Valerian does not appear to reduce symptoms for patients with chronic insomnia in general practice using a series of randomised n-of-I trials

Objectives: To investigate the effectiveness of valerian for the management of chronic insomnia in general practice. Design: Valerian versus placebo in a series of n-of-1 trials, in Queensland, Australia. Results: Of 42 enrolled patients, 24 (57%) had sufficient data for inclusion into the n-of-1 analysis. Response to valerian was fair for 23 (96%) participants evaluating their 'energy level in the previous day' but poor or modest for all 24 (100%) participants' response to 'total sleep time' and for 23 (96%) participants' response to 'number of night awakenings' and 'morning refreshment'. As a group, the proportion of treatment successes ranged from 0.35 (95% CI 0.23, 0.47) to 0.55 (95% CI 0.43, 0.67) for the six elicited outcome sleep variables. There was no significant difference in the number (P = 0.06), distribution (P = 1.00) or severity (P = 0.46) of side effects between valerian and placebo treatments. Conclusions: Valerian was not shown to be appreciably better than placebo in promoting sleep or sleep-related factors for any individual patient or for all patients as a group. (C) 2003 Elsevier Ltd. All rights reserved.

Data-driven fuzzy analysis in quantitative mineral resource assessment

The integration of geo-information from multiple sources and of diverse nature in developing mineral favourability indexes (MFIs) is a well-known problem in mineral exploration and mineral resource assessment. Fuzzy set theory provides a convenient framework to combine and analyse qualitative and quantitative data independently of their source or characteristics. A novel, data-driven formulation for calculating MFIs based on fuzzy analysis is developed in this paper. Different geo-variables are considered fuzzy sets and their appropriate membership functions are defined and modelled. A new weighted average-type aggregation operator is then introduced to generate a new fuzzy set representing mineral favourability. The membership grades of the new fuzzy set are considered as the MFI. The weights for the aggregation operation combine the individual membership functions of the geo-variables, and are derived using information from training areas and L, regression. The technique is demonstrated in a case study of skarn tin deposits and is used to integrate geological, geochemical and magnetic data. The study area covers a total of 22.5 km(2) and is divided into 349 cells, which include nine control cells. Nine geo-variables are considered in this study. Depending on the nature of the various geo-variables, four different types of membership functions are used to model the fuzzy membership of the geo-variables involved. (C) 2002 Elsevier Science Ltd. All rights reserved.

Nonfatal heroin overdoses in Queensland, Australia: an analysis of ambulance data

In the past decade, the utilization of ambulance data to inform the prevalence of nonfatal heroin overdose has increased. These data can assist public health policymakers, law enforcement agencies, and health providers in planning and allocating resources. This study examined the 672 ambulance attendances at nonfatal heroin overdoses in Queensland, Australia, in 2000. Gender distribution showed a typical 70/30 male-to-female ratio. An equal number of persons with nonfatal heroin overdose were between 15 and 24 years of age and 25 and 34 years of age. Police were present in only 1 of 6 cases, and 28.1% of patients reported using drugs alone. Ambulance data are proving to be a valuable population-based resource for describing the incidence and characteristics of nonfatal heroin overdose episodes. Future studies could focus on the differences between nonfatal heroin overdose and fatal heroin overdose samples.

Ex ante evaluations of alternate data structures for end user queries: Theory and experimental test

The data structure of an information system can significantly impact the ability of end users to efficiently and effectively retrieve the information they need. This research develops a methodology for evaluating, ex ante, the relative desirability of alternative data structures for end user queries. This research theorizes that the data structure that yields the lowest weighted average complexity for a representative sample of information requests is the most desirable data structure for end user queries. The theory was tested in an experiment that compared queries from two different relational database schemas. As theorized, end users querying the data structure associated with the less complex queries performed better Complexity was measured using three different Halstead metrics. Each of the three metrics provided excellent predictions of end user performance. This research supplies strong evidence that organizations can use complexity metrics to evaluate, ex ante, the desirability of alternate data structures. Organizations can use these evaluations to enhance the efficient and effective retrieval of information by creating data structures that minimize end user query complexity.

