Effectiveness Of Different Approaches Research Articles

Efficient Developments in Modeling and Optimization of Solid State Fermentation

ABSTRACTArtificial intelligence techniques are important tools for modelling and optimizing the solid-state fermentation (SSF) factors. The performance of fermentation processes is affected by numerous factors, including temperature, moisture content, agitation, inoculum level, carbon and nitrogen sources, etc. In this paper, the identification of non-linear relationship between fermentation factors and targeted objectives is performed, first, using the learning capabilities of a neural network (NN). Then, this approach is coupled with various artificial intelligence techniques to optimize the fermentation process, such as Genetic Algorithm (GA) and Particle Swarm Optimization (PSO). The effectiveness of different approaches is compared with the classical statistical techniques, such as Response Surface Methodology (RSM), that are increasingly being used. This paper presents the first attempt to adapt these approaches on the solid state fermentation process. The obtained results prove the effectiveness of the proposed approach. Particularly, we show that this approach leads to a significant improvement on the fermentation process performance.

A Systematic Review of Family Witnessed Resuscitation and Family Witnessed Invasive Procedures in Adults in Hospital Settings Internationally - Part II: Perspectives of Healthcare Providers.

Medicalization of care has removed family members from loved ones during critical events. Family Witnessed Resuscitation and Family Witnessed Invasive Procedures represent patient / family centered care options that can assist with having the family at the bedside during this perilous time. The objective was to examine the evidence on FWR and FWIP in adults from the perspective of healthcare providers. This review considered studies involving healthcare providers overseeing the medical care of adult patients in intensive care units, emergency departments, trauma rooms and general nursing wards.This review examined interventions used for the adoption/implementation of FWR and FWIP including but not limited to: formal policy and guidelines; family facilitator/chaperone role; educational programming; communication approaches; and debriefing.This review considered studies that included the following outcome measures for healthcare providers: actual or perceived responses to FWR and FWIP, and factors affecting the adoption/implementation of FWR and FWIP.Randomised controlled trials, controlled trials, cohort studies, case-control studies, before and after studies, case series studies, and survey studies were considered for inclusion. A comprehensive multistep search was undertaken for English language published and unpublished studies from 1985-2010. Retrieved papers were assessed for methodological quality independently by two reviewers, using appropriate JBI critical appraisal tools. Findings were extracted using researcher-developed de novo tools, utilizing a framework of experiential, participant, and environmental factors influencing FWR/FWIP. Meta-analysis was possible for 5 studies; all other results of this review are presented in narrative form. 38 studies were retrieved and after critical appraisal a total of 28 studies were included for the perspectives of healthcare providers. There was one randomized controlled trial and one match-controlled study, representing JBI Level II and IIIa evidence, respectively. All other healthcare provider studies were descriptive cross-sectional survey designs representing JBI Level IIIc evidence. There exists mixed support for family witnessed resuscitation among healthcare providers in the included studies. Factors such as duration of clinical practice in nursing or critical care, the study setting and the presence of a formal institutional policy all appear to play an important role in the perspectives of healthcare providers on family witnessed resuscitation. Health care organisations should consider the fact that healthcare providers overall do not object to family witnessed resuscitation on the basis of its outcomes, but rather on the processes of its implementation and the decision-making that is required. There is insufficient evidence on family witnessed invasive procedures to make policy recommendations. There is a need for well-designed randomised controlled designs that test the effectiveness of different approaches to FWR with outcomes that go beyond the level of support for the procedure. NOTE:: This is Part II of the systematic review report. Part II of the review report will explicate the perceptions of healthcare providers on family witnessed resuscitation (FWR) and family witnessed invasive procedures (FWIP) in the adult population in emergency departments, intensive care units and general hospital wards internationally. Part I of the review report will explicate the perceptions of patients and their relatives regarding this phenomenon.Both review reports (part I and part II) are based on the same a priori approved review protocol. The decision to provide two review reports for one review protocol was justified for the sake of improved organization of the results. The volume of information from part I and part II, if combined, would make the review excessively long and difficult to read. Furthermore, some studies analysed the perspectives of both patients/families and healthcare providers. Thus, to minimize the risk of study selection bias, the reviewers decided that a separate round of critical appraisal and data extraction of studies was prudent in order to fully and independently explicate the perspectives of patients/families and healthcare providers.Furthermore, the textual component initially proposed in the approved review protocol was not included namely because the majority of FWR and FWIP protocols from the included studies could not be located for further analysis. Also, the reviewers determined that a separate systematic review that searches specifically for studies rich in textual information would be needed to truly capture the breadth of expert opinions and consensus statements on the issues of FWR and FWIP.

