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Group Level (group + level)
Selected AbstractsOestradiol Protects Against the Harmful Effects of Fluoride More by Increasing Thiol Group Levels than Scavenging Hydroxyl RadicalsBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 6 2009Anna Dlugosz Interactions between xenobiotics and oestrogens need to be investigated, especially as many chemicals interact with the oestrogen receptor. It is still unknown whether free radical-generating xenobiotics can influence the antioxidative ability of oestradiol (E2). In an in vitro examination of human placental mitochondria, thiobarbituric active reagent species (TBARS), hydroxyl radical (,OH) generation and protein thiol (,SH) groups were detected. 17,-E2 was examined in physiological (0.15,0.73 nM) and experimental (1,10 µM) concentrations and sodium fluoride (NaF) in concentrations of 6,24 µM. E2 in all the concentrations significantly decreased lipid peroxidation measured as the TBARS level, in contrast to NaF, which increased lipid peroxidation. Lipid peroxidation induced by NaF was decreased by E2. The influence of E2 on ,OH generation was not very significant and depended on the E2 concentration. The main mechanism of E2 protection in NaF exposure appeared to be connected with the influence of E2 on thiol group levels, not ,OH scavenging ability. The E2 in concentrations 0.44,0.73 nM and 1,10 µM significantly increased the levels of ,SH groups, in contrast to NaF, which significantly decreased them. E2 at every concentration reversed the harmful effects of NaF on ,SH group levels. No unfavourable interactions in the influence of E2 and NaF on TBARS production, ,OH generation, or ,SH group levels were observed. The results suggest that postmenopausal women could be more sensitive to NaF-initiated oxidative stress. [source] Prescribing at the Primary Care Group level: census data and prescribing indicatorsJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2001D. C. E. F. Lloyd BAHons MSc Objective: To examine the relationship between prescribing and morbidity, mortality and deprivation for the 481 Primary Care groups set up on 1 April 1999, by examining the prescribing of their constituent practices in the year 1998/99, i.e. the year before. Design: Cross-sectional study. Outcome measures: Set of 11 prescribing indicators taken from the Prescription Pricing Authority ,Toolkit' system; census measures of morbidity and deprivation and Standardized Mortality Ratio for those aged 75 and under. Setting: All practices in England belonging to a Primary Care Group. Results: Several of the indicators showed strong correlation with morbidity, mortality and, to a weaker extent, with deprivation. There was a negative correlation between the census-based measures and choice of more expensive alternatives or greater duration prescriptions for antibiotic prescribing and with the use of hormone replacement therapy (HRT). Conversely, there was a positive correlation with use of premium products and drugs of limited therapeutic value. Conclusion: Practices in areas of greater need (as measured by permanent sickness and Standardized Mortality Ratio) seem to be trying to hold down costs by the way they prescribe antibiotics. Conversely, their use of premium price products pushes up their costs in the absence of clear evidence concerning compliance. The use of HRT is low in areas of high overall need. [source] An Empirical Study of the Effect of Knowledge Management Processes at Individual, Group, and Organizational Levels,DECISION SCIENCES, Issue 2 2003Rajiv Sabherwal ABSTRACT To enhance our understanding of knowledge management, this paper focuses on a specific question: How do knowledge management processes influence perceived knowledge management effectiveness? Prior literature is used to develop the research model, including hypotheses about the effects of four knowledge management processes (internalization, externalization, socialization, and combination) on perceived individual-level, group-level, and organizational-level knowledge management effectiveness. The study was conducted at the John F. Kennedy Space Center of the National Aeronautics and Space Administration using a survey of 159 individuals and two rounds of personal interviews. Structural equation modeling was performed to test measurement and structural models using the survey data. The emergent model suggests that internalization and externalization impact perceived effectiveness of individual-level knowledge management. Socialization and combination influence perceived effectiveness of knowledge management at group and organizational levels, respectively. The results also support the expected upward impact in perceived effectiveness of knowledge management, from individual to group level, as well as from group level to organizational level. The study's limitations and implications for practice and future research are described. [source] How does early developmental assessment predict academic and attentional,behavioural skills at group and individual levels?DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2009RIITTA VALTONEN LICPSYCH The main aim of the study was to explore the ability of a brief developmental assessment to predict teacher-rated learning and attentional and behavioural skills in the first grade of school at both the group and individual levels. A sample of 394 children (181 males, 213 females) aged 4 years were followed to the age of 6 years, and 283 of the children (145 males, 138 females; mean age 7y 11 mo) were followed further to the first grade (age 7y) at school. The children were administered a brief but comprehensive developmental assessment (Lene , a neurodevelopmental screening method) at their local child health-care centres at ages 4 and 6 years. In the first grade, teachers completed a detailed questionnaire (JLD Teacher Questionnaire) on the children's (mean age 7y 11mo, SD 3.1mo, range 7y 3mo,8y 4mo) performance and behaviour. Structural equation modelling showed that no single developmental area predicted development during the follow-up. Instead, a comprehensive developmental outcome at age 4 years significantly predicted skills in the first grade at the group level. Developmental status at age 4 and 6 years together explained 66% of the