The contribution of major depression to the global burden of ischemic heart disease : a comparative risk assessment

Background Cardiovascular disease and mental health both hold enormous public health importance, both ranking highly in results of the recent Global Burden of Disease Study 2010 (GBD 2010). For the first time, the GBD 2010 has systematically and quantitatively assessed major depression as an independent risk factor for the development of ischemic heart disease (IHD) using comparative risk assessment methodology. Methods A pooled relative risk (RR) was calculated from studies identified through a systematic review with strict inclusion criteria designed to provide evidence of independent risk factor status. Accepted case definitions of depression include diagnosis by a clinician or by non-clinician raters adhering to Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) classifications. We therefore refer to the exposure in this paper as major depression as opposed to the DSM-IV category of major depressive disorder (MDD). The population attributable fraction (PAF) was calculated using the pooled RR estimate. Attributable burden was calculated by multiplying the PAF by the underlying burden of IHD estimated as part of GBD 2010. Results The pooled relative risk of developing IHD in those with major depression was 1.56 (95% CI 1.30 to 1.87). Globally there were almost 4 million estimated IHD disability-adjusted life years (DALYs), which can be attributed to major depression in 2010; 3.5 million years of life lost and 250,000 years of life lived with a disability. These findings highlight a previously underestimated mortality component of the burden of major depression. As a proportion of overall IHD burden, 2.95% (95% CI 1.48 to 4.46%) of IHD DALYs were estimated to be attributable to MDD in 2010. Eastern Europe and North Africa/Middle East demonstrate the highest proportion with Asia Pacific, high income representing the lowest. Conclusions The present work comprises the most robust systematic review of its kind to date. The key finding that major depression may be responsible for approximately 3% of global IHD DALYs warrants assessment for depression in patients at high risk of developing IHD or at risk of a repeat IHD event.

The association between student characteristics and the development of clinical reasoning in a graduate-entry, PBL medical programme

This study sought to assess the extent to which the entry characteristics of students in a graduate-entry medical programme predict the subsequent development of clinical reasoning ability. Subjects comprised 290 students voluntarily recruited from three successive cohorts of the University of Queensland's MBBS Programme. Clinical reasoning was measured once a year over a period of three years using two methods, a set of 10 Clinical Reasoning Problems (CRPs) and the Diagnostic Thinking Inventory (DTI). Data on gender, age at entry into the programme, nature of primary degree, scores on selection criteria (written examination plus interview) and academic performance in the first two years of the programme were recorded for each student, and their association with clinical reasoning skill analysed using univariate and multivariate analysis. Univariate analysis indicated significant associations between CRP score, gender and primary degree with a significant but small association between DTI and interview score. Stage of progression through the programme was also an important predictor of performance on both indicators. Subsequent multivariate analysis suggested that female gender is a positive predictor of CRP score independently of the nature of a subject's primary degree and stage of progression through the programme, although these latter two variables are interdependent. Positive predictors of clinical reasoning skill are stage of progression through the MBBS programme, female gender and interview score. Although the nature of a student's primary degree is important in the early years of the programme, evidence suggests that by graduation differences between students' clinical reasoning skill due to this factor have been resolved.

A view of the Assessment and Feedback Landscape: baseline analysis of policy and practice from the JISC Assessment and Feedback programme

Assessment and feedback lies at the heart of the learning experience, and forms a significant part of both academic and administrative workload. It remains however the single biggest source of student dissatisfaction with the higher education experience. The JISC Assessment and Feedback programme (Sept 2011-Aug 2014) is supporting large-scale changes in assessment and feedback practice, supported by technology, with the aim of enhancing the learning and teaching process and delivering efficiencies and quality improvements. This report summarises baseline reviews undertaken by a number of institutions as part of their programme activity.