A Systematic Review of Family Witnessed Resuscitation and Family Witnessed Invasive Procedures in Adults in Hospital Settings Internationally - Part II: Perspectives of Healthcare Providers

Background Medicalization of care has removed family members from loved ones during critical events. Family Witnessed Resuscitation and Family Witnessed Invasive Procedures represent patient / family centered care options that can assist with having the family at the bedside during this perilous time. Objectives The objective was to examine the evidence on FWR and FWIP in adults from the perspective of healthcare providers. Inclusion Criteria Types of participants This review considered studies involving healthcare providers overseeing the medical care of adult patients in intensive care units, emergency departments, trauma rooms and general nursing wards. Types of interventions This review examined interventions used for the adoption/implementation of FWR and FWIP including but not limited to: formal policy and guidelines; family facilitator/chaperone role; educational programming; communication approaches; and debriefing. Types of outcomes This review considered studies that included the following outcome measures for healthcare providers: actual or perceived responses to FWR and FWIP, and factors affecting the adoption/implementation of FWR and FWIP. Types of studies Randomised controlled trials, controlled trials, cohort studies, case-control studies, before and after studies, case series studies, and survey studies were considered for inclusion. Search strategy A comprehensive multistep search was undertaken for English language published and unpublished studies from 1985-2010. Methodological quality Retrieved papers were assessed for methodological quality independently by two reviewers, using appropriate JBI critical appraisal tools. Data collection Findings were extracted using researcher-developed de novo tools, utilizing a framework of experiential, participant, and environmental factors influencing FWR/FWIP. Data synthesis Meta-analysis was possible for 5 studies; all other results of this review are presented in narrative form. Results 38 studies were retrieved and after critical appraisal a total of 28 studies were included for the perspectives of healthcare providers. There was one randomized controlled trial and one match-controlled study, representing JBI Level II and IIIa evidence, respectively. All other healthcare provider studies were descriptive cross-sectional survey designs representing JBI Level IIIc evidence. Conclusions There exists mixed support for family witnessed resuscitation among healthcare providers in the included studies. Factors such as duration of clinical practice in nursing or critical care, the study setting and the presence of a formal institutional policy all appear to play an important role in the perspectives of healthcare providers on family witnessed resuscitation. Implications for practice Health care organisations should consider the fact that healthcare providers overall do not object to family witnessed resuscitation on the basis of its outcomes, but rather on the processes of its implementation and the decision-making that is required. There is insufficient evidence on family witnessed invasive procedures to make policy recommendations. Implications for research There is a need for well-designed randomised controlled designs that test the effectiveness of different approaches to FWR with outcomes that go beyond the level of support for the procedure. Note: This is Part II of the systematic review report. Part II of the review report will explicate the perceptions of healthcare providers on family witnessed resuscitation (FWR) and family witnessed invasive procedures (FWIP) in the adult population in emergency departments, intensive care units and general hospital wards internationally. Part I of the review report will explicate the perceptions of patients and their relatives regarding this phenomenon. Both review reports (part I and part II) are based on the same a priori approved review protocol. The decision to provide two review reports for one review protocol was justified for the sake of improved organization of the results. The volume of information from part I and part II, if combined, would make the review excessively long and difficult to read. Furthermore, some studies analysed the perspectives of both patients/families and healthcare providers. Thus, to minimize the risk of study selection bias, the reviewers decided that a separate round of critical appraisal and data extraction of studies was prudent in order to fully and independently explicate the perspectives of patients/families and healthcare providers. Furthermore, the textual component initially proposed in the approved review protocol was not included namely because the majority of FWR and FWIP protocols from the included studies could not be located for further analysis. Also, the reviewers determined that a separate systematic review that searches specifically for studies rich in textual information would be needed to truly capture the breadth of expert opinions and consensus statements on the issues of FWR and FWIP.

A Systematic Review of Family Witnessed Resuscitation and Family Witnessed Invasive Procedures in Adults in Hospital Settings Internationally - Part I: Perspectives of Patients and Families.

