Effect of Linguistic and Musical Experience on Distributional Learning of Nonnative Lexical Tones

ERIC Educational Resources Information Center

Ong, Jia Hoong; Burnham, Denis; Escudero, Paola; Stevens, Catherine J.

2017-01-01

Purpose: Evidence suggests that extensive experience with lexical tones or musical training provides an advantage in perceiving nonnative lexical tones. This investigation concerns whether such an advantage is evident in learning nonnative lexical tones based on the distributional structure of the input. Method: Using an established protocol,…

Evidence-based tick acaricide resistance intervention strategy in Uganda: Concept and feedback of farmers and stakeholders.

PubMed

Vudriko, Patrick; Okwee-Acai, James; Byaruhanga, Joseph; Tayebwa, Dickson Stuart; Omara, Robert; Muhindo, Jeanne Bukeka; Lagu, Charles; Umemiya-Shirafuji, Rika; Xuan, Xuenan; Suzuki, Hiroshi

2018-02-01

The emergence of multi-acaricide resistant ticks has led to unprecedented level of acaricide failure in central and western Uganda. In the absence of a national acaricide resistance management strategy, the country's dairy sector is threatened by upsurge of ticks and tick-borne diseases. In this study, we developed a short-to-medium-term intervention approach called Evidence-Based Acaricide Tick Control (EBATIC): Identify, Test, Intervene and Eradicate (IT-IE). Furthermore, the perception of 199 farmers and extension workers, 12 key informants in four districts and 47 stakeholders in the animal industry in Uganda were assessed using semi-structured questionnaires. We report that the establishment of a specialized laboratory is pivotal in identifying and testing (IT) acaricide resistant ticks for prompt intervention and eradication (IE). The laboratory test results and the farm tick control gaps identified are very important in guiding acaricide resistance management strategies such as evidence-based acaricide rotation, development and dissemination of extension materials, training of farmers and extension workers, and stakeholders' engagement towards finding sustainable solutions. All the 47 stakeholders and 91.0% (181/199) of the farmers and extension workers reported that the EBATIC approach will help in solving the tick acaricide resistance crisis in Uganda. Similarly, all the 12 key informants and 92.5% (184/199) of the farmers and extension workers suggested that the EBATIC approach should be sustained and rolled out to other districts. The EBATIC stakeholders' dialogue generated both short-to-medium and long-term strategies for sustainable management of tick acaricide resistance in the country. Overall, the positive feedback from farmers, district veterinarians and stakeholders in the animal industry suggest that the EBATIC approach is a useful proof-of-concept on scalable intervention pathway against tick acaricide resistance in Uganda with possibility of adoption in other African countries. Copyright © 2017 Elsevier GmbH. All rights reserved.

Innovations in interventional pain management of chronic spinal pain.

PubMed

Manchikanti, Laxmaiah; Boswell, Mark V; Hirsch, Joshua A

2016-09-01

Interventional pain management dates back to 1901, with significant innovations, which include the definition, literature synthesis, pathophysiology, and technical interventions. Interventional pain management and interventional techniques include neural blockade, neural ablative procedures, spinal cord and peripheral nerve stimulation, intrathecal drug delivery systems, minimally invasive lumbar decompression (MILD®), percutaneous endoscopic spinal decompression, and regenerative medicine. In addition, advances are also related to the evidence synthesis of comparative effectiveness research. Expert commentary: Multiple innovations in interventional pain management and potential innovations may reduce costs and improve care and outcomes with proper evidence synthesis and application of principles of evidence-based medicine. Innovations in interventional pain management in managing chronic spinal pain depend on extensive research and appropriate evidence synthesis. Innovations should be developed in conjunction with health care policy based on principles of evidence-based medicine.

The role of state mental health authorities in managing change for the implementation of evidence-based practices.

PubMed

Isett, Kimberley Roussin; Burnam, M Audrey; Coleman-Beattie, Brenda; Hyde, Pamela S; Morrissey, Joseph P; Magnabosco, Jennifer L; Rapp, Charles; Ganju, Vijay; Goldman, Howard H

2008-06-01

The evidence-based practice demonstration for services to adults with serious mental illness has ended its pilot stage. This paper presents the approaches states employed to combine traditional policy levers with more strategic/institutional efforts (e.g., leadership) to facilitate implementation of these practices. Two rounds of site visits were completed and extensive interview data collected. The data were analyzed to find trends that were consistent across states and across practices. Two themes emerged for understanding implementation of evidence-based practices: the support and influence of the state mental health authority matters and so does the structure of the mental health systems.

Insular Cortex Is Involved in Consolidation of Object Recognition Memory

ERIC Educational Resources Information Center

Bermudez-Rattoni, Federico; Okuda, Shoki; Roozendaal, Benno; McGaugh, James L.

2005-01-01

Extensive evidence indicates that the insular cortex (IC), also termed gustatory cortex, is critically involved in conditioned taste aversion and taste recognition memory. Although most studies of the involvement of the IC in memory have investigated taste, there is some evidence that the IC is involved in memory that is not based on taste. In…

Two-Stage Categorization in Brand Extension Evaluation: Electrophysiological Time Course Evidence

PubMed Central

Wang, Xiaoyi

2014-01-01

A brand name can be considered a mental category. Similarity-based categorization theory has been used to explain how consumers judge a new product as a member of a known brand, a process called brand extension evaluation. This study was an event-related potential study conducted in two experiments. The study found a two-stage categorization process reflected by the P2 and N400 components in brand extension evaluation. In experiment 1, a prime–probe paradigm was presented in a pair consisting of a brand name and a product name in three conditions, i.e., in-category extension, similar-category extension, and out-of-category extension. Although the task was unrelated to brand extension evaluation, P2 distinguished out-of-category extensions from similar-category and in-category ones, and N400 distinguished similar-category extensions from in-category ones. In experiment 2, a prime–probe paradigm with a related task was used, in which product names included subcategory and major-category product names. The N400 elicited by subcategory products was more significantly negative than that elicited by major-category products, with no salient difference in P2. We speculated that P2 could reflect the early low-level and similarity-based processing in the first stage, whereas N400 could reflect the late analytic and category-based processing in the second stage. PMID:25438152

[Is "evidence-based medicine" followed by "confidence-based medicine"?].

PubMed

Porzsolt, Franz; Fangerau, Heiner

2010-08-01

In an appeal concerning accusations of defamation, the England and Wales Court of Appeal Decisions determined that evidence-based statements are to be judged as opinions and not statements of fact. Since the authors consider it probable that this legal judgment will exert influence on physicians' decisions about the provision of health care services, they have compiled the implications of the judgment and discuss its consequences. The own analyses and considerations lead to the conclusion that confidence-based medicine follows evidence-based medicine. This extension is necessary because evidence-based medicine has not been able to generate the required trust. Therefore, it will be demanded to underpin the existing concept with additional data. These data will be necessary because it is no longer sufficient to convince scientists with data which are obtained under ideal conditions, but to convince critical members of society with additional data which have been obtained under everyday conditions.

Information demands of occupational health physicians and their attitude towards evidence-based medicine.

PubMed

Schaafsma, Frederieke; Hulshof, Carel; van Dijk, Frank; Verbeek, Jos

2004-08-01

This study assessed the extent and nature of information demands among occupational health physicians and their attitude towards the application of evidence-based medicine in occupational health. A questionnaire survey was carried out among a random sample of 159 physicians practicing occupational medicine in The Netherlands. The questionnaire investigated the type and number of questions encountered in daily practice, the actions taken in response, the physicians' experience in using scientific databases on the Internet, and their attitude towards evidence-based medicine. The occupational health physicians' questions concerned medical, legal, and rehabilitation topics in particular. In pursuing answers to their questions, they generally chose to contact colleagues. Scientific databases were not consulted very often, although, in general, the attitude towards evidence-based medicine was positive. In addition to known barriers for practicing evidence-based medicine, occupational health physicians perceive a lack of scientific evidence in their field. The extensiveness of the field of knowledge in occupational health care was not regarded as an obstacle to their application of evidence-based medicine. Occupational health physicians have a demand for information on a broad range of topics, and, in most cases, their attitude towards evidence-based medicine is fairly positive. Besides education and training in evidence-based medicine, access to the Internet and the presence of a good knowledge infrastructure would help occupational health physicians use evidence-based medicine.

Open-Access Physical Activity Programs for Older Adults: A Pragmatic and Systematic Review.

PubMed

Balis, Laura E; Strayer, Thomas; Ramalingam, NithyaPriya; Wilson, Meghan; Harden, Samantha M

2018-01-10

Open-access, community-based programs are recommended to assist older adults in meeting physical activity guidelines, but the characteristics, impact, and scalability of these programs is less understood. The Land-Grant University Cooperative Extension System, an organization providing education through county-based educators, functions as a delivery system for these programs. A systematic review was conducted to determine characteristics of effective older adult physical activity programs and the extent to which programs delivered in Extension employ these characteristics. A systematic review of peer-reviewed and grey literature was conducted from August 2016 to February 2017. The review was limited to open-access (available to all), community-based physical activity interventions for older adults (≥65 years of age). The peer-reviewed literature search was conducted in PubMed and EBSCOhost; the grey literature search for Extension interventions was conducted through Extension websites, Land-Grant Impacts, and the Journal of Extension. Sixteen peer-reviewed studies and 17 grey literature sources met inclusion criteria and were analyzed. Peer-reviewed and Extension programs were similar in their limited use of behavioral theories and group-based strategies. Compared to Extension programs, those in the peer-reviewed literature were more likely to use a combination of physical activity components and be delivered by trained professionals. The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Extension of a suspended soap film: a homogeneous dilatation followed by new film extraction.

PubMed

Seiwert, Jacopo; Monloubou, Martin; Dollet, Benjamin; Cantat, Isabelle

2013-08-30

Liquid foams are widely used in industry for their high effective viscosity, whose local origin is still unclear. This Letter presents new results on the extension of a suspended soap film, in a configuration mimicking the elementary deformation occurring during foam shearing. We evidence a surprising two-step evolution: the film first extends homogeneously, then its extension stops, and a new thicker film is extracted from the meniscus. The second step is independent of the nature of the surfactant solution, whereas the initial extension is only observed for surfactant solutions with negligible dilatational moduli. We predict this complex behavior using a model based on Frankel's theory and on interface rigidification induced by confinement.

Wound closure in flexion versus extension following total knee arthroplasty: a systematic review.

PubMed

Smith, Toby O; Davies, Leigh; Hing, Caroline B

2010-06-01

Optimising knee range of motion following total knee arthroplasty (TKA) is important for patient satisfaction, functional outcome and early rehabilitation to promote accelerated discharge. Historically, wound closure following TKA has been performed in extension. It has been suggested that knee position during wound closure may influence range of motion and clinical outcomes following TKA. The purpose of this study was to determine whether TKA wounds should be closed in flexion or extension. An electronic search of MEDLINE, EMBASE, CINAHL and AMED databases was made in addition to a review of unpublished material. All included papers were critically appraised using a modified PEDro (Physiotherapy Evidence Database) critical appraisal tool. Three papers were eligible, assessing 237 TKAs. On analysis, patients with TKA wounds closed in flexion had greater flexion range of motion and required less domiciliary physiotherapy compared to those with wounds closed in full extension. The specific degree of knee flexion used when closing total knee replacement wounds may be an important variable to clinical outcome. However, the present evidence-base is limited in both size and methodological quality.

Tales of Refusal, Adoption, and Maintenance: Evidence-Based Substance Abuse Prevention via School-Extension Collaborations

ERIC Educational Resources Information Center

St. Pierre, Tena L.; Kaltreider, D. Lynne

2004-01-01

Despite availability of empirically supported school-based substance abuse prevention programs, adoption and implementation fidelity of such programs appear to be low. A replicated case study was conducted to investigate school adoption and implementation processes of the EXSELS model (Project ALERT delivered by program leaders through Cooperative…

Market-Based Reforms in Urban Education.

ERIC Educational Resources Information Center

Ladd, Helen F.

This paper is for policymakers, advocates, and analysts who understand that the issues surrounding the introduction of more market-based mechanisms into education are complex and who accept the view that evidence is useful in sorting out the issues. It uses the market framework of demand, supply, and market pricing to organize the extensive but…

Culturally Adapting an Evidence-Based Parenting Intervention for Latino Immigrants: The Need to Integrate Fidelity and Cultural Relevance1

PubMed Central

Cardona, Jose Ruben Parra; Domenech-Rodriguez, Melanie; Forgatch, Marion; Sullivan, Cris; Bybee, Deborah; Holtrop, Kendal; Escobar-Chew, Ana Rocio; Tams, Lisa; Dates, Brian; Bernal, Guillermo

2011-01-01

Latinos constitute the largest ethnic minority group in the US. However, the cultural adaptation and dissemination of evidence-based parenting interventions among Latino populations continues to be scarce in spite of extensive research that demonstrates the long-term positive effects of these interventions. The purpose of this article is threefold: (a) justify the importance of cultural adaptation research as a key strategy to disseminate efficacious interventions among Latinos, (b) describe the initial steps of a program of prevention research with Latino immigrants aimed at culturally adapting an evidence-based intervention informed by parent management training (PMT) principles, and (c) discuss implications for advancing cultural adaptation prevention practice and research, based on the initial feasibility and cultural acceptability findings of the current investigation. PMID:22428711

Psychoeducational Assessment and Intervention for Ethnic Minority Children: Evidence­-Based Approaches

ERIC Educational Resources Information Center

Graves, Scott L., Jr., Ed.; Blake, Jamilia J., Ed.

2016-01-01

School-based mental health professionals receive extensive training in assessment and treatment techniques with children. However, most of this training is based on research with white, middle-class populations, whose experiences are hardly universal. In the next decade, ethnic minority students are projected to become the numerical majority in…

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

Extension of a Suspended Soap Film: A Homogeneous Dilatation Followed by New Film Extraction

NASA Astrophysics Data System (ADS)

Seiwert, Jacopo; Monloubou, Martin; Dollet, Benjamin; Cantat, Isabelle

2013-08-01

Liquid foams are widely used in industry for their high effective viscosity, whose local origin is still unclear. This Letter presents new results on the extension of a suspended soap film, in a configuration mimicking the elementary deformation occurring during foam shearing. We evidence a surprising two-step evolution: the film first extends homogeneously, then its extension stops, and a new thicker film is extracted from the meniscus. The second step is independent of the nature of the surfactant solution, whereas the initial extension is only observed for surfactant solutions with negligible dilatational moduli. We predict this complex behavior using a model based on Frankel’s theory and on interface rigidification induced by confinement.

Evidence conflict measure based on OWA operator in open world

PubMed Central

Wang, Shiyu; Liu, Xiang; Zheng, Hanqing; Wei, Boya

2017-01-01

Dempster-Shafer evidence theory has been extensively used in many information fusion systems since it was proposed by Dempster and extended by Shafer. Many scholars have been conducted on conflict management of Dempster-Shafer evidence theory in past decades. However, how to determine a potent parameter to measure evidence conflict, when the given environment is in an open world, namely the frame of discernment is incomplete, is still an open issue. In this paper, a new method which combines generalized conflict coefficient, generalized evidence distance, and generalized interval correlation coefficient based on ordered weighted averaging (OWA) operator, to measure the conflict of evidence is presented. Through ordered weighted average of these three parameters, the combinatorial coefficient can still measure the conflict effectively when one or two parameters are not valid. Several numerical examples demonstrate the effectiveness of the proposed method. PMID:28542271

School-Wide Healthy Weight Behaviors: Promoting Universal Longevity via School-Family Ecologies (PULSE)

ERIC Educational Resources Information Center

Anderson, Laura M.; Phelps, LeAdelle

2009-01-01

Rates of childhood obesity have more than tripled in the last 40 years, resulting in a challenge from the public sector and various governmental institutions for the development of effective prevention/early intervention programming. Based on an extensive review of the literature, an evidence-based, school-wide curriculum is proposed. Promoting…

Responsive Evaluation as a Guide to Design and Implementation: Case Study of an E-Health Learning System

ERIC Educational Resources Information Center

Schaffer, Scott P.; Kim, Hannah

2012-01-01

Evaluation of the design and implementation of a web-based e-health application offers an opportunity to apply extensive research findings and evidence-based practices from the learning and performance literature. In this study, we examined how interactions between stakeholders influenced the design, implementation, and outcomes of an e-health…

Computer-Based Training at a Military Medical Center: Understanding Decreased Participation in Training among Staff and Ways to Improve Completion Rates

ERIC Educational Resources Information Center

Lavender, Julie

2013-01-01

Military health care facilities make extensive use of computer-based training (CBT) for both clinical and non-clinical staff. Despite evidence identifying various factors that may impact CBT, the problem is unclear as to what factors specifically influence employee participation in computer-based training. The purpose of this mixed method case…

PRISMA-Children (C) and PRISMA-Protocol for Children (P-C) Extensions: a study protocol for the development of guidelines for the conduct and reporting of systematic reviews and meta-analyses of newborn and child health research.

PubMed

Kapadia, Mufiza Z; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

2016-04-18

Paediatric systematic reviews differ from adult systematic reviews in several key aspects such as considerations of child tailored interventions, justifiable comparators, valid outcomes and child sensitive search strategies. Available guidelines, including PRISMA-P (2015) and PRISMA (2009), do not cover all the complexities associated with reporting systematic reviews in the paediatric population. Using a collaborative, multidisciplinary structure, we aim to develop evidence-based and consensus-based PRISMA-P-C (Protocol for Children) and PRISMA-C (Children) Extensions to guide paediatric systematic review protocol and completed review reporting. This project's methodology follows published recommendations for developing reporting guidelines and involves the following six phases; (1) establishment of a steering committee representing key stakeholder groups; (2) a scoping review to identify potential Extension items; (3) three types of consensus activities including meetings of the steering committee to achieve high-level decisions on the content and methodology of the Extensions, a survey of key stakeholders to generate a list of possible items to include in the Extensions and a formal consensus meeting to select the reporting items to add to, or modify for, the Extension; (4) the preliminary checklist items generated in phase III will be evaluated against the existing evidence and reporting practices in paediatric systematic reviews; (5) extension statements and explanation and elaboration documents will provide detailed advice for each item and examples of good reporting; (6) development and implementation of effective knowledge translation of the extension checklist, and an evaluation of the Extensions by key stakeholders. This protocol was considered a quality improvement project by the Hospital for Sick Children's Ethics Committee and did not require ethical review. The resultant checklists, jointly developed with all relevant stakeholders, will be disseminated through peer-reviewed journals as well as national and international conference presentations. Endorsement of the checklist will be sought simultaneously in multiple journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PRISMA-Children (C) and PRISMA-Protocol for Children (P-C) Extensions: a study protocol for the development of guidelines for the conduct and reporting of systematic reviews and meta-analyses of newborn and child health research

PubMed Central

Kapadia, Mufiza Z; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

2016-01-01

Introduction Paediatric systematic reviews differ from adult systematic reviews in several key aspects such as considerations of child tailored interventions, justifiable comparators, valid outcomes and child sensitive search strategies. Available guidelines, including PRISMA-P (2015) and PRISMA (2009), do not cover all the complexities associated with reporting systematic reviews in the paediatric population. Using a collaborative, multidisciplinary structure, we aim to develop evidence-based and consensus-based PRISMA-P-C (Protocol for Children) and PRISMA-C (Children) Extensions to guide paediatric systematic review protocol and completed review reporting. Methods and analysis This project's methodology follows published recommendations for developing reporting guidelines and involves the following six phases; (1) establishment of a steering committee representing key stakeholder groups; (2) a scoping review to identify potential Extension items; (3) three types of consensus activities including meetings of the steering committee to achieve high-level decisions on the content and methodology of the Extensions, a survey of key stakeholders to generate a list of possible items to include in the Extensions and a formal consensus meeting to select the reporting items to add to, or modify for, the Extension; (4) the preliminary checklist items generated in phase III will be evaluated against the existing evidence and reporting practices in paediatric systematic reviews; (5) extension statements and explanation and elaboration documents will provide detailed advice for each item and examples of good reporting; (6) development and implementation of effective knowledge translation of the extension checklist, and an evaluation of the Extensions by key stakeholders. Ethics and Dissemination This protocol was considered a quality improvement project by the Hospital for Sick Children's Ethics Committee and did not require ethical review. The resultant checklists, jointly developed with all relevant stakeholders, will be disseminated through peer-reviewed journals as well as national and international conference presentations. Endorsement of the checklist will be sought simultaneously in multiple journals. PMID:27091820

Outcomes of Stay Strong, Stay Healthy in community settings.

PubMed

Ball, Stephen; Gammon, Robin; Kelly, Patricia J; Cheng, An-Lin; Chertoff, Keyna; Kaume, Lydia; Abreu, Eduardo L; Brotto, Marco

2013-12-01

Loss of muscle strength, flexibility, and balance are strong predictors of falls in the elderly. The goal of this research was to investigate the effectiveness of a 10-week, strength-based exercise program delivered by Extension professionals. Matched pair t tests were used to compare differences in five measures of fitness collected from 808 participants (mean age = 65.4 years) at the start and finish of the exercise program. Following programming, participants significantly improved strength, flexibility, and balance. Results indicate that an evidence-based program can be translated into a community Extension program that is able to improve the fitness level of seniors.

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

PubMed

Thompson, B Gregory; Brown, Robert D; Amin-Hanjani, Sepideh; Broderick, Joseph P; Cockroft, Kevin M; Connolly, E Sander; Duckwiler, Gary R; Harris, Catherine C; Howard, Virginia J; Johnston, S Claiborne Clay; Meyers, Philip M; Molyneux, Andrew; Ogilvy, Christopher S; Ringer, Andrew J; Torner, James

2015-08-01

The aim of this updated statement is to provide comprehensive and evidence-based recommendations for management of patients with unruptured intracranial aneurysms. Writing group members used systematic literature reviews from January 1977 up to June 2014. They also reviewed contemporary published evidence-based guidelines, personal files, and published expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulated recommendations using standard American Heart Association criteria. The guideline underwent extensive peer review, including review by the Stroke Council Leadership and Stroke Scientific Statement Oversight Committees, before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. Evidence-based guidelines are presented for the care of patients presenting with unruptured intracranial aneurysms. The guidelines address presentation, natural history, epidemiology, risk factors, screening, diagnosis, imaging and outcomes from surgical and endovascular treatment. © 2015 American Heart Association, Inc.

Group Work

ERIC Educational Resources Information Center

Wilson, Kristy J.; Brickman, Peggy; Brame, Cynthia J.

2018-01-01

Science, technology, engineering, and mathematics faculty are increasingly incorporating both formal and informal group work in their courses. Implementing group work can be improved by an understanding of the extensive body of educational research studies on this topic. This essay describes an online, evidence-based teaching guide published by…

Filling the implementation gap: a community-academic partnership approach to early intervention in psychosis.

PubMed

Hardy, Kate V; Moore, Melissa; Rose, Demian; Bennett, Robert; Jackson-Lane, Carletta; Gause, Michael; Jackson, Alma; Loewy, Rachel

2011-11-01

The aim of this study was to describe the development of a sustainable community early psychosis programme created through an academic-community partnership in the United States to other parties interested in implementing early psychosis services founded upon evidence-based practices within community settings. The service was developed around a sustainable core of key components, founded upon evidence-based practice, with additional flexible elements that could be adapted to the needs of the individual commissioning county. This paper describes the ways in which funding was sourced and secured as well as the partnerships developed through this process. Successful development of the Prevention and Recovery from Early Psychosis (PREP) programme in San Francisco County, California. PREP clinicians have received extensive training in the evidence-based approaches that are available through the programme and treated 30 clients and their families in the first year of operation. Development of a sustainable community programme of this type in a non-universal health-care setting, which is historically seen as non-integrated, required extensive partnering with agencies familiar with local resources. Implementation of the community-academic partnership bridged the gap between research and practice with successful integration of fidelity practice at the community level. The community partners were effective in sourcing funding and allocating resources, while the academic side of the partnership provided training in evidence-based models and oversight of clinical implementation of the model. Stringent evaluation of the impact of the service is our next focus. © 2011 Blackwell Publishing Asia Pty Ltd.

Personnel and Welfare: The Case of the Problem Drinker at Work.

ERIC Educational Resources Information Center

Hyman, J.; Beaumont, P. B.

1985-01-01

Presents evidence of welfare activity in a number of work organizations based in Scotland that have introduced recovery programs for employees with alcohol-related problems. The study points to extensive involvement by personnel specialists in the operation of these policies. (CT)

Promoting Adaptive Behavior in Persons with Acquired Brain Injury, Extensive Motor and Communication Disabilities, and Consciousness Disorders

ERIC Educational Resources Information Center

Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Belardinelli, Marta Olivetti; Buonocunto, Francesca; Sacco, Valentina; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa; Badagliacca, Francesco

2012-01-01

These two studies extended the evidence on the use of technology-based intervention packages to promote adaptive behavior in persons with acquired brain injury and multiple disabilities. Study I involved five participants in a minimally conscious state who were provided with intervention packages based on specific arrangements of optic, tilt, or…

Making Students Do the Thinking: Team-Based Learning in a Laboratory Course

ERIC Educational Resources Information Center

Simonson, Shawn R.

2014-01-01

Team-based learning (TBL) is a teaching pedagogy for flipping the classroom that moves the focus of the classroom from the instructor conveying course concepts via lecture to the application of concepts by student teams. It has been used extensively in lecture courses; however, there is little evidence of its use in laboratory courses. The purpose…

An Ensemble Deep Convolutional Neural Network Model with Improved D-S Evidence Fusion for Bearing Fault Diagnosis.

PubMed

Li, Shaobo; Liu, Guokai; Tang, Xianghong; Lu, Jianguang; Hu, Jianjun

2017-07-28

Intelligent machine health monitoring and fault diagnosis are becoming increasingly important for modern manufacturing industries. Current fault diagnosis approaches mostly depend on expert-designed features for building prediction models. In this paper, we proposed IDSCNN, a novel bearing fault diagnosis algorithm based on ensemble deep convolutional neural networks and an improved Dempster-Shafer theory based evidence fusion. The convolutional neural networks take the root mean square (RMS) maps from the FFT (Fast Fourier Transformation) features of the vibration signals from two sensors as inputs. The improved D-S evidence theory is implemented via distance matrix from evidences and modified Gini Index. Extensive evaluations of the IDSCNN on the Case Western Reserve Dataset showed that our IDSCNN algorithm can achieve better fault diagnosis performance than existing machine learning methods by fusing complementary or conflicting evidences from different models and sensors and adapting to different load conditions.

An Ensemble Deep Convolutional Neural Network Model with Improved D-S Evidence Fusion for Bearing Fault Diagnosis

PubMed Central

Li, Shaobo; Liu, Guokai; Tang, Xianghong; Lu, Jianguang

2017-01-01

Intelligent machine health monitoring and fault diagnosis are becoming increasingly important for modern manufacturing industries. Current fault diagnosis approaches mostly depend on expert-designed features for building prediction models. In this paper, we proposed IDSCNN, a novel bearing fault diagnosis algorithm based on ensemble deep convolutional neural networks and an improved Dempster–Shafer theory based evidence fusion. The convolutional neural networks take the root mean square (RMS) maps from the FFT (Fast Fourier Transformation) features of the vibration signals from two sensors as inputs. The improved D-S evidence theory is implemented via distance matrix from evidences and modified Gini Index. Extensive evaluations of the IDSCNN on the Case Western Reserve Dataset showed that our IDSCNN algorithm can achieve better fault diagnosis performance than existing machine learning methods by fusing complementary or conflicting evidences from different models and sensors and adapting to different load conditions. PMID:28788099

Women's sexual pain disorders.

PubMed

van Lankveld, Jacques J D M; Granot, Michal; Weijmar Schultz, Willibrord C M; Binik, Yitzchak M; Wesselmann, Ursula; Pukall, Caroline F; Bohm-Starke, Nina; Achtrari, Chahin

2010-01-01

Women's sexual pain disorders include dyspareunia and vaginismus and there is need for state-of-the-art information in this area. To update the scientific evidence published in 2004, from the 2nd International Consultation on Sexual Medicine pertaining to the diagnosis and treatment of women's sexual pain disorders. An expert committee, invited from six countries by the 3rd International Consultation, was comprised of eight researchers and clinicians from biological and social science disciplines, for the purpose of reviewing and grading the scientific evidence on nosology, etiology, diagnosis, and treatment of women's sexual pain disorders. Expert opinion was based on grading of evidence-based medical literature, extensive internal committee discussion, public presentation, and debate. Results. A comprehensive assessment of medical, sexual, and psychosocial history is recommended for diagnosis and management. Indications for general and focused pelvic genital examination are identified. Evidence-based recommendations for assessment of women's sexual pain disorders are reviewed. An evidence-based approach to management of these disorders is provided. Continued efforts are warranted to conduct research and scientific reporting on the optimal assessment and management of women's sexual pain disorders, including multidisciplinary approaches.

Value-based insurance design: benefits beyond cost and utilization.

PubMed

Gibson, Teresa B; Maclean, Ross J; Chernew, Michael E; Fendrick, A Mark; Baigel, Colin

2015-01-01

As value-based insurance design (VBID) programs proliferate, evidence is emerging on the impact of VBID. To date, studies have largely measured VBID impact on utilization, and a few studies have assessed its impact on quality, outcomes, and cost. In this commentary we discuss these domains, summarize evidence, and propose the extension of measurement of VBID impact into areas including workplace productivity and quality of life, employee and patient engagement, and talent attraction and retention. We contend that VBID evaluations should consider a broad variety of programmatic dividends on both humanistic and health-related outcomes.

Tertiary Teachers and Student Evaluations: Never the Twain Shall Meet?

ERIC Educational Resources Information Center

Stein, Sarah J.; Spiller, Dorothy; Terry, Stuart; Harris, Trudy; Deaker, Lynley; Kennedy, Jo

2013-01-01

Internationally, centralised systems of student evaluation have become normative practice in higher education institutions, providing data for monitoring teaching quality and for teacher professional development. While extensive research has been done on student evaluations, there is less research-based evidence about teachers' perceptions of and…

A systematic review of the literature to support an evidence-based precepting program.

PubMed

Mann-Salinas, Elizabeth; Hayes, Elizabeth; Robbins, Johnnie; Sabido, Jean; Feider, Laura; Allen, David; Yoder, Linda

2014-05-01

To provide a systematic review of the literature regarding development of an evidence-based Precepting Program for nurses transitioning to burn specialty practice. Burned patients are admitted to specialty Burn Centers where highly complex nursing care is provided. Successful orientation and integration into such a specialized work environment is a fundamental component of a nurse's ability to provide safe and holistic patient care. A systematic review of the literature was performed for the period 1995-2011 using electronic databases within PUBMED and Ovid search engines. Databases included Medline, CINHAL, ProQuest for Dissertations and Thesis, and Cochran Collaboration using key search terms: preceptor, preceptee, preceptorship, precept*, nurs*, critical care, personality types, competency-based education, and learning styles. Nurses graded the level and quality of evidence of the included articles using a modified 7-level rating system and the Johns Hopkins Nursing Quality of Evidence Appraisal during journal-club meetings. A total of 43 articles related to competency (n=8), knowledge acquisition and personality characteristics (n=8), learning style (n=5), preceptor development (n=7), and Precepting Programs (n=14). A significant clinical gap existed between the scientific evidence and actual precepting practice of experienced nurses at the Burn Center. Based on this extensive review of the literature, it was determined that a sufficient evidence base existed for development of an evidence-based Precepting Program. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

An Extension to the Constructivist Coding Hypothesis as a Learning Model for Selective Feedback when the Base Rate Is High

ERIC Educational Resources Information Center

Ghaffarzadegan, Navid; Stewart, Thomas R.

2011-01-01

Elwin, Juslin, Olsson, and Enkvist (2007) and Henriksson, Elwin, and Juslin (2010) offered the constructivist coding hypothesis to describe how people code the outcomes of their decisions when availability of feedback is conditional on the decision. They provided empirical evidence only for the 0.5 base rate condition. This commentary argues that…

Developing a Web-Based Developmental Feedback Program

DTIC Science & Technology

2003-03-01

instruments. Theory Behind and Development of the Feedback Instruments The Leadership Practices Inventory (LPI) has been used extensively to...15304,00.pdf. 185 Posner, B.Z. & Kouzes, J.M. (2002). The leadership practices inventory: Theory and evidence behind the five practices...11 Theory Behind and Development of the Feedback Instruments............................14

Status as a Valued Resource

ERIC Educational Resources Information Center

Huberman, Bernardo A.; Loch, Christoph H.; Onculer, Ayse

2004-01-01

The striving for status has long been recognized in sociology and economics. Extensive theoretical arguments and empirical evidence propose that people view status as a sign of competence and pursue it as a means to achieve power and resources. A small literature, however, based on arguments from biology and evolutionary psychology, proposes that…

Learners' Epistemic Criteria for Good Scientific Models

ERIC Educational Resources Information Center

Pluta, William J.; Chinn, Clark A.; Duncan, Ravit Golan

2011-01-01

Epistemic criteria are the standards used to evaluate scientific products (e.g., models, evidence, arguments). In this study, we analyzed epistemic criteria for good models generated by 324 middle-school students. After evaluating a range of scientific models, but before extensive instruction or experience with model-based reasoning practices,…

Ice-core evidence of earliest extensive copper metallurgy in the Andes 2700 years ago

NASA Astrophysics Data System (ADS)

Eichler, A.; Gramlich, G.; Kellerhals, T.; Tobler, L.; Rehren, Th.; Schwikowski, M.

2017-01-01

The importance of metallurgy for social and economic development is indisputable. Although copper (Cu) was essential for the wealth of pre- and post-colonial societies in the Andes, the onset of extensive Cu metallurgy in South America is still debated. Comprehensive archaeological findings point to first sophisticated Cu metallurgy during the Moche culture ~200-800 AD, whereas peat-bog records from southern South America suggest earliest pollution potentially from Cu smelting as far back as ~2000 BC. Here we present a 6500-years Cu emission history for the Andean Altiplano, based on ice-core records from Illimani glacier in Bolivia, providing the first complete history of large-scale Cu smelting activities in South America. We find earliest anthropogenic Cu pollution during the Early Horizon period ~700-50 BC, and attribute the onset of intensified Cu smelting in South America to the activities of the central Andean Chiripa and Chavin cultures ~2700 years ago. This study provides for the first time substantial evidence for extensive Cu metallurgy already during these early cultures.

Ice-core evidence of earliest extensive copper metallurgy in the Andes 2700 years ago.

PubMed

Eichler, A; Gramlich, G; Kellerhals, T; Tobler, L; Rehren, Th; Schwikowski, M

2017-01-31

The importance of metallurgy for social and economic development is indisputable. Although copper (Cu) was essential for the wealth of pre- and post-colonial societies in the Andes, the onset of extensive Cu metallurgy in South America is still debated. Comprehensive archaeological findings point to first sophisticated Cu metallurgy during the Moche culture ~200-800 AD, whereas peat-bog records from southern South America suggest earliest pollution potentially from Cu smelting as far back as ~2000 BC. Here we present a 6500-years Cu emission history for the Andean Altiplano, based on ice-core records from Illimani glacier in Bolivia, providing the first complete history of large-scale Cu smelting activities in South America. We find earliest anthropogenic Cu pollution during the Early Horizon period ~700-50 BC, and attribute the onset of intensified Cu smelting in South America to the activities of the central Andean Chiripa and Chavin cultures ~2700 years ago. This study provides for the first time substantial evidence for extensive Cu metallurgy already during these early cultures.

Ice-core evidence of earliest extensive copper metallurgy in the Andes 2700 years ago

PubMed Central

Eichler, A.; Gramlich, G.; Kellerhals, T.; Tobler, L.; Rehren, Th.; Schwikowski, M.

2017-01-01

The importance of metallurgy for social and economic development is indisputable. Although copper (Cu) was essential for the wealth of pre- and post-colonial societies in the Andes, the onset of extensive Cu metallurgy in South America is still debated. Comprehensive archaeological findings point to first sophisticated Cu metallurgy during the Moche culture ~200–800 AD, whereas peat-bog records from southern South America suggest earliest pollution potentially from Cu smelting as far back as ~2000 BC. Here we present a 6500-years Cu emission history for the Andean Altiplano, based on ice-core records from Illimani glacier in Bolivia, providing the first complete history of large-scale Cu smelting activities in South America. We find earliest anthropogenic Cu pollution during the Early Horizon period ~700–50 BC, and attribute the onset of intensified Cu smelting in South America to the activities of the central Andean Chiripa and Chavin cultures ~2700 years ago. This study provides for the first time substantial evidence for extensive Cu metallurgy already during these early cultures. PMID:28139760

ACOEM practice guidelines: elbow disorders.

PubMed

Hegmann, Kurt T; Hoffman, Harold E; Belcourt, Roger M; Byrne, Kevin; Glass, Lee; Melhorn, J Mark; Richman, Jack; Zinni, Phillip; Thiese, Matthew S; Ott, Ulrike; Tokita, Kylee; Passey, Deborah Gwenevere; Effiong, Atim Cecelia; Robbins, Riann Bree; Ording, Julie A

2013-11-01

The American College of Occupational and Environmental Medicine has updated the treatment guidelines in its Elbow Disorders chapter through revision processes begun in 2006. This abbreviated version of that chapter highlights some of the evidence and recommendations developed. Comprehensive systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking and often relied on analogy to other disorders for which evidence exists. A total of 108 high- or moderate-quality trials were identified for elbow disorders. Guidance has been developed for 13 major diagnoses and includes 270 specific recommendations. Quality evidence is now available to guide treatment for elbow disorders, particularly for lateral epicondylalgia.

Extension of chronological lifespan by ScEcl1 depends on mitochondria in Saccharomyces cerevisiae.

PubMed

Azuma, Kenko; Ohtsuka, Hokuto; Murakami, Hiroshi; Aiba, Hirofumi

2012-01-01

Ecl1, a product of the YGR146C gene in Saccharomyces cerevisiae, was identified as a factor involved in chronological lifespan. In this study we found evidence that the function of Ecl1 in the extension of chronological lifespan is dependent on mitochondrial function. The respiratory activity of cells increased when Ecl1 was overexpressed or cells were grown under calorie restriction, but there was no additive effect of calorie restriction and Ecl1 overexpression on increases in respiratory activity or on the extension of chronological lifespan. Based on these results, we propose that overexpression of Ecl1 has same effect as caloric restriction and that its function also depends on mitochondria, just like caloric restriction.

Pupils' Word Choices and the Teaching of Grammar

ERIC Educational Resources Information Center

Wyse, Dominic

2006-01-01

The idea that formal grammar teaching leads to improvements in school pupils' writing has been a popular one. However, the robust and extensive evidence base shows that this is not the case. Despite this, policy initiatives have continued to suggest that grammar teaching does improve pupils' writing: the "Grammar for Writing" resource is…

Music Matters: How Music Education Helps Students Learn, Achieve, and Succeed

ERIC Educational Resources Information Center

Arts Education Partnership (NJ1), 2011

2011-01-01

Beyond the intrinsic value of music to cultures worldwide, education in music has benefits for young people that transcend the musical domain. The Arts Education Partnership (AEP) reviewed an extensive body of research to identify high-quality, evidence-based studies that document student learning outcomes associated with an education in and…

77 FR 70451 - Report of the Evidence-Based Methodology Workshop on Polycystic Ovary Syndrome-Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

..., 2012. The purpose of the report is to summarize the workshop and identify future research priorities... the workshop agenda. The NIH Library created an extensive, descriptive bibliography on PCOS to... the workshop and identifies future research priorities. The report will be available online beginning...

Recommended Outcomes for Families of Young Children with Disabilities

ERIC Educational Resources Information Center

Bailey, Donald B., Jr.; Bruder, Mary Beth; Hebbeler, Kathy; Carta, Judith; Defosset, Michelle; Greenwood, Charles; Kahn, Lynne; Mallik, Sangeeta; Markowitz, Joy; Spiker, Donna; Walker, Dale; Barton, Lauren

2006-01-01

The Early Childhood Outcomes (ECO) Center was funded by the Office of Special Education Programs to promote the development and implementation of child and family outcome measures for infants, toddlers, and preschoolers with disabilities. An evidence-based process with extensive stakeholder input led to the identification of five outcomes by which…

Librarian contributions to clinical practice guidelines.

PubMed

Cruse, Peggy; Protzko, Shandra

2014-01-01

Librarians have become more involved in developing high quality systematic reviews. Evidence-based practice guidelines are an extension of systematic reviews and offer another significant area for librarian involvement. This column highlights opportunities and challenges for the librarian working on guideline panels and provides practical considerations for meaningful contributions to the guideline creation process.

State of the evidence base for medically necessary oral health care.

PubMed

Patton, L L; White, B A; Field, M J

2001-09-01

The purpose of this article was to highlight the recent call for an evidence-based approach to public policy decision making with respect to funding dental services and the need this creates for enhanced clinical research activities. Systematic reviews on topics of importance to oral health care practitioners are being conducted and published by various national and international groups. Recent activities to assess evidence to support medically necessary dental services were reviewed. An Institute of Medicine Committee on Medicare Coverage Extensions found little published scientific evidence that directly assessed the effectiveness of dental services in preventing or managing systemic health outcomes for patients with head and neck cancer, lymphoma, leukemia, organ transplantation, and heart valve repair or replacement. The scientific community must strive to meet the challenge of conducting well-designed randomized, controlled trials that test the impact of dental treatment interventions on systemic health to meet the growing need for evidence to support or refute widely accepted dental treatment protocols for medically complex patients.

The Effectiveness of Asulam for Bracken ( Pteridium aquilinum) Control in the United Kingdom: A Meta-Analysis

NASA Astrophysics Data System (ADS)

Stewart, Gavin B.; Pullin, Andrew S.; Tyler, Claire

2007-11-01

Bracken ( Pteridium aquilinum) is a major problem for livestock-based extensive agriculture, conservation, recreation, and game management globally. It is an invasive species often achieving dominance to the detriment of other species. Control is essential to maintain plant communities such as grassland and lowland heath or if extensive grazing by domestic stock, particularly sheep, is to be viable on upland margins. Bracken is managed primarily by herbicide application or cutting but other techniques including rolling, burning, and grazing are also utilized. Here we evaluate the evidence regarding the effectiveness of asulam for the control of bracken. Thirteen studies provided data for meta-analyses which demonstrate that application of the herbicide asulam reduces bracken abundance. Subgroup analyses indicate that the number of treatments had an important impact, with multiple follow-up treatments more effective than one or two treatments. Management practices should reflect the requirement for repeated follow-up. There is insufficient available experimental evidence for quantitative analysis of the effectiveness of other management interventions, although this results from lack of reporting in papers where cutting and comparisons of cutting and asulam application are concerned. Systematic searching and meta-analytical synthesis have effectively demonstrated the limits of current knowledge, based on recorded empirical evidence, and increasing the call for more rigorous monitoring of bracken control techniques. Lack of experimental evidence on the effectiveness of management such as rolling or grazing with hardy cattle breeds contrasts with the widespread acceptance of their use through dissemination of experience.

