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Keith, Andrew, Darryl Ahner e Nicole Curtis. "Evaluation theory and its application to military assessments". Journal of Defense Modeling and Simulation: Applications, Methodology, Technology 16, n. 4 (8 marzo 2019): 305–22. http://dx.doi.org/10.1177/1548512919834670.
Testo completoAbstract (sommario):
Evaluation theory provides a rigorous foundation for the practice of military operation assessment. Government and industry assessors have used evaluation theory to improve the effectiveness of assessment across a wide range of fields. This article focuses on the relationship between evaluation theory and military assessment. We briefly survey the major evaluation approaches with a focus on connecting the theoretical models to practical security-related applications. These evaluation approaches include expertise-oriented, program-oriented, decision-oriented, and participant-oriented models. Within the overarching framework of these approaches, we consider alternative monitoring and evaluation designs in detail, including descriptive designs (case study, cross-sectional, time-series), quasi-experimental designs (interrupted time-series, comparison group, case study), and experimental designs (posttest-only, pre-post). Then, we discuss quantitative and qualitative methods for analyzing and reporting uncertainty with respect to each design alternative, with an emphasis on mixed-method approaches. Throughout the review, we make the relationship between evaluation theory and operation assessment practice explicit through examples, and we suggest more detailed references where appropriate.
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Brewer, Britton W., e Robert Shillinglaw. "Evaluation of a Psychological Skills Training Workshop for Male Intercollegiate Lacrosse Players". Sport Psychologist 6, n. 2 (giugno 1992): 139–47. http://dx.doi.org/10.1123/tsp.6.2.139.
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This study evaluated the effects of a four-session psychological skills training (PST) workshop on self-reported knowledge, perceived importance, and use of goal setting, relaxation, imagery, and cognitive restructuring in a sample of male intercollegiate lacrosse players (n=49). In an interrupted time-series design with switching replications, subjects were randomly assigned to one of two groups. Self-report data were collected on three occasions at 2-week intervals. Group 1 received PST during the first 2-week interval and Group 2 received PST during the second 2-week interval. The overall effectiveness of the PST workshop was supported by both between-subjects and within-subjects analyses. This study illustrates that controlled research can viably and ethically be conducted in applied sport settings. Limitations of the current study and directions for future PST outcome research are discussed.
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McDowell, Ronald D., Kathleen Bennett, Frank Moriarty, Sarah Clarke, Michael Barry e Tom Fahey. "Prescriber Variation in Relation to Prescribing Trends within the Preferred Drugs Initiative in Ireland (2012–2015): An Interrupted Time-Series Study Using Latent Curve Models". Medical Decision Making 39, n. 3 (9 febbraio 2019): 278–93. http://dx.doi.org/10.1177/0272989x18818165.
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Objectives. To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at reducing prescribing variation. Design. Interrupted time series spanning 2012 to 2015. Setting. Health Service Executive pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population. Participants. Prescribers issuing preferred drug group items to GMS adults before and after PDI guidelines. Primary Outcome. The percentage coverage of PDI medications within each drug class per calendar quarter per prescriber. Methods. Latent curve models with structured residuals (LCM-SRs) were used to model coverage of the preferred drugs over time. The number of GMS adults receiving medication and the percentage who were 65 years and older at the start of the study were included as covariates. Results. In the quarter following PDI guidelines, coverage of the preferred drugs increased most in absolute terms for proton pump inhibitors (PPIs) (1.50% [SE 0.15], P < 0.001) and selective and norepinephrine reuptake inhibitors (SNRIs) (1.17% [SE 0.26], P < 0.001). Variation between prescribers remained relatively unchanged and increased for urology medications. Prescribers who increased coverage of the preferred PPI also increased coverage of the preferred statin immediately following guidelines (correlation 0.47 [SE 0.13], P < 0.001). Where guidelines were disseminated simultaneously, coverage of one preferred drug did not significantly predict coverage of the other preferred drug in the next calendar quarter. Prescribing of preferred drugs was not moderated by prescriber-level factors. Conclusions. Modest changes in prescribing of the preferred drugs have been observed over the course of the PDI. However, the guidelines have had little impact in reducing variation between prescribers. Further strategies may be necessary to reduce variation in clinical practice and enhance patient care.
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Yash Pal, Rakhee, Win Sen Kuan, Ling Tiah, Ranjeev Kumar, Yoko Kin Yoke Wong, Luming Shi, Charles Qishi Zheng et al. "End-of-life management protocol offered within emergency room (EMPOWER): study protocol for a multicentre study". BMJ Open 10, n. 4 (aprile 2020): e036598. http://dx.doi.org/10.1136/bmjopen-2019-036598.
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BackgroundPatients at their end-of-life (EOL) phase frequently visit the emergency department (ED) due to their symptoms, yet the environment and physicians in ED are not traditionally equipped or trained to provide palliative care. This multicentre study aims to measure the current quality of EOL care in ED to identify gaps, formulate improvements and implement the improved EOL care protocol. We shall also evaluate healthcare resource utilisation and its associated costs.Methods and analysisThis study employs a quasiexperimental interrupted time series design using both qualitative and quantitative methods, involving the EDs of three tertiary hospitals in Singapore, over a period of 3 years. There are five phases in this study: (1) retrospective chart reviews of patients who died within 5 days of ED attendance; (2) pilot phase to validate the CODE questionnaire in the local context; (3) preimplementation phase; (4) focus group discussions (FGDs); and (5) postimplementation phase. In the prospective cohort, patients who are actively dying or have high likelihood of mortality this admission, and whose goal of care is palliation, will be eligible for inclusion. At least 140 patients will be recruited for each preimplementation and postimplementation phase. There will be face-to-face interviews with patients’ family members, review of medical records and self-administered staff survey to evaluate existing knowledge and confidence. The FGDs will involve hospital and community healthcare providers. Data obtained from the retrospective cohort, preimplementation phase and FGDs will be used to guide prospective improvement and protocol changes. Patient, family and staff relevant outcomes from these changes will be measured using time series regression.Ethics and disseminationThe study protocol has been reviewed and ethics approval obtained from the National Healthcare Group Domain Specific Review Board, Singapore. The results from this study will be actively disseminated through manuscript publications and conference presentations.Trial registration numberNCT03906747.
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Kwasnicka, Dominika, Aleksandra Luszczynska, Martin S. Hagger, Eleanor Quested, Sherry L. Pagoto, Peter Verboon, Suzanne Robinson et al. "Theory-based digital intervention to promote weight loss and weight loss maintenance (Choosing Health): protocol for a randomised controlled trial". BMJ Open 10, n. 11 (novembre 2020): e040183. http://dx.doi.org/10.1136/bmjopen-2020-040183.
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IntroductionDigital behavioural weight loss interventions have the potential to improve public health; however, these interventions are often not adequately tailored to the needs of the participants. This is the protocol for a trial that aims to determine the effectiveness and cost-effectiveness of the Choosing Health programme as a means to promote weight loss and weight loss maintenance among overweight/obese adults.Methods and analysisThe proposed study is a two-group randomised controlled trial with a nested interrupted time series (ITS) within-person design. Participants (n=285) will be randomly assigned to either the Choosing Health digital intervention or a control group. For intervention participants, ecological momentary assessment will be used to identify behavioural determinants for each individual in order to tailor evidence-based behaviour change techniques and intervention content.Control group participants will receive non-tailored weight loss advice via e-book and generic emails. The primary outcome is the mean difference in weight loss between groups at 6 months controlled for baseline. Secondary outcomes include blood pressure and percentage of body fat; self-reported measures of physical activity, sitting time, quality of life, cost and theory-derived correlates of weight loss. Secondary outcomes will be measured at baseline, 3, 6 and 12 months. The primary outcome for ITS will be daily weight loss plan adherence. Data will be analysed using regression and time series analyses.Ethics and disseminationEthics approval was granted by Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland, approval number 03/P/12/2019. The project results will be disseminated through structured strategy implemented in collaboration with the Ministry of Health.Trial registration detailsThis trial was registered with www.clinicaltrials.gov; registration number NCT04291482.
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Schwalm, J. D., Noah M. Ivers, Zachary Bouck, Monica Taljaard, Madhu K. Natarajan, Lisa Dolovich, Kednapa Thavorn, Tara McCready, Erin O'Brien e Jeremy M. Grimshaw. "Length of Initial Prescription at Hospital Discharge and Long-Term Medication Adherence for Elderly, Post-Myocardial Infarction Patients: Protocol for an Interrupted Time Series Study". JMIR Research Protocols 9, n. 11 (4 novembre 2020): e18981. http://dx.doi.org/10.2196/18981.
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Background Based on high-quality evidence, guidelines recommend the long-term use of secondary prevention medications post-myocardial infarction (MI) to avoid recurrent cardiovascular events and death. Unfortunately, discontinuation of recommended medications post-MI is common. Observational evidence suggests that prescriptions covering a longer duration at discharge from hospital are associated with greater long-term medication adherence. The following is a proposal for the first interventional study to evaluate the impact of longer prescription duration at discharge post-MI on long-term medication adherence. Objective The overarching goal of this study is to reduce morbidity and mortality among post-MI patients through improved long-term cardiac medication adherence. The specific objectives include the following. First, we will assess whether long-term cardiac medication adherence improves among elderly, post-MI patients following the implementation of (1) standardized discharge prescription forms with 90-day prescriptions and 3 repeats for recommended cardiac medication classes, in combination with education and (2) education alone compared to (3) usual care. Second, we will assess the cost implications of prolonged initial discharge prescriptions compared with usual care. Third, we will compare clinical outcomes between longer (>60 days) versus shorter prescription durations. Fourth, we will collect baseline information to inform a multicenter interventional study. Methods We will conduct a quasiexperimental, interrupted time series design to evaluate the impact of a multifaceted intervention to implement longer duration prescriptions versus usual care on long-term cardiac medication adherence among post-MI patients. Intervention groups and their corresponding settings include: (1) intervention group 1: 1 cardiac center and 1 noncardiac hospital allocated to receive standardized discharge prescription forms supporting the dispensation of 90 days’ worth of cardiac medications with 3 repeats, coupled with education; (2) intervention group 2: 4 sites (including 1 cardiac center) allocated to receive education only; and (3) control group: all remaining hospitals within the province that did not receive an intervention (ie, usual care). Administrative databases will be used to measure all outcomes. Adherence to 4 classes of cardiac medications — statins, beta blockers, angiotensin system inhibitors, and secondary antiplatelets (ie, prasugrel, clopidogrel, or ticagrelor) — will be assessed. Results Enrollment began in September 2017, and results are expected to be analyzed in late 2020. Conclusions The results have the potential to redefine best practices regarding discharge prescribing policies for patients post-MI. A policy of standardized maximum-duration prescriptions at the time of discharge post-MI is a simple intervention that has the potential to significantly improve long-term medication adherence, thus decreasing cardiac morbidity and mortality. If effective, this low-cost intervention to implement longer duration prescriptions post-MI could be easily scaled. Trial Registration ClinicalTrials.gov NCT03257579; https://clinicaltrials.gov/ct2/show/NCT03257579 International Registered Report Identifier (IRRID) DERR1-10.2196/18981
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Linden, Ariel. "Persistent threats to validity in single‐group interrupted time series analysis with a cross over design". Journal of Evaluation in Clinical Practice 23, n. 2 (novembre 2016): 419–25. http://dx.doi.org/10.1111/jep.12668.