Medicalization of care has removed family members from loved ones during critical events. Family Witnessed Resuscitation and Family Witnessed Invasive Procedures represent patient / family centered care options that can assist with having the family at the bedside during this perilous time. The objective was to examine the evidence on FWR and FWIP in adults from the perspective of patients and relatives. This review considered studies involving adult patients and their relatives, in intensive care units, emergency departments, trauma rooms and general nursing wards.This review examined interventions used for the adoption/implementation of FWR and FWIP including but not limited to: formal policy and guidelines; family facilitator/chaperone role; educational programming; communication approaches; and debriefing.This review considered studies that included the following outcome measures for patients and family members: level of support; stress and anxiety; grief and bereavement; coping; psychological sequelae; and impact of family facilitator/chaperone role, formal family presence policy or protocols, educational programming, communication approaches, and debriefing.Any randomised controlled trials, controlled trials, cohort studies, case-control studies, before and after studies, case series studies, and survey studies were considered for inclusion. A comprehensive multistep search was undertaken for English language published and unpublished studies from 1985-2010. Retrieved papers were assessed for methodological quality independently by two reviewers, using appropriate JBI critical appraisal assessment tools. Findings were extracted using researcher-developed de novo tools, utilizing a framework of experiential, participant, and environmental factors influencing FWR/FWIP. The de novo tools best addressed the data collected. Meta-analysis was not possible due to heterogeneity; all the results of this review are presented in narrative form. 38 studies were retrieved and after critical appraisal a total of 15 studies were included. Of the seven patient studies, one was a match-control "actual witness" study representing JBI Level IIIA evidence and the remaining "perception of witness" studies were descriptive cross-sectional survey designs representing JBI Level IIIC evidence. Ten family member studies included four with "actual witness" and six with "perception of witness." All family member studies were descriptive cross-sectional survey designs representing JBI Level IIIC evidence. Two studies surveyed both patients and relatives, reducing the number of unique studies to 15. From the focus of family members with actual resuscitation experience and those with "perception" of witness, there exists strong support/preference for FWR across all countries in the included studies, and the belief that it is a right. Health care organisations should provide family members the option to witness. There is insufficient evidence on FWIP to make policy recommendations. There is a need for well-designed randomised controlled designs that test the effectiveness of different approaches to FWR with outcomes that go beyond the level of support for the procedure. NOTE:: This is Part I of the systematic review report. Part I of the review report will explicate the perceptions of patients and family members on family witnessed resuscitation (FWR) and family witnessed invasive procedures (FWIP) in the adult population in emergency departments, intensive care units and general hospital wards internationally. Part II of the review report will explicate the perceptions of physicians, nurses and other healthcare providers regarding this phenomenon.Both review reports (part I and part II) are based on the same a priori approved review protocol. The decision to provide two review reports for one review protocol was justified for the sake of improved organization of the results. The volume of information from part I and part II, if combined, would make the review excessively long and difficult to read. Furthermore, some studies analysed the perspectives of both patients/families and healthcare providers. Thus, to minimize the risk of study selection bias, the reviewers decided that a separate round of critical appraisal and data extraction of studies was prudent in order to fully and independently explicate the perspectives of patients/families and healthcare providers.Furthermore, the textual component initially proposed in the approved review protocol was not included namely because the majority of FWR and FWIP protocols from the included studies could not be located for further analysis. Also, the reviewers determined that a separate systematic review that searches specifically for studies rich in textual information would be needed to truly capture the breadth of expert opinions and consensus statements on the issues of FWR and FWIP.

An Empirical Analysis Over the Four Different Feature-Based Face and Iris Biometric Recognition Techniques

Recently, multimodal biometric systems have been widely accepted, which has shown increased accuracy and population coverage, while reducing vulnerability to spoofing. The main feature to multimodal biometrics is the amalgamation of different biometric modality data at the feature extraction, matching score, or decision levels. Recently, a lot of works are presented in the literature for multi-modal biometric recognition. In this paper, we have presented comparative analysis of four different feature extraction approaches, such as LBP, LGXP, EMD and PCA. The main steps involved in such four approaches are: 1) Feature extraction from face image, 2) Feature extraction from iris image and 3) Fusion of face and iris features. The performance of the feature extraction methods in multi-modal recognition is analyzed using FMR and FNMR to study the recognition behavior of these approaches. Then, an extensive analysis is carried out to find the effectiveness of different approaches using two different databases. The experimental results show the equal error rate of different feature extraction approaches in multi-modal biometric recognition. From the ROC curve plotted, the performance of the LBP and LGXP method is better compared to PCA-based technique.