The Importance of Supporting Inferences with Evidence: Learning Lessons from Huffman (2014) in the Hope of Providing Stronger Evidence for Extensive Reading

ERIC Educational Resources Information Center

McLean, Stuart

2016-01-01

Stuart McLean refers in this commentary to Jeffrey Huffman's article "Reading Rate Gains during a One-Semester Extensive Reading Course" (v26 n2 p17-33 Oct 2014) [See: EJ1044344], in which Huffman reports that extensive reading (ER) was an effective way to provide large amounts of comprehensible input to foreign language learners, but…

Seasonality of submesoscale dynamics in the Kuroshio Extension

NASA Astrophysics Data System (ADS)

Rocha, Cesar B.; Gille, Sarah T.; Chereskin, Teresa K.; Menemenlis, Dimitris

2016-11-01

Recent studies show that the vigorous seasonal cycle of the mixed layer modulates upper ocean submesoscale turbulence. Here we provide model-based evidence that the seasonally changing upper ocean stratification in the Kuroshio Extension also modulates submesoscale (here 10-100 km) inertia-gravity waves. Summertime restratification weakens submesoscale turbulence but enhances inertia-gravity waves near the surface. Thus, submesoscale turbulence and inertia-gravity waves undergo vigorous out-of-phase seasonal cycles. These results imply a strong seasonal modulation of the accuracy of geostrophic velocity diagnosed from submesoscale sea surface height delivered by the Surface Water and Ocean Topography satellite mission.

German second-opinion network for testicular cancer: sealing the leaky pipe between evidence and clinical practice.

PubMed

Zengerling, Friedemann; Hartmann, Michael; Heidenreich, Axel; Krege, Susanne; Albers, Peter; Karl, Alexander; Weissbach, Lothar; Wagner, Walter; Bedke, Jens; Retz, Margitta; Schmelz, Hans U; Kliesch, Sabine; Kuczyk, Markus; Winter, Eva; Pottek, Tobias; Dieckmann, Klaus-Peter; Schrader, Andres Jan; Schrader, Mark

2014-06-01

In 2006, the German Testicular Cancer Study Group initiated an extensive evidence-based national second-opinion network to improve the care of testicular cancer patients. The primary aims were to reflect the current state of testicular cancer treatment in Germany and to analyze the project's effect on the quality of care delivered to testicular cancer patients. A freely available internet-based platform was developed for the exchange of data between the urologists seeking advice and the 31 second-opinion givers. After providing all data relevant to the primary treatment decision, urologists received a second opinion on their therapy plan within <48 h. Endpoints were congruence between the first and second opinion, conformity of applied therapy with the corresponding recommendation and progression-free survival rate of the introduced patients. Significance was determined by two-sided Pearson's χ2 test. A total of 1,284 second-opinion requests were submitted from November 2006 to October 2011, and 926 of these cases were eligible for further analysis. A discrepancy was found between first and second opinion in 39.5% of the cases. Discrepant second opinions led to less extensive treatment in 28.1% and to more extensive treatment in 15.6%. Patients treated within the framework of the second-opinion project had an overall 2-year progression-free survival rate of 90.4%. Approximately every 6th second opinion led to a relevant change in therapy. Despite the lack of financial incentives, data from every 8th testicular cancer patient in Germany were submitted to second-opinion centers. Second-opinion centers can help to improve the implementation of evidence into clinical practice.

Wet-based glaciation in Phlegra Montes, Mars.

NASA Astrophysics Data System (ADS)

Gallagher, Colman; Balme, Matt

2016-04-01

Eskers are sinuous landforms composed of sediments deposited from meltwaters in ice-contact glacial conduits. This presentation describes the first definitive identification of eskers on Mars still physically linked with their parent system (1), a Late Amazonian-age glacier (~150 Ma) in Phlegra Montes. Previously described Amazonian-age glaciers on Mars are generally considered to have been dry based, having moved by creep in the absence of subglacial water required for sliding, but our observations indicate significant sub-glacial meltwater routing. The confinement of the Phlegra Montes glacial system to a regionally extensive graben is evidence that the esker formed due to sub-glacial melting in response to an elevated, but spatially restricted, geothermal heat flux rather than climate-induced warming. Now, however, new observations reveal the presence of many assemblages of glacial abrasion forms and associated channels that could be evidence of more widespread wet-based glaciation in Phlegra Montes, including the collapse of several distinct ice domes. This landform assemblage has not been described in other glaciated, mid-latitude regions of the martian northern hemisphere. Moreover, Phlegra Montes are flanked by lowlands displaying evidence of extensive volcanism, including contact between plains lava and piedmont glacial ice. These observations provide a rationale for investigating non-climatic forcing of glacial melting and associated landscape development on Mars, and can build on insights from Earth into the importance of geothermally-induced destabilisation of glaciers as a key amplifier of climate change. (1) Gallagher, C. and Balme, M. (2015). Eskers in a complete, wet-based glacial system in the Phlegra Montes region, Mars, Earth and Planetary Science Letters, 431, 96-109.

The PRIME project: developing a patient evidence‐base

PubMed Central

Staniszewska, Sophie; Crowe, Sally; Badenoch, Douglas; Edwards, Carol; Savage, Jan; Norman, Will

2010-01-01

Abstract Background  The concept of evidence has become firmly rooted in health care, with most importance placed on the outcome of research in clinical and economic spheres. Much less emphasis is placed on the patient’s contribution to evidence which remains relatively vague, of low status and often difficult to integrate with other forms of knowledge. Aim  This article proposes a concept of patient‐based evidence, to complement clinical and economic forms of evidence, and demonstrates one way in which it has been operationalized. The PRIME project developed a patient evidence‐base to capture the lived experience of individuals with myalgic encephalitis (ME) or chronic fatigue syndrome (CFS). Design  Interviews were performed with 40 individuals with ME/CFS who varied in a range of demographic characteristics, including age, gender, and how severely affected individuals were. Results  PRIME has developed a patient evidence‐base which has an extensive array of experiences data to provide researchers, clinicians and others with an in‐depth insight into the lived experience of ME/CFS that can be used and analysed. Data are grouped into a wide range of themes, which can be downloaded and used in a variety of ways as a source of evidence to enable understanding of the lived experience of ME/CFS and so contribute to the development of a more patient‐focused research agenda in ME/CFS. Conclusions  While patient‐based evidence used in the PRIME Project provides a useful start, further work is required to develop this area conceptually and methodologically, particularly in relation to how patient‐based evidence can be considered alongside clinical and economic evidence. PMID:20579119

Computer-Based Auditory Training Programs for Children with Hearing Impairment - A Scoping Review.

PubMed

Nanjundaswamy, Manohar; Prabhu, Prashanth; Rajanna, Revathi Kittur; Ningegowda, Raghavendra Gulaganji; Sharma, Madhuri

2018-01-01

Introduction  Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective  To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis  Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was well-structured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions  There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices.

Computer-Based Auditory Training Programs for Children with Hearing Impairment – A Scoping Review

PubMed Central

Nanjundaswamy, Manohar; Prabhu, Prashanth; Rajanna, Revathi Kittur; Ningegowda, Raghavendra Gulaganji; Sharma, Madhuri

2018-01-01

Introduction  Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective  To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis  Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was well-structured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions  There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices. PMID:29371904

Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

PubMed

Cairney, Paul; Oliver, Kathryn

2017-04-26

There is extensive health and public health literature on the 'evidence-policy gap', exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy.We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda - should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise 'evidence-based' policymaking above other factors? The latter includes governance principles such the 'co-production' of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence.We conclude that successful engagement in 'evidence-based policymaking' requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions and familiarity with information; learn 'where the action is', and be prepared to engage in long-term strategies to be able to influence policy; and, in both cases, decide how far you are willing to go to persuade policymakers to act and secure a hierarchy of evidence underpinning policy. These are value-driven and political, not just 'evidence-based', choices.

Surgical simulation: Current practices and future perspectives for technical skills training.

PubMed

Bjerrum, Flemming; Thomsen, Ann Sofia Skou; Nayahangan, Leizl Joy; Konge, Lars

2018-06-17

Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, we use Kern's framework for curriculum development to describe where we are now and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures. Despite principles for optimal SBT (proficiency-based, distributed, and deliberate practice) having been identified, massed training with fixed time intervals or a fixed number of repetitions is still being extensively used, and simulators are generally underutilized. SBT should be part of surgical training curricula, including theoretical, technical, and non-technical skills, and be based on relevant needs assessments. Furthermore, training should follow evidence-based theoretical principles for optimal training, and the effect of training needs to be evaluated using relevant outcomes. There is a larger, still unrealized potential of surgical SBT, which may be realized in the near future as simulator technologies evolve, more evidence-based training programs are implemented, and cost-effectiveness and impact on patient safety is clearly demonstrated.

Promoting evidence-based practice in pharmacies.

PubMed

Toklu, Hale Zerrin

2015-01-01

Evidence-based medicine aims to optimize decision-making by using evidence from well-designed and conducted research. The concept of reliable evidence is essential, since the number of electronic information resources is increasing in parallel to the increasing number and type of drugs on the market. The decision-making process is a complex and requires an extensive evaluation as well as the interpretation of the data obtained. Different sources provide different levels of evidence for decision-making. Not all the data have the same value as the evidence. Rational use of medicine requires that the patients receive "medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community." Pharmacists have a crucial role in the health system to maintain the rational use of medicine and provide pharmaceutical care to patients, because they are the drug experts who are academically trained for this purpose. The rational use of the pharmacist's workforce will improve the outcome of pharmacotherapy as well as decreasing the global health costs.

Open-access evidence database of controlled trials and systematic reviews in youth mental health.

PubMed

De Silva, Stefanie; Bailey, Alan P; Parker, Alexandra G; Montague, Alice E; Hetrick, Sarah E

2018-06-01

To present an update to an evidence-mapping project that consolidates the evidence base of interventions in youth mental health. To promote dissemination of this resource, the evidence map has been translated into a free online database (https://orygen.org.au/Campus/Expert-Network/Evidence-Finder or https://headspace.org.au/research-database/). Included studies are extensively indexed to facilitate searching. A systematic search for prevention and treatment studies in young people (mean age 6-25 years) is conducted annually using Embase, MEDLINE, PsycINFO and the Cochrane Library. Included studies are restricted to controlled trials and systematic reviews published since 1980. To date, 221 866 publications have been screened, of which 2680 have been included in the database. Updates are conducted annually. This shared resource can be utilized to substantially reduce the amount of time involved with conducting literature searches. It is designed to promote the uptake of evidence-based practice and facilitate research to address gaps in youth mental health. © 2017 John Wiley & Sons Australia, Ltd.

A Combined Intervention Targeting Both Teachers' and Students' Social-Emotional Skills: Preliminary Evaluation of Students' Outcomes

ERIC Educational Resources Information Center

Iizuka, Cristina Akiko; Barrett, Paula M.; Gillies, Robyn; Cook, Clayton R.; Marinovic, Welber

2014-01-01

The literature indicates increasing evidence showing the benefits of classroom-based, universal preventive interventions for mental health and the link between social and emotional learning and academic performance. The FRIENDS program has been extensively tested and has showed promising results not only for preventing childhood anxiety, but also…

Scaling up School-Wide Positive Behavioral Interventions and Supports: Experiences of Seven States with Documented Success

ERIC Educational Resources Information Center

Horner, Robert H.; Kincaid, Donald; Sugai, George; Lewis, Timothy; Eber, Lucille; Barrett, Susan; Dickey, Celeste Rossetto; Richter, Mary; Sullivan, Erin; Boezio, Cyndi; Algozzine, Bob; Reynolds, Heather; Johnson, Nanci

2014-01-01

Scaling of evidence-based practices in education has received extensive discussion but little empirical evaluation. We present here a descriptive summary of the experience from seven states with a history of implementing and scaling School-Wide Positive Behavioral Interventions and Supports (SWPBIS) over the past decade. Each state has been…

Cognitive Deficits Associated with Acquired Amusia after Stroke: A Neuropsychological Follow-Up Study

ERIC Educational Resources Information Center

Sarkamo, Teppo; Tervaniemi, Mari; Soinila, Seppo; Autti, Taina; Silvennoinen, Heli M.; Laine, Matti; Hietanen, Marja

2009-01-01

Recent evidence on amusia suggests that our ability to perceive music might be based on the same neural resources that underlie other higher cognitive functions, such as speech perception and spatial processing. We studied the neural correlates of acquired amusia by performing extensive neuropsychological assessments on 53 stroke patients with a…

Training Preparation and the Professional Development of Principals in Henan Province, China: Formal and Informal Learning

ERIC Educational Resources Information Center

Jiang, Na; Sumintono, Bambang; Perera, Corinne J.; Harris, Alma; Jones, Michelle S.

2018-01-01

Principal preparation and training is generally viewed as an important contributor to school and system improvement. While the international evidence based on leadership and leadership development is extensive, contemporary accounts of principal preparation in a number of Asian countries are not widespread. This article outlines the findings from…

Making Sense of the Glass Ceiling in Schools: An Exploration of Women Teachers' Discourses

ERIC Educational Resources Information Center

Moreau, Marie-Pierre; Osgood, Jayne; Halsall, Anna

2007-01-01

There is extensive evidence of a "glass ceiling" for women across the labour market. Though schools have widely been described as "feminized" work environments, the under-representation of women at school management level is well established. Based on a study of women teachers' careers and promotion in the English school sector…

Extension of Positive Behavioral Interventions and Supports from the School to the Bus: A Case Study

ERIC Educational Resources Information Center

Collins, James C.; Ryan, Joseph B.

2016-01-01

Positive Behavioral Interventions and Supports (PBIS) is an evidence-based practice that has been shown to prevent and remediate challenging student behaviors, while concurrently improving academic outcomes. While the implementation of PBIS is a schoolwide process which involves multiple intensive trainings for all instructional and support staff,…

Using Evidence-Based Parenting Programs to Advance CDC Efforts in Child Maltreatment Prevention. Research Brief

ERIC Educational Resources Information Center

Valle, Linda Anne; Whitaker, Daniel J.; Lutzker, John R.; Filene, Jill H.; Wyatt, Jennifer M.; Cephas, Kendell C.; Hoover, D. Michele

2004-01-01

The Centers for Disease Control and Prevention (CDC) recognize child maltreatment as a serious public health problem with extensive short- and long-term health effects. In addition to the immediate physical and emotional effects of maltreatment, children who have experienced abuse and neglect are at increased risk of adverse health effects and…

Preparing Pre-Service Teachers to Integrate Technology in Education: A Synthesis of Qualitative Evidence

ERIC Educational Resources Information Center

Tondeur, Jo; van Braak, Johan; Sang, Guoyuan; Voogt, Joke; Fisser, Petra; Ottenbreit-Leftwich, Anne

2012-01-01

This study reviewed qualitative studies that focused on strategies to prepare pre-service teachers to integrate technology into their lessons. A meta-ethnography approach was utilized to locate, critically appraise, and synthesize the results of these studies. Based on an extensive search in the Web of Science, 19 articles were included in this…

Functional Foods Programs Serve as a Vehicle to Provide Nutrition Education to Groups

ERIC Educational Resources Information Center

Cirignano, Sherri M.

2011-01-01

An increase in consumer interest in functional foods provides an opportunity for FCS educators to use this topic in Extension programming to promote current nutrition recommendations. The Functional Foods for Life Educational Programs (FFL) are a curriculum of six evidence-based mini-seminars that highlight specific functional foods that have the…

The Response in Response to Intervention: Evaluating the Utility of Assessing Maintenance of Intervention Effects

ERIC Educational Resources Information Center

Ardoin, Scott P.

2006-01-01

Extensive evidence exists demonstrating the utility of Curriculum-Based Measurement in reading (R-CBM) for progress-monitoring purposes; however, most studies have evaluated R-CBM from a traditional psychometric perspective, which allows for variability in individual student's data that is not a function of increased skills (i.e., measurement…

A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings.

PubMed

Chilenski, Sarah M; Olson, Jonathan R; Schulte, Jill A; Perkins, Daniel F; Spoth, Richard

2015-02-01

Prior theoretical and empirical research suggests that multiple aspects of an organization's context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization's readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization's readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization's morale was also found to be a strong predictor of an organization's readiness. The findings of the current study are discussed in terms of implications for prevention and intervention.

A Multi-level Examination of how the Organizational Context Relates to Readiness to Implement Prevention and Evidence-Based Programming in Community Settings

PubMed Central

Chilenski, Sarah M.; Olson, Jonathan R.; Schulte, Jill A.; Perkins, Daniel F.; Spoth, Richard

2015-01-01

Prior theoretical and empirical research suggests that multiple aspects of an organization’s context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization’s readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization’s readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization’s morale was also found to be a strong predictor of an organization’s readiness. The findings of the current study are discussed in terms of implications for prevention and intervention. PMID:25463014

Gunshot-induced fractures of the extremities: a review of antibiotic and debridement practices.

PubMed

Sathiyakumar, Vasanth; Thakore, Rachel V; Stinner, Daniel J; Obremskey, William T; Ficke, James R; Sethi, Manish K

2015-09-01

The use of antibiotic prophylaxis and debridement is controversial when treating low- and high-velocity gunshot-induced fractures, and established treatment guidelines are currently unavailable. The purpose of this review was to evaluate the literature for the prophylactic antibiotic and debridement policies for (1) low-velocity gunshot fractures of the extremities, joints, and pelvis and (2) high-velocity gunshot fractures of the extremities. Low-velocity gunshot fractures of the extremities were subcategorized into operative and non-operative cases, whereas low-velocity gunshot fractures of the joints and pelvis were evaluated based on the presence or absence of concomitant bowel injury. In the absence of surgical necessity for fracture care such as concomitant absence of gross wound contamination, vascular injury, large soft-tissue defect, or associated compartment syndrome, the literature suggests that superficial debridement for low-velocity ballistic fractures with administration of antibiotics is a satisfactory alternative to extensive operative irrigation and debridement. In operative cases or those involving bowel injuries secondary to pelvic fractures, the literature provides support for and against extensive debridement but does suggest the use of intravenous antibiotics. For high-velocity ballistic injuries, the literature points towards the practice of extensive immediate debridement with prophylactic intravenous antibiotics. Our systematic review demonstrates weak evidence for superficial debridement of low-velocity ballistic fractures, extensive debridement for high-velocity ballistic injuries, and antibiotic use for both types of injury. Intra-articular fractures seem to warrant debridement, while pelvic fractures with bowel injury have conflicting evidence for debridement but stronger evidence for antibiotic use. Given a relatively low number of studies on this subject, we recommend that further high-quality research on the debridement and antibiotic use for gunshot-induced fractures of the extremities should be conducted before definitive recommendations and guidelines are developed.

The development of evidence-based guidelines in dentistry.

PubMed

Faggion, C M

2013-02-01

Use of guidelines is an important means of reducing the gap between research and clinical practice. Sound and unbiased information should be available to enable dental professionals to provide better clinical treatment for their patients. The development of clinical guidelines in dentistry should follow standard and transparent methodology. The purpose of this article is to propose important steps for developing evidence-based clinical recommendations in dentistry. Initially, dental guidelines should be extensively sought and assessed to answer focused clinical questions. If there is a paucity of guidelines or if existing guidelines are not of good methodological quality, systematic reviews should be searched or conducted to serve as a basis for the development of evidence-based guidelines. When systematic reviews are produced, they should be rigorous in order to provide the best evidence possible. In the last phase of the process, the overall quality of evidence should be scrutinized and assessed, together with other factors (balance between treatment effects and side effects, patients' values, and cost-effectiveness of therapy) to determine the strength of recommendations. It is expected this approach will result in the development of sound clinical guidelines and consequent improvement of dental treatment.

Non-formal educator use of evaluation results.

PubMed

Baughman, Sarah; Boyd, Heather H; Franz, Nancy K

2012-08-01

Increasing demands for accountability in educational programming have resulted in increasing calls for program evaluation in educational organizations. Many organizations include conducting program evaluations as part of the job responsibilities of program staff. Cooperative Extension is a complex organization offering non-formal educational programs through land grant universities. Many Extension services require non-formal educational program evaluations be conducted by field-based Extension educators. Evaluation research has focused primarily on the efforts of professional, external evaluators. The work of program staff with many responsibilities including program evaluation has received little attention. This study examined how field based Extension educators (i.e. program staff) in four Extension services use the results of evaluations of programs that they have conducted themselves. Four types of evaluation use are measured and explored; instrumental use, conceptual use, persuasive use and process use. Results indicate that there are few programmatic changes as a result of evaluation findings among the non-formal educators surveyed in this study. Extension educators tend to use evaluation results to persuade others about the value of their programs and learn from the evaluation process. Evaluation use is driven by accountability measures with very little program improvement use as measured in this study. Practical implications include delineating accountability and program improvement tasks within complex organizations in order to align evaluation efforts and to improve the results of both. There is some evidence that evaluation capacity building efforts may be increasing instrumental use by educators evaluating their own programs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Venous thromboembolism and cancer: guidelines of the Italian Association of Medical Oncology (AIOM).

PubMed

Mandalà, M; Falanga, A; Piccioli, A; Prandoni, P; Pogliani, E M; Labianca, R; Barni, S

2006-09-01

Thromboembolic complications represent one of the most important cause of morbidity and mortality in cancer patients. Although several data have been published demonstrating the strong association between cancer and venous thromboembolism (VTE), there is poor perception, among oncologists, of the level of risk of thrombosis and of relevance of managing VTE in these patients. The Associazione Italiana di Oncologia Medica (AIOM) has provided some recommendations to direct clinical practice according to evidence-based data concerning cancer and VTE. In fact, we conducted an extensive literature review (1996-2005) to produce evidence-based recommendations to improve perceptions of the magnitude of this risk among Italian medical and surgical oncologists and alert on the new approaches to prophylaxis and treatment of VTE in cancer patients. Levels of evidence are given according to a five-point rating system, and similarly for each key recommendation a five-point rating system suggests if the evidence is strong and indicate that the benefits do, or do not, outweigh risks and burden.

What reassurances do the community need regarding life extension? Evidence from studies of community attitudes and an analysis of film portrayals.

PubMed

Underwood, Mair

2014-04-01

It is increasingly recognized that community attitudes impact on the research trajectory, entry, and reception of new biotechnologies. Yet biogerontologists have generally been dismissive of public concerns about life extension. There is some evidence that biogerontological research agendas have not been communicated effectively, with studies finding that most community members have little or no knowledge of life extension research. In the absence of knowledge, community members' attitudes may well be shaped by issues raised in popular portrayals of life extension (e.g., in movies). To investigate how popular portrayals of life extension may influence community attitudes, I conducted an analysis of 19 films depicting human life extension across different genres. I focussed on how the pursuit of life extension was depicted, how life extension was achieved, the levels of interest in life extension shown by characters in the films, and the experiences of extended life depicted both at an individual and societal level. This paper compares the results of this analysis with the literature on community attitudes to life extension and makes recommendations about the issues in which the public may require reassurance if they are to support and accept life extension technologies.

Plant Scientists and the Productivity Effects of Extension Appointments

ERIC Educational Resources Information Center

Foltz, Jeremy D.; Gee, Vanity K.; Barham, Bradford L.

2011-01-01

This article analyzes the primary scholarship activities of agricultural college plant science faculty with and without Extension appointments using survey data from all 1862 land-grant institutions. The evidence suggests that differences between Extension professors and others without Extension appointments are small for minor Extension…

Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Revision 2015 (DAS-Guideline 2015) - short version.

PubMed

Baron, Ralf; Binder, Andreas; Biniek, Rolf; Braune, Stephan; Buerkle, Hartmut; Dall, Peter; Demirakca, Sueha; Eckardt, Rahel; Eggers, Verena; Eichler, Ingolf; Fietze, Ingo; Freys, Stephan; Fründ, Andreas; Garten, Lars; Gohrbandt, Bernhard; Harth, Irene; Hartl, Wolfgang; Heppner, Hans-Jürgen; Horter, Johannes; Huth, Ralf; Janssens, Uwe; Jungk, Christine; Kaeuper, Kristin Maria; Kessler, Paul; Kleinschmidt, Stefan; Kochanek, Matthias; Kumpf, Matthias; Meiser, Andreas; Mueller, Anika; Orth, Maritta; Putensen, Christian; Roth, Bernd; Schaefer, Michael; Schaefers, Rainhild; Schellongowski, Peter; Schindler, Monika; Schmitt, Reinhard; Scholz, Jens; Schroeder, Stefan; Schwarzmann, Gerhard; Spies, Claudia; Stingele, Robert; Tonner, Peter; Trieschmann, Uwe; Tryba, Michael; Wappler, Frank; Waydhas, Christian; Weiss, Bjoern; Weisshaar, Guido

2015-01-01

In 2010, under the guidance of the DGAI (German Society of Anaesthesiology and Intensive Care Medicine) and DIVI (German Interdisciplinary Association for Intensive Care and Emergency Medicine), twelve German medical societies published the "Evidence- and Consensus-based Guidelines on the Management of Analgesia, Sedation and Delirium in Intensive Care". Since then, several new studies and publications have considerably increased the body of evidence, including the new recommendations from the American College of Critical Care Medicine (ACCM) in conjunction with Society of Critical Care Medicine (SCCM) and American Society of Health-System Pharmacists (ASHP) from 2013. For this update, a major restructuring and extension of the guidelines were needed in order to cover new aspects of treatment, such as sleep and anxiety management. The literature was systematically searched and evaluated using the criteria of the Oxford Center of Evidence Based Medicine. The body of evidence used to formulate these recommendations was reviewed and approved by representatives of 17 national societies. Three grades of recommendation were used as follows: Grade "A" (strong recommendation), Grade "B" (recommendation) and Grade "0" (open recommendation). The result is a comprehensive, interdisciplinary, evidence and consensus-based set of level 3 guidelines. This publication was designed for all ICU professionals, and takes into account all critically ill patient populations. It represents a guide to symptom-oriented prevention, diagnosis, and treatment of delirium, anxiety, stress, and protocol-based analgesia, sedation, and sleep-management in intensive care medicine.

Bedside, classroom and bench: collaborative strategies to generate evidence-based knowledge for nursing practice.

PubMed

Weaver, Charlotte A; Warren, Judith J; Delaney, Connie

2005-12-01

The rise of evidence-base practice (EBP) as a standard for care delivery is rapidly emerging as a global phenomenon that is transcending political, economic and geographic boundaries. Evidence-based nursing (EBN) addresses the growing body of nursing knowledge supported by different levels of evidence for best practices in nursing care. Across all health care, including nursing, we face the challenge of how to most effectively close the gap between what is known and what is practiced. There is extensive literature on the barriers and difficulties of translating research findings into practical application. While the literature refers to this challenge as the "Bench to Bedside" lag, this paper presents three collaborative strategies that aim to minimize this gap. The Bedside strategy proposes to use the data generated from care delivery and captured in the massive data repositories of electronic health record (EHR) systems as empirical evidence that can be analysed to discover and then inform best practice. In the Classroom strategy, we present a description for how evidence-based nursing knowledge is taught in a baccalaureate nursing program. And finally, the Bench strategy describes applied informatics in converting paper-based EBN protocols into the workflow of clinical information systems. Protocols are translated into reference and executable knowledge with the goal of placing the latest scientific knowledge at the fingertips of front line clinicians. In all three strategies, information technology (IT) is presented as the underlying tool that makes this rapid translation of nursing knowledge into practice and education feasible.

Building an Evidence-Based Mental Health Program for Children with History of Early Adversity

ERIC Educational Resources Information Center

Kroupina, Maria; Vermeulen, Marlous; Moberg, Stephanie

2015-01-01

Adoption is a major intervention in a child's life, however internationally adopted (IA) children remain at risk for long-term neurodevelopmental and mental health issues due to the fact that most of them have a history of early adversity prior to their adoption. In the last 20 years, extensive research with this population has increased the…

Synthesising Evidence on the Impacts of Programmes and Policies in Education, Crime and Justice, and Social Welfare: Practical Recommendations Based on 14 Test-Bed Reviews

ERIC Educational Resources Information Center

Cottingham, Phoebe; Maynard, Rebecca; Stagner, Matthew

2004-01-01

Review teams tested the systematic review procedures and principles developed under the Campbell Collaboration Fourteen review teams selected topics for intervention reviews in social policy, education, and criminal justice. Review protocols gave criteria for the extensive research literature search. Randomised Controlled Trials were selected.…

Using Blogs and New Media in Academic Practice: Potential Roles in Research, Teaching, Learning, and Extension

ERIC Educational Resources Information Center

Powell, Douglas A.; Jacob, Casey J.; Chapman, Benjamin J.

2012-01-01

Compiling a referenced article for publication in a peer-reviewed journal is traditionally the most respected means of contributing to a body of knowledge. However, we argue that publication of evidence-based information via new media--especially blogging--can also be a valid form of academic scholarship. Blogs allow for rapid sharing of research…

Implementing an Evidence-Based Trauma Treatment in a State System after September 11: The Cats Project

ERIC Educational Resources Information Center

Hoagwood, Kimberly Eaton; Vogel, Juliet M.; Levitt, Jessica Mass; D'Amico, Peter J.; Paisner, Wendy I.; Kaplan, Sandra J.

2007-01-01

Following the World Trade Center (WTC) attacks, an extensive screening survey was undertaken to assess mental health needs of New York City's school-age children. This survey demonstrated that as many as 75,000 children in New York City (10.5%) had symptoms of posttraumatic stress disorder (PTSD) and high percentages of children reported other…

Facing the Challenge of e-Learning: Reflections on Teaching Evidence-Based Practice through Online Discussion Groups

ERIC Educational Resources Information Center

Clegg, Phil; Heap, John

2006-01-01

The advent of e-learning in higher education has entailed extensive use of online discussion boards to promote collaborative learning among students; however, the role of instructors as online facilitators is typically ill-defined due to a lack of sufficient standards or guidelines for good practice. In their audit of online discussion forum…

Peripheral structures of the Rio Grande Rift in the Sangre de Cristo Mountains, around the Colorado-New Mexico border

NASA Astrophysics Data System (ADS)

Fridrich, C. J.; Workman, J. B.

2009-12-01

Recently active faults of the Rio Grande rift near the Colorado-New Mexico border are almost entirely limited to the San Luis basin. In contrast, the early (≈26 to ≈10 Ma) structure of the rift in this area is significantly broader. A wide zone of abandoned, peripheral extensional structures is exposed on the eastern flank of the San Luis basin—in the west half of the Sangre de Cristo Mountains, known in this area as the southern Culebra and northern Taos Ranges. New detailed mapping shows that the eastern limit of the zone of early peripheral extension is marked by an aligned series of north-trending grabens, including the Devil’s Park, Valle Vidal, and Moreno Valley basins. Master faults of these intermontaine basins are partly localized along, and evidently reactivated moderate- to high-angle Laramide (≈70 to ≈40 Ma) reverse faults of the Sangre de Cristo Mountains. Between these grabens and the San Luis basin lies a structural zone that varies in style from block faulting, in the north, to more closely spaced tilted-domino-style faulting in the Latir volcanic field, to the south. Additional early rift structures include several long northwest-striking faults, the largest of which are interpreted to have accommodated significant right-lateral strike-slip, based on abrupt southwestward increase in the magnitude of extension across them. These faults evidently transferred strain from the axial part of the rift into the zone of early peripheral extension, and accommodated lateral changes in structural style. Throughout the area of early peripheral extension, there is a correlation between the magnitude of local volcanism and the degree of extension; however, it is unclear if extension drove volcanism—via mantle upwelling, or if extension was maximized where the crust was weakest, owing to the presence of magma and hot rock at shallow depths.

Wildlife-friendly farming benefits rare birds, bees and plants.

PubMed

Pywell, Richard F; Heard, Matthew S; Bradbury, Richard B; Hinsley, Shelley; Nowakowski, Marek; Walker, Kevin J; Bullock, James M

2012-10-23

Agricultural intensification is a leading cause of global biodiversity loss, especially for threatened and near-threatened species. One widely implemented response is 'wildlife-friendly farming', involving the close integration of conservation and extensive farming practices within agricultural landscapes. However, the putative benefits from this controversial policy are currently either unknown or thought unlikely to extend to rare and declining species. Here, we show that new, evidence-based approaches to habitat creation on intensively managed farmland in England can achieve large increases in plant, bee and bird species. In particular, we found that habitat enhancement methods designed to provide the requirements of sensitive target biota consistently increased the richness and abundance of both rare and common species, with 10-fold to greater than 100-fold more rare species per sample area than generalized conventional conservation measures. Furthermore, targeting landscapes of high species richness amplified beneficial effects on the least mobile taxa: plants and bees. Our results provide the first unequivocal support for a national wildlife-friendly farming policy and suggest that this approach should be implemented much more extensively to address global biodiversity loss. However, to be effective, these conservation measures must be evidence-based, and developed using sound knowledge of the ecological requirements of key species.

Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS.

PubMed

Santiago, Catherine Decarlo; Pears, Gillian; Baweja, Shilpa; Vona, Pamela; Tang, Jennifer; Kataoka, Sheryl H

2013-12-01

This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed.

Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS

PubMed Central

Santiago, Catherine DeCarlo; Pears, Gillian; Baweja, Shilpa; Vona, Pamela; Tang, Jennifer; Kataoka, Sheryl H.

2013-01-01

This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed. PMID:24273613

A description of Seismicity based on Non-extensive Statistical Physics: An introduction to Non-extensive Statistical Seismology.

NASA Astrophysics Data System (ADS)

Vallianatos, Filippos

2015-04-01

Despite the extreme complexity that characterizes earthquake generation process, simple phenomenology seems to apply in the collective properties of seismicity. The best known is the Gutenberg-Richter relation. Short and long-term clustering, power-law scaling and scale-invariance have been exhibited in the spatio-temporal evolution of seismicity providing evidence for earthquakes as a nonlinear dynamic process. Regarding the physics of "many" earthquakes and how this can be derived from first principles, one may wonder, how can the collective properties of a set formed by all earthquakes in a given region, be derived and how does the structure of seismicity depend on its elementary constituents - the earthquakes? What are these properties? The physics of many earthquakes has to be studied with a different approach than the physics of one earthquake making the use of statistical physics necessary to understand the collective properties of earthquakes. Then a natural question arises. What type of statistical physics is appropriate to commonly describe effects from the microscale and crack opening level to the level of large earthquakes? An answer to the previous question could be non-extensive statistical physics, introduced by Tsallis (1988), as the appropriate methodological tool to describe entities with (multi) fractal distributions of their elements and where long-range interactions or intermittency are important, as in fracturing phenomena and earthquakes. In the present work, we review some fundamental properties of earthquake physics and how these are derived by means of non-extensive statistical physics. The aim is to understand aspects of the underlying physics that lead to the evolution of the earthquake phenomenon introducing the new topic of non-extensive statistical seismology. This research has been funded by the European Union (European Social Fund) and Greek national resources under the framework of the "THALES Program: SEISMO FEAR HELLARC" project. References F. Vallianatos, "A non-extensive approach to risk assessment", Nat. Hazards Earth Syst. Sci., 9, 211-216, 2009 F. Vallianatos and P. Sammonds "Is plate tectonics a case of non-extensive thermodynamics?" Physica A: Statistical Mechanics and its Applications, 389 (21), 4989-4993, 2010, F. Vallianatos, G. Michas, G. Papadakis and P. Sammonds " A non extensive statistical physics view to the spatiotemporal properties of the June 1995, Aigion earthquake (M6.2) aftershock sequence (West Corinth rift, Greece)", Acta Geophysica, 60(3), 758-768, 2012 F. Vallianatos and L. Telesca, Statistical mechanics in earth physics and natural hazards (editorial), Acta Geophysica, 60, 3, 499-501, 2012 F. Vallianatos, G. Michas, G. Papadakis and A. Tzanis "Evidence of non-extensivity in the seismicity observed during the 2011-2012 unrest at the Santorini volcanic complex, Greece" Nat. Hazards Earth Syst. Sci.,13,177-185, 2013 F. Vallianatos and P. Sammonds, "Evidence of non-extensive statistical physics of the lithospheric instability approaching the 2004 Sumatran-Andaman and 2011 Honshu mega-earthquakes" Tectonophysics, 590 , 52-58, 2013 G. Papadakis, F. Vallianatos, P. Sammonds, " Evidence of Nonextensive Statistical Physics behavior of the Hellenic Subduction Zone seismicity" Tectonophysics, 608, 1037 -1048, 2013 G. Michas, F. Vallianatos, and P. Sammonds, Non-extensivity and long-range correlations in the earthquake activity at the West Corinth rift (Greece) Nonlin. Processes Geophys., 20, 713-724, 2013

Secure base representations in middle childhood across two Western cultures: Associations with parental attachment representations and maternal reports of behavior problems.

PubMed

Waters, Theodore E A; Bosmans, Guy; Vandevivere, Eva; Dujardin, Adinda; Waters, Harriet S

2015-08-01

Recent work examining the content and organization of attachment representations suggests that 1 way in which we represent the attachment relationship is in the form of a cognitive script. This work has largely focused on early childhood or adolescence/adulthood, leaving a large gap in our understanding of script-like attachment representations in the middle childhood period. We present 2 studies and provide 3 critical pieces of evidence regarding the presence of a script-like representation of the attachment relationship in middle childhood. We present evidence that a middle childhood attachment script assessment tapped a stable underlying script using samples drawn from 2 western cultures, the United States (Study 1) and Belgium (Study 2). We also found evidence suggestive of the intergenerational transmission of secure base script knowledge (Study 1) and relations between secure base script knowledge and symptoms of psychopathology in middle childhood (Study 2). The results from this investigation represent an important downward extension of the secure base script construct. (c) 2015 APA, all rights reserved).

Secure Base Representations in Middle Childhood Across Two Western Cultures: Associations with Parental Attachment Representations and Maternal Reports of Behavior Problems

PubMed Central

Waters, Theodore E. A.; Bosmans, Guy; Vandevivere, Eva; Dujardin, Adinda; Waters, Harriet S.

2015-01-01

Recent work examining the content and organization of attachment representations suggests that one way in which we represent the attachment relationship is in the form of a cognitive script. That said, this work has largely focused on early childhood or adolescence/adulthood, leaving a large gap in our understanding of script-like attachment representations in the middle childhood period. We present two studies and provide three critical pieces of evidence regarding the presence of a script-like representation of the attachment relationship in middle childhood. We present evidence that a middle childhood attachment script assessment tapped a stable underlying script using samples drawn from two western cultures, the United States (Study 1) and Belgium (Study 2). We also found evidence suggestive of the intergenerational transmission of secure base script knowledge (Study 1) and relations between secure base script knowledge and symptoms of psychopathology in middle childhood (Study 2). The results from this investigation represent an important downward extension of the secure base script construct. PMID:26147774

Summary of the recommendations on sexual dysfunctions in women.

PubMed

Basson, Rosemary; Wierman, Margaret E; van Lankveld, Jacques; Brotto, Lori

2010-01-01

Women's sexual dysfunction includes reduced interest/incentives for sexual engagement, difficulties with becoming subjectively and/or genitally aroused, difficulties in triggering desire during sexual engagement, orgasm disorder, and sexual pain. To update the recommendations published in 2004, from the 2nd International Consultation on Sexual Medicine (ICSM) pertaining to the diagnosis and treatment of women's sexual dysfunctions. A third international consultation in collaboration with the major sexual medicine associations assembled over 186 multidisciplinary experts from 33 countries into 25 committees. Twenty one experts from six countries contributed to the Recommendations on Sexual Dysfunctions in Women. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. A comprehensive assessment of medical, sexual, and psychosocial history is recommended for diagnosis and management. Indications for general and focused pelvic genital examination are identified. Evidence based recommendations for further revisions of definitions for sexual disorders are given. An evidence based approach to management is provided. Extensive references are provided in the full ICSM reports. There remains a need for more research and scientific reporting on the optimal management of women's sexual dysfunctions including multidisciplinary approaches.

Diagnostic tests in urology: magnetic resonance imaging (MRI) for the staging of prostate cancer.

PubMed

Preston, Mark A; Harisinghani, Mukesh G; Mucci, Lorelei; Witiuk, Kelsey; Breau, Rodney H

2013-03-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The use of MRI for prostate cancer diagnosis and staging is increasing. Indications for prostate MRI are not defined and many clinicians are unsure of how best to use MRI to aid clinical decisions. This evidence-based medicine article addresses the clinical utility of prostate MRI for preoperative staging. Based on a common patient scenario, a guide to calculating the probability of extraprostatic extension is provided. © 2013 BJU International.

Towards evidence-based computational statistics: lessons from clinical research on the role and design of real-data benchmark studies.

PubMed

Boulesteix, Anne-Laure; Wilson, Rory; Hapfelmeier, Alexander

2017-09-09

The goal of medical research is to develop interventions that are in some sense superior, with respect to patient outcome, to interventions currently in use. Similarly, the goal of research in methodological computational statistics is to develop data analysis tools that are themselves superior to the existing tools. The methodology of the evaluation of medical interventions continues to be discussed extensively in the literature and it is now well accepted that medicine should be at least partly "evidence-based". Although we statisticians are convinced of the importance of unbiased, well-thought-out study designs and evidence-based approaches in the context of clinical research, we tend to ignore these principles when designing our own studies for evaluating statistical methods in the context of our methodological research. In this paper, we draw an analogy between clinical trials and real-data-based benchmarking experiments in methodological statistical science, with datasets playing the role of patients and methods playing the role of medical interventions. Through this analogy, we suggest directions for improvement in the design and interpretation of studies which use real data to evaluate statistical methods, in particular with respect to dataset inclusion criteria and the reduction of various forms of bias. More generally, we discuss the concept of "evidence-based" statistical research, its limitations and its impact on the design and interpretation of real-data-based benchmark experiments. We suggest that benchmark studies-a method of assessment of statistical methods using real-world datasets-might benefit from adopting (some) concepts from evidence-based medicine towards the goal of more evidence-based statistical research.