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Mbuagbaw, Lawrence, Carmen H. Logie, Lehana Thabane, Fiona Smaill, Marek Smieja, Ann N. Burchell, Beth Rachlis et al. "The impact of routine HIV drug resistance testing in Ontario: A controlled interrupted time series study". PLOS ONE 16, n. 4 (2 aprile 2021): e0246766. http://dx.doi.org/10.1371/journal.pone.0246766.
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Background Knowledge of HIV drug resistance informs the choice of regimens and ensures that the most efficacious options are selected. In January 2014, a policy change to routine resistance testing was implemented in Ontario, Canada. The objective of this study was to investigate the policy change impact of routine resistance testing in people with HIV in Ontario, Canada since January 2014. Methods We used data on people with HIV living in Ontario from administrative databases of the Institute for Clinical Evaluative Sciences (ICES) and Public Health Ontario (PHO), and ran ordinary least squares (OLS) models of interrupted time series to measure the levels and trends of 2-year mortality, 2-year hospitalizations and 2-year emergency department visits before (2005–2013) and after the policy change (2014–2017). Outcomes were collected in biannual periods, generating 18 periods before the intervention and 8 periods after. We included a control series of people who did not receive a resistance test within 3 months of HIV diagnosis. Results Data included 12,996 people with HIV, of which 8881 (68.3%) were diagnosed between 2005 and 2013, and 4115 (31.7%) were diagnosed between 2014 and 2017. Policy change to routine resistance testing within 3 months of HIV diagnosis led to a decreasing trend in 2-year mortality of 0.8% every six months compared to the control group. No significant differences in hospitalizations or emergency department visits were noted. Interpretation The policy of routine resistance testing within three months of diagnosis is beneficial at the population level.
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Wong, Rosa Sze Man, Frederick Ka Wing Ho, Keith Tsz Suen Tung, King-Wa Fu e Patrick Ip. "Effect of Pokémon Go on Self-Harm Using Population-Based Interrupted Time-Series Analysis: Quasi-Experimental Study". JMIR Serious Games 8, n. 2 (12 giugno 2020): e17112. http://dx.doi.org/10.2196/17112.
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Background Pokémon Go is a very popular location-based augmented reality game with widespread influences over the world. An emerging body of research demonstrates that playing Pokémon Go can lead to improvements in physical activity and psychosocial well-being; however, whether Pokémon Go reduces self-harm incidence at the population-level is still questionable. Objective This study aimed to quantify how the launch of Pokémon Go in Hong Kong affected the incidence of self-harm using a quasi-experimental design. Methods An interrupted time-series design with Poisson segmented regression adjusted for time and seasonality trends was used on data from 2012 to 2018 to detect any changes in the number of accident and emergency attendances due to self-harm, after Pokémon Go was launched. The findings were validated using a baseline control period and using other intentional injuries and minor noninjuries as control outcomes. We also assessed intervention effects by age group. Results From January 1, 2012 to July 31, 2018, there were 13,463 accident and emergency attendances due to self-harm in Hong Kong. During the period after launching Pokémon Go, self-harm attendances dropped by 34% (adjusted incidence rate ratio: 0.66, 95% CI 0.61-0.73). When analyzed by age group, a reduction in self-harm incidence was only apparent in adults (18 to 24 years of age: adjusted incidence rate ratio: 0.78, P=.02; 25 to 39 years of age: adjusted incidence rate ratio: 0.75, P<.001; 40 years of age and older: adjusted incidence rate ratio: 0.57, P<.001). Conclusions Self-harm incidence in the population, particularly in adults, showed a significant decline in the period after Pokémon Go was launched. Augmented reality games such as Pokémon Go show great promise as a tool to enhance psychosocial well-being and improve mental health.
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Etminani, Kobra, Carina Göransson, Alexander Galozy, Margaretha Norell Pejner e Sławomir Nowaczyk. "Improving Medication Adherence Through Adaptive Digital Interventions (iMedA) in Patients With Hypertension: Protocol for an Interrupted Time Series Study". JMIR Research Protocols 10, n. 5 (12 maggio 2021): e24494. http://dx.doi.org/10.2196/24494.
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Background There is a strong need to improve medication adherence (MA) for individuals with hypertension in order to reduce long-term hospitalization costs. We believe this can be achieved through an artificial intelligence agent that helps the patient in understanding key individual adherence risk factors and designing an appropriate intervention plan. The incidence of hypertension in Sweden is estimated at approximately 27%. Although blood pressure control has increased in Sweden, barely half of the treated patients achieved adequate blood pressure levels. It is a major risk factor for coronary heart disease and stroke as well as heart failure. MA is a key factor for good clinical outcomes in persons with hypertension. Objective The overall aim of this study is to design, develop, test, and evaluate an adaptive digital intervention called iMedA, delivered via a mobile app to improve MA, self-care management, and blood pressure control for persons with hypertension. Methods The study design is an interrupted time series. We will collect data on a daily basis, 14 days before, during 6 months of delivering digital interventions through the mobile app, and 14 days after. The effect will be analyzed using segmented regression analysis. The participants will be recruited in Region Halland, Sweden. The design of the digital interventions follows the just-in-time adaptive intervention framework. The primary (distal) outcome is MA, and the secondary outcome is blood pressure. The design of the digital intervention is developed based on a needs assessment process including a systematic review, focus group interviews, and a pilot study, before conducting the longitudinal interrupted time series study. Results The focus groups of persons with hypertension have been conducted to perform the needs assessment in a Swedish context. The design and development of digital interventions are in progress, and the interventions are planned to be ready in November 2020. Then, the 2-week pilot study for usability evaluation will start, and the interrupted time series study, which we plan to start in February 2021, will follow it. Conclusions We hypothesize that iMedA will improve medication adherence and self-care management. This study could illustrate how self-care management tools can be an additional (digital) treatment support to a clinical one without increasing burden on health care staff. Trial Registration ClinicalTrials.gov NCT04413500; https://clinicaltrials.gov/ct2/show/NCT04413500 International Registered Report Identifier (IRRID) DERR1-10.2196/24494
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Tonta, Yaşar. "Does Monetary Support Increase the Number of Scientific Papers? An Interrupted Time Series Analysis". Journal of Data and Information Science 3, n. 1 (13 marzo 2018): 19–39. http://dx.doi.org/10.2478/jdis-2018-0002.
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Abstract Purpose One of the main indicators of scientific production is the number of papers published in scholarly journals. Turkey ranks 18th place in the world based on the number of scholarly publications. The objective of this paper is to find out if the monetary support program initiated in 1993 by the Turkish Scientific and Technological Research Council (TÜBİTAK) to incentivize researchers and increase the number, impact, and quality of international publications has been effective in doing so. Design/methodology/approach We analyzed some 390,000 publications with Turkish affiliations listed in the Web of Science (WoS) database between 1976 and 2015 along with about 157,000 supported ones between 1997 and 2015. We used the interrupted time series (ITS) analysis technique (also known as “quasi-experimental time series analysis” or “intervention analysis”) to test if TÜBİTAK’s support program helped increase the number of publications. We defined ARIMA (1,1,0) model for ITS data and observed the impact of TÜBİTAK’s support program in 1994, 1997, and 2003 (after one, four and 10 years of its start, respectively). The majority of publications (93%) were full papers (articles), which were used as the experimental group while other types of contributions functioned as the control group. We also carried out a multiple regression analysis. Findings TÜBİTAK’s support program has had negligible effect on the increase of the number of papers with Turkish affiliations. Yet, the number of other types of contributions continued to increase even though they were not well supported, suggesting that TÜBİTAK’s support program is probably not the main factor causing the increase in the number of papers with Turkish affiliations. Research limitations Interrupted time series analysis shows if the “intervention” has had any significant effect on the dependent variable but it does not explain what caused the increase in the number of papers if it was not the intervention. Moreover, except the “intervention”, other “event(s)” that might affect the time series data (e.g., increase in the number of research personnel over the years) should not occur during the period of analysis, a prerequisite that is beyond the control of the researcher. Practical implications TÜBİTAK’s “cash-for-publication” program did not seem to have direct impact on the increase of the number of papers published by Turkish authors, suggesting that small amounts of payments are not much of an incentive for authors to publish more. It might perhaps be a better strategy to concentrate limited resources on a few high impact projects rather than to disperse them to thousands of authors as “micropayments.” Originality/value Based on 25 years’ worth of payments data, this is perhaps one of the first large-scale studies showing that “cash-for-publication” policies or “piece rates” paid to researchers tend to have little or no effect on the increase of researchers’ productivity. The main finding of this paper has some implications for countries wherein publication subsidies are used as an incentive to increase the number and quality of papers published in international journals. They should be prepared to consider reviewing their existing support programs (based usually on bibliometric measures such as journal impact factors) and revising their reward policies.
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Carson, Jennifer V., e Ashley P. Wellman. "Problem-Oriented Policing in Suburban Low-Income Housing: A Quasi-Experiment". Police Quarterly 21, n. 2 (6 dicembre 2017): 139–70. http://dx.doi.org/10.1177/1098611117744005.
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Informed by the literature on prior problem-oriented policing evaluations, this study evaluated a response within a suburban public housing unit. Specifically, we examined the Crime Response Team (CRT), a multifaceted intervention, in relation to disaggregated calls for service and reported crime. We utilized a quasi-experimental design combining interrupted time-series analysis (ARIMAX) and series hazard models in order to assess the intervention’s effect. A possible diffusion site and two pseudointervention sites were also included for comparison purposes. This investigation yielded largely negligible effects, which we primarily attributed to a mismatch between administrative-led initiatives and program execution.