Road Safety Issues for Bus Transport Management

In twenty of the countries composing the European Union (EU20), there are approximately 800,000 buses, equivalent to 0.35% of the total road vehicle fleet (230 million vehicles), while 10% of road trips are made by bus. Given these rates, bus crashes account for very few events, involving less than 1% of total road fatalities (ERF, 2010). It is evident that despite the significance of crashes involving buses and the assumption that public transport improves road safety by reducing vehicular traffic, few studies are available in the literature on crash data involving buses. The paper presents an overall analysis and comparison of crash data related to bus at European level. A more in depth study carried out at Italian National level provides a useful summary of practice in the area of bus safety management. The work focuses on the expertise of fleet managers to evaluate the effectiveness of different approaches and systems to reach higher safety standards. A survey form was defined referring to relevant factors affecting safety related to the driver (training, skills, performance evaluation and behavior), the vehicle (maintenance and advanced devices) and the road (traffic conflicts and urban road environment).Results provide useful information on the state of the art and current practices of urban public road transport in the area of road safety. Start inhibition, automatic door opening, and bus materials and internal architecture were unanimously considered the top safety items for bus passenger safety. Brake assistance and vehicle monitoring systems were also generally considered very effective.

Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women

Pelvic floor muscle training is the most commonly recommended physical therapy treatment for women with stress urinary incontinence. It is also sometimes recommended for mixed and, less commonly, urge urinary incontinence. The supervision and content of pelvic floor muscle training programmes are highly variable, and some programmes use additional strategies in an effort to increase adherence or training effects. To compare the effects of different approaches to pelvic floor muscle training for women with urinary incontinence. We searched the Cochrane Incontinence Group Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and CINAHL, and handsearching of journals and conference proceedings (searched 17 May 2011), and the reference lists of relevant articles. Randomised trials or quasi-randomised trials in women with stress, urge or mixed urinary incontinence (based on symptoms, signs or urodynamics). One arm of the study included pelvic floor muscle training. Another arm was an alternative approach to pelvic floor muscle training, such as a different way of teaching, supervising or performing pelvic floor muscle training. We independently assessed trials for eligibility and methodological quality. We extracted then cross-checked data. We resolved disagreements by discussion. We processed data as described in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.2.2). We subgrouped trials by intervention. We screened 574 records for eligibility and included 21 trials in the review. The 21 trials randomised 1490 women and addressed 11 comparisons. These were: differences in training supervision (amount, individual versus group), in approach (one versus another, the effect of an additional component) and the exercise training (type of contraction, frequency of training). In women with stress urinary incontinence, 10% of those who received weekly or twice-weekly group supervision in addition to individual appointments with the therapist did not report improvement post-treatment compared to 43% of the group who had individual appointments only (risk ratio (RR) for no improvement 0.29, 95% confidence interval (CI) 0.15 to 0.55, four trials). Looking at this another way, 90% of those who had combined group and individual supervision reported improvement versus 57% of women receiving individual supervision only. While women receiving the combination of frequent group supervision and individual supervision of pelvic floor muscle training were more likely to report improvement, the confidence interval was wide, and more than half of the 'control' group (the women who did not get the additional weekly or twice-weekly group supervision) reported improvement. This finding, of subjective improvement in both active treatment groups, with more improvement reported by those receiving more health professional contact, was consistent throughout the review.We feel there are several reasons why caution is needed when interpreting the results of the review: there were few data in any comparison; a number of trials were confounded by comparing two arms with multiple differences in the approaches to pelvic floor muscle training; there was a likelihood of a relationship between attention and reporting of more improvement in women who were not blind to treatment allocation; some trials chose interventions that were unlikely to have a muscle training effect; and some trials did not adequately describe their intervention. This review found that the existing evidence was insufficient to make any strong recommendations about the best approach to pelvic floor muscle training. We suggest that women are offered reasonably frequent appointments during the training period, because the few data consistently showed that women receiving regular (e.g. weekly) supervision were more likely to report improvement than women doing pelvic floor muscle training with little or no supervision.