'Slippage' is not a dirty word: Considering the usefulness of Giddens' notion of knowledgeability in understanding the possibilities for teacher education

The attempt to understand the relationship between messages intended and messages received has been an enduring issue in teacher education. For the past three decades researchers have made forays into understanding this enduring issue, and in the process have drawn on various explanatory frameworks, one of them being socialisation. In this paper we work with Giddens' structuration theory as well as his concept of knowledgeability as analytical frameworks for understanding the relationship between messages intended (by the teacher educator) and messages received (by the student-teachers). Our discussion is informed by the findings of a study that investigated student-teachers' interpretations of the pedagogical process of a physical education teacher education course. Data generated from conversations with, and observations of, the student-teachers indicated that there was considerable “slippage” between the teacher educator's critical pedagogy inspired intentions and what was understood by the student-teachers.

The design and implementation of a repository for the management of spatial data integrity constraints

This paper reviews the key features of an environment to support domain users in spatial information system (SIS) development. It presents a full design and prototype implementation of a repository system for the storage and management of metadata, focusing on a subset of spatial data integrity constraint classes. The system is designed to support spatial system development and customization by users within the domain that the system will operate.

Are diagnosis specific outcome indicators based on administrative data useful in assessing quality of hospital care?

Background: Hospital performance reports based on administrative data should distinguish differences in quality of care between hospitals from case mix related variation and random error effects. A study was undertaken to determine which of 12 diagnosis-outcome indicators measured across all hospitals in one state had significant risk adjusted systematic ( or special cause) variation (SV) suggesting differences in quality of care. For those that did, we determined whether SV persists within hospital peer groups, whether indicator results correlate at the individual hospital level, and how many adverse outcomes would be avoided if all hospitals achieved indicator values equal to the best performing 20% of hospitals. Methods: All patients admitted during a 12 month period to 180 acute care hospitals in Queensland, Australia with heart failure (n = 5745), acute myocardial infarction ( AMI) ( n = 3427), or stroke ( n = 2955) were entered into the study. Outcomes comprised in-hospital deaths, long hospital stays, and 30 day readmissions. Regression models produced standardised, risk adjusted diagnosis specific outcome event ratios for each hospital. Systematic and random variation in ratio distributions for each indicator were then apportioned using hierarchical statistical models. Results: Only five of 12 (42%) diagnosis-outcome indicators showed significant SV across all hospitals ( long stays and same diagnosis readmissions for heart failure; in-hospital deaths and same diagnosis readmissions for AMI; and in-hospital deaths for stroke). Significant SV was only seen for two indicators within hospital peer groups ( same diagnosis readmissions for heart failure in tertiary hospitals and inhospital mortality for AMI in community hospitals). Only two pairs of indicators showed significant correlation. If all hospitals emulated the best performers, at least 20% of AMI and stroke deaths, heart failure long stays, and heart failure and AMI readmissions could be avoided. Conclusions: Diagnosis-outcome indicators based on administrative data require validation as markers of significant risk adjusted SV. Validated indicators allow quantification of realisable outcome benefits if all hospitals achieved best performer levels. The overall level of quality of care within single institutions cannot be inferred from the results of one or a few indicators.

How does social security affect economic growth? Evidence from cross-country data

This paper investigates how social security interacts with growth and growth determinants (savings, human capital investment, and fertility). Our empirical investigation finds that the estimated coefficient on social security is significantly negative in the fertility equation, insignificant in the saving equation, and significantly positive in the growth and education equations. By contrast, the estimated coefficient on growth is insignificant in the social security equation. The results suggest that social security may indeed be conducive to growth through tipping the trade-off between the number and quality of children toward the latter.