Discussion: physiological research design and implementation.
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Ninety-nine healthy elderly volunteers were tested to assess the effects of: 1) a pipradrol-vitamin (Alertonic) elixir, 2) a placebo, and 3) no treatment, during a one-week period. The assessment measures were the Minnesota Multiphasic Personality Inventory Depression Scale, the Zung Depression Scale, Profile of Mood States, and the WAIS Digit Span. Alertonic had no sigmificant effects on mood, memory or appetite, and the placebo effect was rarely greater than 50 per cent. There were no significant side effects. The findings demonstrate a valid method for studying psychotropic agents in the elderly.
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PurposeThis study examines Evidence-Based Design (EBD) as an epistemological framework for guiding design research and practice, with a particular focus on its reliance on Evidence-Based Medicine (EBM) as a source of methodological inspiration.BackgroundOver the past two decades, EBD has been promoted as a way to strengthen design processes through the systematic use of scientific evidence. Its relationship to EBM, however, remains conceptually ambiguous: EBD draws legitimacy from EBM's hierarchical conception of "best evidence" while at the same time acknowledging the specificities of design practice, which do not easily fit such a model.MethodologyA systematic review was conducted on 31 publications in the design research literature that explicitly address the tension surrounding EBD's conception of "best evidence." The criticisms raised were coded and analyzed by main topics and subtopics.ResultsThe review highlights several reasons why EBM's hierarchical view of "best evidence" is an unsuitable epistemological foundation for EBD. It imposes scientifically inappropriate and practically ineffective methodological standards, devalues important sources of design knowledge, and fails to address central epistemic challenges intrinsic to design processes.ConclusionsBy bringing together critical yet fragmented insights from the literature, this study argues for the development of an updated epistemological framework for EBD. Constructing this framework will require sustained interdisciplinary dialogue between design research and philosophy of science.
Little is known about the frequency with which various research designs appear in the clinical literature and how this frequency has changed in recent years. This study describes the research designs used in 612 articles randomly selected from original research published in three general medical journals from 1946 to 1976. Cross-sectional studies increased from 25 to 44 per cent, cohort studies declined from 59 to 34 per cent, and clinical trials increased from 13 to 21 per cent of articles (P less than 0.001). Randomized controlled trials comprised 5 per cent of articles published in 1976 and were not represented 30 years before. In 1976, 37 per cent of articles reported on 10 subjects or less, and this number has not changed substantially since 1946. The frequency of studies with weak research designs has increased in these general medical journals over the past 30 years. The trend deserves critical attention.
BACKGROUND: Longitudinal cohort studies have traditionally relied on clinic-based recruitment models, which limit cohort diversity and the generalizability of research outcomes. Digital research platforms can be used to increase participant access, improve study engagement, streamline data collection, and increase data quality; however, the efficacy and sustainability of digitally enabled studies rely heavily on the design, implementation, and management of the digital platform being used. OBJECTIVE: We sought to design and build a secure, privacy-preserving, validated, participant-centric digital health research platform (DHRP) to recruit and enroll participants, collect multimodal data, and engage participants from diverse backgrounds in the National Institutes of Health's (NIH) All of Us Research Program (AOU). AOU is an ongoing national, multiyear study aimed to build a research cohort of 1 million participants that reflects the diversity of the United States, including minority, health-disparate, and other populations underrepresented in biomedical research (UBR). METHODS: We collaborated with community members, health care provider organizations (HPOs), and NIH leadership to design, build, and validate a secure, feature-rich digital platform to facilitate multisite, hybrid, and remote study participation and multimodal data collection in AOU. Participants were recruited by in-person, print, and online digital campaigns. Participants securely accessed the DHRP via web and mobile apps, either independently or with research staff support. The participant-facing tool facilitated electronic informed consent (eConsent), multisource data collection (eg, surveys, genomic results, wearables, and electronic health records [EHRs]), and ongoing participant engagement. We also built tools for research staff to conduct remote participant support, study workflow management, participant tracking, data analytics, data harmonization, and data management. RESULTS: We built a secure, participant-centric DHRP with engaging functionality used to recruit, engage, and collect data from 705,719 diverse participants throughout the United States. As of April 2024, 87% (n=613,976) of the participants enrolled via the platform were from UBR groups, including racial and ethnic minorities (n=282,429, 46%), rural dwelling individuals (n=49,118, 8%), those over the age of 65 years (n=190,333, 31%), and individuals with low socioeconomic status (n=122,795, 20%). CONCLUSIONS: We built a participant-centric digital platform with tools to enable engagement with individuals from different racial, ethnic, and socioeconomic backgrounds and other UBR groups. This DHRP demonstrated successful use among diverse participants. These findings could be used as best practices for the effective use of digital platforms to build and sustain cohorts of various study designs and increase engagement with diverse populations in health research.