A systematic review of integrated working between care homes and health care services

BackgroundIn the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working.MethodsA systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis.ResultsSeventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in duration.ConclusionsDespite evidence about what inhibits and facilitates integrated working there was limited evidence about what the outcomes of different approaches to integrated care between health service and care homes might be. The majority of studies only achieved integrated working at the patient level of care and the focus on health service defined problems and outcome measures did not incorporate the priorities of residents or acknowledge the skills of care home staff. There is a need for more research to understand how integrated working is achieved and to test the effect of different approaches on cost, staff satisfaction and resident outcomes.

Improving second language skills of immigrant students: A field trial study evaluating the effects of a summer learning program

Immigrant students’ school success is often hampered by limited second language (L2) proficiency, yet the effectiveness of different approaches to L2 support is unclear. Using a summer camp setting, we tested effects of (1) implicit support focusing on meaning of language by engaging students in language-intensive activities without drawing their attention to rules (operationalization: theatre program) and (2) combined implicit and explicit support focusing students’ attention on both meaning and form of language (operationalization: theatre program and instruction in German as L2). A baseline group received no support. N = 149 third-graders with German as L2 participated. There was no effect for the implicit condition on L2, yet children in the combined condition performed significantly better in grammar and reading after the treatment than the baseline group. The difference for vocabulary did not reach significance. Three months later, a significant effect for the combined condition was only found for reading.

Impact of demand load size on strategies for reliable process heat supply

When providing high-temperature process steam to a user such as a chemical plant, high availability and reliability are necessary to maintain production and avoid sudden, unscheduled shutdowns with potentially adverse investment consequences. Therefore, the availability and reliability requirements are expected to be higher than those applicable to dedicated electric power plants. This paper evaluates the impact of the size of the process steam demand on the effectiveness of different approaches for meeting these high reliability requirements using High Temperature Reactor (HTR) process steam supply systems. Such systems will require significant backup redundancy, since individual reactor modules have inherently lower availability than that required by a process heat plant. Systems using additional HTRs and systems using traditional gas-fired boilers for backup capacity are both analyzed. Potential system configurations are analyzed for a wide range of process heat plant steam demands, from 200MWt to 1500MWt. The analysis includes availability analysis, assessment of overall redundancy, and economic evaluation. Consideration is also given to the benefit of selling surplus electricity generated with excess steam. Finally, the sensitivity of different plant configurations to fossil fuel price volatility is discussed briefly.

Drama grammar: towards a performative postmethod pedagogy

This article presents the original concept of drama grammar, the synthesis of grammar instruction and drama pedagogy, which integrates both structural and communicative paradigms through a dialectic combination of acting and linguistic analysis. Based on the principles of drama pedagogy, drama grammar makes use of techniques from the performing arts, encompassing cognitive, emotional, social, practical and kinesthetic learning dimensions. Both the failed quest for the ultimate foreign language teaching method and inconclusive evidence regarding the effectiveness of different approaches to grammar instruction highlight the necessity for postmethod approaches to grammar teaching and learning. An introduction of common drama pedagogy techniques provides an insight into drama-based forms of learning for the foreign language classroom, and a prototypical drama grammar lesson shows how the teaching and learning of grammar can be operationalized within the performative paradigm. Drama grammar can thus be understood as an important step towards a postmethod grammar pedagogy.

The role of performance indicators in management commentary

Recent literature on financial reporting underlines that, in order to meet the changing needs of business reporting users, more information with a forward-looking perspective should be provided, with a focus on those factors that are responsible for longer- term value, including non-financial measurers. This article hence focuses on the importance of Key Performance Indicators (KPIs) in Management Commentary (MC). Through content analysis, we examine a sample of 111 reports from around the world (following different local and/or international regulations). The paper explores how organizations in practice use KPIs for external purposes, first investigating to what extent KPIs provide the information required by the MC frameworks, and, secondly, whether such KPIs have the suggested characteristics. Results show that although KPIs seem to potentially play a valuable and recognized role in providing the information required by the different MC frameworks, a large number of companies have not provided an effective and balanced picture of the drivers and factors that will lead their future performance. This paper contributes to the scarce research on the effectiveness of different approaches to regulate MC reports, with a specific focus on KPIs. It also highlights some critical issues concerning what and how KPI information should be produced and reported.