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Fielding, Shona, Paul Alexander Tiffin, Rachel Greatrix, Amanda J. Lee, Fiona Patterson, Sandra Nicholson e Jennifer Cleland. "Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis". BMJ Open 8, n. 10 (ottobre 2018): e023274. http://dx.doi.org/10.1136/bmjopen-2018-023274.
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IntroductionMedical admissions must balance two potentially competing missions: to select those who will be successful medical students and clinicians and to increase the diversity of the medical school population and workforce. Many countries address this dilemma by reducing the heavy reliance on prior educational attainment, complementing this with other selection tools. However, evidence to what extent this shift in practice has actually widened access is conflicting.AimTo examine if changes in medical school selection processes significantly impact on the composition of the student population.Design and settingObservational study of medical students from 18 UK 5-year medical programmes who took the UK Clinical Aptitude Test from 2007 to 2014; detailed analysis on four schools.Primary outcomeProportion of admissions to medical school for four target groups (lower socioeconomic classes, non-selective schooling, non-white and male).Data analysisInterrupted time-series framework with segmented regression was used to identify the impact of changes in selection practices in relation to invitation to interview to medical school. Four case study medical schools were used looking at admissions within for the four target groups.ResultsThere were no obvious changes in the overall proportion of admissions from each target group over the 8-year period, averaging at 3.3% lower socioeconomic group, 51.5% non-selective school, 30.5% non-white and 43.8% male. Each case study school changed their selection practice in decision making for invite to interview during 2007–2014. Yet, this within-school variation made little difference locally, and changes in admission practices did not lead to any discernible change in the demography of those accepted into medical school.ConclusionAlthough our case schools changed their selection procedures, these changes did not lead to any observable differences in their student populations. Increasing the diversity of medical students, and hence the medical profession, may require different, perhaps more radical, approaches to selection.
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Riggs, Elisha, Jane Yelland, Fiona K. Mensah, Lisa Gold, Josef Szwarc, Ida Kaplan, Rhonda Small et al. "Group Pregnancy Care for refugee background women: a codesigned, multimethod evaluation protocol applying a community engagement framework and an interrupted time series design". BMJ Open 11, n. 7 (luglio 2021): e048271. http://dx.doi.org/10.1136/bmjopen-2020-048271.
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IntroductionPregnancy and early parenthood are key opportunities for interaction with health services and connecting to other families at the same life stage. Public antenatal care should be accessible to all, however barriers persist for families from refugee communities to access, navigate and optimise healthcare during pregnancy. Group Pregnancy Care is an innovative model of care codesigned with a community from a refugee background and other key stakeholders in Melbourne, Australia. Group Pregnancy Care aims to provide a culturally safe and supportive environment for women to participate in antenatal care in a language they understand, to improve health literacy and promote social connections and inclusion. This paper outlines Froup Pregnancy Care and provides details of the evaluation framework.Methods and analysisThe evaluation uses community-based participatory research methods to engage stakeholders in codesign of evaluation methods. The study is being conducted across multiple sites and involves multiple phases, use of quantitative and qualitative methods, and an interrupted time series design. Process and cost-effectiveness measures will be incorporated into quality improvement cycles. Evaluation measures will be developed using codesign and participatory principles informed by community and stakeholder engagement and will be piloted prior to implementation.Ethics and disseminationEthics approvals have been provided by all six relevant authorities. Study findings will be shared with communities and stakeholders via agreed pathways including community forums, partnership meetings, conferences, policy and practice briefs and journal articles. Dissemination activities will be developed using codesign and participatory principles.
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Putra, Edwindhana Mareza, Dany M. Handarini e Muslihati Muslihati. "Keefektifan Achievement Motivation Training untuk Meningkatkan Motivasi Berprestasi Siswa Sekolah Menengah Pertama". Jurnal Kajian Bimbingan dan Konseling 4, n. 2 (28 giugno 2019): 62. http://dx.doi.org/10.17977/um001v4i22019p062.
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Abstract: The particular study aimed to determine the effectiveness of achievement motivation training (AMT) in increasing the achievement motivation of junior high school students. The study used an interrupted time-series design which conducted on an intact group consisting of eight subjects. Data measurements carried out three times in the pre-test and post-test conditions with six forms of achievement motivation scale. The AMT intervention in the psychoeducation frame consists of two strategies, namely achievement thinking and action strategies which are carried out in 12 sessions. The results showed that there is a difference between achievement motivation scores before and after AMT interventions.Abstrak: Penelitian ini bertujuan untuk mengetahui keefektifan achievement motivation training (AMT) dalam meningkatkan motivasi berprestasi siswa sekolah menengah pertama (SMP). Penelitian ini menggunakan desain interrupted time series yang dilakukan pada kelompok intak yang terdiri dari delapan subjek. Pengukuran data dilakukan sebanyak tiga kali pada kondisi pre-test dan kondisi post-test dengan enam bentuk skala motivasi berprestasi. Intervensi AMT dalam bingkai psikoedukasi terdiri dari dua strategi yaitu achievement thinking dan action strategies yang dilakukan dalam 12 sesi pertemuan. Hasil menunjukkan terdapat perbedaan antara skor motivasi berprestasi sebelum dan sesudah diberikan intervensi AMT.
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Fettig, Angel, e Michaelene M. Ostrosky. "Functional Assessment Based Parent Intervention in Reducing Children’s Challenging Behaviors: Exploratory Study of Group Training". Child Development Research 2014 (16 dicembre 2014): 1–11. http://dx.doi.org/10.1155/2014/656327.
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This study examined the effects of group parent training on children’s challenging behaviors in home settings. Eight parents of young children with challenging behaviors were trained in a large group setting on using functional assessment to design interventions that fit the strengths and needs of individual families. The training included information sharing and collaborating with parents on designing functional-assessment based interventions. An Interrupted Time Series Design was used to examine the effects of large group training by comparing parent and child behaviors prior to intervention with behaviors after the intervention. Data were analyzed using Repeated Measures ANOVA. The results indicated that group training increased parents’ ability to implement functional assessment based strategies and these strategies resulted in a significant reduction in children’s challenging behaviors. Furthermore, parent implementation of functional assessment based strategies and children’s decreased levels of challenging behaviors were maintained after the completion of the intervention.
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Rimondini, M., L. Del Piccolo, C. Goss, M. Mazzi, M. Paccaloni e C. Zimmermann. "The evaluation of training in patient-centred interviewing skills for psychiatric residents". Psychological Medicine 40, n. 3 (23 luglio 2009): 467–76. http://dx.doi.org/10.1017/s0033291709990730.
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BackgroundCommunication skills are considered ‘core skills’ in the curriculum of psychiatry but studies evaluating the effectiveness of a time-limited training course in interviewing skills in psychiatry have remained rare. The aim was to assess the effectiveness of training in patient-centred interviewing on the interview performance of psychiatric residents.MethodPsychiatric residents (n=10) each interviewed 12 different anonymized standardized patients (SPs), eight before and another four after training. SPs simulated psychiatric out-patients who attended for a first visit to the psychiatric out-patient clinic. The consultations were videotaped, transcribed and coded with a classification scheme developed for psychiatric consultations from which an interview performance index was derived. An interrupted time-series design and a segmented regression analysis with multilevel analysis explored the performance trend within the series of consultations.ResultsThe regression model evidenced a horizontal slope at pre- and post-training, with a significant level change. These findings excluded the presence of a practice effect and indicated a significant effect of training. Performance variability between and within residents over the series of consultations increased at post-training.ConclusionsThe training improved patient-centred interviewing performance. More post-training exercise time and supervised practice are necessary to establish consistent performance patterns at a higher skill level.
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Nomi, Takako. "The Unintended Consequences of an Algebra-for-All Policy on High-Skill Students". Educational Evaluation and Policy Analysis 34, n. 4 (dicembre 2012): 489–505. http://dx.doi.org/10.3102/0162373712453869.
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In 1997, Chicago implemented a policy that required algebra for all ninth-grade students, eliminating all remedial coursework. This policy increased opportunities to take algebra for low-skill students who had previously enrolled in remedial math. However, little is known about how schools respond to the policy in terms of organizing math classrooms to accommodate curricular changes. The policy unintentionally affected high-skill students who were not targeted by the policy—those who would enroll in algebra in its absence. Using an interrupted time-series design combined with within-cohort comparisons, this study shows that schools created more mixed-ability classrooms when eliminating remedial math classes, and peer skill levels declined for high-skill students. Consequently, their test scores also declined.
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Rezel-Potts, Emma, Veline L’Esperance e Martin C. Gulliford. "Antimicrobial stewardship in the UK during the COVID-19 pandemic: a population-based cohort study and interrupted time-series analysis". British Journal of General Practice 71, n. 706 (9 marzo 2021): e331-e338. http://dx.doi.org/10.3399/bjgp.2020.1051.
Testo completoAbstract (sommario):
BackgroundThe COVID-19 pandemic has altered the context for antimicrobial stewardship in primary care.AimTo assess the effect of the pandemic on antibiotic prescribing, accounting for changes in consultations for respiratory and urinary tract infections (RTIs/UTIs).Design and settingPopulation-based cohort study using the UK Clinical Practice Research Datalink (CPRD) GOLD database from January 2017 to September 2020.MethodInterrupted time-series analysis evaluated changes in antibiotic prescribing and RTI/UTI consultations adjusting for age, sex, season, and secular trends. The authors assessed the proportion of COVID-19 episodes associated with antibiotic prescribing.ResultsThere were 253 655 registered patients in 2017 and 232 218 in 2020, with 559 461 antibiotic prescriptions, 216 110 RTI consultations, and 36 402 UTI consultations. Compared with prepandemic months, March 2020 was associated with higher antibiotic prescribing (adjusted rate ratio [ARR] 1.13; 95% confidence interval [CI] = 1.11 to 1.16). Antibiotic prescribing fell below predicted rates between April and August 2020, reaching a minimum in May (ARR 0.73; 95% CI = 0.71 to 0.75). Pandemic months were associated with lower rates of RTI/UTI consultations, particularly in April for RTIs (ARR 0.23; 95% CI = 0.22 to 0.25). There were small reductions in the proportion of RTI consultations with antibiotic prescribed and no reduction for UTIs. Among 25 889 COVID-19 patients, 2942 (11%) had antibiotics within a COVID-19 episode.ConclusionPandemic months were initially associated with increased antibiotic prescribing, which then fell below expected levels during the national lockdown. Findings are reassuring that antibiotic stewardship priorities have not been neglected because of COVID-19. Research is required into the effects of reduced RTI/UTI consultations on incidence of serious bacterial infections.
