D Barratt, Vanessa T LeBlanc, Philip Ryan, Robert Peck, Graeme Killer and Andrew L Gilber
Clinical effectiveness and cost-effectiveness of issuing longer versus shorter duration (3-month vs. 28-day) prescriptions in patients with chronic conditions: systematic review and economic modelling.
BACKGROUND: To reduce expenditure on, and wastage of, drugs, some commissioners have encouraged general practitioners to issue shorter prescriptions, typically 28 days in length; however, the evidence base for this recommendation is uncertain. OBJECTIVE: To evaluate the evidence of the clinical effectiveness and cost-effectiveness of shorter versus longer prescriptions for people with stable chronic conditions treated in primary care. DESIGN/DATA SOURCES: The design of the study comprised three elements. First, a systematic review comparing 28-day prescriptions with longer prescriptions in patients with chronic conditions treated in primary care, evaluating any relevant clinical outcomes, adherence to treatment, costs and cost-effectiveness. Databases searched included MEDLINE (PubMed), EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Cochrane Central Register of Controlled Trials. Searches were from database inception to October 2015 (updated search to June 2016 in PubMed). Second, a cost analysis of medication wastage associated with < 60-day and ≥ 60-day prescriptions for five patient cohorts over an 11-year period from the Clinical Practice Research Datalink. Third, a decision model adapting three existing models to predict costs and effects of differing adherence levels associated with 28-day versus 3-month prescriptions in three clinical scenarios. REVIEW METHODS: In the systematic review, from 15,257 unique citations, 54 full-text papers were reviewed and 16 studies were included, five of which were abstracts and one of which was an extended conference abstract. None was a randomised controlled trial: 11 were retrospective cohort studies, three were cross-sectional surveys and two were cost studies. No information on health outcomes was available. RESULTS: An exploratory meta-analysis based on six retrospective cohort studies suggested that lower adherence was associated with 28-day prescriptions (standardised mean difference -0.45, 95% confidence interval -0.65 to -0.26). The cost analysis showed that a statistically significant increase in medication waste was associated with longer prescription lengths. However, when accounting for dispensing fees and prescriber time, longer prescriptions were found to be cost saving compared with shorter prescriptions. Prescriber time was the largest component of the calculated cost savings to the NHS. The decision modelling suggested that, in all three clinical scenarios, longer prescription lengths were associated with lower costs and higher quality-adjusted life-years. LIMITATIONS: The available evidence was found to be at a moderate to serious risk of bias. All of the studies were conducted in the USA, which was a cause for concern in terms of generalisability to the UK. No evidence of the direct impact of prescription length on health outcomes was found. The cost study could investigate prescriptions issued only; it could not assess patient adherence to those prescriptions. Additionally, the cost study was based on products issued only and did not account for underlying patient diagnoses. A lack of good-quality evidence affected our decision modelling strategy. CONCLUSIONS: Although the quality of the evidence was poor, this study found that longer prescriptions may be less costly overall, and may be associated with better adherence than 28-day prescriptions in patients with chronic conditions being treated in primary care. FUTURE WORK: There is a need to more reliably evaluate the impact of differing prescription lengths on adherence, on patient health outcomes and on total costs to the NHS. The priority should be to identify patients with particular conditions or characteristics who should receive shorter or longer prescriptions. To determine the need for any further research, an expected value of perfect information analysis should be performed. STUDY REGISTRATION: This study is registered as PROSPERO CRD42015027042. FUNDING: The National Institute for Health Research Health Technology Assessment programme
Data from ‘Cohort Differences in Big Five Personality Factors Over a Period of 25 Years’
Data from https://openpsychologydata.metajnl.com/articles/10.5334/jopd.e
A Bayesian semi-parametric approach for modeling memory decay in dynamic social networks
This project contains scripts and data for the reproducibility of the results presented in the paper "A Bayesian semi-parametric approach for modeling memory decay in dynamic social networks" ( published in "journal's name here" ). The project is temporary not complete (some files need still to be uploaded). Changes will affect the repository in the coming month
Dynamic relational event modeling. Testing, exploring, and applying
Information on the different steps and files to reproduce the results for the paper "Dynamic relational event modeling: Testing, exploring and applying
Bayesian testing of linear versus nonlinear effects using Gaussian process priors
A Bayes factor is proposed for testing whether the effect of a key predictor variable on a dependent variable is linear or nonlinear, possibly while controlling for certain covariates. The test can be used (i) in substantive research for assessing the nature of the relationship between certain variables based on scientific expectations, and (ii) for statistical model building to infer whether a (transformed) variable should be added as a linear or nonlinear predictor in a regression model. Under the nonlinear model, a Gaussian process prior is employed using a parameterization similar to Zellner’s g prior resulting in a scale-invariant test. Unlike existing p-values, the proposed Bayes factor can be used for quantifying the relative evidence in the data in favor of linearity. Furthermore the Bayes factor does not overestimate the evidence against the linear null model resulting in more parsimonious models. An extension is proposed for Bayesian one-sided testing of whether a nonlinear effect is consistently positive, consistently negative, or neither. Applications are provided from various fields including social network research and education
Jack of all trades, Master of none
The files in this repository are used to replicate the numerical experiments associated with the linked publication and as part of the PhD thesis. The main purpose is to assess methods to estimate sparse solution of the PCA problem
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