Betydningen av pilotundersøkelse før validering av oversatte instrumenter

Sykepleiere har uttrykt behov for et instrument for vurdering og oppfølging av etterlevelse av helseråd for hjertesviktpasienter. I USA er det utviklet to spørreskjemaer som tar sikte på å vurdere etterlevelse av helseråd innenfor rammen av saltfattig mat og å ta medisiner som forordnet. Disse instrumentene ble oversatt til norsk. To pilotundersøkelser ble gjennomført med hensikt å sikre kulturell tilpasning av instrumentene og kartlegging av rekrutterings- og datasamlingsprosedyre. Kulturell tilpasning av instrumentene ble gjort gjennom et fokusgruppeintervju med fire pasienter. Kartlegging av ønskede prosedyrer for rekruttering av pasienter, og elementer i datasamlingsprosessen ble gjennomført med strukturerte intervju og åpne spørsmål med 16 pasienter. Fokusgruppeintervjuet resulterte i noen endringer i formuleringer. Det strukturerte intervjuet avdekket sentrale elementer: Under halvparten av informantene ville ha svart på et tilsendt spørreskjema. De ville heller bli intervjuet enn å fylle ut svarene selv. Et entydig funn var at de ikke ville delta om det dreide seg om forpliktelser til flere undersøkelser eller tester. Deltagelse måtte helst skje i forbindelse med et sammenfallende ærend på sykehuse

Effect of Vascepa (icosapent ethyl) on progression of coronary atherosclerosis in patients with elevated triglycerides (200-499 mg/dL) on statin therapy: Rationale and design of the EVAPORATE study.

Despite reducing progression and promoting regression of coronary atherosclerosis, statin therapy does not fully address residual cardiovascular (CV) risk. High-purity eicosapentaenoic acid (EPA) added to a statin has been shown to reduce CV events and induce regression of coronary atherosclerosis in imaging studies; however, data are from Japanese populations without high triglyceride (TG) levels and baseline EPA serum levels greater than those in North American populations. Icosapent ethyl is a high-purity prescription EPA ethyl ester approved at 4 g/d as an adjunct to diet to reduce TG levels in adults with TG levels >499 mg/dL. The objective of the randomized, double-blind, placebo-controlled EVAPORATE study is to evaluate the effects of icosapent ethyl 4 g/d on atherosclerotic plaque in a North American population of statin-treated patients with coronary atherosclerosis, TG levels of 200 to 499 mg/dL, and low-density lipoprotein cholesterol levels of 40 to 115 mg/dL. The primary endpoint is change in low-attenuation plaque volume measured by multidetector computed tomography angiography. Secondary endpoints include incident plaque rates; quantitative changes in different plaque types and morphology; changes in markers of inflammation, lipids, and lipoproteins; and the relationship between these changes and plaque burden and/or plaque vulnerability. Approximately 80 patients will be followed for 9 to 18 months. The clinical implications of icosapent ethyl 4 g/d treatment added to statin therapy on CV endpoints are being evaluated in the large CV outcomes study REDUCE-IT. EVAPORATE will provide important imaging-derived data that may add relevance to the clinically derived outcomes from REDUCE-IT

Telecentre functionality in South Africa: re-enabling the community ICT access environment

Despite the availability and capabilities of Information and Communication Technologies (ICT) in low and middle-income countries, the use of these constantly evolving tools remains limited for the majority of resource-poor citizens. This is especially the case for internet-based tools. In South Africa, an upper middle-income country, the percentage of the population categorised as individual 'internet users' increased from 5.4 percent in 2000 to just 18.0 percent in 2010 (ITU, 2011). In order to overcome these low percentages, government intervention is frequently adopted, especially in rural areas, where it is not profitable for telecommunication operators to build infrastructure as a means to promote the uptake of internet use in poorer communities (USAASA, 2009: 47). In South Africa and elsewhere, government sponsored telecentres are a common non-profit mode of delivery, however there is much evidence of recurring problems (Gomez et al., 2012). Telecentres have many structural components (human, political and technical) which need to support each other in order to create a functional telecentre (Benjamin, 2001a; Heeks, 2002; Proenza, 2002). The failure of one or more of these components, as detailed by Roman & Colle (2002), Hulbert & Snyman (2007), and Parkinson (2005) can render telecentres non-functional. Such failures continue to plague the delivery of Public Access Computing (PAC) services in South Africa and elsewhere; and in the light of the growth of smartphones, it could be argued that telecentres are not a meaningful mode through which internet access can be delivered (Chigona et al., 2011; Gomez et al., 2012). However, ICT4D has lacked a robust theoretical base (Flor, 2012; Urquhart et al., 2008) and the literature has been dominated by a rather 'structuralist' and supply-side approach with less attention to individual agency and the demand-side. By considering how elements of agency and structure combine in relation to ICTs, the Choice Framework (CF) developed by Kleine (2010) is a step forward. This approach facilitates the analyses of people's varied ability to empower themselves and improve their quality of life (QoL). Using this Framework, this article analyses the operational experiences of telecentre provision of computer and internet access, alongside user experiences that reveal how telecentre and other structural issues interact with the characteristics of users and their various sets of resources. Based on this analysis, we suggest that PACs should remain a part of the ICT debate, although we question the business model that has come to dominate their operation.International Bibliography of Social Science