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Wilrycx, G. K. M. L., M. A. Croon, A. H. S. van den Broek e Ch van Nieuwenhuizen. "Mental Health Recovery: Evaluation of a Recovery-Oriented Training Program". Scientific World Journal 2012 (2012): 1–8. http://dx.doi.org/10.1100/2012/820846.
Testo completoAbstract (sommario):
Aim. This study investigates the effectiveness of a recovery-oriented training program on knowledge and attitudes of mental health care professionals towards recovery of people with serious mental illness.Methods. Using data from a longitudinal study of recovery, changes in knowledge and attitudes of 210 mental health care professionals towards recovery were explored using the Recovery Attitude Questionnaire and the Recovery Knowledge Inventory. The study uses a two-group multiple intervention interrupted time-series design which is a variant of the stepped-wedge trial design. A total of six measurements occasions took place.Results. This study shows that professionals' attitudes towards recovery from mental illness can improve with training. After two intensive recovery-oriented training sessions, mental health care professionals have a more positive attitude towards recovery in clinical practice.Conclusion. A recovery-oriented training program can change attitudes of mental health care professionals towards recovery of serious mental illness.
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Cecil, Elizabeth, Alex Bottle, Aneez Esmail, Samantha Wilkinson, Charles Vincent e Paul P. Aylin. "Investigating the association of alerts from a national mortality surveillance system with subsequent hospital mortality in England: an interrupted time series analysis". BMJ Quality & Safety 27, n. 12 (4 maggio 2018): 965–73. http://dx.doi.org/10.1136/bmjqs-2017-007495.
Testo completoAbstract (sommario):
ObjectiveTo investigate the association between alerts from a national hospital mortality surveillance system and subsequent trends in relative risk of mortality.BackgroundThere is increasing interest in performance monitoring in the NHS. Since 2007, Imperial College London has generated monthly mortality alerts, based on statistical process control charts and using routinely collected hospital administrative data, for all English acute NHS hospital trusts. The impact of this system has not yet been studied.MethodsWe investigated alerts sent to Acute National Health Service hospital trusts in England in 2011–2013. We examined risk-adjusted mortality (relative risk) for all monitored diagnosis and procedure groups at a hospital trust level for 12 months prior to an alert and 23 months post alert. We used an interrupted time series design with a 9-month lag to estimate a trend prior to a mortality alert and the change in trend after, using generalised estimating equations.ResultsOn average there was a 5% monthly increase in relative risk of mortality during the 12 months prior to an alert (95% CI 4% to 5%). Mortality risk fell, on average by 61% (95% CI 56% to 65%), during the 9-month period immediately following an alert, then levelled to a slow decline, reaching on average the level of expected mortality within 18 months of the alert.ConclusionsOur results suggest an association between an alert notification and a reduction in the risk of mortality, although with less lag time than expected. It is difficult to determine any causal association. A proportion of alerts may be triggered by random variation alone and subsequent falls could simply reflect regression to the mean. Findings could also indicate that some hospitals are monitoring their own mortality statistics or other performance information, taking action prior to alert notification.
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Pitoy, Frendy Fernando, e Dina D. Galang. "The EFFECT OF FOOT EXERCISE ON LOWER LIMB STRENGTH AND BALANCE AMONG ELDERLY". Abstract Proceedings International Scholars Conference 7, n. 1 (18 dicembre 2019): 255–87. http://dx.doi.org/10.35974/isc.v7i1.955.
Testo completoAbstract (sommario):
Introduction: The primary aim of this study was to determine the effects of foot exercise (senam kaki diabetes) on lower limb strength and balance among the elderly.
Methods: A quasi-experimental interrupted time-series design with control group was utilized. Participants were chosen through purposive sampling technique. Consequently, 60 participants met the criteria set for the study. Simple random sampling was used to divide the participants into experimental and control groups with 30 participants in each group.
Results: Lower limb strength and balance of the participants in the experimental group gradually improved in every week of intervention compared to those in the control group. Further, the result shows that age, sex, and body weight did not affect the lower limb strength and balance of the elderly who underwent foot exercise.
Discussion: Based on the findings, foot exercise was effective in improving lower limb strength and balance among the elderly. The longer the elderly will engage in senam kaki diabetes, irrespective of age sex and body weight, the better is their balance and the strength of their lower limb.
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Molla, Eyayu, e Meseret Muche. "Impact of Cooperative Learning Approaches on Students’ Academic Achievement and Laboratory Proficiency in Biology Subject in Selected Rural Schools, Ethiopia". Education Research International 2018 (2018): 1–9. http://dx.doi.org/10.1155/2018/6202484.
Testo completoAbstract (sommario):
The main objective of this study was to evaluate the impact of cooperative learning methods on students’ academic achievement and laboratory proficiency in biology subject. Quasi-experimental control group interrupted time series design was employed. Data pertaining to these variables were collected from 369 students and 18 biology teachers in three schools. A series of biological tests and semistructured questionnaire were used to collect data. Multivariate analysis (two-way ANOVA) was used to analyze the test scores exposed by teaching methods, and semistructured questionnaire was administered to comprehend factors that hamper the successive execution of CL. Hence, multivariate analysis revealed that there was no significant (P>0.05) difference in the pretest score of the learner academic performance; however, there were significant differences (P<0.01) in the posttest results by teaching methods, but not by schools. Correspondingly, there were significant differences in the pretest P<0.05 and posttest (P<0.01) results of the students’ laboratory proficiency by teaching methods. The results exemplify that there was significant learning gain obtained via CLAD followed by cooperative discussion group (CDG). The result from the questionnaire survey showed that the number of students, lack of laboratory equipment, and so on hamper consecutive execution of CL.
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Scrimshire, Ashley B., Caroline Fairhurst, Catriona McDaid e David J. Torgerson. "Effectiveness of pre-operative anaemia screening and increased Tranexamic acid dose on outcomes following unilateral primary, elective total hip or knee replacement: a statistical analysis plan for an interrupted time series and regression discontinuity study". F1000Research 9 (1 aprile 2020): 224. http://dx.doi.org/10.12688/f1000research.22962.1.
Testo completoAbstract (sommario):
Perioperative blood transfusion is associated with poorer postoperative outcomes following hip and knee replacement surgery. Evidence for the effectiveness of some measures aimed at reducing blood transfusions in this setting are limited and often rely on weak pre-post study designs. Quasi-experimental study designs such as interrupted time series (ITS) and regression discontinuity design (RDD) address many of the weaknesses of the pre-post study design. In addition, a priori publication of statistical analysis plans for such studies increases their transparency and likely validity, as readers are able to distinguish between pre-planned and exploratory analyses. As such, this article, written prospective of any analysis, provides the statistical analysis plan for an ITS and RDD study based on a data set of 20,772 primary elective hip and knee replacement patients in a single English NHS Trust. The primary aim is to evaluate the impact of a preoperative anaemia optimisation service on perioperative blood transfusion (within 7 days of surgery) using both ITS and RDD methods. A secondary aim is to evaluate the impact of a policy of increased tranexamic acid dose given at the time of surgery, using ITS methods.
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Scrimshire, Ashley B., Caroline Fairhurst, Catriona McDaid e David J. Torgerson. "Effectiveness of pre-operative anaemia screening and increased Tranexamic acid dose policies on outcomes following unilateral primary, elective total hip or knee replacement: a statistical analysis plan for an interrupted time series and regression discontinuity study". F1000Research 9 (13 maggio 2021): 224. http://dx.doi.org/10.12688/f1000research.22962.2.
Testo completoAbstract (sommario):
Perioperative blood transfusion is associated with poorer postoperative outcomes following hip and knee replacement surgery. Evidence for the effectiveness of some measures aimed at reducing blood transfusions in this setting are limited and often rely on weak pre-post study designs. Quasi-experimental study designs such as interrupted time series (ITS) and regression discontinuity design (RDD) address many of the weaknesses of the pre-post study design. In addition, a priori publication of statistical analysis plans for such studies increases their transparency and likely validity, as readers are able to distinguish between pre-planned and exploratory analyses. As such, this article, written prospective of any analysis, provides the statistical analysis plan for an ITS and RDD study based on a data set of 20,772 primary elective hip and knee replacement patients in a single English NHS Trust. The primary aim is to evaluate the impact of a preoperative anaemia optimisation service on perioperative blood transfusion (within 7 days of surgery) using both ITS and RDD methods. A secondary aim is to evaluate the impact of a policy of increased tranexamic acid dose given at the time of surgery, using ITS methods.
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Mulholland, Rachel H., Rachael Wood, Helen R. Stagg, Colin Fischbacher, Jaime Villacampa, Colin R. Simpson, Eleftheria Vasileiou et al. "Impact of COVID-19 on accident and emergency attendances and emergency and planned hospital admissions in Scotland: an interrupted time-series analysis". Journal of the Royal Society of Medicine 113, n. 11 (4 ottobre 2020): 444–53. http://dx.doi.org/10.1177/0141076820962447.
Testo completoAbstract (sommario):
Objectives Following the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and the subsequent global spread of the 2019 novel coronavirus disease (COVID-19), health systems and the populations who use them have faced unprecedented challenges. We aimed to measure the impact of COVID-19 on the uptake of hospital-based care at a national level. Design The study period (weeks ending 5 January to 28 June 2020) encompassed the pandemic announcement by the World Health Organization and the initiation of the UK lockdown. We undertook an interrupted time-series analysis to evaluate the impact of these events on hospital services at a national level and across demographics, clinical specialties and National Health Service Health Boards. Setting Scotland, UK. Participants Patients receiving hospital care from National Health Service Scotland. Main outcome measures Accident and emergency (A&E) attendances, and emergency and planned hospital admissions measured using the relative change of weekly counts in 2020 to the averaged counts for equivalent weeks in 2018 and 2019. Results Before the pandemic announcement, the uptake of hospital care was largely consistent with historical levels. This was followed by sharp drops in all outcomes until UK lockdown, where activity began to steadily increase. This time-period saw an average reduction of −40.7% (95% confidence interval [CI]: −47.7 to −33.7) in A&E attendances, −25.8% (95% CI: −31.1 to −20.4) in emergency hospital admissions and −60.9% (95% CI: −66.1 to −55.7) in planned hospital admissions, in comparison to the 2018–2019 averages. All subgroup trends were broadly consistent within outcomes, but with notable variations across age groups, specialties and geography. Conclusions COVID-19 has had a profoundly disruptive impact on hospital-based care across National Health Service Scotland. This has likely led to an adverse effect on non-COVID-19-related illnesses, increasing the possibility of potentially avoidable morbidity and mortality. Further research is required to elucidate these impacts.
