Effects of study precision and risk of bias in networks of interventions: a network meta-epidemiological study

BACKGROUND Empirical research has illustrated an association between study size and relative treatment effects, but conclusions have been inconsistent about the association of study size with the risk of bias items. Small studies give generally imprecisely estimated treatment effects, and study variance can serve as a surrogate for study size. METHODS We conducted a network meta-epidemiological study analyzing 32 networks including 613 randomized controlled trials, and used Bayesian network meta-analysis and meta-regression models to evaluate the impact of trial characteristics and study variance on the results of network meta-analysis. We examined changes in relative effects and between-studies variation in network meta-regression models as a function of the variance of the observed effect size and indicators for the adequacy of each risk of bias item. Adjustment was performed both within and across networks, allowing for between-networks variability. RESULTS Imprecise studies with large variances tended to exaggerate the effects of the active or new intervention in the majority of networks, with a ratio of odds ratios of 1.83 (95% CI: 1.09,3.32). Inappropriate or unclear conduct of random sequence generation and allocation concealment, as well as lack of blinding of patients and outcome assessors, did not materially impact on the summary results. Imprecise studies also appeared to be more prone to inadequate conduct. CONCLUSIONS Compared to more precise studies, studies with large variance may give substantially different answers that alter the results of network meta-analyses for dichotomous outcomes.

A Student-Initiated Elective in Medical Ethics: Innovations in Design and Institutionalization

Introduction: This study addresses how to best approach the instruction and evaluation of clinical ethics with preclinical medical students. [See PDF for complete abstract]

Dental knowledge and attitude toward school dental-health programs among parents of kindergarten children in Winterthur.

The current study investigated the attitudes and knowledge regarding diet and oral hygiene of parents with kindergarten children. The parents' statements were evaluated in terms of their socioeconomic background and were compared with the annual clinical examination of the children. The objective of the study was to assess the effectiveness of the school dental-health program and adapt it to today's societal needs. Of those who participated in the interview, 61% were Swiss, 16% were from former Yugoslavia or Turkey, and 12% each from the EU or other countries. Of the children examined, 39% already had caries, and 18% of those showed more than two lesions. The parents' knowledge correlated with the severity of the child's caries as well as with the parents' income, country of origin, and education. There was a correlation between the child's dental decay and lower income, as well as lower education and non-Swiss nationality of the parents. Parents with higher income and better education more often participated in the preschool's preventive program. Parents from former Yugoslavia or Turkey participated less frequently than parents from other countries. The study demonstrated that parents who especially needed instruction and prophylaxis are contacted too late or not at all through the dental-health program at kindergarten and that new approaches to prevention should be implemented to more effectively reach the parents.

The impact of absolute importance and processing overlaps on prospective memory performance

Prospective memory is the ability to remember an intention at an appropriate moment in the future. Prospective memory tasks can be more or less important. Previously, importance was manipulated by emphasizing the importance of the prospective memory task relative to the ongoing task it was embedded in. This resulted in better prospective memory performance but also ongoing task costs. In the present study, we simply instructed one group of participants that the prospective memory task was important (i.e., absolute importance instruction) and compared them to a group with relative importance instructions and a control group. The results showed that absolute importance lead to an increase in prospective memory performance without enhancing ongoing task costs, whereas relative importance resulted in both increased prospective memory performance and ongoing task costs. Thus, prospective memory can be enhanced without ongoing task costs, which is particularly crucial for safety-work contexts.

Undergraduate Engineering Students' Understanding of Heat, Temperature, and Radiation

Difficulty understanding heat and temperature concepts has been recognized in engineering education. Confusion has been shown to persist after instruction. The purpose of this study was to determine whether undergraduate engineering students’ knowledge of four heat transfer concept areas significantly changed with instruction and whether this varied by major and GPA. Two hundred twenty-eight undergraduate engineering students from six institutions were assessed prior to and after instruction. Results showed significant improvement in most concept areas but mean scores were below mastery. Previously documented misconceptions persisted after instruction. Significant differences were found by major and GPA. Suggestions for future research provided.

The Relation Between Civic Education and Political Attitudes and Behavior

It is generally assumed that civic education efforts will have a positive effect on the political attitudes and behaviors of adolescents and young adults. There is less agreement, however, on the most effective forms of civic education. In the present study, we distinguish between formal civic education, an open classroom climate and active learning strategies, and we explore their effect on political interest, efficacy, trust and participation. To analyze these effects, we rely on the results of a two-year panel study among late adolescents in Belgium. The results indicate that formal civic education (classroom instruction) and active learning strategies (school council membership and, to a lesser extent, group projects) are effective in shaping political attitudes and behavior. An open classroom climate, on the other hand, has an effect on political trust. We conclude that there is no reason to privilege specific forms of civic education, as each form contributes to different relevant political attitudes and behaviors.

Sound and music: an elementary treatise on the physical constitution of musical sounds and harmony, including the chief acoustical discoveries of Professor Helmholtz.

Mode of access: Internet.

Jigs and reels. [music] : containing all favorite reels, jigs, hornpipes, flings, country dances, buck and wing dances, etc., both old and new; for the piano or organ.

Mode of access: Internet.

Preludes and fugues. [music] /

Mode of access: Internet.

Introduction and passacaglia for the organ. [music] /

Mode of access: Internet.

Chamber and solo instrument music.

Mode of access: Internet.

Falstaff, symphonic study in C minor. Op. 68.

Duration: about 30 minutes.

Märchenbilder = [music] : Pictures from fairyland : four pieces for viola (or violin) and piano, op. 113 /

Reproduction (printout).

Instruction élémentaire sur les moyens de calculer les intervalles musicaux : en prenant, pour unités ou termes de comparaison, soit l'octave, soit le douzième d'octave, et en se servant de tables qui rendent ce calcul extrêmement prompt et facile. Formules analytiques, pour calculer logarithme acoustique d'un nombre donné, et réciproquement; progessions harmoniques; autres formules relative à l'acoustique musicale, avec des applications aux instruments de musique; détermination du son fixe, etc. /

Contains 2 fold. tables of acoustic logarithms.