Interactions between dietary components and environmental contaminants may influence the outcome of toxicological testing. A comparison was made between the vitamin and mineral content of laboratory animal basal diets as supplied by two major feed companies. Striking differences in nutrient content of Guinea pig, rat, and primate diets, as supplied by these companies are cited. Attention is drawn to the lack of data on selenium content of these feeds. The importance of Vitamin C in regards to ameliorating toxic effects of heavy metals is discussed.
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Two instructional strategies, the traditional lecture method and a standardized self-instructional (ACORDE) format, were compared for efficiency and perceived usefulness in a preclinical restorative dentistry technique course through the use of a posttest-only control group research design. Control and experimental groups were compared on (a) technique grades, (b) didactic grades, (c) amount of time spent, (d) student and faculty perceptions, and (e) observation of social dynamics. The results of this study demonstrated the effectiveness of Project ACORDE materials in teaching dental students, provided an example of applied research designed to test contemplated instructional innovations prior to use and used a method which highlighted qualitative, as well as quantitative, techniques for data gathering in applied research.
A number of measurement and design issues that are critical to the use of multiple-baseline procedures in evaluating instructional interventions were highlighted. First, issues related to the interaction between length of baseline assessment and the following outcomes were presented: (a) deceleration in behavior across baseline, (b) prediction of behavior change, (c) error analyses performance on instructional stimuli, and (d) reactivity of observation. Finally, an attempt was made to match the variety of multiple-baseline designs to specific questions often asked by instructional researchers.
The key provisions necessary in the development, implementation, and evaluation of a film designed for Continuing Medical Education are described. A case history approach is utilized with discussion on each of the following points: (1) problem identification, (2) audience, (3) media selection, (4) media production, (5) research design, (6) media distribution, (7) evaluation and (8) results. Attention to each of the above items contributed to this project's success, and reaffirms the important role which the medium of film can have in continuing professional education.
Research into tardive dyskinesia, an involuntary movement disorder secondary to chronic neuroleptic treatment, has so far produced conflicting results with no clear clinical applications. Heterogeneous diagnostic criteria, research designs, and rating scales, plus an emphasis on single-drug trials, are probably responsible. A strategy of developing pharmacological response profiles for patients participating in tardive dyskinesia research is suggested as one way to produce meaningful data, which may delineate pharmacological and clinical subtypes that would respond to different treatment approaches. Further suggestions are made about future trends in this area of research.
The validity of process evaluations of medical care has been challenged by a number of studies which purport to show that process and outcome measures are unrelated. However, each of the studies had numerous methodological flaws which biased their results against finding a relationship: either their outcome measures had questionable validity, their research designs were inappropriate, or the statistical analyses were poorly conceived. Better studies have found significant, although modest, correlations between process and outcome measures. Since the validity of outcome measures has never been determined, there is little reason at present for believing that outcome measures are more valid than process measures.
We have answered technical criticisms of our work in which anticholinergic agents were added to ongoing neuroleptic treatment in an ABA' research design. The suggested analysis of variance for repeated measures of the three periods is inappropriate because of the expected carryover effects from continuous neuroleptic treatment. The multivariate analysis of various parameters seems unsuitable because homogeneity of covariance cannot be ensured due to the heterogeneity of schizophrenia and the diverse factors represented in the psychopathology measures. We have summarized the results of recent parametric and nonparametric analyses of combined data from our three studies to show that the significant effects clearly pointed to therapeutic antagonism between anticholinergic agents and neuroleptics. We suggest that cholinergic neurons may be part of some crucial discriminative control mechanisms in the brain organization that are ineffective in schizophrenia and lead to a relative overactivity of the opposing catecholaminergic neurons in the midbrain-limbic circuitry which promote repetition of behaviors in goal-directed activity.
