To use individual participant data meta-analysis (IPDMA) to estimate the minimal detectable change (MDC) of the Geriatric Depression Scale-15 (GDS-15) and to examine whether MDC may differ based on ...participant characteristics and study-level variables.
This was a secondary analysis of data from an IPDMA on the depression screening accuracy of the GDS. Datasets from studies published in any language were eligible for the present study if they included GDS-15 scores for participants aged 60 or older. MDC of the GDS-15 was estimated via random-effects meta-analysis using 2.77 (MDC95) and 1.41 (MDC67) standard errors of measurement (SEM). Subgroup analyses were used to evaluate differences in MDC by participant age and sex. Meta-regression was conducted to assess for differences based on study-level variables, including mean age, proportion male, proportion with major depression, and recruitment setting.
5,876 participants (mean age 76 years, 40% male, 11% with major depression) from 21 studies were included. The MDC95 was 3.81 points (95% confidence interval CI 3.59, 4.04), and MDC67 was 1.95 (95% CI 1.83, 2.03). The difference in MDC95 was 0.26 points (95% CI 0.04, 0.48) between ≥ 80-year-olds and < 80-year-olds; MDC95 was similar for females and males (0.05, 95% CI -0.12, 0.22). The MDC95 increased by 0.29 points (95% CI 0.17, 0.41) per 10% increase in proportion of participants with major depression; mean age had a small association (0.04 points, 95% CI 0.00 to 0.09) with MDC95, but sex and recruitment setting were not significantly associated.
The MDC95 was 3.81 points and MDC67 was 1.95 points. MDC95 increased with the proportion of participants with major depression. Results can be used to evaluate individual changes in depression symptoms and as a threshold for assessing minimal clinical important difference estimates.
•Key findings.•We estimated the minimal detectable change (MDC) of the Geriatric Depression Scale-15 (GDS-15) in 21 studies (5,876 participants).•The MDC95 of the GDS-15 was 3.81 points (95% CI 3.59, 4.04), and the MDC67 was 1.95 (95% CI 1.83, 2.03).The proportion of participants with major depression in primary studies and mean age were positively associated with the MDC95, but sex and study recruitment setting do not appear to meaningfully influence MDC.•What this adds to what is known.•The only previous study that assessed the MDC or minimal important difference of the GDS-15 was a single-center study of 189 patients who underwent lung transplantation. We investigated the MDC of the GDS-15 in over 5,876 participants in 21 studies and evaluated participant and study characteristics potentially associated with the MDC.•What is the implication, what should change now?.•The overall MDC can be applied in non-psychiatric research and clinical settings but may need adjustment based on the proportion of participants with major depression. The MDC of the GDS-15 should be compared to MID estimated with an anchor-based approach.
The author explores the relationship of play to choreography. He defines choreography as the rules that guide body movements from their minute physicality to their broad social and cultural contours. ...He conducts a review of the literature and accentuates five general topics--learning through creativity; choreography as writing and pedagogy; comparisons of dance and choreography to play and sport; children's play and environments as choreographies; and choreography as critical play interventions in public spaces. He argues that viewing play through a choreographic lens helps us understand how players physically communicate and create meaning through action in various play situations. Key words: choreography and play; participatory sense making
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Community-based participatory research (CBPR) represents an important improvement in the integration of marginalized voices into research programs by including community members in the designs, ...conduct, and dissemination of studies. CBPR often features a social justice component, generating studies designed to reduce societal disparities and improve outcomes for disenfranchised groups. However, the practical implementation of CBPR usually fails to capitalize on this promise, using the same traditional research methodologies, leadership structures, trial designs, and research questions that inculcate researcher bias. In response to the problem, we propose a new solution: Applied critical rhetorical research (ACRR) integrated into the CBPR approach to clinical health research. ACRR research combines critical/cultural studies and rhetorical methods to amplify the figurative voice of marginalized populations. ACRR can expose how majority power (i.e., hegemony) manifests in social institutions like healthcare and government, where its meanings and subjectivities are absorbed. ACRR analyses enhance CBPR by shaping research in directions that reduce stigma, unintended disenfranchisement, and culturally bound bias, increasing the yield from CBPR for researchers and the community.