variance of academic skills and 40% of the variance of attentional and behavioural skills in the first grade. Age-specific logistic regression analyses were constructed to produce the risk indices. At the individual level it was possible to reach acceptable levels of sensitivity and specificity for academic skills at age 4 and age 6 years. Identification of attentional and behavioural problems at the individual level was possible at age 6 years, but the number of false positives was high. [source] Visual spatial attention and speech segmentation are both impaired in preschoolers at familial risk for developmental dyslexiaDYSLEXIA, Issue 3 2010Andrea Facoetti Abstract Phonological skills are foundational of reading acquisition and impaired phonological processing is widely assumed to characterize dyslexic individuals. However, reading by phonological decoding also requires rapid selection of sublexical orthographic units through serial attentional orienting, and recent studies have shown that visual spatial attention is impaired in dyslexic children. Our study investigated these different neurocognitive dysfunctions, before reading acquisition, in a sample of preschoolers including children with (N=20) and without (N=67) familial risk for developmental dyslexia. Children were tested on phonological skills, rapid automatized naming, and visual spatial attention. At-risk children presented deficits in both visual spatial attention and syllabic segmentation at the group level. Moreover, the combination of visual spatial attention and syllabic segmentation scores was more reliable than either single measure for the identification of at-risk children. These findings suggest that both visuo-attentional and perisylvian-auditory dysfunctions might adversely affect reading acquisition, and may offer a new approach for early identification and remediation of developmental dyslexia. Copyright © 2010 John Wiley & Sons, Ltd. [source] Past success and convergent thinking in groups: The role of group-focused attributionsEUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 4 2004Jack A. Goncalo Past success often causes groups to think narrowly around strategies that have worked in the past, even when environmental change has rendered these strategies ineffective. From a psychological perspective, this research seems to indicate that past success may give rise to convergent thinking in groups. Why might successful groups be prone to convergent thinking? I argue that the relationship between past success and convergent thinking may depend on the attributions that groups generate to explain their shared success. In this paper, I focus on two distinct attributions at the group level: Individual-focused attributions that reflect the idiosyncratic characteristics of individual group members and group-focused attributions that reflect the emergent properties of the group as a whole. I found that group-focused attributions for past success cause groups to generate fewer ideas that are, on average, more convergent. In contrast, individual-focused attributions cause groups to generate more ideas that are on average more divergent. These findings suggest that the experience of success may actually stimulate divergent thinking depending on how a group chooses to explain it. Copyright © 2004 John Wiley & Sons, Ltd. [source] Group-level variations in motor representation areas of thenar and anterior tibial muscles: Navigated Transcranial Magnetic Stimulation StudyHUMAN BRAIN MAPPING, Issue 8 2010Eini Niskanen Abstract Navigated transcranial magnetic stimulation (TMS) can be used to stimulate functional cortical areas at precise anatomical location to induce measurable responses. The stimulation has commonly been focused on anatomically predefined motor areas: TMS of that area elicits a measurable muscle response, the motor evoked potential. In clinical pathologies, however, the well-known homunculus somatotopy theory may not be straightforward, and the representation area of the muscle is not fixed. Traditionally, the anatomical locations of TMS stimulations have not been reported at the group level in standard space. This study describes a methodology for group-level analysis by investigating the normal representation areas of thenar and anterior tibial muscle in the primary motor cortex. The optimal representation area for these muscles was mapped in 59 healthy right-handed subjects using navigated TMS. The coordinates of the optimal stimulation sites were then normalized into standard space to determine the representation areas of these muscles at the group-level in healthy subjects. Furthermore, 95% confidence interval ellipsoids were fitted into the optimal stimulation site clusters to define the variation between subjects in optimal stimulation sites. The variation was found to be highest in the anteroposterior direction along the superior margin of the precentral gyrus. These results provide important normative information for clinical studies assessing changes in the functional cortical areas because of plasticity of the brain. Furthermore, it is proposed that the presented methodology to study TMS locations at the group level on standard space will be a suitable tool for research purposes in population studies. Hum Brain Mapp, 2010. © 2010 Wiley-Liss, Inc. [source] Comparing MEG and fMRI views to naming actions and objectsHUMAN BRAIN MAPPING, Issue 6 2009Mia Liljeström Abstract Most neuroimaging studies are performed using one imaging method only, either functional magnetic resonance imaging (fMRI), electroencephalography (EEG), or magnetoencephalography (MEG). Information on both location and timing has been sought by recording fMRI and EEG, simultaneously, or MEG and fMRI in separate sessions. Such approaches assume similar active areas whether detected via hemodynamic or electrophysiological signatures. Direct comparisons, after independent analysis of data from each imaging modality, have been conducted primarily on low-level sensory processing. Here, we report MEG (timing and location) and fMRI (location) results in 11 subjects when they named pictures that depicted an action or an object. The experimental design was exactly the same for the two imaging modalities. The MEG data were analyzed with two standard approaches: a set of equivalent current dipoles and a distributed minimum norm estimate. The fMRI blood-oxygen-level dependent (BOLD) data were subjected to the usual random-effect contrast analysis. At the group level, MEG and fMRI data showed fairly good convergence, with both overall activation patterns and task effects localizing to comparable cortical regions. There were some systematic discrepancies, however, and the correspondence was less compelling in the individual subjects. The present analysis should be helpful in reconciling results of fMRI and MEG studies on high-level cognitive functions. