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Appropriate Methods (appropriate + methods)
Selected AbstractsSelenium effects: A weight-of-evidence approachINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 1 2007Blair G McDonald Abstract Selenium is increasingly an issue for a wide range of mining, industrial, and agricultural operations. Appropriate methods for evaluating the impacts of selenium in aquatic ecosystems are vigorously debated in the literature. Two common approaches include the use of tissue residue guidelines and reproductive toxicity testing using field-collected fish; however, each approach on its own does not provide sufficient evidence that wild fish populations are in fact impaired. The limitations of each method are discussed, and recommendations to improve the relevance of each line of evidence are provided. A 3rd line of evidence, field measurement of fish population dynamics, is proposed and also discussed. A framework, consistent with an ecological risk assessment methodology, for the design, application, and interpretation of selenium weight-of-evidence investigations is proposed. [source] How many species of cichlid fishes are there in African lakes?MOLECULAR ECOLOGY, Issue 3 2001George F. Turner Abstract The endemic cichlid fishes of Lakes Malawi, Tanganyika and Victoria are textbook examples of explosive speciation and adaptive radiation, and their study promises to yield important insights into these processes. Accurate estimates of species richness of lineages in these lakes, and elsewhere, will be a necessary prerequisite for a thorough comparative analysis of the intrinsic and extrinsic factors influencing rates of diversification. This review presents recent findings on the discoveries of new species and species flocks and critically appraises the relevant evidence on species richness from recent studies of polymorphism and assortative mating, generally using behavioural and molecular methods. Within the haplochromines, the most species-rich lineage, there are few reported cases of postzygotic isolation, and these are generally among allopatric taxa that are likely to have diverged a relatively long time in the past. However, many taxa, including many which occur sympatrically and do not interbreed in nature, produce viable, fertile hybrids. Prezygotic barriers are more important, and persist in laboratory conditions in which environmental factors have been controlled, indicating the primary importance of direct mate preferences. Studies to date indicate that estimates of alpha (within-site) diversity appear to be robust. Although within-species colour polymorphisms are common, these have been taken into account in previous estimates of species richness. However, overall estimates of species richness in Lakes Malawi and Victoria are heavily dependent on the assignation of species status to allopatric populations differing in male colour. Appropriate methods for testing the specific status of allopatric cichlid taxa are reviewed and preliminary results presented. [source] Prospective study of the patient-level cost of asthma care in children,PEDIATRIC PULMONOLOGY, Issue 2 2001Wendy J. Ungar PhD Abstract Our objective was to assess the cost of asthma care at the patient level in children from the perspectives of society, the Ontario Ministry of Health, and the patient. In this longitudinal evaluation, health service use data and costs were collected during telephone interviews at 1, 3, and 6 months with parents of 339 Ontario children with asthma. Direct costs were respiratory-related visits to healthcare providers, emergency rooms, hospital admissions, pulmonary function tests, prescription medications, devices, and out-of-pocket expenses. Indirect costs were parents' absences from work/usual activities and travel and waiting time. Hospital admissions accounted for 43%, medications for 31%, and parent productivity losses for 12% of total costs from a societal perspective. Statistically significant predictors of higher total costs were worse symptoms, younger age group, and season of participation. Adjusted annual societal costs per patient in 1995 Canadian dollars varied from $1,122 in children aged 4,14 years to $1,386 in children under 4 years of age. From the Ministry of Health perspective, adjusted annual costs per patient were $663 in children over 4 years and $904 in younger children. Adjusted annual costs from the patient perspective were $132 in children over 4 years and $129 in children under 4 years. The rising incidence of pediatric asthma demands that greater attention be paid to the delivery of optimal care to this segment of the population. Appropriate methods must be used to analyze healthcare costs and the use of services in the midst of widespread healthcare reform. The quality of clinical and health policy decision-making may be enhanced by cost-of-illness estimates that are comprehensive, precise, and expressed from multiple perspectives. Pediatr Pulmonol. 2001; 32:101,108. © 2001 Wiley-Liss, Inc. [source] Method optimisation for peptide profiling of microdissected breast carcinoma tissue by matrix-assisted laser desorption/ionisation-time of flight and matrix-assisted laser desorption/ionisation-time of flight/time of flight-mass spectrometryPROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 10 2005Arzu Umar Abstract Appropriate methods for the analysis of microdissected solid tumour tissues by matrix-assisted laser desorption/ionisation-time of flight-mass spectrometry (MALDI-TOF MS) are not yet well established. Optimisation of sample preparation was performed first on undissected tissue slices, representing ,200,000 cells, which were solubilised either in urea containing buffer, trifluoroethanol/NH4HCO3, 0.1% sodium dodecyl sulphate (SDS) or in 0.1% RapiGest solution, then trypsin digested and analysed by MALDI-TOF MS. Solubilisation in 0.1% SDS resulted in detection of the highest number of sample specific peak signals. Interestingly, there was little overlap in detectable peaks using the different buffers, implying that they can be used complementarily to each other. Additionally, we fractionated tryptic digests on a monolithic high-performance liquid chromatography column. Fractionation of tryptic digest from whole tissue sections resulted in a four-fold increase in the total number of peaks detected. To prove this principle, we used 0.1% SDS to generate peptide patterns from 2000 microdissected tumour