Plant use in the Lower and Middle Palaeolithic: Food, medicine and raw materials

NASA Astrophysics Data System (ADS)

Hardy, Karen

2018-07-01

There is little surviving evidence for plant use in the Lower and Middle Palaeolithic periods yet the evidence there is, clearly indicates the importance of plants in the diet, as medicines and as raw materials. Here, the current evidence for plants is summarised, and the way this can be used to enrich perceptions of the Lower and Middle Palaeolithic are explored. The evidence for plant food fits well with basic nutritional requirements while the presence of medicinal plants correlates with plant-based self-medication by animals. Many plant-based technologies are likely to have developed early in the Palaeolithic. Though investigating this is challenging due to a lack of evidence, the extensive evidence for use of plant materials as tools by chimpanzees provides a broad backdrop. The ecological knowledge carried by all hominins would have provided a safety net when moving into new regions, while varying levels of neophobia would have enabled adaptation to new environments as hominin populations moved and climates changed. Recent plant use among traditional societies in high latitudes shows that even in locations with reduced biodiversity, plant resources can fulfil essential dietary requirements.

Hydrolysed formula and risk of allergic or autoimmune disease: systematic review and meta-analysis

PubMed Central

Ierodiakonou, Despo; Khan, Tasnia; Chivinge, Jennifer; Robinson, Zoe; Geoghegan, Natalie; Jarrold, Katharine; Afxentiou, Thalia; Reeves, Tim; Cunha, Sergio; Trivella, Marialena; Garcia-Larsen, Vanessa; Leonardi-Bee, Jo

2016-01-01

Objective To determine whether feeding infants with hydrolysed formula reduces their risk of allergic or autoimmune disease. Design Systematic review and meta-analysis, as part of a series of systematic reviews commissioned by the UK Food Standards Agency to inform guidelines on infant feeding. Two authors selected studies by consensus, independently extracted data, and assessed the quality of included studies using the Cochrane risk of bias tool. Data sources Medline, Embase, Web of Science, CENTRAL, and LILACS searched between January 1946 and April 2015. Eligibility criteria for selecting studies Prospective intervention trials of hydrolysed cows’ milk formula compared with another hydrolysed formula, human breast milk, or a standard cows’ milk formula, which reported on allergic or autoimmune disease or allergic sensitisation. Results 37 eligible intervention trials of hydrolysed formula were identified, including over 19 000 participants. There was evidence of conflict of interest and high or unclear risk of bias in most studies of allergic outcomes and evidence of publication bias for studies of eczema and wheeze. Overall there was no consistent evidence that partially or extensively hydrolysed formulas reduce risk of allergic or autoimmune outcomes in infants at high pre-existing risk of these outcomes. Odds ratios for eczema at age 0-4, compared with standard cows’ milk formula, were 0.84 (95% confidence interval 0.67 to 1.07; I2=30%) for partially hydrolysed formula; 0.55 (0.28 to 1.09; I2=74%) for extensively hydrolysed casein based formula; and 1.12 (0.88 to 1.42; I2=0%) for extensively hydrolysed whey based formula. There was no evidence to support the health claim approved by the US Food and Drug Administration that a partially hydrolysed formula could reduce the risk of eczema nor the conclusion of the Cochrane review that hydrolysed formula could prevent allergy to cows’ milk. Conclusion These findings do not support current guidelines that recommend the use of hydrolysed formula to prevent allergic disease in high risk infants. Review registration PROSPERO CRD42013004252. PMID:26956579

Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines

PubMed Central

Norris, Susan L.; Schulman, Sam; Hirsh, Jack; Eckman, Mark H.; Akl, Elie A.; Crowther, Mark; Vandvik, Per Olav; Eikelboom, John W.; McDonagh, Marian S.; Lewis, Sandra Zelman; Gutterman, David D.; Cook, Deborah J.; Schünemann, Holger J.

2012-01-01

Background: To develop the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: ACCP Evidence-Based Clinical Practice Guidelines (AT9), the American College of Chest Physicians (ACCP) assembled a panel of clinical experts, information scientists, decision scientists, and systematic review and guideline methodologists. Methods: Clinical areas were designated as articles, and a methodologist without important intellectual or financial conflicts of interest led a panel for each article. Only panel members without significant conflicts of interest participated in making recommendations. Panelists specified the population, intervention and alternative, and outcomes for each clinical question and defined criteria for eligible studies. Panelists and an independent evidence-based practice center executed systematic searches for relevant studies and evaluated the evidence, and where resources and evidence permitted, they created standardized tables that present the quality of the evidence and key results in a transparent fashion. Results: One or more recommendations relate to each specific clinical question, and each recommendation is clearly linked to the underlying body of evidence. Judgments regarding the quality of evidence and strength of recommendations were based on approaches developed by the Grades of Recommendations, Assessment, Development, and Evaluation Working Group. Panel members constructed scenarios describing relevant health states and rated the disutility associated with these states based on an additional systematic review of evidence regarding patient values and preferences for antithrombotic therapy. These ratings guided value and preference decisions underlying the recommendations. Each topic panel identified questions in which resource allocation issues were particularly important and, for these issues, experts in economic analysis provided additional searches and guidance. Conclusions: AT9 methodology reflects the current science of evidence-based clinical practice guideline development, with reliance on high-quality systematic reviews, a standardized process for quality assessment of individual studies and the body of evidence, an explicit process for translating the evidence into recommendations, disclosure of financial as well as intellectual conflicts of interest followed by management of disclosed conflicts, and extensive peer review. PMID:22315256

An Evidence Framework for Off-Patent Pharmaceutical Review (EFOR) for Health Technology Assessment in Emerging Markets.

PubMed

Brixner, Diana; Kaló, Zoltán; Maniadakis, Nikos; Kim, Kyoo; Wijaya, Kalman

2018-03-29

This article introduces an Evidence Framework for Off-Patent Pharmaceutical Review (EFOR), which establishes value-based criteria in a template that manufacturers use to provide evidence showing how their products meet those criteria. Health authorities in emerging markets can then use the evidence presented in the EFOR to evaluate off-patent pharmaceuticals (OPPs) in a consistent, transparent, and evidence-based manner to support policy decisions, including pricing, reimbursement, formulary listing, and drug procurement. A literature search found no multi-criteria evidence framework for evaluating OPPs in emerging markets. An International Outcomes Research Board (IORB) of academia and industry experts conducted extensive research, meetings, and workshops to define high-priority criteria to incorporate into an evidence-based health technology assessment (HTA) tool using the multi-criteria decision analysis (MCDA) technique. The resulting framework was further tailored for country-specific needs in workshops in three emerging countries (Kazakhstan, Vietnam, and Indonesia). The IORB defined nine criteria four categories (Product, Manufacturing, Service, and Value Assessment), which OPP manufacturers can use to provide evidence for reimbursement and health policy decision making. Then the IORB developed the EFOR as a base case document, which can be adapted and used as a template by health authorities in emerging countries. Emerging countries have a significant need for an HTA tool that balances affordability with accurate evidence showing the value differentiation of OPPs. The value attributes in this setting often are different from those in developed markets, which emphasize new products and have high regulation and manufacturing standards. The EFOR is an easy-to-use, adaptable framework that emerging countries can use to increase the consistency, transparency, and effectiveness of drug decision making. The open source EFOR is available as Supplemental Materials. Copyright © 2018. Published by Elsevier Inc.

Queer challenges to evidence-based practice.

PubMed

Zeeman, Laetitia; Aranda, Kay; Grant, Alec

2014-06-01

This paper aims to queer evidence-based practice by troubling the concepts of evidence, knowledge and mental illness. The evidence-based narrative that emerged within biomedicine has dominated health care. The biomedical notion of 'evidence' has been critiqued extensively and is seen as exclusive and limiting, and even though the social constructionist paradigm attempts to challenge the authority of biomedicine to legitimate what constitutes acceptable evidence or knowledge for those experiencing mental illness, biomedical notions of evidence appear to remain relatively intact. Queer theory offers theoretical tools to disrupt biomedical norms and challenges biomedical normativity to indicate how marginalisation occurs when normative truths about mental health classify those who differ from the norm as 'ill' or 'disordered'. Queer theory's emphasis on normativity serves the political aim to subvert marginalisation and bring about radical social and material change. Reference will be made to mental health subjects within each discourse by indicating how the body acts as a vehicle for knowing. Deleuzian notions of the rhizome are used as metaphor to suggest a relational approach to knowledge that does away with either/or positions in either biomedical, or queer knowledge to arrive at a both/and position where the biomedical, constructionist and queer are interrelated and entangled in needing the other for their own evolution. However, queer does not ask for assimilation but celebrates difference by remaining outside to disrupt that which is easily overlooked, assumed to be natural or represented as the norm. The task of queer knowledge is to do justice to the lives lived in the name of evidence-based practice and demands that we consider the relations of power where knowledge is produced. This pursuit creates different knowledge spaces where we identify new intersections that allow for socially just understandings of knowing or evidence to emerge. © 2013 John Wiley & Sons Ltd.

Using an iPad2® with Systematic Instruction to Teach Shared Stories for Elementary-Aged Students with Autism

ERIC Educational Resources Information Center

Spooner, Fred; Ahlgrim-Delzell, Lynn; Kemp-Inman, Amy; Wood, Leah A.

2014-01-01

Literacy skills are important for accessing all areas of academic content as well as for increasing quality of life. The use of shared stories to teach early literacy skills to students with extensive support needs, including students with autism, is an evidence-based practice. This project extends the research by examining the effects of…

Compiling an Evidence-Based Improvement Plan for the Support of Distance-Education Students at a Southern African University

ERIC Educational Resources Information Center

Makhakhane, Bothephana; Wilkinson, Annette C.; Ndeya-Ndereya, Charity N.

2016-01-01

This article illustrates how an event guide can be used to organise, systematise and prioritise the large amount of findings from an extensive study. The study aimed to enhance student support at a distance-education institute in a Southern African country (Lesotho). In this case study an improvement-oriented evaluation of the strengths,…

Fighting in Thin Air: Operational Wilderness Medicine in High Asia

DTIC Science & Technology

2011-01-01

data sources , gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this...Afghanistan. Additionally, there will be discussion of evidence-based interventions being used to attempt to maintain optimal health of the warfighter at...the high altitude environment has resulted in extensive risk management recommendations from the US Army, specifically aimed at preventing altitude

The scale of the evidence base on the health effects of conventional yogurt consumption: findings of a scoping review

PubMed Central

Glanville, Julie M.; Brown, Sam; Shamir, Raanan; Szajewska, Hania; Eales, Jacqualyn F.

2015-01-01

Background: The health effects of conventional yogurt have been investigated for over a century; however, few systematic reviews have been conducted to assess the extent of the health benefits of yogurt. Objective: The aim of this scoping review was to assess the volume of available evidence on the health effects of conventional yogurt. Methods: The review was guided by a protocol agreed a priori and informed by an extensive literature search conducted in November 2013. Randomized controlled trials were selected and categorized according to the eligibility criteria established in the protocol. Results: 213 studies were identified as relevant to the scoping question. The number of eligible studies identified for each outcome were: bone health (14 studies), weight management and nutrition related health outcomes (81 studies), metabolic health (6 studies); cardiovascular health (57 studies); gastrointestinal health (24 studies); cancer (39 studies); diabetes (13 studies), Parkinson's disease risk (3 studies), all-cause mortality (3 studies), skin complaints (3 studies), respiratory complaints (3 studies), joint pain/function (2 studies); the remaining 8 studies reported a variety of other outcomes. For studies of a similar design and which assessed the same outcomes in similar population groups, we report the potential for the combining of data across studies in systematic reviews. Conclusions: This scoping review has revealed the extensive evidence base for many outcomes which could be the focus of systematic reviews exploring the health effects of conventional yogurt consumption. PMID:26578956

Topography and behavior of Sertoli cells in sparse culture during the transitional remodeling phase.

PubMed

Tung, P S; Choi, A H; Fritz, I B

1988-01-01

We report observations on the behavior of Sertoli cells in sparse culture during the period from the time of plating to the time of initial confluence (the transitional remodeling phase). Changes in shape, structure, and polarity of cells, as well as changes in migration patterns and cell-cell association patterns, have been followed during the transitional remodeling phase with the aid of topographical markers. These markers are based upon differences between ultrastructural features of the basolateral and apicolateral surfaces. The basolateral surface is characterized by plasmalemmal blebs, whereas the apicolateral surface is characterized by filopodial extensions. Structural differences observed in situ remain evident in Sertoli cells isolated by sequential enzymatic treatments that are described. Another marker is provided by laminin-binding sites, which are detected exclusively on the blebbed, basolateral surfaces of freshly prepared Sertoli cell aggregates. The orientation described is sustained during the initial radial migration of Sertoli cells explanted on uncoated glass coverslips. Under these conditions, blebs are detected only on the dorsal surfaces, and filopodial extensions are evident only on the ventral surfaces. In contrast, Sertoli cells sparsely plated on a reconstituted basement membrane (air-dried Matrigel) migrate rapidly, display an extraordinary capacity to form elaborate cytoplasmic extensions for cell-cell and cell-substratum contacts, and readily retract blebs and filopodial extensions. These cells do not form mosaic borders, whereas cells plated on uncoated glass do form a monolayer with mosaic-like borders. Cells sparsely seeded on gelated Matrigel migrate preferentially at gaps between adjacent cell explants, and develop a compact cell-cell association pattern. These cells display few, if any, cytoplasmic extensions. We compare the behavior of Sertoli cells sparsely plated on Matrigel with the behavior of Sertoli cells in situ during different stages of development.

Do lightning positive leaders really "step"?

NASA Astrophysics Data System (ADS)

Petersen, D.

2015-12-01

It has been known for some time that positive leaders exhibit impulsive charge motion and optical emissions as they extend. However, laboratory and field observations have not produced any evidence of a process analogous to the space leader mechanism of negative leader extension. Instead, observations have suggested that the positive leader tip undergoes a continuous to intermittent series of corona streamer bursts, each burst resulting in a small forward extension of the positive leader channel. Traditionally, it has been held that lightning positive leaders extend in a continuous or quasi-continuous fashion. Lately, however, many have become concerned that this position is incongruous with observations of impulsive activity during lightning positive leader extension. It is increasingly suggested that this impulsive activity is evidence that positive leaders also undergo "stepping". There are two issues that must be addressed. The first issue concerns whether or not the physical processes underlying impulsive extension in negative and positive leaders are distinct. We argue that these processes are in fact physically distinct, and offer new high-speed video evidence to support this position. The second issue regards the proper use of the term "step" as an identifier for the impulsive forward extension of a leader. Traditional use of this term has been applied only to negative leaders, due primarily to their stronger impulsive charge motions and photographic evidence of clearly discontinuous forward progression of the luminous channel. Recently, due to the increasing understanding of the distinct "space leader" process of negative leader extension, the term "step" has increasingly come to be associated with the space leader process itself. Should this emerging association, "step" = space leader attachment, be canonized? If not, then it seems reasonable to use the term "step" to describe impulsive positive leader extension. If, however, we do wish to associate the term "step" with space leader attachment, a process unique to negative leaders, should we devise a term for those process(es) that underly impulsive positive leader extension?

Use of Theory in Behavior Change Interventions.

PubMed

Bluethmann, Shirley M; Bartholomew, L Kay; Murphy, Caitlin C; Vernon, Sally W

2017-04-01

Theory use may enhance effectiveness of behavioral interventions, yet critics question whether theory-based interventions have been sufficiently scrutinized. This study applied a framework to evaluate theory use in physical activity interventions for breast cancer survivors. The aims were to (1) evaluate theory application intensity and (2) assess the association between extensiveness of theory use and intervention effectiveness. Studies were previously identified through a systematic search, including only randomized controlled trials published from 2005 to 2013, that addressed physical activity behavior change and studied survivors who were <5 years posttreatment. Eight theory items from Michie and Prestwich's coding framework were selected to calculate theory intensity scores. Studies were classified into three subgroups based on extensiveness of theory use (Level 1 = sparse; Level 2 = moderate; and Level 3 = extensive). Fourteen randomized controlled trials met search criteria. Most trials used the transtheoretical model ( n = 5) or social cognitive theory ( n = 3). For extensiveness of theory use, 5 studies were classified as Level 1, 4 as Level 2, and 5 as Level 3. Studies in the extensive group (Level 3) had the largest overall effect size ( g = 0.76). Effects were more modest in Level 1 and 2 groups with overall effect sizes of g = 0.28 and g = 0.36, respectively. Theory use is often viewed as essential to behavior change, but theory application varies widely. In this study, there was some evidence to suggest that extensiveness of theory use enhanced intervention effectiveness. However, there is more to learn about how theory can improve interventions for breast cancer survivors.

Towards evidence-based critical thinking medicine? Uses of best evidence in flawless argumentations.

PubMed

Jenicek, Milos

2006-08-01

Uses of informal logic and critical thinking methodology are increasingly taught, learnt and advantageously applied in such diverse domains as law, the military, business, and education. Health sciences are also following this trend. However, production and critical appraisal of evidence as already practiced in Evidence-Based Medicine must be coupled with equally rigorous uses in order to ensure appropriate health problem understanding and decision-making. Making most proposals and decisions in medicine is the conclusion of an argumentation process that lies behind any communication between health professionals working with patients, performing research or sharing ideas about health problems, their interpretations and solutions with numerous stakeholders in public life. Modern critical thinking and decision making in medicine is not instantly mastered, but is instead a learnt experience as anything else in professional and social interactions. The modern argument as outlined, illustrated and applied to health problems in this essay is an extension of a previously established way of thinking in Evidence-Based Medicine. Ideally, health professionals, their patients and all other stakeholders should speak the same language and it is up to us to make this possible. Evidence and critical thinking - based medicine might be a solution. As modern critical thinkers, we are at the forefront and we must see to it that patients and professional and general communities benefit from this more so even than from other remarkable historical and current contributions to the well-being of those under our care.

Russell body apical periodontitis: an unusual case report.

PubMed

Dos Santos, Jean Nunes; Ramos, Eduardo Antônio Gonçalves; Gurgel, Clarissa Araújo Silva; Barros, Adna Conceição; de Freitas, André Carlos; Crusoé-Rebello, Iêda Maria

2008-12-01

Russell bodies (RBs) changes in chronic apical lesions have rarely been reported in the literature. We describe a case of a periapical lesion abundantly and extensively composed of RB. Microscopic examination showed accumulation of plasma cells containing globular, spherical, polygonal, and eosinophilic structures against fibrous connective tissue. Initial diagnostic considerations based on a smaller magnification included hypersecretory plasmocytoma, although there was no evidence of infiltrative growth, mitotic activity, nuclear atypia, or cellular pleomorphism. Then, a panel of immunohistochemical markers was applied and the cells showed positivity with both kappa and lambda chains demonstrating their polyclonal origin. The extensive accumulation of RBs involving the periapical region represents an unreported and significant histologic change, as it was mimicking a malignant neoplasm.

Testing for Lorentz violation: constraints on standard-model-extension parameters via lunar laser ranging.

PubMed

Battat, James B R; Chandler, John F; Stubbs, Christopher W

2007-12-14

We present constraints on violations of Lorentz invariance based on archival lunar laser-ranging (LLR) data. LLR measures the Earth-Moon separation by timing the round-trip travel of light between the two bodies and is currently accurate to the equivalent of a few centimeters (parts in 10(11) of the total distance). By analyzing this LLR data under the standard-model extension (SME) framework, we derived six observational constraints on dimensionless SME parameters that describe potential Lorentz violation. We found no evidence for Lorentz violation at the 10(-6) to 10(-11) level in these parameters. This work constitutes the first LLR constraints on SME parameters.

Diet Assessment Methods in the Nurses' Health Studies and Contribution to Evidence-Based Nutritional Policies and Guidelines

PubMed Central

Satija, Ambika; Rimm, Eric B.; Spiegelman, Donna; Sampson, Laura; Rosner, Bernard; Camargo, Carlos A.; Stampfer, Meir; Willett, Walter C.

2016-01-01

Objectives. To review the contribution of the Nurses’ Health Studies (NHSs) to diet assessment methods and evidence-based nutritional policies and guidelines. Methods. We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016. Results. Through periodic assessment of diet by validated dietary questionnaires over 40 years, the NHSs have identified dietary determinants of diseases such as breast and other cancers; obesity; type 2 diabetes; cardiovascular, respiratory, and eye diseases; and neurodegenerative and mental health disorders. Nutritional biomarkers were assessed using blood, urine, and toenail samples. Robust findings, from the NHSs, together with evidence from other large cohorts and randomized dietary intervention trials, have contributed to the evidence base for developing dietary guidelines and nutritional policies to reduce intakes of trans fat, saturated fat, sugar-sweetened beverages, red and processed meats, and refined carbohydrates while promoting higher intake of healthy fats and carbohydrates and overall healthful dietary patterns. Conclusions. The long-term, periodically collected dietary data in the NHSs, with documented reliability and validity, have contributed extensively to our understanding of the dietary determinants of various diseases, informing dietary guidelines and shaping nutritional policy. PMID:27459459

Exploring the Level of Evidence of Impact Collected through Program Evaluation by Cooperative Extension as Published in the "Journal of Extension"

ERIC Educational Resources Information Center

Workman, Jeffrey Dale

2010-01-01

Documenting evidence of impact demonstrates that organizations and programs are making a difference and/or accomplishing something positive. The results of a program must ultimately change people's attitudes or behavior, or benefit society in other ways (Diem, 1997). As competition increases and the availability of financial resources decreases,…

Brief Report: An Independent Replication and Extension of Psychometric Evidence Supporting the Theory of Mind Inventory

ERIC Educational Resources Information Center

Greenslade, Kathryn J.; Coggins, Truman E.

2016-01-01

This study presents an independent replication and extension of psychometric evidence supporting the "Theory of Mind Inventory" ("ToMI"). Parents of 20 children with ASD (4; 1-6; 7 years; months) and 20 with typical development (3; 1-6; 5), rated their child's theory of mind abilities in everyday situations. Other parent report…

Ice core evidence for extensive melting of the greenland ice sheet in the last interglacial.

PubMed

Koerner, R M

1989-05-26

Evidence from ice at the bottom of ice cores from the Canadian Arctic Islands and Camp Century and Dye-3 in Greenland suggests that the Greenland ice sheet melted extensively or completely during the last interglacial period more than 100 ka (thousand years ago), in contrast to earlier interpretations. The presence of dirt particles in the basal ice has previously been thought to indicate that the base of the ice sheets had melted and that the evidence for the time of original growth of these ice masses had been destroyed. However, the particles most likely blew onto the ice when the dimensions of the ice caps and ice sheets were much smaller. Ice texture, gas content, and other evidence also suggest that the basal ice at each drill site is superimposed ice, a type of ice typical of the early growth stages of an ice cap or ice sheet. If the present-day ice masses began their growth during the last interglacial, the ice sheet from the earlier (Illinoian) glacial period must have competely or largely melted during the early part of the same interglacial period. If such melting did occur, the 6-meter higher-than-present sea level during the Sangamon cannot be attributed to disintegration of the West Antarctic ice sheet, as has been suggested.

Hippocampome.org: a knowledge base of neuron types in the rodent hippocampus.

PubMed

Wheeler, Diek W; White, Charise M; Rees, Christopher L; Komendantov, Alexander O; Hamilton, David J; Ascoli, Giorgio A

2015-09-24

Hippocampome.org is a comprehensive knowledge base of neuron types in the rodent hippocampal formation (dentate gyrus, CA3, CA2, CA1, subiculum, and entorhinal cortex). Although the hippocampal literature is remarkably information-rich, neuron properties are often reported with incompletely defined and notoriously inconsistent terminology, creating a formidable challenge for data integration. Our extensive literature mining and data reconciliation identified 122 neuron types based on neurotransmitter, axonal and dendritic patterns, synaptic specificity, electrophysiology, and molecular biomarkers. All ∼3700 annotated properties are individually supported by specific evidence (∼14,000 pieces) in peer-reviewed publications. Systematic analysis of this unprecedented amount of machine-readable information reveals novel correlations among neuron types and properties, the potential connectivity of the full hippocampal circuitry, and outstanding knowledge gaps. User-friendly browsing and online querying of Hippocampome.org may aid design and interpretation of both experiments and simulations. This powerful, simple, and extensible neuron classification endeavor is unique in its detail, utility, and completeness.

Contradictory cooling in a warmer world? the climate of the Mediterranean region during the ';Holocene Thermal Maximum'

NASA Astrophysics Data System (ADS)

Davis, B.

2013-12-01

Extensive evidence from high latitudes of the Northern Hemisphere indicates that temperatures were warmer than present during the early-mid Holocene, a period known as the Holocene thermal maximum (HTM). The existence of the HTM over lower mid-latitudes and the sub-tropics however is less clear, with pollen-based reconstructions in particular actually indicating a contrary cooling at this time in these regions. This apparent cooling is controversial because it is not shown in climate model simulations, which indicate that the HTM occurred across all extra-tropical latitudes of the Northern Hemisphere. This is also supported by alkenone based SST reconstructions, which also show a much more widespread HTM than indicated by the pollen data. Here this problem is investigated by reviewing the evidence both for, and against, the HTM in the Mediterranean region, which represents one of the most intensively studied regions of sub-tropical climate in the Northern Hemisphere. This evidence includes a large number of both marine and terrestrial records that can be directly compared due to their close proximity around the Mediterranean Sea. The results highlight the potential for bias in both marine and terrestrial climate proxies, but despite many criticisms of the pollen-based record, it is shown that the existence of more extensive temperate vegetation in the early-mid Holocene in the Mediterranean is difficult to explain by anything other than a cooler climate. For instance, vegetation models driven by climate model output show that the warmer climate suggested by the models produces a HTM vegetation even more arid than today. The results have important implications in the interpretation of proxy records, but perhaps most importantly, the potential for climate models to underestimate cooling processes in a warmer world needs further investigation.

Avoiding a fate worse than death: an argument for legalising voluntary physician-based euthanasia.

PubMed

Werren, Julia; Yuksel, Necef; Smith, Saxon

2012-09-01

The legalisation of voluntary physician-based euthanasia is currently the subject of much political, social and ethical debate and there is evidence in Australia of growing support for its implementation. In addressing many of the issues that surround legalisation, the article looks at some overseas jurisdictions that have legalised euthanasia to determine whether the social, political and ethical concerns prominent in the Australian debate have proved problematic in other jurisdictions. In addition, the article examines the report on the Dying with Dignity Bill 2009 (Tas) which commented extensively on the issues relating to voluntary physician-based euthanasia.

Preventive interventions addressing underage drinking: state of the evidence and steps toward public health impact.

PubMed

Spoth, Richard; Greenberg, Mark; Turrisi, Robert

2008-04-01

The epidemiological features of underage drinking and evidence of its social, health, and economic consequences suggest compelling reasons for the development and dissemination of effective preventive interventions. To clarify the nature and extent of the current evidence base on preventive interventions addressing underage drinking, a review of the literature was conducted through extensive searches of the research literature on outcome evaluations, existing reviews of this body of outcome research (N = 25), and summary reports of evidence on specific interventions. More than 400 interventions were identified and screened, and the evidence for 127 was reviewed. Criteria for the evaluation of evidence were established for intervention studies with alcohol-specific outcome measures for 3 developmental periods (< 10, 10-15, and 16 to > or = 20 years of age). Ultimately, 12 interventions met criteria for "most promising" evidence and 29 met criteria for "mixed or emerging" evidence. Conducting this review revealed clear advances in the number of evidence-based interventions available and the quality of outcome research; however, much work remains to achieve greater public health impact through evidence-based interventions. This work should consider (1) the great need for intervention research related to understudied developmental phases, intervention domains (eg, family, school, community, and media), and populations (eg, early tweens, late teens, young adults not attending college, and nonmajority populations); (2) the critical importance of addressing key issues in research design and methods (eg, limited longitudinal studies, replication studies, and dissemination research); and (3) the need for improved consistency in application of evidence and reporting standards. Finally, we recommend the application of emerging consumer-oriented and community-participatory models for intervention development and research, designed to increase the likelihood of "real-world" public health impact through improved translation of intervention science into practice.

Challenges of integrating evidence into health policy and planning: linking multiple disciplinary approaches.

PubMed

Huckel Schneider, Carmen; Blyth, Fiona

2017-04-27

To explore the challenges that arise through the multidisciplinary nature of evidence informed policy making (EIPM). Type of program or service: Education and practice for EIPM. This article summarises and compares four disciplinary approaches to EIPM with highly contrasting starting points: behavioural science, policy science, critical theory and intervention research. Key insights and theories are highlighted to provide a gateway into each, and to complement what is already known about the evidence needs of policy makers in terms of high-quality, timely and well-communicated research evidence. The extension of the evidence based medicine approach to EIPM has created interest in the processes of use of evidence in health policy and planning. Research in this field has spanned multiple disciplines; however, the disciplines use very different research methods and begin with different basic assumptions. Thus, despite the multidisciplinary nature of EIPM, true interdisciplinary research and action remain a challenge. We conclude with a set of key questions that can be used as a gateway to interdisciplinary EIPM in the future.

Pre-mesozoic palinspastic reconstruction of the eastern great basin (Western United States).

PubMed

Levy, M; Christie-Blick, N

1989-09-29

The Great Basin of the western United States has proven important for studies of Proterozoic and Paleozoic geology [2500 to 245 million years ago (Ma)] and has been central to the development of ideas about the mechanics of crustal shortening and extension. An understanding of the deformational history of this region during Mesozoic and Cenozoic time (245 Ma to the present) is required for palinspastic reconstruction of now isolated exposures of older geology in order to place these in an appropriate regional geographic context. Considerable advances in unraveling both the crustal shortening that took place during Mesozoic to early Cenozoic time (especially from about 150 to 50 Ma) and the extension of the past 37 million years have shown that earlier reconstructions need to be revised significantly. A new reconstruction is developed for rocks of middle Proterozoic to Early Cambrian age based on evidence that total shortening by generally east-vergent thrusts and folds was at least 104 to 135 kilometers and that the Great Basin as a whole accommodated approximately 250 kilometers of extension in the direction 287 degrees +/- 12 degrees between the Colorado Plateau and the Sierra Nevada. Extension is assumed to be equivalent at all latitudes because available paleomagnetic evidence suggests that the Sierra Nevada experienced little or no rotation with respect to the extension direction since the late Mesozoic. An estimate of the uncertainty in the amount of extension obtained from geological and paleomagnetic uncertainties increases northward from +/-56 kilometers at 36 degrees 30N to (-87)(+108) kilometers at 40 degrees N. On the basis of the reconstruction, the original width of the preserved part of the late Proterozoic and Early Cambrian basin was about 150 to 300 kilometers, about 60 percent of the present width, and the basin was oriented slightly more north-south with respect to present-day coordinates.

Past, Present and Future of UHECR Observations

NASA Astrophysics Data System (ADS)

Dawson, B. R.; Fukushima, M.; Sokolsky, P.

2017-12-01

Great advances have been made in the study of ultra-high energy cosmic rays (UHECR) in the past two decades. These include the discovery of the spectral cut-off near 5 x 10^19 eV and complex structure at lower energies, as well as increasingly precise information about the composition of cosmic rays as a function of energy. Important improvements in techniques, including extensive surface detector arrays and high resolution air fluorescence detectors, have been instrumental in facilitating this progress. We discuss the status of the field, including the open questions about the nature of spectral structure, systematic issues related to our understanding of composition, and emerging evidence for anisotropy at the highest energies. We review prospects for upgraded and future observatories including Telescope Array, Pierre Auger and JEM-EUSO and other space-based proposals, and discuss promising new technologies based on radio emission from extensive air showers produced by UHECR.

Hydrate for health: listening to older adults' need for information.

PubMed

Palmer, Mary H; Marquez, Celine S; Kline, Katherine V; Morris, Erin; Linares, Brenda; Carlson, Barbara W

2014-10-01

An interdisciplinary team of faculty and students developed the Hydrate for Health project to provide relevant and evidence-based information to community-dwelling older adults. Evidence-based factsheets on bladder health, nighttime urination, medication safety, and physical activity/exercise, as well as a fluid intake self-monitoring tool, were developed. Four focus groups were conducted and included older adults (N = 21) who participated in activities at two local senior centers to obtain their feedback about the relevance of the factsheets. Extensive revisions were required based on the feedback received. Older adults expressed a desire for pragmatic information (i.e., how to determine fluid sources from food, how to measure water, how to determine their own fluid needs). They also wanted information that could be easily incorporated into daily life. Nurses play a central role in listening to and incorporating older adults' voices into consumer education materials. Copyright 2014, SLACK Incorporated.

Reviving Cochrane's contribution to evidence-based medicine: bridging the gap between evidence of efficacy and evidence of effectiveness and cost-effectiveness.

PubMed

James, Jack E

2017-09-01

Throughout the quarter century since the advent of evidence-based medicine (EBM), medical research has prioritized 'efficacy' (i.e. internal validity) using randomized controlled trials. EBM has consistently neglected 'effectiveness' and 'cost-effectiveness', identified in the pioneering work of Archie Cochrane as essential for establishing the external (i.e. clinical) validity of health care interventions. Neither Cochrane nor other early pioneers appear to have foreseen the extent to which EBM would be appropriated by the pharmaceutical and medical devices industries, which are responsible for extensive biases in clinical research due to selective reporting, exaggeration of benefits, minimization of risks, and misrepresentation of data. The promise of EBM to effect transformational change in health care will remain unfulfilled until (i) studies of effectiveness and cost-effectiveness are pursued with some of the same fervour that previously succeeded in elevating the status of the randomized controlled trial, and (ii) ways are found to defeat threats to scientific integrity posed by commercial conflicts of interest. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

ACR Appropriateness Criteria® Headache-Child.

PubMed

Hayes, Laura L; Palasis, Susan; Bartel, Twyla B; Booth, Timothy N; Iyer, Ramesh S; Jones, Jeremy Y; Kadom, Nadja; Milla, Sarah S; Myseros, John S; Pakalnis, Ann; Partap, Sonia; Robertson, Richard L; Ryan, Maura E; Saigal, Gaurav; Soares, Bruno P; Tekes, Aylin; Karmazyn, Boaz K

2018-05-01

Headaches in children are not uncommon and have various causes. Proper neuroimaging of these children is very specific to the headache type. Care must be taken to choose and perform the most appropriate initial imaging examination in order to maximize the ability to properly determine the cause with minimum risk to the child. This evidence-based report discusses the different headache types in children and provides appropriate guidelines for imaging these children. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Drug-induced gynecomastia: an evidence-based review.

PubMed

Deepinder, Fnu; Braunstein, Glenn D

2012-09-01

Drugs are estimated to cause about 10 - 25% of all cases of gynecomastia. Over the course of several decades, multiple medications have been implicated in the development of gynecomastia mostly in the form of case reports and case series. However, these reports suffer from a multitude of deficiencies, including poor quality of evidence. Studies were selected for this review by performing an extensive electronic and hand-search using BIOSIS, EMBASE and Medline, from 1940 to present, for all reported drug associations of gynecomastia and their possible pathophysiology. Quality of evidence was assessed on a three-point scale: good, fair and poor, and each of the drugs reported to cause gynecomastia was assigned a level of strength. The pathophysiology of gynecomastia is also discussed in detail for each of the drugs found to have a good or fair evidence of association with gynecomastia. Most of the reported drug-gynecomastia associations were based on poor quality evidence. The drugs definitely associated with the onset of gynecomastia are spironolactone, cimetidine, ketoconazole, hGH, estrogens, hCG, anti-androgens, GnRH analogs and 5-α reductase inhibitors. Medications probably associated with gynecomastia include risperidone, verapamil, nifedipine, omeprazole, alkylating agents, HIV medications (efavirenz), anabolic steroids, alcohol and opioids.

Evidence-based guidelines for treating bipolar disorder: revised third edition Recommendations from the British Association for Psychopharmacology

PubMed Central

Goodwin, G.M.; Haddad, P. M.; Ferrier, I.N.; Aronson, J.K.; Barnes, T.R.H.; Cipriani, A.; Coghill, D.R.; Fazel, S.; Geddes, J.R.; Grunze, H.; Holmes, E.A.; Howes, O.; Hudson, S.; Hunt, N.; Jones, I.; Macmillan, I.C.; McAllister-Williams, H.; Miklowitz, D.M.; Morriss, R.; Munafò, M.; Paton, C.; Saharkian, B.J.; Saunders, K.E.A.; Sinclair, J.M.A.; Taylor, D.; Vieta, E.; Young, A.H.

2016-01-01

The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines: in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change. PMID:26979387

Treatment of dyslipidemia in HIV-infected patients.

PubMed

Sekhar, Rajagopal V; Balasubramanyam, Ashok

2010-08-01

Patients infected with HIV are at high risk for dyslipidemia, insulin resistance and cardiovascular disease. Therapies to reverse these risks are complex, sometimes controversial, and not uniformly effective. Pathophysiology of the lipid abnormalities in HIV is discussed, including the causes of alterations in triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and insulin resistance. We discuss the therapy of dyslipidemia in HIV using a combination of available clinical evidence and expert opinion based on extensive clinical experience, with discussions of lifestyle intervention and diet, conventional pharmacotherapy with lipid-lowering medications including statins, fibrates, niacin and thiazolidinediones for dyslipidemia, and newer therapeutic approaches including omega fatty acids, acipimox, growth hormone and leptin. A detailed understanding of the pathophysiology and rational or evidence-based approach to therapy of lipid abnormalities in patients infected with HIV. Treatment of dyslipidemia in patients with HIV is challenging and complicated by the risk of drug interactions. Appropriate therapy requires a sound understanding of pathophysiology and the principles of pharmacological and nonpharmacological therapeutic interventions. An evidence-based approach that combines lifestyle changes and drugs that are both safe and effective, singly and in combination, is described.

The big bang? An eventful year in workers' compensation.

PubMed

Guidotti, Tee L

2006-01-01

Workers' compensation in the past two years has been dominated by events in California, which have been so fundamental as to merit the term big bang. Passage of Senate Bill 899 has led to a comprehensive program of reform in access to medical care, access to rehabilitation services, temporary and permanent disability, evidence-based management, dispute resolution, and system innovation. Two noteworthy developments thus arose: a new requirement for apportionment by cause in causation analysis, and the adoption of evidence-based criteria for impairment assessment, treatment guidelines, and, soon, utilization review. Elsewhere in the United States, changes were modest, but extensive legislative activity in Texas suggests that Texas will be next to make major changes. In Canada, the Workers' Compensation Board of British Columbia has adopted an ambitious strategic initiative, and there is a Canadawide movement to establish presumption for certain diseases in firefighters. Suggestions for future directions include an increased emphasis on prevention, integration of programs, worker participation, enhancing the expertise of health care professionals, evidence-based management, process evaluation, and opportunities for innovation.

[Evidence-based aspects of clinical mastitis treatment].

PubMed

Mansion-de Vries, E M; Hoedemaker, M; Krömker, V

2015-01-01

Mastitis is one of the most common and expensive diseases in dairy cattle. The decision to treat clinical mastitis is usually made without any knowledge of the etiology, and can therefore only be evidence-based to a limited extent. Evidence-based medicine relies essentially on a combination of one's own clinical competence and scientific findings. In mastitis therapy, those insights depend mostly on pathogen-specific factors. Therefore, in evidence-based therapeutic decision making the pathogen identification should serve as a basis for the consideration of scientifically validated therapeutic concepts. The present paper considers evidence-based treatment of clinical mastitis based on a literature review. The authors conclude that an anti-inflammatory treatment using an NSAID should be conducted regardless of the pathogen. However, the choice of an antibiotic therapy depends on the mastitis causative pathogen, clinical symptoms and the animal itself. In principle, a local antibiotic treatment should be chosen for mild and moderate mastitis. It should be noted, that the benefit of an antibiotic therapy for coliform infections is questionable. With knowledge concerning the pathogen, it appears entirely reasonable to refrain from an antibiotic therapy. For severe (i.   e. feverish) mastitis, a parenteral antibiotic therapy should be selected. An extension of the antibiotic therapy beyond the manufacturer's information is only reasonable for streptococcal infections. It is important to make the decision on a prolonged antibiotic therapy only with the knowledge of the mastitis-causative pathogen. In terms of the therapy of a staphylococcus or streptococcus infection, a narrow-spectrum antibiotic from the penicillin family should be adopted when selecting the active agents.

Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults.

PubMed

Lucendo, Alfredo J; Molina-Infante, Javier; Arias, Ángel; von Arnim, Ulrike; Bredenoord, Albert J; Bussmann, Christian; Amil Dias, Jorge; Bove, Mogens; González-Cervera, Jesús; Larsson, Helen; Miehlke, Stephan; Papadopoulou, Alexandra; Rodríguez-Sánchez, Joaquín; Ravelli, Alberto; Ronkainen, Jukka; Santander, Cecilio; Schoepfer, Alain M; Storr, Martin A; Terreehorst, Ingrid; Straumann, Alex; Attwood, Stephen E

2017-04-01

Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE. General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted up to August 2015 and periodically updated. The working group consisted of gastroenterologists, allergists, pediatricians, otolaryngologists, pathologists, and epidemiologists. Systematic evidence-based reviews were performed based upon relevant clinical questions with respect to patient-important outcomes. The guidelines include updated concept of EoE, evaluated information on disease epidemiology, risk factors, associated conditions, and natural history of EoE in children and adults. Diagnostic conditions and criteria, the yield of diagnostic and disease monitoring procedures, and evidence-based statements and recommendation on the utility of the several treatment options for patients EoE are provided. Recommendations on how to choose and implement treatment and long-term management are provided based on expert opinion and best clinical practice. Evidence-based recommendations for EoE diagnosis, treatment modalities, and patients' follow up are proposed in the guideline.

