French by osmosis

The typical nursery school in the province of Quebec, Canada, is conducted in French, the official language of schools and business. Even so, it is not unusual to find English- as well as French-speaking students at many of these schools. Both languages are spoken in the province.     

Making the Critical Appraisal for Summaries of Evidence (CASE) for evidence-based medicine (EBM): critical appraisal of summaries of evidence

Objectives:

Standards for evaluating evidence-based medicine (EBM) point-of-care (POC) summaries of research are lacking. The authors developed a “Critical Appraisal for Summaries of Evidence” (CASE) worksheet to help assess the evidence in these tools. The authors then evaluated the reliability of the worksheet.

Methods:

The CASE worksheet was developed with 10 questions covering specificity, authorship, reviewers, methods, grading, clarity, citations, currency, bias, and relevancy. Two reviewers independently assessed a random selection of 384 EBM POC summaries using the worksheet. The responses of the raters were then compared using a kappa score.

Results:

The kappa statistic demonstrated an overall moderate agreement (κ = 0.44) between the reviewers using the CASE worksheet for the 384 summaries. The 3 categories of evaluation questions in which the reviewers disagreed most often were citations (κ =  0), bias (κ = 0.11), and currency (κ = −0.18).

Conclusions:

The CASE worksheet provided an effective checklist for critically analyzing a treatment summary. While the reviewers agreed on worksheet responses for most questions, variation occurred in how the raters navigated the tool and interpreted some of the questions. Further validation of the form by other groups of users should be investigated.

Highlights

• Few critical appraisal tools have been evaluated with inter-rater reliability testing.
• The ways that users of evidence-based medicine (EBM) point-of-care (POC) tools interpret how to appraise an evidence summary—particularly when defining the grading of evidence, currency, and bias—may vary even when a standard evaluation sheet is used.
• The Critical Appraisal for Summaries of Evidence (CASE) worksheet had a moderate level of inter-rater reliability, similar to previous evaluative studies of critical appraisals tools.

Implications

• Medical librarians can develop tools useful for librarians, students, and clinicians to guide them in appraising clinical evidence summaries.
• The CASE worksheet can be a valuable tool to consider the quality of individual evidence summaries and to see patterns of overall quality in EBM POC tools.

     

The Changing Role of Higher Education in the United States

The role of higher education has changed in the United States. It has become a learning society where egalitarian pressures for equal opportunities led to the expansion of educational services to broader and more representative segments of society. Five propositions illustrate the current pressures for change. (1) Institutions of higher education no longer enjoy a monopoly on the provision of educational services. The learning society has given higher education new competition for the growing adult market. (2) The roles of education providers are increasingly blurred. (3) Higher education no longer has the full‐time commitment of students or of faculty. (4) Lifelong learning has become a lifelong necessity for almost everyone, which demands flexibility and responsiveness to change on the part of higher education. (5) A change is needed in the methods of teaching and learning to accommodate adult learners and to provide for the long‐ range needs of the learning society.     

Availability of accessible publications: designing a methodology to provide reliable estimates for the Right to Read Alliance

OBJECTIVES: To establish reliable estimates of the proportion of books available in formats accessible to visually impaired people; to recommend a practical method of updating the estimates. METHODS: The project had two stages. Stage one estimated the overall availability of all categories of books. The British National Bibliography (BNB) for 1999-2003 was chosen as the sampling frame. A sample of 2069 titles over the 5 years was selected using a systematic sample design. These titles were then checked for availability against the catalogues of four major producer/suppliers of materials in accessible formats. The second stage involved checking the availability of books in six genres; about 400 titles for each genre were examined. RESULTS: Of the titles selected for the overall estimate, 92 (4.4%) were found to be available in one or more accessible formats. Availability of titles in accessible formats varied greatly between categories. Adult fiction had the highest number of available publications (26.3%), least represented were cookery (1.9%) and gardening (1.8%). CONCLUSIONS: This study provided baseline figures and a methodology for the Right to Read Alliance to monitor their progress in campaigning for more books to be accessible to visually impaired people.     

Avoiding versus seeking: the relationship of information seeking to avoidance, blunting, coping, dissonance, and related concepts.

QUESTION: How have theorists and empirical researchers treated the human tendency to avoid discomforting information? DATA SOURCES: A historical review (1890-2004) of theory literature in communication and information studies, coupled with searches of recent studies on uptake of genetic testing and on coping strategies of cancer patients, was performed. STUDY SELECTION: The authors' review of the recent literature included searches of the MEDLINE, PsychInfo, and CINAHL databases between 1992 and summer of 2004 and selective, manual searches of earlier literature. Search strategies included the following subject headings and key words: MeSH headings: Genetic Screening/psychology, Decision Making, Neoplasms/diagnosis/genetics/psychology; CINAHL headings: Genetic Screening, Genetic Counseling, Anxiety, Decision Making, Decision Making/Patient; additional key words: avoidance, worry, monitoring, blunting, cancer. The "Related Articles" function in MEDLINE was used to perform additional "citation pearl" searching. MAIN RESULTS: The assumption that individuals actively seek information underlies much of psychological theory and communication practice, as well as most models of the information-seeking process. However, much research has also noted that sometimes people avoid information, if paying attention to it will cause mental discomfort or dissonance. Cancer information in general and genetic screening for cancer in particular are discussed as examples to illustrate this pattern. CONCLUSION: That some patients avoid knowledge of imminent disease makes avoidance behavior an important area for social and psychological research, particularly with regard to genetic testing.     

String tension effects on tennis ball rebound speed and accuracy during playing conditions

The primary aim of this study was to determine whether variations in rebound speed and accuracy of a tennis ball could be detected during game-simulated conditions when using three rackets strung with three string tensions. Tennis balls were projected from a ball machine towards participants who attempted to stroke the ball cross-court into the opposing singles court. The rebound speed of each impact was measured using a radar gun located behind the baseline of the court. An observer also recorded the number of balls landing in, long, wide and in the net. It was found that rebound speeds for males (110.1+/-10.2 km.h-1; mean+/-s) were slightly higher than those of females (103.6+/-8.6 km.h-1; P<0.05) and that low string tensions (180 N) produced greater rebound speeds (108.1+/-9.9 km.h-1) than high string tensions (280 N, 105.3+/-9.6 km.h-1; P<0.05). This finding is in line with laboratory results and theoretical predictions of other researchers. With respect to accuracy, the type of error made was significantly influenced by the string tension (P<0.05). This was particularly evident when considering whether the ball travelled long or landed in the net. High string tension was more likely to result in a net error, whereas low string tension was more likely to result in the ball travelling long. It was concluded that both gender and the string tension influence the speed and accuracy of the tennis ball.