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Bayar, Mohamed Amine, Gwénaël Le Teuff, Franz Koenig, Marie-Cécile Le Deley e Stefan Michiels. "Group sequential adaptive designs in series of time-to-event randomised trials in rare diseases: A simulation study". Statistical Methods in Medical Research 29, n. 6 (29 luglio 2019): 1483–98. http://dx.doi.org/10.1177/0962280219862313.
Testo completoAbstract (sommario):
In rare diseases, fully powered large trials may not be doable in a reasonable time frame even with international collaborations. In a previous work, we proposed an approach based on a series of smaller parallel group two-arm randomised controlled trials (RCT) performed over a long research horizon. Within the series of trials, the treatment selected after each trial becomes the control treatment of the next one. We concluded that running more trials with smaller sample sizes and relaxed α-levels leads in the long term and under reasonable assumptions to larger survival benefits with a moderate increase of risk as compared to traditional designs based on larger but fewer trials designed to meet stringent evidence criteria. We now extend this quantitative framework with more ‘flexible’ designs including interim analyses for futility and/or efficacy, and three-arm adaptive designs with treatment selection at interim. In the simulation study, we considered different disease severities, accrual rates, and hypotheses of how treatments improve over time. For each design, we estimated the long-term survival benefit as the relative difference in hazard rates between the end and the start of the research horizon, and the risk defined as the probability of selecting at the end of the research horizon a treatment inferior to the initial control. We assessed the impact of the α-level and the choice of the stopping rule on the operating characteristics. We also compared the performance of series based on two- vs. three-arm trials. We show that relaxing α-levels within the limit of 0.1 is associated with larger survival gains and moderate increase of risk which remains within acceptable ranges. Including an interim analysis with a futility rule is associated with an additional survival gain and a better risk control as compared to series with no interim analysis, when the α-level is below or equal to 0.1, whereas the benefit of including an interim analysis is rather small for higher α-levels. Including an interim analysis for efficacy yields almost no additional gain. Series based on three-arm trials are associated with a systematic improvement in terms of survival gain and risk control as compared to series of two-arm trials.
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Doheny, Megan, Janne Agerholm, Nicola Orsini, Pär Schön e Bo Burström. "Impact of integrated care on trends in the rate of emergency department visits among older persons in Stockholm County: an interrupted time series analysis". BMJ Open 10, n. 6 (giugno 2020): e036182. http://dx.doi.org/10.1136/bmjopen-2019-036182.
Testo completoAbstract (sommario):
ObjectiveTo investigate the association between the implementation of an integrated care (IC) system in Norrtälje municipality and changes in trends of the rate of emergency department (ED) visits.DesignInterrupted time series analysis from 2000 to 2015.SettingStockholm County.ParticipantsAll inhabitants 65+ years in Stockholm County on 31 December of each study year.InterventionIC was established by combining the funding, administration and delivery of health and social care for older persons in Norrtälje municipality, within Stockholm County.OutcomeRates of hospital-based ED visits.ResultsIC was associated with a decrease in the rate of ED visits (incidence rate ratio: 0.997, 95% CI 0.995 to 0.998) among inhabitants 65+ years in Norrtälje. However, the rate of ED visits remained higher in Norrtälje than the rest of Stockholm in the preintervention and postintervention periods. Stratified analyses showed that IC was associated with a decline in the trend of the rate of ED visits among those 65–79 years, the lowest income group and born outside of Sweden. However, there was no significant decrease in the trend among those 80+ years.ConclusionThe implementation of IC was associated with a modest change in the trend of ED visits in Norrtälje, though the rate of ED visits remained higher than in the rest of Stockholm. Changes in the composition of the population and contextual changes may have impacted our findings. Further research, using other outcome measures is needed to assess the impact of IC on healthcare utilisation.
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Wong, Vivian C., e Peter M. Steiner. "Designs of Empirical Evaluations of Nonexperimental Methods in Field Settings". Evaluation Review 42, n. 2 (aprile 2018): 176–213. http://dx.doi.org/10.1177/0193841x18778918.
Testo completoAbstract (sommario):
Over the last three decades, a research design has emerged to evaluate the performance of nonexperimental (NE) designs and design features in field settings. It is called the within-study comparison (WSC) approach or the design replication study. In the traditional WSC design, treatment effects from a randomized experiment are compared to those produced by an NE approach that shares the same target population. The nonexperiment may be a quasi-experimental design, such as a regression-discontinuity or an interrupted time-series design, or an observational study approach that includes matching methods, standard regression adjustments, and difference-in-differences methods. The goals of the WSC are to determine whether the nonexperiment can replicate results from a randomized experiment (which provides the causal benchmark estimate), and the contexts and conditions under which these methods work in practice. This article presents a coherent theory of the design and implementation of WSCs for evaluating NE methods. It introduces and identifies the multiple purposes of WSCs, required design components, common threats to validity, design variants, and causal estimands of interest in WSCs. It highlights two general approaches for empirical evaluations of methods in field settings, WSC designs with independent and dependent benchmark and NE arms. This article highlights advantages and disadvantages for each approach, and conditions and contexts under which each approach is optimal for addressing methodological questions.
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Burns, Ryan D., Timothy A. Brusseau e James C. Hannon. "Effect of a Comprehensive School Physical Activity Program on School Day Step Counts in Children". Journal of Physical Activity and Health 12, n. 12 (dicembre 2015): 1536–42. http://dx.doi.org/10.1123/jpah.2014-0578.
Testo completoAbstract (sommario):
Background:Comprehensive School Physical Activity Programming (CSPAP) has the potential to increase physical activity (PA) in children over time. The purpose of this study was to examine the effect of CSPAP on school day step counts in children.Methods:Participants were 327 fourth and fifth grade children recruited from 4 elementary schools. The study was conducted within an Interrupted Time-Series Design framework. School day step counts were collected for 5 days across preintervention and postintervention time-points (10 days total) using NL-1000 piezoelectric pedometers. Robust piecewise regression examined pre- and postintervention intercepts and slopes, and the change in these parameters using postestimation statistics.Results:The slope coefficient was statistically significant across preintervention (β = –105.23, P < .001) but not postintervention time-points (β = –63.23, P = .347), suggesting decreases in steps counts across preintervention and stability of step counts across postintervention school days. Postestimation statistics yielded increases in school day step counts from the end of preintervention (day 5) to the start of postintervention (day 6; t(319) = –4.72, P < .001, Cohen’s d = 4.72).Conclusions:The CSPAP intervention increased average school day step counts and attenuated decreases in step counts throughout the school week in children.
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Mullins, Robyn M., e Christopher F. Sharpley. "Vividness of Imagery and Locus of Control as Predictors of Normotensives' Ability to Learn Downward Control of Blood Pressure". Behaviour Change 5, n. 2 (giugno 1988): 66–73. http://dx.doi.org/10.1017/s0813483900008093.
Testo completoAbstract (sommario):
Two ‘individual’ variables (level of imagery, locus of control) were investigated for their effects upon subjects' ability to learn and generalise downward control of blood pressure via biofeedback procedures. Also investigated was the effect of visual numerical feedback versus no-feedback combined with instructions. Subjects were volunteers with normal blood pressure who were randomly assigned to feedback of systolic blood pressure, feedback of diastolic blood pressure or no-feedback under an interrupted time-series design which consisted of an adaptation period, baseline, training, rest, and post-test (generalisation of task without feedback). Results indicated that neither of the two ‘individual’ variables was associated with any significant reductions of blood pressure within either the training or generalisation periods. Feedback was negatively associated with training effects. Findings are discussed in terms of the ease of comprehension of numerical feedback of a fluctuating variable, with suggestions for future research using fine-grained and stable measures of cardiac performance.
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Simison, Emilia. "Nation or District? Evaluating the Territorial Scope of Bills through Experimental Designs". Journal of Politics in Latin America 9, n. 2 (agosto 2017): 93–120. http://dx.doi.org/10.1177/1866802x1700900204.
Testo completoAbstract (sommario):
This paper studies the territorial scope of the bills presented by members of the Chamber of Deputies (the lower chamber of the Argentine National Congress) during Juan Domingo Perón's first two terms in office (1946–1955). Its main objective is to observe the effect that modifying the electoral system (switching from incomplete party ballots in multimember districts to relative majorities in single-member districts) had on that scope. Experimental techniques (an interrupted time-series and a within-subjects design) are used to analyze a novel database including every bill presented in the Chamber of Deputies during the period in question. Contrary to theoretical expectations, an increase is observed in the share of bills with a territorial scope that goes beyond deputies’ districts – especially for those presented by legislators from the opposition and from larger provinces. In addition, by separately analyzing the effect on the ruling party and the opposition, the paper uncovers a plausible explanation for previous nonconclusive findings.
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Speed, David, e Shelley Fyffe. "Investigating Open-access Booking in New Brunswick Occupational Therapy". Canadian Journal of Occupational Therapy 87, n. 5 (dicembre 2020): 382–89. http://dx.doi.org/10.1177/0008417420968683.
Testo completoAbstract (sommario):
Background. Open-access booking (OAB) describes administrative changes to improve system efficiency. However, OAB studies have focused on GP practices and have not applied OAB to other health care services. Purpose. The purpose of the study was to investigate the associations between OAB and administrative outcomes in the Saint John region. Method. Evaluators compared three years of pre-OAB data against two years of post-OAB data using an interrupted-time series design (February 2014–January 2019). Findings. OAB was associated with a 12% jump in the likelihood of being discharged within three months even though clients received an equivalent level of service. OAB was not associated with more missed appointments (∼8% vs. ∼7%). While OAB was not associated with reduced wait times, the post-OAB period handled a larger number of client referrals, which may explain the null finding. Implications. OAB shows potential for improving administrative outcomes, but further research is needed.
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Post, Dannielle Kay, Mark Daniel, Gary Misan e Matthew T. Haren. "A workplace health promotion application of the Precede-Proceed model in a regional and remote mining company in Whyalla, South Australia". International Journal of Workplace Health Management 8, n. 3 (14 settembre 2015): 154–74. http://dx.doi.org/10.1108/ijwhm-08-2014-0028.
