Home About us Contact
|
Home About us Contact | ||
|
|
||
Prospective Approach (prospective + approach)
Selected AbstractsQuantitative trait association in parent offspring trios: Extension of case/pseudocontrol method and comparison of prospective and retrospective approachesGENETIC EPIDEMIOLOGY, Issue 8 2007Eleanor Wheeler Abstract The case/pseudocontrol method provides a convenient framework for family-based association analysis of case-parent trios, incorporating several previously proposed methods such as the transmission/disequilibrium test and log-linear modelling of parent-of-origin effects. The method allows genotype and haplotype analysis at an arbitrary number of linked and unlinked multiallelic loci, as well as modelling of more complex effects such as epistasis, parent-of-origin effects, maternal genotype and mother-child interaction effects, and gene-environment interactions. Here we extend the method for analysis of quantitative as opposed to dichotomous (e.g. disease) traits. The resulting method can be thought of as a retrospective approach, modelling genotype given trait value, in contrast to prospective approaches that model trait given genotype. Through simulations and analytical derivations, we examine the power and properties of our proposed approach, and compare it to several previously proposed single-locus methods for quantitative trait association analysis. We investigate the performance of the different methods when extended to allow analysis of haplotype, maternal genotype and parent-of-origin effects. With randomly ascertained families, with or without population stratification, the prospective approach (modeling trait value given genotype) is found to be generally most effective, although the retrospective approach has some advantages with regard to estimation and interpretability of parameter estimates when applied to selected samples. Genet. Epidemiol. 2007. © 2007 Wiley-Liss, Inc. [source] Kaizen: A Method of Process Improvement in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 12 2009Gregory H. Jacobson MD Abstract Introduction:, Recent position statements from health care organizations have placed a strong emphasis on continuous quality improvement (CQI). CQI finds many of its roots in kaizen, which emphasizes small, low-cost, low-risk improvements. Based on the successful Kaizen Programs at organizations such as Toyota, the authors thought the emergency department (ED) would be an ideal environment to benefit from such a program. Objectives:, The authors sought to create a CQI program using a suggestion-based model that did not require a large time commitment, was easy to implement, and had the potential to empower all physicians in the department. It would not take the place of other improvement efforts, but instead augment them. The hypothesis was that such a program would foster sustainable engagement of emergency physicians in system improvement efforts and lead to a continuous stream of low-cost implementable system improvement interventions. Methods:, A CQI program was created for the physician staff of the Department of Emergency Medicine at Vanderbilt University Medical Center, focusing on a suggestion-based model using kaizen philosophy. Lectures teaching kaizen philosophy were presented. Over the past 4 years, a methodology was developed utilizing a Web-based application, the Kaizen Tracker, which aids in the submission and implementation of suggestions that are called kaizen initiatives (KIs). The characteristics of the KIs submitted, details regarding resident and faculty participation, and the effectiveness of the Kaizen Tracker were retrospectively reviewed. Results:, There were 169, 105, and 101 KIs placed in the postimplementation calendar years 2006, 2007, and 2008, respectively. Seventy-six percent of KIs submitted thus far have identified a "process problem." Fifty-three percent of KIs submitted have led to operational changes within the ED. Ninety-three percent of the resident physicians entered at least one KI, and 73% of these residents submitted more than one KI. Sixty-nine percent of the attendings entered at least one KI, and 89% of these attendings submitted more than one KI. Conclusions:, Over the past 4 years, the Kaizen Program at Vanderbilt has been widely and frequently used within the ED. It has resulted in over 400 changes in our adult ED system and has met the challenge of using CQI to drive ED improvements. There are limitations to this study, including the fact that its impact on patient outcomes remains unknown. However, this Kaizen Program may be an excellent tool for other departments to assist with quality improvement and should be studied with a multicenter prospective approach. [source] Visual orienting in the early broader autism phenotype: disengagement and facilitationTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 5 2009Mayada Elsabbagh Background:, Recent studies of infant siblings of children diagnosed with autism have allowed for a prospective approach to examine the emergence of symptoms and revealed behavioral differences in the broader autism phenotype within the early years. In the current study we focused on a set of functions associated with visual attention, previously reported to be atypical in autism. Method:, We compared performance of a group of 9,10-month-old infant siblings of children with autism to a control group with no family history of autism on the ,gap-overlap task', which measures the cost of disengaging from a central stimulus in order to fixate a peripheral one. Two measures were derived on the basis of infants' saccadic reaction times. The first is the Disengagement effect, which measures the efficiency of disengaging from a central stimulus to orient to a peripheral one. The second was a Facilitation effect, which arises when the infant is cued by a temporal gap preceding the onset of the peripheral stimulus, and would orient