Extensible Probabilistic Repository Technology (XPRT)

DTIC Science & Technology

2004-10-01

projects, such as, Centaurus , Evidence Data Base (EDB), etc., others were fabricated, such as INS and FED, while others contain data from the open...Google Web Report Unlimited SOAP API News BBC News Unlimited WEB RSS 1.0 Centaurus Person Demographics 204,402 people from 240 countries...objects of the domain ontology map to the various simulated data-sources. For example, the PersonDemographics are stored in the Centaurus database, while

Parental Perceptions of Charter Schools: Evidence from Two Nationally Representative Surveys of U.S. Parents. Program on Education Policy and Governance Working Papers Series. PEPG 17-01

ERIC Educational Resources Information Center

Barrows, Samuel; Cheng, Albert; Peterson, Paul E.; West, Martin R.

2017-01-01

This first report of charter school parents' perceptions based on nationally representative samples finds that charter parents, as compared with parents from district schools, are less likely to see serious problems at their children's school, report more extensive communications with the school, and are more satisfied with most aspects of the…

Numerical Experiments Investigating the Source of Explosion S-Waves

DTIC Science & Technology

2007-09-01

simulations in this study are based on the well-recorded 1993 Nonproliferation experiment (NPE) ( chemical kiloton). A regional 3-dimensional model...1-kiloton chemical explosion at the NTS. NPE details and research reports can be found in Denny and Stull (1994). Figure 3 shows the extensive...T., D. Helmberger, and G. Engen (1985). Evidence for tectonic release from underground nuclear explosions in long period S waves, Bull. Seismol. Soc

ePortfolios, Badges, and the Whole Digital Self: How Evidence-Based Learning Pedagogies and Technologies Can Support Integrative Learning and Identity Development

ERIC Educational Resources Information Center

Kehoe, Ashley; Goudzwaard, Michael

2015-01-01

Extensive research on student development and learning theory shows that the value of a college experience can be challenging to measure because its impact is not strictly academic, but holistic (e.g., Evans, Forney, & Guido-DiBrito, 1998). ePortfolio programs have been successfully implemented at many campuses as 1 way for students to…

A Proposal for a Dimensional Classification System Based on the Shared Features of the "DSM-IV" Anxiety and Mood Disorders: Implications for Assessment and Treatment

ERIC Educational Resources Information Center

Brown, Timothy A.; Barlow, David H.

2009-01-01

A wealth of evidence attests to the extensive current and lifetime diagnostic comorbidity of the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., "DSM-IV") anxiety and mood disorders. Research has shown that the considerable cross-sectional covariation of "DSM-IV" emotional disorders is accounted for by common higher order…

Evidence-Based Practice in Online Higher Education: An Exploratory Study of the Online Policies and Practices of United States Doctoral/Research-Extensive Universities

ERIC Educational Resources Information Center

Bruce, Peter A.

2010-01-01

The availability of online education in universities and colleges across the nation has significantly increased during the past decade. The increase has been due in part to recent federal policy changes authorizing access to financial aid for online higher education students. The dramatic growth in the number of students taking online courses and…

Wildlife-friendly farming benefits rare birds, bees and plants

PubMed Central

Pywell, Richard F.; Heard, Matthew S.; Bradbury, Richard B.; Hinsley, Shelley; Nowakowski, Marek; Walker, Kevin J.; Bullock, James M.

2012-01-01

Agricultural intensification is a leading cause of global biodiversity loss, especially for threatened and near-threatened species. One widely implemented response is ‘wildlife-friendly farming’, involving the close integration of conservation and extensive farming practices within agricultural landscapes. However, the putative benefits from this controversial policy are currently either unknown or thought unlikely to extend to rare and declining species. Here, we show that new, evidence-based approaches to habitat creation on intensively managed farmland in England can achieve large increases in plant, bee and bird species. In particular, we found that habitat enhancement methods designed to provide the requirements of sensitive target biota consistently increased the richness and abundance of both rare and common species, with 10-fold to greater than 100-fold more rare species per sample area than generalized conventional conservation measures. Furthermore, targeting landscapes of high species richness amplified beneficial effects on the least mobile taxa: plants and bees. Our results provide the first unequivocal support for a national wildlife-friendly farming policy and suggest that this approach should be implemented much more extensively to address global biodiversity loss. However, to be effective, these conservation measures must be evidence-based, and developed using sound knowledge of the ecological requirements of key species. PMID:22675140

A contemporary view of atrioventricular nodal physiology.

PubMed

Markowitz, Steven M; Lerman, Bruce B

2018-06-16

In delaying transmission of the cardiac impulse from the atria to the ventricles, the atrioventricular (AV) node serves a critical function in augmenting ventricular filling during diastole and limiting the ventricular response during atrial tachyarrhythmias. The complex structure of the nodal region, however, also provides the substrate for reentrant rhythms. Recent discoveries have elucidated the cellular basis and anatomical determinants of slow conduction in the node. Based on analysis of gap junction proteins, distinct structural components of the AV node have been defined, including the compact node, right and left inferior nodal extensions, the lower nodal bundle, and transitional tissue. Emerging evidence supports the role of the inferior nodal extensions in mediating slow pathway conduction. The most common form of reentry involving the node, slow-fast AV nodal reentrant tachycardia (AVNRT), utilizes the inferior nodal extensions for anterograde slow pathway conduction; the structures responsible for retrograde fast pathway activation in the superior septum are less well defined and likely heterogeneous. Atypical forms of AVNRT arise from circuits that activate at least one of the inferior extensions in the retrograde direction.

Hydrogen sensors based on electrophoretically deposited Pd nanoparticles onto InP

PubMed Central

2011-01-01

Electrophoretic deposition of palladium nanoparticles prepared by the reverse micelle technique onto InP substrates is addressed. We demonstrate that the substrate pre-deposition treatment and the deposition conditions can extensively influence the morphology of the deposited palladium nanoparticle films. Schottky diodes based on these films show notably high values of the barrier height and of the rectification ratio giving evidence of a small degree of the Fermi level pinning. Moreover, electrical characteristics of these diodes are exceptionally sensitive to the exposure to gas mixtures with small hydrogen content. PMID:21711912

"Keeping on track"-Hospital nurses' struggles with maintaining workflow while seeking to integrate evidence-based practice into their daily work: A grounded theory study.

PubMed

Renolen, Åste; Høye, Sevald; Hjälmhult, Esther; Danbolt, Lars Johan; Kirkevold, Marit

2018-01-01

Evidence-based practice is considered a foundation for the provision of quality care and one way to integrate scientific knowledge into clinical problem-solving. Despite the extensive amount of research that has been conducted to evaluate evidence-based practice implementation and research utilization, these practices have not been sufficiently incorporated into nursing practice. Thus, additional research regarding the challenges clinical nurses face when integrating evidence-based practice into their daily work and the manner in which these challenges are approached is needed. The aim of this study was to generate a theory about the general patterns of behaviour that are discovered when clinical nurses attempt to integrate evidence-based practice into their daily work. We used Glaser's classical grounded theory methodology to generate a substantive theory. The study was conducted in two different medical wards in a large Norwegian hospital. In one ward, nurses and nursing assistants were developing and implementing new evidence-based procedures, and in the other ward, evidence-based huddle boards for risk assessment were being implemented. A total of 54 registered nurses and 9 assistant nurses were observed during their patient care and daily activities. Of these individuals, thirteen registered nurses and five assistant nurses participated in focus groups. These participants were selected through theoretical sampling. Data were collected during 90h of observation and 4 focus groups conducted from 2014 to 2015. Each focus group session included four to five participants and lasted between 55 and 65min. Data collection and analysis were performed concurrently, and the data were analysed using the constant comparative method. "Keeping on track" emerged as an explanatory theory for the processes through which the nurses handled their main concern: the risk of losing the workflow. The following three strategies were used by nurses when attempting to integrate evidence-based practices into their daily work: "task juggling", "pausing for considering" and "struggling along with quality improvement". The "keeping on track" theory contributes to the body of knowledge regarding clinical nurses' experiences with evidence-based practice integration. The nurses endeavoured to minimize workflow interruptions to avoid decreasing the quality of patient care provided, and evidence-based practices were seen as a consideration that was outside of their ordinary work duties. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Evidence for α-Linolenic Acid and Cardiovascular Disease Benefits: Comparisons with Eicosapentaenoic Acid and Docosahexaenoic Acid12

PubMed Central

Fleming, Jennifer A.; Kris-Etherton, Penny M.

2014-01-01

Our understanding of the cardiovascular disease (CVD) benefits of α-linolenic acid (ALA, 18:3n–3) has advanced markedly during the past decade. It is now evident that ALA benefits CVD risk. The expansion of the ALA evidence base has occurred in parallel with ongoing research on eicosapentaenoic acid (EPA, 20:5n–3) and docosahexaenoic acid (DHA, 22:6n–3) and CVD. The available evidence enables comparisons to be made for ALA vs. EPA + DHA for CVD risk reduction. The epidemiologic evidence suggests comparable benefits of plant-based and marine-derived n–3 (omega-3) PUFAs. The clinical trial evidence for ALA is not as extensive; however, there have been CVD event benefits reported. Those that have been reported for EPA + DHA are stronger because only EPA + DHA differed between the treatment and control groups, whereas in the ALA studies there were diet differences beyond ALA between the treatment and control groups. Despite this, the evidence suggests many comparable CVD benefits of ALA vs. EPA + DHA. Thus, we believe that it is time to revisit what the contemporary dietary recommendation should be for ALA to decrease the risk of CVD. Our perspective is that increasing dietary ALA will decrease CVD risk; however, randomized controlled clinical trials are necessary to confirm this and to determine what the recommendation should be. With a stronger evidence base, the nutrition community will be better positioned to revise the dietary recommendation for ALA for CVD risk reduction. PMID:25398754

Sequence-based evidence for major histocompatibility complex-disassortative mating in a colonial seabird.

PubMed

Juola, Frans A; Dearborn, Donald C

2012-01-07

The major histocompatibility complex (MHC) is a polymorphic gene family associated with immune defence, and it can play a role in mate choice. Under the genetic compatibility hypothesis, females choose mates that differ genetically from their own MHC genotypes, avoiding inbreeding and/or enhancing the immunocompetence of their offspring. We tested this hypothesis of disassortative mating based on MHC genotypes in a population of great frigatebirds (Fregata minor) by sequencing the second exon of MHC class II B. Extensive haploid cloning yielded two to four alleles per individual, suggesting the amplification of two genes. MHC similarity between mates was not significantly different between pairs that did (n = 4) or did not (n = 42) exhibit extra-pair paternity. Comparing all 46 mated pairs to a distribution based on randomized re-pairings, we observed the following (i): no evidence for mate choice based on maximal or intermediate levels of MHC allele sharing (ii), significantly disassortative mating based on similarity of MHC amino acid sequences, and (iii) no evidence for mate choice based on microsatellite alleles, as measured by either allele sharing or similarity in allele size. This suggests that females choose mates that differ genetically from themselves at MHC loci, but not as an inbreeding-avoidance mechanism.

Prognostic significance of extranodal extension in head and neck squamous cell carcinoma cN0 patients with occult metastatic neck nodes.

PubMed

Lop, Joan; Rigó, Antoni; Codina, Alberto; de Juan, Julia; Quer, Miquel; León, Xavier

Extranodal extension in nodal metastases is an independent adverse prognostic factor in head and neck squamous cell carcinoma patients. However, few studies specifically address the subgroup of patients with no clinical evidence of nodal disease. We retrospectively analysed data from 348 head and neck squamous cell carcinoma patients without any previous treatment and lacking clinical or radiological evidence of neck node metastases during the initial workup, treated with an elective neck dissection between 1992-2014. The incidence of occult metastatic neck nodes with extranodal extension and the impact of extranodal extension in survival were evaluated. The proportion of patients with occult neck node metastases was 33%. Of these, 23.5% had at least one metastatic neck node with extranodal extension. There were significant differences in the disease-specific survival rate according to neck node status. Five-year disease-specific survival for patients without histopathological metastases was 90%, for patients with occult neck node metastases without extranodal extension it was 71.2%, and for patients with occult neck node metastases with extranodal extension it was 25.9% (P=.0001). The multivariate analysis revealed that the presence of occult node metastases with extranodal extension was the factor with strongest impact on survival. The inclusion of the extranodal extension as a criterion of histopathological evaluation in the 8th TNM classification edition improves the prognostic capacity compared to previous TNM editions. Appearance of metastatic neck nodes with extranodal extension is an adverse prognostic factor in head and neck squamous cell carcinoma patients without clinical evidence of regional disease during the initial workup of the tumour. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Gender Differences in Access to Extension Services and Agricultural Productivity

ERIC Educational Resources Information Center

Ragasa, Catherine; Berhane, Guush; Tadesse, Fanaye; Taffesse, Alemayehu Seyoum

2013-01-01

Purpose: This article contributes new empirical evidence and nuanced analysis on the gender difference in access to extension services and how this translates to observed differences in technology adoption and agricultural productivity. Approach: It looks at the case of Ethiopia, where substantial investments in the extension system have been…

12 CFR 202.7 - Rules concerning extensions of credit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 2 2010-01-01 2010-01-01 false Rules concerning extensions of credit. 202.7... EQUAL CREDIT OPPORTUNITY ACT (REGULATION B) § 202.7 Rules concerning extensions of credit. (a.... (c) Action concerning existing open-end accounts—(1) Limitations. In the absence of evidence of the...

Glenohumeral osteoarthritis: overview, therapy, and rehabilitation.

PubMed

Macías-Hernández, Salvador Israel; Morones-Alba, Juan Daniel; Miranda-Duarte, Antonio; Coronado-Zarco, Roberto; Soria-Bastida, María de Los Angeles; Nava-Bringas, Tania; Cruz-Medina, Eva; Olascoaga-Gómez, Andrea; Tallabs-Almazan, Laura Verónica; Palencia, Chanell

2017-08-01

Glenohumeral osteoarthritis (GHOA) is a common cause of pain and functional disability of the shoulder. Despite the limited evidence, there are several options for the treatment of this pathology. The aim of this article is to provide current information on the characteristics of the disease and the pathophysiology, evidence based on medical and surgical treatments with emphasis on the rehabilitation process. It was performed with an extensive literature review, mainly clinical practice guidelines, randomized controlled trials, reviews, focusing on the rehabilitation management. There are few clinical practice guidelines that address GHOA as a pathology with unique characteristics. Evidence based treatment recommendations are mostly supported by low-quality evidence and experts' opinions, with few high levels of evidence studies guiding treatment decisions. Despite the lack of good quality evidence, rehabilitation programs have proven to be efficient and reliable, and this revision provides information and recommendations in this field. Implication of Rehabilitation Glenohumeral osteoarthritis is a common cause of pain and functional disability of the shoulder There are few clinical practice guidelines that address Glenohumeral Osteoarthritis as a pathology with unique characteristics, and recommendations for rehabilitation and therapeutic exercise are poor The paper provides current information on the characteristics of the disease, its rehabilitation process, and could be of interest for rehabilitation professionals to direct their practices in this field.

A Knowledge Translation Programme to Increase the Utilization of Thoracic Spine Mobilization and Manipulation for Patients with Neck Pain.

PubMed

Karas, Steve; Westerheide, Angela; Daniel, Laura

2016-06-01

There is extensive evidence that mobilization and manipulation of the thoracic spine is associated with improved outcomes in patients with neck pain. However, these evidence-based techniques are not always utilized. Successful knowledge translation programmes are needed to move the best available evidence to clinical practice. The purpose of the present research was to evaluate the effects of a structured knowledge translation programme on the frequency of manual therapy techniques performed by physical therapists on patients with neck pain. Prior to our intervention, we assessed physical therapists' use of thoracic spine intervention for the treatment of neck pain and their knowledge of the evidence. We delivered a multimodal knowledge translation programme and then reassessed their use and knowledge of the interventions. The majority of our physical therapists increased the use of thoracic spine techniques for their patients with neck pain. The increase was greater in those who used the techniques infrequently. Overall knowledge of the evidence appeared unchanged. Knowledge translation programmes are essential in ensuring clinical use of evidence-based practice. Our programme results, although on a small scale and not statistically significant, showed a positive trend toward increased thoracic spine manual therapy use for neck pain. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Evidence that bisphenol A (BPA) can be accurately measured without contamination in human serum and urine, and that BPA causes numerous hazards from multiple routes of exposure

PubMed Central

vom Saal, Frederick S.; Welshons, Wade V.

2016-01-01

There is extensive evidence that bisphenol A (BPA) is related to a wide range of adverse health effects based on both human and experimental animal studies. However, a number of regulatory agencies have ignored all hazard findings. Reports of high levels of unconjugated (bioactive) serum BPA in dozens of human biomonitoring studies have also been rejected based on the prediction that the findings are due to assay contamination and that virtually all ingested BPA is rapidly converted to inactive metabolites. NIH and industry-sponsored round robin studies have demonstrated that serum BPA can be accurately assayed without contamination, while the FDA lab has acknowledged uncontrolled assay contamination. In reviewing the published BPA biomonitoring data, we find that assay contamination is, in fact, well controlled in most labs, and cannot be used as the basis for discounting evidence that significant and virtually continuous exposure to BPA must be occurring from multiple sources. PMID:25304273

What are the indications for using probiotics in children?

PubMed

Szajewska, Hania

2016-04-01

The health benefits of probiotics have been the subject of extensive research. Still, some questions are being repeatedly asked: should one use or not use probiotics? If yes, how and when should probiotics be used? The purpose of this review is to summarise current evidence on specific probiotics' efficacy and safety to help healthcare professionals make evidence-based decisions on the indications for using specific probiotic strains or combinations in children. To identify relevant data, searches of MEDLINE and the Cochrane Library databases were performed in July 2015 to locate randomised controlled trials or their meta-analyses published in the last five years. The MEDLINE database also was searched for evidence-based clinical practice guidelines, developed by scientific societies. Considering that probiotics have strain-specific effects, the main focus was on data on individual probiotic strains, not on probiotics in general. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Septal Cartilage/Ethmoid Bone Composite Graft: A New and Improved Method for the Correction Underdeveloped Nasal Septum in Patients with Short Noses.

PubMed

Lee, Soo Hyang; Koo, Mun Geun; Kang, Eun Taek

2017-04-01

Septal extension grafts are an effective means of extending nasal length in patients with a short nose. However, such grafts can be challenging in patients who only have small quantities of weak septal cartilage, such as some East Asian patients. We developed a rhinoplasty technique using ethmoid bone to create a cartilage-bone complex to overcome this issue, allowing adequate nasal lengthening. Sixty-four women with short noses and inadequate septal cartilage determined by preoperative computed tomography underwent septal extension grafting with a cartilage-bone complex between January 2009 and December 2014. Septal cartilage and ethmoid bone were harvested during open rhinoplasty and secured to the septal cartilage. Most patients were in their twenties or thirties. All patients underwent septal extension grafting using a cartilage-bone complex and dorsal augmentation with silicone implants. Short nasal length, decreased nasolabial angle and increased nostril show, were rectified. There was no recurrence during a mean follow-up period of 12.3 months, although one patient (1.5%) requested revision surgery. Septal extension grafting with a cartilage-bone complex can be used to correct a short nose, especially in Asians who have relatively small amounts of septal cartilage. The ethmoid bone augments the inadequate septum and provides structural support. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Lenalidomide in multiple myeloma: an evidence-based review of its role in therapy

PubMed Central

Richardson, Paul; Mitsiades, Constantine; Laubach, Jacob; Schlossman, Robert; Ghobrial, Irene; Hideshima, Teru; Munshi, Nikhil; Anderson, Kenneth

2010-01-01

Introduction: Multiple myeloma (MM) is a relatively common and incurable hematological malignancy. Currently, there is no single standard therapy, with choice of treatment dependent on individual patient factors. Lenalidomide is an immunomodulatory drug with potent antitumor, antiangiogenic, immunomodulatory, and proapoptotic activity in MM. Aims: To evaluate the evidence for the use of lenalidomide in its current indication in relapsed or refractory MM, and additionally its investigational use for the treatment of newly diagnosed MM. Evidence review: In patients with relapsed and refractory MM, adding lenalidomide to high-dose dexamethasone significantly improves response rates and time-to-progression, relative to high-dose dexamethasone alone. This translates into a significant extension of overall survival (with a median extension of 9.1 months in a pivotal phase III study). Outcome is independent of patient age, number of previous therapies, type of previous therapy (including thalidomide or autologous stem cell transplantation), renal impairment, and β2-microglobulin level. Evidence suggests that combining lenalidomide with low-dose dexamethasone improves outcomes in patients with newly diagnosed disease and is superior to lenalidomide combined with high-dose dexamethasone. Myelosuppression is the predominant toxicity observed, although some studies have shown high incidences of venous thromboembolism in the absence of prophylactic antithrombotic anticoagulation therapy. There is currently only limited evidence regarding the health economics of lenalidomide. Role in therapy: The encouraging results obtained with lenalidomide alone and in combination with dexamethasone in patients with relapsed or refractory MM have led to its adoption as a recommended therapy in patients who have received at least one prior treatment. Emerging evidence supports the ongoing investigation of lenalidomide in combination with low-dose dexamethasone, and in other combinations including bortezomib, for use both in relapsed, refractory, and newly diagnosed MM. PMID:20694078

Use of Theory in Behavior Change Interventions: An Analysis of Programs to Increase Physical Activity in Posttreatment Breast Cancer Survivors

PubMed Central

Bluethmann, Shirley M.; Bartholomew, L. Kay; Murphy, Caitlin C.; Vernon, Sally W.

2017-01-01

Objective Theory use may enhance effectiveness of behavioral interventions, yet critics question whether theory-based interventions have been sufficiently scrutinized. This study applied a framework to evaluate theory use in physical activity interventions for breast cancer survivors. The aims were to (1) evaluate theory application intensity and (2) assess the association between extensiveness of theory use and intervention effectiveness. Methods Studies were previously identified through a systematic search, including only randomized controlled trials published from 2005 to 2013, that addressed physical activity behavior change and studied survivors who were <5 years posttreatment. Eight theory items from Michie and Prestwich’s coding framework were selected to calculate theory intensity scores. Studies were classified into three subgroups based on extensiveness of theory use (Level 1 = sparse; Level 2 = moderate; and Level 3 = extensive). Results Fourteen randomized controlled trials met search criteria. Most trials used the transtheoretical model (n = 5) or social cognitive theory (n = 3). For extensiveness of theory use, 5 studies were classified as Level 1, 4 as Level 2, and 5 as Level 3. Studies in the extensive group (Level 3) had the largest overall effect size (g = 0.76). Effects were more modest in Level 1 and 2 groups with overall effect sizes of g = 0.28 and g = 0.36, respectively. Conclusions Theory use is often viewed as essential to behavior change, but theory application varies widely. In this study, there was some evidence to suggest that extensiveness of theory use enhanced intervention effectiveness. However, there is more to learn about how theory can improve interventions for breast cancer survivors. PMID:27226430

Faulting of gas-hydrate-bearing marine sediments - contribution to permeability

USGS Publications Warehouse

Dillon, William P.; Holbrook, W.S.; Drury, Rebecca; Gettrust, Joseph; Hutchinson, Deborah; Booth, James; Taylor, Michael

1997-01-01

Extensive faulting is observed in sediments containing high concentrations of methane hydrate off the southeastern coast of the United States. Faults that break the sea floor show evidence of both extension and shortening; mud diapirs are also present. The zone of recent faulting apparently extends from the ocean floor down to the base of gas-hydrate stability. We infer that the faulting resulted from excess pore pressure in gas trapped beneath the gas hydrate-beating layer and/or weakening and mobilization of sediments in the region just below the gas-hydrate stability zone. In addition to the zone of surface faults, we identified two buried zones of faulting, that may have similar origins. Subsurface faulted zones appear to act as gas traps.

Commerce, Research and Education: Contributions and Challenges of Marine Extension Work in NOAA Sea Grant Program-Puerto Rico, Michigan and National office

NASA Astrophysics Data System (ADS)

Aleman Diaz, A.

2006-12-01

The National Sea Grant program represents NOAA's nationwide university-based program in support of coastal resource use and conservation. This program is composed of 30 university-based programs that work with local coastal communities. This study focuses on a historical and multi-sited ethnographic approach that analyzes two Sea Grant Programs and their connection to the overarching NOAA national goals from 1980- 2000.The project aims to offer insight on how the extension agent position facilitates the resolution of coastal and marine management and tourism issues. The extension agents are staff who have an extensive knowledge of available coastal resources and have the role of translating this information to coastal stakeholders. Additionally, these agents assess the needs of coastal communities and report back to the program making their role into a position that can effectively alter and/or contribute to institutional and environmental management programs at broader, cross-country and global levels. The extension programs in Michigan and Puerto Rico were examined to understand how local programs respond to cultural and regional processes shaping marine extension and the management of issues faced by coastal stakeholders. A total of 36 semi- structured in-depth interviews were completed at each site, to address the following questions: (1) How do extension agents view their role at the Puerto Rico and Michigan offices and in the Sea Grant program? How do they view the conditions of their work? (2) How do their views compare to the accomplishments by each Sea Grant administration and internal inquiries? How do their views reveal conditions documented in Puerto Rico and Michigan (e.g., social, cultural, political, economic, etc)? (3) What kind of strategies do agents develop for the management of specific coastal and tourism related projects? (4) How do the Puerto Rico and Michigan offices coordinate their work, and collaborate with other "college" programs and with the National office? Although differences based on organizational structure were evident, there were similarities regarding the marine extension work history, practices, and challenges among these local programs. Preliminary findings suggests that current challenges for Sea Grant marine extension include maintenance of non- advocacy and mediation roles among coastal stakeholders, their positioning relative to research especially conducting and delivering of science to public, and development of their multi-faceted skills sets essential to extension. Simultaneously, the Sea Grant program and marine extension agents provide comprehensive ways for integrated resource management like avenues for dialogue and information-technology transfer with bottom up approaches.

Midwifery in Iceland: From vocational training to university education.

PubMed

Olafsdottir, Olof A; Kristjansdottir, Hildur; Halfdansdottir, Berglind; Gottfredsdottir, Helga

2018-07-01

Midwifery education is a foundation for health professionals' competence in providing quality healthcare for the benefit of women, their families and society. This paper describes midwifery and the development of midwifery education in Iceland. It examines policy and extensive reforms, from hospital-based vocational training in midwifery to an academic university education, and the impact on the scope of midwifery practice in Iceland. The university-based programme, with its emphasis on autonomy of the midwife, seems to have affected the context of home birth and strengthened midwives' role in primary healthcare. Education reform with a focus on evidence-based practice and midwife-led continuity of care has had limited influence within the hospital system, where the structure of care is fragmented and childbirth is under threat of increasing interventions. Research is needed on the role of education in supporting evidence-based practice, normal childbirth and reproductive health in the Icelandic context. Copyright © 2018 Elsevier Ltd. All rights reserved.

Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community.

PubMed

McCambridge, Jim; Mialon, Melissa

2018-06-13

Alcohol companies have recently invested large sums of money in answering research questions to which they have clear vested interests in the outcomes. There have been extensive concerns about corporate influence on public health sciences, following the experience with the tobacco industry. This systematic review aims to investigate the perspectives of researchers on the activities of alcohol industry actors in relation to science, in order to guide future research. All data published in peer-reviewed journals (including commentaries, opinion pieces, editorials and letters as well as research reports) were eligible for inclusion. This analysis focuses on the manifest rather than latent content of the articulated views, and accordingly adopts a thematic analysis using an inductive approach to the generation of themes. There are serious concerns identified in three main areas, principally defined by where the impacts of industry scientific activities occur; on evidence informed policy making (instrumental uses of research by industry actors), on the content of the scientific evidence base itself (industry funding as a source of bias); and on the processes of undertaking research (transgressions of basic scientific norms). There are also opposing views which provide a useful critique. The evidence-base on the validity of all concerns has been slow to develop. The concerns are extensive, longstanding and unresolved and high quality investigations are needed. This study informs the detailed content of the research needed to address the concerns identified here. © 2018 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

An evidence-based review of pregabalin for the treatment of fibromyalgia.

PubMed

Arnold, Lesley M; Choy, Ernest; Clauw, Daniel J; Oka, Hiroshi; Whalen, Ed; Semel, David; Pauer, Lynne; Knapp, Lloyd

2018-04-16

Pregabalin, an α2-δ agonist, is approved for the treatment of fibromyalgia (FM) in the United States, Japan, and 37 other countries. The purpose of this article was to provide an in-depth, evidence-based summary of pregabalin for FM as demonstrated in randomized, placebo-controlled clinical studies, including open-label extensions, meta-analyses, combination studies and post-hoc analyses of clinical study data. PubMed was searched using the term "pregabalin AND fibromyalgia" and the Cochrane Library with the term "pregabalin". Both searches were conducted on 2 March 2017 with no other date limits set. Eleven randomized, double-blind, placebo-controlled clinical studies were identified including parallel group, two-way crossover and randomized withdrawal designs. One was a neuroimaging study. Five open-label extensions were also identified. Evidence of efficacy was demonstrated across the studies identified with significant and clinically relevant improvements in pain, sleep quality and patient status. The safety and tolerability profile of pregabalin is consistent across all the studies identified, including in adolescents, with dizziness and somnolence the most common adverse events reported. These efficacy and safety data are supported by meta-analyses (13 studies). Pregabalin in combination with other pharmacotherapies (7 studies) is also efficacious. Post-hoc analyses have demonstrated the onset of pregabalin efficacy as early as 1-2 days after starting treatment, examined the effect of pregabalin on other aspects of sleep beyond quality, and shown it is effective irrespective of the presence of a wide variety of patient demographic and clinical characteristics. Pregabalin is a treatment option for FM; its clinical utility has been comprehensively demonstrated.

Analysis of evidence within the AUA's clinical practice guidelines.

PubMed

Antoine, Samuel G; Small, Alexander C; McKiernan, James M; Shah, Ojas

2018-02-01

Surgical subspecialty societies release clinical practice guidelines (CPGs) to provide topic-specific recommendations to healthcare providers. We hypothesize that there may be significant differences in statement strength and evidence quality both within the American Urological Association (AUA) guidelines and compared to those published by the American Academy of Orthopedic Surgeons (AAOS) and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). CPGs issued through 2017 were extracted from the AUAnet.org. Statements were characterized by evidence basis, strength, and evidence quality. CPGs were compared among urologic subspecialties and to those from the AAOS and AAO-HNS. Analysis used Fisher's exact tests and Student's t-tests with significance p < 0.05. A total of 25 AUA CPGs (672 statements) were reviewed and 34.6% were non-evidence based with the highest proportions in pediatrics (47.5%) and sexual medicine (46.5%). The AUA has published over twice as many statements as the AAOS and quadruple that of the AAO-HNS. A smaller proportion of the AUA statements were evidence-based (65.4%) compared to the AAOS (80.5%, p < 0.001) and AAO-HNS (99.8%, p < 0.001), and fewer used "high" quality evidence (AUA 7.2% versus AAOS 21.2%, p < 0.001; versus AAO-HNS 16.1%, p < 0.001). The AUA has published broad CPGs that far exceed those from the AAOS and AAO-HNS. The AUA has utilized extensive resources to provide guidance to help standardize care among urologists. The AAOS and AAO-HNS may not provide guidelines when evidence is limited. With the continued increase of high quality clinical trials, the AUA will be able to continue improving its robust set of evidence-based CPGs.

Safety-relevant hydrogeological properties of the claystone barrier of a Swiss radioactive waste repository: An evaluation using multiple lines of evidence

NASA Astrophysics Data System (ADS)

Gautschi, Andreas

2017-09-01

In Switzerland, the Opalinus Clay - a Jurassic (Aalenian) claystone formation - has been proposed as the first-priority host rock for a deep geological repository for both low- and intermediate-level and high-level radioactive wastes. An extensive site and host rock investigation programme has been carried out during the past 30 years in Northern Switzerland, comprising extensive 2D and 3D seismic surveys, a series of deep boreholes within and around potential geological siting regions, experiments in the international Mont Terri Rock Laboratory, compilations of data from Opalinus Clay in railway and motorway tunnels and comparisons with similar rocks. The hydrogeological properties of the Opalinus Clay that are relevant from the viewpoint of long-term safety are described and illustrated. The main conclusions are supported by multiple lines of evidence, demonstrating consistency of conclusions based on hydraulic properties, porewater chemistry, distribution of natural tracers across the Opalinus Clay as well as small- and large-scale diffusion models and the derived conceptual understanding of solute transport.

[A rare case of infant poisoning due to accidental administration of 1,2,3-triketohydrinden hydrate (ninhydrin)].

PubMed

Polak, Piotr; Sołtyszewski, Ireneusz; Niemcunowicz-Janica, Anna; Siwińska-Ziółkowska, Agnieszka; Widecka-Deptuch, Emilia; Lukasik, Marcin; Janica, Jerzy

2007-01-01

The paper presents a case of medical malpractice during the test for phenylketonuria. The authors analyzed all documents collected in the course of the investigation of infant poisoning due to accidental administration of ninhydrin. The medical assessment was based on an extensive review of the case history, as well as on spectroscopy (FT-IR), chromatography and chemical analysis findings that allowed for confirming the presence of the toxic substance in the evidence material collected during the initial investigation. The obtained results confirmed the presence of ninhydrin in the tea cup and in the teaspoon, which were used to prepare the diagnostic medium. No ninhydrin was found in other investigated materials. The employment of routine research methods, including GC-MS, FT-IR and UV-VIS, allowed for detection and identification of the pure chemical form of ninhydrin, as well as its color complex with amino acids. The detailed case analysis, as well as the variability of extensive evidence material collected during the investigation allowed for determining the identity of persons responsible for accidental administration of the poisoning substance to the infant.

Material souls and imagination in late Aristotelian embryology.

PubMed

Blank, Andreas

2010-04-01

This article explores some continuities between Late Aristotelian and Cartesian embryology. In particular, it argues that there is an interesting consilience between some accounts of the role of imagination in trait acquisition in Late Aristotelian and Cartesian embryology. Evidence for this thesis is presented using the extensive biological writings of the Padua-based philosopher and physician, Fortunio Liceti (1577-1657). Like the Cartesian physiologists, Liceti believed that animal souls are material beings and that acts of imagination result in material images that can be transmitted by means of medical spirits to the embryo. Moreover, while the Cartesian embryologists accepted such a view in a quite speculative way, one finds penetrating criticism of imagination theories of trait acquisition in the Late Aristotelian tradition. Evidence for this thesis is presented using the no less extensive biological writings of Liceti's contemporary, Emilio Parisano (1567-1643). In conclusion, the Late Aristotelian tradition itself provides the theoretical tools for excising immaterial formative forces from embryology and at the same time evinces a much more acute sense for the problems inherent in imagination theories of trait acquisition than the Cartesian tradition.

Homeostatic theory of obesity

PubMed Central

2015-01-01

Health is regulated by homeostasis, a property of all living things. Homeostasis maintains equilibrium at set-points using feedback loops for optimum functioning of the organism. Imbalances in homeostasis causing overweight and obesity are evident in more than 1 billion people. In a new theory, homeostatic obesity imbalance is attributed to a hypothesized ‘Circle of Discontent’, a system of feedback loops linking weight gain, body dissatisfaction, negative affect and over-consumption. The Circle of Discontent theory is consistent with an extensive evidence base. A four-armed strategy to halt the obesity epidemic consists of (1) putting a stop to victim-blaming, stigma and discrimination; (2) devalorizing the thin-ideal; (3) reducing consumption of energy-dense, low-nutrient foods and drinks; and (4) improving access to plant-based diets. If fully implemented, interventions designed to restore homeostasis have the potential to halt the obesity epidemic. PMID:28070357

Definition of drug-resistant epilepsy: is it evidence based?

PubMed

Wiebe, Samuel

2013-05-01

Clinical case definitions are the cornerstone of clinical communication and of clinical and epidemiologic research. The ramifications of establishing a case definition are extensive, including potentially large changes in epidemiologic estimates of frequency, and decisions for clinical management. Yet, defining a condition entails numerous challenges such as defining the scope and purpose, incorporating the strongest evidence base with clinical expertise, accounting for patients' values, and considering impact on care. The clinical case definition of drug-resistant epilepsy, in addition, must address what constitutes an adequate intervention for an individual drug, what are the outcomes of relevance, what period of observation is sufficient to determine success or failure, how many medications should be tried, whether seizure frequency should play a role, and what is the role of side effects and tolerability. On the other hand, the principles of evidence-based medicine (EBM) aim at providing a systematic approach to incorporating the best available evidence into the process of clinical decision for individual patients. The case definition of drug-resistant epilepsy proposed by the the International League Against Epilepsy (ILAE) in 2009 is evaluated in terms of the principles of EBM as well as the stated goals of the authors of the definition. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Guidelines for Inclusion of Patient-Reported Outcomes in Clinical Trial Protocols: The SPIRIT-PRO Extension.

PubMed

Calvert, Melanie; Kyte, Derek; Mercieca-Bebber, Rebecca; Slade, Anita; Chan, An-Wen; King, Madeleine T; Hunn, Amanda; Bottomley, Andrew; Regnault, Antoine; Chan, An-Wen; Ells, Carolyn; O'Connor, Daniel; Revicki, Dennis; Patrick, Donald; Altman, Doug; Basch, Ethan; Velikova, Galina; Price, Gary; Draper, Heather; Blazeby, Jane; Scott, Jane; Coast, Joanna; Norquist, Josephine; Brown, Julia; Haywood, Kirstie; Johnson, Laura Lee; Campbell, Lisa; Frank, Lori; von Hildebrand, Maria; Brundage, Michael; Palmer, Michael; Kluetz, Paul; Stephens, Richard; Golub, Robert M; Mitchell, Sandra; Groves, Trish

2018-02-06

Patient-reported outcome (PRO) data from clinical trials can provide valuable evidence to inform shared decision making, labeling claims, clinical guidelines, and health policy; however, the PRO content of clinical trial protocols is often suboptimal. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was published in 2013 and aims to improve the completeness of trial protocols by providing evidence-based recommendations for the minimum set of items to be addressed, but it does not provide PRO-specific guidance. To develop international, consensus-based, PRO-specific protocol guidance (the SPIRIT-PRO Extension). The SPIRIT-PRO Extension was developed following the Enhancing Quality and Transparency of Health Research (EQUATOR) Network's methodological framework for guideline development. This included (1) a systematic review of existing PRO-specific protocol guidance to generate a list of potential PRO-specific protocol items (published in 2014); (2) refinements to the list and removal of duplicate items by the International Society for Quality of Life Research (ISOQOL) Protocol Checklist Taskforce; (3) an international stakeholder survey of clinical trial research personnel, PRO methodologists, health economists, psychometricians, patient advocates, funders, industry representatives, journal editors, policy makers, ethicists, and researchers responsible for evidence synthesis (distributed by 38 international partner organizations in October 2016); (4) an international Delphi exercise (n = 137 invited; October 2016 to February 2017); and (5) consensus meeting (n = 30 invited; May 2017). Prior to voting, consensus meeting participants were informed of the results of the Delphi exercise and given data from structured reviews evaluating the PRO protocol content of 3 defined samples of trial protocols. The systematic review identified 162 PRO-specific protocol recommendations from 54 sources. The ISOQOL Taskforce (n = 21) reduced this to 56 items, which were considered by 138 international stakeholder survey participants and 99 Delphi panelists. The final wording of the SPIRIT-PRO Extension was agreed on at a consensus meeting (n = 29 participants) and reviewed by external group of experts during a consultation period. Eleven extensions and 5 elaborations to the SPIRIT 2013 checklist were recommended for inclusion in clinical trial protocols in which PROs are a primary or key secondary outcome. Extension items focused on PRO-specific issues relating to the trial rationale, objectives, eligibility criteria, concepts used to evaluate the intervention, time points for assessment, PRO instrument selection and measurement properties, data collection plan, translation to other languages, proxy completion, strategies to minimize missing data, and whether PRO data will be monitored during the study to inform clinical care. The SPIRIT-PRO guidelines provide recommendations for items that should be addressed and included in clinical trial protocols in which PROs are a primary or key secondary outcome. Improved design of clinical trials including PROs could help ensure high-quality data that may inform patient-centered care.

Building the capacity of Extension educators to address climate change and agricultural sustainability

NASA Astrophysics Data System (ADS)

Pathak, T. B.; Doll, J. E.

2016-12-01

It is evident that changes in climate will adversely impact various sectors including agriculture and natural resources worldwide. Increased temperatures, longer than normal growing seasons, more frequent extreme weather events, decreased winter snowpack, earlier snowmelt, and vulnerability to pest are some of the examples of changes and impacts documented in the literature. According to the IPCC 2007, mainstreaming` climate change issues into decision-making is an important aspect for sustainability. Due to the lack of locally and regionally focused educational programs, it becomes difficult for people to translate the science into meaningful actions. One of the strengths of the Cooperative Extension system is that it is one of the most trusted sources of science-based information that is locally relevant. In order to utilize strong network of Cooperative Extension system, we implemented a project to provide regionally tailored climate change and sustainable agriculture professional development for Cooperative Extension and Natural Resources Conservation Services (NRCS) educators in 12 states in north central US. We conducted these activities: 1) creation and dissemination of a Climate Change and Sustainable Agriculture Resource Handbook and a curriculum and 2) two climate change and sustainable agriculture workshops. In general, this project resulted in improved ability of Cooperative Extension academics to respond to climate change questions with science-based information. Several workshop attendees also integrated information provided to them through resource handbook and curriculum into their existing programming. In the long-term, we hope these programs will result in educators and farmers making informed choices and recommendations that lead to sustainable agriculture in the face of climate change.

Bridging the implementation gap between knowledge and action for health.

PubMed Central

Haines, Andy; Kuruvilla, Shyama; Borchert, Matthias

2004-01-01

There is widespread evidence of failure to implement health interventions that have been demonstrated to be cost-effective by high-quality research; this failure affects both high-income and low-income countries. Low-income countries face additional challenges to using research evidence including: the weakness of their health systems, the lack of professional regulation and a lack of access to evidence. There is a need to strengthen institutions and mechanisms that can more systematically promote interactions between researchers, policy-makers and other stakeholders who can influence the uptake of research findings. The concept of public engagement with health research requires a public that is both informed and active. Even when systematic reviews are available further work is needed to translate their findings into guidelines or messages that are understandable to patients and health professionals. Many of the commonly used approaches for keeping health professionals' knowledge up-to-date appear to have small or inconsistent effects. The evidence-base is more extensive for interventions directed towards professionals, such as education, reminders or feedback, than for those directed at organizations or patients. The effect of interventions varies according to the setting and the behaviour that is targeted. Case studies in low-income settings suggest that some strategies can result in increased coverage of evidence-based interventions, but there is a lack of evidence from systematic reviews of rigorous research. Given the potential for near-term improvements in health, finding more effective ways of promoting the uptake of evidence-based interventions should be a priority for researchers, practitioners and policy-makers. PMID:15643791

Measurement properties of the upright motor control test for adults with stroke: a systematic review.