Post-dural Puncture Headache: A Comparison Between Median and Paramedian Approaches in Orthopedic Patients

Background: Post-dural puncture headache (PDPH) is an iatrogenic complication of spinal anesthesia. Reported risk factors for PDPH include sex, age, pregnancy, needle tip shape and size, bevel orientation, approach and others. Little is known regarding the effect of different approaches on the incidence of PDPH. Objectives: In this study we aimed to compare the incidence of PDPH in the case of median and paramedian approaches in patients undergoing spinal anesthesia for orthopedic operations. Patients and Methods: Patients scheduled for orthopedic surgery under spinal anesthesia between 2007 and 2008 were studied in a double-blinded randomized controlled trial. The patients were randomized to receive spinal anesthesia by either a median (n = 75) or paramedian (n = 75) approach through a 25-gauge Crawford needle. No premedication was given, and all patients received 500 mL of normal saline intravenously and 4 mL of 0.5% isobaric Marcaine 30 minutes prior to surgery in both approaches. Results: Fifteen patients (10%) developed PDPH. There was no significant difference in the incidence of PDPH in both groups, with 7 (9.3%) patients in the median approach group versus 8 (10.7%) in the paramedian approach group developing typical PDPH (P = 0.875). However, a significant difference in PDPH incidence (P = 0.041) was observed between females (9; 16.7%) and males (6; 6.3%). Conclusions: There is no difference between median and paramedian approaches with respect to PDPH incidence; the paramedian approach is therefore recommended, especially for older patients with degenerative changes in the spine and intervertebral spaces and those who cannot take the proper position. Moreover, the rate of PDPH was found to be significantly higher in females than in males.

College student reactions to health warning labels: Sociodemographic and psychosocial factors related to perceived effectiveness of different approaches

Objective To examine factors associated with perceiving different types of pictorial cigarette health warning labels as most effective in motivating smokers to quit or preventing smoking initiation among college students. Method We administered an online survey to 24,055 students attending six Southeast colleges in Fall, 2010. We obtained complete data for the current analyses from 2600. Results Current smoking prevalence was 23.5%. The largest majority (78.6%) consistently rated gruesome images as most effective, 19.5% rated testimonial images as most effective, and only a small proportion rated either standard (1.6%) or human suffering images (0.3%) as most effective. Subsequent analyses focused on differences between those endorsing gruesome images or testimonials as most effective. Factors related to ranking testimonials versus gruesome images as most effective included being female (p < 0.01), White (p < 0.01), and nonsmokers (p = 0.04), lower perceived smoking prevalence (p < 0.01), and greater receptivity to laws/restrictions around smoking (p < 0.01) and tobacco marketing (p = 0.01). Among smokers, factors related to ranking testimonials as most effective versus gruesome images included being female (p = 0.03), being White (p = 0.03), higher autonomous motivation (p = 0.03), and greater extrinsic self-efficacy (p = 0.02). Conclusions Understanding factors related to perceived effectiveness of different pictorial warnings among subpopulations should inform health warning labels released by the FDA.

What can we learn from car sharing experiences in the UK?

Car sharing has become synonymous with sustainable transport planning across the UK, but to date there is limited evidence on the effectiveness of different approaches in different settings and contexts. Research undertaken by Integrated Transport Planning Ltd in 2010 on behalf of the Yorkshire and Humber Rural Affairs and Rural Transport Forums has examined the extent, reach and coverage of current car sharing schemes in the Yorkshire and Humber region, with the aim of assessing their potential for improving access to employment, training and key services for people in areas of geographic isolation. The research shows that car sharing has the potential to play a far greater role in transport strategy without the need for significant investment. The paper combines the 2010 research findings with a review of earlier research and explores the contribution that car sharing can play in reducing carbon emissions and improving access to services.

Lateral preference and schizotypy revisited: Comparison of handedness measurement and classification methods

A sample of 256 undergraduate students was administered five schizotypy scales and a lateral preference questionnaire consisting of 41 handedness items, in order to examine the effect of different approaches to the measurement and classification of handedness on the relationship between schizotypy and lateral preference. The extended handedness questionnaire included the 12 items of Annett's handedness questionnaire, the 10 items of Oldfield's (1971) Edinburgh Handedness Inventory, the 19 items of the lateral preference questionnaire used by Kelley and Coursey (1992a), and additional items from Steenhuis and Bryden's (1989) 32-item Waterloo Handedness Inventory, allowing the examination and comparison of a variety of handedness classification schemes and the computation of several continuous measures of handedness, and comparison of their relationships to schizotypy. Different approaches to the measurement and classification of handedness yielded somewhat different findings concerning the relationship to schizotypy, which also varied depending on gender and the schizotypy measure involved. Among males, higher schizotypy scores were associated with more dextral lateral preference, whereas among females higher schizotypy was associated with mixed right-handedness.