Professional Development to Encourage Pedagogical Use of the Schoology Learning Management System

This purpose of this study was to provide teacher professional development to the Franklin High School science department teachers about the Schoology learning management system purchased by the El Paso ISD. The teachers were engaging minimally with the new technology because of a lack of time to experiment with the new platform and limited opportunities for professional development during their work days. Technology integration at the Franklin High School campus was important because it was a one-to-one computer to student campus. The participants worked at Franklin High School in the science department, covering all the science courses taught on the campus. They were experienced with technology in general but most did not have experience with Schoology. Six teachers completed the pre-training surveys, 17 to 20 teachers participated in each of the training sessions, and seven were interviewed. Three training sessions were developed around the basics of the Schoology platform. Pretraining surveys from experienced users provided information about the most useful aspects of the platform to guide planning for the training sessions. Science department teachers selected the topics chosen for the trainings. I observed the teacher engagement and behaviors and recorded them during the sessions. After all three sessions were complete, I individually interviewed seven teachers about the sessions. I employed a qualitative research method. I coded the interview data and categorized them to generate the common themes. Results indicated that teachers’ attitudes towards the Schoology platform improved and their interest in using it in their practice increased. Receiving participant input about training topics increased their engagement during the training sessions, suggesting that involving teachers in content selection increases interest in the training

Antitumor activity and safety of the PARP inhibitor rucaparib in patients with high grade ovarian carcinoma and a germline or somatic BRCA1 or BRCA2 mutation: integrated analysis of data from Study 10 and ARIEL2

Objective: An integrated analysis was undertaken to characterize the antitumor activity and safety profile of the oral poly(ADP-ribose) polymerase inhibitor rucaparib in patients with relapsed high-grade ovarian carcinoma (HGOC). Methods: Eligible patients from Study 10 (NCT01482715) and ARIEL2 (NCT01891344) who received a starting dose of oral rucaparib 600 mg twice daily (BID) with or without food were included in these analyses. The integrated efficacy population included patients with HGOC and a deleterious germline or somatic BRCA1 or BRCA2 (BRCA1/2) mutation who received at least two prior chemotherapies and were sensitive, resistant, or refractory to platinum-based chemotherapy. The primary endpoint was investigator-assessed confirmed objective response rate (ORR). Secondary endpoints included duration of response (DOR) and progression-free survival (PFS). The integrated safety population included patients with HGOC who received at least one dose of rucaparib 600 mg BID, irrespective of BRCA1/2 mutation status and prior treatments. Results: In the efficacy population (n = 106), ORR was 53.8% (95% confidence interval [CI], 43.8–63.5); 8.5% and 45.3% of patients achieved complete and partial responses, respectively. Median DOR was 9.2 months (95% CI, 6.6–11.6). In the safety population (n = 377), the most frequent treatment-emergent adverse events (AEs) were nausea, asthenia/fatigue, vomiting, and anemia/hemoglobin decreased. The most common grade ≥ 3 treatment-emergent AE was anemia/hemoglobin decreased. Treatment-emergent AEs led to treatment interruption, dose reduction, and treatment discontinuation in 58.6%, 45.9%, and 9.8% of patients, respectively. No treatment-related deaths occurred. Conclusions: Rucaparib has antitumor activity in advanced BRCA1/2-mutated HGOC and a manageable safety profile

Associations between lifestyle factors and an unhealthy diet.

: Unhealthy dietary patterns have been associated with other unhealthy lifestyle factors such as smoking and physical inactivity. Whether these associations are similar in high- and low-educated individuals is currently unknown

Professional Development to Encourage Pedagogical Use of the Schoology Learning Management System

