We surveyed 450 respondents in central business districts, outlets, transportation hubs, office buildings, and large enterprises in Tangshan. Out of the total of 424 questionnaires received, 419 are qualified. The calculation is executed by SPSS Estrogen Receptor Pathway software. 4.2. Utility Function The MNL model is used to model the individual travel mode choice. It is assumed that all the factors are independent from each other and obey the Gumbel distribution with zero mean. Equation (4) is the utility function: Vin=θiXin=θi0+∑k=1KθikXink, i∈An.

(4) In (5), Pin is the probability of traveler n selecting travel mode i: Pin=exp⁡Vin∑j∈Anexp⁡Vjn=exp⁡θiXin∑j∈Anexp⁡θXjn, i∈An, (5) where Vin is the utility function when traveler n chooses travel mode i; Xin = [Xin0, Xin1,…, Xink,…, XinK] is an eigenvector of traveler n choosing travel mode i; the component Xink is the value of variable k when traveler n chooses mode i, Xin0 = 1; θi = [θi0, θi1,…, θik,…, θiK] is the vector

of utility coefficients; and θik is the impact coefficient of variable k on travel mode i. 4.3. Results and Model Validation SPSS17.0 is used to process the data. The results of the MNL model are shown in Table 2. Table 2 The calculated parameters of the MNL model. The calculated parameters in Table 2 and the variable values in Table 1 are put into (4) and (5) to calculate the utility value and choice probability. Therefore, it is possible to forecast the sample individuals’ choice. The observed and forecasted choices are presented in Table 3. Table 3 Comparison of predicted and observed selection. There are different tests for model validation, the main ones of which are the goodness-of-fit test, F-test, and t-test. These three methods are fitted to test the linear model. Because the MNL model is a nonlinear

exponential model and the unbiased estimate of the error variance cannot be obtained from the estimated residuals, the t-test or F-test cannot be used here to test the significance either for the individual or for the population [27]. Furthermore, the model residuals do not necessarily sum to zero and ESS and RSS do not necessarily add up to TSS; therefore, R2 = ESS/TSS may not be a meaningful descriptive statistic for this model. Consequently, an alternative to pseudo R-square is proposed to estimate the goodness GSK-3 of fit. It can be seen as a rough approximation of model prediction accuracy [28]. Three pseudo R-squares calculated by SPSS are shown in Table 4. Generally, the pseudo R-squared value falls in [0, 1]. When the independent variable is completely unrelated to the dependent variable, the pseudo R-squared value will be close to zero; otherwise, it will be close to 1, which indicates that the model perfectly predicts the objective. The results listed in Table 4 show that the model is acceptable. Table 4 Pseudo R-square. 5. Analysis and Implication 5.1.

The findings are presented below by comparing the utility coefficients of the different variables. (1) Gender. It is noticed that the utility coefficient of males and females differs significantly among the alternatives. The differences in the three proenvironmental modes (walking, riding bicycle, and taking

public transport) are much larger than those of carbon-intensive modes (taxi and private car); combined VQD-002 clinical trial with that, the male utility values of all the travel modes are negative. This implies that men prefer carbon-intensive travel to proenvironmental travel, unlike women. The conclusion is in line with similar research [29] showing that women tend to adopt more socially responsible behavior. (2) Age. The 20~50-year-old respondents prefer bicycles and private cars to electric bicycles, buses, and taxis, which

indicates that there are two subgroups with different preferences in this group. The tendencies of the other groups are unclear. They may have a closer relationship with other characteristics. (3) Occupation. First, it is noticed that civil servants extremely dislike electric bicycles and taxis. The Chinese Government had not strictly regulated official car use when the survey was conducted. If official cars were available freely, no civil servant would drive a private car, let alone ride an electric bicycle, which is more dangerous. Second, students show partiality for bicycles, taxis, and private cars. The choices of students are extremely different, which is related to their family status and the distance between school and home. Some students, whose home is very far away from school, usually lodge in the school or rent an apartment near school. The former mostly use taxis or private cars once a week, while walking or taking