and stromal cells from five different breast carcinoma tumours. The tumour and stroma specific peaks could be detected upon comparison of the peptide profiles. Identification of differentially expressed peaks by MALDI-TOF/TOF MS was performed on fractionated tryptic digests derived from a whole tissue slice. In conclusion, we describe a method that is suitable for direct peptide profiling on small amounts of microdissected cells obtained from breast cancer tissues. [source] The challenge of external validity in policy-relevant systematic reviews: a case study from the field of substance misuseADDICTION, Issue 1 2010Mark Pearson ABSTRACT Aim To critically evaluate the methods utilized in the conduct of a systematic review in the field of substance misuse Design Participant-observation in the review process, semi-structured interviews with review team members and management and structured observation of the process of guidance development. Setting An ,arm's-length' government body. Participants Review team members, management and the committee responsible for producing evidence-based guidance for policy and practice. Measurements Data from interviews and (participant-)observation were reflected upon critically in order to increase understanding of the systematic review process. Findings The application of systematic review methods produced an evidence base that did not inform the development of guidance to the extent that it could have done: (i) an emphasis upon internal research validity produced an evidence base with an emphasis on short-term interventions at the level of the individual; (ii) criteria for appraising the external validity of studies were not developed sufficiently; and (iii) the systematic review of evidence and development of guidance are strongly reliant upon the judgement of reviewers and committee members. Conclusions Prioritizing internal validity in a systematic review risks producing an evidence base that is not informed adequately by the wider determinants of health and which does not give sufficient consideration to external validity. The use of appropriate methods requires that commissioners of systematic reviews are clear at the outset how the review is proposed to be utilized. Review methods such as meta-ethnography and realist synthesis could contribute to making the frameworks within which judgements are made more explicit. [source] Statistical methods for the evaluation of health effects of prenatal mercury exposureENVIRONMETRICS, Issue 2 2003Esben Budtz-Jřrgensen Abstract Environmental risk assessment based on epidemiological data puts stringent demands on the statistical procedures. First, convincing evidence has to be established that there is a risk at all. In practice this endeavor requires prudent use of the observational epidemiological information with delicate balancing between utilizing the information optimally but not over-interpreting it. If a case for an environmental risk has been made, the second challenge is to provide useful input that regulatory authorities can use to set standards. This article surveys some of these issues in the concrete case of neurobehavioral effects in Faroese children prenatally exposed to methylmercury. A selection of modern, appropriate methods has been applied in the analysis of this material that may be considered typical of environmental epidemiology today. In particular we emphasize the potential of structural equation models for improving standard multiple regression analysis of complex environmental epidemiology data. Copyright © 2003 John Wiley & Sons, Ltd. [source] Theories of drug craving, ancient and modernADDICTION, Issue 1 2001D. Colin Drummond This paper reviews the principal theoretical models of drug craving and provides some directions for future research. The main models are classified broadly into three categories: (1) phenomenological models; based on clinical observation and description; these have been influential in classification systems of addictive disorders and in the development of pharmacological therapies; (2) conditioning models: based on conditioning theory; these have been influential in the development of cue exposure treatments; (3) cognitive theories; based on cognitive social learning theory: these have been influential in the development of cognitive therapies of addiction. It is concluded that no one specific theory provides a complete explanation of the phenomenon of craving. However, theories of craving grounded in general theories of human behaviour offer greatest promise, and generate more specific and testable research hypotheses. Theories that do not require craving to be present for relapse to occur have more empirical support than those that provide simplistic causal explanations. The cue-reactivity model shows promise in the exploration of the relationship between craving and relapse. However, further attention to the phenomenology of craving could help to advise the future measurement and study of drug craving, particularly in the context of research in which drugs are available to human subjects, with adequate ethical safeguards. There is a need for further study of the temporal dynamics of craving and consensus in the field on the most appropriate methods of measurement. Finally, new psychotherapies such as cue exposure and pharmacotherapies that aim to attenuate drinking behaviour, such as naltrexone and acamprosate, provide opportunities to improve understanding of the nature and significance of craving. However, the relatively uncritical assumption that craving is the underlying basis of addiction and represents the most appropriate target for treatment is challenged. [source] Twenty-five strategies for improving the design, implementation and analysis of health services research related to alcohol and other drug abuse treatmentADDICTION, Issue 11s3 2000Michael L. Dennis While some aspects of addiction can be studied in laboratory or controlled settings, the study of long-term recovery management and the health services that support it requires going out into the community and dealing with populations and systems that are much more diverse and less under our control. This in turn raises many methodological challenges for the health service researchers studying alcohol and other drug abuse treatment. This paper identifies some of these challenges related to the design, measurement, implementation and effectiveness of health services research. It then