Influence of study goals on study design and execution

From the viewpoint of a clinician who makes recommendations to patients about choosing from the multiple possible management schemes, quantitative information derived from statistical analyses of observational studies is useful. Although random assignment of therapy is optimal, appropriately performed studies in which therapy has been nonrandomly “assigned” are considered acceptable, albeit occasionally with limitations in inferences. The analyses are considered most useful when they generate multivariable equations suitable for predicting time-related outcomes in individual patients. Graphic presentations improve communication with patients and facilitate truly informed consent.     

TATE case study

Purpose.?To evaluate if marking up heading elements of Web sites improves usability and accessibility.

Method.?Task completion times and questionnaire responses were collected from sighted and blind users for two kinds of Web sites: sites marked up appropriately with heading elements, and sites with the same visual appearance but with no heading elements marked up. The experiment was carried out with user agents that could navigate through heading elements.

Results.?(1) Heading elements improved usability both for sighted and blind users in terms of significantly reduced task completion time and also higher user satisfaction with the structured site. (2) A significant difference in accessibility (i.e., if reduction of task completion time is larger for blind users than sighted users) was not observed when heading elements were marked up. The lack of significant effect in this case might have been due to blind users making use of the user-agent's navigation functions to find the target information efficiently when the heading elements were not present.

Conclusions.?A combination of content with heading elements marked up, user agents with functions that utilise structure markup, and users with sufficient knowledge about user agents functionality, improves usability for both sighted and blind users and may improve accessibility for blind users.     

Ultrasonic toxicity study

Ultrasound in a delivery format similar to that used clinically in pulse echo diagnostic techniques (1 MHz frequency range, 1000 Hz pulse repetition frequency—peak spatial and temporal intensities and pulse width are larger than those used clinically) has been applied to the male mouse testicles, non-pregnant female mouse ovaries and pregnant mouse uterus at day 8 of gestation. The time average spatial peak intensity for a 20 sec irradiation period at each matrix site for onset of adult mortality in the males and non-pregnant females is essentially 70 W/cm². These data are for a focused beam having a 6 dB beam width of 2 mm. For the pregnant animals, adult mortality begins at 23 W/cm². Significant changes in litter size occur for similar intensity levels. When anomalies which occur in controls are significantly increased for irradiated animals (a striking feature of this study is the almost total lack of appearance of anomalies in irradiated animals which are not present in controls), this increased incidence is not always presented in a unidirectional manner as a function of increasing average intensity. As the average intensity levels are increased in grades to 180 W/cm² there is generally an increased incidence of a given bioeffect. There are, however, some notable exceptions to this generalization. When a 6 dB beam width of 4 mm is used with the pregnant animals the adult mortality begins at 8 W/cm².     

护理管理人员学习需求调查与建议

目的 了解护理管理人员的学习需求，加强对护理管理人员的培训。达到提高医院护理管理水平和护理质量的目的。方法 对三所三级医院护士长以上的管理人员进行了问卷式教育需求调查。结果 护理管理人员继续教育内容首选是管理知识和管理技能，其次是护理新知识，新技术。结论 继续教育内容应因需，因岗设置，并形成制度化和规范化。     

The SYNTAX study

The SYNTAX study randomized patients (pts) with three-vessel or left main coronary artery disease (CAD) into pts who underwent bypass grafting (CABG) or percutaneous coronary intervention (PCI). The primary endpoint of the study was a major adverse cardiac or cerebrovascular event (death from any cause, stroke, myocardial infarction, repeated revascularization)(MACCE). Rates of MACCE at 12 months were significantly higher in the PCI group (17.8%) than in the CAGB group (12.4%, p?<?0.002). This was caused by an increased rate of repeated revascularizations in PCI pts (13.5%) compared to CABG pts (5.9%, p?<?0.001). The rates of death and myocardial infarction were similar between the two groups. Stroke was significantly more likely to occur with CABG (2.2%) versus 0.6% with PCI (p?=?0.003). Despite the results of the SYNTAX study, an individual strategy is necessary for each patient.