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Search Results: 1 - 10 of 32477 matches for " John Rovers "
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Advancing Pharmacy Practice Through Social Theory
John Rovers, PharmD, MIPH
INNOVATIONS in Pharmacy , 2011,
Abstract: Although there is a substantial role for social theory in explaining patients’ health behaviors, it does not appear that pharmacists commonly use such theories to provide patient care. This paper attempts to demonstrate an explicit link between social theory and pharmacy practice. The theory of structure and agency and the practice problem of poor medication adherence (MA) in patients with HIV/AIDS are used as exemplars to illustrate such a link. Factors influencing MA were identified from qualitative studies of adherence in patients with HIV/AIDS. All factors identified were stratified into one of four categories: agency related factors that facilitate MA; agency related factors that are barriers to MA; structural factors that facilitate MA; structural factors that are barriers to MA. Stratifying MA in this manner allows pharmacists to identify clinical interventions that are targeted towards the specific cause of MA problems.
C. Kirkels, Architect van onderwijsvernieuwing. Denken en daden van Gerrit Bolkestein 1871-1956
Frits Rovers
BMGN : Low Countries Historical Review , 2010,
Abstract:
Subgroup effects despite homogeneous heterogeneity test results
Rolf HH Groenwold, Maroeska M Rovers, Jacobus Lubsen, Geert Heijden
BMC Medical Research Methodology , 2010, DOI: 10.1186/1471-2288-10-43
Abstract: A qualitative, visual method to explore the potential for subgroup effects was provided by a modification of the forest plot, i.e., adding a vertical axis indicating the proportion of a subgroup variable in the individual trials. Such a plot was used to assess the potential for clinically relevant subgroup effects and was illustrated by a clinical example on the effects of antibiotics in children with acute otitis media.Statistical tests did not indicate heterogeneity in the meta-analysis on the effects of amoxicillin on acute otitis media (Q = 3.29, p = 0.51; I2 = 0%; T2 = 0). Nevertheless, in a modified forest plot, in which the individual trials were ordered by the proportion of children with bilateral otitis, a clear relation between bilaterality and treatment effects was observed (which was also found in an individual patient data meta-analysis of the included trials: p-value for interaction 0.021).A modification of the forest plot, by including an additional (vertical) axis indicating the proportion of a certain subgroup variable, is a qualitative, visual, and easy-to-interpret method to explore potential subgroup effects in studies included in meta-analyses.Practice guidelines increasingly rely on systematic reviews and meta-analyses. The ultimate purpose of a meta-analysis is to produce an overall estimate of the effect of an intervention by quantitatively combining study results. However, several issues arise in the process of integrating evidence. One of the main issues concerns heterogeneity, i.e. the extent to which different studies give similar or different results. Statistical tests are routinely available to evaluate the presence of statistical heterogeneity (between-study heterogeneity) in meta-analysis [1-3]. Strictly speaking, however, one is not really interested in statistical heterogeneity. What one is interested in is clinical heterogeneity, i.e., specific causes that underlie heterogeneity across studies, especially since the direction and ma
Individual Participant Data (IPD) Meta-analyses of Randomised Controlled Trials: Guidance on Their Use
Jayne F. Tierney?,Claire Vale?,Richard Riley?,Catrin Tudur Smith?,Lesley Stewart?,Mike Clarke?,Maroeska Rovers
PLOS Medicine , 2015, DOI: 10.1371/journal.pmed.1001855
Abstract:
The Effects of Probiotic Supplementation on Experimental Acute Pancreatitis: A Systematic Review and Meta-Analysis
Carlijn R. Hooijmans, Rob B. M. de Vries, Maroeska M. Rovers, Hein G. Gooszen, Merel Ritskes-Hoitinga
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0048811
Abstract: Background In February 2008, the results of the PRObiotics in PAncreatitis TRIAl (PROPATRIA) were published. This study investigated the use of probiotics in patients suffering from severe acute pancreatitis. No differences between the groups were found for any of the primary endpoints. However, mortality in the probiotics group was significantly higher than in the placebo group. This result was unexpected in light of the results of the animal studies referred to in the trial protocol. We used the methods of systematic review and meta-analysis to take a closer look at the relation between the animal studies on probiotics and pancreatitis and the PROPATRIA-trial, focussing on indications for harmful effects and efficacy. Methods and results Both PubMed and Embase were searched for original articles concerning the effects of probiotics in experimental acute pancreatitis, yielding thirteen studies that met the inclusion criteria. Data on mortality, bacterial translocation and histological damage to the pancreas were extracted, as well as study quality indicators. Meta-analysis of the four animal studies published before PROPATRIA showed that probiotic supplementation did not diminish mortality, reduced the overall histopathological score of the pancreas and reduced bacterial translocation to pancreas and mesenteric lymph nodes. Comparable results were found when all relevant studies published so far were taken into account. Conclusions A more thorough analysis of all relevant animal studies carried out before (and after) the publication of the study protocol of the PROPATRIA trial could not have predicted the harmful effects of probiotics found in the PROPATRIA-trial. Moreover, meta-analysis of the preclinical animal studies did show evidence for efficacy. It may be suggested, however, that the most appropriate animal experiments in relation to the design of the human trial have not yet been conducted, which compromises a fair comparison between the results of the animal studies and the PROPATRIA trial.
