Responsiveness and clinical utility of the geriatric self-efficacy index for urinary incontinence

OBJECTIVES: To report on the responsiveness testing and clinical utility of the 12-item Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI). DESIGN: Prospective cohort study. SETTING: Six urinary incontinence (UI) outpatient clinics in Quebec, Canada. PARTICIPANTS: Community-dwelling incontinent adults aged 65 and older. MEASUREMENTS: The abridged 12-item GSE-UI, measuring older adults' level of confidence for preventing urine loss, was administered to all new consecutive incontinent patients 1 week before their initial clinic visit, at baseline, and 3 months posttreatment. At follow-up, a positive rating of improvement in UI was ascertained from patients and their physicians using the Patient's and Clinician's Global Impression of Improvement scales, respectively. Responsiveness of the GSE-UI was calculated using Guyatt's change index. Its clinical utility was determined using receiver operating curves. RESULTS: Eighty-nine of 228 eligible patients (39.0%) participated (mean age 72.6+5.8, range 65–90). At 3-month follow-up, 22.5% of patients were very much better, and 41.6% were a little or much better. Guyatt's change index was 2.6 for patients who changed by a clinically meaningful amount and 1.5 for patients having experienced any level of improvement. An improvement of 14 points on the 12-item GSE-UI had a sensitivity of 75.1% and a specificity of 78.2% for detecting clinically meaningful changes in UI status. Mean GSE-UI scores varied according to improvement status (P<.001) and correlated with changes in quality-of-life scores (r=0.7, P<.001) and reductions in UI episodes (r=0.4, P=.004). CONCLUSION: The GSE-UI is responsive and clinically useful.

Inflammation dans les bronches du modèle d'asthme chez le rat Brown Norway = Inflammation in the airways of the Brown Norway rat model of asthma

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

The responsiveness of government revenue to marginal tax rates

Ce document utilise des données fiscales et démographiques pour calculer les changements dans les recettes du gouvernement engendrés par les ajustements dans le taux marginal d'imposition, et cela en mettant l’accent sur la fourchette d'imposition la plus élevée. La portée de l’étude est une sélection de pays de l’O.C.D.E. Une analyse des changement de comportement des contribuables et des différentes alternatives dont le gouvernement dispose en termes de politique fiscale en suivaient. En fin, les possibles faiblesses dans des techniques de référence sont examinées en détail.