Testo completoAbstract (sommario):
Purpose – Workplace health promotion enables the dissemination of health-related information to a large portion of society and provides a vehicle for translating results of efficacy studies to effective lifestyle interventions under less controlled real-world conditions. To achieve effectiveness there needs to be a systematic approach to the design, implementation, and evaluation of workplace health promotion interventions. The purpose of this paper is to describe the development of a workplace programme in a mining and steel making town in regional South Australia. Design/methodology/approach – The Precede-Proceed model (PPM) was used as a framework to design the development, implementation, and evaluation of the programme. Findings – Quality of life issues and antecedents of modifiable behavioural and environmental factors to be targeted by interventions were identified. Relevant socio-behavioural theories were used to guide intervention development and evaluation. An intervention programme was planned to enable the delivery of educational and skills-development strategies by peers within structured organisational work units. Originality/value – This research utilises the PPM to develop, implement, and evaluate intervention strategies targeting the development of diabetes and cardiometabolic risk in a remotely located workplace population. Novel to this approach is the utilisation of the entire PPM in the research; the multiple baseline, interrupted time series design of the study; and its application in a workplace environment noted for increased health risk factors, within a community at high risk of development of type 2 diabetes.
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Jeannet, Anne-Marie. "Internal migration and public opinion about the European Union: a time series cross-sectional study". Socio-Economic Review 18, n. 3 (3 agosto 2018): 817–38. http://dx.doi.org/10.1093/ser/mwy034.
Testo completoAbstract (sommario):
Abstract Although the European Union (EU) allows citizens from member countries to migrate freely within its confines to facilitate integration, it may be alienating public support for Europe. This article investigates this by extending group threat theory to explain how internal migration is related to public opinion about the EU using annual Eurobarometer data from 1998 to 2014 across 15 Western European countries. Employing a pooled time cross-sectional design, I find that the presence of EU citizens from Central and Eastern European member states is positively related to public beliefs that EU membership is not beneficial for their country. The results also show that this relationship is even stronger during an economic downturn. There is weak evidence that it may be related to distrust in European institutions as well. These findings shed light on why public support for the EU can erode over time and how it responds to contextual changes in Europe’s internal migration patterns. The study concludes by discussing how group threat theory is relevant for understanding public opinion about the EU.
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Valasik, Matthew, Shannon E. Reid e Matthew D. Phillips. "CRASH and burn: abatement of a specialised gang unit". Journal of Criminological Research, Policy and Practice 2, n. 2 (13 giugno 2016): 95–106. http://dx.doi.org/10.1108/jcrpp-06-2015-0024.
Testo completoAbstract (sommario):
Purpose – The purpose of this paper is to examine the impact of the temporary disbandment of a gang unit on collecting gang intelligence and arresting gang members in one of the Los Angeles Police Department’s Community Policing Areas. Design/methodology/approach – An interrupted time series methodology (ARIMA) is utilised to examine 1,429 field interview cards and 1,174 arrests of gang members that occurred from 1 January 2010 to 31 December 2011 within one police division. Findings – Results indicated that the dismantling of the gang unit negatively impacted the collection of intelligence on gang members by officers, regardless of whether the officers were officially serving in the gang unit. Suppression efforts by gang unit officers also resulted in a sustained decline. Originality/value – Given that many urban centres have specialised gang units, this study demonstrates how organisational turnover or disbandment of a gang unit negatively impacts a department’s ability to deal with local gang issues. Furthermore, these finding suggest that police organisations should consider such ramifications on intelligence-based policing activities.
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Almeida, Fabio A., Renae L. Smith-Ray, Rain Van Den Berg, Patti Schriener, Mike Gonzales, Pierre Onda e Paul A. Estabrooks. "Utilizing a Simple Stimulus Control Strategy to Increase Physician Referrals for Physical Activity Promotion". Journal of Sport and Exercise Psychology 27, n. 4 (dicembre 2005): 505–14. http://dx.doi.org/10.1123/jsep.27.4.505.
Testo completoAbstract (sommario):
Within the busy clinic visit and multiple preventive guidelines to follow, the rate of physician referral for physical activity (PA) is disappointing. This study used an interrupted time-series design to determine the effect of a simple stimulus control strategy to increase physician referrals for PA when compared to standard care before and after exposure to the stimulus control intervention. The number of referrals (N = 218 total) per week was significantly higher during weeks when the stimulus control intervention was used (p < .01). Approximately 77% of participants referred during standard care weeks initiated a PA program while 67% of those referred during stimulus control weeks initiated PA. These rate differences were significant (p < .05). Nonetheless, the number of individuals who initiated PA was greater during stimulus control weeks than during usual care weeks (p < .05; 9.8 vs. 5.6), due to the larger total volume of referrals. We concluded that stimulus control interventions targeting physician referrals are a practical method for enhancing participation in PA programs.
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Adler-Milstein, Julia, e Michael D. Wang. "The impact of transitioning from availability of outside records within electronic health records to integration of local and outside records within electronic health records". Journal of the American Medical Informatics Association 27, n. 4 (5 marzo 2020): 606–12. http://dx.doi.org/10.1093/jamia/ocaa006.
Testo completoAbstract (sommario):
Abstract Objective While there has been a substantial increase in health information exchange, levels of outside records use by frontline providers are low. We assessed whether integration between outside data and local data results in increased viewing of outside records, overall and by encounter, provider, and patient type. Materials and Methods Using data from UCSF Health, we measured change in outside record views after integrating the list of local (UCSF) and outside (other health systems on Epic [Epic Systems, Verona, WI]) encounters on the Chart Review tab. Previously, providers only viewed records from outside encounters on a separate tab. We used an interrupted time series design (with outside record viewing event counts aggregated to the week level) to measure changes in the level and trend over a 1-year period. Results There was a large increase in the level of outside record views of 22 920 per week (P < .001). The change in trend went from a weekly increase of 116 (P < .05) to a decrease of 402 (P = .08), reflecting a small effect decay. There were increases in the level of views for all provider and encounter types: attendings (n = 3675), residents (n = 3277), and nurses (n = 914); and inpatient (n = 1676), emergency (n = 487), and outpatient (n = 7228) (P < .001 for all). Results persisted when adjusted for total encounter volume. Discussion While outside records were readily available before the encounter integration, the simple step of clicking on a separate tab appears to have depressed use. Conclusions User interface designs that comingle local and outside data result in higher levels of viewing and should be more broadly pursued.
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Warriner, Amy H., Ryan C. Outman, Jeroan J. Allison, Jeffrey R. Curtis, Nathan J. Markward, David T. Redden, Monika M. Safford, Eric J. Stanek, Amy R. Steinkellner e Kenneth G. Saag. "An Internet-based Controlled Trial Aimed to Improve Osteoporosis Prevention among Chronic Glucocorticoid Users". Journal of Rheumatology 42, n. 8 (1 luglio 2015): 1478–83. http://dx.doi.org/10.3899/jrheum.141238.
Testo completoAbstract (sommario):
Objective.To address the low prevention and treatment rates for those at risk of glucocorticoid-induced osteoporosis (GIOP), we evaluated the influence of a direct-to-patient, Internet-based educational video intervention using “storytelling” on rates of antiosteoporosis medication use among chronic glucocorticoid users who were members of an online pharmacy refill service.Methods.We identified members who refilled ≥ 5 mg/day of prednisone (or equivalent) for 90 contiguous days and had no GIOP therapy for ≥ 12 months. Using patient stories, we developed an online video addressing risk factors and treatment options, and delivered it to members refilling a glucocorticoid prescription. The intervention consisted of two 45-day “Video ON” periods, during which the video automatically appeared at the time of refill, and two 45-day “Video OFF” periods, during which there was no video. Members could also “self-initiate” watching the video by going to the video link. We used an interrupted time series design to evaluate the effectiveness of this intervention on GIOP prescription therapies over 6 months.Results.Among 3017 members (64.8%) exposed to the intervention, 59% had measurable video viewing time, of which 3% “self-initiated” the video. The GIOP prescription rate in the “Video ON” group was 2.9% versus 2.7% for the “Video OFF” group. There was a nonsignificant trend toward greater GIOP prescription in members who self-initiated the video versus automated viewing (5.7% vs 2.9%, p = 0.1).Conclusion.Among adults at high risk of GIOP, prescription rates were not significantly affected by an online educational video presented at the time of glucocorticoid refill. ClinicalTrials.gov Identifier: NCT01378689.
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Murthy, Sanjay K., Jahanara Begum, Eric I. Benchimol, Charles N. Bernstein, Gilaad G. Kaplan, Jeffrey D. McCurdy, Harminder Singh, Laura Targownik e Monica Taljaard. "Introduction of anti-TNF therapy has not yielded expected declines in hospitalisation and intestinal resection rates in inflammatory bowel diseases: a population-based interrupted time series study". Gut 69, n. 2 (12 giugno 2019): 274–82. http://dx.doi.org/10.1136/gutjnl-2019-318440.
Testo completoAbstract (sommario):
ObjectivesTo better understand the real-world impact of biologic therapy in persons with Crohn’s disease (CD) and ulcerative colitis (UC), we evaluated the effect of marketplace introduction of infliximab on the population rates of hospitalisations and surgeries and public payer drug costs.DesignWe used health administrative data to study adult persons with CD and UC living in Ontario, Canada between 1995 and 2012. We used an interrupted time series design with segmented regression analysis to evaluate the impact of infliximab introduction on the rates of IBD-related hospitalisations, intestinal resections and public payer drug costs over 10 years among patients with CD and 5 years among patients with UC, allowing for a 1-year transition.ResultsRelative to what would have been expected in the absence of infliximab, marketplace introduction of infliximab did not produce significant declines in the rates of CD-related hospitalisations (OR at the last observation quarter 1.06, 95% CI 0.811 to 1.39) or intestinal resections (OR 1.10, 95% CI 0.810 to 1.50), or in the rates of UC-related hospitalisations (OR 1.22, 95% CI 1.07 to 1.39) or colectomies (OR 0.933, 95% CI 0.54 to 1.61). The findings were similar among infliximab users, except that hospitalisation rates declined substantially among UC patients following marketplace introduction of infliximab (OR 0.515, 95% CI 0.342 to 0.777). There was a threefold rise over expected trends in public payer drug cost among patients with CD following infliximab introduction (OR 2.98,95% CI 2.29 to 3.86), suggesting robust market penetration in this group, but no significant change among patients with UC (OR 1.06, 95% CI 0.955 to 1.18).ConclusionsMarketplace introduction of infliximab has not yielded anticipated reductions in the population rates of IBD-related hospitalisations or intestinal resections, despite robust market penetration among patients with CD. Misguided use of infliximab in CD patients and underuse of infliximab in UC patients may largely explain our study findings.