PubMed

Gorgon, Edward James R; Lazaro, Rolando T

2016-01-01

The Upright Motor Control Test (UMCT) has been used in clinical practice and research to assess functional strength of the hemiparetic lower limb in adults with stroke. It is unclear if evidence is sufficient to warrant its use. The purpose of this systematic review was to synthesize available evidence on the measurement properties of the UMCT for stroke rehabilitation. Electronic databases that indexed biomedical literature were systematically searched from inception until October 2015 (week 4): Embase, PubMed, Web of Science, CINAHL, PEDro, Cochrane Library, Scopus, ScienceDirect, SPORTDiscus, LILACS, DOAJ, and Google Scholar. All studies that had used the UMCT in the time period covered underwent hand searching for any additional study. Observational studies involving adults with stroke that explored any measurement property of the UMCT were included. The COnsensus-based Standards for the selection of health Measurement INstruments was used to assess the methodological quality of included studies. The CanChild Outcome Measures Rating Form was used for extracting data on measurement properties and clinical utility. The search yielded three methodologic studies that addressed criterion-related validity and contruct validity. Two studies of fair methodological quality demonstrated moderate-level evidence that Knee Extension and Knee Flexion subtest scores were predictive of community-level and household-level ambulation. One study of fair methodological quality provided limited-level evidence for the correlation of Knee Extension subtest scores with a laboratory measure of ground reaction forces. No published studies formally assessed reliability, responsiveness, or clinical utility. Limited information on responsiveness and clinical utility dimensions could be inferred from the included studies. The UMCT is a practical assessment tool for voluntary control or functional strength of the hemiparetic lower limb in standing in adults with stroke. Although different levels of evidence suggest that the Knee Extension and Knee Flexion subtests may possess criterion and construct validity, the lack of published literature examining content validity, reliability, and responsiveness raises questions regarding the use of the UMCT in routine clinical practice. These key findings highlight the need to further investigate the UMCT's measurement properties toward enhancing its standardization.

Reconsidering community-based health promotion: promise, performance, and potential.

PubMed

Merzel, Cheryl; D'Afflitti, Joanna

2003-04-01

Contemporary public health emphasizes a community-based approach to health promotion and disease prevention. The evidence from the past 20 years indicates, however, that many community-based programs have had only modest impact, with the notable exception of a number of HIV prevention programs. To better understand the reasons for these outcomes, we conducted a systematic literature review of 32 community-based prevention programs. Reasons for poor performance include methodological challenges to study design and evaluation, concurrent secular trends, smaller-than-expected effect sizes, limitations of the interventions, and limitations of theories used. The effectiveness of HIV programs appears to be related in part to extensive formative research and an emphasis on changing social norms.

CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments: A 2017 Update and a CONSORT Extension for Nonpharmacologic Trial Abstracts.

PubMed

Boutron, Isabelle; Altman, Douglas G; Moher, David; Schulz, Kenneth F; Ravaud, Philippe

2017-07-04

Incomplete and inadequate reporting is an avoidable waste that reduces the usefulness of research. The CONSORT (Consolidated Standards of Reporting Trials) Statement is an evidence-based reporting guideline that aims to improve research transparency and reduce waste. In 2008, the CONSORT Group developed an extension to the original statement that addressed methodological issues specific to trials of nonpharmacologic treatments (NPTs), such as surgery, rehabilitation, or psychotherapy. This article describes an update of that extension and presents an extension for reporting abstracts of NPT trials. To develop these materials, the authors reviewed pertinent literature published up to July 2016; surveyed authors of NPT trials; and conducted a consensus meeting with editors, trialists, and methodologists. Changes to the CONSORT Statement extension for NPT trials include wording modifications to improve readers' understanding and the addition of 3 new items. These items address whether and how adherence of participants to interventions is assessed or enhanced, description of attempts to limit bias if blinding is not possible, and specification of the delay between randomization and initiation of the intervention. The CONSORT extension for abstracts of NPT trials includes 2 new items that were not specified in the original CONSORT Statement for abstracts. The first addresses reporting of eligibility criteria for centers where the intervention is performed and for care providers. The second addresses reporting of important changes to the intervention versus what was planned. Both the updated CONSORT extension for NPT trials and the CONSORT extension for NPT trial abstracts should help authors, editors, and peer reviewers improve the transparency of NPT trial reports.

Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults

PubMed Central

Molina-Infante, Javier; Arias, Ángel; von Arnim, Ulrike; Bredenoord, Albert J; Bussmann, Christian; Amil Dias, Jorge; Bove, Mogens; González-Cervera, Jesús; Larsson, Helen; Miehlke, Stephan; Papadopoulou, Alexandra; Rodríguez-Sánchez, Joaquín; Ravelli, Alberto; Ronkainen, Jukka; Santander, Cecilio; Schoepfer, Alain M; Storr, Martin A; Terreehorst, Ingrid; Straumann, Alex; Attwood, Stephen E

2017-01-01

Introduction Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE. Methods General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted up to August 2015 and periodically updated. The working group consisted of gastroenterologists, allergists, pediatricians, otolaryngologists, pathologists, and epidemiologists. Systematic evidence-based reviews were performed based upon relevant clinical questions with respect to patient-important outcomes. Results The guidelines include updated concept of EoE, evaluated information on disease epidemiology, risk factors, associated conditions, and natural history of EoE in children and adults. Diagnostic conditions and criteria, the yield of diagnostic and disease monitoring procedures, and evidence-based statements and recommendation on the utility of the several treatment options for patients EoE are provided. Recommendations on how to choose and implement treatment and long-term management are provided based on expert opinion and best clinical practice. Conclusion Evidence-based recommendations for EoE diagnosis, treatment modalities, and patients’ follow up are proposed in the guideline. PMID:28507746

The Wolfpack Leadership Academy: Providing Leadership Development for the Newest Members of the Extension Family

ERIC Educational Resources Information Center

Bruce, Jacklyn A.; Kistler, Mark

2011-01-01

The need for leadership is evident in today's society. More and more, educational responsibilities are being turned over to local governments and community organizations like Extension. This increased responsibility equates to a need for all Extension educators to assume positions of leadership, if indeed they are to succeed in this increasingly…

Factors Affecting Performance of Agricultural Extension: Evidence from Democratic Republic of Congo

ERIC Educational Resources Information Center

Ragasa, Catherine; Ulimwengu, John; Randriamamonjy, Josee; Badibanga, Thaddee

2016-01-01

Purpose: As part of the institutional reforms and agricultural restructuring in the Democratic Republic of Congo (DRC), this paper provides an assessment of the performance of the agricultural extension system as well as factors explaining it. Method: This paper involves key informants' interviews and surveys of 107 extension organizations and 162…

Using Science as Evidence in Public Policy

ERIC Educational Resources Information Center

Prewitt, Kenneth, Ed.; Schwandt, Thomas A., Ed.; Straf, Miron L., Ed.

2012-01-01

"Using Science as Evidence in Public Policy" encourages scientists to think differently about the use of scientific evidence in policy making. This report investigates why scientific evidence is important to policy making and argues that an extensive body of research on knowledge utilization has not led to any widely accepted explanation…

Evidence for extensive methane venting on the southeastern U.S. Atlantic margin

USGS Publications Warehouse

Brothers, L.L.; Van Dover, C.L.; German, C.R.; Kaiser, C.L.; Yoerger, D.R.; Ruppel, C.D.; Lobecker, E.; Skarke, A.D.; Wagner, J.K.S.

2013-01-01

We present the first evidence for widespread seabed methane venting along the southeastern United States Atlantic margin beyond the well-known Blake Ridge diapir seep. Recent ship- and autonomous underwater vehicle (AUV)–collected data resolve multiple water-column anomalies (>1000 m height) and extensive new chemosynthetic seep communities at the Blake Ridge and Cape Fear diapirs. These results indicate that multiple, highly localized fluid conduits punctuate the areally extensive Blake Ridge gas hydrate province, and enable the delivery of significant amounts of methane to the water column. Thus, there appears to be an abundance of seabed fluid flux not previously ascribed to the Atlantic margin of the United States.

Forensic Assertive Community Treatment: A Review of the Literature.

PubMed

Marquant, Thomas; Sabbe, Bernard; Van Nuffel, Meike; Goethals, Kris

2016-11-01

An extensive body of literature provides evidence supporting the effectiveness of assertive community treatment (ACT) with regard to non-forensic outcome measures, such as number of hospital admissions and length of stay. However, research findings on the effectiveness of ACT for forensic outcome measures, such as rearrests or detentions, is much less clear. The present review, therefore, focuses on the application of ACT in forensic populations, combining key elements of ACT with elements of forensic rehabilitation models. Specifically, a review of the literature was conducted using a systematic methodology in an attempt to combine evidence-based elements of 40 years of research on regular ACT with elements of forensic rehabilitation models. Results reveal limited yet promising evidence in support of the effectiveness of forensic ACT for forensic outcome measures. Implications for future research and clinical practice are discussed.

Opportunities to Meet Challenges in Rural Prevention Research

PubMed Central

Spoth, Richard

2008-01-01

Various rural prevention research challenges have been articulated through a series of sessions convened since the mid 1990s by the National Institutes of Health, particularly the National Institute on Drug Abuse. Salient in this articulation was the need for effective collaboration among rural practitioners and scientists, with special consideration of accommodating the diversity of rural areas and surmounting barriers to implementation of evidence-based interventions. This paper summarizes the range of challenges in rural prevention research and describes an evolving community-university partnership model addressing them. The model entails involvement of public school staff and other rural community stakeholders, linked with scientists by Land Grant University-based Extension system staff. Examples of findings from over 16 years of partnership-based intervention research projects include those on engagement of rural residents, quality implementation of evidence-based interventions, and long-term community-level outcomes, as well as factors in effectiveness of the partnerships. Findings suggest a future focus on building capacity for practitioner-scientist collaboration and developing a network for more widespread implementation of the partnership model in a manner informed by lessons learned from partnership-based research to date. PMID:18237324

Contingency Management Approaches for Adolescent Substance Use Disorders

PubMed Central

Stanger, Catherine; Budney, Alan J.

2010-01-01

The addition of contingency management (CM) to the menu of effective treatments for adolescent substance abuse has generated excitement in the research and treatment communities. CM interventions are based on extensive basic science and clinical research evidence demonstrating that drug use is sensitive to systematically applied consequences. This article provides (a) a review of basic CM principles, (b) implementation guidelines, (c) a review of the clinical CM research targeting adolescent substance abuse, and (d) a discussion of implementation successes and challenges. Although the research base for CM with adolescents is in its infancy, there are multiple reasons for high expectations. PMID:20682220

Non-equilibrium scale invariance and shortcuts to adiabaticity in a one-dimensional Bose gas

PubMed Central

Rohringer, W.; Fischer, D.; Steiner, F.; Mazets, I. E.; Schmiedmayer, J.; Trupke, M.

2015-01-01

We present experimental evidence for scale invariant behaviour of the excitation spectrum in phase-fluctuating quasi-1d Bose gases after a rapid change of the external trapping potential. Probing density correlations in free expansion, we find that the temperature of an initial thermal state scales with the spatial extension of the cloud as predicted by a model based on adiabatic rescaling of initial eigenmodes with conserved quasiparticle occupation numbers. Based on this result, we demonstrate that shortcuts to adiabaticity for the rapid expansion or compression of the gas do not induce additional heating. PMID:25867640

Ayurveda and Traditional Chinese Medicine: A Comparative Overview

PubMed Central

2005-01-01

Ayurveda, the traditional Indian medicine (TIM) and traditional Chinese medicine (TCM) remain the most ancient yet living traditions. There has been increased global interest in traditional medicine. Efforts to monitor and regulate herbal drugs and traditional medicine are underway. China has been successful in promoting its therapies with more research and science-based approach, while Ayurveda still needs more extensive scientific research and evidence base. This review gives an overview of basic principles and commonalities of TIM and TCM and discusses key determinants of success, which these great traditions need to address to compete in global markets. PMID:16322803

Multi-day activity scheduling reactions to planned activities and future events in a dynamic model of activity-travel behavior

NASA Astrophysics Data System (ADS)

Nijland, Linda; Arentze, Theo; Timmermans, Harry

2014-01-01

Modeling multi-day planning has received scarce attention in activity-based transport demand modeling so far. However, new dynamic activity-based approaches are being developed at the current moment. The frequency and inflexibility of planned activities and events in activity schedules of individuals indicate the importance of incorporating those pre-planned activities in the new generation of dynamic travel demand models. Elaborating and combining previous work on event-driven activity generation, the aim of this paper is to develop and illustrate an extension of a need-based model of activity generation that takes into account possible influences of pre-planned activities and events. This paper describes the theory and shows the results of simulations of the extension. The simulation was conducted for six different activities, and the parameter values used were consistent with an earlier estimation study. The results show that the model works well and that the influences of the parameters are consistent, logical, and have clear interpretations. These findings offer further evidence of face and construct validity to the suggested modeling approach.

Hippocampome.org: a knowledge base of neuron types in the rodent hippocampus

PubMed Central

Wheeler, Diek W; White, Charise M; Rees, Christopher L; Komendantov, Alexander O; Hamilton, David J; Ascoli, Giorgio A

2015-01-01

Hippocampome.org is a comprehensive knowledge base of neuron types in the rodent hippocampal formation (dentate gyrus, CA3, CA2, CA1, subiculum, and entorhinal cortex). Although the hippocampal literature is remarkably information-rich, neuron properties are often reported with incompletely defined and notoriously inconsistent terminology, creating a formidable challenge for data integration. Our extensive literature mining and data reconciliation identified 122 neuron types based on neurotransmitter, axonal and dendritic patterns, synaptic specificity, electrophysiology, and molecular biomarkers. All ∼3700 annotated properties are individually supported by specific evidence (∼14,000 pieces) in peer-reviewed publications. Systematic analysis of this unprecedented amount of machine-readable information reveals novel correlations among neuron types and properties, the potential connectivity of the full hippocampal circuitry, and outstanding knowledge gaps. User-friendly browsing and online querying of Hippocampome.org may aid design and interpretation of both experiments and simulations. This powerful, simple, and extensible neuron classification endeavor is unique in its detail, utility, and completeness. DOI: http://dx.doi.org/10.7554/eLife.09960.001 PMID:26402459

A Review of the Cognitive Effects Observed in Humans Following Acute Supplementation with Flavonoids, and Their Associated Mechanisms of Action.

PubMed

Bell, Lynne; Lamport, Daniel J; Butler, Laurie T; Williams, Claire M

2015-12-09

Flavonoids are polyphenolic compounds found in varying concentrations in many plant-based foods. Recent studies suggest that flavonoids can be beneficial to both cognitive and physiological health. Long term flavonoid supplementation over a period of weeks or months has been extensively investigated and reviewed, particularly with respect to cognitive ageing and neurodegenerative disease. Significantly less focus has been directed towards the short term effects of single doses of flavonoids on cognition. Here, we review 21 such studies with particular emphasis on the subclass and dose of flavonoids administered, the cognitive domains affected by flavonoid supplementation, and the effect size of the response. The emerging evidence suggests that flavonoids may be beneficial to attention, working memory, and psychomotor processing speed in a general population. Episodic memory effects are less well defined and may be restricted to child or older adult populations. The evidence also points towards a dose-dependent effect of flavonoids, but the physiological mechanisms of action remain unclear. Overall, there is encouraging evidence that flavonoid supplementation can benefit cognitive outcomes within an acute time frame of 0-6 h. But larger studies, combining cognitive and physiological measures, are needed to strengthen the evidence base.

Effects of enviromentally imposed roughness on airfoil performance

NASA Technical Reports Server (NTRS)

Cebeci, Tuncer

1987-01-01

The experimental evidence for the effects of rain, insects, and ice on airfoil performance are examined. The extent to which the available information can be incorporated in a calculation method in terms of change of shape and surface roughness is discussed. The methods described are based on the interactive boundary layer procedure of Cebeci or on the thin layer Navier Stokes procedure developed at NASA. Cases presented show that extensive flow separation occurs on the rough surfaces.

Application of plausible reasoning to AI-based control systems

NASA Technical Reports Server (NTRS)

Berenji, Hamid; Lum, Henry, Jr.

1987-01-01

Some current approaches to plausible reasoning in artificial intelligence are reviewed and discussed. Some of the most significant recent advances in plausible and approximate reasoning are examined. A synergism among the techniques of uncertainty management is advocated, and brief discussions on the certainty factor approach, probabilistic approach, Dempster-Shafer theory of evidence, possibility theory, linguistic variables, and fuzzy control are presented. Some extensions to these methods are described, and the applications of the methods are considered.

At the Dawn of Science

NASA Astrophysics Data System (ADS)

Lopez, Claude-Anne

2003-04-01

This talk will provide a snap shot of the scientific life of Benjamin Franklin from the perspective, not of Franklin's science, but of his social interactions with other great scientists of the enlightenment. We will find that the pursuit of science was cross-disciplinary -- indeed, the disciplinary boundaries as we know them today were not so well-defined -- and characterized by conviviality. I will focus in particular on Franklin's relationship with Lavoisier, based on the extensive documentary evidence drawn from Franklin's correspondence.

The SWAN Scientific Discourse Ontology

PubMed Central

Ciccarese, Paolo; Wu, Elizabeth; Kinoshita, June; Wong, Gwendolyn T.; Ocana, Marco; Ruttenberg, Alan

2015-01-01

SWAN (Semantic Web Application in Neuromedicine) is a project to construct a semantically-organized, community-curated, distributed knowledge base of Theory, Evidence, and Discussion in biomedicine. Unlike Wikipedia and similar approaches, SWAN’s ontology is designed to represent and foreground both harmonizing and contradictory assertions within the total community discourse. Releases of the software, content and ontology will be initially by and for the Alzheimer Disease (AD) research community, with the obvious potential for extension into other disease research areas. The Alzheimer Research Forum, a 4,000-member web community for AD researchers, will host SWAN’s initial public release, currently scheduled for late 2007. This paper presents the current version of SWAN’s ontology of scientific discourse and presents our current thinking about its evolution including extensions and alignment with related communities, projects and ontologies. PMID:18583197

Physiotherapy for functional motor disorders: a consensus recommendation

PubMed Central

Nielsen, Glenn; Stone, Jon; Matthews, Audrey; Brown, Melanie; Sparkes, Chris; Farmer, Ross; Masterton, Lindsay; Duncan, Linsey; Winters, Alisa; Daniell, Laura; Lumsden, Carrie; Carson, Alan; David, Anthony S; Edwards, Mark

2015-01-01

Background Patients with functional motor disorder (FMD) including weakness and paralysis are commonly referred to physiotherapists. There is growing evidence that physiotherapy is an effective treatment, but the existing literature has limited explanations of what physiotherapy should consist of and there are insufficient data to produce evidence-based guidelines. We aim to address this issue by presenting recommendations for physiotherapy treatment. Methods A meeting was held between physiotherapists, neurologists and neuropsychiatrists, all with extensive experience in treating FMD. A set of consensus recommendations were produced based on existing evidence and experience. Results We recommend that physiotherapy treatment is based on a biopsychosocial aetiological framework. Treatment should address illness beliefs, self-directed attention and abnormal habitual movement patterns through a process of education, movement retraining and self-management strategies within a positive and non-judgemental context. We provide specific examples of these strategies for different symptoms. Conclusions Physiotherapy has a key role in the multidisciplinary management of patients with FMD. There appear to be specific physiotherapy techniques which are useful in FMD and which are amenable to and require prospective evaluation. The processes involved in referral, treatment and discharge from physiotherapy should be considered carefully as a part of a treatment package. PMID:25433033

A mapping review of international guidance on the management and care of amyotrophic lateral sclerosis (ALS).

PubMed

Janssens, Astrid I W A; Ruytings, Marijke; Al-Chalabi, Ammar; Chio, Adriano; Hardiman, Orla; Mcdermott, Christopher J; Meyer, Thomas; Mora, Gabriele; Van Damme, Philip; Van Den Berg, Leonard H; Vanhaecht, Kris; Winkler, Andrea S; Sermeus, Walter

2016-01-01

Management of ALS is suboptimal. Consequently, quality improvement interventions are needed to improve ALS care. An evidence-based insight into how patients should be managed is essential when developing quality improvement interventions. Therefore, this study aimed to map, categorize and summarize international guidance on the management and care of ALS and to identify gaps in this guidance by means of a mapping review. Literature was searched for clinical practice guidelines, quality indicators and evidence-based clinical summaries. A content analysis and meta-synthesis of the included literature was performed. Interventions and outcomes used in the management and care of ALS were identified and categorized. Furthermore, the amount of guidance underpinning these interventions and outcomes was analysed. Six clinical practice guidelines, one set of quality indicators and three evidence-based clinical summaries were identified. The results demonstrated that certain domains in ALS care, mainly disease-specific domains such as breathing and swallowing, are extensively addressed in the literature whereas other subjects, such as care coordination, receive little attention. In conclusion, this mapping review provides a scientific basis for targeting and developing the clinical content of a quality improvement intervention for the management of ALS.

Prevalence and quality of clinical pathways in Swedish intensive care units: a national survey.

PubMed

Bjurling-Sjöberg, Petronella; Jansson, Inger; Wadensten, Barbro; Engström, Gabriella; Pöder, Ulrika

2014-02-01

To identify the prevalence of clinical pathways (CPs) in Swedish intensive care units (ICUs) and to explore the quality, content and evidence base of the documents. A descriptive and explorative survey of all Swedish ICUs (N84) and a review of submitted examples of CPs (n12) were conducted. CPs were in use at 20% of the Swedish ICUs. There was a significant geographic variation but no relationship between the use of CPs and category of hospital, type of ICU, size of ICU or type of health record applied. In total, 56 CPs were reported within a range of scopes and extensions. The content of the ICUs' CPs, as well as the degree to which they were interprofessional, evidence based, and renewed varied. Progress has been made in relation to CPs in recent years, but there is potential for further improvements. None of the ICUs had CPs that contained all key characteristics of a high-quality, interprofessional and evidence-based CP identified in the literature. Greater knowledge sharing and cooperation within the field would be beneficial, and further research is needed. © 2013 John Wiley & Sons, Ltd.

Clinical practice recommendations for bipolar disorder.

PubMed

Malhi, G S; Adams, D; Lampe, L; Paton, M; O'Connor, N; Newton, L A; Walter, G; Taylor, A; Porter, R; Mulder, R T; Berk, M

2009-01-01

To provide clinically relevant evidence-based recommendations for the management of bipolar disorder in adults that are informative, easy to assimilate and facilitate clinical decision-making. A comprehensive literature review of over 500 articles was undertaken using electronic database search engines (e.g. MEDLINE, PsychINFO and Cochrane reviews). In addition articles, book chapters and other literature known to the authors were reviewed. The findings were then formulated into a set of recommendations that were developed by a multidisciplinary team of clinicians who routinely deal with mood disorders. These preliminary recommendations underwent extensive consultative review by a broader advisory panel that included experts in the field, clinical staff and patient representatives. The clinical practice recommendations for bipolar disorder (bipolar CPR) summarise evidence-based treatments and provide a synopsis of recommendations relating to each phase of the illness. They are designed for clinical use and have therefore been presented succinctly in an innovative and engaging manner that is clear and informative. These up-to-date recommendations provide an evidence-based framework that incorporates clinical wisdom and consideration of individual factors in the management of bipolar disorder. Further, the novel style and practical approach should promote their uptake and implementation.

A cluster randomized control field trial of the ABRACADABRA web-based reading technology: replication and extension of basic findings

PubMed Central

Piquette, Noella A.; Savage, Robert S.; Abrami, Philip C.

2014-01-01

The present paper reports a cluster randomized control trial evaluation of teaching using ABRACADABRA (ABRA), an evidence-based and web-based literacy intervention (http://abralite.concordia.ca) with 107 kindergarten and 96 grade 1 children in 24 classes (12 intervention 12 control classes) from all 12 elementary schools in one school district in Canada. Children in the intervention condition received 10–12 h of whole class instruction using ABRA between pre- and post-test. Hierarchical linear modeling of post-test results showed significant gains in letter-sound knowledge for intervention classrooms over control classrooms. In addition, medium effect sizes were evident for three of five outcome measures favoring the intervention: letter-sound knowledge (d= +0.66), phonological blending (d = +0.52), and word reading (d = +0.52), over effect sizes for regular teaching. It is concluded that regular teaching with ABRA technology adds significantly to literacy in the early elementary years. PMID:25538663

Healthcare-associated infections and their prevention after extensive flooding.

PubMed

Apisarnthanarak, Anucha; Warren, David K; Mayhall, Clovus Glen

2013-08-01

This review will focus on the epidemiology of healthcare-associated infections (HAIs) after extensive blackwater flooding as well as preventive measures. There is evidence suggesting an increased incidence of HAIs and pseudo-outbreaks due to molds after extensive flooding in healthcare facilities. However, there is no strong evidence of an increased incidence of typical nosocomial infections (i.e., ventilator-associated pneumonia, healthcare-associated pneumonia, central line-associated bloodstream infection and catheter-associated urinary tract infections). The prevalence of multidrug-resistant organisms may decrease after extensive flooding, due to repeated and thorough environmental cleaning prior to re-opening hospitals. Contamination of hospital water sources by enteric Gram-negative bacteria (e.g., Aeromonas species), Legionella species and nontuberculous Mycobacterium species in flood-affected hospitals has been reported. Surveillance is an important initial step to detect potential outbreaks/pseudo-outbreaks of HAIs. Hospital preparedness policies before extensive flooding, particularly with environmental cleaning and mold remediation, are key to reducing the risk of flood-related HAIs. These policies are still lacking in most hospitals in countries that have experienced or are at risk for extensive flooding, which argues for nationwide policies to strengthen preparedness planning. Additional studies are needed to evaluate the epidemiology of flood-related HAIs and the optimal surveillance and control methods following extensive flooding.

Use of microbiological indicators for assessing hygiene controls for the manufacture of powdered infant formula.

PubMed

Buchanan, Robert L; Oni, Ruth

2012-05-01

Microbiological testing for various indicator microorganisms is used extensively as a means of verifying the effectiveness of efforts to ensure the microbiological quality and safety of a wide variety of foods. However, for each use of an indicator organism the underlying scientific assumptions related to the behavior of the target microorganism, the characteristics of the food matrix, the details of the food manufacturing processes, environment, and distribution system, and the methodological basis for the assay must be evaluated to determine the validity, utility, and efficacy of potential microbiological indicator tests. The recent adoption by the Codex Alimentarius Commission of microbiological criteria for powdered infant formulae and related products provides an excellent example of an evidence-based approach for the establishment of consensus microbiological criteria. The present article reviews these criteria and those of various national governments in relation to emerging principles for the evidence-based establishment of effective indicator organisms.

Extending Cancer Prevention to Improve Fruit and Vegetable Consumption

PubMed Central

Freedman, Darcy A.; Peña-Purcell, Ninfa; Friedman, Daniela B.; Ory, Marcia; Flocke, Susan; Barni, Marie T.; Hébert, James R.

2014-01-01

Consuming a diet that is rich in fruits and vegetables is critical for preventing cancer and cancer-related disparities. Food systems approaches that increase spatial-temporal, economic, and social access to fruits and vegetables may ultimately result in improved consumption patterns among Americans. Engaging the triad of Cooperative Extension Services, public health systems, and community health centers may yield maximal public health benefits from food systems interventions. These entities have a mutual interest in promoting health equity and community and economic vitality that provides common ground to (a) implement solutions through the dissemination of evidence-based programs and (b) share resources to foster grassroots support for sustained change. Working together, these systems have an unprecedented opportunity to build on their common ground to implement, evaluate, and disseminate evidence-based food systems interventions in communities and with populations experiencing disparate risk for cancer and cancer-related diseases. PMID:24748060

What Does Children's Spatial Language Reveal about Spatial Concepts? Evidence from the Use of Containment Expressions

ERIC Educational Resources Information Center

Johanson, Megan; Papafragou, Anna

2014-01-01

Children's overextensions of spatial language are often taken to reveal spatial biases. However, it is unclear whether extension patterns should be attributed to children's overly general spatial concepts or to a narrower notion of conceptual similarity allowing metaphor-like extensions. We describe a previously unnoticed extension of…

Speech and language therapists' approaches to communication intervention with children and adults with profound and multiple learning disability.

PubMed

Goldbart, Juliet; Chadwick, Darren; Buell, Susan

2014-11-01

People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the factors informing the decisions to use specific interventions and the extent to which the rationales underpinning these decisions related to the components of evidence based practice (EBP), namely empirical evidence, clinical experience and client/carer views and values. A questionnaire on communication assessment and intervention for people with PMLD was sent to SLTs in the UK to elicit information on: the communication intervention approaches they used; their rationales for their intervention choices; their use of published evidence to inform decision making. Intensive interaction and objects of reference were the communication interventions most often used with people with PMLD, with some differences between children and adults evident. Rationales provided conformed somewhat to the EBP framework though extension of the existing framework and addition of practical and organizational considerations led to a revised typology of rationale for decision making. Rationales most frequently related to the empowerment, development and behavioural preferences of the person with PMLD. Empirical research evidence was seldom mentioned by SLTs as informing intervention decision making leading to very diverse practice. There is a need for further research on the effectiveness of commonly used but under-evaluated interventions. There is also a need to alert SLTs to the evidence base supporting other approaches, particularly switch-based, cause and effect approaches. © 2014 Royal College of Speech and Language Therapists.

Effect of Auditory Constraints on Motor Performance Depends on Stage of Recovery Post-Stroke

PubMed Central

Aluru, Viswanath; Lu, Ying; Leung, Alan; Verghese, Joe; Raghavan, Preeti

2014-01-01

In order to develop evidence-based rehabilitation protocols post-stroke, one must first reconcile the vast heterogeneity in the post-stroke population and develop protocols to facilitate motor learning in the various subgroups. The main purpose of this study is to show that auditory constraints interact with the stage of recovery post-stroke to influence motor learning. We characterized the stages of upper limb recovery using task-based kinematic measures in 20 subjects with chronic hemiparesis. We used a bimanual wrist extension task, performed with a custom-made wrist trainer, to facilitate learning of wrist extension in the paretic hand under four auditory conditions: (1) without auditory cueing; (2) to non-musical happy sounds; (3) to self-selected music; and (4) to a metronome beat set at a comfortable tempo. Two bimanual trials (15 s each) were followed by one unimanual trial with the paretic hand over six cycles under each condition. Clinical metrics, wrist and arm kinematics, and electromyographic activity were recorded. Hierarchical cluster analysis with the Mahalanobis metric based on baseline speed and extent of wrist movement stratified subjects into three distinct groups, which reflected their stage of recovery: spastic paresis, spastic co-contraction, and minimal paresis. In spastic paresis, the metronome beat increased wrist extension, but also increased muscle co-activation across the wrist. In contrast, in spastic co-contraction, no auditory stimulation increased wrist extension and reduced co-activation. In minimal paresis, wrist extension did not improve under any condition. The results suggest that auditory task constraints interact with stage of recovery during motor learning after stroke, perhaps due to recruitment of distinct neural substrates over the course of recovery. The findings advance our understanding of the mechanisms of progression of motor recovery and lay the foundation for personalized treatment algorithms post-stroke. PMID:25002859

Can we create a valid treatment algorithm for patients with drug resistant overactive bladder (OAB) syndrome or detrusor overactivity (DO)? Results from a think tank (ICI-RS 2015).

PubMed

Apostolidis, Apostolos; Averbeck, Marcio Augusto; Sahai, Arun; Rahnama'i, Mohhamad Sajjad; Anding, Ralf; Robinson, Dudley; Gravas, Stavros; Dmochowski, Roger

2017-04-01

To review and assess the definitions of drug resistance and the evidence supporting treatment for drug resistant overactive bladder/detrusor overactivity (OAB/DO). Evidence review of the extant literature and consensus of opinion was used to derive the summary recommendations. Drug resistance or drug refractory status has been inconsistently defined and reported in current evident sources. Recent publications use some correlation of lack of efficacy and or experienced side effects to define drug resistance. Algorithms based upon these definitions largely relate to the appropriate use of neuromodulation or botulinum neurotoxin, based upon patient selection and patient choice. Current treatment pathways are hampered by inability to consistently profile patients to optimize management, particularly after failure of initial pragmatic treatment. Further research is recommended to better identify patient phenotype for purposes of directing optimized therapy for OAB/DO. Current treatment algorithms are influenced by extensive data generated from recent neuromodulation and botulinum neurotoxin trials. © 2017 Wiley Periodicals, Inc.

Radiographic diagnosis of sagittal plane rotational displacement in pelvic fractures: a cadaveric model and clinical case study.

PubMed

Shui, Xiaolong; Ying, Xiaozhou; Kong, Jianzhong; Feng, Yongzeng; Hu, Wei; Guo, Xiaoshan; Wang, Gang

2015-08-01

Our objective was to measure the sagittal plane rotational (flexion and extension) displacement of hemipelvis radiologically and analyze the ratio of flexion and extension displacement of unstable pelvic fractures. We used 8 cadaveric models to study the radiographic evidence of pelvic fractures in the sagittal plane. We performed pelvic osteotomy on 8 cadavers to simulate anterior and posterior pelvic ring injury. Radiological data were measured in the flexion and extension group under different angles (5°, 10°, 15°, 20°, and 25°). We retrospectively reviewed 164 patients who were diagnosed with a unilateral fracture of the pelvis. Pelvic ring displacement was identified and recorded radiographically in cadaveric models. The flexion and extension displacement of pelvic fractures was measured in terms of the vertical distance of fracture from the top of iliac crest to the pubic tubercle (CD) or from the top of iliac crest to the lowest point of ischial tuberosity (AB). Fifty-seven pelves showed flexion displacement and 15 showed extension displacement. Closed reduction including internal fixation and external fixation was successfully used in 141 cases (86.0 %). The success rates of closed reduction in flexion and extension displacement groups were 77 and 73 %, respectively, which were lower than in unstable pelvic ring fractures. The sagittal plane rotation (flexion and extension) displacement of pelvic fractures could be measured by special points and lines on the radiographs. Minimally invasive reduction should be based on clearly identified differences between the sagittal plane rotation and the vertical displacement of pelvic fractures.

Meso-Cenozoic tectonic evolution of the SE Brazilian continental margin: Petrographic, kinematic and dynamic analysis of the onshore Araruama Lagoon Fault System

NASA Astrophysics Data System (ADS)

Souza, Pricilla Camões Martins de; Schmitt, Renata da Silva; Stanton, Natasha

2017-09-01

The Ararauama Lagoon Fault System composes one of the most prominent set of lineaments of the SE Brazilian continental margin. It is located onshore in a key tectonic domain, where the basement inheritance rule is not followed. This fault system is characterized by ENE-WSW silicified tectonic breccias and cataclasites showing evidences of recurrent tectonic reactivations. Based on field work, microtectonic, kinematic and dynamic analysis, we reconstructed the paleostresses in the region and propose a sequence of three brittle deformational phases accountable for these reactivations: 1) NE-SW dextral transcurrence; 2) NNW-SSE dextral oblique extension that evolved to NNW-SSE "pure" extension; 3) ENE-WSW dextral oblique extension. These phases are reasonably correlated with the tectonic events responsible for the onset and evolution of the SE onshore rift basins, between the Neocretaceous and Holocene. However, based on petrographic studies and supported by regional geological correlations, we assume that the origin of this fault system is older, related to the Early Cretaceous South Atlantic rifting. This study provides significant information about one of the main structural trends of the SE Brazilian continental margin and the tectonic events that controlled its segmentation, since the Gondwana rifting, and compartmentalization of its onshore sedimentary deposits during the Cenozoic.

[Guidelines for management of epilepsy--commentary on Scottish ("SIGN") guidelines].

PubMed

Planjar-Prvan, Miljenka; Granić, Davorka

2005-01-01

The choice of AED (antiepileptic drug), worldwide and in Croatia, is been still based on the physician's subjective decision, personal experience, knowledge and marketing pressure made by big pharmaceutical industries. Therefore, according to some opinions, there is a need of treatment guidelines for epilepsy that would provide relevant information based on scientific evidence on the efficacy, tolerability and safety of AEDs. The guidelines, published by a competent source, should be designed as to allow for easy access to the information on the best practice in specific cases. An extensive background literature review was made to identify such a type of guidelines for the management of epilepsy. The literature review revealed a number of references with the recommendations for treating epilepsy in different groups of patients and from various, specific aspects of epilepsy treatment. However, only one comprehensive set of guidelines for the diagnosis and treatment of epilepsy treatment was found, i.e. the evidence-based guidelines published by the Scottish Intercollegiate Guidelines Network (SIGN). The development of this set of guidelines is quite extensively described in order to illustrate how rigorous and long-lasting the process was, including a great number of health professionals at the national level. Such a type of well designed guidelines facilitates access to highest educational standards for all professionals involved in the primary and secondary care of people with epilepsy. However, it is clear that guidelines can fully replace the standards of clinical practice based on critical evaluation and integration of all clinical data of each individual patient. No guidelines can replace the physician's obligation to keep informed of the novel achievements in the epileptology either.

Transcriptome dynamics along axolotl regenerative development are consistent with an extensive reduction in gene expression heterogeneity in dedifferentiated cells

PubMed Central

2017-01-01

Although in recent years the study of gene expression variation in the absence of genetic or environmental cues or gene expression heterogeneity has intensified considerably, many basic and applied biological fields still remain unaware of how useful the study of gene expression heterogeneity patterns might be for the characterization of biological systems and/or processes. Largely based on the modulator effect chromatin compaction has for gene expression heterogeneity and the extensive changes in chromatin compaction known to occur for specialized cells that are naturally or artificially induced to revert to less specialized states or dedifferentiate, I recently hypothesized that processes that concur with cell dedifferentiation would show an extensive reduction in gene expression heterogeneity. The confirmation of the existence of such trend could be of wide interest because of the biomedical and biotechnological relevance of cell dedifferentiation-based processes, i.e., regenerative development, cancer, human induced pluripotent stem cells, or plant somatic embryogenesis. Here, I report the first empirical evidence consistent with the existence of an extensive reduction in gene expression heterogeneity for processes that concur with cell dedifferentiation by analyzing transcriptome dynamics along forearm regenerative development in Ambystoma mexicanum or axolotl. Also, I briefly discuss on the utility of the study of gene expression heterogeneity dynamics might have for the characterization of cell dedifferentiation-based processes, and the engineering of tools that afforded better monitoring and modulating such processes. Finally, I reflect on how a transitional reduction in gene expression heterogeneity for dedifferentiated cells can promote a long-term increase in phenotypic heterogeneity following cell dedifferentiation with potential adverse effects for biomedical and biotechnological applications. PMID:29134148

A Web-Based Lifestyle Medicine Curriculum: Facilitating Education About Lifestyle Medicine, Behavioral Change, and Health Care Outcomes.

PubMed

Frates, Elizabeth Pegg; Xiao, Ryan C; Sannidhi, Deepa; McBride, Yasamina; McCargo, Tracie; Stern, Theodore A

2017-09-11

Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors. A semester-long undergraduate course focused on lifestyle medicine can be a useful intervention to help adopt and sustain healthy habits. To describe a novel, evidence based curriculum for a course teaching the concepts of Lifestyle Medicine based on a web-based course offered at the Harvard Extension School. The course was delivered in a web-based format. The Lifestyle Medicine course used evidence based principles to guide students toward a "coach approach" to behavior change, increasing their self-efficacy regarding various lifestyle-related preventive behaviors. Students are made to understand the cultural trends and national guidelines that have shaped lifestyle medicine recommendations relating to behaviors. They are encouraged to engage in behavior change. Course topics include physical activity, nutrition, addiction, sleep, stress, and lifestyle coaching and counseling. The course addressed all of the American College of Preventive Medicine/American College of Lifestyle Medicine competencies save for the competency of office systems and technologies to support lifestyle medicine counseling. The course was well-received, earning a ranking of 4.9/5 at the school. A novel, semester-long course on Lifestyle Medicine at the Harvard Extension School is described. Student evaluations suggest the course was well-received. Further research is needed to evaluate whether such a course empowers students to adopt behavior changes. ©Elizabeth Pegg Frates, Ryan C Xiao, Deepa Sannidhi, Yasamina McBride, Tracie McCargo, Theodore A Stern. Originally published in JMIR Medical Education (http://mededu.jmir.org), 11.09.2017.

Identifying Conservation Successes, Failures and Future Opportunities; Assessing Recovery Potential of Wild Ungulates and Tigers in Eastern Cambodia

PubMed Central

O'Kelly, Hannah J.; Evans, Tom D.; Stokes, Emma J.; Clements, Tom J.; Dara, An; Gately, Mark; Menghor, Nut; Pollard, Edward H. B.; Soriyun, Men; Walston, Joe

2012-01-01

Conservation investment, particularly for charismatic and wide-ranging large mammal species, needs to be evidence-based. Despite the prevalence of this theme within the literature, examples of robust data being generated to guide conservation policy and funding decisions are rare. We present the first published case-study of tiger conservation in Indochina, from a site where an evidence-based approach has been implemented for this iconic predator and its prey. Despite the persistence of extensive areas of habitat, Indochina's tiger and ungulate prey populations are widely supposed to have precipitously declined in recent decades. The Seima Protection Forest (SPF), and broader Eastern Plains Landscape, was identified in 2000 as representing Cambodia's best hope for tiger recovery; reflected in its designation as a Global Priority Tiger Conservation Landscape. Since 2005 distance sampling, camera-trapping and detection-dog surveys have been employed to assess the recovery potential of ungulate and tiger populations in SPF. Our results show that while conservation efforts have ensured that small but regionally significant populations of larger ungulates persist, and density trends in smaller ungulates are stable, overall ungulate populations remain well below theoretical carrying capacity. Extensive field surveys failed to yield any evidence of tiger, and we contend that there is no longer a resident population within the SPF. This local extirpation is believed to be primarily attributable to two decades of intensive hunting; but importantly, prey densities are also currently below the level necessary to support a viable tiger population. Based on these results and similar findings from neighbouring sites, Eastern Cambodia does not currently constitute a Tiger Source Site nor meet the criteria of a Global Priority Tiger Landscape. However, SPF retains global importance for many other elements of biodiversity. It retains high regional importance for ungulate populations and potentially in the future for Indochinese tigers, given adequate prey and protection. PMID:23077476

Identifying conservation successes, failures and future opportunities; assessing recovery potential of wild ungulates and tigers in Eastern Cambodia.