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Single-trial analysis of oddball event-related potentials in simultaneous EEG-fMRIHUMAN BRAIN MAPPING, Issue 7 2007Christian-G. Abstract There has recently been a growing interest in the use of simultaneous electroencephalography (EEG) and functional MRI (fMRI) for evoked activity in cognitive paradigms, thereby obtaining functional datasets with both high spatial and temporal resolution. The simultaneous recording permits obtaining event-related potentials (ERPs) and MR images in the same environment, conditions of stimulation, and subject state; it also enables tracing the joint fluctuations of EEG and fMRI signals. The goal of this study was to investigate the possibility of tracking the trial-to-trial changes in event-related EEG activity, and of using this information as a parameter in fMRI analysis. We used an auditory oddball paradigm and obtained single-trial amplitude and latency features from the EEG acquired during fMRI scanning. The single-trial P300 latency presented significant correlation with parameters external to the EEG (target-to-target interval and reaction time). Moreover, we obtained significant fMRI activations for the modulation by P300 amplitude and latency, both at the single-subject and at the group level. Our results indicate that, in line with other studies, the EEG can bring a new dimension to the field of fMRI analysis by providing fine temporal information on the fluctuations in brain activity. Hum Brain Mapp, 2007. © 2007 Wiley-Liss, Inc. [source] Exploring the rabbit hole of possibilities by myself or with my group: The benefits and liabilities of activating counterfactual mind-sets for information sharing and group coordination,JOURNAL OF BEHAVIORAL DECISION MAKING, Issue 4 2004Katie A. Liljenquist Abstract The current experiment explored the effect of activating a counterfactual mind-set on the discussion of unique information and group judgment accuracy. Evidence suggests that a counterfactual mind-set is characterized by a focused, analytic mental state and, when activated at the group level, improves group judgment accuracy in the murder mystery paradigm (a hidden profile task). We hypothesized that the beneficial effect of the counterfactual mind-set would only help group problem-solving tasks if the mind-set had been activated at the group level, allowing the analytical mind-set to play out in an atmosphere of synergistic coordination. In contrast, if this highly focused mental state is activated at the individual level, it could impair group judgment quality because inwardly focused analytical individuals may fail to coordinate their behavior with other group members. Consistent with our hypothesis, activating a counterfactual mind-set at the individual level had a debilitating effect on the group judgment task, whereas activating a counterfactual mind-set at the group level had a facilitative effect, increasing information sharing, synergistic coordination and judgment accuracy. Copyright © 2004 John Wiley & Sons, Ltd. [source] Modelling the distribution of a threatened habitat: the California sage scrubJOURNAL OF BIOGEOGRAPHY, Issue 11 2009Erin C. Riordan Abstract Aim, Using predictive species distribution and ecological niche modelling our objectives are: (1) to identify important climatic drivers of distribution at regional scales of a locally complex and dynamic system , California sage scrub; (2) to map suitable sage scrub habitat in California; and (3) to distinguish between bioclimatic niches of floristic groups within sage scrub to assess the conservation significance of analysing such species groups. Location, Coastal mediterranean-type shrublands of southern and central California. Methods, Using point localities from georeferenced herbarium records, we modelled the potential distribution and bioclimatic envelopes of 14 characteristic sage scrub species and three floristic groups (south-coastal, coastal,interior disjunct and broadly distributed species) based upon current climate conditions. Maxent was used to map climatically suitable habitat, while principal components analysis followed by canonical discriminant analysis were used to distinguish between floristic groups and visualize species and group distributions in multivariate ecological space. Results, Geographical distribution patterns of individual species were mirrored in the habitat suitability maps of floristic groups, notably the disjunct distribution of the coastal,interior species. Overlap in the distributions of floristic groups was evident in both geographical and multivariate niche space; however, discriminant analysis confirmed the separability of floristic groups based on bioclimatic variables. Higher performance of floristic group models compared with sage scrub as a whole suggests that groups have differing climate requirements for habitat suitability at regional scales and that breaking sage scrub into floristic groups improves the discrimination between climatically suitable and unsuitable habitat. Main conclusions, The finding that presence-only data and climatic variables can produce useful information on habitat suitability of California sage scrub species and floristic groups at a regional scale has important implications for ongoing efforts of habitat restoration for sage scrub. In addition, modelling at a group level provides important information about the differences in climatic niches within California sage scrub. Finally, the high performance of our floristic group models highlights the potential a community-level modelling approach holds for investigating plant distribution patterns. [source] Corporate Failure Prediction Modeling: Distorted by Business Groups' Internal Capital