recommends 25 strategies (and key primers) for addressing them: (1) identifying in advance all stakeholders and issues; (2) developing conceptual models of intervention and context; (3) identifying the population to whom the conclusions will be generalized; (4) matching the research design to the question; (5) conducting randomized experiments only when appropriate and necessary; (6) balancing methodological and treatment concerns; (7) prioritizing analysis plans and increasing design sensitivity, (8) combining qualitative and quantitative methods; (9) identifying the four basic types of measures needed; (10) identifying and using standardized measures; (11) carefully balancing measurement selection and modification; (12) developing and evaluating modified and new measures when necessary; (13) identifying and tracking major clinical subgroups; (14) measuring and analyzing the actual pattern of services received; (15) incorporating implementation checks into the design; (16) inc rporating baseline measures into the intervention; (17) monitoring implementation and dosage as a form of quality assurance; (18) developing procedures early to facilitate tracking and follow-up of study participants; (19) using more appropriate representations of the actual experiment; (20) using appropriate and sensitive standard deviation terms; (21) partialing out variance due to design or known sources prior to estimating experimental effect sizes; (22) using dimensional, interval and ratio measures to increase sensitivity to change; (23) using path or structural equation models; (24) integrating qualitative and quantitative analysis into reporting; and (25) using quasi-experiments, economic or organizational studies to answer other likely policy questions. Most of these strategies have been tried and tested in this and other areas, but are not widely used. Improving the state of the art of health services research and bridging the gap between research and practice do not depend upon using the most advanced methods, but rather upon using the most appropriate methods. [source] The relationship between baseline value and its change: problems in categorization and the proposal of a new methodEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2005Yu-Kang Tu Oral health researchers have shown great interest in the relationship between the initial status of diseases and subsequent changes following treatment. Two main approaches have been adopted to provide evidence of a positive association between baseline values and their changes following treatment. One approach is to use correlation or regression to test the relationship between baseline measurements and subsequent change (correlation/regression approach). The second approach is to categorize the lesions into subgroups, according to threshold values, and subsequently compare the treatment effects across the two (or more) subgroups (categorization approach). However, the correlation/regression approach suffers a methodological weakness known as mathematical coupling. Consequently, the statistical procedure of testing the null hypothesis becomes inappropriate. Categorization seems to avoid the problem of mathematical coupling, although it still suffers regression to the mean. We show, first, how the appropriate null hypothesis may be established to analyze the relationship between baseline values and change in the correlation approach and, second, we use computer simulations to investigate the impact of regression to the mean on the significance testing of the differences in the average treatment effects (or average baseline values) in the categorization approach. Data available from previous literature are reanalyzed by testing the appropriate null hypotheses and the results are compared to those from testing the usual (incorrect) null hypothesis. The results indicate that both the correlation and categorization approaches can give rise to misleading conclusions and that more appropriate methods, such as Oldham's method and our new approach of deriving the correct null hypothesis, should be adopted. [source] A European Legal Method?EUROPEAN LAW JOURNAL, Issue 1 2009On European Private Law, Scientific Method This article examines the relationship between European private law and scientific method. It argues that a European legal method is a good idea. Not primarily because it will make European private law scholarship look more scientific, but because a debate on the method of a normative science necessarily has to be a debate on its normative assumptions. In other words, a debate on a European legal method will have much in common with the much desired debate on social justice in European law. Moreover, it submits that, at least after the adoption of the Common Frame of Reference by the European institutions, European contract law can be regarded as a developing multi-level system that can be studied from the inside. Finally, it concludes that the Europeanisation of private law is gradually blurring the dividing line between the internal and external perspectives, with their respective appropriate methods, in two mutually reinforcing ways. First, in the developing multi-level system it is unclear where the external borders of the system lie, in particular the borders between Community law and national law. Second, because of the less formal legal culture the (formerly) external perspectives, such as the economic perspective, have easier access and play an increasing role as policy considerations. [source] BROADENING THE APPLICATION OF EVOLUTIONARILY BASED GENETIC PEST MANAGEMENTEVOLUTION, Issue 2 2008Fred Gould Insect- and tick-vectored diseases such as malaria, dengue fever, and Lyme disease cause human suffering, and current approaches for prevention are not adequate. Invasive plants and animals such as Scotch broom, zebra mussels, and gypsy moths continue to cause environmental damage and economic losses in agriculture and forestry. Rodents transmit diseases and cause major pre- and postharvest losses, especially in less affluent countries. Each of these problems might benefit from the developing field of Genetic Pest Management that is conceptually based on principles of evolutionary biology. This article briefly describes the history of this field, new molecular tools in this field, and potential applications of those tools. There will be a need for evolutionary biologists to interact with researchers and practitioners in a variety of other