PubMed

O'Kelly, Hannah J; Evans, Tom D; Stokes, Emma J; Clements, Tom J; Dara, An; Gately, Mark; Menghor, Nut; Pollard, Edward H B; Soriyun, Men; Walston, Joe

2012-01-01

Conservation investment, particularly for charismatic and wide-ranging large mammal species, needs to be evidence-based. Despite the prevalence of this theme within the literature, examples of robust data being generated to guide conservation policy and funding decisions are rare. We present the first published case-study of tiger conservation in Indochina, from a site where an evidence-based approach has been implemented for this iconic predator and its prey. Despite the persistence of extensive areas of habitat, Indochina's tiger and ungulate prey populations are widely supposed to have precipitously declined in recent decades. The Seima Protection Forest (SPF), and broader Eastern Plains Landscape, was identified in 2000 as representing Cambodia's best hope for tiger recovery; reflected in its designation as a Global Priority Tiger Conservation Landscape. Since 2005 distance sampling, camera-trapping and detection-dog surveys have been employed to assess the recovery potential of ungulate and tiger populations in SPF. Our results show that while conservation efforts have ensured that small but regionally significant populations of larger ungulates persist, and density trends in smaller ungulates are stable, overall ungulate populations remain well below theoretical carrying capacity. Extensive field surveys failed to yield any evidence of tiger, and we contend that there is no longer a resident population within the SPF. This local extirpation is believed to be primarily attributable to two decades of intensive hunting; but importantly, prey densities are also currently below the level necessary to support a viable tiger population. Based on these results and similar findings from neighbouring sites, Eastern Cambodia does not currently constitute a Tiger Source Site nor meet the criteria of a Global Priority Tiger Landscape. However, SPF retains global importance for many other elements of biodiversity. It retains high regional importance for ungulate populations and potentially in the future for Indochinese tigers, given adequate prey and protection.

Defining post-sternotomy mediastinitis for clinical evidence-based studies.

PubMed

van Wingerden, Jan J; de Mol, Bas A J M; van der Horst, Chantal M A M

2016-05-01

Considerable advances have already been made in the treatment of deep thoracic wound infections following a median sternotomy for cardiac surgery. Further improvement in diagnosis, treatment, and outcome will require a targeted approach by multidisciplinary teams. Clear communication and synergy between the various clinical and supportive disciplines would assist in removing the last barriers to standardized evidence-based studies and the development of improved evidence-based guidelines. An extensive literature search without language restrictions was carried out on PubMed (Medline), EMBASE, and Web of Science, covering the period 1988 to week 16, 2014, and a manual search of the reference lists was performed regarding all possible definitions and classifications of post-sternotomy mediastinitis. Two hundred and eighteen papers describing post-sternotomy infections in a multitude of terms were identified, and the strengths and weaknesses of the most popular definitions and terms relating specifically to post-sternotomy infections were examined. This study revealed that clinicians use a multitude of terms to describe post-sternotomy infections without defining the condition under treatment. Occasionally, older epidemiological (surveillance) definitions were used. It also shows that supportive disciplines have their own definitions, or interpretations of existing definitions, to describe these infections. The outcome of this study is that clinicians have adopted no single definition, which is essential for further improvement for evidence-based studies. We suggest that it is possible to adopt a single term for thoracic infection after a sternotomy (and only sternotomy), and propose a clinical definition for this purpose. © The Author(s) 2016.

PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes

PubMed Central

Eddy, Sarah L.; Converse, Mercedes; Wenderoth, Mary Pat

2015-01-01

There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both clarifies the research-supported elements of best practices for instructor implementation of active learning in the classroom setting and measures instructors’ alignment with these practices. We describe how we reviewed the discipline-based education research literature to identify best practices in active learning for adult learners in the classroom and used these results to develop an observation tool (Practical Observation Rubric To Assess Active Learning, or PORTAAL) that documents the extent to which instructors incorporate these practices into their classrooms. We then use PORTAAL to explore the classroom practices of 25 introductory biology instructors who employ some form of active learning. Overall, PORTAAL documents how well aligned classrooms are with research-supported best practices for active learning and provides specific feedback and guidance to instructors to allow them to identify what they do well and what could be improved. PMID:26033871

Model-Based and Model-Free Pavlovian Reward Learning: Revaluation, Revision and Revelation

PubMed Central

Dayan, Peter; Berridge, Kent C.

2014-01-01

Evidence supports at least two methods for learning about reward and punishment and making predictions for guiding actions. One method, called model-free, progressively acquires cached estimates of the long-run values of circumstances and actions from retrospective experience. The other method, called model-based, uses representations of the environment, expectations and prospective calculations to make cognitive predictions of future value. Extensive attention has been paid to both methods in computational analyses of instrumental learning. By contrast, although a full computational analysis has been lacking, Pavlovian learning and prediction has typically been presumed to be solely model-free. Here, we revise that presumption and review compelling evidence from Pavlovian revaluation experiments showing that Pavlovian predictions can involve their own form of model-based evaluation. In model-based Pavlovian evaluation, prevailing states of the body and brain influence value computations, and thereby produce powerful incentive motivations that can sometimes be quite new. We consider the consequences of this revised Pavlovian view for the computational landscape of prediction, response and choice. We also revisit differences between Pavlovian and instrumental learning in the control of incentive motivation. PMID:24647659

Model-based and model-free Pavlovian reward learning: revaluation, revision, and revelation.

PubMed

Dayan, Peter; Berridge, Kent C

2014-06-01

Evidence supports at least two methods for learning about reward and punishment and making predictions for guiding actions. One method, called model-free, progressively acquires cached estimates of the long-run values of circumstances and actions from retrospective experience. The other method, called model-based, uses representations of the environment, expectations, and prospective calculations to make cognitive predictions of future value. Extensive attention has been paid to both methods in computational analyses of instrumental learning. By contrast, although a full computational analysis has been lacking, Pavlovian learning and prediction has typically been presumed to be solely model-free. Here, we revise that presumption and review compelling evidence from Pavlovian revaluation experiments showing that Pavlovian predictions can involve their own form of model-based evaluation. In model-based Pavlovian evaluation, prevailing states of the body and brain influence value computations, and thereby produce powerful incentive motivations that can sometimes be quite new. We consider the consequences of this revised Pavlovian view for the computational landscape of prediction, response, and choice. We also revisit differences between Pavlovian and instrumental learning in the control of incentive motivation.

Flash Flood Trail near Parras, Coahuila, Mexico

NASA Image and Video Library

1991-12-01

Evidence of a recent flash flood can be seen in the form of light brown sediment that flowed down gullies and mountain sides forming ponds of debris over agricultural areas in the broad valley near the town of Parras (26.5N, 102.5W). This part of Mexico has extensive vineyards, orchards and both dry land and irrigated agriculture. Based on the photo, it appears that flash flood waters damaged some 300 square miles of property in this area alone.

Flash Flood Trail near Parras, Coahuila, Mexico

NASA Technical Reports Server (NTRS)

1991-01-01

Evidence of a recent flash flood can be seen in the form of light brown sediment that flowed down gullies and mountain sides forming ponds of debris over agricultural areas in the broad valley near the town of Parras (26.5N, 102.5W). This part of Mexico has extensive vineyards, orchards and both dry land and irrigated agriculture. Based on the photo, it appears that flash flood waters damaged some 300 square miles of property in this area alone.

The Effects of Spaceflight on Neurocognitive Performance: Extent, Longevity, and Neural Bases

NASA Technical Reports Server (NTRS)

Seidler, Rachael D.; Bloomberg, Jacob; Wood, Scott; Mason, Sara; Mulavara, Ajit; Kofman, Igor; De Dios, Yiri; Gadd, Nicole; Stepanyan, Vahagn; Szecsy, Darcy

2017-01-01

Spaceflight effects on gait, balance, & manual motor control have been well studied; some evidence for cognitive deficits. Rodent cortical motor & sensory systems show neural structural alterations with spaceflight. We found extensive changes in behavior, brain structure & brain function following 70 days of HDBR. Specific Aim: Aim 1-Identify changes in brain structure, function, and network integrity as a function of spaceflight and characterize their time course. Aim 2-Specify relationships between structural and functional brain changes and performance and characterize their time course.

Impact of ICT on Agricultural Extension Services Delivery: Evidence from the Catholic Relief Services SMART Skills and Farmbook Project in Kenya

ERIC Educational Resources Information Center

Tata, Joyous S.; McNamara, Paul E.

2018-01-01

Purpose: The study was carried out to assess the impact of the Catholic Relief Services (CRS) Skills for Marketing and Rural Transformation (SMART) skills and Farmbook information communication technology (ICT) on agricultural extension service delivery by front-line extension officers in two counties in Kenya. The second objective was to assess…

Research-Based Implementation of Peer Instruction: A Literature Review

PubMed Central

Vickrey, Trisha; Rosploch, Kaitlyn; Rahmanian, Reihaneh; Pilarz, Matthew; Stains, Marilyne

2015-01-01

Current instructional reforms in undergraduate science, technology, engineering, and mathematics (STEM) courses have focused on enhancing adoption of evidence-based instructional practices among STEM faculty members. These practices have been empirically demonstrated to enhance student learning and attitudes. However, research indicates that instructors often adapt rather than adopt practices, unknowingly compromising their effectiveness. Thus, there is a need to raise awareness of the research-based implementation of these practices, develop fidelity of implementation protocols to understand adaptations being made, and ultimately characterize the true impact of reform efforts based on these practices. Peer instruction (PI) is an example of an evidence-based instructional practice that consists of asking students conceptual questions during class time and collecting their answers via clickers or response cards. Extensive research has been conducted by physics and biology education researchers to evaluate the effectiveness of this practice and to better understand the intricacies of its implementation. PI has also been investigated in other disciplines, such as chemistry and computer science. This article reviews and summarizes these various bodies of research and provides instructors and researchers with a research-based model for the effective implementation of PI. Limitations of current studies and recommendations for future empirical inquiries are also provided. PMID:25713095

[Buccal mucosa graft for the treatment of long ureteral stenosis: Bibliographic review.

PubMed

Del Pozo Jiménez, Gema; Castillón-Vela, Ignacio; Carballido Rodríguez, Joaquín

2017-05-01

To perform a literature review on the use of buccal mucosa graft (BMG) in the treatment of extensive ureteral stenosis, according to the criteria of Evidence Based Medicine. Pubmed search of published studies with the following keywords: "ureteral stricture treatment", "buccal mucosa graft ureteral treatment" and "buccal mucosa graft ureteroplasty", without time limits, in English and Spanish; 12 articles were identified with a total of 48 cases (46 patients) of BMG use in ureteral repair. The main etiologies of ureteral stenosis, where BMG has been applied, have been iatrogenic and inflammatory strictures. This graft has been used complicamainly in proximal or middle ureter stenosis, as a patch according to onlay technique or as a tubularized graft. Early and late complications of the procedure have been reported in 16.7% and 10.4%, respectively, with a restenosis rate of 6.25%. A 91.6% success rate was observed with this technique, with an average follow-up time of 22 (3-85) months. The findings of the present review do not justify the universal use of BMG in all ureteral strictures, particularly in the absence of long-term followup, but still provide evidence that BMG can be effectively used in extensive ureteral strictures.

Perceptual decision making: drift-diffusion model is equivalent to a Bayesian model

PubMed Central

Bitzer, Sebastian; Park, Hame; Blankenburg, Felix; Kiebel, Stefan J.

2014-01-01

Behavioral data obtained with perceptual decision making experiments are typically analyzed with the drift-diffusion model. This parsimonious model accumulates noisy pieces of evidence toward a decision bound to explain the accuracy and reaction times of subjects. Recently, Bayesian models have been proposed to explain how the brain extracts information from noisy input as typically presented in perceptual decision making tasks. It has long been known that the drift-diffusion model is tightly linked with such functional Bayesian models but the precise relationship of the two mechanisms was never made explicit. Using a Bayesian model, we derived the equations which relate parameter values between these models. In practice we show that this equivalence is useful when fitting multi-subject data. We further show that the Bayesian model suggests different decision variables which all predict equal responses and discuss how these may be discriminated based on neural correlates of accumulated evidence. In addition, we discuss extensions to the Bayesian model which would be difficult to derive for the drift-diffusion model. We suggest that these and other extensions may be highly useful for deriving new experiments which test novel hypotheses. PMID:24616689

A common origin for woody Sonchus and five related genera in the Macaronesian islands: molecular evidence for extensive radiation.

PubMed Central

Kim, S C; Crawford, D J; Francisco-Ortega, J; Santos-Guerra, A

1996-01-01

Woody Sonchus and five related genera (Babcockia, Taeckholmia, Sventenia, Lactucosonchus, and Prenanthes) of the Macaronesian islands have been regarded as an outstanding example of adaptive radiation in angiosperms. Internal transcribed spacer region of the nuclear rDNA (ITS) sequences were used to demonstrate that, despite the extensive morphological and ecological diversity of the plants, the entire alliance in insular Macaronesia has a common origin. The sequence data place Lactucosonchus as sister group to the remainder of the alliance and also indicate that four related genera are in turn sister groups to subg. Dendrosonchus and Taeckholmia. This implies that the woody members of Sonchus were derived from an ancestor similar to allied genera now present on the Canary Islands. It is also evident that the alliance probably occurred in the Canary Islands during the late Miocene or early Pliocene. A rapid radiation of major lineages in the alliance is consistent with an unresolved polytomy near the base and low ITS sequence divergence. Increase of woodiness is concordant with other insular endemics and refutes the relictural nature of woody Sonchus in the Macaronesian islands. PMID:8755546

Middle East Consensus Statement on the Prevention, Diagnosis, and Management of Cow's Milk Protein Allergy

PubMed Central

Abuabat, Ahmed; Al-Hammadi, Suleiman; Aly, Gamal Samy; Miqdady, Mohamad S; Shaaban, Sanaa Youssef; Torbey, Paul-Henri

2014-01-01

Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers. PMID:25061580

SEE: structured representation of scientific evidence in the biomedical domain using Semantic Web techniques

PubMed Central

2014-01-01

Background Accounts of evidence are vital to evaluate and reproduce scientific findings and integrate data on an informed basis. Currently, such accounts are often inadequate, unstandardized and inaccessible for computational knowledge engineering even though computational technologies, among them those of the semantic web, are ever more employed to represent, disseminate and integrate biomedical data and knowledge. Results We present SEE (Semantic EvidencE), an RDF/OWL based approach for detailed representation of evidence in terms of the argumentative structure of the supporting background for claims even in complex settings. We derive design principles and identify minimal components for the representation of evidence. We specify the Reasoning and Discourse Ontology (RDO), an OWL representation of the model of scientific claims, their subjects, their provenance and their argumentative relations underlying the SEE approach. We demonstrate the application of SEE and illustrate its design patterns in a case study by providing an expressive account of the evidence for certain claims regarding the isolation of the enzyme glutamine synthetase. Conclusions SEE is suited to provide coherent and computationally accessible representations of evidence-related information such as the materials, methods, assumptions, reasoning and information sources used to establish a scientific finding by adopting a consistently claim-based perspective on scientific results and their evidence. SEE allows for extensible evidence representations, in which the level of detail can be adjusted and which can be extended as needed. It supports representation of arbitrary many consecutive layers of interpretation and attribution and different evaluations of the same data. SEE and its underlying model could be a valuable component in a variety of use cases that require careful representation or examination of evidence for data presented on the semantic web or in other formats. PMID:25093070

SEE: structured representation of scientific evidence in the biomedical domain using Semantic Web techniques.

PubMed

Bölling, Christian; Weidlich, Michael; Holzhütter, Hermann-Georg

2014-01-01

Accounts of evidence are vital to evaluate and reproduce scientific findings and integrate data on an informed basis. Currently, such accounts are often inadequate, unstandardized and inaccessible for computational knowledge engineering even though computational technologies, among them those of the semantic web, are ever more employed to represent, disseminate and integrate biomedical data and knowledge. We present SEE (Semantic EvidencE), an RDF/OWL based approach for detailed representation of evidence in terms of the argumentative structure of the supporting background for claims even in complex settings. We derive design principles and identify minimal components for the representation of evidence. We specify the Reasoning and Discourse Ontology (RDO), an OWL representation of the model of scientific claims, their subjects, their provenance and their argumentative relations underlying the SEE approach. We demonstrate the application of SEE and illustrate its design patterns in a case study by providing an expressive account of the evidence for certain claims regarding the isolation of the enzyme glutamine synthetase. SEE is suited to provide coherent and computationally accessible representations of evidence-related information such as the materials, methods, assumptions, reasoning and information sources used to establish a scientific finding by adopting a consistently claim-based perspective on scientific results and their evidence. SEE allows for extensible evidence representations, in which the level of detail can be adjusted and which can be extended as needed. It supports representation of arbitrary many consecutive layers of interpretation and attribution and different evaluations of the same data. SEE and its underlying model could be a valuable component in a variety of use cases that require careful representation or examination of evidence for data presented on the semantic web or in other formats.

ACR Appropriateness Criteria® Routine Chest Radiography.

PubMed

McComb, Barbara L; Chung, Jonathan H; Crabtree, Traves D; Heitkamp, Darel E; Iannettoni, Mark D; Jokerst, Clinton; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Mohammed, Tan-Lucien H; Ravenel, James G

2016-03-01

Chest radiographs are sometimes taken before surgeries and interventional procedures on hospital admissions and outpatients. This manuscript summarizes the American College of Radiology review of the literature and recommendations on routinely performed chest radiographies in these settings. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Turning Over Patient Turnover: An Ethnographic Study of Admissions, Discharges, and Transfers

PubMed Central

Mowinski Jennings, Bonnie; Sandelowski, Margarete; Boshamer, Cary C.; Higgins, Melinda K.

2014-01-01

The impact on nursing work of patient turnover (admissions, discharges, and transfers) became evident in an ethnographic study of turbulence. The patient turnover data were generated from extensive observations, 21 formal interviews, and a year of admission and discharge records on one medical and one surgical unit. Timing of turnover events on the two units differed, but on both units admissions typically interrupted workflow more than did discharges, clustered admissions were more disruptive than staggered admissions, and patient turnover during change of shift was more disruptive than during medication administration. Understanding the complexity of patient turnover will elucidate the work involved and improve the evidence base for nurse staffing, a key determinant of quality and safety of care. PMID:24242196

Nutritional Deficiency in Patients with Heart Failure.

PubMed

Sciatti, Edoardo; Lombardi, Carlo; Ravera, Alice; Vizzardi, Enrico; Bonadei, Ivano; Carubelli, Valentina; Gorga, Elio; Metra, Marco

2016-07-22

Heart failure (HF) is the main cause of mortality and morbidity in Western countries. Although evidence-based treatments have substantially improved outcomes, prognosis remains poor with high costs for health care systems. In patients with HF, poor dietary behaviors are associated with unsatisfactory quality of life and adverse outcome. The HF guidelines have not recommended a specific nutritional strategy. Despite the role of micronutrient deficiency, it has been extensively studied, and data about the efficacy of supplementation therapy in HF are not supported by large randomized trials and there is limited evidence regarding the outcomes. The aim of the present review is to analyze the state-of-the-art of nutritional deficiencies in HF, focusing on the physiological role and the prognostic impact of micronutrient supplementation.

Birthbeats: music to your ears.

PubMed

Beckett, Rachel

2012-05-01

Promoting normal birth is fundamental to the midwife's role yet it is easy to overlook simple coping strategies on a busy labour ward. As The Code (Nursing and Midwifery Council (NMC) 2008) directs us to ensure that our practice is evidence based, it is valuable to review the literature exploring the alternatives available to reduce pain and anxiety during labour and birth. In March 2011 an extensive literature search was completed to review the evidence relating to the use of music to reduce pain and anxiety. As a result of these findings a free web resource was developed for parents and professionals to promote the use of music and explain how music can be beneficial during labour. The birthbeats project was funded by the Iolanthe Trust.

[Evidence-based Chinese medicine：theory and practice].

PubMed

Zhang, Jun-Hua; Li, You-Ping; Zhang, Bo-Li

2018-01-01

The introduction and popularization of evidence-based medicine has opened up a new research field of clinical efficacy evaluation of traditional Chinese medicine(TCM), produced new research ideas and methods, and promoted the progress of clinical research of TCM. After about 20 years assiduous study and earnest practice, the evidence based evaluation method and technique, which conforms to the characteristics of TCM theory and practice, has been developing continuously. Evidence-based Chinese medicine (EBCM) has gradually formed and become an important branch of evidence-based medicine. The basic concept of evidence-based Chinese medicine: EBCM is an applied discipline, following the theory and methodology of evidence-based medicine, to collect, evaluate, produce, transform the evidence of effectiveness, safety and economy of TCM, to reveal the feature and regular pattern of TCM taking effect, and to guide the development of clinical guidelines, clinical pathways and health decisions. The effects and achievements of EBCM development: secondary studies mainly based on systematic review/Meta-analysis were extensively carried out; clinical efficacy studies mainly relying on randomized controlled trials grew rapidly; clinical safety evaluations based on real world study have been conducted; methodological researches mainly focused on study quality control deepened gradually; internationalization researches mainly on report specifications have got some breakthroughs; standardization researches based on treatment specification were strengthened gradually; the research team and talents with the characteristics of inter-disciplinary have been steadily increased. A number of high-quality research findings have been published at international well-known journals; the clinical efficacy and safety evidence of TCM has been increased; the level of clinical rational use of TCM has been improved; a large number of Chinese patent medicines with big market have been cultured. The future missions of EBCM mainly consist of four categories (scientific research, methodology and standard, platform construction and personnel training) with nine tasks. ①Carry out systematic reviews to systematically collect clinical trial reports of TCM and establish database of clinical evidence of TCM; ②Carry out evidence transformation research to lay the foundation for the development of clinical diagnosis and treatment guidelines, clinical pathways of TCM, and for the screening of basic drug list and medical insurance list, and for the policy-making relevant to TCM; ③Conduct researches to evaluate the advantages and effective regular patterns of TCM and form the evidence chain of TCM efficacy; ④Carry out researches for the safety evaluation of TCM, and provide evidence supporting the rational and safe use of TCM in clinical practice; ⑤Conduct researches on methodology of EBCM and provide method for developing high quality evidence; ⑥Carry out researches to develop standards and norms of TCM, and to form methods, standards, specifications and technical systems; ⑦Establish data management platform for evidence-based evaluation of TCM, and promote data sharing; ⑧Build international academic exchange platform to promote international cooperation and mutual recognition of EBCM research; ⑨Carry out education and popularization activities of evidence-based evaluation methods, and train undergraduate students, graduate students, clinical healthcare providers and practitioners of TCM. The development of EBCM, as it was, not only promoted the transformation of clinical research and decision-making mode of TCM, contributed to the modernization and internationalization of TCM, but also enriched the connotation of Evidence-based Medicine. Copyright© by the Chinese Pharmaceutical Association.

Facilitating access to pre-processed research evidence in public health

PubMed Central

2010-01-01

Background Evidence-informed decision making is accepted in Canada and worldwide as necessary for the provision of effective health services. This process involves: 1) clearly articulating a practice-based issue; 2) searching for and accessing relevant evidence; 3) appraising methodological rigor and choosing the most synthesized evidence of the highest quality and relevance to the practice issue and setting that is available; and 4) extracting, interpreting, and translating knowledge, in light of the local context and resources, into practice, program and policy decisions. While the public health sector in Canada is working toward evidence-informed decision making, considerable barriers, including efficient access to synthesized resources, exist. Methods In this paper we map to a previously developed 6 level pyramid of pre-processed research evidence, relevant resources that include public health-related effectiveness evidence. The resources were identified through extensive searches of both the published and unpublished domains. Results Many resources with public health-related evidence were identified. While there were very few resources dedicated solely to public health evidence, many clinically focused resources include public health-related evidence, making tools such as the pyramid, that identify these resources, particularly helpful for public health decisions makers. A practical example illustrates the application of this model and highlights its potential to reduce the time and effort that would be required by public health decision makers to address their practice-based issues. Conclusions This paper describes an existing hierarchy of pre-processed evidence and its adaptation to the public health setting. A number of resources with public health-relevant content that are either freely accessible or requiring a subscription are identified. This will facilitate easier and faster access to pre-processed, public health-relevant evidence, with the intent of promoting evidence-informed decision making. Access to such resources addresses several barriers identified by public health decision makers to evidence-informed decision making, most importantly time, as well as lack of knowledge of resources that house public health-relevant evidence. PMID:20181270

Advance care planning in dementia: recommendations for healthcare professionals.

PubMed

Piers, Ruth; Albers, Gwenda; Gilissen, Joni; De Lepeleire, Jan; Steyaert, Jan; Van Mechelen, Wouter; Steeman, Els; Dillen, Let; Vanden Berghe, Paul; Van den Block, Lieve

2018-06-21

Advance care planning (ACP) is a continuous, dynamic process of reflection and dialogue between an individual, those close to them and their healthcare professionals, concerning the individual's preferences and values concerning future treatment and care, including end-of-life care. Despite universal recognition of the importance of ACP for people with dementia, who gradually lose their ability to make informed decisions themselves, ACP still only happens infrequently, and evidence-based recommendations on when and how to perform this complex process are lacking. We aimed to develop evidence-based clinical recommendations to guide professionals across settings in the practical application of ACP in dementia care. Following the Belgian Centre for Evidence-Based Medicine's procedures, we 1) performed an extensive literature search to identify international guidelines, articles reporting heterogeneous study designs and grey literature, 2) developed recommendations based on the available evidence and expert opinion of the author group, and 3) performed a validation process using written feedback from experts, a survey for end users (healthcare professionals across settings), and two peer-review groups (with geriatricians and general practitioners). Based on 67 publications and validation from ten experts, 51 end users and two peer-review groups (24 participants) we developed 32 recommendations covering eight domains: initiation of ACP, evaluation of mental capacity, holding ACP conversations, the role and importance of those close to the person with dementia, ACP with people who find it difficult or impossible to communicate verbally, documentation of wishes and preferences, including information transfer, end-of-life decision-making, and preconditions for optimal implementation of ACP. Almost all recommendations received a grading representing low to very low-quality evidence. No high-quality guidelines are available for ACP in dementia care. By combining evidence with expert and user opinions, we have defined a unique set of recommendations for ACP in people living with dementia. These recommendations form a valuable tool for educating healthcare professionals on how to perform ACP across settings.

A diagnostic approach to hemochromatosis

PubMed Central

Tavill, Anthony S; Adams, Paul C

2006-01-01

In the present clinical review, a diagnostic approach to hemochromatosis is discussed from the perspective of two clinicians with extensive experience in this area. The introduction of genetic testing and large-scale population screening studies have broadened our understanding of the clinical expression of disease and the utility of biochemical iron tests for the detection of disease and for the assessment of disease severity. Liver biopsy has become more of a prognostic test than a diagnostic test. The authors offer a stepwise, diagnostic algorithm based on current evidence-based data, that they regard as most cost-effective. An early diagnosis can lead to phlebotomy therapy to prevent the development of cirrhosis. PMID:16955151

Daytime Water Detection by Fusing Multiple Cues for Autonomous Off-Road Navigation

NASA Technical Reports Server (NTRS)

Rankin, A. L.; Matthies, L. H.; Huertas, A.

2004-01-01

Detecting water hazards is a significant challenge to unmanned ground vehicle autonomous off-road navigation. This paper focuses on detecting the presence of water during the daytime using color cameras. A multi-cue approach is taken. Evidence of the presence of water is generated from color, texture, and the detection of reflections in stereo range data. A rule base for fusing water cues was developed by evaluating detection results from an extensive archive of data collection imagery containing water. This software has been implemented into a run-time passive perception subsystem and tested thus far under Linux on a Pentium based processor.

ELAV Links Paused Pol II to Alternative Polyadenylation in the Drosophila Nervous System

PubMed Central

Oktaba, Katarzyna; Zhang, Wei; Lotz, Thea Sabrina; Jun, David Jayhyun; Lemke, Sandra Beatrice; Ng, Samuel Pak; Esposito, Emilia; Levine, Michael; Hilgers, Valérie

2014-01-01

SUMMARY Alternative polyadenylation (APA) has been implicated in a variety of developmental and disease processes. A particularly dramatic form of APA occurs in the developing nervous system of flies and mammals, whereby various developmental genes undergo coordinate 3′ UTR extension. In Drosophila, the RNA-binding protein ELAV inhibits RNA processing at proximal polyadenylation sites, thereby fostering the formation of exceptionally long 3′ UTRs. Here, we present evidence that paused Pol II promotes recruitment of ELAV to extended genes. Replacing promoters of extended genes with heterologous promoters blocks normal 3′ extension in the nervous system, while extension-associated promoters can induce 3′ extension in ectopic tissues expressing ELAV. Computational analyses suggest that promoter regions of extended genes tend to contain paused Pol II and associated cis-regulatory elements such as GAGA. ChIP-Seq assays identify ELAV in the promoter regions of extended genes. Our study provides evidence for a regulatory link between promoter-proximal pausing and APA. PMID:25544561

Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding.

PubMed

Rippe, James M; Angelopoulos, Theodore J

2016-11-04

Added sugars are a controversial and hotly debated topic. Consumption of added sugars has been implicated in increased risk of a variety of chronic diseases including obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD) as well as cognitive decline and even some cancers. Support for these putative associations has been challenged, however, on a variety of fronts. The purpose of the current review is to summarize high impact evidence including systematic reviews, meta-analyses, and randomized controlled trials (RCTs), in an attempt to provide an overview of current evidence related to added sugars and health considerations. This paper is an extension of a symposium held at the Experimental Biology 2015 conference entitled "Sweeteners and Health: Current Understandings, Controversies, Recent Research Findings and Directions for Future Research". We conclude based on high quality evidence from randomized controlled trials (RCT), systematic reviews and meta-analyses of cohort studies that singling out added sugars as unique culprits for metabolically based diseases such as obesity, diabetes and cardiovascular disease appears inconsistent with modern, high quality evidence and is very unlikely to yield health benefits. While it is prudent to consume added sugars in moderation, the reduction of these components of the diet without other reductions of caloric sources seems unlikely to achieve any meaningful benefit.

Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding

PubMed Central

Rippe, James M.; Angelopoulos, Theodore J.

2016-01-01

Added sugars are a controversial and hotly debated topic. Consumption of added sugars has been implicated in increased risk of a variety of chronic diseases including obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD) as well as cognitive decline and even some cancers. Support for these putative associations has been challenged, however, on a variety of fronts. The purpose of the current review is to summarize high impact evidence including systematic reviews, meta-analyses, and randomized controlled trials (RCTs), in an attempt to provide an overview of current evidence related to added sugars and health considerations. This paper is an extension of a symposium held at the Experimental Biology 2015 conference entitled “Sweeteners and Health: Current Understandings, Controversies, Recent Research Findings and Directions for Future Research”. We conclude based on high quality evidence from randomized controlled trials (RCT), systematic reviews and meta-analyses of cohort studies that singling out added sugars as unique culprits for metabolically based diseases such as obesity, diabetes and cardiovascular disease appears inconsistent with modern, high quality evidence and is very unlikely to yield health benefits. While it is prudent to consume added sugars in moderation, the reduction of these components of the diet without other reductions of caloric sources seems unlikely to achieve any meaningful benefit. PMID:27827899

A Review of the Cognitive Effects Observed in Humans Following Acute Supplementation with Flavonoids, and Their Associated Mechanisms of Action

PubMed Central

Bell, Lynne; Lamport, Daniel J.; Butler, Laurie T.; Williams, Claire M.

2015-01-01

Flavonoids are polyphenolic compounds found in varying concentrations in many plant-based foods. Recent studies suggest that flavonoids can be beneficial to both cognitive and physiological health. Long term flavonoid supplementation over a period of weeks or months has been extensively investigated and reviewed, particularly with respect to cognitive ageing and neurodegenerative disease. Significantly less focus has been directed towards the short term effects of single doses of flavonoids on cognition. Here, we review 21 such studies with particular emphasis on the subclass and dose of flavonoids administered, the cognitive domains affected by flavonoid supplementation, and the effect size of the response. The emerging evidence suggests that flavonoids may be beneficial to attention, working memory, and psychomotor processing speed in a general population. Episodic memory effects are less well defined and may be restricted to child or older adult populations. The evidence also points towards a dose-dependent effect of flavonoids, but the physiological mechanisms of action remain unclear. Overall, there is encouraging evidence that flavonoid supplementation can benefit cognitive outcomes within an acute time frame of 0–6 h. But larger studies, combining cognitive and physiological measures, are needed to strengthen the evidence base. PMID:26690214

Cognition in multiple sclerosis

PubMed Central

Benedict, Ralph; Enzinger, Christian; Filippi, Massimo; Geurts, Jeroen J.; Hamalainen, Paivi; Hulst, Hanneke; Inglese, Matilde; Leavitt, Victoria M.; Rocca, Maria A.; Rosti-Otajarvi, Eija M.; Rao, Stephen

2018-01-01

Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS), especially deficits in episodic memory and processing speed. The field aims to (1) incorporate cognitive assessment into standard clinical care and clinical trials, (2) utilize state-of-the-art neuroimaging to more thoroughly understand neural bases of cognitive deficits, and (3) develop effective, evidence-based, clinically feasible interventions to prevent or treat cognitive dysfunction, which are lacking. There are obstacles to these goals. Our group of MS researchers and clinicians with varied expertise took stock of the current state of the field, and we identify several important practical and theoretical challenges, including key knowledge gaps and methodologic limitations related to (1) understanding and measurement of cognitive deficits, (2) neuroimaging of neural bases and correlates of deficits, and (3) development of effective treatments. This is not a comprehensive review of the extensive literature, but instead a statement of guidelines and priorities for the field. For instance, we provide recommendations for improving the scientific basis and methodologic rigor for cognitive rehabilitation research. Toward this end, we call for multidisciplinary collaborations toward development of biologically based theoretical models of cognition capable of empirical validation and evidence-based refinement, providing the scientific context for effective treatment discovery. PMID:29343470

Opportunities to meet challenges in rural prevention research: findings from an evolving community-university partnership model.

PubMed

Spoth, Richard

2007-01-01

Various rural prevention research challenges have been articulated through a series of sessions convened since the mid 1990s by the National Institutes of Health, particularly the National Institute on Drug Abuse. Salient in this articulation was the need for effective collaboration among rural practitioners and scientists, with special consideration of accommodating the diversity of rural areas and surmounting barriers to implementation of evidence-based interventions. This paper summarizes the range of challenges in rural prevention research and describes an evolving community-university partnership model addressing them. The model entails involvement of public school staff and other rural community stakeholders, linked with scientists by Land Grant University-based Extension system staff. Examples of findings from over 16 years of partnership-based intervention research projects include those on engagement of rural residents, quality implementation of evidence-based interventions, and long-term community-level outcomes, as well as factors in effectiveness of the partnerships. Findings suggest a future focus on building capacity for practitioner-scientist collaboration and developing a network for more widespread implementation of the partnership model in a manner informed by lessons learned from partnership-based research to date.

Climate Envelope Modeling and Dispersal Simulations Show Little Risk of Range Extension of the Shipworm, Teredo navalis (L.), in the Baltic Sea

PubMed Central

Appelqvist, Christin; Al-Hamdani, Zyad K.; Jonsson, Per R.; Havenhand, Jon N.

2015-01-01

The shipworm, Teredo navalis, is absent from most of the Baltic Sea. In the last 20 years, increased frequency of T. navalis has been reported along the southern Baltic Sea coasts of Denmark, Germany, and Sweden, indicating possible range-extensions into previously unoccupied areas. We evaluated the effects of historical and projected near-future changes in salinity, temperature, and oxygen on the risk of spread of T. navalis in the Baltic. Specifically, we developed a simple, GIS-based, mechanistic climate envelope model to predict the spatial distribution of favourable conditions for adult reproduction and larval metamorphosis of T. navalis, based on published environmental tolerances to these factors. In addition, we used a high-resolution three-dimensional hydrographic model to simulate the probability of spread of T. navalis larvae within the study area. Climate envelope modeling showed that projected near-future climate change is not likely to change the overall distribution of T. navalis in the region, but will prolong the breeding season and increase the risk of shipworm establishment at the margins of the current range. Dispersal simulations indicated that the majority of larvae were philopatric, but those that spread over a wider area typically spread to areas unfavourable for their survival. Overall, therefore, we found no substantive evidence for climate-change related shifts in the distribution of T. navalis in the Baltic Sea, and no evidence for increased risk of spread in the near-future. PMID:25768305

Angry facial expressions bias gender categorization in children and adults: behavioral and computational evidence

PubMed Central

Bayet, Laurie; Pascalis, Olivier; Quinn, Paul C.; Lee, Kang; Gentaz, Édouard; Tanaka, James W.

2015-01-01

Angry faces are perceived as more masculine by adults. However, the developmental course and underlying mechanism (bottom-up stimulus driven or top-down belief driven) associated with the angry-male bias remain unclear. Here we report that anger biases face gender categorization toward “male” responding in children as young as 5–6 years. The bias is observed for both own- and other-race faces, and is remarkably unchanged across development (into adulthood) as revealed by signal detection analyses (Experiments 1–2). The developmental course of the angry-male bias, along with its extension to other-race faces, combine to suggest that it is not rooted in extensive experience, e.g., observing males engaging in aggressive acts during the school years. Based on several computational simulations of gender categorization (Experiment 3), we further conclude that (1) the angry-male bias results, at least partially, from a strategy of attending to facial features or their second-order relations when categorizing face gender, and (2) any single choice of computational representation (e.g., Principal Component Analysis) is insufficient to assess resemblances between face categories, as different representations of the very same faces suggest different bases for the angry-male bias. Our findings are thus consistent with stimulus-and stereotyped-belief driven accounts of the angry-male bias. Taken together, the evidence suggests considerable stability in the interaction between some facial dimensions in social categorization that is present prior to the onset of formal schooling. PMID:25859238

Controls of late Palaeozoic and Mesozoic extension in the British Isles: evidence from seismic reflection data in the Central North Sea

NASA Astrophysics Data System (ADS)

Smith, K.; Cameron, T. D. J.

2009-04-01

Controls of late Palaeozoic and Mesozoic extension in the British Isles: evidence from seismic reflection data in the Central North Sea. Kevin Smith (1) and Don Cameron (2) (1) British Geological Survey, Murchison House, West Mains Road, Edinburgh, EH9 3LA. (ksm@bgs.ac.uk). (2) British Geological Survey, 376 Gilmerton Road, Edinburgh, EH17 7QS. In the area of the British Isles during the late Devonian and early Carboniferous, the oblique convergence of Laurentia and Gondwana imposed a torque on the adjoining terranes of Baltica and Avalonia. Their resulting clockwise rotation was accommodated by widely distributed N-S extension in the intervening zones previously formed by Caledonian and Acadian convergence. South of Laurentia and Baltica, late Palaeozoic extension was focused (1) at terrane margins, (2) in areas of limited Caledonian-Acadian plutonism, and (3) in places where the western (Iapetus) and eastern (Tornquist) convergence zones intersect at a high angle. One of these latter areas lies in Central England immediately north of the Midland Microcraton (part of Eastern Avalonia), where thermal subsidence associated with early Carboniferous extension gave rise to the late Carboniferous Pennine Basin. Interpretation of an extensive set of 3D and 2D long-offset seismic reflection data suggests that a similar area of enhanced extension at a fold belt intersection lies to north of the Mid North Sea High in the middle of the Central North Sea. Variscan uplift and inversion of the late Palaeozoic basins began to predominate in mid-Carboniferous times as final amalgamation of all the different terranes to form Pangaea curtailed the initial episode of extension and thermal subsidence. This change in the tectonic regime was associated with the onset of tholeiitic volcanism within the convergence zones, and was followed by localised extension during the earliest Permian. Evidence obtained from seismic interpretation of the deep structure of the UK sector of the Central North Sea, suggests that late Carboniferous uplift and inversion along a northerly-trending axis analogous to the Pennine anticline controlled rift orientation during the episode of late Jurassic and early Cretaceous extension that formed the Central Graben. Other evidence indicates that subsequent local inversion of the Mesozoic basins in the same area can be spatially linked to the previous framework of late Devonian and early Carboniferous extension. In Scotland, north of the Southern Uplands, the pattern of late Palaeozoic extension in the Midland Valley is similar to that in England and the Central North Sea. Minor differences can be attributed to the greater effect of Laurentian tectonics in Scotland, including the development of Lower Devonian basins and volcanic rocks, and the influence of strike-slip faults of the NNE-trending Great Glen set, which originated between Laurentia and Baltica, largely to the north of the terranes of southern, Gondwanan, affinity. Published regional interpretations of variation in depth to the Moho in the UK can be used to examine the relative contribution of crustal stretching and magmatic underplating across the area.

Deep Recurrent Neural Network-Based Autoencoders for Acoustic Novelty Detection

PubMed Central

Vesperini, Fabio; Schuller, Björn

2017-01-01

In the emerging field of acoustic novelty detection, most research efforts are devoted to probabilistic approaches such as mixture models or state-space models. Only recent studies introduced (pseudo-)generative models for acoustic novelty detection with recurrent neural networks in the form of an autoencoder. In these approaches, auditory spectral features of the next short term frame are predicted from the previous frames by means of Long-Short Term Memory recurrent denoising autoencoders. The reconstruction error between the input and the output of the autoencoder is used as activation signal to detect novel events. There is no evidence of studies focused on comparing previous efforts to automatically recognize novel events from audio signals and giving a broad and in depth evaluation of recurrent neural network-based autoencoders. The present contribution aims to consistently evaluate our recent novel approaches to fill this white spot in the literature and provide insight by extensive evaluations carried out on three databases: A3Novelty, PASCAL CHiME, and PROMETHEUS. Besides providing an extensive analysis of novel and state-of-the-art methods, the article shows how RNN-based autoencoders outperform statistical approaches up to an absolute improvement of 16.4% average F-measure over the three databases. PMID:28182121

Exploring the Roles of Nucleobase Desolvation and Shape Complementarity during the Misreplication of O6-Methylguanine

PubMed Central

Chavarria, Delia; Ramos-Serrano, Andrea; Hirao, Ichiro; Berdis, Anthony J.

