Initial medication adherence-review and recommendations for good practices in outcomes research: an ISPOR medication adherence and persistence special interest group report

Background: Positive associations between medication adherence and beneficial outcomes primarily come from studying filling/consumption behaviors after therapy initiation. Few studies have focused on what happens before initiation, the point from prescribing to dispensing of an initial prescription. Objective: Our objective was to provide guidance and encourage high-quality research on the relationship between beneficial outcomes and initial medication adherence (IMA), the rate initially prescribed medication is dispensed. Methods: Using generic adherence terms, an international research panel identified IMA publications from 1966 to 2014. Their data sources were classified as to whether the primary source reflected the perspective of a prescriber, patient, or pharmacist or a combined perspective. Terminology and methodological differences were documented among core (essential elements of presented and unpresented prescribing events and claimed and unclaimed dispensing events regardless of setting), supplemental (refined for accuracy), and contextual (setting-specific) design parameters. Recommendations were made to encourage and guide future research. Results: The 45 IMA studies identified used multiple terms for IMA and operationalized measurements differently. Primary data sources reflecting a prescriber's and pharmacist's perspective potentially misclassified core parameters more often with shorter/nonexistent pre- and postperiods (1-14 days) than did a combined perspective. Only a few studies addressed supplemental issues, and minimal contextual information was provided. Conclusions: General recommendations are to use IMA as the standard nomenclature, rigorously identify all data sources, and delineate all design parameters. Specific methodological recommendations include providing convincing evidence that initial prescribing and dispensing events are identified, supplemental parameters incorporating perspective and substitution biases are addressed, and contextual parameters are included.

The introduction of an undergraduate interventional radiology (IR) curriculum: impact on medical student knowledge and interest in IR

INTRODUCTION: Interventional radiology (IR) plays a vital role in modern medicine, with increasing demand for services, but with a shortage of experienced interventionalists. The aim of this study was to determine the impact of a recently introduced IR curriculum on perception, knowledge, and interest of medical students regarding various aspects of IR. METHODS: In 2014, an anonymous web-based questionnaire was sent to 309 4th year medical students in a single institution within an EU country, both before and after delivery of a 10-h IR teaching curriculum. RESULTS: Seventy-six percent (236/309) of the respondents participated in the pre-IR module survey, while 50 % (157/309) responded to the post-IR module survey. While 62 % (147/236) of the respondents reported poor or no knowledge of IR compared to other medical disciplines in the pre-IR module survey, this decreased to 17 % (27/157) in the post-IR module survey. The correct responses regarding knowledge of selected IR procedures improved from 70 to 94 % for venous access, 78 to 99 % for uterine fibroid embolization, 75 to 97 % for GI bleeding embolization, 60 to 92 % for trauma embolization, 71 to 92 % for tumor ablation, and 81 to 94 % for angioplasty and stenting in peripheral arterial disease. With regard to knowledge of IR clinical roles, responses improved from 42 to 59 % for outpatient clinic review of patients and having inpatient beds, 63-76 % for direct patient consultation, and 43-60 % for having regular ward rounds. The number of students who would consider a career in IR increased from 60 to 73 %. CONCLUSION: Delivering an undergraduate IR curriculum increased the knowledge and understanding of various aspects of IR and also the general enthusiasm for pursuing this specialty as a future career choice.

A framework for classifying online mental health related communities with an interest in depression

Mental illness has a deep impact on individuals, families, and by extension, society as a whole. Social networks allow individuals with mental disorders to communicate with others sufferers via online communities, providing an invaluable resource for studies on textual signs of psychological health problems. Mental disorders often occur in combinations, e.g., a patient with an anxiety disorder may also develop depression. This co-occurring mental health condition provides the focus for our work on classifying online communities with an interest in depression. For this, we have crawled a large body of 620,000 posts made by 80,000 users in 247 online communities. We have extracted the topics and psycho-linguistic features expressed in the posts, using these as inputs to our model. Following a machine learning technique, we have formulated a joint modelling framework in order to classify mental health-related co-occurring online communities from these features. Finally, we performed empirical validation of the model on the crawled dataset where our model outperforms recent state-of-the-art baselines.

Book review. Emancipatory practices : adult/youth engagement for social and environmental justice

Book review of Emancipatory practices: Adult/youth engagement for social and environmental justice W. Linds, L. Goulet, A. Sammel, 2010, ISBN 9789087901514 (pbk), Sense Publishers, Rotterdam.

Influencing girls' interest in information technology

The lack of skilled labour that can support digital economies is a worldwide problem, exacerbated by the lack of female participation in the Information Technology (IT) industry. Interventions that promote IT study and career opportunities for girls can be a powerful means to counter the ongoing decline in IT interest amongst females. However, the impact of such interventions is rarely being evaluated. This study is, therefore, aimed at gaining insights into the influence on IT career perceptions of one IT intervention event for secondary school girls conducted in Australia in 2014. The analysis of comprehensive survey data (n=781) using the Partial Least Squares and other statistical techniques revealed that a positive attitude toward the analysed event had significant direct and indirect positive impacts on girls' intentions to choose a career in IT. The indirect influence was supported by such mediating factors as girls' self-efficacy towards IT careers and their intentions to learn more about IT, which the event affected directly. In addition to reporting on the results of testing the research model, further insights into girls' opinions and attitudes towards the intervention and IT in general are provided in the paper.