fields to determine the most appropriate targets for genetic pest management, the most appropriate methods for specific targets, and the potential of natural selection to diminish the effectiveness of genetic pest management. In addition to producing environmentally sustainable pest management solutions, research efforts in this area could lead to new insights about the evolution of selfish genetic elements in natural systems and will provide students with the opportunity to develop a more sophisticated understanding of the role of evolutionary biology in solving societal problems. [source] Scale and trends in species richness: considerations for monitoring biological diversity for political purposesGLOBAL ECOLOGY, Issue 2 2004Darius Weber ABSTRACT Switzerland's governmental ,Biodiversity Monitoring' program is designed to produce factual information on the dynamics of biodiversity within the country for governmental agencies, politicians, and the general public. Monitoring a complex issue like biodiversity in order to give relevant and accurate messages to the general public and politicians within a politically relevant timescale and at moderate cost means focusing on few elements. Because relevant human impacts on biodiversity operate differently at different spatial scales, we need at least three different indicators to observe changes over time in local (,within-habitat'), landscape (,habitat-mosaic'), and macro-scale (,regional') diversity. To keep things as simple as possible, we use species richness as an indicator for all three levels of diversity, just defining three different spatial scales (10 m2, 1 km2, regions, respectively). Each indicator is based on a number of taxonomic groups which have been selected mainly on the basis of costs and the availability of appropriate methods. [source] Stakeholders' views on measuring outcomes for people with learning disabilitiesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2006Anita F. Young PhD DipCOT Abstract What works and how do we know? These are recurring questions for health and social care professionals, although mediated through differing philosophies and historical perspectives. The aims of the study reported here were to discover views of managers and commissioners of services for people with learning disabilities in Scotland regarding (a) current approaches to service evaluation (as an indication of what is to be measured) and (b) healthcare outcome measurement (as an indication of preferences regarding how this should be measured). A postal questionnaire was used to survey 94 stakeholders from the NHS, Local Authorities, and non-statutory organisations across Scotland. Respondents' views were sought on current approaches to service evaluation within learning disabilities; outcome measurement; appropriateness of specified methods of measuring health outcomes; desired future methods of outcome measurement within learning disabilities; and service user involvement in care. A 77% (73/94) response rate to the questionnaire was achieved. Different methods of service evaluation were used by different stakeholders. Staff appraisal was the most frequently identified method (used by 85% of respondents). Specific outcome measures were used by 32% of respondents although there were differences of opinion as to what constitutes specific outcome measures. Overall there was strong support for goal-setting and reviewing (83%) and individualised outcome measures (75%) as appropriate methods for use with people with learning disabilities. The hypothetical question asking what outcome measures should be introduced for this client group had by far the lowest response rate (51/73). The overwhelming majority of all respondents, 68 (92%), reported user involvement in their service. Staff ambivalence to outcome measurement was evident in the research and respondents highlighted the complexity and multidimensional nature of outcomes for this service user group. Managers recognised that outcome measurement was expected but were uncertain how to go about it. [source] Managing challenging behaviour in the community: methods and results of interactive staff trainingHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2001Malcolm Gentry MA MPhil Abstract A necessary condition for a high quality of community care in relation to challenging behaviour is staff training in appropriate methods. This paper describes the application of a practical ,interactive staff training' approach with n = 101 staff, featuring the use of focused and experiential learning in teams. The findings indicated that the course was socially acceptable to the participants, led to a significant improvement in their knowledge of nonphysical methods, and resulted in written guidelines for managing their own clients' challenging behaviour. Furthermore, agreements were clarified on how these guidelines would be implemented by each team following training. Implications are drawn for improved evaluation of this promising training programme, including developing the measures of learning and adding a generalisation assessment. [source] Methods for incorporating covariate adjustment, subgroup analysis and between-centre differences into cost-effectiveness evaluationsHEALTH ECONOMICS, Issue 12 2005Richard M. Nixon Abstract Background: Overall assessments of cost,effectiveness are now commonplace in informing medical policy decision making. It is often important, however, also to investigate how cost,effectiveness varies between patient subgroups. Yet such analyses are rarely undertaken, because appropriate methods have not been sufficiently developed. Methods: We propose a coherent set of Bayesian methods to extend cost,effectiveness analyses to adjust for baseline covariates, to investigate differences between subgroups, and to allow for differences between centres in a multicentre study using a hierarchical model. These methods consider costs and effects jointly, and allow for the typically skewed distribution of cost data. The results are presented as inferences on the cost,effectiveness plane, and as cost,effectiveness acceptability curves. Results: In applying these methods to a randomised trial of case management of psychotic patients, we show that overall cost,effectiveness can be affected by ignoring the skewness of cost data, but that it may be difficult to gain substantial precision by adjusting for baseline covariates. While analyses of overall cost,effectiveness