Assessing condom use practices. Implications for evaluating method and user effectiveness

A case report of swelling of the right submandibular gland, with spontaneous remission, is described. Clinical, ultrasonographical and cytological features suggest that the swelling could be ascribed to a necrotizing sialometaplasia. The etiopathological hypothesis and pathology of the lesion are presented, and the differential diagnosis with other spreading lesions of the submandibular gland is discussed.     

The myth of evaluating treatment effectiveness.

Suggests an alternative to H. H. Strupp and S. W. Hadley's (see record 1977-29884-001) tripartite model for evaluating treatment outcome, in which primary prevention, self-regulation methods are used to evaluate individuals' ability to control emotions that interfere with everyday functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Morphological criteria for the therapeutic effectiveness of antirheumatic drugs

Sixteen healthy adults had serial studies of delayed-type skin test reactivity and in vitro lymphocyte blastogenesis to several antigens over a period of 7 months. In many subjects blastogenesis varied broadly from month to month without apparent cause. Responses to all antigens usually increased or decreased together on sequential testing. Blastogenesis to coccidioidin appeared to result largely from cross-reaction with histoplasmin. Humoral factors were not demonstrably responsible for these changes. Blastogenesis rose consistently and non-specifically in subjects following revaccination to vaccinia virus. These studies reflect the lymphocyte blastogenesis reaction as a dynamic equilibrium, subject to spontaneous variation, and responding non-specifically to stimuli such as vaccination. Whatever the causes for these changes, it is clear that serial determinations of blastogenesis response to various antigens do not carry the apparent consistency of the skin test response to that antigen, and single tests must be cautiously interpreted.     

Study designs for evaluating different efficacy and effectiveness aspects of vaccines

Vaccine efficacy and effectiveness (VE) are generally measured as 1 minus some measure of relative risk (RR) in the vaccinated group compared with the unvaccinated group (VE = 1 - RR). In designing a study to evaluate vaccination, the type of effect and the question of interest determine the appropriate choice of comparison population and parameter. Possible questions of interest include that of the biologic effect of vaccination on susceptibility, on infectiousness, or on progression to disease in individuals. The indirect effects, total effects, and overall public health benefits of widespread vaccination of individuals within the context of a vaccination program might also be of primary concern. The change in behavior induced by belief in the protective effects of vaccination might influence the estimates of these effects or might itself be of interest. In this paper, the authors present a framework of study designs that relates the scientific question of interest to the choice of comparison groups, the unit of observation, the level of information available for analysis, and the parameter of effect.     

The use of decision making analysis for evaluating hepatitis B inoculation strategy

We used a recently described anion-exchange chromatographic method (Vedie et al. J Lipid Res 1991;32:1359) to study the protective effect of potential inhibitors of low-density lipoprotein (LDL) oxidation mediated by cupric ion. By way of an example, we studied eight flavonoids (flavone, 3-hydroxyflavone, chrysin, galangin, fisetin, morin, quercetin, and myricetin) as well as three non-flavonoid antioxidants, butylated hydroxytoluene (BHT), probucol, and vitamin C, as reference compounds. Each compound was tested at various concentrations (1-100 microM). For flavonoid concentrations of 10 microM, an index was calculated as the (LDL control-flavonoid)/(LDL control-probucol) ratio, in which each term is expressed as the percentage of the most electronegative LDL fraction (fraction E). If the index is positive, the flavonoid inhibits LDL oxidation. A value > 1 (3-hydroxyflavone and galangin) means greater activity than probucol, whereas a value < 1 means lower activity (fisetin). If the index is around 0 (flavone and chrysin), the flavonoid is inactive. Finally, a negative value reflects possible prooxidant activity (morin, quercetin, and myricetin). Our results show that this chromatographic method can be applied to screening new pharmacological agents for activity against LDL oxidation.     

The use of ambulatory pressure monitoring for evaluating antihypertensive treatment in clinical practice

OBJECTIVE: To describe the clinical experience of our Centre in the assessment of antihypertensive therapy with 24-hour ambulatory blood pressure monitoring (ABPM). DESIGN AND PATIENTS: We retrospectively studied all the 241 out-patients on antihypertensive therapy submitted to ABPM (SpaceLabs 90207, USA) between March 1992 and March 1993 for clinical purposes. We evaluated: 1) the clinical indications for the test; 2) the modifications of drug treatment suggested by the ABPM results; 3) the referring physicians' acceptance of these suggestions; 4) the changes of office BP measured before and 3-6 months after ABPM. RESULTS: 1) The indications for ABPM were: resistant or poorly controlled hypertension (n = 170-71%); suspected "white coat effect" (n = 51-21%); assessment of symptoms (n = 20-8%). 2) The analysis of ABPM suggested to modify drug treatment in 51% of the patients; a "white-coat effect" was found in 18% of the patients. 3) The ABPM suggestions about treatment were accepted by the referring physicians in 89% of the patients. 4) Office BP decreased from 163 +/- 18/99 +/- 9 mm Hg (before ABPM) to 151 +/- 13/91 +/- 7 (3-6 months after ABPM), (p < 0.001). CONCLUSIONS: The use of ABPM in our Centre, which is based on specific clinical indications, provided indications to modify the drug treatment in a high percentage of patients.     