Prospective Validation of a Prognostic Model for Respiratory Syncytial Virus Bronchiolitis in Late Preterm Infants: A Multicenter Birth Cohort Study
Maarten O. Blanken, Hendrik Koffijberg, Elisabeth E. Nibbelke, Maroeska M. Rovers, Louis Bont, on behalf of the Dutch RSV Neonatal Network
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0059161
Abstract: Objectives This study aimed to update and validate a prediction rule for respiratory syncytial virus (RSV) hospitalization in preterm infants 33–35 weeks gestational age (WGA). Study Design The RISK study consisted of 2 multicenter prospective birth cohorts in 41 hospitals. Risk factors were assessed at birth among healthy preterm infants 33–35 WGA. All hospitalizations for respiratory tract infection were screened for proven RSV infection by immunofluorescence or polymerase chain reaction. Multivariate logistic regression analysis was used to update an existing prediction model in the derivation cohort (n = 1,227). In the validation cohort (n = 1,194), predicted versus actual RSV hospitalization rates were compared to determine validity of the model. Results RSV hospitalization risk in both cohorts was comparable (5.7% versus 4.9%). In the derivation cohort, a prediction rule to determine probability of RSV hospitalization was developed using 4 predictors: family atopy (OR 1.9; 95%CI, 1.1–3.2), birth period (OR 2.6; 1.6–4.2), breastfeeding (OR 1.7; 1.0–2.7) and siblings or daycare attendance (OR 4.7; 1.7–13.1). The model showed good discrimination (c-statistic 0.703; 0.64–0.76, 0.702 after bootstrapping). External validation showed good discrimination and calibration (c-statistic 0.678; 0.61–0.74). Conclusions Our prospectively validated prediction rule identifies infants at increased RSV hospitalization risk, who may benefit from targeted preventive interventions. This prediction rule can facilitate country-specific, cost-effective use of RSV prophylaxis in late preterm infants.
Systematic Reviews of Animal Studies; Missing Link in Translational Research?
Judith van Luijk, Brenda Bakker, Maroeska M. Rovers, Merel Ritskes-Hoitinga, Rob B. M. de Vries, Marlies Leenaars
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0089981
Abstract: Background The methodological quality of animal studies is an important factor hampering the translation of results from animal studies to a clinical setting. Systematic reviews of animal studies may provide a suitable method to assess and thereby improve their methodological quality. Objectives The aims of this study were: 1) to evaluate the risk of bias assessment in animal-based systematic reviews, and 2) to study the internal validity of the primary animal studies included in these systematic reviews. Data Sources We systematically searched Pubmed and Embase for SRs of preclinical animal studies published between 2005 and 2012. Results A total of 91 systematic reviews met our inclusion criteria. The risk of bias was assessed in 48 (52.7%) of these 91 systematic reviews. Thirty-three (36.3%) SRs provided sufficient information to evaluate the internal validity of the included studies. Of the evaluated primary studies, 24.6% was randomized, 14.6% reported blinding of the investigator/caretaker, 23.9% blinded the outcome assessment, and 23.1% reported drop-outs. Conclusions To improve the translation of animal data to clinical practice, systematic reviews of animal studies are worthwhile, but the internal validity of primary animal studies needs to be improved. Furthermore, risk of bias should be assessed by systematic reviews of animal studies to provide insight into the reliability of the available evidence.
Evaluating the Use of Role Playing Simulations in Teaching Negotation Skills to University Students  [PDF]
John Andrew, John Meligrana
Creative Education (CE) , 2012, DOI: 10.4236/ce.2012.36104
Abstract: This paper critically evaluates the use of role-playing simulations in a negotiation course taught to graduate students. The course consisted primarily of a series of simulations involving the alternative dispute resolution (ADR) processes of negotiation, facilitation and mediation. Data were obtained from two sets of questionnaires completed by 41 students before and after the course. A review of previous research reveals that despite the widespread use of role-playing simulations in education, there has been very little empirical evaluation of their effectiveness, especially in conflict resolution and planning. Comparison of the data acquired from the two surveys generated findings regarding student understanding of ADR processes and key issues in conflict resolution; the educational value of simulations; the amenability of types of planning and planning goals to ADR; appropriate learning objectives; the importance of negotiation skills in planning; challenges in conducting effective simulations; the value of simulations in resolving real conflicts; the utility of negotiation theory; and obstacles to applying ADR to planning disputes. More generally, the paper concludes that role-playing simulations are very effective for teaching negotiation skills to students, and preparing them to manage actual conflicts skillfully and to participate effectively in real ADR processes. However, this technique is somewhat less valuable for teaching aspects of planning other than conflict resolution. Surprisingly, prior experience with simulations had no significant influence on the responses to the pre-course survey. Also surprising was the lack of a significant correlation between final exam scores and responses to relevant questions on the post-course survey.
Bronchoscopy Simulation in Anesthesia Resident Education  [PDF]
John McNeil,John Pawlowski
Open Journal of Anesthesiology (OJAnes) , 2013, DOI: 10.4236/ojanes.2013.33041
Abstract: Simulation in residency training is becoming more popular but there is limited evidence showing that it can improve a resident’s fund of knowledge, particularly in anesthesiology. We looked at whether a bronchoscopy simulation could improve performance on a thoracic anesthesia knowledge test administered both before and after using the simulator. Fourteen first-year anesthesiology residents completed the study with an average improvement on the test of 28% (p < 0.05). We conclude that bronchoscopy simulation is an effective method of educating anesthesiology residents.
Bronchoscopy Simulation in Anesthesia Resident Education  [PDF]
John McNeil, John Pawlowski
Open Journal of Anesthesiology (OJAnes) , 2013, DOI: 10.4236/ojanes.2013.33041
Abstract:

Simulation in residency training is becoming more popular but there is limited evidence showing that it can improve a resident’s fund of knowledge, particularly in anesthesiology. We looked at whether a bronchoscopy simulation could improve performance on a thoracic anesthesia knowledge test administered both before and after using the simulator. Fourteen first-year anesthesiology residents completed the study with an average improvement on the test of 28% (p < 0.05). We conclude that bronchoscopy simulation is an effective method of educating anesthesiology residents.


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