As is often the case, these surgery legends usually designed the instruments secondary to perceived clinical needs or occasionally to suit their own anatomic characteristics.
For many years, higher education in Africa has received far less attention than primary and secondary schooling, perceived by African governments as a driver of economic growth and poverty reduction (14).
The positive results in our study on the secondary outcomes perceived work attitude, persistence in the face of adversity and skill discretion acknowledge that the intervention changed the awareness and behaviour of workers to enhance work participation.
In contrast, paired t-tests on five measures of physical and mental health (Table 3), found no significant differences, suggesting SW's judgements were specific, and not secondary to perceived health status.
This survey showed that patients with secondary AI perceived their QoL as more impaired than patients with primary AI, which is in agreement with a previous study using validated QoL questionnaires showing that patients with AI have compromised QoL and that the impairment of QoL is worse in patients with secondary AI [ 14].
The secondary outcome "perceived recovery", reported on in the first publication based on the trial [ 20], was not measured at the long term follow-ups because of the risk of bias in recalling recovery back for time more than three months.
It has been reported that, doctors from all primary and secondary care perceive their effectiveness at facilitating weight management as poor, have low confidence, feel they have little time within consultations and have inadequate training [ 30].
It is unlikely that secondary benefits are perceived in the same way across different stakeholder groups.
For example, Slatter (2009) found that secondary school teachers perceived that they were implementing more critical thinking in their science classes than the students perceived.
We expected concurrent presentation to produce larger costs to primary task performance, with this cost increasing when the secondary task was perceived as more relevant.
Outcome measures: The primary outcome was knowledge, and the secondary outcomes were perceived confidence to treat people with spinal cord injuries and satisfaction with the learning experience.