Analyzing the effect of different approaches of penalized relationship in multistage selection schemes1

The aim of this study was to extend optimum contribution selection to more realistic breeding schemes with multistage selection. It seems that if the last selection stage accounts for the relationship of the selected animals, then previous selection stages also account for this relationship. An extreme example was considered here: the preselection of dairy bulls that enter a progeny testing scheme. First the penalty on the average relationship in selection step 1 is assumed the same as in step 2. Thereafter, situations with different penalties on the average relationship in the 2 selection steps were analyzed. The simulation started with the generation of prior EBV, which were sampled from a truncated normal distribution. Possible candidates for further progeny testing were selected and progeny test EBV were simulated, where the progeny test was based on 100 daughters per young bull. In situations with greater accuracy of prior EBV, high trait heritability and prior EBV were available for 2,000 bulls; the results were similar for both approaches, independent of family size. However, in a situation with low accuracy of prior EBV and low trait heritability it could be observed that with increasing penalty on the average relationship, correction for relationship in stage 1 yielded in a similar genetic level compared with selecting only for high prior EBV. If the number of bulls with prior EBV increased from 2,000 to 4,000, an increasing penalty on an average relationship gave an improved genetic level. A further improvement of the results with respect to genetic level and average relationship could be observed by increasing the penalty on an average relationship in selection step 1 above that in selection step 2. Overall, this study showed that it is beneficial to use a penalty on an average relationship already for the selection of bulls that enter the progeny test. In case optimum contribution was applied with a constraint on the average relationship in stage 2, this constraint may be translated into a penalty on the average relationship, and the current results suggested that the optimal penalty in selection stage 1 should be twice that of stage 2.

Diets of minority ethnic groups in the UK: influence on chronic disease risk and implications for prevention

Summary Introduction 1Definitions of ethnic groups and demographics of minority ethnic groups in the UK ○ 1.1 Definitions of ‘ethnic groups’ and ‘ethnicity’ ○ 1.2 Demographics and characteristics of minority ethnic groups in the UK – Countries of origin – Age/sex distribution and life expectancy – Geographical distribution and size of household – Religious beliefs – Education and employment patterns Key points 2Overview of the health profile and dietary habits of minority ethnic groups in the UK ○ 2.1 Available surveys ○ 2.2 Overview of the health profiles among adults from minority ethnic groups – Overall health – Cardiovascular disease (CVD) – Coronary heart disease (CHD) – Stroke – Type 2 diabetes – Obesity ○ 2.3 Possible causes of increased disease risk among minority ethnic groups ○ 2.4 Smoking, drinking and physical activity habits ○ 2.5 Dietary habits and nutritional status ○ 2.6 Overview of the health profiles and dietary and health behaviour patterns of children from minority ethnic groups – Overall health – Diet and health behaviour patterns ○ 2.7 Gaps in data availability Key points 3Factors affecting food choice – Income and socio-economic status – Food availability and access – Awareness of healthy eating – Religious beliefs – Food beliefs – Time and cooking skills – Generation and gender Key points 4Traditional diets of minority ethnic groups ○ 4.1 Overview of traditional diets of minority ethic groups – South Asians – African-Caribbeans – Chinese ○ 4.2 Dietary acculturation ○ 4.3 Nutritional composition of ethnic-style cuisine Key points 5Nutritional interventions and health promotion among minority ethnic groups ○ 5.1 Effective nutritional interventions ○ 5.2 Health promotion interventions to prevent problems associated with fasting ○ 5.3 Priorities for nutritional interventions and health promotion ○ 5.4 Using behaviour change models ○ 5.5 Current community initiatives ○ 5.6 Catering for institutionalised individuals ○ 5.7 Recommendations for future research, policy and practice Key points 6Conclusion • Acknowledgements • References Summary According to the latest census, non-white minority ethnic groups made up 7.9% of the UK's population in 2001. The largest of these groups were South Asians, Black African-Caribbeans and Chinese. Studies have shown that some minority ethnic groups are more likely to experience poorer health outcomes compared with the mainstream population. These include higher rates of cardiovascular disease (CVD), type 2 diabetes and obesity. The differences in health outcomes may reflect interactions between diet and other health behaviours, genetic predisposition and developmental programming, all of which vary across different groups. As is the case for the rest of the population, the dietary habits of minority ethnic groups are affected by a wide variety of factors, but acquiring a better understanding of these can help health professionals and educationalists to recognise the needs of these groups and help them to make healthier food choices. Unfortunately, to date, there have been few tailored, well-designed and evaluated nutritional interventions in the UK targeting minority ethnic population groups. Further needs assessment and better evaluation of nutritional interventions have been recommended to enhance the understanding of the effectiveness of different approaches amongst minority ethnic groups. This briefing paper will provide an overview of the health profile, dietary habits and other health behaviours of the three largest non-white minority ethnic groups in the UK, explore the factors affecting their food choices, provide a summary of their traditional diets and review the evidence base to identify the factors that support successful nutrition interventions in these groups.