The multiple-baseline design has utility for evaluating the instructional programs used with mentally retarded persons; however, there are several pitfalls of measurement that may be encountered in using this design. Subjects' performance may be inadvertently altered by (a) repeated testing during baseline, (b) a procedural contrast between training and testing, and (c) inaccurate generalization during testing. Procedures to mitigate the effects of these problems were recommended. The pitfalls may arise in part because of the direct interpersonal nature of measuring the dependent variable in instructional research. Also, the pitfalls are not inherent in the multiple-baseline design per se but are issues of measurement that may occur in other designs as well. Finally, the advantage of using the multiple-baseline design to study covariation of responding was highlighted.
The EEG effects of twenty, clinically most frequently used psychotropic drugs and five placebos were studied in 75 male volunteers in five simultaneously designed basic studies. In each of the five studies single oral dosages of five drugs (well known representatives of neuroleptics, antidepressants, anxiolytics and psychostimulants, as well as placebos) were investigated in 15 subjects in a double-blind latin-square research design using the methods of the Quantitative Pharmaco-EEG. The results demonstrated that the therapeutically equivalent effective compounds also have similar effects on human EEG. With a classification rule, based on discriminant function 20, and with a classification rule, based on correlation statistics 19 of 25 compounds could be reclassified into correct clinical-therapeutic psychotropic drug groups. It is suggested that CEEG is an important tool in predicting and describing psychotropic properties of compounds, and should routinely be used in psychotropic drug development.
PURPOSE: The primary purpose of the study was to explore the impact of health workers' awareness of artificial intelligence (AI) on their workplace well-being, addressing a critical gap in the literature. By examining this relationship through the lens of the Job demands-resources (JD-R) model, the study aimed to provide insights into how health workers' perceptions of AI integration in their jobs and careers could influence their informal learning behaviour and, consequently, their overall well-being in the workplace. The study's findings could inform strategies for supporting healthcare workers during technological transformations. DESIGN/METHODOLOGY/APPROACH: The study employed a quantitative research design using a survey methodology to collect data from 420 health workers across 10 hospitals in Ghana that have adopted AI technologies. The study was analysed using OLS and structural equation modelling. FINDINGS: The study findings revealed that health workers' AI awareness positively impacts their informal learning behaviour at the workplace. Again, informal learning behaviour positively impacts health workers' workplace well-being. Moreover, informal learning behaviour mediates the relationship between health workers' AI awareness and workplace wellbeing. Furthermore, employee learning orientation was found to strengthen the effect of AI awareness on informal learning behaviour. RESEARCH LIMITATIONS/IMPLICATIONS: While the study provides valuable insights, it is important to acknowledge its limitations. The study was conducted in a specific context (Ghanaian hospitals adopting AI), which may limit the generalizability of the findings to other healthcare settings or industries. Self-reported data from the questionnaires may be subject to response biases, and the study did not account for potential confounding factors that could influence the relationships between the variables. PRACTICAL IMPLICATIONS: The study offers practical implications for healthcare organizations navigating the digital transformation era. By understanding the positive impact of health workers' AI awareness on their informal learning behaviour and well-being, organizations can prioritize initiatives that foster a learning-oriented culture and provide opportunities for informal learning. This could include implementing mentorship programs, encouraging knowledge-sharing among employees and offering training and development resources to help workers adapt to AI-driven changes. Additionally, the findings highlight the importance of promoting employee learning orientation, which can enhance the effectiveness of such initiatives. ORIGINALITY/VALUE: The study contributes to the existing literature by addressing a relatively unexplored area - the impact of AI awareness on healthcare workers' well-being. While previous research has focused on the potential job displacement effects of AI, this study takes a unique perspective by examining how health workers' perceptions of AI integration can shape their informal learning behaviour and, subsequently, their workplace well-being. By drawing on the JD-R model and incorporating employee learning orientation as a moderator, the study offers a novel theoretical framework for understanding the implications of AI adoption in healthcare organizations.