35 resultados para quality use of medicines


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Introduction: Online databases can support the implementation of evidence-based practice by providing easy access to research. OTseeker (www.otseeker.com), an electronic evidence database, was introduced in 2003 to assist occupational therapists to locate and interpret research. Objectives: This study explored Australian occupational therapists' use and perceptions of OTseeker and its impact on their knowledge and practice. Methods: A postal survey questionnaire was distributed to two samples: (i) a proportionate random sample of 400 occupational therapists from all states and territories of Australia, and (ii) a random sample of occupational therapists working in 95 facilities in two Australian states (Queensland and New South Wales). Results: The questionnaire was completed by 213 participants. While most participants (85.9%) had heard of OTseeker, only 103 (56.6%) had accessed it, with lack of time being the main reason for non-use. Of the 103 participants who had accessed OTseeker, 68.9% had done so infrequently, 63.1% agreed that it had increased their knowledge and 13.6% had changed their practice after accessing information on OTseeker. Conclusion: Despite OTseeker being developed to provide occupational therapists with easy access to research, lack of time was the main reason why over half of the participants in this study had not accessed it. This exploratory research suggests, however, that there is potential for the database to influence occupational therapists' knowledge and practice about treatment efficacy through access to the research literature.

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Birds show striking interspecific variation in their use of carotenoid-based coloration. Theory predicts that the use of carotenoids for coloration is closely associated with the availability of carotenoids in the diet but, although this prediction has been supported in single-species studies and those using small numbers of closely related species, there have been no broad-scale quantitative tests of the link between carotenoid coloration and diet. Here we test for such a link using modern comparative methods, a database on 140 families of birds and two alternative avian phylogenies. We show that carotenoid pigmentation is more common in the bare parts (legs, bill and skin) than in plumage, and that yellow coloration is more common than red. We also show that there is no simple, general association between the availability of carotenoids in the diet and the overall use of carotenoid-based coloration. However, when we look at plumage coloration separately from bare part coloration, we find there is a robust and significant association between diet and plumage coloration, but not between diet and bare part coloration. Similarly, when we look at yellow and red plumage colours separately, we find that the association between diet and coloration is typically stronger for red coloration than it is for yellow coloration. Finally, when we build multivariate models to explain variation in each type of carotenoid-based coloration we find that a variety of life history and ecological factors are associated with different aspects of coloration, with dietary carotenoids only being a consistent significant factor in the case of variation in plumage. All of these results remain qualitatively unchanged irrespective of the phylogeny used in the analyses, although in some cases the precise life history and ecological variables included in the multivariate models do vary. Taken together, these results indicate that the predicted link between carotenoid coloration and diet is idiosyncratic rather than general, being strongest with respect to plumage colours and weakest for bare part coloration. We therefore suggest that, although the carotenoid-based bird plumage may a good model for diet-mediated signalling, the use of carotenoids in bare part pigmentation may have a very different functional basis and may be more strongly influenced by genetic and physiological mechanisms, which currently remain relatively understudied.

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Objectives: To estimate differences in self-rated health by mode of administration and to assess the value of multiple imputation to make self-rated health comparable for telephone and mail. Methods: In 1996, Survey 1 of the Australian Longitudinal Study on Women's Health was answered by mail. In 1998, 706 and 11,595 mid-age women answered Survey 2 by telephone and mail respectively. Self-rated health was measured by the physical and mental health scores of the SF-36. Mean change in SF-36 scores between Surveys 1 and 2 were compared for telephone and mail respondents to Survey 2, before and after adjustment for socio-demographic and health characteristics. Missing values and SF-36 scores for telephone respondents at Survey 2 were imputed from SF-36 mail responses and telephone and mail responses to socio-demographic and health questions. Results: At Survey 2, self-rated health improved for telephone respondents but not mail respondents. After adjustment, mean changes in physical health and mental health scores remained higher (0.4 and 1.6 respectively) for telephone respondents compared with mail respondents (-1.2 and 0.1 respectively). Multiple imputation yielded adjusted changes in SF-36 scores that were similar for telephone and mail respondents. Conclusions and Implications: The effect of mode of administration on the change in mental health is important given that a difference of two points in SF-36 scores is accepted as clinically meaningful. Health evaluators should be aware of and adjust for the effects of mode of administration on self-rated health. Multiple imputation is one method that may be used to adjust SF-36 scores for mode of administration bias.

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The development of TDR for measurement of soil water content and electrical conductivity has resulted in a large shift in measurement methods for a breadth of soil and hydrological characterization efforts. TDR has also opened new possibilities for soil and plant research. Five examples show how TDR has enhanced our ability to conduct our soil- and plant-water research. (i) Oxygen is necessary for healthy root growth and plant development but quantitative evaluation of the factors controlling oxygen supply in soil depends on knowledge of the soil water content by TDR. With water content information we have modeled successfully some impact of tillage methods on oxygen supply to roots and their growth response. (ii) For field assessment of soil mechanical properties influencing crop growth, water content capability was added to two portable soil strength measuring devices; (a) A TDT (Time Domain Transmittivity)-equipped soil cone penetrometer was used to evaluate seasonal soil strengthwater content relationships. In conventional tillage systems the relationships are dynamic and achieve the more stable no-tillage relationships only relatively late in each growing season; (b) A small TDR transmission line was added to a modified sheargraph that allowed shear strength and water content to be measured simultaneously on the same sample. In addition, the conventional graphing procedure for data acquisition was converted to datalogging using strain gauges. Data acquisition rate was improved by more than a factor of three with improved data quality. (iii) How do drought tolerant plants maintain leaf water content? Non-destructive measurement of TDR water content using a flat serpentine triple wire transmission line replaces more lengthy procedures of measuring relative water content. Two challenges remain: drought-stressed leaves alter salt content, changing electrical conductivity, and drought induced changes in leaf morphology affect TDR measurements. (iv) Remote radar signals are reflected from within the first 2 cm of soil. Appropriate calibration of radar imaging for soil water content can be achieved by a parallel pair of blades separated by 8 cm, reaching 1.7 cm into soil and forming a 20 cm TDR transmission line. The correlation between apparent relative permittivity from TDR and synthetic aperture radar (SAR) backscatter coefficient was 0.57 from an airborne flyover. These five examples highlight the diversity in the application of TDR in soil and plant research.