2011-01-01

O6-methylguanine is a miscoding DNA lesion arising from the alkylation of guanine. This report uses the bacteriophage T4 DNA polymerase as a model to probe the roles hydrogen-bonding interactions, shape/size, and nucleobase desolvation during the replication of this miscoding lesion. This was accomplished by using transient kinetic techniques to monitor the kinetic parameters for incorporating and extending natural and non-natural nucleotides. In general, the efficiency of nucleotide incorporation does not depend on the hydrogen-bonding potential of the incoming nucleotide. Instead, nucleobase hydrophobicity and shape complementarity appear to be the preeminent factors controlling nucleotide incorporation. In addition, shape complementarity plays a large role in controlling the extension of various mispairs containing O6-methylguanine. This is evident as the rate constants for extension correlate with proper interglycosyl distances and symmetry between the base angles of the formed mispair. Base pairs not conforming to an acceptable geometry within the polymerase’s active site are refractory to elongation and are processed via exonuclease proofreading. The collective data set encompassing nucleotide incorporation, extension, and excision is used to generate a model accounting for the mutagenic potential of O6-methylguanine observed in vivo. In addition, kinetic studies monitoring the incorporation and extension of non-natural nucleotides identified an analog that displays high selectivity for incorporation opposite O6-methylguanine compared to unmodified purines. The unusual selectivity of this analog for replicating damaged DNA provides a novel biochemical tool to study translesion DNA synthesis. PMID:21819995

Scandinavian guidelines for initial management of minor and moderate head trauma in children.

PubMed

Astrand, Ramona; Rosenlund, Christina; Undén, Johan

2016-02-18

The management of minor and moderate head trauma in children differs widely between countries. Presently, there are no existing guidelines for management of these children in Scandinavia. The purpose of this study was to produce new evidence-based guidelines for the initial management of head trauma in the paediatric population in Scandinavia. The primary aim was to detect all children in need of neurosurgical intervention. Detection of any traumatic intracranial injury on CT scan was an important secondary aim. General methodology according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used. Systematic evidence-based review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology and based upon relevant clinical questions with respect to patient-important outcomes. Quality ratings of the included studies were performed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 and Centre of Evidence Based Medicine (CEBM)-2 tools. Based upon the results, GRADE recommendations, a guideline, discharge instructions and in-hospital observation instructions were drafted. For elements with low evidence, a modified Delphi process was used for consensus, which included relevant clinical stakeholders. The guidelines include criteria for selecting children for CT scans, in-hospital observation or early discharge, and suggestions for monitoring routines and discharge advice for children and guardians. The guidelines separate mild head trauma patients into high-, medium- and low-risk categories, favouring observation for mild, low-risk patients as an attempt to reduce CT scans in children. We present new evidence and consensus based Scandinavian Neurotrauma Committee guidelines for initial management of minor and moderate head trauma in children. These guidelines should be validated before extensive clinical use and updated within four years due to rapid development of new diagnostic tools within paediatric neurotrauma.

Do the cerebellar tonsils move during flexion and extension of the neck in patients with Chiari I malformation? A radiological study with clinical implications.

PubMed

Tubbs, R Shane; Kirkpatrick, Christina M; Rizk, Elias; Chern, Joshua J; Oskouian, Rod J; Oakes, W Jerry

2016-03-01

In the past, diagnosis of the Chiari I malformation has primarily been made on midsagittal MRI. We hypothesized that based on the frequent presentation of opisthotonos in patients with hindbrain hernia (primarily Chiari II malformation but sometimes Chiari I malformation) that the hyperextension might be a compensatory technique used by such patients to bring the cerebellar tonsils up out of the cervical spine. This prospective study reviewed imaging of patients with Chiari I malformation who underwent flexion/extension MRI for evaluation of their hindbrain herniation. Age-matched controls were used for comparison. In general, there was elevation of the cerebellar tonsils with extension and increased descent with flexion of the cervical spine. In 72 % of patients, flexion of the neck resulted in descent of the cerebellar tonsils. In 64 % of patients, extension of the neck resulted in ascent of the cerebellar tonsils. In the 14 patients with an associated syrinx, 71 % were found to have caudal movement of the cerebellar tonsils with neck flexion, and only 43 % were observed to have any movement of the cerebellar tonsils in neck extension compared to patients without a syrinx where ascent of the tonsils was seen in only nine during neck extension. Two patients were observed to have the reverse finding of ascent of the cerebellar tonsils with neck flexion and descent of the cerebellar tonsils with neck extension. Five patients had no movement of the cerebellar tonsils in either flexion or extension of the neck, and one of these had a small syrinx. Although minimal and not in all patients, we observed elevation of the herniated cerebellar tonsils with extension of the cervical spine in patients with Chiari I malformation. This finding provides evidence as to why some patients with hindbrain herniation present with opisthotonos and supports earlier findings that CSF flow is reduced at the craniocervical junction in flexion in patients with Chiari I malformation.

Vulnerability-specific stress generation: An examination of negative cognitive and interpersonal styles

PubMed Central

Liu, Richard T.; Alloy, Lauren B.; Mastin, Becky M.; Choi, Jimmy Y.; Boland, Elaine M.; Jenkins, Abby L.

2014-01-01

Although there is substantial evidence documenting the stress generation effect in depression (i.e., the tendency for depression-prone individuals to experience higher rates of life stress to which they contribute), additional research is required to advance current understanding of the specific types of dependent stress (i.e., events influenced by characteristics and attendant behaviors of the individual) relevant to this effect. The present study tested an extension of the stress generation hypothesis, in which the content of dependent stress that is produced by depression-prone individuals is contingent upon, and matches, the nature of their particular vulnerabilities. This extension was tested within the context of two cognitive models (i.e., hopelessness theory [Abramson, Metalsky, & Alloy, 1989] and Cole’s [1990, 1991] competency-based model) and two interpersonal models (i.e., Swann’s [1987] self-verification theory and Coyne’s [1976] interpersonal theory) of depression. Overall, support was obtained for vulnerability-specific stress generation. Specifically, in analyses across vulnerability domains, evidence of stress-generation specificity was found for all domain-specific cognitive vulnerabilities except self-perceived social competence. The within-domain analyses for cognitive vulnerabilities produced more mixed results, but were largely supportive. Additionally, excessive reassurance-seeking was specifically predictive of dependent stress in the social domain, and moderated, but did not mediate, the relation between negative inferential styles overall and in the interpersonal domain and their corresponding generated stress. Finally, no evidence was found for a stress generation effect with negative feedback-seeking. PMID:24679143

Property rights and water markets in Australia: An evolutionary process toward institutional reform

NASA Astrophysics Data System (ADS)

Pigram, John J.

1993-04-01

In the past decade far-reaching reforms have taken place in the Australian water industry. Extensive restructuring of water administration has been accompanied by increased evidence of willingness by public agencies to consider alternative institutional arrangements to the traditional regulatory approach to water allocation and use. In irrigated agriculture, a market-based system linked to enforceable property rights to water is seen as preferable to rule-based management of water resources. However, significant social and economic considerations and political realities constrain the unfettered operation of water markets. The challenge facing the irrigation industry in Australia is to put in place institutional arrangements which reflect the most appropriate mix of incentive-based and regulatory mechanisms for water management.

How children remember neutral and emotional pictures: boundary extension in children's scene memories.

PubMed

Candel, Ingrid; Merckelbach, Harald; Houben, Katrijn; Vandyck, Inne

2004-01-01

Boundary extension is the tendency to remember more of a scene than was actually shown. The dominant interpretation of this memory illusion is that it originates from schemata that people construct when viewing a scene. Evidence of boundary extension has been obtained primarily with adult participants who remember neutral pictures. The current study addressed the developmental stability of this phenomenon. Therefore, we investigated whether children aged 10-12 years display boundary extension for neutral pictures. Moreover, we examined emotional scene memory. Eighty-seven children drew pictures from memory after they had seen either neutral or emotional pictures. Both their neutral and emotional drawings revealed boundary extension. Apparently, the schema construction that underlies boundary extension is a robust and ubiquitous process.

Distilling Common History and Practice Elements to Inform Dissemination: Hanf-Model BPT Programs as an Example

PubMed Central

Kaehler, Laura A.; Jacobs, Mary; Jones, Deborah J.

2016-01-01

There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically-supported interventions in general and the core components of specific approaches in particular. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early-onset disruptive behavior disorders (Oppositional Defiant Disorder and Conduct Disorder), which frequently co-occur with Attention Deficit Hyperactivity Disorder, is well-established; yet, an ahistorical, program-specific lens tells little regarding how leaders, including Constance Hanf at the University of Oregon, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; Cunningham, Bremner, & Boyle, 1995; Cunningham, Bremner, Secord, & Harrison, 2009), Defiant Children (DC; Barkley 1987; Barkley, 2013), Helping the Noncompliant Child (HNC; Forehand & McMahon, 1981; McMahon & Forehand, 2003), Parent-Child Interaction Therapy (PCIT; Eyberg, & Robinson, 1982; Eyberg, 1988; Eyberg & Funderburk, 2011), and the Incredible Years (IY; Webster-Stratton, 1981; 1982; 2008). Our goal is not to provide an exhaustive review of the evidence-base for the Hanf-Model programs; rather, our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed. PMID:27389606

Educational Mismatches and Earnings: Extensions of Occupational Mobility Theory and Evidence of Human Capital Depreciation

ERIC Educational Resources Information Center

Rubb, Stephen

2006-01-01

Using a human capital theory framework, this study examines the impact of educational mismatches on earnings and occupational mobility. Occupational mobility theory suggests that overeducated workers observe greater upward occupational mobility and undereducated workers observe lower upward occupational mobility. By extension, this leads to…

Modelling uncertainty with generalized credal sets: application to conjunction and decision

NASA Astrophysics Data System (ADS)

Bronevich, Andrey G.; Rozenberg, Igor N.

2018-01-01

To model conflict, non-specificity and contradiction in information, upper and lower generalized credal sets are introduced. Any upper generalized credal set is a convex subset of plausibility measures interpreted as lower probabilities whose bodies of evidence consist of singletons and a certain event. Analogously, contradiction is modelled in the theory of evidence by a belief function that is greater than zero at empty set. Based on generalized credal sets, we extend the conjunctive rule for contradictory sources of information, introduce constructions like natural extension in the theory of imprecise probabilities and show that the model of generalized credal sets coincides with the model of imprecise probabilities if the profile of a generalized credal set consists of probability measures. We give ways how the introduced model can be applied to decision problems.

Can therapeutic Thai massage improve upper limb muscle strength in Parkinson's disease? An objective randomized-controlled trial.

PubMed

Miyahara, Yuka; Jitkritsadakul, Onanong; Sringean, Jirada; Aungkab, Nicharee; Khongprasert, Surasa; Bhidayasiri, Roongroj

2018-04-01

Muscle weakness is a frequent complaint amongst Parkinson's disease (PD) patients. However, evidence-based therapeutic options for this symptom are limited. We objectively measure the efficacy of therapeutic Thai massage (TTM) on upper limb muscle strength, using an isokinetic dynamometer. A total of 60 PD patients with muscle weakness that is not related to their 'off' periods or other neurological causes were equally randomized to TTM intervention (n = 30), consisting of six TTM sessions over a 3-week period, or standard medical care (no intervention, n = 30). Primary outcomes included peak extension and flexion torques. Scale-based outcomes, including Unified Parkinson's Disease Rating Scale (UPDRS) and visual analogue scale for pain (VAS) were also performed. From baseline to end of treatment, patients in the intervention group showed significant improvement on primary objective outcomes, including peak flexion torque (F = 30.613, p  < .001) and peak extension torque (F = 35.569, p  < .001) and time to maximal flexion speed (F = 14.216, p  = .001). Scale-based assessments mirrored improvements in the objective outcomes with a significant improvement from baseline to end of treatment of the UPDRS-bradykinesia of a more affected upper limb (F = 9.239, p  = .005), and VAS (F = 69.864, p  < .001) following the TTM intervention, compared to the control group. No patients reported adverse events in association with TTM. Our findings provide objective evidence that TTM used in combination with standard medical therapies is effective in improving upper limb muscle strength in patients with PD. Further studies are needed to determine the efficacy of TTM on other motor and non-motor symptoms in PD.

Two cases of sarcoidosis presenting as longitudinally extensive transverse myelitis.

PubMed

Scott, Amanda Mary; Yinh, Janeth; McAlindon, Timothy; Kalish, Robert

2018-05-17

Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment. Given its rarity and the diversity of possible manifestations, establishing the diagnosis of spinal cord sarcoidosis is often very difficult. Extensive evaluation must be conducted to rule out primary neurologic, primary rheumatologic, infectious, and neoplastic diseases. MRI often demonstrates hyperintensity on T2-weighted images and enhancement following gadolinium administration. CSF analysis most consistently shows a lymphocytic pleocytosis and elevated proteins. While these less invasive investigations may be helpful, the gold standard for diagnosis is biopsy of neurologic or non-neurologic tissue confirming the presence of non-caseating granulomas. Evidence-based guidelines for the treatment of transverse myelitis secondary to sarcoidosis are lacking due to its rarity; therefore, therapy is based on expert and anecdotal experience and usually consists of high doses of steroids in combination with various immunosuppressive agents. The use of infliximab in particular appears promising, but there is a need for further investigation into the ideal treatment regimen.

Dental Students' Use of AMSTAR to Critically Appraise Systematic Reviews.

PubMed

Teich, Sorin T; Heima, Masahiro; Lang, Lisa

2015-09-01

The idea of basing clinical procedures upon evidence gathered by observation is less than 200 years old, with the first set of evidence-based position papers dating back only to the early 1970s. The relationship between evidence-based education and health outcomes is difficult to test and may be indirect, but teaching critical appraisal skills may be beneficial in developing knowledge. Systematic reviews have a central role in the process of clinical decision making in practice and therefore should be of high quality, following a rigorous protocol that can be evaluated with validated tools. The aim of this study was to assess how dental students utilized the Assessment of Multiple Systematic Reviews (AMSTAR) appraisal tool to evaluate systematic reviews in the context of a treatment planning course. During the in-class final exam, students were required to appraise the quality of a systematic review and to justify their answers. Of the 74 third-year students who took the exam, 100% answered all questions on the AMSTAR form. The mean number of correct answers was nine (SD=1.047, Min=6, Max=10), with no student providing all 11 correct answers. The fact that nearly 90% of the students provided eight or more correct answers suggests that AMSTAR can be used by students to evaluate the methodological quality of systematic reviews. It also was evident that although the AMSTAR tool requires less than 15 minutes to complete an evaluation, using it requires extensive training and repetition to achieve consistent and reliable results.

Structures in the transition zone of the northeast South China Sea: serpentinite dome vs mantle exhumation, or evidence of Mesozoic active subduction transferring to Cenozoic passive extension?

NASA Astrophysics Data System (ADS)

Sun, Z.; Zhou, D.

2013-12-01

Complete sedimentary sequences and weak erosion make the transition zone of the South China Sea the optimal place to study the entire evolution history of marginal sea basins, as well as the transition mechanism from active subduction to passive extension. 2D long cable seismic profiles revealed that both Baiyun and Liwan sag in the northeast South China Sea margin were lack of large controlling faults, especially in Liwan sag, syn-rift sequences waved above the basement. Dome-like uplifts(serpetinite uplifts?) or diapirs(?) came from below the basement, caused the syn-rift sequences pushed up around 36Ma(T80). Gravity inversion based on seismic reflection indicated that the dome has a lower density and a lower layer velocity than normal crust. Also around the Continent-Ocean Boundary (COB), a small segment similar to the lower crust was exposed. Between this exposed segment and the Cenozoic oceanic crust, mantle seems to be exhumed along the breakup point. Between the COB and roughly the shelf break, high velocity lower crust was discriminated in the northeast continental margin. Structures in northeast South China Sea seems having many similarities with Newfoundland-Iberia margin, by serpentinite(?) dome and exhumed mantle, although spreading rate here is intermediate. In fact, regional background suggests that there might be another interpretation: transition from Mesozoic subduction to Cenozoic extension occurred through paleo oceanic crust breakup in the northeast, which in turn retained Mesozoic subduction system beneath the northeast continental margin. Confined with magnetic anomaly, Bouguer gravity gradient anomaly, and well drilling lithological evidences, Cenozoic Baiyun sag developed upon Mesozoic fore-arc, while Cenozoic Liwan sag developed upon Mesozoic accretionary prism. The high velocity lower crust was caused by both remnant subducted slab and by Oceanic-Continent interaction due to subduction. There might also be serpentinite dome and exhumed mantle, but may be caused by extension and breakup of paleo oceanic slab, not the depth-dependent extension. IODP drillings are needed to test all these scientific conjectures.

Strike-slip brittle shear zone from coastal Deccan in and around Mumbai, India: Evidence for N-S extension

NASA Astrophysics Data System (ADS)

Bhattacharya, Gourab; Ayan Misra, Achyuta; Bose, Narayan; Mukherjee, Soumyajit

2013-04-01

An E-W extension separated India from the Seychelles micro-continent at ~ 62 Ma. This post-dated the Deccan volcanic eruptions. However, the structures attributed to this extension lack geometrical quantification, especially in the western Indian coast. The Narmada-Tapi region, ~ 400 Km north of Mumbai, experienced a ~ N-S extension prior to and/or concurrent with the volcanism. Normal faults dip towards W. Sub-horizontal lava flows, slickensides, N-S shear zones etc. have been reported from the western part of the Deccan Large Igneous Province (DLIP). This work, for the first time, identifies and investigates a ~ 20°N strike-slip brittle shear zone, traced for ~ 100 Km along the west coast of India from Mumbai to Murud by fieldworks. The W-block moved north through a dextral-slip. Deformation is more enhanced in the south (near Murud). Field observations reveal Y-planes (~ N20°E; abundant), Riedels (~ 0-N30°E; abundant), anti-Riedels (~ N30-50°W; less abundant), asymmetric elevations (~ N15°E; locally abundant), extension and en-echelon fractures (2 sets: ~N-S and ~E-W) with a single miniature pull-apart basin (~ N-S extension). The E-W fractures reactivated locally and around Murud slipped/faulted ~ N-S dykes. Average directions of paleostress tensors were computed for the regime yielding σ1 (trend = 99°; plunge = 0°), σ2 (trend = 196°; plunge = 90°) and σ3 (trend = 10°; plunge = 0°). Associated strain results convincingly display a dominant N-S extension. It was not possible to establish which set of extensions (i.e. between N-S and E-W) occurred earlier. Alongside E-W extension, structurally weak shear zones might have channelized late-stage intrusions of ~ N-S dykes. The DLIP was not subject to any post-rifting deformations regionally, except isostatic adjustments. Hence, based on available data, we postulate that these two extensions were coevally operating in the late phases of the Deccan eruptions. As the Indian plate drifted NE, the strike-slip brittle shear zone might have been a structural adjustment in response to the E-W extension.

Extending the Implicit Association Test (IAT): Assessing Consumer Attitudes Based on Multi-Dimensional Implicit Associations

PubMed Central

Gattol, Valentin; Sääksjärvi, Maria; Carbon, Claus-Christian

2011-01-01

Background The authors present a procedural extension of the popular Implicit Association Test (IAT; [1]) that allows for indirect measurement of attitudes on multiple dimensions (e.g., safe–unsafe; young–old; innovative–conventional, etc.) rather than on a single evaluative dimension only (e.g., good–bad). Methodology/Principal Findings In two within-subjects studies, attitudes toward three automobile brands were measured on six attribute dimensions. Emphasis was placed on evaluating the methodological appropriateness of the new procedure, providing strong evidence for its reliability, validity, and sensitivity. Conclusions/Significance This new procedure yields detailed information on the multifaceted nature of brand associations that can add up to a more abstract overall attitude. Just as the IAT, its multi-dimensional extension/application (dubbed md-IAT) is suited for reliably measuring attitudes consumers may not be consciously aware of, able to express, or willing to share with the researcher [2], [3]. PMID:21246037

ANIMAL ANALOGIES IN FIRST IMPRESSIONS OF FACES.

PubMed

Zebrowitz, Leslie A; Wadlinger, Heather A; Luevano, Victor X; White, Benjamin M; Xing, Cai; Zhang, Yi

2011-08-01

Analogies between humans and animals based on facial resemblance have a long history. We report evidence for reverse anthropomorphism and the extension of facial stereotypes to lions, foxes, and dogs. In the stereotype extension, more positive traits were attributed to animals judged more attractive than con-specifics; more childlike traits were attributed to those judged more babyfaced. In the reverse anthropomorphism, human faces with more resemblance to lions, ascertained by connectionist modeling of facial metrics, were judged more dominant, cold, and shrewd, controlling attractiveness, babyfaceness, and sex. Faces with more resemblance to Labradors were judged warmer and less shrewd. Resemblance to foxes did not predict impressions. Results for lions and dogs were consistent with trait impressions of these animals and support the species overgeneralization hypothesis that evolutionarily adaptive reactions to particular animals are overgeneralized, with people perceived to have traits associated with animals their faces resemble. Other possible explanations are discussed.

ANIMAL ANALOGIES IN FIRST IMPRESSIONS OF FACES

PubMed Central

Zebrowitz, Leslie A.; Wadlinger, Heather A.; Luevano, Victor X.; White, Benjamin M.; Xing, Cai; Zhang, Yi

2013-01-01

Analogies between humans and animals based on facial resemblance have a long history. We report evidence for reverse anthropomorphism and the extension of facial stereotypes to lions, foxes, and dogs. In the stereotype extension, more positive traits were attributed to animals judged more attractive than con-specifics; more childlike traits were attributed to those judged more babyfaced. In the reverse anthropomorphism, human faces with more resemblance to lions, ascertained by connectionist modeling of facial metrics, were judged more dominant, cold, and shrewd, controlling attractiveness, babyfaceness, and sex. Faces with more resemblance to Labradors were judged warmer and less shrewd. Resemblance to foxes did not predict impressions. Results for lions and dogs were consistent with trait impressions of these animals and support the species overgeneralization hypothesis that evolutionarily adaptive reactions to particular animals are overgeneralized, with people perceived to have traits associated with animals their faces resemble. Other possible explanations are discussed. PMID:25339791

Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District.

PubMed

Souza, Bruna Marcela Lima de; Salviano, Cristiane Feitosa; Martins, Gisele

2018-01-01

To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

Integrating evidence-based treatments for common mental disorders in routine primary care: feasibility and acceptability of the MANAS intervention in Goa, India

PubMed Central

CHATTERJEE, SUDIPTO; CHOWDHARY, NEERJA; PEDNEKAR, SULOCHANA; COHEN, ALEX; ANDREW, GRACY; ANDREW, GRACY; ARAYA, RICARDO; SIMON, GREGORY; KING, MICHAEL; TELLES, SHIRLEY; VERDELI, HELENA; CLOUGHERTY, KATHLEEN; KIRKWOOD, BETTY; PATEL, VIKRAM

2008-01-01

Common mental disorders, such as depression and anxiety, pose a major public health burden in developing countries. Although these disorders are thought to be best managed in primary care settings, there is a dearth of evidence about how this can be achieved in low resource settings. The MANAS project is an attempt to integrate an evidence based package of treatments into routine public and private primary care settings in Goa, India. Before initiating the trial, we carried out extensive preparatory work, over a period of 15 months, to examine the feasibility and acceptability of the planned intervention. This paper describes the systematic development and evaluation of the intervention through this preparatory phase. The preparatory stage, which was implemented in three phases, utilized quantitative and qualitative methods to inform our understanding of the potential problems and possible solutions in implementing the trial and led to critical modifications of the original intervention plan. Investing in systematic formative work prior to conducting expensive trials of the effectiveness of complex interventions is a useful exercise which potentially improves the likelihood of a positive result of such trials. PMID:18458786

Quality assurance in pathology in colorectal cancer screening and diagnosis—European recommendations

PubMed Central

Quirke, Phil; Risio, Mauro; Lambert, René; von Karsa, Lawrence

2010-01-01

In Europe, colorectal cancer is the most common newly diagnosed cancer and the second most common cause of cancer deaths, accounting for approximately 436,000 incident cases and 212,000 deaths in 2008. The potential of high-quality screening to improve control of the disease has been recognized by the Council of the European Union who issued a recommendation on cancer screening in 2003. Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document consists of ten chapters and an extensive evidence base. The content of the chapter dealing with pathology in colorectal cancer screening and diagnosis is presented here in order to promote international discussion and collaboration leading to improvements in colorectal cancer screening and diagnosis by making the principles and standards recommended in the new EU Guidelines known to a wider scientific community. PMID:21061133

Yoga for Health Care in Korea: A Protocol for Systematic Review of Clinical Trials.

PubMed

Choi, Jiae; Jun, Ji Hee; Lee, Ju Ah; Lee, Myeong Soo

2016-08-01

This systematic review aims to evaluate the therapeutic effects of yoga therapy using an evidence-based approach and investigates the relationship between yoga and the meridian energies based on all available clinical studies in Korea. Sixteen electronic databases will be searched from the inception of the study until January 2016. All clinical evidences that evaluate any type of yoga and any type of control in individuals with any type of condition will be eligible. The methodological quality will be assessed using the Cochrane risk of bias tool for randomized clinical trials and the Newcastle-Ottawa scale for nonrandomized studies. Two authors will independently assess each study for eligibility and the risk of bias, and then they will extract the data. With its extensive, unbiased search of the Korean literature from various databases without any language restrictions, this systematic review will be useful for both practitioners in the field of yoga research as well as for patients. Copyright © 2016. Published by Elsevier B.V.

The Florence Statement on Triclosan and Triclocarban

PubMed Central

Halden, Rolf U.; Aiello, Allison E.; Andrews, David; Arnold, William A.; Fair, Patricia; Fuoco, Rebecca E.; Geer, Laura A.; Johnson, Paula I.; Lohmann, Rainer; McNeill, Kristopher; Sacks, Victoria P.; Schettler, Ted; Weber, Roland; Zoeller, R. Thomas; Blum, Arlene

2017-01-01

Summary: The Florence Statement on Triclosan and Triclocarban documents a consensus of more than 200 scientists and medical professionals on the hazards of and lack of demonstrated benefit from common uses of triclosan and triclocarban. These chemicals may be used in thousands of personal care and consumer products as well as in building materials. Based on extensive peer-reviewed research, this statement concludes that triclosan and triclocarban are environmentally persistent endocrine disruptors that bioaccumulate in and are toxic to aquatic and other organisms. Evidence of other hazards to humans and ecosystems from triclosan and triclocarban is presented along with recommendations intended to prevent future harm from triclosan, triclocarban, and antimicrobial substances with similar properties and effects. Because antimicrobials can have unintended adverse health and environmental impacts, they should only be used when they provide an evidence-based health benefit. Greater transparency is needed in product formulations, and before an antimicrobial is incorporated into a product, the long-term health and ecological impacts should be evaluated. https://doi.org/10.1289/EHP1788 PMID:28632490

Current status of psychiatric rehabilitation in Portugal: A national survey.

PubMed

Teixeira, Carina; Santos, Eduardo; Abreu, Manuel Viegas; Rogers, E Sally

2015-09-01

This article reports on the current state of psychiatric rehabilitation in Portugal. A paper-and-pencil survey was sent to 70 institutions to inquire about the provision of psychiatric rehabilitation services and programs. With a response rate of 40%, 14% of institutions indicated that supported education was provided, 36% offered nonmainstream vocational training, and 29% provided supported employment; none provided evidence-based Individual Placement and Support. Permanent group homes in the community (29%) followed by transitional group homes on institutional grounds (18%) were the most common residential services, with supported housing services (14%) offered less frequently. Finally, 93% of institutions offered occupational activities, 61% provided multifamily psychoeducation, and 36% provided single-family psychoeducation. Despite recent national initiatives promoting effective psychiatric rehabilitation services, supported employment, supported education, and supported housing are not widely implemented in Portugal. To achieve better outcomes for clients, it is critical that evidence-based and promising practices be extensively disseminated. (c) 2015 APA, all rights reserved).

Fire and vegetation history of the Jemez Mountains

USGS Publications Warehouse

Allen, Craig D.; Johnson, Peggy S.

2001-01-01

Historic patterns of fire occurrence and vegetation change in the Jemez Mountains of northern New Mexico have been described in detail by using multiple lines of evidence. Data sources include old aerial and ground-based photographs, historic records, charcoal deposits from bogs, fire-scarred trees (Figure 1), tree-ring reconstructions of precipitation, and field sampling of vegetation and soils. The forests and woodlands that cloak the Southwestern uplands provide the most extensive and detailed regional-scale network of fire history data available in the world (Swetnam and Baisan 1996, Swetnam et al. 1999, Allen 2002).

Cool circumstellar matter around nearby main-sequence stars

NASA Technical Reports Server (NTRS)

Walker, H. J.; Wolstencroft, R. D.

1988-01-01

Stars are presented which have characteristics similar to Vega and other main-sequence stars with cool dust disks, based on the IRAS Point Source Catalog fluxes. The objects are selected to have a 60-micron/100-micron ratio similar to Vega, Beta Pic, Alpha PsA, and Epsilon Eri, and they are also required to show evidence of extension in the IRAS Working Survey Database. The fluxes are modeled using a blackbody energy distribution. The temperatures derived range from 50 to 650 K. The diameters of the dust disks observed by IRAS are estimated.

Water-soluble constituents of the root barks of Fraxinus rhynchophylla (Chinese drug Qinpi).

PubMed

Xiao, Kai; Song, Qing-Hong; Zhang, Shu-Wei; Xuan, Li-Jiang

2008-01-01

Chemical studies on the roots of Fraxinus rhynchophylla led to the isolation of fraxisecoside (1), a novel coumarin-secoiridoid hybrid glycoside, namely, fraxetin-8-O-[11'-methyl-oleosidyl-(7'-->6'')]-beta-D-glucopyranoside and 14 known compounds. Their structures were elucidated based on chemical evidence and spectroscopic analysis, including extensive 2D NMR methods. Compound 2 was first isolated as a pure compound. Compound 1 exhibited moderate PTP1B inhibition activity. Compounds 1 and 2 showed inhibition activity against B- and T-cell proliferation, without cytotoxicity.

Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol.

PubMed

Akram, Yasmin; Copello, Alex; Moore, David

2014-08-15

Worldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse. Extensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded. The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted. This systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of family-based interventions for substance misuse. It will evaluate all the available systematic-review-level literature to report on the effectiveness of family-based psychological interventions in improving substance-related outcomes and improving health and wellbeing of substance misusers and/or their families. This will inform future treatment policies and commissioning decisions.In addition, it will identify areas of poor quality, inconsistency and gaps in the evidence base for family-based psychological interventions in substance misuse with respect to secondary evidence in order to inform future research. PROSPERO CRD42014006834.

The epidemiology of bovine respiratory disease: What is the evidence for preventive measures?

PubMed Central

Taylor, Jared D.; Fulton, Robert W.; Lehenbauer, Terry W.; Step, Douglas L.; Confer, Anthony W.

2010-01-01

Bovine respiratory disease (BRD) is the most common and costly disease of beef cattle in North America. Despite extensive research, industry practices are often more informed by dogma than by fact. Frequently advocated interventions, including vaccination, various processing procedures, and nutritional manipulation, have limited impact on morbidity and mortality. Evidence for use of oral antimicrobials, either in feed or water, appears to be equivocal. In contrast, preconditioning and metaphylaxis have significant scientific evidence of efficacy, with weaning prior to sale potentially being the most important component of preconditioning. The inability to reach more definitive conclusions in preventing BRD may be attributable to difficulties in investigating the disease. Study challenges include potential for extensive confounding, tremendous variability, the multi-factorial nature of the disease, and inadequate methods for diagnosis. PMID:21358927

Psychological Perspectives on Interrogation.

PubMed

Vrij, Aldert; Meissner, Christian A; Fisher, Ronald P; Kassin, Saul M; Morgan, Charles A; Kleinman, Steven M

2017-11-01

Proponents of "enhanced interrogation techniques" in the United States have claimed that such methods are necessary for obtaining information from uncooperative terrorism subjects. In the present article, we offer an informed, academic perspective on such claims. Psychological theory and research shows that harsh interrogation methods are ineffective. First, they are likely to increase resistance by the subject rather than facilitate cooperation. Second, the threatening and adversarial nature of harsh interrogation is often inimical to the goal of facilitating the retrieval of information from memory and therefore reduces the likelihood that a subject will provide reports that are extensive, detailed, and accurate. Third, harsh interrogation methods make lie detection difficult. Analyzing speech content and eliciting verifiable details are the most reliable cues to assessing credibility; however, to elicit such cues subjects must be encouraged to provide extensive narratives, something that does not occur in harsh interrogations. Evidence is accumulating for the effectiveness of rapport-based information-gathering approaches as an alternative to harsh interrogations. Such approaches promote cooperation, enhance recall of relevant and reliable information, and facilitate assessments of credibility. Given the available evidence that torture is ineffective, why might some laypersons, policymakers, and interrogation personnel support the use of torture? We conclude our review by offering a psychological perspective on this important question.

Evidence for Phanerozoic reactivation of the Najd Fault System in AVHRR, TM, and SPOT images of central Arabia

NASA Technical Reports Server (NTRS)

Andre, Constance G.

1989-01-01

SPOT stereoscopic and TM multispectral images support evidence in AVHRR thermal-IR images of a major unmapped shear zone in Phanerozoic cover rocks southeast of the ancient Najd Fault System in the Arabian Shield. This shear zone and faults of the Najd share a common alignment, orientation, and sinistral sense of movement. These similarities suggest a 200-km extension of the Najd Fault System and reactivation since it formed in the late Precambrian. Topographic and lithologic features in the TM and SPOT data along one of three faults inferred from the AVHRR data indicate sinistral offsets up to 2.5 km, en echelon folds and secondary faults like those predicted by models of left-lateral strike-slip faulting. The age of the affected outcrops indicates reactivation of Najd faults in the Cretaceous, judging from TM and SPOT data or in the Tertiary, based on AVHRR data. The total length of the system visible at the surface measures 1300 km. If the Najd Fault System is extrapolated beneath sands of the Empty Quarter to faults of a similar trend in South Yemen, the shear zone would span the Arabian Plate. Furthermore, if extensions into the Arabian Sea bed and into Egypt proposed by others are considered, it would exceed 3000 km.

Extending Cognitive Load Theory to Incorporate Working Memory Resource Depletion: Evidence from the Spacing Effect

ERIC Educational Resources Information Center

Chen, Ouhao; Castro-Alonso, Juan C.; Paas, Fred; Sweller, John

2018-01-01

Depletion of limited working memory resources may occur following extensive mental effort resulting in decreased performance compared to conditions requiring less extensive mental effort. This "depletion effect" can be incorporated into cognitive load theory that is concerned with using the properties of human cognitive architecture,…

Assessing efficacy and therapeutic claims in emerging indications for recombinant factor VIIa: regulatory perspectives.

PubMed

Farrugia, Albert

2006-01-01

When compared with the evidence-based, cost-effectiveness criteria underpinning most government reimbursement schemes in the social market economies, the three regulatory hurdles of safety, quality and efficacy are probably of modest impact in influencing increased usage of recombinant activated factor VII (rFVIIa; NovoSeven, Novo Nordisk, Bagsvaerd, Denmark). Nevertheless, efficacy claims must be supported if regulatory approval is to be granted for the wider range of indications that have been proposed for rFVIIa. With the refinement of clinical trial designs over the past 40 years, the randomized controlled trial (RCT) has assumed the role of gold standard, providing the highest level of evidence for therapeutic efficacy. However, it is incorrect to assume that regulatory authorities give sole credence to RCTs in assessing claims. It is noteworthy that the indications already accepted for rFVIIa by international regulatory authorities--including the treatment of inhibitors to factor VIII and factor IX, substitution for FVII deficiency, and treatment of Glanzmann's thrombasthenia--were supported not by RCTs but by studies conventionally considered to provide modest evidence levels. Therefore, the use of studies other than RCTs for the more recently proposed indications for rFVIIa in a range of conditions requiring hemostatic correction is perfectly feasible. What regulators expect are well-conducted and well-described studies adhering to principles of good clinical practice, which can be scrutinized for evidence of clinical efficacy and which are based on the initially proven principle for the drug. This paper discusses the regulatory history of rFVIIa in the major regulatory authorities and assesses the route needed to support claims being made in the mainstream literature. Recent episodes where post-market events have forced regulators to be more than usually cautious will be used as examples to suggest possible pitfalls to the extension of approved claims for rFVIIa. The major paths for enhancing access for indications in small patient numbers, where RCTs are even more difficult to perform, will be described and their use for possible extension of rFVIIa indications will be discussed.

Engaging the Voice of Patients Affected by Gender-Based Violence: Informing Practice and Policy.

PubMed

Lewis-O'Connor, Annie; Chadwick, Mardi

2015-01-01

Evidence regarding the benefits, opportunities, and risks associated with providing health care to patients experiencing gender-based violence (GBV) and, moreover, their satisfaction with health care services is sparse. Using a patient- and trauma-informed relationship-based framework, survivors of GBV who were referred for follow-up care were asked to participate in a quality improvement (QI) initiative in an effort to understand their perspectives of receiving healthcare services. Patients were asked to answer three open-ended questions in regard to their healthcare experience. Individuals who were eligible for evidence collection after sexual assault (<5 days) were asked two additional questions. Of the 353 women and six men (359) referred to the C.A.R.E. (Coordinated Approach to Recovery and Empowerment) Clinic, 327 patients were contacted. Of the participants, 24% (86) had a mental health diagnosis; 41% (145) reported their incident to the police; 8% (28) had comorbidities of substance abuse, mental health, and/or homelessness; and 33% (118) of the incidents involved alcohol or drugs. Most of the patients stated that they were well cared for and felt safe during their visit. However, many reported "long waits," "disjointed," "chaotic," "too many" providers, "conflicting" and "miss-information," and "confusion" about what to do after their acute care visit. Over half (59%) did not report incident to the police. Some reported regrets with reporting to the police (16%) and regrets in having evidence collection (15%). Of the patients who did not have evidence collected (47), none expressed regret over choosing not to have evidence collected. Five patients with mental health problems were hospitalized within 5 days of their emergency department visit for suicidal thoughts. A number of opportunities to improve the healthcare response were identified. Patients affected by GBV require an improved coordinated and trauma-informed approach. Explicit consent related to evidence collection is needed. Not all patients who have been sexually assaulted should have evidence collected. More extensive research and program evaluation including outcomes research are warranted.

Strategic analytics: towards fully embedding evidence in healthcare decision-making.

PubMed

Garay, Jason; Cartagena, Rosario; Esensoy, Ali Vahit; Handa, Kiren; Kane, Eli; Kaw, Neal; Sadat, Somayeh

2015-01-01

Cancer Care Ontario (CCO) has implemented multiple information technology solutions and collected health-system data to support its programs. There is now an opportunity to leverage these data and perform advanced end-to-end analytics that inform decisions around improving health-system performance. In 2014, CCO engaged in an extensive assessment of its current data capacity and capability, with the intent to drive increased use of data for evidence-based decision-making. The breadth and volume of data at CCO uniquely places the organization to contribute to not only system-wide operational reporting, but more advanced modelling of current and future state system management and planning. In 2012, CCO established a strategic analytics practice to assist the agency's programs contextualize and inform key business decisions and to provide support through innovative predictive analytics solutions. This paper describes the organizational structure, services and supporting operations that have enabled progress to date, and discusses the next steps towards the vision of embedding evidence fully into healthcare decision-making. Copyright © 2014 Longwoods Publishing.

ACR Appropriateness Criteria® Chronic Ankle Pain.

PubMed

Chang, Eric Y; Tadros, Anthony S; Amini, Behrang; Bell, Angela M; Bernard, Stephanie A; Fox, Michael G; Gorbachova, Tetyana; Ha, Alice S; Lee, Kenneth S; Metter, Darlene F; Mooar, Pekka A; Shah, Nehal A; Singer, Adam D; Smith, Stacy E; Taljanovic, Mihra S; Thiele, Ralf; Kransdorf, Mark J

2018-05-01

Chronic ankle pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic ankle pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Recombinant factor VIIa in major abdominal surgery and liver transplantation.

PubMed

da Silva Viana, J

2006-04-01

The author reviewed the literature regarding recombinant activated Factor VII (rFVIIa) in major abdominal surgery and liver transplantation and concluded that, on the basis of evidence-based medicine, there is no evidence to support an extensive use of rFVIIa. Nevertheless, various case reports suggest the usefulness of rFVIIa to treat life-threatening bleeding after failure of conventional therapies. It appears that there is a consensus that rFVIIa can be used with good results as a rescue therapy in extremely severe situations. Economic cost and potential thrombosis risk remain arguments against more widespread use of rFVIIa. Doses from 5 to 120 kg/kg in each administration have been reported without clear evidence to support a specific protocol. Efficacy of 15 to 20 kg/kg in surgical settings has been reported, but higher doses are more frequently used. The majority of the reviewed investigators accepted the use of rFVIIa after or simultaneously with the use of aprotinin; no data refute the safety of this association.

ACR Appropriateness Criteria® Chronic Hip Pain.

PubMed

Mintz, Douglas N; Roberts, Catherine C; Bencardino, Jenny T; Baccei, Steven J; Caird, Michelle S; Cassidy, R Carter; Chang, Eric Y; Fox, Michael G; Gyftopoulos, Soterios; Kransdorf, Mark J; Metter, Darlene F; Morrison, William B; Rosenberg, Zehava S; Shah, Nehal A; Small, Kirstin M; Subhas, Naveen; Tambar, Siddharth; Towers, Jeffrey D; Yu, Joseph S; Weissman, Barbara N

2017-05-01

Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The oldest known communal latrines provide evidence of gregarism in Triassic megaherbivores

PubMed Central

Fiorelli, Lucas E.; Ezcurra, Martín D.; Hechenleitner, E. Martín; Argañaraz, Eloisa; Taborda, Jeremías R. A.; Trotteyn, M. Jimena; von Baczko, M. Belén; Desojo, Julia B.