can mask important subgroup differences, crude differences between centres may provide an unrealistic indication of the true differences between them. Conclusions: The methods developed allow a flexible choice for the distributions used for cost data, and have a wide range of applicability , to both randomised trials and observational studies. Experience needs to be gained in applying these methods in practice, and using their results in decision making. Copyright © 2005 John Wiley & Sons, Ltd. [source] Validating the Relationship Qualities of Influence and Persuasion With the Family Social Relations ModelHUMAN COMMUNICATION RESEARCH, Issue 1 2003Rachel Oakley Hsiung Influence and persuasion are related, fundamental constructs in interpersonal communication. Both display the relationship qualities of interdependence, bidirectionality, reciprocity, and multiple levels of analysis. Yet, empirical validation of these relationship qualities is lacking, largely due to an absence of appropriate methods and statistical procedures. This article uses the family social relations model (SRM) to test for the personal relationship qualities of influence and persuasion in the family decision-making context of buying a new car. New relationship measures of influence and persuasion were developed because, historically, measures have been at the individual level. The sample size of 110 families proved sufficient for stable parameter estimates. The results uncovered patterns in the relationship qualities of influence and persuasion across 3 decisions families make when buying a new car (i.e., how much to spend, car model choice, final decision). The findings confirm that both influence and persuasion are truly relational. The novel use of the model across decisions allowed the patterns of relationships among family members to be compared, and demonstrated the importance of the relationship qualities of influence and persuasion in decision making. Predictions were examined across decisions as well so as to check the consistency of hypotheses. The results provide further insight into the meaning of influence and persuasion, and of SRM terms. [source] Toxicity Evaluation for Safe Use of Nanomaterials: Recent Achievements and Technical ChallengesADVANCED MATERIALS, Issue 16 2009Saber M. Hussain Abstract Recent developments in the field of nanotechnology involving the synthesis of novel nanomaterials (NM) have attracted the attention of numerous scientists owing to the possibility of degradative perturbations in human health. This Review evaluates previous investigations related to NM toxicity studies using biological models and describes the limitations that often prevent toxicologists from identifying whether NM pose a real hazard to human health. One major limitation to assess toxicity is the characterization of the NM prior to and after exposure to living cells or animals. The most relevant physicochemical characteristics of NM are: size, surface chemistry, crystallinity, morphology, solubility, aggregation tendency, homogeneity of dispersions, and turbidity. All of these properties need to be assessed in order to determine their contribution to toxicity. Due to the lack of appropriate methods to determine the physicochemical nature of nanoparticles in biological systems, the exact nature of NM toxicity is not fully described or understood at this time. This Review emphasizes the need for state-of-the-art physicochemical characterization, the determination of appropriate exposure protocols and reliable methods for assessing NM internalization and their kinetics in living organisms. Once these issues are addressed, optimal experimental conditions could be established in order to identify if NM pose a threat to human health. Multidisciplinary research between materials scientists and life scientists should overcome these limitations in identifying the true hazards of NM. [source] In situ-based effects measures: Determining the ecological relevance of measured responsesINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 2 2007Donald J Baird Abstract The aim of this review is to examine how the choice of test species and study design employed in the use of in situ approaches in ecological risk assessment can maximize the ecological relevance of data. We provide a framework to define and assess ecological relevance that permits study designs to remain focused on the ecological question being addressed. This framework makes explicit the linkages between effects at lower levels of biological organization and higher-order ecological effects at the population, community, and ecosystem levels. The usefulness of this framework is illustrated by reference to specific examples from aquatic ecotoxicology. The use of models as both interpretive and predictive tools is discussed, with suggestions of appropriate methods for different protection goals. [source] In situ methods of measurement,an important line of evidence in the environmental risk frameworkINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 2 2007Jim Wharfe Abstract A tiered framework provides a structured approach to assess and manage risk and underpins much of the legislation concerning chemicals and environmental management. Management decisions regarding appropriate controls can have high cost implications to the regulated community. The risk framework provides an evidence-based approach to reduce uncertainty in decision making. Traditional assessment is heavily dependent on laboratory-generated toxicity test data and estimations of exposure and effect. Despite many well documented demonstrations of in situ methodologies, they are rarely used by regulators to help improve assessment or to validate risk. Emerging legislation puts greater emphasis on environmental outcomes and represents a significant shift from the reliance on chemical measures alone toward biological responses that improve assessment and demonstrate ecological benefit. Diagnostic methods, that could include in situ-based measures, will help assess and manage environments failing to achieve good status and it is likely that a weight of evidence approach will be needed to help inform management decisions. The potential application of such measures in the risk framework is reviewed in the context of current and emerging legislation concerning chemicals. Effect measures on the basis of in situ methods provide an alternative line of evidence and can help reduce uncertainty in