Estimates of Insulin Secretory Function in Apparently Healthy Volunteers Vary as a Function of How the Relevant Variables Are Quantified

Several surrogate estimates have been used to define relationships between insulin action and pancreatic β-cell function in healthy individuals. Because it is unclear how conclusions about insulin secretory function depend on specific estimates used, we evaluated the effect of different approaches to measurement of insulin action and secretion on observations of pancreatic β-cell function in individuals whose fasting plasma glucose (FPG) was <7.0 mmol/L (126 mg/dL). We determined 2 indices of insulin secretion [homeostasis model assessment of β-cell function (HOMA-β) and daylong insulin response to mixed meals], insulin action [homeostasis model assessment of insulin resistance (HOMA-IR) and steady-state plasma glucose (SSPG) concentration during the insulin suppression test], and degree of glycemia [fasting plasma glucose (FPG) and daylong glucose response to mixed meals] in 285 individuals with FPG <7.0 mmol/L. We compared the relationship between the 2 measures of insulin secretion as a function of the measures of insulin action and degree of glycemia. Assessment of insulin secretion varied dramatically as a function of which of the 2 methods was used and which measure of insulin resistance or glycemia served as the independent variable. For example, the correlation between insulin secretion (HOMA-β) and insulin resistance varied from an r value of 0.74 (when HOMA-IR was used) to 0.22 (when SSPG concentration was used). Conclusions about β-cell function in nondiabetic individuals depend on the measurements used to assess insulin action and insulin secretion. Viewing estimates of insulin secretion in relationship to measures of insulin resistance and/or degree of glycemia does not mean that an unequivocal measure of pancreatic β-cell function has been obtained.

Homeopathy for Depression - DEP-HOM: study protocol for a randomized, partially double-blind, placebo controlled, four armed study

BackgroundHomeopathy is often sought by patients with depression. In classical homeopathy, the treatment consists of two main elements: the case history and the prescription of an individually selected homeopathic remedy. Previous data suggest that individualized homeopathic Q-potencies were not inferior to the antidepressant fluoxetine in a sample of patients with moderate to severe depression. However, the question remains whether individualized homeopathic Q-potencies and/or the type of the homeopathic case history have a specific therapeutical effect in acute depression as this has not yet been investigated. The study aims to assess the two components of individualized homeopathic treatment for acute depression, i.e., to investigate the specific effect of individualized Q-potencies versus placebo and to investigate the effect of different approaches to the homeopathic case history.Methods/DesignA randomized, partially double-blind, placebo-controlled, four-armed trial using a 2 × 2 factorial design with a six-week study duration per patient will be performed. 228 patients diagnosed with major depression (moderate episode) by a psychiatrist will be included. The primary endpoint is the total score on the 17-item Hamilton Depression Rating Scale after six weeks. Secondary end points are: Hamilton Depression Rating Scale total score after two and four weeks; response and remission rates, Beck Depression inventory total score, quality of life and safety at two, four and six weeks. Statistical analyses will be by intention-to-treat. The main endpoint will be analysed by a two-factorial analysis of covariance. Within this model generalized estimation equations will be used to estimate differences between verum and placebo, and between both types of case history.DiscussionFor the first time this study evaluates both the specific effect of homeopathic medicines and of a homeopathic case taking in patients with depression. It is an attempt to deal with the challenges of homeopathic research and the results might be useful information in the current discussion about the evidence on homeopathyTrial registrationClinicalTrials.gov: NCT01178255