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Systematic Evidence (systematic + evidence)
Selected AbstractsReaching the population with dementia drugs: what are the challenges?INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2007Fiona E Matthews Abstract Background Systematic evidence became available in the late 1990s on efficacy of cholinesterase inhibitors (CHEIs) for patients with mild to moderate Alzheimer's disease (AD) and they began to be used sporadically. Since January 2001 UK based guidelines indicated that one of three cholinesterase inhibitors (CHEIs) could be prescribed for these patients. Since then the cost of prescription in England and Wales has risen. There has been little investigation of uptake at the population level. Objective To estimate the population uptake of CHEIs in a population based study of dementia spanning this period. Design Using data from a 10-year follow up and a later 12 year interview of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS), a UK population based longitudinal cohort study of people originally aged 65 years and above, we investigated who was taking CHEIs during the period 2001,2004. We sought information from respondents taking part in the study what medication they were taking on a regular basis. Results Only 12, of the 219 individuals who received a study diagnosis of dementia were prescribed CHEIs [5%, 95% Confidence Intervals (CI) 3%,9%]) in 2001/2003 and none of the 28 individuals with a study diagnosis of dementia (0%, 95% CI 0,18%) in 2004 were prescribed CHEIs. Uptake was biased towards individuals with more education and higher social class. Conclusions These data suggest that any impact on AD progression at the population level will be negligible as prescription of CHEIs and uptake in the age group at highest risk is so limited. There is little evidence that this has changed over time. Copyright © 2006 John Wiley & Sons, Ltd. [source] ,Riches beyond the dreams of avarice?': commerical returns on British warship construction, 1889-1914ECONOMIC HISTORY REVIEW, Issue 2 2001A.J. Arnold The contracts for naval warships placed in private shipyards in the nineteenth century provide an early example of state procurement policy. It has been widely argued that these contracts allowed the firms concerned to earn unusually high profits, although the evidence provided has been very limited. This article analyses the effects of naval warship contracts on the profitability of the dominant suppliers during the ,naval arms race' of 1889-1914 in order to provide new and more systematic evidence on the workings of an early form of regulation and on a tangible aspect of the relationship between firms and the British government. [source] Self-Interest, Foreign Need, and Good Governance: Are Bilateral Investment Treaty Programs Similar to Aid Allocation?FOREIGN POLICY ANALYSIS, Issue 3 2006ERIC NEUMAYER Bilateral investment treaties (BITs) have become the most important legal mechanism for the encouragement and governance of foreign direct investment (FDI) in developing countries. Yet practically no systematic evidence exists on what motivates capital-exporting developed countries to sign BITs earlier with some developing countries than with others, if at all. The theoretical framework from the aid allocation literature suggests that developed countries pursue a mixture of self-interest, foreign need and, possibly, good governance. We find evidence that both economic interests of developed countries' foreign investors and political interests of developed countries determine their scheduling of BITs. However, foreign need as measured by per capita income is also a factor, whereas good governance by and large does not matter. These results suggest that BIT programs can be explained using the same framework successfully applied to the allocation of aid. At the same time, self-interest seems to be substantively more important than developing country need when it comes to BITs. [source] Familial multiple coagulation factor deficiencies , chance associations and distinct clinical disordersHAEMOPHILIA, Issue 1 2009P. J. ROBSON Summary., The familial multiple coagulation factor deficiencies (FMCFDs) are a group of rare haemostatic disorders of genetic origin in which there is reduced plasma activity of more than one coagulation factor. FMCFDs may arise from co-incidental inheritance of separate coagulation factor deficiencies or from a single genetic or cytogenetic defect. All the FMCFDs present significant challenges in diagnosis and management yet there is little systematic evidence with which to guide clinical practice. This review summarizes the historical literature that describes the FMCFDs and introduces a refined classification of these disorders. The clinical and laboratory characteristics of the most common FMCFDs are considered in detail. [source] Money with a Mean Streak?INTERNATIONAL STUDIES QUARTERLY, Issue 2 2001Foreign Economic Penetration, Government Respect for Human Rights in Developing Countries This study examines the relationship between foreign economic capital and the level of government respect for two types of human rights in developing countries. Two opposing schools of thought offer explanations as to what this relationship might be like. According to the liberal neoclassical school, the acceptance of liberal economic doctrine will