decision making. Criteria are presented to help select appropriate methods in a multiple-line, weight of evidence approach. [source] The roles of science and technology in energy and environment research and developmentINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 13 2001Ibrahim Dincer Abstract Countries are becoming increasingly aware of the importance of science and technology in relation to national development and the necessity of formulating a concise science and technology policy. The need to strengthen and orient the scientific and technological infrastructure in line with national development goals, through more effective use of an available qualified work force and the higher education system, is becoming widely recognized. Consequently, appropriate methods of assessing the impact of science and technology on national development are needed so that efforts are concentrated on areas potentially having substantial impacts. Numerous planning studies have been undertaken to this end, particularly by international organizations such as UNESCO, UNIDO, OECD and IEA. This study examines the inter-relationships of the disciplines of science and technology with energy and environment research and development (R&D) activities, particularly for developing countries. The connections between these topics are discussed along with some basic methods that can be used to exploit the relations. Some illustrative examples are presented. It is anticipated that the present study will serve as a preliminary step for more comprehensive work by providing an example of the utilization of formal methods in formulating science and technology policy for energy and environment R&D. Copyright © 2001 John Wiley & Sons, Ltd. [source] Evaluating outpatient pharmacy services: a literature review of specialist heart failure servicesINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2006Tracey-Lea Hargraves Pharmacist (formerly) Objective To identify appropriate methods to evaluate a specialist pharmacy service for heart failure patients in an ambulatory care setting. Method An extensive literature review was undertaken to identify the published data on evaluative studies of specialist pharmacy services, including those directed at heart failure patients in an ambulatory care model of service provision. Key findings Six studies were identified evaluating outpatient pharmacy services for heart failure. The pharmacy services provided in these settings were not well defined. The impact of the pharmacist was compared to ,usual care', that is care delivered without a pharmacist, by either a prospective randomised controlled trial (RCT), or before and after studies. In most cases the service was delivered by one pharmacist at one site. Services were primarily targeted at patients and focused on medication and lifestyle education, adverse drug reaction monitoring, and compliance/adherence. In all studies, there was a trend for improvement in the outcomes measured. Different study endpoints were examined, including process indicators such as compliance and outcome measures such as morbidity (clinical), quality of life (humanistic), and hospital admissions (economic). The ideal evaluative study would be an adequately powered, prospective, randomised controlled trial, comparing the effect of the pharmacist service to usual care (without the specified pharmacy service). Appropriate study endpoints including process indicators and outcome measures are needed. Identification of specific components and the extent of the service that would provide the most benefit to selected patient groups would be of interest. Conclusions Specialist ambulatory care pharmacy services have not been well defined or evaluated in the literature. Limited randomised controlled data exist. [source] Patients' evaluations of the quality of care: influencing factors and the importance of engagementJOURNAL OF ADVANCED NURSING, Issue 5 2005Sophie H. Staniszewska BSc DPhil Aims., This paper reports a study exploring the process of patient evaluation and identifying the factors which influence this. Background., Patient experiences of health care have become a central focus for researchers, policymakers, clinicians and patient groups in many countries. While surveys of patient experiences have become increasingly common internationally, concerns about the validity of concepts such as satisfaction have cast doubt on the utility of their findings. These concerns reflect our limited understanding of patient evaluation and the factors that can influence this process. Methods., A qualitative design was adopted, using semi-structured interviews with a sample of outpatients in their homes in one county in England. In total, 41 patients participated in the study and were interviewed before their appointment. Of these patients, 37 were interviewed again after their appointment. Six of the latter were then re-interviewed 6 weeks after the appointment to explore whether evaluations had changed. Findings., Patient evaluation was influenced by a number of factors, including gratitude, faith, loyalty, luck and equity. The overall effect was to prompt positive evaluation, even when care was poor. These factors should be accounted for in the interpretation of patient experiences surveys. Patient experiences were further influenced by their sense of engagement with the system. A negative sense of engagement could have a major impact on the patient, resulting in disappointment or fear and a desire to leave the health care system, and in a negative evaluation of a specific aspect of care. Conclusions., Engagement may provide a more appropriate indicator of negative experience than dissatisfaction. The influence of these factors should be considered in future attempts to develop more sensitive and appropriate methods of eliciting patient experiences. [source] Therapist effects in randomised controlled trials: what to do about themJOURNAL OF CLINICAL NURSING, Issue 7-8 2010Stephen J Walters Aims and objectives., The aim of this study is to describe and compare three statistical methods to allow for therapist effects in individually randomised controlled trials. Background., In an individually randomised controlled trial where the intervention is delivered by a health professional it seems likely that the effectiveness of the intervention, independent of any treatment effect, could depend on the skill of the health professional delivering it. This leads