a bicycle is the best choice for the latter. (4) Family-Owned Private Travel Tools. Only the utility coefficient of private cars is negative among all the travel modes of families that have no private car. Although they currently choose a proenvironmental travel mode, it does not explain whether their attitudes are proenvironmental. Their decisions probably change as soon as they own a private car. (5) Travel Distance. When the distance is less than 1 kilometer, people tend to choose walking, a bicycle, or an electric bicycle; sometimes they Dacomitinib also choose a private car, but seldom a bus or taxi. (6) Travel Purpose. For commuting, the most frequent reason for travel, the utility coefficients of bicycles and electric bicycles are positive, while those of taxis and private cars are negative. The travel cost may explain the above choice, as well as some other factors, like the size of the city. 5.2. Implication Public transportation plays a very important role in meeting the large travel demand and reducing carbon emissions. A high-level public transportation service is the premise for the public to choose a proenvironmental travel mode voluntarily.

(QoL, quality of life). n, number of patients with progression by independent review/ investigator assessment. Patients … Baseline HRQoL questionnaires were completed by 94% of patients in LUX-Lung 1 and 97% of patients in LUX-Lung 3.12 13 In both studies, compliance with questionnaire completion remained high (92–99%) at or after progression, in both treatment groups. c-Kit expression The mean number of assessments at or after progression in patients with at least one baseline assessment was 2.5 by independent review and 1.4 by investigator assessment. Results of ANCOVA The progression effects (PEs) over the treatment period

in LUX-Lung 1 (12 weeks) and LUX-Lung 3 (36 weeks), in terms of adjusted mean changes from baseline in EORTC Global Health/QoL, EQ-5D UK Utility and EQ VAS scores in patients with and without progression for independent review, are shown in figure 2. Figure 2 Progression effect and adjusted mean change from baseline for Global health status/QoL, EQ-5D utility and EQ VAS scores, by progression status in LUX-Lung 1 and LUX-Lung 3, independent review (QoL, quality of life; VAS, visual analogue scale). Progression … In LUX-Lung 1, patients with progression by independent review consistently experienced numerically poorer HRQoL at the time of progression than

patients without progression over the first 12 weeks of treatment. Mean scores differed significantly between patients with and without progression at week 4 for Global Health/QoL (PE: −8.5),

EQ-5D UK Utility (PE: −0.1) and EQ VAS scores (PE: −7.3; all p<0.05). Differences in mean change from baseline in VAS scores were also statistically significant (p<0.05) between patients who experienced progression by independent review and those who did not at week 8 (PE: −5.4). Results were similar for investigator assessment of progression (see online supplementary figure 1). In LUX-Lung 3, patients with progression by independent review consistently experienced poorer HRQoL progression than patients without progression. Differences in mean change from baseline in EORTC Global Health/QoL, EQ-5D UK Utility and EQ VAS scores were statistically significant between patients who experienced progression and those who did not at multiple time points in all assessments (figure 2). Results were similar for investigator assessment Entinostat of progression (see online supplementary figure 1). Interaction tests investigating the PE with each of baseline HRQoL and randomised treatment as well as with gender and ECOG score in LUX-Lung 1, and EGFR status and race in LUX-Lung 3 did not show any consistent trend. This indicates that these factors do not have a significant impact on the analyses and therefore supports the conclusion that the effects of progression on HRQoL that were identified by the ANCOVA models are consistent throughout the patient population.

