Abstract Objectives Despite successful treatment, people living with HIV experience persisting and burdensome multidimensional problems. We aimed to assess the validity, reliability and responsiveness of Positive Outcomes, a patient‐reported outcome measure for use in clinical practice. Methods In all, 1392 outpatients in five European countries self‐completed Positive Outcomes, PAM‐13 (patient empowerment), PROQOL‐HIV (quality of life) and FRAIL (frailty) at baseline and 12 months. Analysis assessed: (a) validity (structural, convergent and divergent, discriminant); (b) reliability (internal consistency, test‐retest); and (c) responsiveness. Results An interpretable four‐factor structure was identified: ‘emotional wellbeing’, ‘interpersonal and sexual wellbeing’, ‘socioeconomic wellbeing’ and ‘physical wellbeing’. Moderate to strong convergent validity was found for three subscales of Positive Outcomes and PROQOL ( ρ = −0.481 to −0.618, all p < 0.001). Divergent validity was found for total scores with weak ρ (−0.295, p < 0.001). Discriminant validity was confirmed with worse Positive Outcomes score associated with increasing odds of worse FRAIL group (4.81‐fold, p < 0.001) and PAM‐13 level (2.28‐fold, p < 0.001). Internal consistency for total Positive Outcomes and its factors exceeded the conservative α threshold of 0.6. Test‐retest reliability was established: those with stable PAM‐13 and FRAIL scores also reported median Positive Outcomes change of 0. Improved PROQOL‐HIV score baseline to 12 months was associated with improved Positive Outcomes score ( r = −0.44, p < 0.001). Conclusions Positive Outcomes face and content validity was previously established, and the remaining validity, reliability and responsiveness properties are now demonstrated. The items within the brief 22‐item tool are designed to be actionable by health and social care professionals to facilitate the goal of person‐centred care.
The ECRAN (European Communication on Research Awareness Needs) project was initiated in 2012, with support from the European Commission, to improve public knowledge about the importance of independent, multinational, clinical trials in Europe. Participants in the ECRAN consortium included clinicians and methodologists directly involved in clinical trials; researchers working in partnership with the public and patients; representatives of patients; and experts in science communication. We searched for, and evaluated, relevant existing materials and developed additional materials and tools, making them freely available under a Creative Commons licence. The principal communication materials developed were: Over a 2-year project, our multidisciplinary and multinational consortium was able to produce, and make freely available in many languages, new materials to promote public knowledge about the importance of independent and international clinical trials. Sustained funding for the ECRAN information platform could help to promote successful recruitment to independent clinical trials supported through the European Clinical Research Infrastructure Network.
At a satellite meeting preceding the 2013 Controlling the HIV Epidemic With Antiretrovirals evidence summit in London, England, a group of organizations and advocates discussed and formulated the final draft of a document, the Community Consensus Statement on the Use of Antiretroviral Therapy in Preventing HIV Transmission, that succinctly outlines a set of principles that should be followed in the provision of antiretroviral therapy to people with living with human immunodeficiency virus (HIV) for the purposes of preventing HIV, particularly as a public health measure. The satellite meeting's conclusions were subsequently outlined in a presentation and panel discussion at the evidence summit.
We introduce models for the runaway coevolution of female mating preferences and male display traits. The models generalize earlier results by allowing for direct natural selection on the preference, arbitrary forms of mate choice, and fairly general assumptions about the underlying genetics. Results show that a runaway is less likely when there is direct selection on the preference, but that it is still possible if there is a sufficiently large phenotypic correlation between the female's preference and the male's trait among mated pairs. Comparison of three preference functions introduced by Lande (1981) shows that open‐ended preferences are particularly prone to a runaway, and that absolute preferences require very large differences between females in their preferences. We analyze the causes of the runaway seen in a model developed by Iwasa and Pomiankowski (1995).
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