Markets?JOURNAL OF BUSINESS FINANCE & ACCOUNTING, Issue 5-6 2006Nico Dewaelheyns However, in view of the importance of business groups in Continental Europe, ignoring group ties may have a negative impact on predictive reliability. We find that models encompassing both bankruptcy variables defined at subsidiary level and at group level have a substantially better fit and classification performance. Furthermore we find that the group's support causes improved survival chances for subsidiaries, especially when these subsidiaries belong to the group's core business. Overall our results are consistent with existing theoretical and empirical findings from the internal capital markets literature. [source] Is good ,quality of life' possible at the end of life?JOURNAL OF CLINICAL NURSING, Issue 4 2001An explorative study of the experiences of a group of cancer patients in two different care cultures INFORMATION POINT: Factor analysis ,,The purpose of this paper was to explore how a group of gravely ill patients, cared for in different care cultures, assessed their quality of life during their last month of life. ,,The study material comprised quality of life assessments from 47 cancer patients, completed during their last month of life. Two quality of life questionnaires, the EORTC QLQ-C30 and a psychosocial well-being questionnaire, were used. The data were treated in accordance with instructions for the respective questionnaires, and the results are presented primarily as means, mostly at the group level. Assessments from patients in two different care cultures, care-orientated and cure-orientated, were compared. ,,The results show that despite having an assessed lower quality of life in many dimensions than people in general, several patients experienced happiness and satisfaction during their last month of life. ,,,Cognitive functioning' and ,emotional functioning' were the dimensions that differed least from those of the general population, and ,physical functioning', ,role functioning' and ,global health status/quality of life' differed the most. ,Fatigue' showed the highest mean for the symptom scales/items. ,,There was a tendency for those cared for in the cure-orientated care culture to report more symptoms than those in the care-orientated care culture. An exception to this was ,pain', which was reported more often by those in the care-orientated care culture. ,,The implications of the results are discussed from different angles. The significance of knowledge concerning how patients experience their quality of life is also discussed with respect to the care and the planning of care for dying patients. [source] Dose,response relationship between periodontal inflamed surface area and HbA1c in type 2 DiabeticsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2009Willem Nesse Abstract Background: A dose,response relationship between the amount of inflamed periodontal tissue and HbA1c level, might be indicative for a causal association between periodontitis and type 2 diabetes. Aim: To assess a dose,response relationship between the periodontal inflamed surface area (PISA), as a measure of the amount of inflamed periodontal tissue, and HbA1c levels in type 2 diabetics. Material and Methods: Forty consecutive dentate type 2 diabetics attending their general practitioner for regular check-up, underwent full-mouth probing pocket depth and bleeding on probing assessment. From these data PISA was calculated. HbA1c levels were retrieved from patients' medical files. The dose,response relationship between PISA and HbA1c levels was assessed using multiple linear regression analyses, controlling for factors that might influence PISA or HbA1c levels. Results: The higher the PISA of type 2 diabetics was, the higher their HbA1c levels were. On a group level, an increase of PISA with 333 mm2 was associated with a 1.0 percentage point increase of HbA1c, independent of the influence of other factors. Conclusion: On a group level, there is a dose,response relationship between PISA and HbA1c in type 2 diabetics. This might be an indication of a causal relationship between type 2 diabetes and periodontitis. [source] Leader-member exchange, differentiation, and task interdependence: implications for individual and group performanceJOURNAL OF ORGANIZATIONAL BEHAVIOR, Issue 6 2006Robert C. Liden We investigated the effects of leader-member exchange (LMX) differentiation on individual and group performance with a sample of 120 work groups consisting of 834 employees who represented six different organizations. LMX differentiation was defined as the degree of variability in the quality of LMX relationships formed within work groups. Hierarchical Linear Modeling (HLM) results did not indicate support for a main effect of LMX differentiation on individual performance. Rather, the results demonstrated that LMX moderated the relation between LMX differentiation and individual performance, such that increases in LMX differentiation were accompanied by increases in individual performance for low LMX members, but no change in individual performance for high LMX members. At the group level, there was not a main effect for LMX differentiation on group performance. However, the hierarchical regression results revealed that the relation between LMX differentiation and group performance was moderated by task interdependence, such that for groups high in task interdependence, the greater the differentiation among group members, the higher the performance of the group. Conversely, for groups with relatively lower levels of task interdependence, differentiation among subordinates was not related to group performance. Finally, LMX differentiation was positively related to group performance in groups with a low LMX median, but was not related to performance in groups with a high LMX median. Copyright © 2006 John Wiley & Sons, Ltd. [source] Interactions of cyclosporines with lipid membranes as studied by solid-state nuclear magnetic resonance spectroscopy and high-sensitivity titration calorimetryJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 3 2002Uwe Schote Abstract Cyclosporin A (CyA) interacts with lipid membranes. Binding reaction and membrane location of CyA and analogs were examined with 2H-NMR, high-sensitivity isothermal titration calorimetry (ITC), and CD spectroscopy. Effects of CyA and charged analogs on the phosphocholine head group and on the membrane interior were investigated using selectively deuterated phospholipids. Incorporation of cyclosporin generated small disordering of the lipid acyl chains. Binding of CyA and neutral and positively charged analogs to lipid membranes showed endothermic heats of reaction between +,5.9 and +,11.3 kcal/mol, whereas enthalpy of binding was close to zero for the negatively charged derivative. Binding constants of cyclosporines to liposomal membranes were in the range of KP,=,1650,5560 M,,1 depending on the cholesterol content. 