Natural family planning effectiveness: evaluating published reports

OBJECTIVE: To equip the reader with the tools necessary to evaluate studies of natural family planning (NFP) effectiveness found in the literature and to make recommendations for future NFP effectiveness studies. DESIGN: Current standards to evaluate contraceptive method effectiveness are reviewed. A framework for evaluating reports on NFP is presented. RESULTS: Most NFP studies found in the literature are flawed in design and do not calculate pregnancy rates correctly. The results from the few well-designed studies are presented. DISCUSSION: Many factors influence NFP effectiveness, and these factors must be considered when evaluating published studies and designing future studies.     

Criteria for evaluating the effectiveness of myocardial infarct patient rehabilitation (posthospital phase)

On the basis of the analysis of a 24- to 30-month posthospital phase of rehabilitation in 486 patients with myocardial infarction, critera were elaborated for dividing them into 4 classes with mathematically determined severity index. Criteria for analysing rehabilitation efficacy available for wide practice and a definite algorithm for differentiated management of patients with stage by stage appraisal of the condition and reaching alternate decisions are suggested. The strict dependence of the results of the post-hospital rehabilitation phase on the appraisal of the patients, condition and the corresponding correction of the rehabilitation program is shown.     

Methodological issues in evaluating the effectiveness of aversion therapies for institutionalised child molesters.

Child molesters confined to secure settings because of their dangerousness present those responsible for their release with thorny problems of assessment. Penile volume measurements can provide valuable information regarding the sexual preferences of these persons but such information is not an infallible predictor of a child molester's dangerousness. Similarly, the fact he has received aversion therapy does not make the decision regarding his release appreciably easier because success rates with this therapy are not high enough to allow confidence in making individual decisions. Further research is needed to determine the relation of penile volume and other measures to recidivism in this population, to clarify the theoretical nature of aversion therapy and to develop more effective methods of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The implications of pager use for the therapeutic relationship in independent practice.

Therapist accessibility by pagers raises many questions regarding between-session and within-session calls. What are the main purposes of pagers in clinical settings, and what are the rationales for their use? The authors explored the parameters established by clinicians regarding pagers and how these expectations were communicated to patients. The degree of interference the clinician allows in the therapy session when paged is pivotal because of the potentially distancing, distracting, and enervating effect this may have on the relationship. The implications for the therapist's private life and his or her significance in the patient's life are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's effective use of multiple standards for evaluating their comprehension.

Two experiments examined children's ability to apply 3 different standards for evaluating their understanding. 71 5-, 7-, 9-, and 11-yr-olds were presented with short narrative passages within which were embedded 3 types of problems (nonsense words, internal inconsistencies, and prior knowledge violations), each of which could only be identified if a specific standard of evaluation were used (lexical, internal consistency, and external consistency, respectively). Ss were explicitly instructed in advance that their task was to find the "mistakes." Moreover, Ss were given immediate feedback after each trial and a 2nd opportunity to find any missed problems. Although older Ss used all 3 standards more effectively than younger Ss, problem identification was considerably better than that reported in noninstructed settings. The internal consistency standard was applied least effectively, but even the youngest Ss were able to use it. Results illustrate the need to consider comprehension-monitoring skills with respect to specific standards of evaluation, rather than as a unitary phenomenon. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the use of Bayesian methods for evaluating compartmental neural models

Computational modeling is being used increasingly in neuroscience. In deriving such models, inference issues such as model selection, model complexity, and model comparison must be addressed constantly. In this article we present briefly the Bayesian approach to inference. Under a simple set of commonsense axioms, there exists essentially a unique way of reasoning under uncertainty by assigning a degree of confidence to any hypothesis or model, given the available data and prior information. Such degrees of confidence must obey all the rules governing probabilities and can be updated accordingly as more data becomes available. While the Bayesian methodology can be applied to any type of model, as an example we outline its use for an important, and increasingly standard, class of models in computational neuroscience--compartmental models of single neurons. Inference issues are particularly relevant for these models: their parameter spaces are typically very large, neurophysiological and neuroanatomical data are still sparse, and probabilistic aspects are often ignored. As a tutorial, we demonstrate the Bayesian approach on a class of one-compartment models with varying numbers of conductances. We then apply Bayesian methods on a compartmental model of a real neuron to determine the optimal amount of noise to add to the model to give it a level of spike time variability comparable to that found in the real cell.     

Identification and therapeutic effectiveness in group therapy.

Determined whether identification with members in group therapy has a relation to progress in therapy. Ss were 20 22-52 yr old clients. Change in therapy was determined by MMPI pre- and posttests and incidence of identification with a self-report apparatus. Results indicate that the incidence of identification was significantly higher for group members who showed positive change in therapy (p