(QoL, quality of life). n, number of patients with progression by independent review/ investigator assessment. Patients … Baseline HRQoL questionnaires were completed by 94% of patients in LUX-Lung 1 and 97% of patients in LUX-Lung 3.12 13 In both studies, compliance with questionnaire completion remained high (92–99%) at or after progression, in both treatment groups. ksp inhibitor The mean number of assessments at or after progression in patients with at least one baseline assessment was 2.5 by independent review and 1.4 by investigator assessment. Results of ANCOVA The progression effects (PEs) over the treatment period

in LUX-Lung 1 (12 weeks) and LUX-Lung 3 (36 weeks), in terms of adjusted mean changes from baseline in EORTC Global Health/QoL, EQ-5D UK Utility and EQ VAS scores in patients with and without progression for independent review, are shown in figure 2. Figure 2 Progression effect and adjusted mean change from baseline for Global health status/QoL, EQ-5D utility and EQ VAS scores, by progression status in LUX-Lung 1 and LUX-Lung 3, independent review (QoL, quality of life; VAS, visual analogue scale). Progression … In LUX-Lung 1, patients with progression by independent review consistently experienced numerically poorer HRQoL at the time of progression than

patients without progression over the first 12 weeks of treatment. Mean scores differed significantly between patients with and without progression at week 4 for Global Health/QoL (PE: −8.5),

EQ-5D UK Utility (PE: −0.1) and EQ VAS scores (PE: −7.3; all p<0.05). Differences in mean change from baseline in VAS scores were also statistically significant (p<0.05) between patients who experienced progression by independent review and those who did not at week 8 (PE: −5.4). Results were similar for investigator assessment of progression (see online supplementary figure 1). In LUX-Lung 3, patients with progression by independent review consistently experienced poorer HRQoL progression than patients without progression. Differences in mean change from baseline in EORTC Global Health/QoL, EQ-5D UK Utility and EQ VAS scores were statistically significant between patients who experienced progression and those who did not at multiple time points in all assessments (figure 2). Results were similar for investigator assessment Carfilzomib of progression (see online supplementary figure 1). Interaction tests investigating the PE with each of baseline HRQoL and randomised treatment as well as with gender and ECOG score in LUX-Lung 1, and EGFR status and race in LUX-Lung 3 did not show any consistent trend. This indicates that these factors do not have a significant impact on the analyses and therefore supports the conclusion that the effects of progression on HRQoL that were identified by the ANCOVA models are consistent throughout the patient population.

Our search will be refined for individual databases by a highly experienced medical librarian (RC; see online supplementary appendix 1, which is a proposed search strategy for MEDLINE). Reviewers will scan the bibliographies of all retrieved trials and other relevant publications, including reviews Lapatinib clinical and meta-analyses, for additional relevant articles. Eligibility criteria and their application to potentially eligible articles Using standardised

forms, reviewers trained in health research methodology will work in pairs to screen, independently and in duplicate, titles and abstracts of identified citations, and acquire the full-text publication of articles that both reviewers judge as potentially eligible. Using a standardised form, the same reviewer teams will independently apply eligibility criteria to the full text of potentially eligible trials. We will measure agreement between reviewers to assess the reliability of full-text review using the guidelines proposed by Landis and Koch.61 Specifically, we will calculate κ values, and interpret them using the following thresholds: <0.20 as slight agreement, 0.21–0.40 as fair agreement, 0.41–0.60 as moderate agreement, 0.61–0.80 as substantial agreement and >0.80 as almost perfect agreement. Eligible trials will be: (1) enrol patients presenting

with chronic neuropathic pain (see online supplementary appendix 2 for lists of all syndromes we are studying) and (2) randomise patients to alternative interventions (pharmacological or non-pharmacological)

or to an intervention and control arm. Data abstraction and analysis Before starting data abstraction, we will conduct calibration exercises to ensure consistency between reviewers. Teams of reviewers will extract data independently and in duplicate from each eligible study using standardised forms and a detailed instruction manual to inform tailoring of an online data abstraction programme, DistillerSR (http://systematic-review.net/). We will extract data regarding patient demographics, trial methodology, intervention details and outcome data guided by the Initiative on Methods, Measurement and Pain Assessment in Clinical Trials (IMMPACT).62 63 Specifically, we will collect outcome data across AV-951 the following nine IMMPACT-recommended core outcome domains: (1) pain; (2) physical functioning; (3) emotional functioning; (4) participant ratings of improvement and satisfaction with treatment; (5) symptoms and adverse events; (6) participation disposition; (7) role functioning; (8) interpersonal functioning; and (9) sleep and fatigue. We will collect data for all adverse outcomes as guided by Ioannidis and Lau.64 We will resolve disagreements by discussion to achieve consensus.