2H-NMR provides evidence that CyA is essentially located in the interior of the bilayer membrane. For the charged analogs an additional interaction occurs at the head group level, placing the polar groups of these CyA analogs in the vicinity of the phosphocholine dipoles. The association of CyA and its analogs is accompanied by a positive enthalpy change, which is overcompensated by positive entropy changes. Binding of CyA to lipid membranes thus follows the classical hydrophobic effect, which is in contrast to many other peptide-lipid binding reactions. © 2002 Wiley-Liss, Inc. and the American Pharmaceutical Association J Pharm Sci 91: 856,867, 2002 [source] Depressive symptoms and suicidal ideation during isotretinoin treatment: a 12-week follow-up study of male Finnish military conscriptsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 11 2009LMH Rehn Abstract Objective, To investigate the putative association between isotretinoin treatment and depressive symptoms or suicidal ideation among Finnish male military conscripts. Methods, Consecutive acne patients were enrolled into an uncontrolled, prospective 12-week follow-up study conducted at the Central Military Hospital, Helsinki, Finland. Of the 135 patients prescribed isotretinoin, 126 (93.3%) completed the follow-up. Depression and suicidal ideation were investigated with the Beck Depression Inventory (BDI) at baseline, weeks 4,6, and weeks 10,12. Results, BDI mean score was low at baseline and declined further significantly (p < 0.001) during the follow-up from 3.0 (SD 3.948) to 1.8 (SD 3.783) among patients on isotretinoin. Moreover, the proportion of patients with clinically significant depressive symptoms (BDI , 10) declined non-significantly from 7.1 % to 3.2 %. Suicidal ideation was reported by 17 (13.5 %) patients at baseline and 9 (7.1%) patients at the end of the follow-up (NS). During the follow-up, one non-depressed patient attempted suicide while intoxicated by alcohol. Conclusion, On group level, isotretinoin seems not to be typically associated with treatment-emergent depression or suicidal ideation among young men. However, the possibility that individual patients may be susceptible for mood effects of isotretinoin as a rare idiosyncratic reaction can not be excluded. [source] Temporal dynamics of marginal steppic vegetation over a 26-year period of substantial environmental changeJOURNAL OF VEGETATION SCIENCE, Issue 2 2009Silvia Matesanz Abstract Questions: (1) Is climate a strong driver of vegetation dynamics, including interannual variation, in a range margin steppic community? (2) Are there long-term trends in cover and species richness in this community, and are these consistent across species groups and species within groups? (3) Can long-term trends in plant community data be related to variation in local climate over the last three decades? Location: A range margin steppic grassland community in central Germany. Methods: Cover, number and size of all individuals of all plant species present in three permanent 1-m2 plots were recorded in spring for 26 years (1980,2005). Climatic data for the study area were used to determine the best climatic predictor for each plant community, functional group and species variable (annual data and interannual variation) using best subsets regression. Results: April and autumn temperature showed the highest correlation with total cover and species richness and with interannual variations of cover and richness. However, key climate drivers differed between the five most abundant species. Similarly, total cover and number and cover of perennials significantly decreased over time, while no trend was found for the cover and number of annuals. However, within functional groups there were also contrasting species-specific responses. Long-term temperature increases and high interannual variability in both temperature and precipitation were strongly related to long-term trends and interannual variations in plant community data. Conclusions: Temporal trends in vegetation were strongly associated with temporal trends in climate at the study site, with key roles for autumn and spring temperature and precipitation. Dynamics of functional groups and species within groups and their relationships to changes in temperature and precipitation reveal complex long-term and interannual patterns that cannot be inferred from short-term studies with only one or a few individual species. Our results also highlight that responses detected at the functional group level may mask contrasting responses within functional groups. We discuss the implications of these findings for attempts to predict the future response of biodiversity to climate change. [source] Reliability of the Clinical Teaching Effectiveness InstrumentMEDICAL EDUCATION, Issue 9 2005H H Van Der Hem-Stokroos Introduction, The Clinical Teaching Effectiveness Instrument (CTEI) was developed to evaluate the quality of the clinical teaching of educators. Its authors reported evidence supporting content and criterion validity and found favourable reliability findings. We tested the validity and reliability of this instrument in a European context and investigated its reliability as an instrument to evaluate the quality of clinical teaching at group level rather than at the level of the individual teacher. Methods, Students participating in a surgical clerkship were asked to fill in a questionnaire reflecting a student,teacher encounter with a staff member or a resident. We calculated variance components using the urgenova program. For individual score interpretation of the quality of clinical teaching the standard error of estimate was calculated. For group interpretation we