provide positive political benefits to developing countries. The "dependency" school, on the other hand, argues that because ties between core and periphery elites give governments in developing nations an incentive to repress, human rights conditions will worsen as foreign economic penetration increases. The results of previous empirical queries into this matter have been mixed. In contrast to most studies, we focus on a broader measure of foreign economic capital, including foreign direct investment, portfolio investment, debt, and official development assistance. Using ordered logit analysis on a cross-national sample of forty-three developing countries from 1981 to 1995, we discover systematic evidence of an association between foreign economic penetration and government respect for two types of human rights, physical integrity rights and political rights and civil liberties. Of particular interest is the finding that both foreign direct investment and portfolio investment are reliably associated with increased government respect for human rights. [source] Compliance with the Disclosure Requirements of Germany's New Market: IAS Versus US GAAPJOURNAL OF INTERNATIONAL FINANCIAL MANAGEMENT & ACCOUNTING, Issue 1 2003Martin Glaum This research examines compliance with both International Accounting Standards (IAS) and United States Generally Accepted Accounting Principles (US GAAP) for companies listed on Germany's New Market. Based on a sample of 100 firms that apply IAS and 100 that apply US GAAP, we investigate the extent to which companies comply with IAS and US GAAP disclosure requirements in their year,2000 financial statements. Compliance levels range from 100% to 41.6%, with an average of 83.7%. The average compliance level is significantly lower for companies that apply IAS as compared to companies applying US GAAP. This study provides the first systematic evidence regarding the enforcement of US GAAP outside the US, and accordingly not subject to Securities Exchange Commission (SEC) review. The results unveil a considerable extent of non,compliance. The overall level of compliance with IAS and US GAAP disclosures is positively related to firms being audited by Big 5 auditing firms and to cross,listings on US exchanges. Compliance is also associated with references to the use of International Standards of Auditing (ISA) or US GAAS in the audit opinion. The findings add to the growing concerns regarding the lack of effective supervision in the German capital market. [source] Clinical Judgment Versus Decision Analysis for Managing Device AdvisoriesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2008MITESH S. AMIN M.D. Introduction: Implantable cardioverter-defibrillator (ICD) and pacemaker (PM) advisories may have a significant impact on patient management. Surveys of clinical practice have shown a great deal of variability in patient management after a device advisory. We compared our management of consecutive patients in a single large university practice with device advisories to the "best" patient management strategy predicted by a decision analysis model. Methods: We performed a retrospective review of all patients who had implanted devices affected by an advisory at our medical center between March 2005 and May 2006 and compared our actual patient management strategy with that subsequently predicted by a decision analysis model. Results: Over 14 months, 11 advisories from three different manufacturers affected 436 patients. Twelve patients (2.8%) were deceased and 39 patients (8.9%) were followed at outside facilities. Management of the 385 remaining patients varied based on type of malfunction or potential malfunction, manufacturer recommendations, device dependency, and patient or physician preferences. Management consisted of the following: 57 device replacements (15.2%), 44 devices reprogrammed or magnets issued (11.7%), and 268 patients underwent more frequent follow-up (71.3%). No major complications, related to device malfunction or device replacement, occurred among any patient affected with a device advisory. Concordance between the decision analysis model and our management strategy occurred in 57.1% of cases and 25 devices were replaced when it was not the preferred treatment strategy predicted by the decision model (43.9%, 37.3% when excluding devices replaced based on patient preference). The decision analysis favored replacement for all patients with PM dependency, but only for four patients with ICDs for secondary prevention. No devices were left implanted that the decision analysis model predicted should have been replaced. Conclusions: We found that despite a fairly conservative device replacement strategy for advisories, we still replaced more devices when it was not the preferred device management strategy predicted by a decision analysis model. This study demonstrates that even when risks and benefits are being considered by experienced clinicians, a formal decision analysis can help to develop a systematic evidence based approach and potentially avoid unnecessary procedures. [source] Personifying the State: Consequences for Attitude FormationPOLITICAL PSYCHOLOGY, Issue 3 2007Kathleen M. McGraw Because states are abstract entities, they often require embodiment for mass publics and elites to understand them. This embodiment often occurs as personification, where the state is