Draft Wortmannin ATM interpretations were then discussed within the research team, retested against the transcripts, and used to identify the overarching imagery and themes. The lead author reviewed all transcripts and regular team discussions ensured the themes identified were tested for coherence and validity. We analysed the interview transcripts using discourse analysis, which views language

as a social function that participants use to construct a reality.32 33 Discourses reflect common assumptions, reveal how these structure participants’ thoughts and actions, and uncover how participants privilege some positions while minimising those that challenge their ‘reality’.34 This approach enabled us to explore what emotions the messages elicited,

which metaphors they employed, and how this imagery functioned.34 We use quotations to illustrate the metaphor patterns and the interpretations at which we arrived. Results Phase 1: The illusion of choice and control Responses to the photo sort task revealed two dominant metaphors: choice and control. Participants resisted acknowledging they were addicted by asserting smoking as a choice over which they maintained control. Yet despite constructing this position, none described smoking as a conscious choice and nearly all began smoking to avoid deviating from the peer group and family social norms: “We were raised in a smoking house…there was just smoke… It wasn’t really peer pressure or ’cause it was just to be cool, ’cause everybody else was doing it at the time.” These comments highlight the pervasiveness and normality of smoking, where ‘everybody else’ and ‘everyone’ smoked: “When I was going out [to pubs] all the time and everyone

was just smoking outside, so that’s mainly why I started.” Smoking defined group membership; rather than reflecting deeply on their actions, participants adopted behaviours others modelled: “Yeah. It means a lot. It means like- ah, um, I can actually smoke. I can actually afford a smoke, and I can, um, actually, um, be my boss.” Despite the apparent passivity of their smoking initiation, smoking provided participants with a tool they used to AV-951 assert their social identity. While they had not made active choices to smoke, participants nevertheless regarded smoking and quitting as a choice that only they (or other smokers) could make. They saw choice as a personal entitlement: “…it’s my choice. Freedom of choice”; a general right: “… these guys [smokers] have made the choice …”, and a national freedom: “It’s New Zealanders’ choice… if they wanna quit they’ll quit.” By framing smoking and quitting as “choices”, participants maintained control and distanced themselves from stereotypes of addicted smokers who had lost control.

2 4 Many of these health, social and psychological difficulties are related to the reasons for the child entering the care system. Sixty-two per cent of these children entered the care system due to abuse or neglect, and for 3% of looked-after Tofacitinib alopecia children, their own health problems led to them entering into care.2 It

is likely that these disadvantages continue into adult life for many of these children.5 Despite these health and social disadvantages, there is very little evidence on the health status of this group. They are an under-represented group in research as they are a highly mobile group, with issues of parental consent making enrolment into research studies difficult.6 Few studies have used nationally representative samples focusing on health outcomes over the life course of children who have been in care.1 4 5 Even fewer have investigated outcomes during pregnancy and early motherhood.7

