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Same Outcomes (same + outcome)
Selected AbstractsOptimal timing and dosing of platelet transfusionsISBT SCIENCE SERIES: THE INTERNATIONAL JOURNAL OF INTRACELLULAR TRANSPORT, Issue n1 2010N. M. Heddle Background, Over the past 20 years there have been more than 20 randomized controlled trials (RCTs) that have investigated various aspects of platelet transfusion therapy in haematology/oncology patients. These studies have focused on the best platelet product, the importance of ABO compatibility, pathogen inactivation of platelets, platelet triggers and the optimal platelet dose. Aims, This article summarizes current evidence to support the timing and dosing of platelet transfusions and to explore some ideas of where clinical research in this area may be heading. Materials and Methods, The articles reviewed in this presentation were identified through a search of PubMed using the term, platelet transfusion and setting limits to identify clinical studies, human studies and manuscripts in English. Results and Discussion, Three RCTs have informed practices around platelet transfusion trigger with the largest study by Rebulla et al., being the primary study that has changed practices worldwide, with a move towards a lower prophylactic platelet transfusion trigger of 10 × 109/l. Two groups (Germany and Oxford, UK) are currently investigating whether we can push the boundaries of prophylactic platelet transfusions even further by eliminating this form of therapy. Preliminary results from these studies have been published but we will await the final results to determine whether this research will indeed change practice. Over the past year there has also been two major studies (one by the BEST Collaborative, and the second by the US Transfusion Medicine/Hemostasis Network), that provide new information to guide platelet dosing. The Study by the BEST Collaborative (SToP) compared low dose platelets to standard dose platelets with WHO bleeding greater than or equal to Grade 2 as the primary outcome. The US study (PLADO) compared three doses (low, medium and high) and measured the same outcome (WHO bleeding , Grade 2). Conclusions, Although all of these studies further our knowledge to prescribe platelet transfusions, they also raise some interesting questions about the clinical relevance of the outcomes that we are currently using for these studies. The trend over the past decade has been to use bleeding as the primary outcome; however, bleeding is a complex composite outcome (Grades 2, 3 and 4) comprised of some surrogate components (Grades 2 and 3). It is also an outcome that may be difficult to measure and grade in a consistent and reliable manner. The clinical relevance of this outcome is also complex and may vary depending on the perspective from which it is viewed. [source] Active learning support vector machines for optimal sample selection in classificationJOURNAL OF CHEMOMETRICS, Issue 6 2004Simeone Zomer Abstract Labelling samples is a procedure that may result in significant delays particularly when dealing with larger datasets and/or when labelling implies prolonged analysis. In such cases a strategy that allows the construction of a reliable classifier on the basis of a minimal sized training set by labelling a minor fraction of samples can be of advantage. Support vector machines (SVMs) are ideal for such an approach because the classifier relies on only a small subset of samples, namely the support vectors, while being independent from the remaining ones that typically form the majority of the dataset. This paper describes a procedure where a SVM classifier is constructed with support vectors systematically retrieved from the pool of unlabelled samples. The procedure is termed ,active' because the algorithm interacts with the samples prior to their labelling rather than waiting passively for the input. The learning behaviour on simulated datasets is analysed and a practical application for the detection of hydrocarbons in soils using mass spectrometry is described. Results on simulations show that the active learning SVM performs optimally on datasets where the classes display an intermediate level of separation. On the real case study the classifier correctly assesses the membership of all samples in the original dataset by requiring for labelling around 14% of the data. Its subsequent application on a second dataset of analogous nature also provides perfect classification without further labelling, giving the same outcome as most classical techniques based on the entirely labelled original dataset. Copyright © 2004 John Wiley & Sons, Ltd. [source] Evidence regarding the integrity of the posterior medial lateral suprasylvian visual area in the catTHE JOURNAL OF COMPARATIVE NEUROLOGY, Issue 16 2010Helen Sherk Abstract Among the areas of lateral suprasylvian visual cortex in cats defined by Palmer et al. (J Comp Neurol [1978] 177:237,256), PMLS (posterior lateral suprasylvian area) has been the most studied. Although PMLS has strong and well-documented connections with area 17, it is unclear whether these connections extend to its upper visual field representation. We asked what cortical areas send input to the upper field representation in PMLS by making tracer injections in areas 17, 19, and posterior suprasylvian cortex. Tracer injections made in area 17's upper field representation in 15 cats failed to label the corresponding region in PMLS. Instead, they showed that area 17 is strongly connected with the posterior bank of the posterior suprasylvian sulcus (pSS), a region attributed by Palmer et al. to area 21a. Injections in area 19 had the same outcome. We consider this posterior upper field representation plus the lower field representation in PMLS to belong to a single area, LS (lateral suprasylvian visual area). Our data suggest that the upper field representation in PMLS belongs to a different area, most likely AMLS (anterior medial lateral suprasylvian area). J. Comp. Neurol. 