Abstract
We present a new semi-quantum signature protocol which is suitable for participant without quantum capabilities to communicate securely. In addition, the application of EPR steering is first ...extended to the field of quantum digital signature in our protocol. On the one hand, in order to avoid attacks by attackers, our protocol allows one participant to determine the identity of the other, if the steering conditions for EPR steering are satisfied. On the other hand, original message can be transmitted between participants via EPR steering. Moreover, our scheme is simple to implement and more efficient. The security analysis shows that our protocol can avoid the attack of deny, forgery and entangle-measure.
Researchers interested in testing mediation often use designs where participants are measured on a dependent variable Y and a mediator M in both of 2 different circumstances. The dominant approach to ...assessing mediation in such a design, proposed by Judd, Kenny, and McClelland (2001), relies on a series of hypothesis tests about components of the mediation model and is not based on an estimate of or formal inference about the indirect effect. In this article we recast Judd et al.'s approach in the path-analytic framework that is now commonly used in between-participant mediation analysis. By so doing, it is apparent how to estimate the indirect effect of a within-participant manipulation on some outcome through a mediator as the product of paths of influence. This path-analytic approach eliminates the need for discrete hypothesis tests about components of the model to support a claim of mediation, as Judd et al.'s method requires, because it relies only on an inference about the product of paths-the indirect effect. We generalize methods of inference for the indirect effect widely used in between-participant designs to this within-participant version of mediation analysis, including bootstrap confidence intervals and Monte Carlo confidence intervals. Using this path-analytic approach, we extend the method to models with multiple mediators operating in parallel and serially and discuss the comparison of indirect effects in these more complex models. We offer macros and code for SPSS, SAS, and Mplus that conduct these analyses.
We tested the hypothesis that underrepresented students in active-learning classrooms experience narrower achievement gaps than underrepresented students in traditional lecturing classrooms, averaged ...across all science, technology, engineering, and mathematics (STEM) fields and courses. We conducted a comprehensive search for both published and unpublished studies that compared the performance of underrepresented students to their overrepresented classmates in active-learning and traditional-lecturing treatments. This search resulted in data on student examination scores from 15 studies (9,238 total students) and data on student failure rates from 26 studies (44,606 total students). Bayesian regression analyses showed that on average, active learning reduced achievement gaps in examination scores by 33% and narrowed gaps in passing rates by 45%. The reported proportion of time that students spend on in-class activities was important, as only classes that implemented high-intensity active learning narrowed achievement gaps. Sensitivity analyses showed that the conclusions are robust to sampling bias and other issues. To explain the extensive variation in efficacy observed among studies, we propose the heads-and-hearts hypothesis, which holds that meaningful reductions in achievement gaps only occur when course designs combine deliberate practice with inclusive teaching. Our results support calls to replace traditional lecturing with evidence-based, active-learning course designs across the STEM disciplines and suggest that innovations in instructional strategies can increase equity in higher education.
This study is aimed at understanding the Human-Nature Relationships (HNRs) in the Lower Mngeta and Upper Zigi catchments, as parts of Eastern Arc water catchment areas, in the United Republic of ...Tanzania. This study employed the Theory of Planned Behavior (TPB) and Norm-Activation Model (NAM) to understand the position of humans in the two catchments' ecosystems. The study design involved Focus Group Discussions, Key Informant Interview, and Household Questionnaire Surveys. A total of 310 (185 males and 125 females) villagers were involved in this study. Furthermore, four HRN typologies, master over nature, partner with nature, a participant in nature, and steward of nature, were adopted. The study findings indicated that there was no significant difference (X
2
test, p > 0.05) in HNRs between the two catchments. Moreover, master over nature typology was dominant in both catchments, with values of 59.4% (n = 200) and 59.5% (n = 85) in Lower Mngeta and Upper Zigi, respectively. The main reason is that HNR is dependent on the nature of the livelihood activities and the mode of subsistence of a particular community. It was also found that the communities in Lower Mngeta and Upper Zigi catchments are mostly dependent on agricultural and hunting activities that highly depended on the two catchment resources. This study, therefore, recommends an increase in the level of community participation in all decision-making activities, as well as an increase in environmental education for sustainable utilization and management of the two catchment resources.