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Deb, Koyel, e Dolly Gurumayum. "Effectiveness of deep breathing and walking exercise in reducing menopausal symptoms among post-menopausal women of Tripura, India". International Journal Of Community Medicine And Public Health 8, n. 6 (25 maggio 2021): 2881. http://dx.doi.org/10.18203/2394-6040.ijcmph20211989.
Testo completoAbstract (sommario):
Background: Menopause is the part of women’s life. Menopausal symptoms refer any feeling of illness or physical or mental change caused by menopause. Purpose of the study; to evaluate the effectiveness of deep breathing and walking exercise in reducing menopausal symptoms among post-menopausal women in selected community, Tripura and to find out the association between the pre-test menopausal symptoms among post-menopausal women with their selected demographic variables.Methods: A quantitative Quasi experimental research approach with short interrupted time series study design was used. The researcher selected 40 post-menopausal women as a sample by non-probability sampling technique. Data were collected with structured interview schedule on symptoms checklist and deep breathing and walking exercise practice checklist.Results: The study results show that the pre-observation of post-menopausal symptoms in the experimental group were; 12 (60%) post-menopausal women belong to Moderate group, 8 (40%) belong to severe group and nobody belong to mild group. Post-observation of post-menopausal symptoms of the experimental group were; 1(5%) post-menopausal woman belong to mild, 19 (95%) belong to moderate group and nobody belong to severe group. The pre-observation of post-menopausal symptoms in the control group were; post-menopausal women belong to Mild, Moderate and Severe group were 2 (10%), 13 (65%) and 5 (25%) respectively. Post-observation of post-menopausal symptoms of the control group were; 2 (10%) post-menopausal women belong to mild, 15 (75%) belong to moderate and 3 (15%) belong to severe group.Conclusions: The finding of present study revealed that breathing and walking exercise improved the post-menopausal symptoms in experimental group.
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Panda, Ajaya Kumar, e Swagatika Nanda. "Time-varying synchronization and dynamic conditional correlation among the stock market returns of leading South American economies". International Journal of Managerial Finance 14, n. 2 (3 aprile 2018): 245–62. http://dx.doi.org/10.1108/ijmf-11-2016-0206.
Testo completoAbstract (sommario):
Purpose The purpose of this paper is to capture the pattern of return volatility and information spillover and the extent of conditional correlation among the stock markets of leading South American economies. It also examines the connectedness of market returns within the region. Design/methodology/approach The time series properties of weekly stock market returns of benchmark indices spanning from the second week of 1995 to the fourth week of December 2015 are analyzed. Using univariate auto-regressive conditional heteroscedastic, generalized auto-regressive conditional heteroscedastic, and dynamic conditional correlation multivariate GARCH model approaches, the study finds evidence of returns and volatility linkages along with the degree of connectedness among the markets. Findings The findings of this study are consistent with increasing market connectedness among a group of leading South American economies. Stocks exhibit relatively fewer asymmetries in conditional correlations in addition to conditional volatility; yet, the asymmetry is relatively less apparent in integrated markets. The results demonstrate that co-movements are higher toward the end of the sample period than in the early phase. The stock markets of Argentina, Brazil, Chile, and Peru are closely and strongly connected within the region followed by Colombia, whereas Venezuela is least connected with the group. Practical implications The implication is that foreign investors may benefit from the reduction of the risk by adding the stocks to their investment portfolio. Originality/value The unique features of the paper include a large sample of national stock returns with updated time series data set that reveals the time series properties and empirical evidence on volatility testing. Unlike other studies, this paper uncovers the relation between the stock markets within the same region facing the same market condition.
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Broom, Jennifer, Alex Broom, Chris Anstey, Katherine Kenny, Sharon Young, David Grieve, David Sowden et al. "Barriers-enablers-ownership approach: a mixed methods analysis of a social intervention to improve surgical antibiotic prescribing in hospitals". BMJ Open 11, n. 5 (maggio 2021): e046685. http://dx.doi.org/10.1136/bmjopen-2020-046685.
Testo completoAbstract (sommario):
ObjectivesTo assess an intervention for surgical antibiotic prophylaxis (SAP) improvement within surgical teams focused on addressing barriers and fostering enablers and ownership of guideline compliance.DesignThe Queensland Surgical Antibiotic Prophylaxis (QSAP) study was a multicentre, mixed methods study designed to address barriers and enablers to SAP compliance and facilitate engagement in self-directed audit/feedback and assess the efficacy of the intervention in improving compliance with SAP guidelines. The implementation was assessed using a 24-month interrupted time series design coupled with a qualitative evaluation.SettingThe study was undertaken at three hospitals (one regional, two metropolitan) in Australia.ParticipantsSAP-prescribing decisions for 1757 patients undergoing general surgical procedures from three health services were included. Six bimonthly time points, pre-implementation and post implementation of the intervention, were measured. Qualitative interviews were performed with 29 clinical team members. SAP improvements varied across site and time periods.InterventionQSAP embedded ownership of quality improvement in SAP within surgical teams and used known social influences to address barriers to and enablers of optimal SAP prescribing.ResultsThe site that reported senior surgeon engagement showed steady and consistent improvement in prescribing over 24 months (prestudy and poststudy). Multiple factors, including resource issues, influenced engagement and sites/time points where these were present had no improvement in guideline compliance.ConclusionsThe barriers-enablers-ownership model shows promise in its ability to facilitate prescribing improvements and could be expanded into other areas of antimicrobial stewardship. Senior ownership was a predictor of success (or failure) of the intervention across sites and time periods. The key role of senior leaders in change leadership indicates the critical need to engage other specialties in the stewardship agenda. The influence of contextual factors in limiting engagement clearly identifies issues of resource distributions/inequalities within health systems as limiting antimicrobial optimisation potential.
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Merlin D, Merlin D., e Siti Hajar Larekeng. "The Effectiveness of Suggestopedia Method with Wordwall Picture in Increasing Vocabulary Mastery with Learning Disabilities". EDUVELOP 1, n. 2 (15 marzo 2018): 193–204. http://dx.doi.org/10.31605/eduvelop.v1i2.37.
Testo completoAbstract (sommario):
This study investigates the effects of Suggestopedia method with wordwall picture in increase the vocabulary mastery students of SMPLB Negeri Parepare in academic year 2016/ 2017. This method engages the students’ attentions and various fun learning activities which decreased the students’ boredom during their learning. Wordwall picture provides the students’ illustrations and ideas in their minds. It applied mixed methods research design quantitative and qualitative approaches with single group interrupted time-series design. The population are who students with learning disabilities of SMPLB Parepare in academic year 2016/2017 which consist of 11 students and the sample constitútes consist of 5 students. This research used sampling as a technique of sampling. Based on the quantitative analysis, the result showed that 1) student test were significant accorbing to the questionnaire, the result show thet the students motivation incresed. It means that suggestopedia method with wordwall picture affected the students vocebulary mastery in learning. The result also proved that students interest in learning english has a significant relationship or influence with students vocebulary score. 2) The qualitative data from questionnaire showed that students’ motivation increased. It means that Suggestopedia method with wordwall picture affected the students vocabulary, mastery in learning, it proved that Suggestopedia Method with Wordwall Picture able to increase the interest in learning English of the students with disabilities learning of SMPLB Parepare;
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Matsuzaki, Mika, Brisa N. Sánchez, R. David Rebanal, Joel Gittelsohn e Emma V. Sanchez-Vaznaugh. "California and federal school nutrition policies and obesity among children of Pacific Islander, American Indian/Alaska Native, and Filipino origins: Interrupted time series analysis". PLOS Medicine 18, n. 5 (24 maggio 2021): e1003596. http://dx.doi.org/10.1371/journal.pmed.1003596.
Testo completoAbstract (sommario):
Background Obesity prevalence remains high among children of Pacific Islander (PI) origin, Filipino (FI), and American Indian/Alaska Native (AIAN) origins in the United States. While school nutrition policies may help prevent and reduce childhood obesity, their influences specifically among PI, FI, and AIAN children remain understudied. We evaluated the association of the California (CA) state school nutrition policies for competitive food and beverages and the federal policy for school meals (Healthy, Hunger-Free Kids Act of 2010 (HHFKA 2010)) with overweight/obesity among PI, FI, and AIAN students. Methods and findings We used an interrupted time series (ITS) design with FitnessGram data from 2002 to 2016 for PI (78,841), FI (328,667), AIAN (97,129), and White (3,309,982) students in fifth and seventh grades who attended CA public schools. Multilevel logistic regression models estimated the associations of the CA school nutrition policies (in effect beginning in academic year 2004 to 2005) and HHFKA 2010 (from academic year 2012 to 2013) with overweight/obesity prevalence (above the 85 percentile of the age- and sex-specific body mass index (BMI) distribution). The models were constructed separately for each grade and sex combination and adjusted for school district-, school-, and student-level characteristics such as percentage of students eligible for free and reduced price meals, neighborhood income and education levels, and age. Across the study period, the crude prevalence of overweight/obesity was higher among PI (39.5% to 52.5%), FI (32.9% to 36.7%), and AIAN (37.7% to 45.6%) children, compared to White (26.8% to 30.2%) students. The results generally showed favorable association of the CA nutrition policies with overweight/obesity prevalence trends, although the magnitudes of associations and strengths of evidence varied among racial/ethnic subgroups. Before the CA policies went into effect (2002 to 2004), overweight/obesity prevalence increased for White, PI, and AIAN students in both grades and sex groups as well as FI girls in seventh grade. After the CA policies took place (2005 to 2012), the overweight/obesity rates decreased for almost all subgroups who experienced increasing trends before the policies, with the largest decrease seen among PI girls in fifth grade (before: log odds ratio = 0.149 (95% CI 0.108 to 0.189; p < 0.001); after: 0.010 (−0.005 to 0.025; 0.178)). When both the CA nutrition policies and HHFKA 2010 were in effect (2013 to 2016), declines in the overweight/obesity prevalence were seen among White girls and FI boys in fifth grade. Despite the evidence of the favorable association of the school nutrition policies with overweight/obesity prevalence trends, disparities between PI and AIAN students and their White peers remained large after the policies took place. As these policies went into effect for all public schools in CA, without a clear comparison group, we cannot conclude that the changes in prevalence trends were solely attributable to these policies. Conclusions The current study found evidence of favorable associations of the state and federal school nutrition policies with overweight/obesity prevalence trends. However, the prevalence of overweight/obesity continued to be high among PI and AIAN students and FI boys. There remain wide racial/ethnic disparities between these racial/ethnic minority subgroups and their White peers. Additional strategies are needed to reduce childhood obesity and related disparities among these understudied racial/ethnic populations.