This purpose of this study was to provide teacher professional development to the Franklin High School science department teachers about the Schoology learning management system purchased by the El Paso ISD. The teachers were engaging minimally with the new technology because of a lack of time to experiment with the new platform and limited opportunities for professional development during their work days. Technology integration at the Franklin High School campus was important because it was a one-to-one computer to student campus. The participants worked at Franklin High School in the science department, covering all the science courses taught on the campus. They were experienced with technology in general but most did not have experience with Schoology. Six teachers completed the pre-training surveys, 17 to 20 teachers participated in each of the training sessions, and seven were interviewed. Three training sessions were developed around the basics of the Schoology platform. Pretraining surveys from experienced users provided information about the most useful aspects of the platform to guide planning for the training sessions. Science department teachers selected the topics chosen for the trainings. I observed the teacher engagement and behaviors and recorded them during the sessions. After all three sessions were complete, I individually interviewed seven teachers about the sessions. I employed a qualitative research method. I coded the interview data and categorized them to generate the common themes. Results indicated that teachers’ attitudes towards the Schoology platform improved and their interest in using it in their practice increased. Receiving participant input about training topics increased their engagement during the training sessions, suggesting that involving teachers in content selection increases interest in the training

Mortality According to CD4 Count at Start of Combination Antiretroviral Therapy Among HIV-infected Patients Followed for up to 15 Years After Start of Treatment: Collaborative Cohort Study.

BACKGROUND: CD4 count at start of combination antiretroviral therapy (ART) is strongly associated with short-term survival, but its association with longer-term survival is less well characterized. METHODS: We estimated mortality rates (MRs) by time since start of ART (<0.5, 0.5-0.9, 1-2.9, 3-4.9, 5-9.9, and ≥10 years) among patients from 18 European and North American cohorts who started ART during 1996-2001. Piecewise exponential models stratified by cohort were used to estimate crude and adjusted (for sex, age, transmission risk, period of starting ART [1996-1997, 1998-1999, 2000-2001], and AIDS and human immunodeficiency virus type 1 RNA at baseline) mortality rate ratios (MRRs) by CD4 count at start of ART (0-49, 50-99, 100-199, 200-349, 350-499, ≥500 cells/µL) overall and separately according to time since start of ART. RESULTS: A total of 6344 of 37 496 patients died during 359 219 years of follow-up. The MR per 1000 person-years was 32.8 (95% confidence interval [CI], 30.2-35.5) during the first 6 months, declining to 16.0 (95% CI, 15.4-16.8) during 5-9.9 years and 14.2 (95% CI, 13.3-15.1) after 10 years' duration of ART. During the first year of ART, there was a strong inverse association of CD4 count at start of ART with mortality. This diminished over the next 4 years. The adjusted MRR per CD4 group was 0.97 (95% CI, .94-1.00; P = .054) and 1.02 (95% CI, .98-1.07; P = .32) among patients followed for 5-9.9 and ≥10 years, respectively. CONCLUSIONS: After surviving 5 years of ART, the mortality of patients who started ART with low baseline CD4 count converged with mortality of patients with intermediate and high baseline CD4 counts

Impact of Risk Factors for Specific Causes of Death in the First and Subsequent Years of Antiretroviral Therapy Among HIV-Infected Patients

Among HIV-infected patients who initiated antiretroviral therapy (ART), patterns of cause-specific death varied by ART duration and were strongly related to age, sex, and transmission risk group. Deaths from non-AIDS malignancies were much more frequent than those from cardiovascular diseas

Mortality according to CD4 count at start of combination antiretroviral therapy among HIV-infected patients followed for up to 15 years after start of treatment:collaborative cohort study

Background. CD4 count at start of combination antiretroviral therapy (ART) is strongly associated with short-term survival, but its association with longer-term survival is less well characterised. Methods. We estimated mortality rates (MR) by time since start of ART (&lt;0.5, 0.5-0.9, 1-2.9, 3-3.9, 5-9.9 and ≥10 years) among patients from 18 European and North American cohorts who started ART during 1996-2001. Piecewise exponential models stratified by cohort were used to estimate crude and adjusted (for sex, age, transmission risk, period of starting ART [1996-7, 1998-9, 2000-1], AIDS and HIV-1 RNA at baseline) mortality rate ratios (MRR) by CD4 count at start of ART (0-49, 50-99, 100-199, 200-349, 350-499, ≥500 cells/μL) overall and separately according to time since start of ART. Results. 6,344 of 37,496 patients died during 359,219 years of follow up. The MR per 1000 person-years was 32.8 (95% CI 30.2-35.5) during the first 6 months, declining to 16.0 (15.4, 16.8) during 5-9.9 years and 14.2 (13.3-15.1) after 10 years duration of ART. During the first year of ART there was a strong inverse association of CD4 count at start of ART with mortality. This diminished over the next 4 years. The adjusted MRR per CD4 group were 0.97 (0.94-1.00), p=0.054 and 1.02 (0.98-1.07), p=0.32 among patients followed for 5-9.9 and &gt;10 years respectively. Conclusions. After surviving five years of ART, the mortality of patients who started ART with low baseline CD4 count converged with mortality of patients with intermediate and high baseline CD4 counts. </p