to a potential clustering of the outcomes for the patients being treated by the same health professional. Design., Retrospective statistical analysis of outcomes from four example randomised controlled trial datasets with potential clustering by health professional. Methods., Three methods to allow for clustering are described: cluster level analysis; random effects models and marginal models. These models were fitted to continuous outcome data from four example randomised controlled trial datasets with potential clustering by health professional. Results., The cluster level models produced the widest confidence intervals. Little difference was found between the estimates of the regression coefficients for the treatment effect and confidence intervals between the individual patient level models for the datasets. The conclusions reached for each dataset match those published in the original papers. The intracluster correlation coefficient ranged from <0·001,0·04 for the outcomes, which shows only minor levels of clustering within the datasets. Conclusions., The models, which use individual level data are to be preferred. Treatment coefficients from these models have different interpretations. The choice of model should depend on the scientific question being asked. Relevance to clinical practice., We recommend that researchers should be aware of any potential clustering, by health professional, in their randomised controlled trial and use appropriate methods to account for this clustering in the statistical analysis of the data. [source] Local Banks Efficiency and EmploymentLABOUR, Issue 3 2008Patrizia Ordine We argue that if banks are not efficient in monitoring the borrowers in the presence of asymmetric information, credit market imperfections have real effects. We estimate dynamic equations using system generalized method of moments (GMM) for bank loans and employment on panel data for Italian firms. The system GMM estimates indicate that the impact of credit market on employment is higher where the local financial market is less developed, asymmetric information is widespread, bank managers are less efficient in assessing the firms' solvency and do not use appropriate methods to evaluate the borrowers' payback capacity. [source] Have studies of urinary tract infection and preterm delivery used the most appropriate methods?PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2003Marie S. O'Neill Summary Published investigations of the association between urinary tract infection (UTI) and preterm delivery used logistic regression or chi-squared tests. Because both exposure and outcome are time dependent, these methods were not optimal and did not account for person,time under observation, potentially an important feature given the variability of women's entry to prenatal care as well as of gestational lengths. Previous researchers probably classified as exposed some women whose UTI occurred after their pregnancies exceeded 37 weeks. We applied the previous analytical methods to 1990,93 births from two Durham, NC, USA, hospitals (n = 4053) and demonstrate survival methods as an alternative. Two logistic regression models were fitted with differing exposure definitions: model 1 in which exposed = UTI diagnosed after 20 weeks' gestation; and model 2 in which exposed = UTI diagnosed between 20 weeks' and 37 weeks' gestation. Model 3 used proportional hazards regression with person,time after 20 weeks and before UTI diagnosis as unexposed, and person,time after diagnosis as exposed. Models were fit with and without five time-constant potential confounders. Model 1 yielded an adjusted odds ratio (OR) of 0.8 [95% confidence interval (CI) 0.5, 1.2], and model 2, which did not include UTI diagnoses after 37 weeks, an adjusted OR of 0.9 [95% CI 0.6, 1.4]. The Cox model hazard ratio (HR) for preterm delivery was 1.1 (adjusted) [95% CI 0.7, 1.7]. As these results indicated some bias, but not remarkable differences, we conducted a sensitivity analysis using 100 samples of 80% of the original data set, with replacement to determine how large the differences might be in other, similar data sets. The Cox method consistently produced higher effect estimates than either logistic model. The two samples with the greatest differences between the Cox and logistic model estimates yielded an OR of 1.47 [95% CI 0.95, 2.29] for model 1 vs. HR of 2.06 [95% CI 1.39, 3.06] for model 3, and an OR of 1.41 [95% CI 0.88, 2.25] for model 2 vs. HR of 1.79 [95% CI 1.17, 2.71] for model 3 respectively. Previous published results on UTI and preterm delivery require cautious interpretation. Data on UTI timing should be gathered to allow appropriate analyses; survival methods account for person,time under observation and ensure that studied exposures precede effects. [source] Enthesopathies as occupational stress markers: Evidence from the upper limbAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2010Sébastien Villotte Abstract Enthesopathies,that is, "musculo-skeletal stress markers",are frequently used to reconstruct past lifestyles and activity patterns. Relatively little attention has been paid in physical anthropology to methodological gaps implicit in this approach: almost all methods previously employed neglect current medical insights into enthesopathies and the distinction between healthy and pathological aspects has been arbitrary. This study presents a new visual method of studying fibrocartilaginous enthesopathies of the upper limb (modified from Villotte: Bull Mém Soc Anthropol Paris n.s. 18 (2006) 65,85), and application of this method to 367 males who died between the 18th and 20th centuries, from four European identified skeletal collections: the Christ Church Spitalfields Collection, the identified skeletal collection of the anthropological museum of the University of Coimbra, and the Sassari and Bologna collections of the museum of Anthropology, University of Bologna. The analysis, using generalized estimating equations to model repeated binary outcome variables, has established a strong link between enthesopathies and physical activity: men with occupations involving heavy manual tasks have significantly (P -value < 0.001) more lesions of the upper limbs than nonmanual and light manual workers. Probability of the presence of an enthesopathy also increases with age and is higher for the right side compared with the left. Our study failed to distinguish significant differences between the