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Pokorny, Marie E., Dixie Koldjeski e Melvin Swanson. "Skin Care Intervention for Patients Having Cardiac Surgery". American Journal of Critical Care 12, n. 6 (1 novembre 2003): 535–44. http://dx.doi.org/10.4037/ajcc2003.12.6.535.
Testo completoAbstract (sommario):
• Background Pressure ulcers are a major problem after cardiovascular surgery, occurring in 9.2% to 38% of patients.• Objectives To determine the effectiveness of a skin care intervention program in preventing development of ulcers or progression from one stage to another and to determine the extent to which selected risk factors were associated with development and progression of pressure ulcers.• Methods A simple interrupted time series design was used. The protocol involved interrelated assessment, staging, and type of intervention provided. The Braden Scale was used to determine risk for skin breakdown.• Results Of the 351 patients in the study, 327 (93%) maintained skin integrity and 24 (7%) had skin breakdown. Breakdown by stages was as follows: stage 1, 62% (n = 15); stage 2, 29% (n = 7); stage 3, 4% (n = 1); and stage 4, 4% (n = 1). Age, sex (female), and heart failure were statistically significant risk factors for breakdown (P = <.001, .02, and .02, respectively). The mean scores on the Braden Scale of the breakdown group differed significantly from those of the skin integrity group from days 2 through 5 after surgery (P = .01). Seventeen (71%) of the breakdowns occurred during the first 4 days after surgery.• Conclusions Skin assessments and nursing interventions should be increased on the day of surgery and the first to fifth postoperative days, including multiple assessments and skin care focused on maintaining skin integrity.
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Wilson, Richard H. "Variables that Influence the Recognition Performance of Interrupted Words: Rise-Fall Shape and Temporal Location of the Interruptions". Journal of the American Academy of Audiology 25, n. 07 (luglio 2014): 688–96. http://dx.doi.org/10.3766/jaaa.25.7.8.
Testo completoAbstract (sommario):
Background: The abrupt transition of a signal from off to on and vice versa typically produces spectral splatter that can mask other signals that are spectrally removed from the nominal signal frequency. Both the Miller and Licklider (1950) and Cherry (1953) studies of interrupted speech and alternated speech, respectively, acknowledged the generation of extraneous noise by the rapid on and off characteristics of their unshaped signals but noted for slower interruption rates (e.g., 10 interruptions per second); the masking effects were minimal. Recent studies of interrupted speech have avoided this issue by shaping the rise-fall times with a digital algorithm (e.g., Jin and Nelson, 2010; Wang and Humes, 2010). A second variable in the interrupted speech paradigm is the temporal location or placement of the interruptions (i.e., where in the waveform the interruptions occur). Here the issue is this: what parts of an utterance are necessary to enable intelligibility (e.g., Fogerty and Kewley-Port, 2009)? Interruptions may or may not disturb these necessary cues. Purpose: Here is the prompting question: do shaped and unshaped rise-fall characteristics of the on-segments of interrupted speech produce the same or different recognition performances? A second question arises: are recognition performances on complementary halves of an interrupted signal the same or different? Research Design: This study used a mixed-model design with two within-subject variables (unshaped and shaped rise-fall characteristic, complementary halves) and one between-subjects variable (listener group). Study Sample: A total of 12 young listeners (age range: 19–29 yr) with normal hearing and 12 older listeners (age range: 53–80 yr) with hearing loss for pure tones participated. Data Collection and Analysis: A total of 95 consonant-vowel nucleus-consonant words were interrupted (10 interruptions per second; 50% duty cycle) by parsing alternate 50 msec segments to separate files, which provided complementary temporal halves of the target word referenced to word onset; the first on-segment of the 0 msec condition started at word onset, whereas the first on-segment of the 50 msec condition started 50 msec after word onset. The interruption routine either applied no shaping of the 4 msec rise-fall times or a cos2 shape. Each listener received 25 practice words then a unique randomization of 280 interrupted words (70 words, 2 rise-fall shapes, and 2 interrupt onset conditions). Results: The listeners with normal hearing performed 8–16% better on the various comparable conditions than did the older listeners with hearing loss. The mean performance differences between shaped and unshaped rise-fall characteristics ranged from <1–3% and were not significant. Performance was significantly 10–17% better on the 0 msec condition than on the 50 msec condition. There was no significant interaction between the two main variables, rise-fall shape, and onset time of the interruptions. Conclusions: The rise-fall shape of the onset and offset of the on-segment of the interruption cycle does not affect recognition performance of words. The location of the interruptions in a word can have a significant effect on recognition performance.
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Costa, Flávia Azevedo de Mattos Moura, Ruth França Cizino da Trindade e Claudia Benedita dos Santos. "Deaths from homicides: a historical series". Revista Latino-Americana de Enfermagem 22, n. 6 (dicembre 2014): 1017–25. http://dx.doi.org/10.1590/0104-1169.3603.2511.
Testo completoAbstract (sommario):
OBJECTIVE: to describe mortality from homicides in Itabuna, in the State of Bahia.METHOD: study with hybrid, ecological and time-trend design. The mortality coefficients per 1,000 inhabitants, adjusted by the direct technique, proportional mortality by sex and age range, and Potential Years of Life Lost were all calculated.RESULTS: since 2005, the external causes have moved from third to second most-common cause of death, with homicides being responsible for the increase. In the 13 years analyzed, homicides have risen 203%, with 94% of these deaths occurring among the male population. Within this group, the growth occurred mainly in the age range from 15 to 29 years of age. It was ascertained that 83% of the deaths were caused by firearms; 57.2% occurred in public thoroughfares; and 98.4% in the urban zone. In 2012, the 173 homicides resulted in 7,837 potential years of life lost, with each death causing, on average, the loss of 45.3 years.CONCLUSIONS: mortality by homicide in a medium-sized city in Bahia reaches levels observed in the big cities of Brazil in the 1980s, evidencing that the phenomenon of criminality - formerly predominant only in the big urban centers - is advancing into the rural area of Brazil, causing changes in the map of violent homicide in Brazil.
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Wong, Ambrose H., Jessica M. Ray, Marc A. Auerbach, Arjun K. Venkatesh, Caitlin McVaney, Danielle Burness, Christopher Chmura et al. "Study protocol for the ACT response pilot intervention: development, implementation and evaluation of a systems-based Agitation Code Team (ACT) in the emergency department". BMJ Open 10, n. 6 (giugno 2020): e036982. http://dx.doi.org/10.1136/bmjopen-2020-036982.
Testo completoAbstract (sommario):
IntroductionEmergency department (ED) visits for behavioural conditions are rising, with 1.7 million associated episodes of patient agitation occurring annually in acute care settings. When de-escalation techniques fail during agitation management, patients are subject to use of physical restraints and sedatives, which are associated with up to 37% risk of hypotension, apnoea and physical injuries. At the same time, ED staff report workplace violence due to physical assaults during agitation events. We recently developed a theoretical framework to characterise ED agitation, which identified teamwork as a critical component to reduce harm. Currently, no structured team response protocol for ED agitation addressing both patient and staff safety exists.Methods and analysisOur proposed study aims to develop and implement the agitation code team (ACT) response intervention, which will consist of a standardised, structured process with defined health worker roles/responsibilities, work processes and clinical protocols. First, we will develop the ACT response intervention in a two-step design loop; conceptual design will engage users in the creation of the prototype, and iterative refinement will occur through in situ simulated agitated patient encounters in the ED to assess and improve the design. Next, we will pilot the intervention in the clinical environment and use a controlled interrupted time series design to evaluate its effect on our primary outcome of patient restraint use. The intervention will be considered efficacious if we effectively lower the rate of restraint use over a 6-month period.Ethics and disseminationEthical approval by the Yale University Human Investigation Committee was obtained in 2019 (HIC #2000025113). Results will be disseminated through peer-reviewed publications and presentations at scientific meetings for each phase of the study. If this pilot is successful, we plan to formally integrate the ACT response intervention into clinical workflows at all EDs within our entire health system.
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McMullen, Heather, Victoria Boydell, Joanna Paula Cordero, Petrus S. Steyn, James Kiarie, Patrick Kinemo, Alice Monyo, Mary Awelana Addah, Jacob Tetteh Ahuno e Osei-Bonsu Gyamfi. "Accounting for complexity – Intervention design in the context of studying social accountability for reproductive health". Gates Open Research 5 (22 luglio 2021): 107. http://dx.doi.org/10.12688/gatesopenres.13260.1.
Testo completoAbstract (sommario):
Background: Social accountability interventions aim to propel change by raising community voices and holding duty bearers accountable for delivering on rights and entitlements. Evidence on the role of such interventions for improving community health outcomes is steadily emerging, including for sexual and reproductive health and rights (SRHR). However, these interventions are complex social processes with numerous actors, multiple components, and a highly influential local context. Unsurprisingly, determining the mechanisms of change and what outcomes may be transferable to other similar settings can be a challenge. We report our methodological considerations to account for complexity in a social accountability intervention exploring contraceptive uptake and use in Ghana and Tanzania. Main Body: The Community and Provider driven Social Accountability Intervention (CaPSAI) study explores the relationship between a health facility-focused social accountability intervention and contraceptive service provision in two countries. This 24-month mixed-method quasi-experimental study, using an interrupted time series with a parallel control group, is being undertaken in 16 sites across Ghana and Tanzania in collaboration with local research and implementation partners. The primary outcomes include changes in contraceptive uptake and use. We also measure outcomes related to current social accountability theories of change and undertake a process evaluation. We present three design features: co-design, ‘conceptual’ fidelity, and how we aim to track the intervention as ‘intended vs. implemented’ to explore how the intervention could be responsive to the embedded routines, local contextual realities, and the processual nature of the social accountability intervention. Conclusions: Through a discussion of these design features and their rationale, we conclude by suggesting approaches to intervention design that may go some way in responding to recent challenges in accounting for social accountability interventions, bearing relevance for evaluating health system interventions.