calculated the root mean square error. Results, The results did not differ statistically between staff and residents. The average score was 3.42. The largest variance component was associated with rater variance. For individual score interpretation a reliability of >,0.80 was reached with 7 ratings or more. To reach reliable outcomes at group level, 15 educators or more were needed with a single rater per educator. Discussion, The required sample size for appraisal of individual teaching is easily achievable. Reliable findings can also be obtained at group level with a feasible sample size. The results provide additional evidence of the reliability of the CTEI in undergraduate medical education in a European setting. The results also showed that the instrument can be used to measure the quality of teaching at group level. [source] Reliability, validity and responsiveness of a new leisure index: The Patient-Specific Leisure Scale (PSLS)MUSCULOSKELETAL CARE, Issue 3 2009Ingegerd Wikström Abstract Objectives:,To investigate the reliability, validity and responsiveness of a new Patient-Specific Leisure Scale (PSLS), constructed to identify goals and outcomes for individual patients with rheumatoid arthritis (RA). Methods:,Forty-nine patients with RA were used to evaluate test,retest reliability, and 100 consecutive RA patients were used for construct validity. Twenty-five RA patients, commencing with treatment on tumour necrosis factor (TNF) inhibitors, were evaluated before the start and after three months of therapy, to test responsiveness. The most important leisure activity (as judged by the patients) was used when evaluating reliability and validity. The perceived difficulty with each activity was scored from 0 to 10 (0 = able to perform activity without difficulty, 10 = unable to perform activity). Results:,Test,retest reliability indicated a good agreement (0.62,0.87) using weighted kappa. Construct validity was demonstrated by modest positive correlation between leisure activity and Health Assessment Questionnaire (HAQ) (rs = 0.27, p = 0.005) visual analogue scale (VAS) pain (rs = 0.28, p = 0.004) VAS global (rs = 0.22, p = 0.027), VAS fatigue (rs = 0.24, p = 0.013), joint index of 28 swollen joints (rs = 0.22, p = 0.027) and negative correlations with short-form-36 (SF-36) physical functioning (rs = ,0.18, p = 0.008), bodily pain (rs = ,0.31, p < 0.001), general health (rs = ,0.23, p = 0.019), vitality (rs = ,0.31, p < 0.001), social function (rs = ,0.24, p = 0.016) and role-emotional (rs = ,0.28, p = 0.005). Mean improvement for the most important leisure activity was 1.36, (p = 0.036, 95% confidence interval 0.10,2.62). Standardized response mean and effect size for the most important activity in PSLS was 1.05 and 0.72, respectively, and for HAQ 0.34 and 0.28, respectively. Conclusions:,PSLS appears to be feasible, reliable, valid and responsive for measuring leisure activities in RA. It provides both an individual result which is useful in clinical work, and results at a group level. Copyright © 2009 John Wiley & Sons, Ltd. [source] Neuronal correlates of gastric pain induced by fundus distension: a 3T-fMRI studyNEUROGASTROENTEROLOGY & MOTILITY, Issue 5 2004C.-L. Lu Abstract Visceral hypersensitivity in gastric fundus is a possible pathogenesis for functional dyspepsia. The cortical representation of gastric fundus is still unclear. Growing evidence shows that the insula, but not the primary or secondary somatosensory region (SI or SII), may be the cortical target for visceral pain. Animal studies have also demonstrated that amygdala plays an important role in processing visceral pain. We used fMRI to study central projection of stomach pain from fundus balloon distension. We also tested the hypothesis that there will be neither S1 nor S2 activation, but amygdala activation with the fundus distension. A 3T-fMRI was performed on 10 healthy subjects during baseline, fullness (12.7 ± 0.6 mmHg) and moderate gastric pain (17.0 ± 0.8 mmHg). fMRI signal was modelled by convolving the predetermined psychophysical response. Statistical comparisons were performed between conditions on a group level. Gastric pain activated a wide range of cortical and subcortical structures, including thalamus and insula, anterior and posterior cingulate cortices, basal ganglia, caudate nuclei, amygdala, brain stem, cerebellum and prefrontal cortex (P < 0.001). A subset of these neuronal substrates was engaged in the central processing of fullness sensation. SI and SII were not activated during the fundus stimulation. In conclusion, the constellation of neuronal structures activated by fundus distension overlaps the pain matrices induced musculocutaneous pain, with the exception of the absence of SI or SII activation. This may account for the vague nature of visceral sensation/pain. Our data also confirms that the insula and amygdala may act as the central role in visceral sensation/pain, as well as in the proposed sensory-limbic model of learning and memory of pain. [source] Cariogenic Bacteria as Biomarkers for Sugar IntakeNUTRITION REVIEWS, Issue 3 2007Karin E. Vågstrand MS Cariogenic bacteria (lactobacilli and mutans streptococci) in saliva are possible biomarkers for sugar intake. We evaluated the strength of the evidence for an association between sugar intake and the two groups of bacteria, and concluded that there is a limited to moderately scientific basis for this association. Because of many confounding factors, bacteria counts can never be used as a precise measurement of sugar intake, but might still be useful on a group level. [source] A Pilot Study Investigating the Effects of Fast Left Prefrontal rTMS on Chronic Neuropathic PainPAIN MEDICINE, Issue 5 2009Jeffrey J. Borckardt PhD ABSTRACT Objective., Stimulating the human cortex using transcranial magnetic stimulation (TMS) temporarily reduces clinical and experimental pain; however, it is unclear which cortical targets are the most effective. The motor cortex has been a popular target for managing neuropathic pain, while the prefrontal cortex has been investigated for an array of nociceptive pain conditions. It is unclear whether the motor cortex is the only effective cortical target for managing neuropathic pain, and no published studies to date have investigated the effects of prefrontal