518:3343,3358, 2010. © 2010 Wiley-Liss, Inc. [source] Considering a multisite study?JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2002How to take the leap, have a soft landing Although most policymakers agree that a fundamental goal of the mental health system is to provide integrated community-based services, there is little empirical evidence with which to plan such a system. Studies in the community mental health literature have not used a standard set of evaluation methods. One way of addressing this gap is through a multisite program evaluation in which multiple sites and programs evaluate the same outcomes using the same instruments and time frame. The proposition of introducing the same study design in different settings and programs is deceptively straightforward. The difficulty is not in the conceptualization but in the implementation. This article examines the factors that act as implementation barriers, how are they magnified in a multisite study design, and how they can be successfully addressed. In discussing the issue of study design, this article considers processes used to address six major types of barriers to conducting collaborative studies identified by Lancaster or Lancaster's six Cs,contribution, communication, compatibility, consensus, credit, and commitment. A case study approach is used to examine implementation of a multisite community mental health evaluation of services and supports (case management, self-help initiatives, crisis interventions) represented by six independent evaluations of 15 community health programs. A principal finding was that one of the main vehicles to a successful multisite project is participation. It is only through participation that Lancaster's six Cs can be addressed. Key factors in large, geographically dispersed, and diverse groups include the use of advisory committees, explicit criteria and opportunities for participation, reliance on all modes of communication, and valuing informal interactions. The article concludes that whereas modern technology has assisted in making complicated research designs feasible, the operationalization of timeless virtues such as mutual respect and trust, flexibility, and commitment make them successful. © 2002 John Wiley & Sons, Inc. [source] Capital at Home and at School: A Review and SynthesisJOURNAL OF MARRIAGE AND FAMILY, Issue 4 2010Toby L. Parcel Human, financial, and social capital from several contexts affects child and adolescent well-being. Families and schools are among the most important, and research is increasingly studying how effects of capital across such contexts affect child and adolescent academic and social outcomes. Some research suggests that families may be more powerful than schools in promoting child and adolescent well-being. Additional research is needed to more fully understand how capital across institutions interacts in producing child well-being, when and why multiple institutions or levels of analysis are relevant, and how several contexts can form chains of causation. Theories of social capital may promote increased conversation among researchers who study the same outcomes yet focus their analyses on different contexts. [source] Formal mentoring versus supervisor and coworker relationships: differences in perceptions and impactJOURNAL OF ORGANIZATIONAL BEHAVIOR, Issue 3 2003Babette Raabe Formal mentoring programs in two companies were examined regarding (1) the extent to which mentees and mentors agreed on the nature of the mentoring relationships and (2) the extent to which dimensions of mentoring relationships were related to outcomes for the mentees, compared with the extent to which dimensions of supervisory and coworker relationships were related to the same outcomes: job satisfaction, organizational commitment, and turnover intentions. Mentors were at least two hierarchical levels above the mentee, and both were part of the companyies' formal mentoring program. Sixty-one pairs of mentors and mentees participated. Overall, there was little agreement between mentees and mentors regarding the nature of the mentoring relationship. Furthermore, the mentoring relationship was not related to mentee outcomes, while supervisory and coworker relationships were. It is suggested that, if one desires to affect job satisfaction, turnover intentions, and organizational commitment, mentoring functions may be best performed by supervisors and coworkers rather than assigned formal mentors from higher up in the organizational hierarchy. Copyright © 2003 John Wiley & Sons, Ltd. [source] Racial disparities in age at time of cardiovascular events and cardiovascular-related death in patients with systemic lupus erythematosusARTHRITIS & RHEUMATISM, Issue 9 2010Lisabeth V. Scalzi Objective To determine whether racial disparities exist with regard to the age at which patients with systemic lupus erythematosus (SLE) experience cardiovascular disease (CVD) and CVD-associated death. Methods Using the 2003,2006 Nationwide Inpatient Sample, we calculated the age difference between patients with SLE and their race- and sex-matched controls at the time of hospitalization for a cardiovascular event and for CVD-associated death. In addition, we calculated the age difference between white patients with SLE and sex-matched controls for each minority group for the same outcomes. Results The mean age difference between women with and those without SLE at the time of admission for a CVD event was 10.5 years. All age differences between women with SLE (n = 3,627) and women without SLE admitted for CVD were significant (P < 0.0001). Among different racial groups with SLE, black women were the youngest to be admitted with CVD (53.9 years) and to have a CVD-associated in-hospital death (52.8 years; n = 218). Black women with SLE were 19.8 years younger than race- and sex-matched controls at the time of CVD-associated death. Admission trends for CVD were reversed for black women, such that the highest proportions of these patients were admitted before age 55 years, and then the proportions steadily decreased across age categories. Among the 805 men with SLE who were admitted with a CVD event, those who were black or Hispanic were youngest. Conclusion There are significant racial disparities with regard to age at the time of hospital admission for CVD events and CVD-related hospitalization resulting in death in patients with SLE. [source] The outcomes of a longitudinal study of non-organic failure-to-thriveCHILD ABUSE REVIEW, Issue 4 2003Dorota Iwaniec Abstract Individuals who had failed-to-thrive for non-organic reasons received psychosocial intervention which was tailor-made to their particular needs during childhood. Their progress was followed up over 20 years later, including their physical growth and social and cognitive functioning. Not all clients showed the same outcomes. The quality of the parental relationship and the reason for the growth-faltering were found to be related to the outcomes at 20 years. Unless they experienced a positive and sustained change in their life or circumstances, individuals who had experienced abuse showed poorer outcomes than those whose growth-faltering had been thought due to neglect, lack of parenting or feeding dif,culties. Abuse tended to be a contributing factor to growth-faltering more frequently in families where the parents were observed to have a poor relationship with each other. However, a signi,cant change in the quality of care given to the child and the emotional environment experienced by them resulted in positive outcomes 20 years later despite experiencing abuse during childhood. Copyright © 2003 John Wiley & Sons, Ltd. [source] | |||||||||||||