In particular, whether mothers with a history of time spent in care have adverse maternal and pregnancy outcomes is currently unknown. Pregnancy and early motherhood is an important stage in the life cycle: a time when women have a high level of contact with health and social care services. As a consequence, there is potential to identify high-risk women and provide interventions to improve pregnancy outcomes.8 This may be particularly relevant to adults who have previously been in care and who may have had a reduction in residential stability leading to disjointed health service access and reduced exposure to health advice and information. Measures have been proposed to improve outcomes for socially disadvantaged women such as multiagency working, tailored antenatal services, community-based continuity of care schemes and Family Nurse Partnerships for young mothers.9 10 Although

previous work has looked at the associations between sexual risk behaviours Brefeldin_A and a history of time in care, very little evidence is available on the health status and maternal outcomes of these women. Previous research has shown that girls who have been in care have worse sexual health outcomes than girls who have never been in care. Girls who have been in care have a greater risk of teenage pregnancy, an earlier age at first intercourse and an increased number of sexual partners compared to girls who had not spent any time in the care system.11–15 In addition to a higher risk of teenage pregnancy and an increased number of sexual partners, Hobcraft15 found that girls who had been in care were at an increased risk of factors relating to social exclusion, such as no qualifications, homelessness and poor-quality housing.

“I think they should work on teaching session, according to level of each, e.g. dividing them in groups and take them step by step even if it take 10 sessions or more” (FG2). Participants specified that the IT team and super users selleck chem Z-VAD-FMK were always available

during the early time of implementation. They also suggested having regular meetings with the IT team to re-evaluate the physicians, answer their queries and have an updated training session for each system upgrade, for example, “they make a training they have to meet the users again to evaluate them. For example, I am using the Cerner and I collect questions there should be someone professional to answer me” (FG3). “They should give us updating; now what I learn 2 years ago I am developing myself. This should be like regular because this will answer a lot of questions for me for the system” (FG1). Patient-related outcomes Patient–physician relationship Physicians’ perceptions about patient reaction were mixed. Initially, they were unhappy because of the disturbed

patient–doctors relationship, for example, “It was bad but now it is improving a lot” (FG1) and “The real thing is eye contact is missing” (FG2). Furthermore, the waiting time increased due to data entry causing more frustration to the patients, for example, “The patient upset because of waiting time” (FG3). Physicians believed that the waiting time was not caused by them but was mainly in the registration and nursing assessment, for example, “I found that nursing assessment they have to do a lot of things” (FG2). However, they believed that the benefits outweighed the waiting time issue and included beneficial issues as improved patient care, patient education and the health maintenance schedule. They stated that the patient flow was initially reduced but eventually returned to the same level as prior to implementation of the EMR, for example, “the same, the same” (FG2). Many physicians were concerned about their patients’ perception about the new technology. They felt that

many patients were unhappy but indicated that few patients approved and made positive remarks to their physicians. Physicians Entinostat tried to adapt some strategies to maintain their relationship with their patients. Some were talking to their patients while dealing with the computer so that the patients would not feel neglected, for example, “ok now I am checking your results, I am checking your past file” (FG1). Others reserved data entry work for immediately after the visit, for example, “we can put the diagnosis, then put the medication, because we can’t put medication without diagnosis then put the labs then ask the patient to go and continue documentation” (FG2). “The proper thing is to take full history from the patient, maintaining the good communication with the patient then turn and document” (FG3).

We found evidence for good reliability with high correlations between the test–retest for total PA, occupational PA, active transportation and vigorous intensity activity. Our results show that considering except for domestic PA and sitting time, ICC values for domains of PA were consistently above 0.70, a level of reproducibility that has been considered acceptably good for IPAQ data.33 34 Similar to a previous IPAQ-LF study in Hong Kong,34 domestic activity demonstrated the lowest ICC value in our study. However, it is possible

that the infrequent nature of household activities undertaken, especially by men, may account for the low reliability reported for domestic PA in our study. In addition to the traditional African patriarchal norm that makes most African men rarely engage in indoor household activities, men in the high socioeconomic group in Nigeria may also not engage in outdoor domestic activities such as gardening and outdoor home appliances and equipment maintenance, because they are able to employ the services of domestic helpers and repair men. Our findings of lower reliability for domestic activity among men, those with more than secondary school education and those who were employed compared to their counterparts

seem to support this assumption. The highest and strongest reliability coefficients (0.82) were found for active transportation as well as vigorous intensity activity. Perhaps active transportation was more stable, consistent and reproducible over time than other PA domains because it is a common and ubiquitous PA behaviour in the African region. Mostly, the performance of active transportation, especially walking, is often out of necessity rather than choice within the African context. Our finding of higher ICC value for vigorous intensity PA is consistent with findings of other studies that found the reliability of vigorous intensity activity to be higher compared to that of moderate intensity activity.10 30 34 35