stimulation on neuropathic pain. Design., This preliminary pilot trial employed a sham-controlled, within-subject, crossover design to evaluate clinical pain as well as laboratory pain thresholds among four patients with chronic neuropathic pain. Each participant underwent three real and three sham 20-minute sessions of 10 Hz left prefrontal repetitive TMS. Daily pain diaries were collected for 3 weeks before and after each treatment phase along with a battery of self-report pain and mood questionnaires. Results., Time-series analysis at the individual patient level indicated that real TMS was associated with significant improvements in average daily pain in 3 of the 4 participants. These effects were independent of changes in mood in two of the participants. At the group level, a decrease of 19% in daily pain on average, pain at its worst, and pain at its least was observed while controlling for changes in mood, activity level and sleep. The effects of real TMS were significantly greater than sham. Real TMS was associated with increases in thermal and mechanical pain thresholds, whereas sham was not. No statistically significant effects were observed across the questionnaire data. Conclusions., The prefrontal cortex may be an important TMS cortical target for managing certain types of pain, including certain neuropathic pain syndromes. [source] Confounders and confusion: Dealing with cancer cases of occupational origin,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2010Paolo Crosignani MD Abstract Background The recognition of occupational cancers is often hampered by confusion between the individual determinants of the disease and effects at the group level. Methods Here we propose an approach, based on the evaluation of the attributable risk at the group level, that provides quantitative estimates of the roles of multiple causes in individuals affected of cancer within a population exposed to occupational risk. Results The estimate of individual probability can be easily obtained computing the attributable risk. This can be often achieved by using the existing information available in the literature. Conclusions Dismissing the occupation as a cause of a cancer in an exposed subject on the sole basis of potential confounding is erroneous and should be withdrawn from medical practice. Am. J. Ind. Med. 53:1002,1005, 2010. © 2010 Wiley-Liss, Inc. [source] Effectiveness of an occupational health intervention program to reduce whole body vibration exposure: An evaluation study with a controlled pretest,post-test design,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009Ivo J.H. Tiemessen PhD Abstract Background An effective intervention program aiming to reduce whole body vibration (WBV) exposure at work will reduce the number of low back complaints in the near future. Methods An evaluation study with a controlled pretest,post-test design. Nine companies and 126 drivers were included in the study. Cluster randomization on company level divided the drivers and their employers in an intervention group and a "care-as-usual" group. At baseline (T0) and intervention program was implemented and evaluated after 7 months (T1). The main outcome measure was WBV exposure. Process measures included knowledge, attitude, and (intended) behavior towards reduction of WBV exposure for the drivers and knowledge and WBV policy for the employers. Results At T1, no significant reduction was found in WBV exposure within both groups compared with T0. Conclusions Probably due to poor to moderate compliance, the intervention program was not effective in reducing the WBV exposure on group level but small reductions in WBV exposure are possible when intervention compliance is high. Am. J. Ind. Med. 52:943,952, 2009. © 2009 Wiley-Liss, Inc. [source] Psychosocial Work Characteristics as Predictors of Affective Organisational Commitment: A Longitudinal Multi-Level Analysis of Occupational Well-BeingAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 2 2010Thomas Clausen The purpose of this study was to identify longitudinal associations between psychosocial work characteristics and affective organisational commitment among 6,299 employees in the Danish eldercare services. Individual-level measures and group-level measures of psychosocial work characteristics were included in multi-level analyses. At the workgroup level, quality of leadership, influence at work, emotional demands, and work pace predicted affective organisational commitment at follow-up. At the individual level, quality of leadership, influence at work, team climate, role ambiguity, and work pace predicted affective organisational commitment at follow-up. Finally, a multi-level model including both individual- and group-level measures showed that quality of leadership measured at the group level and influence at work and quality of leadership measured at the individual level contributed to predicting affective organisational commitment at follow-up, while adjusting for baseline levels of affective organisational commitment. The results thus imply that affective organisational commitment is conditioned by individual and contextual factors in the psychosocial work environment and that multi-level models add to our understanding of complex organisational phenomena. As affective organisational commitment can be considered an important constituent of occupational well-being, implications for interventions in the psychosocial work environment to increase affective organisational commitment are also discussed. [source] Comparison of Hierarchical Bayesian Models for Overdispersed Count Data using DIC and Bayes' FactorsBIOMETRICS, Issue 3 2009Russell B. Millar Summary When replicate count data are overdispersed, it is common practice to incorporate this extra-Poisson variability by including latent parameters at the observation level. For example, the negative binomial and Poisson-lognormal (PLN) models are obtained by using gamma and lognormal latent parameters, respectively. Several recent publications have employed the deviance information criterion (DIC) to choose between these two models, with the deviance defined using the Poisson likelihood that is obtained from conditioning on these latent parameters. The results herein show that this use of DIC is inappropriate. Instead, DIC was seen