faster after its onset. Results and conclusion:, Infant siblings of children with autism showed longer Disengagement latencies as well as less Facilitation relative to the control group. The findings are discussed in relation to how differences in visual attention may relate to characteristics observed in autism and the broader phenotype. [source] Changes in body image satisfaction during pregnancy: A comparison of high exercising and low exercising womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2003Nadia Boscaglia Abstract Objective: This study aimed to compare ratings of body image satisfaction (BIS) from 6 months prepregnancy to 23,30 weeks' gestation for high exercising and low exercising pregnant women. The authors also aimed to assess and compare expectations of BIS for the post-partum period in high and low exercising women. Design: A partial prospective approach was implemented. Sample: A total of 71 healthy pregnant women (40 high exercisers and 31 low exercisers) participated. Methods: Participants completed a series of questionnaires at 15,22 weeks' gestation and 23,30 weeks' gestation. Main outcome measures: There were two main outcome measures. At 15,22 weeks' gestation there was an exercise inventory and two versions of the Body Cathexis Scale (BCS) (retrospective prepregnancy BIS and current BIS). At 23,30 weeks' gestation there was an exercise inventory and two versions of the BCS (current BIS and projected post-partum BIS). Results: ,At 15,22 weeks' gestation, high exercisers demonstrated significantly higher levels of BIS compared to low exercisers. There were no other significant differences between groups. Within groups, high exercisers were significantly more satisfied with their bodies at 15,22 weeks' gestation compared to 6 months prepregnancy, and expected to be less satisfied with their bodies at 6 weeks' post-partum than they were during pregnancy. Low exercisers demonstrated no significant changes over time. Conclusions: The findings suggest that women are able to assimilate the bodily changes of pregnancy without a negative shift in BIS. However, women who exercise during pregnancy may respond more favourably to changes in their bodies at early pregnancy compared to women who remain sedentary. [source] Research engagement and outcomes in public health and health services research in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Armita Adily Abstract Objectives: To retrospectively explore research outcomes in Australian public health research and their relationship to full engagement with potential research users during the research process. Methods: A self-administered survey of all principal investigators (PIs) receiving research funds from one of three well-known research funding agencies. ,Research value' and ,research utility' were self-reported using fixed response sets. Associations between outcomes and ,full engagement' were examined. Results: Our response rate (75.1%) yielded data for 187 research projects. For just over one-quarter (26.7%), ,research value' was rated ,very important' in terms of knowledge generation. The most common ,research utility' was ,continuing education' (27.3%) followed by ,policy formulation' (25.7%). While 66 (35.3%) projects engaged at least one potential research user group throughout ,full engagement', such an intertwined relationship between researchers and research users was not associated with research value (,2=0.46, 1df, p=0.5) or research utility (,2=2.19, 1df, p=0.14). There were no predictors of ,full engagement'. In just over a third of projects (34.8%), both part of the awarded grant and additional funding had been spent to promote research use. Conclusions and Implications: This snapshot demonstrates patchy research engagement between researchers and research users. Other academic groups were the most common partner for full engagement. In an evidence-based era, innovation in health research funding policy should be evaluated. As NHMRC embarks upon its ,Partnerships initiative' in 2009, we recommend a prospective approach to evaluation. [source] Quantitative trait association in parent offspring trios: Extension of case/pseudocontrol method and comparison of prospective and retrospective approachesGENETIC EPIDEMIOLOGY, Issue 8 2007Eleanor Wheeler Abstract The case/pseudocontrol method provides a convenient framework for family-based association analysis of case-parent trios, incorporating several previously proposed methods such as the transmission/disequilibrium test and log-linear modelling of parent-of-origin effects. The method allows genotype and haplotype analysis at an arbitrary number of linked and unlinked multiallelic loci, as well as modelling of more complex effects such as epistasis, parent-of-origin effects, maternal genotype and mother-child interaction effects, and gene-environment interactions. Here we extend the method for analysis of quantitative as opposed to dichotomous (e.g. disease) traits. The resulting method can be thought of as a retrospective approach, modelling genotype given trait value, in contrast to prospective approaches that model trait given genotype. Through simulations and analytical derivations, we examine the power and properties of our proposed approach, and compare it to several previously proposed single-locus methods for quantitative trait association analysis. We investigate the performance of the different methods when extended to allow analysis of haplotype, maternal genotype and parent-of-origin effects. With randomly ascertained families, with or without population stratification, the prospective approach (modeling trait value given genotype) is found to be generally most effective, although the retrospective approach has some advantages with regard to estimation and interpretability of parameter estimates when applied to selected samples. Genet. Epidemiol. 2007. © 2007 Wiley-Liss, Inc. [source] | ||||||||||