Food security and poverty alleviation under the National Special Programme for Food Security: a preliminary socio-economic assessment of Yamama Lake, Kebbi state, Nigeria

The World Food Summit in its meeting in Rome in 1999 estimated that 790 million people in the developing world do not have enough food to eat. This is more than the total populations of North America and Europe combined. Nigeria is one of the developing countries affected by hunger, deprivation and abject poverty by its citizenry inspite of its enormous natural and human resources. To reduce poverty and increase food supplies to the masses the Federal Government of Nigeria embarked on a programmed-tagged National Special Programme for Food Security (NSPFS) in the year 2002. The programme's broad objectives are to attain food security in the broadest sense and alleviate rural poverty in Nigeria. One of the areas of the programme's intervention is in the aquaculture and inland fisheries development because Nigeria imported 681mt of fish in 2003 with a total cost of about N50 million. The paper assesses the socio-economic conditions of one of the selected water bodies (Yamama Lake) with a view to introducing community-based fisheries management plan for the rational exploitation and management of the fishery and other aquatic resources of the water body thereby increasing fish supply and improving the living standard of the fisherfolk in the area. Data were collected using Participatory Rural Appraisal (PRA) tools and questionnaire administration

Global and local challenges for best practices in assessment. The 9th Conference on the International Test Commission. Book of abstracts

The 9th International Test Commission Conference (ITC) took place at the Miramar Palace in San Sebastian, Spain, between the 2nd and 5th of July, 2014. The Conference was titled, “Global and Local Challenges for Best Practices in Assessment.” The International Test Commission, ITC (www.intestcom.org), is an association of national psychological associations, test commissions, publishers, and other organizations, as well as individuals who are committed to the promotion of effective testing and assessment policies and to the proper development, evaluation, and uses of educational and psychological instruments. The ITC facilitates the exchange of information among members and stimulates their cooperation on problems related to the construction, distribution, and uses of psychological and educational tests and other psychodiagnostic tools. This volume contains the abstracts of the contributions presented at the 9th International Test Commission Conference. The four themes of the Conference were closely linked to the goals of the ITC: - Challenges and Opportunities in International Assessment. - Application of New Technoloogies and New Psychometric Models in Testing. - Standards and Guidelines for Best Testing Practices. - Testing in Multilingual and Multicultural Contexts.

An international standardization programme towards the application of gene expression profiling in routine leukaemia diagnostics: the Microarray Innovations in LEukemia study prephase

Gene expression profiling has the potential to enhance current methods for the diagnosis of haematological malignancies. Here, we present data on 204 analyses from an international standardization programme that was conducted in 11 laboratories as a prephase to the Microarray Innovations in LEukemia (MILE) study. Each laboratory prepared two cell line samples, together with three replicate leukaemia patient lysates in two distinct stages: (i) a 5-d course of protocol training, and (ii) independent proficiency testing. Unsupervised, supervised, and r(2) correlation analyses demonstrated that microarray analysis can be performed with remarkably high intra-laboratory reproducibility and with comparable quality and reliability.

An international review of the patterns and determinants of health service utilisation by adult cancer survivors

Background: There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services.

Methods: Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review.

Results: Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provisions- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors.

Conclusions: Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure that post-treatment needs and recommendations for care are met.

Assessment of Intervention Fidelity and Recommendations for Researchers Conducting Studies on the Diagnosis and Treatment of Chronic Cough in the Adult: CHEST Guideline and Expert Panel Report

BACKGROUND: Successful management of chronic cough has varied in the primary research studies in the reported literature. One of the potential reasons relates to a lack of intervention fidelity to the core elements of the diagnostic and/or therapeutic interventions that were meant to be used by the investigators.

METHODS: We conducted a systematic review to summarize the evidence supporting intervention fidelity as an important methodologic consideration in assessing the effectiveness of clinical practice guidelines used for the diagnosis and management of chronic cough. We developed and used a tool to assess for five areas of intervention fidelity. Medline (PubMed), Scopus, and the Cochrane Database of Systematic Reviews were searched from January 1998 to May 2014. Guideline recommendations and suggestions for those conducting research using guidelines or protocols to diagnose and manage chronic cough in the adult were developed and voted upon using CHEST Organization methodology.