associated with the most salient figure in the political system, but embodiment can also occur through political institutions and social groups. Surprisingly, there is virtually no systematic empirical work on the political and psychological consequences of state personification, or other forms of embodiment. In this experiment, we investigate how various ways of embodying the state influence attitude formation processes. Drawing on the on-line/memory-based processing and entitativity literatures, we hypothesize that personification of the state should facilitate on-line processing and stronger attitudes, whereas embodying the state as a parliamentary institution should produce weaker attitudes that are formed in a memory-based fashion. The results support these hypotheses. Embodiment as a social group produced inconsistent results. This study provides the first systematic evidence that the widespread practice of personification of the state has robust and potentially far-reaching attitudinal consequences that have meaningful implications for strategic interaction, perception and learning, and attitude change in the international realm. [source] Who Learns from What in Policy Diffusion Processes?AMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 3 2010Fabrizio Gilardi The idea that policy makers in different states or countries may learn from one another has fascinated scholars for a long time, but little systematic evidence has been produced so far. This article improves our understanding of this elusive argument by distinguishing between the,policy,and,political,consequences of reforms and by emphasizing the conditional nature of learning processes. Using a directed dyadic approach and multilevel methods, the analysis of unemployment benefits retrenchment in OECD countries demonstrates that policy makers learn selectively from the experience of others. Right governments tend to be more sensitive to information on the electoral consequences of reforms, while left governments are more likely to be influenced by their policy effects. [source] Randomized trial of vein versus dacron patching during carotid endarterectomyBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2001P. D. Hayes Background: A recent overview has indicated that, while routine patching is safer than primary closure following carotid endarterectomy (CEA), there is no systematic evidence that patch type influences outcome. Most surgeons perceive that prosthetic patches are more thrombogenic than vein patches. This study tested the hypothesis that it is the patient who is prothrombotic rather than the nature of the patch. Methods: Some 274 patients undergoing 276 CEAs were randomized to either dacron (Du Pont, Stevenage, UK) patch closure (n = 137) or vein patch closure (n = 139). All patients with an accessible cranial window were monitored for 3 h after operation using transcranial Doppler (TCD) ultrasonography. The number and rate of embolizations were quantified, together with the requirement for selective dextran therapy to control high rates of postoperative embolization. All patients were assessed after operation and again at 30 days by a neurologist, and all underwent duplex imaging at 30 days. Results: The 30-day death or any stroke rate was 2·2 per cent for dacron-patched patients and 3·6 per cent for vein-patched patients (P = 0·72). Dacron-patched patients had a higher incidence of postoperative emboli (median 5 (interquartile range 0,10·5)), compared with a median of 3 (interquartile range 1,17) for vein (P = 0·028). However, the incidence of detecting more than 50 emboli was virtually identical and patch type had no effect on the incidence of sustained high-rate embolization requiring dextran therapy (5·3 per cent for dacron versus 3·7 per cent for vein). No patient had a carotid thrombosis at 30 days. Conclusion: Sustained high-rate embolization, previously shown to be highly predictive of progression to carotid thrombosis, appears to be patient dependent rather than related to patch type. © 2001 British Journal of Surgery Society Ltd [source] Can Young Infants Add and Subtract?CHILD DEVELOPMENT, Issue 6 2000Ann Wakeley Three experiments (N= 68), using Wynn's procedure, tested 5-month-old infants' looking time reactions to correct and incorrect results of simple addition and subtraction transformations. The aim was to investigate both the robustness and the parameters of infants' arithmetic competence. Experiments 1 and 2 (N= 44) were replications of Wynn's first two experiments in which infants were shown addition (1 + 1 = 1 or 2) and subtraction (2 , 1 = 1 or 2) requiring imprecise calculation. Experiment 3 (N= 24) was a subtraction counterpart (3 , 1 = 1 or 2) to Wynn's third experiment requiring precise calculation of addition (1 + 1 = 2 or 3). Unlike Wynn, we found no systematic evidence of either imprecise or precise adding and subtracting in young infants. Our results, together with the mix of both positive and negative findings from other studies of infant arithmetic, suggest that infants' reactions to displays of adding and subtracting are variable and, therefore, that infants' numerical competencies are not robust. This conclusion is consistent with previous findings indicating that simple adding and subtracting develops gradually and continuously throughout infancy and early childhood. [source] | ||||||||||||||||||||||