collections when adjusted for the other effects. It appears that enthesopathies can be used to reconstruct past lifestyles of populations if physical anthropologists: 1) pay attention to the choice of entheses in their studies and 2) use appropriate methods. Am J Phys Anthropol, 2010. © 2009 Wiley-Liss, Inc. [source] Identification of degradation products formed during performic oxidation of peptides and proteins by high-performance liquid chromatography with matrix-assisted laser desorption/ionization and tandem mass spectrometryRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 9 2005Jingquan Dai Oxidation of proteins with performic acid is extensively used to cleave disulfide bonds. Due to its efficiency and many other advantages it deserves more attention especially in proteomics as a method for sample treatment. However, some unwanted degradations can occur during performic oxidation. In this work the degradation products during performic oxidation of two peptides and bovine serum albumin as model substrates were explored by coupling high-performance liquid chromatography (HPLC) to matrix-assisted laser desorption/ionization tandem mass spectrometry (MALDI-TOF/TOFMS). In addition to well-known modifications such as oxidation of tryptophan and oxidation and chlorination of tyrosine, novel degradation products including nonspecific cleavage after asparagine or tryptophan, formylation of lysine, and , -elimination of cysteine, were observed. Although almost all of these modification/degradation products except oxidation products of tryptophan were formed at sub-stoichiometric levels, they can cause confusion as a result of the sensitivity of mass spectrometry in analysis of the oxidized samples, especially in proteomics research. The results presented here will facilitate the interpretation of analytical data for performate-oxidized samples, and help to select appropriate methods for each unique sample. Copyright © 2005 John Wiley & Sons, Ltd. [source] Practitioner Review: Short-term and working memory impairments in neurodevelopmental disorders: diagnosis and remedial supportTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 1 2006Susan E. Gathercole Background:, This article provides an introduction to current models of working and short-term memory, their links with learning, and diagnosis of impairments. The memory impairments associated with a range of neurodevelopmental disorders (Down's syndrome, Williams syndrome, Specific Language Impairment, and attentional deficits) are discussed. Methods:, Methods of alleviating the adverse consequences of working and short-term memory impairments for learning are identified. Conclusion:, Impairments of short-term and working memory are associated with learning difficulties that can be substantial, and that can be minimised by appropriate methods of remedial support. [source] Real-time measurement of nitric oxide in single mature mouse skeletal muscle fibres during contractionsTHE JOURNAL OF PHYSIOLOGY, Issue 1 2007Deborah Pye Nitric oxide (NO) is thought to play multiple roles in skeletal muscle including regulation of some adaptations to contractile activity, but appropriate methods for the analysis of intracellular NO activity are lacking. In this study we have examined the intracellular generation of NO in isolated single mature mouse skeletal muscle fibres at rest and following a period of contractile activity. Muscle fibres were isolated from the flexor digitorum brevis muscle of mice and intracellular NO production was visualized in real-time using the fluorescent NO probe 4-amino-5-methylamino-2,,7,-difluorofluorescein diacetate (DAF-FM DA). Some leakage of DAF-FM was apparent from fibres loaded with the probe, but they retained sufficient probe to respond to changes in intracellular NO following addition of the NO donor 3-(2-hydroxy-1-methyl-2-nitrosohydrazino)- N -methyl-1-propanamine (NOC-7) up to 30 min after loading. Electrically stimulated contractions in isolated fibres increased the rate of change in DAF-FM fluorescence by ,48% compared to non-stimulated fibres (P < 0.05) and the rate of change in DAF-FM fluorescence in the stimulated fibres returned to control values by 5 min after contractions. Treatment of isolated fibres with the NO synthase inhibitors NG -nitro- l -arginine methyl ester hydrochloride (l -NAME) or NG -monomethyl- l -arginine (l -NMMA) reduced the increase in DAF-FM fluorescence observed in response to contractions of untreated fibres. Treatment of fibres with the cell-permeable superoxide scavenger 4,5-dihydroxy-1,3-benzenedisulphonic acid (Tiron) also reduced the increase in fluorescence observed during contractions suggesting that superoxide, or more probably peroxynitrite, contributes to the fluorescence observed. Thus this technique can be used to examine NO generation in quiescent and contracting skeletal muscle fibres in real time, although peroxynitrite and other reactive nitrogen species may potentially contribute to the fluorescence values observed. [source] Participation in research programBIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION, Issue 5 2007A Novel Course in Undergraduate Education of Life Science Abstract A novel course, "Participation in Research Program (PRP)" in life sciences is open for 1st to 3rd year undergraduates. PRP introduces the principles of a variety of biological methods and techniques and also offers an opportunity to explore some specific knowledge in more detail prior to thesis research. In addition, the PRP introduces some methodologies that have been proven to be successful at each institution to participants. Through disciplines crossing, students were trained theoretically and practically about modern techniques, facilitating the efficient commutation of general laboratory skills and modern laboratory skills, and the possession of higher research ability. Therefore, during some basic training (e.g., usage and maintenance of equipments, designing and completing experiments, analyzing data and reporting results, etc.), a series of capabilities are strengthened, such as basic experimental skills, searching appropriate methods, explaining unknown biological phenomena, and the capacity of solving problems. To determine the efficiency of these strategies, we carefully examined students' performance and demonstrated the progress in students' basic abilities of scientific research in their training. [source] | ||||||||||||||||||||||||||||||||||