RESULTS: A total of 23 studies (17 uncontrolled prospective observational, two randomized controlled, and four retrospective observational) met our inclusion criteria. These articles included 3,636 patients. Data could not be pooled for meta-analysis because of heterogeneity. Findings related to the five areas of intervention fidelity included three areas primarily related to the provider and two primarily related to the patients. In the area of study design, 11 of 23 studies appeared to be underpinned by a single guideline/protocol; for training of providers, two of 23 studies reported training, and zero of 23 reported the use of an intervention manual; and for the area of delivery of treatment, when assessing the treatment of gastroesophageal reflux disease, three of 23 studies appeared consistent with the most recent guideline/protocol referenced by the authors. For receipt of treatment, zero of 23 studies mentioned measuring concordance of patient-interventionist understanding of the treatment recommended, and zero of 23 mentioned measuring enactment of treatment, with three of 23 measuring side effects and two of 23 measuring adherence. The overall average intervention fidelity score for all 23 studies was poor (20.74 out of 48).

CONCLUSIONS: Only low-quality evidence supports that intervention fidelity strategies were used when conducting primary research in diagnosing and managing chronic cough in adults. This supports the contention that some of the variability in the reporting of patients with unexplained or unresolved chronic cough may be due to lack of intervention fidelity. By following the recommendations and suggestions in this article, researchers will likely be better able to incorporate strategies to address intervention fidelity, thereby strengthening the validity and generalizability of their results that provide the basis for the development of trustworthy guidelines.

ILS and RTP: Support to Researchers Provided by Information and Learning Services as Part of the Research Training Programme at the University of Worcester, Past, Present and Future.

The purpose of this article is to investigate the involvement of Information and Learning Services staff in the delivery of the Research Training Programme at the University of Worcester, UK with a focus on researcher receptivity. I believe that by constantly reflecting on the development of that part of the programme delivered by ILS and by examining feedback from the sessions, it is possible to improve and increase the level of researcher receptivity. It is hoped that such examination and reflection will be of value and relevance to the IL community since by reflecting on success and failure in a local context and by mapping this reflection to existing research enables librarians to improve the support provided to researchers within their institutions. This article outlines the support given to research students at the University of Worcester in the past, examines the changes leading to present programme delivery and reflects on considerations for future support. The article is underpinned by reference to current research undertaken in international (albeit Western-centric) contexts. I note that the rationale behind changes is embedded in current adult learning and teaching theory. In an increasingly competitive research environment where funding is dependent on a statistically monitored research output, the aim of such support is to integrate any IL contribution into the wider research training programme. Thus resource discovery becomes part of the reflexive research cycle. Implicit in this investigative reflection is the desire of the IL community to constantly strive towards the positive reception of IL into research support programmes which are perceived by researchers as highly valuable to the process and progress of their work.

The Development of Environmental Assessment Tools to Support the Creation of Dementia Friendly Care Environments: Innovative Practice

The need for more dementia friendly design in hospitals and other care settings is now widely acknowledged. Working with 26 NHS Trusts in England as part of a Department of Health commissioned programme, The King’s Fund developed a set of overarching design principles and an environmental assessment tool for hospital wards in 2012. Following requests from other sectors, additional tools were developed for hospitals, care homes, health centres and housing with care. The tools have proven to be effective in both disseminating the principles of dementia friendly design and in enabling the case to be made for improvements that have a positive effect on patient outcomes and staff morale. This paper reports on the development,use and review of the environmental assessment tools, including further work that is now being taken forward by The Association for Dementia Studies, University of Worcester.

Assessment of the effects of a cooperative play programme for children aged 10-11 years on social adaptation and on the perception that parents, teachers and peers have of children's prosocial behaviours. 'Evaluación de los efectos de un programa de juego cooperativo para los niños de 10-11 años en la adapatación social y en la percepción que padres, profesores y compañeros tienen de las conductas prosociales de los niños'.

Resumen tomado de la publicación

A vector approach to the assessment of undergraduate engineering courses

In any undergraduate engineering programme there is a need to assess the balance and flavour of the various educational strands. In order for a quality assurance of these programmes to be met there is a need to evaluate the course load, academic content and the assessment marks of each course in the undergraduate programme. The existing ranges of QA methods for these programmes are focused on one or two of these issues and do not provide a comprehensive assessment procedure. Following a review of the existing QA methods, this paper will define a three-dimensional approach to the assessment of the educational aspects of an undergraduate course. Various features of this method will be described and potential benefits explained.