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@ secref [ "structures" #:doc ' (lib "scribblings/reference/reference.scrbl") ]
@ secref [ "structures" #:doc ' (lib "scribblings/reference/reference.scrbl") ]

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introduces structure types via struct .

A structure type is a record datatype composing a number of fields . A structure , an instance of a structure type, is a first-class value that contains a value for each field of the structure type. A structure instance is created with a type-specific Buy Cheap Get To Buy Discount Pay With Visa shuzumiao 6 Color Wedding Shoe Woman Platform Summer Best Seller Cheap Price Sale Outlet Store To Buy 1JMy5W
procedure, and its field values are accessed and changed with type-specific accessor and mutator procedures. In addition, each structure type has a predicate procedure that answers #t for instances of the structure type and #f for any other value.

A structure type’s fields are essentially unnamed, though names are supported for error-reporting purposes. The constructor procedure takes one value for each field of the structure type, except that some of the fields of a structure type can be automatic fields ; the Brand New Unisex For Sale Cheap mesh designer italian men shoes Cheap Sale Big Sale B9bUZTl7z
are initialized to a constant that is associated with the structure type, and the corresponding arguments are omitted from the constructor procedure. All automatic fields in a structure type follow the non-automatic fields.

A structure type can be created as a structure subtype of an existing base structure type. An instance of a structure subtype can always be used as an instance of the base structure type, but the subtype gets its own predicate procedure, and it may have its own fields in addition to the fields of the base type.

A structure subtype “inherits” the fields of its base type. If the base type has m fields, and if n fields are specified for the new structure subtype, then the resulting structure type has m+n fields. The value for automatic fields can be different in a subtype than in its base type.

Recognising an unreliable basis for a claim

Treatments can harm.*†

Anecdotes are unreliable evidence.*†

Association is not the same as causation.†

Common practice is not always evidence-based.*†

Newer is not necessarily better.*

Expert opinion is not always right.*†

Beware of conflicting interests.*

More is not necessarily better.

Earlier is not necessarily better.

Hope may lead to unrealistic expectations.

Explanations about how treatments work can be wrong.

Dramatic treatment effects are rare.

Understanding whether comparisons are fair and reliable

Comparisons are needed to identify treatment effects.*†

Comparison groups should be similar.*†

Peoples’ outcomes should be analysed in their original groups.

Comparison groups should be treated equally.

People should not know which treatment they get.*

Peoples’ outcomes should be assessed similarly.

All should be followed up.

Consider all the relevant fair comparisons.*†

Reviews of fair comparisons should be systematic.

Peerreview and publication does not guarantee reliable information.

All fair comparisons and outcomes should be reported.

Subgroup analyses may be misleading.

Relative measures of effects can be misleading.

Average measures of effects can be misleading.

Fair comparisons with few people or outcome events can be misleading.*

Confidence intervals should be reported.

Donot confuse ‘statistical significance’ with ‘importance’.

Donot confuse ‘no evidence of a difference’ with ‘evidence of no difference’.

Making informed choices

Do the outcomes measured matter to you?

Are you very different from the people studied?

Are the treatments practical in your setting?

Do treatment comparisons reflect your circumstances?

How certain is the evidence?

Do the advantages outweigh the disadvantages?*†

*Concepts included in the IHC primary school resources (Nsangi et al , 2017).

†Concepts included in the IHC podcast (Semakula et al , 2017).

IHC,Informed Health Choices.

The concepts inthe box were developed as the first step in the Informed Health Choices (IHC) project as a conceptual framework to guide the development and evaluation of learning resources for primary school children and their parents in Uganda. 5 6 We believe this to be the first framework with this objective. This paper describes the current status of the IHC Key Concepts List 7 and some of its uses.

What do we mean by ‘concepts’?

We use the term ‘concepts’ (‘ideas or objects of thought’) defined as ‘criteria’; that is, ‘standards for judgement; or rules or principles for evaluating or testing something’. In addition to being ideas or objects of thought, in the practical sense, they are issues worthy of attention or consideration in assessing and making choices based on claims.

The IHC Key Concepts List was initially developed to serve as a syllabus for identifying the resources needed to help people understand and apply the concepts. It is a framework, or starting point, for teachers and others to identify and develop resources (such as longer explanations, examples, games and interactive applications) to help people understand and apply the concepts. The IHC Key Concepts List currently includes 36 concepts ( box ), divided into three groups:

The original List included 32 concepts divided into six groups. 7 The List is reviewed and amended annually, and an up-to-date List and explanations for each concept can be found on the Testing Treatments interactive and Informed Health Choices websites.

The IHC Key Concepts List is based on a combination of evidence and logic. For example, for the concept ‘association is not the same as causation’; there is plenty of evidence that a ‘treatment’ can be associated with an outcome without causing the outcome; and there are logical explanations for this, such as confounding. 8 For the concept ‘comparison groups should be similar’, there is plenty of evidence that treatment comparisons between dissimilar comparison groups can be misleading; and there are logical explanations of how dissimilar comparison groups lead to biased estimates of treatment effects. 9

The concepts are intended to apply to decisions about any type of treatment (defined as any action to improve or maintain the health of individuals or communities). We also believe the concepts to be relevant to claims and choices outside healthcare—including education, social welfare, crime and justice, international development interventions, environmental measures and veterinary treatments.

Recognising an unreliable basis for a claim.

Neurology: Genetics | Online ISSN: 2376 - 7839

© 2018 American Academy of Neurology