to perform well if calculated using likelihood that was marginalized at the group level by integrating out the observation-level latent parameters. This group-level marginalization is explicit in the case of the negative binomial, but requires numerical integration for the PLN model. Similarly, DIC performed well to judge whether zero inflation was required when calculated using the group-marginalized form of the zero-inflated likelihood. In the context of comparing multilevel hierarchical models, the top-level DIC was obtained using likelihood that was further marginalized by additional integration over the group-level latent parameters, and the marginal densities of the models were calculated for the purpose of providing Bayes' factors. The computational viability and interpretability of these different measures is considered. [source] Lower prevalence of mild hyperthyroidism related to a higher iodine intake in the population: prospective study of a mandatory iodization programmeCLINICAL ENDOCRINOLOGY, Issue 3 2009Pernille Vejbjerg Summary Objective, Marked differences in pattern of thyroid dysfunction are seen in populations with different iodine intakes. We evaluated the influence of a higher iodine intake on thyroid hormone levels and the prevalence of thyroid dysfunction in the Danish population. Design, Two cross-sectional studies matched on a group level according to sex and age. Participants, In all, 8219 individuals were examined before (n = 4649) or after (n = 3570) the introduction of a mandatory iodization programme in 2000 in two regions with established mild and moderate iodine deficiency. Serum TSH, fT4 and fT3 were measured. An ultrasonography of the thyroid was performed. Results, We found a higher median serum TSH after the introduction of mandatory iodization of salt: 1·51 mU/l (10,90th percentiles: 0·72,3·00) vs. 1·30 mU/l (10,90th percentiles: 0·59,2·66) before iodization. The difference was found in both regions and across age groups. There was a lower prevalence of mild hyperthyroidism and a tendency towards a lower prevalence of overt hyperthyroidism. The prevalence of mild hypothyroidism increased, most pronounced among young women after iodization. Conversely, there was a lower prevalence of undiagnosed overt hypothyroidism. However, when currently treated participants were included, the prevalence of hypothyroidism increased after iodization in the area with formerly mild iodine deficiency. Conclusion, A change in pattern of thyroid dysfunction was seen in relation to mandatory iodization of salt. There was no rise in the prevalence of hyperthyroidism and the prevalence of mild hyperthyroidism was halved. Conversely, prevalence of hypothyroidism increased. [source] Ascorbic acid oral treatment modifies lipolytic response and behavioural activity but not glucocorticoid metabolism in cafeteria diet-fed ratsACTA PHYSIOLOGICA, Issue 4 2009D. F. Garcia-Diaz Abstract Aim:, To analyse the effects of vitamin C (VC), a potent dietary antioxidant, oral supplementation on body weight gain, behavioural activity, lipolytic response and glucocorticoid metabolism in the early stages of diet-induced overweight in rats. Methods:, Food intake, locomotive activity and faecal corticosterone were assessed during the 14 day trial period. After 2 weeks, the animals were sacrificed and the body composition, biochemical markers and lipolytic response from isolated adipocytes from retroperitoneal white adipose tissue were examined. Results:, The intake of a high-fat diet by rats induced a significant increase in body weight, adiposity and insulin resistance markers as well as a decrease in faecal corticosterone levels compared with standard diet-fed rats. Interestingly, the animals fed on the cafeteria diet showed a significant increase in the isoproterenol-induced lipolytic response in isolated adipocytes. Furthermore, this cafeteria-fed group showed a reduced locomotive behaviour than the control rats. On the other hand, oral VC supplementation in animals receiving the high-fat diet restored the cafeteria diet effect in some of the analysed variables such as final body weight and plasma insulin to control group levels. Remarkably, increases in locomotive behaviour and a significant decrease in the lipolytic response induced by isoproterenol on isolated adipocytes from animals treated with VC were observed. Conclusion:, This work demonstrates that an oral ascorbic acid supplementation has direct effects on behavioural activity and on adipocyte lipolysis in early obesity stages in rats, which could indicate a protective short-term role of this vitamin against adiposity induced by chronic high-fat diet consumption. [source] Social action with youth: Interventions, evaluation, and psychopolitical validityJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2007Julie Morsillo We describe two interventions designed to encourage community action with youth in a school and a community service setting. The school intervention took place with a Year 10 class, while the community-based intervention took place with a group of same-sex attracted youth. Using a participatory action research framework, youth in both settings devised a series of community projects to promote personal, group, and community wellness. Projects included drama presentations addressing homophobia, designing an aboriginal public garden, children's activities in a cultural festival for refugees, a drug-free underage dance party, a community theatre group, and a student battle of the bands. We evaluated the various community projects using self-reports, videotapes, and ethnographic data. While goals of personal and group wellness were meaningfully met, wellness at the community level was harder to achieve. Introducing a tool for the evaluation of psychopolitical validity, we examined the degree of both epistemic and transformational validity present in the interventions. Our assessment indicates that (a) psychological changes are easier to achieve than political transformations, (b) epistemic validity is easier to accomplish than transformational validity, and (c) changes at the personal and group levels are easier to achieve than changes at the community level. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 725,740, 2007. [source] | ||||||||||||||||||||||||||||