Background
Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self‐reported alcohol use, we conducted an individual participant data (IPD) ...meta‐analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self‐reporting unhealthy alcohol consumption.
Methods
We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1‐step IPD meta‐analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index—BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger‐prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self‐reported alcohol use using the AUDIT‐C score.
Results
One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT‐C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables.
Conclusions
Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.
This is an analysis of data from 21 studies that included 3085 persons from four continents who reported unhealthy alcohol use. We found that the sensitivity of phosphatidylethanol (PEth), a blood alcohol biomarker indicating prior 2–4 weeks’ alcohol use, increased with level of alcohol use, but did not vary by sex, race/ethnicity, or age. PEth sensitivity was lower for persons with higher body mass index, more severe anemia, and among persons with HIV infection. These factors may need to be considered in interpreting negative PEth results.
Aim
To synthesize international findings on the alcohol–dementia relationship, including representation from low‐ and middle‐income countries.
Methods
Individual participant data meta‐analysis of 15 ...prospective epidemiological cohort studies from countries situated in six continents. Cox regression investigated the dementia risk associated with alcohol use in older adults aged over 60 years. Additional analyses assessed the alcohol–dementia relationship in the sample stratified by sex and by continent. Participants included 24 478 community dwelling individuals without a history of dementia at baseline and at least one follow‐up dementia assessment. The main outcome measure was all‐cause dementia as determined by clinical interview.
Results
At baseline, the mean age across studies was 71.8 (standard deviation = 7.5, range = 60–102 years), 14 260 (58.3%) were female and 13 269 (54.2%) were current drinkers. During 151 636 person‐years of follow‐up, there were 2124 incident cases of dementia (14.0 per 1000 person‐years). When compared with abstainers, the risk for dementia was lower in occasional hazard ratio (HR) = 0.78; 95% confidence interval (CI) = 0.68–0.89, light–moderate (HR = 0.78; 95% CI = 0.70–0.87) and moderate–heavy drinkers (HR = 0.62; 95% CI = 0.51–0.77). There was no evidence of differences between life‐time abstainers and former drinkers in terms of dementia risk (HR = 0.98; 95% CI = 0.81–1.18). In dose–response analyses, moderate drinking up to 40 g/day was associated with a lower risk of dementia when compared with lif‐time abstaining. Among current drinkers, there was no consistent evidence for differences in terms of dementia risk. Results were similar when the sample was stratified by sex. When analysed at the continent level, there was considerable heterogeneity in the alcohol–dementia relationship.
Conclusions
Abstinence from alcohol appears to be associated with an increased risk for all‐cause dementia. Among current drinkers, there appears to be no consistent evidence to suggest that the amount of alcohol consumed in later life is associated with dementia risk.
In research involving human subjects, large participation payments often are deemed undesirable because they may provide ‘undue inducement’ for potential participants to expose themselves to risk. ...However, although large incentives may encourage participation, they also may signal the riskiness of a study's procedures. In three experiments, we measured people's interest in participating in potentially risky research studies, and their perception of the risk associated with those studies, as functions of participation payment amounts. All experiments took place 2007–2008 with an on-line nationwide sample or a sample from a northeastern U.S. city. We tested whether people judge studies that offer higher participation payments to be riskier, and, if so, whether this increased perception of risk increases time and effort spent learning about the risks. We found that high participation payments increased willingness to participate, but, consistent with the idea that people infer riskiness from payment amount, high payments also increased perceived risk and time spent viewing risk information. Moreover, when a link between payment amount and risk level was made explicit in Experiment 3, the relationship between high payments and perceived risk strengthened. Research guidelines usually prohibit studies from offering participation incentives that compensate for risks, yet these experiments' results indicate that potential participants naturally assume that the magnitude of risks and incentives are related. This discrepancy between research guidelines and participants' assumptions about those guidelines has implications for informed consent in human subjects research.
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