Brefeldin_A Compared to structured vigorous PAs such as sports and exercise, which can be more easily recalled, moderate intensity PA is often of low salience, incidental and may not easily be remembered by people.36 37 Furthermore, our finding that the reliability of vigorous intensity PA was meaningfully higher among men than women seems to confirm our previous findings with the IPAQ-SF.21 Plausibly, men in Nigeria are more consistent than women when responding to PA items that pertain to intense vigorous PA than other intensities of activity. Overall, the moderate-to-good evidence of reliability found for all items indicates that the modified IPAQ-LF is reproducible, internally consistent and is promising for research in Nigeria.

ICC estimates >0.75 were considered as good reliability scores, between 0.50 and 0.75 as moderate reliability, and

<0.50 as poor reliability.31 Second, the Bland and Altman Method was used to assess agreement on scores of PA from the first and second administrations.32 Variables used for the Bland and Altman selleck analysis were weekly time spent in moderate-to-vigorous activity (MVPA), total PA and sitting. MVPA was computed by summing the total min/week of reported PA of moderate and vigorous intensities across all four domains. For total PA, the total min/week of activities in each domain was summed (total work+total transport+total domestic+total leisure-time min/week scores) to gain an overall estimate of PA in a week. Also, the

independent t test and one-way ANOVA were used as appropriate to compare the time spent (min/week) in PA at both administrations across sociodemographic subgroups. To assess construct validity, the non-parametric Spearman correlation coefficients (r) were utilised to explore the relationship between MET-min/week of PA from the Hausa IPAQ-LF, and resting blood pressure and BMI. Data were analysed using Statistical Package for the Social Sciences (SPSS), V.15.0 for Windows (SPSS Inc, Chicago, Illinois, USA) and the level of significance was set at p<0.05. Results The sociodemographic characteristic of the participants are shown in table 1. The participants comprised equally of women and men, with a mean age of 35.6±10.3 years and BMI of 23.8±3.9 kg/m2. The majority of the participants were married (58.9%, n=106), had more than secondary school education (62.7%, n=111) and were employed (75%, n=117). Compared to men, the women were more likely to be married (71.1% vs 46.7%, p=0.001) and unemployed (52.2% vs 17.8%, p<0.001), but men were more likely to have more than secondary school education (76.7% vs 48.2%, p<0.001). Table 1 Descriptive characteristics of the participants (N=180) Reliability Table 2 shows the test–retest reliability of the modified IPAQ-LF. Overall, reliability coefficients were good (ICC

>75) for total PA, occupational PA, active transportation and vigorous intensity (very hard) PA. Domestic PA, sitting activity and Drug_discovery leisure PA demonstrated moderate reliability (ICC ranges from 0.51 to 0.71). While the reliability coefficients of total PA (ICC=0.80, 95% CI 0.69 to 0.87), active transportation (ICC=0.83, 95% CI 0.73 to 0.89), occupational PA (ICC=0.78, 95% CI 0.66 to 0.85) and leisure time PA (ICC=0.75, 95% CI 0.63 to 0.84) were substantially higher among men than women, reliability coefficients for domestic PA (ICC=0.38, 95%, CI 0.01 to 0.57) and sitting time (ICC=0.71, 95% CI 0.46 to 0.85) were higher among women than men. According to the intensity of PA, ICCs range between 0.61 and 0.82, with the lowest value recorded for moderate intensity (hard) PA and the highest value for vigorous intensity (very hard) PA.