2013-01-01

Defecation in communal latrines is a common behaviour of extant mammals widely distributed among megaherbivores. This behaviour has key social functions with important biological and ecological implications. Herbivore communal latrines are only documented among mammals and their fossil record is exceptionally restricted to the late Cenozoic. Here we report the discovery of several massive coprolite associations in the Middle-Late Triassic of the Chañares Formation, Argentina, which represent fossil communal latrines based on a high areal density, small areal extension and taphonomic attributes. Several lines of evidence (size, morphology, abundance and coprofabrics) and their association with kannemeyeriiform dicynodonts indicate that these large synapsids produced the communal latrines and had a gregarious behaviour comparable to that of extant megaherbivores. This is the first evidence of megaherbivore communal latrines in non-mammal vertebrates, indicating that this mammal-type behaviour was present in distant relatives of mammals, and predates its previous oldest record by 220 Mya. PMID:24287957

Late Cenozoic crustal extension and magmatism, southern Death Valley region, California

USGS Publications Warehouse

Calzia, J.P.; Rämö, O.T.

2000-01-01

The late Cenozoic geologic history of the southern Death Valley region is characterized by coeval crustal extension and magamatism. Crustal extension is accommodated by numerous listric and planar normal faults as well as right- and left-lateral strike slip faults. The normal faults sip 30°-50° near the surface and flatten and merge leozoic miogeoclinal rocks; the strike-slip faults act as tear faults between crustal blocks that have extended at different times and at different rates. Crustal extension began 13.4-13.1 Ma and migrated northwestward with time; undeformed basalt flows and lacustrine deposits suggest that extension stopped in this region (but continued north of the Death Valley graben) between 5 and 7 Ma. Estimates of crustal extension in this region vary from 30-50 percent to more than 100 percent. Magmatic rocks syntectonic with crustal extension in the southern Death Valley region include 12.4-6.4 Ma granitic rocks as well as bimodal 14.0-4.0 Ma volcanic rocks. Geochemical and isotopic evidence suggest that the granitic rocks get younger and less alkalic from south to north; the volcanic rocks become more mafic with less evidence of crustal interaction as they get younger. The close spatial and temporal relation between crustal extension and magmatism suggest a genetic and probably a dynamic relation between these geologic processes. We propose a rectonic-magmatic model that requires heat to be transported into the crust by mantle-derived mafic magmas. These magmas pond at lithologic or rheologic boundaries, begin the crystallize, and partially melt the surrounding crustal rocks. With time, the thermally weakened crust is extended (given a regional extensional stress field) concurrent with granitic magmatism and bimodal volcanism.

Evidence against the involvement of ionically bound cell wall proteins in pea epicotyl growth

NASA Technical Reports Server (NTRS)

Melan, M. A.; Cosgrove, D. J.

1988-01-01

Ionically bound cell wall proteins were extracted from 7 day old etiolated pea (Pisum sativum L. cv Alaska) epicotyls with 3 molar LiCl. Polyclonal antiserum was raised in rabbits against the cell wall proteins. Growth assays showed that treatment of growing region segments (5-7 millimeters) of peas with either dialyzed serum, serum globulin fraction, affinity purified immunoglobulin, or papain-cleaved antibody fragments had no effect on growth. Immunofluorescence microscopy confirmed antibody binding to cell walls and penetration of the antibodies into the tissues. Western blot analysis, immunoassay results, and affinity chromatography utilizing Sepharose-bound antibodies confirmed recognition of the protein preparation by the antibodies. Experiments employing in vitro extension as a screening measure indicated no effect upon extension by antibodies, by 50 millimolar LiCl perfusion of the apoplast or by 3 molar LiCl extraction. Addition of cell wall protein to protease pretreated segments did not restore extension nor did addition of cell wall protein to untreated segments increase extension. It is concluded that, although evidence suggests that protein is responsible for the process of extension, the class(es) of proteins which are extracted from pea cell walls with 3 molar LiCl are probably not involved in this process.

Protocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials.

PubMed

Welch, Vivian; Jull, J; Petkovic, J; Armstrong, R; Boyer, Y; Cuervo, L G; Edwards, Sjl; Lydiatt, A; Gough, D; Grimshaw, J; Kristjansson, E; Mbuagbaw, L; McGowan, J; Moher, D; Pantoja, T; Petticrew, M; Pottie, K; Rader, T; Shea, B; Taljaard, M; Waters, E; Weijer, C; Wells, G A; White, H; Whitehead, M; Tugwell, P

2015-10-21

Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies.

Alemtuzumab CARE-MS II 5-year follow-up

PubMed Central

Cohen, Jeffrey A.; Fox, Edward J.; Giovannoni, Gavin; Hartung, Hans-Peter; Havrdova, Eva; Schippling, Sven; Selmaj, Krzysztof W.; Traboulsee, Anthony; Compston, D. Alastair S.; Margolin, David H.; Thangavelu, Karthinathan; Chirieac, Madalina C.; Jody, Darlene; Xenopoulos, Panos; Hogan, Richard J.; Panzara, Michael A.; Arnold, Douglas L.

2017-01-01

Objective: To evaluate 5-year efficacy and safety of alemtuzumab in patients with active relapsing-remitting multiple sclerosis and inadequate response to prior therapy. Methods: In the 2-year Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis (CARE-MS) II study (NCT00548405), alemtuzumab-treated patients received 2 courses (baseline and 12 months later). Patients could enter an extension (NCT00930553), with as-needed alemtuzumab retreatment for relapse or MRI activity. Annualized relapse rate (ARR), 6-month confirmed disability worsening (CDW; ≥1-point Expanded Disability Status Scale [EDSS] score increase [≥1.5 if baseline EDSS = 0]), 6-month confirmed disability improvement (CDI; ≥1-point EDSS decrease [baseline score ≥2.0]), no evidence of disease activity (NEDA), brain volume loss (BVL), and adverse events (AEs) were assessed. Results: Most alemtuzumab-treated patients (92.9%) who completed CARE-MS II entered the extension; 59.8% received no alemtuzumab retreatment. ARR was low in each extension year (years 3–5: 0.22, 0.23, 0.18). Through 5 years, 75.1% of patients were free of 6-month CDW; 42.9% achieved 6-month CDI. In years 3, 4, and 5, proportions with NEDA were 52.9%, 54.2%, and 58.2%, respectively. Median yearly BVL remained low in the extension (years 1–5: −0.48%, −0.22%, −0.10%, −0.19%, −0.07%). AE exposure-adjusted incidence rates in the extension were lower than in the core study. Thyroid disorders peaked at year 3, declining thereafter. Conclusions: Alemtuzumab provides durable efficacy through 5 years in patients with an inadequate response to prior therapy in the absence of continuous treatment. Classification of evidence: This study provides Class III evidence that alemtuzumab provides efficacy and slowing of brain atrophy through 5 years. PMID:28835403

Tidal extension and sea-level rise: recommendations for a research agenda

USGS Publications Warehouse

Ensign, Scott H.; Noe, Gregory

2018-01-01

Sea-level rise is pushing freshwater tides upstream into formerly non-tidal rivers. This tidal extension may increase the area of tidal freshwater ecosystems and offset loss of ecosystem functions due to salinization downstream. Without considering how gains in ecosystem functions could offset losses, landscape-scale assessments of ecosystem functions may be biased toward worst-case scenarios of loss. To stimulate research on this concept, we address three fundamental questions about tidal extension: Where will tidal extension be most evident, and can we measure it? What ecosystem functions are influenced by tidal extension, and how can we measure them? How do watershed processes, climate change, and tidal extension interact to affect ecosystem functions? Our preliminary answers lead to recommendations that will advance tidal extension research, enable better predictions of the impacts of sea-level rise, and help balance the landscape-scale benefits of ecosystem function with costs of response.

Evidence as Source of Power in School Reforms: The Quest for the Extension of Compulsory Education in Zurich

ERIC Educational Resources Information Center

Imlig, Flavian; Ruoss, Thomas

2015-01-01

This article investigates the use of evidence in educational policy and politics, and how this use has changed over time. Using an analytical framework that combines research approaches from both political and educational science, evidence-related arguments in two major school reforms in the canton of Zurich, Switzerland are described. In…

Crustal deformation at long Valley Caldera, eastern California, 1992-1996 inferred from satellite radar interferometry

USGS Publications Warehouse

Thatcher, W.; Massonnet, D.

1997-01-01

Satellite radar interferometric images of Long Valley caldera show a pattern of surface deformation that resembles that expected from analysis of an extensive suite of ground-based geodetic data. Images from 2 and 4 year intervals respectively, are consistent with uniform movement rates determined from leveling surveys. Synthetic interferograms generated from ellipsoidal-inclusion source models based on inversion of the ground-based data show generally good agreement with the observed images. Two interferograms show evidence for a magmatic source southwest of the caldera in a region not covered by ground measurements. Poorer image quality in the 4 year interferogram indicates that temporal decorrelation of surface radar reflectors is progressively degrading the fringe pattern in the Long Valley region. Copyright 1997 by the American Geophysical Union.

Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review.

PubMed

Pentland, Duncan; Forsyth, Kirsty; Maciver, Donald; Walsh, Mike; Murray, Richard; Irvine, Linda; Sikora, Simon

2011-07-01

This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Contextual control of conditioning is not affected by extinction in a behavioral task with humans.

PubMed

Nelson, James Byron; Lamoureux, Jeffrey A

2015-06-01

The Attentional Theory of Context Processing (ATCP) states that extinction will arouse attention to contexts resulting in learning becoming contextually controlled. Participants learned to suppress responding to colored sensors in a video-game task where contexts were provided by different gameplay backgrounds. Four experiments assessed the contextual control of simple excitatory learning acquired to a test stimulus (T) after (Exp. 1) or during (Exp. 2-4) extinction of another stimulus (X). Experiment 1 produced no evidence of contextual control of T, though renewal to X was present both at the time T was trained and tested. In Experiment 2 no contextual control of T was evident when X underwent extensive conditioning and extinction. In Experiment 3 no contextual control of T was evident after extensive conditioning and extinction of X, and renewal to X was present. In Experiment 4 contextual control was evident to T, but it neither depended upon nor was enhanced by extinction of X. The results presented here appear to limit the generality of ATCP.

Long-term effects of the iron-based phosphate binder, sucroferric oxyhydroxide, in dialysis patients.

PubMed

Floege, Jürgen; Covic, Adrian C; Ketteler, Markus; Mann, Johannes F E; Rastogi, Anjay; Spinowitz, Bruce; Chong, Edward M F; Gaillard, Sylvain; Lisk, Laura J; Sprague, Stuart M

2015-06-01

Hyperphosphatemia necessitates the use of phosphate binders in most dialysis patients. Long-term efficacy and tolerability of the iron-based phosphate binder, sucroferric oxyhydroxide (previously known as PA21), was compared with that of sevelamer carbonate (sevelamer) in an open-label Phase III extension study. In the initial Phase III study, hemo- or peritoneal dialysis patients with hyperphosphatemia were randomized 2:1 to receive sucroferric oxyhydroxide 1.0-3.0 g/day (2-6 tablets/day; n = 710) or sevelamer 2.4-14.4 g/day (3-18 tablets/day; n = 349) for 24 weeks. Eligible patients could enter the 28-week extension study, continuing the same treatment and dose they were receiving at the end of the initial study. Overall, 644 patients were available for efficacy analysis (n = 384 sucroferric oxyhydroxide; n = 260 sevelamer). Serum phosphorus concentrations were maintained during the extension study. Mean ± standard deviation (SD) change in serum phosphorus concentrations from extension study baseline to Week 52 end point was 0.02 ± 0.52 mmol/L with sucroferric oxyhydroxide and 0.09 ± 0.58 mmol/L with sevelamer. Mean serum phosphorus concentrations remained within Kidney Disease Outcomes Quality Initiative target range (1.13-1.78 mmol/L) for both treatment groups. Mean (SD) daily tablet number over the 28-week extension study was lower for sucroferric oxyhydroxide (4.0 ± 1.5) versus sevelamer (10.1 ± 6.6). Patient adherence was 86.2% with sucroferric oxyhydroxide versus 76.9% with sevelamer. Mean serum ferritin concentrations increased over the extension study in both treatment groups, but transferrin saturation (TSAT), iron and hemoglobin concentrations were generally stable. Gastrointestinal-related adverse events were similar and occurred early with both treatments, but decreased over time. The serum phosphorus-lowering effect of sucroferric oxyhydroxide was maintained over 1 year and associated with a lower pill burden, compared with sevelamer. Sucroferric oxyhydroxide was generally well tolerated long-term and there was no evidence of iron accumulation. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA.

Measuring activities and participation in persons with haemophilia: A systematic review of commonly used instruments.

PubMed

Timmer, M A; Gouw, S C; Feldman, B M; Zwagemaker, A; de Kleijn, P; Pisters, M F; Schutgens, R E G; Blanchette, V; Srivastava, A; David, J A; Fischer, K; van der Net, J

2018-03-01

Monitoring clinical outcome in persons with haemophilia (PWH) is essential in order to provide optimal treatment for individual patients and compare effectiveness of treatment strategies. Experience with measurement of activities and participation in haemophilia is limited and consensus on preferred tools is lacking. The aim of this study was to give a comprehensive overview of the measurement properties of a selection of commonly used tools developed to assess activities and participation in PWH. Electronic databases were searched for articles that reported on reliability, validity or responsiveness of predetermined measurement tools (5 self-reported and 4 performance based measurement tools). Methodological quality of the studies was assessed according to the COSMIN checklist. Best evidence synthesis was used to summarize evidence on the measurement properties. The search resulted in 3453 unique hits. Forty-two articles were included. The self-reported Haemophilia Acitivity List (HAL), Pediatric HAL (PedHAL) and the performance based Functional Independence Score in Haemophilia (FISH) were studied most extensively. Methodological quality of the studies was limited. Measurement error, cross-cultural validity and responsiveness have been insufficiently evaluated. Albeit based on limited evidence, the measurement properties of the PedHAL, HAL and FISH are currently considered most satisfactory. Further research needs to focus on measurement error, responsiveness, interpretability and cross-cultural validity of the self-reported tools and validity of performance based tools which are able to assess limitations in sports and leisure activities. © 2018 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

Prophylaxis and management of acute radiation-induced skin toxicity: a survey of practice across Europe and the USA.

PubMed

O'Donovan, A; Coleman, M; Harris, R; Herst, P

2015-05-01

Radiation-induced toxicity is a common adverse side effect of radiation therapy. Previous studies have demonstrated a lack of evidence to support common skincare advice for radiotherapy patients. The aim of the current study was to investigate the management of radiation-induced skin toxicity across Europe and the USA. Where previous surveys have focused on national practice or treatment of specific sites, the current study aimed to gain a broader representation of skincare practice. An anonymous online survey investigating various aspects of radiotherapy skincare management was distributed to departments across Europe and the USA (n = 181/737 responded i.e. 25%). The UK was excluded as a similar survey was carried out in 2011. The results highlight the lack of consistency in both the prevention and management of radiation-induced skin toxicity. Recommended products are often not based on evidence-based practice. Examples include the continued use of aqueous cream and gentian violet, as well as the recommendations on washing restrictions during treatment. To our knowledge, this is the most extensive survey to date on the current management of radiation-induced skin toxicity. This study highlights significant disparities between clinical practice and research-based evidence published in recent systematic reviews and guidelines. Ongoing large prospective randomised trials are urgently needed. © 2014 John Wiley & Sons Ltd.

Impact of a web-based tool (WebCONSORT) to improve the reporting of randomised trials: results of a randomised controlled trial.

PubMed

Hopewell, Sally; Boutron, Isabelle; Altman, Douglas G; Barbour, Ginny; Moher, David; Montori, Victor; Schriger, David; Cook, Jonathan; Gerry, Stephen; Omar, Omar; Dutton, Peter; Roberts, Corran; Frangou, Eleni; Clifton, Lei; Chiocchia, Virginia; Rombach, Ines; Wartolowska, Karolina; Ravaud, Philippe

2016-11-28

The CONSORT Statement is an evidence-informed guideline for reporting randomised controlled trials. A number of extensions have been developed that specify additional information to report for more complex trials. The aim of this study was to evaluate the impact of using a simple web-based tool (WebCONSORT, which incorporates a number of different CONSORT extensions) on the completeness of reporting of randomised trials published in biomedical publications. We conducted a parallel group randomised trial. Journals which endorsed the CONSORT Statement (i.e. referred to it in the Instruction to Authors) but do not actively implement it (i.e. require authors to submit a completed CONSORT checklist) were invited to participate. Authors of randomised trials were requested by the editor to use the web-based tool at the manuscript revision stage. Authors registering to use the tool were randomised (centralised computer generated) to WebCONSORT or control. In the WebCONSORT group, they had access to a tool allowing them to combine the different CONSORT extensions relevant to their trial and generate a customised checklist and flow diagram that they must submit to the editor. In the control group, authors had only access to a CONSORT flow diagram generator. Authors, journal editors, and outcome assessors were blinded to the allocation. The primary outcome was the proportion of CONSORT items (main and extensions) reported in each article post revision. A total of 46 journals actively recruited authors into the trial (25 March 2013 to 22 September 2015); 324 author manuscripts were randomised (WebCONSORT n = 166; control n = 158), of which 197 were reports of randomised trials (n = 94; n = 103). Over a third (39%; n = 127) of registered manuscripts were excluded from the analysis, mainly because the reported study was not a randomised trial. Of those included in the analysis, the most common CONSORT extensions selected were non-pharmacologic (n = 43; n = 50), pragmatic (n = 20; n = 16) and cluster (n = 10; n = 9). In a quarter of manuscripts, authors either wrongly selected an extension or failed to select the right extension when registering their manuscript on the WebCONSORT study site. Overall, there was no important difference in the overall mean score between WebCONSORT (mean score 0.51) and control (0.47) in the proportion of CONSORT and CONSORT extension items reported pertaining to a given study (mean difference, 0.04; 95% CI -0.02 to 0.10). This study failed to show a beneficial effect of a customised web-based CONSORT checklist to help authors prepare more complete trial reports. However, the exclusion of a large number of inappropriately registered manuscripts meant we had less precision than anticipated to detect a difference. Better education is needed, earlier in the publication process, for both authors and journal editorial staff on when and how to implement CONSORT and, in particular, CONSORT-related extensions. ClinicalTrials.gov: NCT01891448 [registered 24 May 2013].

Pain care for patients with epidermolysis bullosa: best care practice guidelines.

PubMed

Goldschneider, Kenneth R; Good, Julie; Harrop, Emily; Liossi, Christina; Lynch-Jordan, Anne; Martinez, Anna E; Maxwell, Lynne G; Stanko-Lopp, Danette

2014-10-09

Inherited epidermolysis bullosa (EB) comprises a group of rare disorders that have multi-system effects and patients present with a number of both acute and chronic pain care needs. Effects on quality of life are substantial. Pain and itching are burdensome daily problems. Experience with, and knowledge of, the best pain and itch care for these patients is minimal. Evidence-based best care practice guidelines are needed to establish a base of knowledge and practice for practitioners of many disciplines to improve the quality of life for both adult and pediatric patients with EB. The process was begun at the request of Dystrophic Epidermolysis Bullosa Research Association International (DEBRA International), an organization dedicated to improvement of care, research and dissemination of knowledge for EB patients worldwide. An international panel of experts in pain and palliative care who have extensive experience caring for patients with EB was assembled. Literature was reviewed and systematically evaluated. For areas of care without direct evidence, clinically relevant literature was assessed, and rounds of consensus building were conducted. The process involved a face-to-face consensus meeting that involved a family representative and methodologist, as well as the panel of clinical experts. During development, EB family input was obtained and the document was reviewed by a wide variety of experts representing several disciplines related to the care of patients with EB. The first evidence-based care guidelines for the care of pain in EB were produced. The guidelines are clinically relevant for care of patients of all subtypes and ages, and apply to practitioners of all disciplines involved in the care of patients with EB. When the evidence suggests that the diagnosis or treatment of painful conditions differs between adults and children, it will be so noted. Evidence-based care guidelines are a means of standardizing optimal care for EB patients, whose disease is often times horrific in its effects on quality of life, and whose care is resource-intensive and difficult. The guideline development process also highlighted areas for research in order to improve further the evidence base for future care.

Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation.

PubMed

Richmond, Helen; Hall, Amanda M; Hansen, Zara; Williamson, Esther; Davies, David; Lamb, Sarah E

2018-03-01

Our objectives were two-fold: (i) to describe physiotherapists' experiences of implementing a cognitive behavioural approach (CBA) for managing low back pain (LBP) after completing an extensive online training course (iBeST), and (ii) to identify how iBeST could be enhanced to support long-term implementation before scale up for widespread use. We conducted semi-structured interviews with 11 physiotherapists from six National Health Service departments in the Midlands, Oxfordshire and Derbyshire. Questions centred on (i) using iBeST to support implementation, (ii) what barriers they encountered to implementation and (iii) what of information or resources they required to support sustained implementation. Interviews were transcribed and thematically analysed using NVivo. Themes were categorised using the Theoretical Domains Framework (TDF). Evidence-based techniques were identified using the behaviour change technique taxonomy to target relevant TDF domains. Three themes emerged from interviews: anxieties about using a CBA, experiences of implementing a CBA, and sustainability for future implementation of a CBA. Themes crossed multiple TDF domains and indicated concerns with knowledge, beliefs about capabilities and consequences, social and professional roles, social influences, emotion, and environmental context and resources. We identified evidence-based strategies that may support sustainable implementation of a CBA for LBP in a physiotherapy setting. This study highlighted potential challenges for physiotherapists in the provision of evidence-based LBP care within the current UK NHS. Using the TDF provided the foundation to develop a tailored, evidence-based, implementation intervention to support long term use of a CBA by physiotherapists managing LBP within UK NHS outpatient departments. Copyright © 2017 Chartered Society of Physiotherapy. All rights reserved.

Adapting evidence-based clinical practice guidelines at university teaching hospitals: A model for the Eastern Mediterranean Region.

PubMed

Amer, Yasser S; Wahabi, Hayfaa A; Abou Elkheir, Manal M; Bawazeer, Ghada A; Iqbal, Shaikh M; Titi, Maher A; Ekhzaimy, Aishah; Alswat, Khalid A; Alzeidan, Rasmieh A; Al-Ansary, Lubna A

2018-04-24

Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration between the Research Chair for Evidence-Based Healthcare and Knowledge Translation and the Quality Management Department. This study aims to develop a fast-track method for adaptation of evidence-based CPGs and describe results of the program. Twenty-two clinical departments participated in the program. Following a CPGs awareness week directed to all health care professionals (HCPs), 22 teams were trained to set priorities, search, screen, assess, select, and customize the best available CPGs. The teams were technically supported by the program's CPG advisors. To address the local health care context, a modified version of the ADAPTE was used where recommendations were either accepted or rejected but not changed. A strict peer-review process for clinical content and methodology was employed. In addition to raising awareness and building capacity, 35 CPGs were approved for implementation by March 2018. These CPGs were integrated with other existing projects such as accreditation, electronic medical records, performance management, and training and education. Preliminary implementation audits suggest a positive impact on patient outcomes. Leadership commitment was a strength, but the high turnover of the team members required frequent and extensive training for HCPs. This model for CPG adaptation represents a quick, practical, economical method with a sense of ownership by staff. Using this modified version can be replicated in other countries to assess its validity. © 2018 John Wiley & Sons, Ltd.

Figure summarizer browser extensions for PubMed Central

PubMed Central

Agarwal, Shashank; Yu, Hong

2011-01-01

Summary: Figures in biomedical articles present visual evidence for research facts and help readers understand the article better. However, when figures are taken out of context, it is difficult to understand their content. We developed a summarization algorithm to summarize the content of figures and used it in our figure search engine (http://figuresearch.askhermes.org/). In this article, we report on the development of web browser extensions for Mozilla Firefox, Google Chrome and Apple Safari to display summaries for figures in PubMed Central and NCBI Images. Availability: The extensions can be downloaded from http://figuresearch.askhermes.org/articlesearch/extensions.php. Contact: agarwal@uwm.edu PMID:21493658

Understanding Drug Use Over the Life Course: Past, Present, and Future

PubMed Central

Hser, Yih-Ing; Hamilton, Alison; Niv, Noosha

2009-01-01

Over the past 20 years, much exciting addiction research has been conducted. Extensive knowledge has been gathered about comorbid issues, particularly mental health disorders, HIV, and criminal justice involvement. Health services addiction research has become increasingly sophisticated, shifting its focus from patients to consider also services, organizations, and financing structures. Furthermore, through several long-term follow-up studies, empirical evidence convincingly demonstrates that drug dependence is not an acute disorder, and is best understood through a life course perspective with an emphasis on chronicity This article highlights three major directions for future addiction research: developing strategies for chronic care (including longitudinal intervention studies), furthering cross-system linkage and coordination, and utilizing innovative methods (e.g., growth curve modeling, longitudinal mixed methods research) to strengthen the evidence base for the life course perspective on drug addiction. PMID:21234276

Unresolved pain in children: a relational ethics perspective.

PubMed

Olmstead, Deborah L; Scott, Shannon D; Austin, Wendy J

2010-11-01

It is considered the right of children to have their pain managed effectively. Yet, despite extensive research findings, policy guidelines and practice standard recommendations for the optimal management of paediatric pain, clinical practices remain inadequate. Empirical evidence definitively shows that unrelieved pain in children has only harmful consequences, with no benefits. Contributing factors identified in this undermanaged pain include the significant role of nurses. Nursing attitudes and beliefs about children's pain experiences, the relationships nurses share with children who are suffering, and knowledge deficits in pain management practices are all shown to impact unresolved pain in children. In this article, a relational ethics perspective is used to explore the need for nurses to engage in authentic relationships with children who are experiencing pain, and to use evidence-based practices to manage that pain in order for this indefensible suffering of children to end.

Neural Insights into the Relation between Language and Communication

PubMed Central

Willems, Roel M.; Varley, Rosemary

2010-01-01

The human capacity to communicate has been hypothesized to be causally dependent upon language. Intuitively this seems plausible since most communication relies on language. Moreover, intention recognition abilities (as a necessary prerequisite for communication) and language development seem to co-develop. Here we review evidence from neuroimaging as well as from neuropsychology to evaluate the relationship between communicative and linguistic abilities. Our review indicates that communicative abilities are best considered as neurally distinct from language abilities. This conclusion is based upon evidence showing that humans rely on different cortical systems when designing a communicative message for someone else as compared to when performing core linguistic tasks, as well as upon observations of individuals with severe language loss after extensive lesions to the language system, who are still able to perform tasks involving intention understanding. PMID:21151364

Genomic profiling reveals extensive heterogeneity in somatic DNA copy number aberrations of canine hemangiosarcoma

PubMed Central

Thomas, Rachael; Borst, Luke; Rotroff, Daniel; Motsinger-Reif, Alison; Lindblad-Toh, Kerstin; Modiano, Jaime F.; Breen, Matthew

2017-01-01

Canine hemangiosarcoma is a highly aggressive vascular neoplasm associated with extensive clinical and anatomical heterogeneity and a grave prognosis. Comprehensive molecular characterization of hemangiosarcoma may identify novel therapeutic targets and advanced clinical management strategies, but there are no published reports of tumor-associated genome instability and disrupted gene dosage in this cancer. We performed genome-wide microarray-based somatic DNA copy number profiling of 75 primary intra-abdominal hemangiosarcomas from five popular dog breeds that are highly predisposed to this disease. The cohort exhibited limited global genomic instability, compared to other canine sarcomas studied to date, and DNA copy number aberrations (CNAs) were predominantly of low amplitude. Recurrent imbalances of several key cancer-associated genes were evident; however the global penetrance of any single CNA was low and no distinct hallmark aberrations were evident. Copy number gains of dog chromosomes 13, 24 and 31, and loss of chromosome 16, were the most recurrent CNAs involving large chromosome regions, but their relative distribution within and between cases suggests they most likely represent passenger aberrations. CNAs involving CDKN2A, VEGFA and the SKI oncogene were identified as potential driver aberrations of hemangiosarcoma development, highlighting potential targets for therapeutic modulation. CNA profiles were broadly conserved between the five breeds, although subregional variation was evident, including a near two-fold lower incidence of VEGFA gain in Golden Retrievers versus other breeds (22% versus 40%). These observations support prior transcriptional studies suggesting that the clinical heterogeneity of this cancer may reflect the existence of multiple, molecularly-distinct subtypes of canine hemangiosarcoma. PMID:24599718

Genomic profiling reveals extensive heterogeneity in somatic DNA copy number aberrations of canine hemangiosarcoma.

PubMed

Thomas, Rachael; Borst, Luke; Rotroff, Daniel; Motsinger-Reif, Alison; Lindblad-Toh, Kerstin; Modiano, Jaime F; Breen, Matthew

2014-09-01

Canine hemangiosarcoma is a highly aggressive vascular neoplasm associated with extensive clinical and anatomical heterogeneity and a grave prognosis. Comprehensive molecular characterization of hemangiosarcoma may identify novel therapeutic targets and advanced clinical management strategies, but there are no published reports of tumor-associated genome instability and disrupted gene dosage in this cancer. We performed genome-wide microarray-based somatic DNA copy number profiling of 75 primary intra-abdominal hemangiosarcomas from five popular dog breeds that are highly predisposed to this disease. The cohort exhibited limited global genomic instability, compared to other canine sarcomas studied to date, and DNA copy number aberrations (CNAs) were predominantly of low amplitude. Recurrent imbalances of several key cancer-associated genes were evident; however, the global penetrance of any single CNA was low and no distinct hallmark aberrations were evident. Copy number gains of dog chromosomes 13, 24, and 31, and loss of chromosome 16, were the most recurrent CNAs involving large chromosome regions, but their relative distribution within and between cases suggests they most likely represent passenger aberrations. CNAs involving CDKN2A, VEGFA, and the SKI oncogene were identified as potential driver aberrations of hemangiosarcoma development, highlighting potential targets for therapeutic modulation. CNA profiles were broadly conserved between the five breeds, although subregional variation was evident, including a near twofold lower incidence of VEGFA gain in Golden Retrievers versus other breeds (22 versus 40 %). These observations support prior transcriptional studies suggesting that the clinical heterogeneity of this cancer may reflect the existence of multiple, molecularly distinct subtypes of canine hemangiosarcoma.

No Evidence for Extensions to the Standard Cosmological Model.

PubMed

Heavens, Alan; Fantaye, Yabebal; Sellentin, Elena; Eggers, Hans; Hosenie, Zafiirah; Kroon, Steve; Mootoovaloo, Arrykrishna

2017-09-08

We compute the Bayesian evidence for models considered in the main analysis of Planck cosmic microwave background data. By utilizing carefully defined nearest-neighbor distances in parameter space, we reuse the Monte Carlo Markov chains already produced for parameter inference to compute Bayes factors B for many different model-data set combinations. The standard 6-parameter flat cold dark matter model with a cosmological constant (ΛCDM) is favored over all other models considered, with curvature being mildly favored only when cosmic microwave background lensing is not included. Many alternative models are strongly disfavored by the data, including primordial correlated isocurvature models (lnB=-7.8), nonzero scalar-to-tensor ratio (lnB=-4.3), running of the spectral index (lnB=-4.7), curvature (lnB=-3.6), nonstandard numbers of neutrinos (lnB=-3.1), nonstandard neutrino masses (lnB=-3.2), nonstandard lensing potential (lnB=-4.6), evolving dark energy (lnB=-3.2), sterile neutrinos (lnB=-6.9), and extra sterile neutrinos with a nonzero scalar-to-tensor ratio (lnB=-10.8). Other models are less strongly disfavored with respect to flat ΛCDM. As with all analyses based on Bayesian evidence, the final numbers depend on the widths of the parameter priors. We adopt the priors used in the Planck analysis, while performing a prior sensitivity analysis. Our quantitative conclusion is that extensions beyond the standard cosmological model are disfavored by Planck data. Only when newer Hubble constant measurements are included does ΛCDM become disfavored, and only mildly, compared with a dynamical dark energy model (lnB∼+2).

No Evidence for Extensions to the Standard Cosmological Model

NASA Astrophysics Data System (ADS)

Heavens, Alan; Fantaye, Yabebal; Sellentin, Elena; Eggers, Hans; Hosenie, Zafiirah; Kroon, Steve; Mootoovaloo, Arrykrishna

2017-09-01

We compute the Bayesian evidence for models considered in the main analysis of Planck cosmic microwave background data. By utilizing carefully defined nearest-neighbor distances in parameter space, we reuse the Monte Carlo Markov chains already produced for parameter inference to compute Bayes factors B for many different model-data set combinations. The standard 6-parameter flat cold dark matter model with a cosmological constant (Λ CDM ) is favored over all other models considered, with curvature being mildly favored only when cosmic microwave background lensing is not included. Many alternative models are strongly disfavored by the data, including primordial correlated isocurvature models (ln B =-7.8 ), nonzero scalar-to-tensor ratio (ln B =-4.3 ), running of the spectral index (ln B =-4.7 ), curvature (ln B =-3.6 ), nonstandard numbers of neutrinos (ln B =-3.1 ), nonstandard neutrino masses (ln B =-3.2 ), nonstandard lensing potential (ln B =-4.6 ), evolving dark energy (ln B =-3.2 ), sterile neutrinos (ln B =-6.9 ), and extra sterile neutrinos with a nonzero scalar-to-tensor ratio (ln B =-10.8 ). Other models are less strongly disfavored with respect to flat Λ CDM . As with all analyses based on Bayesian evidence, the final numbers depend on the widths of the parameter priors. We adopt the priors used in the Planck analysis, while performing a prior sensitivity analysis. Our quantitative conclusion is that extensions beyond the standard cosmological model are disfavored by Planck data. Only when newer Hubble constant measurements are included does Λ CDM become disfavored, and only mildly, compared with a dynamical dark energy model (ln B ˜+2 ).

39 CFR 962.21 - Appeal of initial decision to judicial officer.

Code of Federal Regulations, 2010 CFR

2010-07-01

... request for an extension within the initial 30-day period and demonstrates good cause for such extension... is material and that there were reasonable grounds for the failure to present such evidence, the... issued unless a petition for judicial review is filed. [52 FR 12904, Apr. 20, 1987, as amended at 67 FR...

Public Value Posters: Conveying Societal Benefits of Extension Programs through Evaluation Evidence

ERIC Educational Resources Information Center

Chazdon, Scott; Meyer, Nathan; Mohr, Caryn; Troschinetz, Alexis

2017-01-01

The public value poster session is a new tool for effectively demonstrating and reporting the public value of Extension programming. Akin to the research posters that have long played a critical role in the sharing of findings from academic studies, the public value poster provides a consistent format for conveying the benefits to society of…

Reading Rate Gains during a One-Semester Extensive Reading Course

ERIC Educational Resources Information Center

Huffman, Jeffrey

2014-01-01

Extensive reading (ER) is an effective way to provide large amounts of comprehensible input to foreign language learners, but many teachers and administrators remain unconvinced, and it has been argued that there is still insufficient evidence to support the claims that have been made regarding its benefits. Few studies have looked at ER's effect…

Impacts of extension access and cooperative membership on technology adoption and household welfare.

PubMed

Wossen, Tesfamicheal; Abdoulaye, Tahirou; Alene, Arega; Haile, Mekbib G; Feleke, Shiferaw; Olanrewaju, Adetunji; Manyong, Victor

2017-08-01

This paper examines the impacts of access to extension services and cooperative membership on technology adoption, asset ownership and poverty using household-level data from rural Nigeria. Using different matching techniques and endogenous switching regression approach, we find that both extension access and cooperative membership have a positive and statistically significant effect on technology adoption and household welfare. Moreover, we find that both extension access and cooperative membership have heterogeneous impacts. In particular, we find evidence of a positive selection as the average treatment effects of extension access and cooperative membership are higher for farmers with the highest propensity to access extension and cooperative services. The impact of extension services on poverty reduction and of cooperatives on technology adoption is significantly stronger for smallholders with access to formal credit than for those without access. This implies that expanding rural financial markets can maximize the potential positive impacts of extension and cooperative services on farmers' productivity and welfare.

Zirconia in dentistry: part 2. Evidence-based clinical breakthrough.

PubMed

Koutayas, Spiridon Oumvertos; Vagkopoulou, Thaleia; Pelekanos, Stavros; Koidis, Petros; Strub, Jörg Rudolf

2009-01-01

An ideal all-ceramic restoration that conforms well and demonstrates enhanced biocompatibility, strength, fit, and esthetics has always been desirable in clinical dentistry. However, the inherent brittleness, low flexural strength, and fracture toughness of conventional glass and alumina ceramics have been the main obstacles for extensive use. The recent introduction of zirconia-based ceramics as a restorative dental material has generated considerable interest in the dental community, which has been expressed with extensive industrial, clinical, and research activity. Contemporary zirconia powder technology contributes to the fabrication of new biocompatible all-ceramic restorations with improved physical properties for a wide range of promising clinical applications. Especially with the development of computer-aided design (CAD)/computer-aided manufacturing (CAM) systems, high-strength zirconia frameworks can be viable for the fabrication of full and partial coverage crowns, fixed partial dentures, veneers, posts and/or cores, primary double crowns, implant abutments, and implants. Data from laboratory and clinical studies are promising regarding their performance and survival. However, clinical data are considered insufficient and the identified premature complications should guide future research. In addition, different zirconia-based dental auxiliary components (i.e., cutting burs and surgical drills, extra-coronal attachments and orthodontic brackets) can also be technologically feasible. This review aims to present and discuss zirconia manufacturing methods and their potential for successful clinical application in dentistry.

Non-surgical management of a pediatric "intoed" gait pattern - a systematic review of the current best evidence.

PubMed

Uden, Hayley; Kumar, Saravana

2012-01-01

An intoed gait pattern is one of the most common referrals for children to an orthopedic consultation. Parental concern as to the aesthetics of the child's gait pattern and/or its symptomatic nature will primarily drive these referrals during a child's early developmental years. Whilst some of these referrals prove to be the result of a normal growth variant, some children will present with a symptomatic intoed gait pattern. Various treatments, both conservative and surgical, have been proposed including: braces, wedges, stretches and exercises, shoe modifications, and surgical procedures. However, which treatments are effective and justified in the management of this condition is not clear within the literature. The aim of this systematic review was to therefore identify and critique the best available evidence for the non-surgical management of an intoed gait pattern in a pediatric population. A systematic review was conducted of which only experimental studies investigating a management option for an intoeing gait pattern were included. Studies needed to be written in English, pertaining to a human pediatric population, and published within a peer reviewed journal. Electronic databases were searched: Ovid (Medline), EMBASE, AMED, PubMed, SportDiscus, CINAHL, and Cochrane Library. The National Health and Medical Research Council's designation of levels of hierarchy and the Critical Appraisal Skills Programme cohort studies critical appraisal tool were used. Five level IV studies were found. The studies were of varied quality and with mixed results. Gait plates, physiologic/standardized shoes, and orthotic devices (with gate plate extension) were shown to produce a statistically significant improvement to an intoed gait pattern. Shoe wedges, torqheels, and a leather counter splint were not able to reduce an intoed gait pattern. There is limited evidence to inform the non-surgical management of a pediatric intoed gait pattern. The body of evidence that does exist is small (n = 5) and of varied quality, which means recommendations arising from this evidence base should be interpreted with caution. There is generally weak evidence that suggests that gait plates and orthotic devices with a gait plate extension may assist in the management of a pediatric intoed gait pattern.

Petrophysical, Geochemical, and Hydrological Evidence for Extensive Fracture-Mediated Fluid and Heat Transport in the Alpine Fault's Hanging-Wall Damage Zone

NASA Astrophysics Data System (ADS)

Townend, John; Sutherland, Rupert; Toy, Virginia G.; Doan, Mai-Linh; Célérier, Bernard; Massiot, Cécile; Coussens, Jamie; Jeppson, Tamara; Janku-Capova, Lucie; Remaud, Léa.; Upton, Phaedra; Schmitt, Douglas R.; Pezard, Philippe; Williams, Jack; Allen, Michael John; Baratin, Laura-May; Barth, Nicolas; Becroft, Leeza; Boese, Carolin M.; Boulton, Carolyn; Broderick, Neil; Carpenter, Brett; Chamberlain, Calum J.; Cooper, Alan; Coutts, Ashley; Cox, Simon C.; Craw, Lisa; Eccles, Jennifer D.; Faulkner, Dan; Grieve, Jason; Grochowski, Julia; Gulley, Anton; Hartog, Arthur; Henry, Gilles; Howarth, Jamie; Jacobs, Katrina; Kato, Naoki; Keys, Steven; Kirilova, Martina; Kometani, Yusuke; Langridge, Rob; Lin, Weiren; Little, Tim; Lukacs, Adrienn; Mallyon, Deirdre; Mariani, Elisabetta; Mathewson, Loren; Melosh, Ben; Menzies, Catriona; Moore, Jo; Morales, Luis; Mori, Hiroshi; Niemeijer, André; Nishikawa, Osamu; Nitsch, Olivier; Paris, Jehanne; Prior, David J.; Sauer, Katrina; Savage, Martha K.; Schleicher, Anja; Shigematsu, Norio; Taylor-Offord, Sam; Teagle, Damon; Tobin, Harold; Valdez, Robert; Weaver, Konrad; Wiersberg, Thomas; Zimmer, Martin

2017-12-01

Fault rock assemblages reflect interaction between deformation, stress, temperature, fluid, and chemical regimes on distinct spatial and temporal scales at various positions in the crust. Here we interpret measurements made in the hanging-wall of the Alpine Fault during the second stage of the Deep Fault Drilling Project (DFDP-2). We present observational evidence for extensive fracturing and high hanging-wall hydraulic conductivity (˜10-9 to 10-7 m/s, corresponding to permeability of ˜10-16 to 10-14 m2) extending several hundred meters from the fault's principal slip zone. Mud losses, gas chemistry anomalies, and petrophysical data indicate that a subset of fractures intersected by the borehole are capable of transmitting fluid volumes of several cubic meters on time scales of hours. DFDP-2 observations and other data suggest that this hydrogeologically active portion of the fault zone in the hanging-wall is several kilometers wide in the uppermost crust. This finding is consistent with numerical models of earthquake rupture and off-fault damage. We conclude that the mechanically and hydrogeologically active part of the Alpine Fault is a more dynamic and extensive feature than commonly described in models based on exhumed faults. We propose that the hydrogeologically active damage zone of the Alpine Fault and other large active faults in areas of high topographic relief can be subdivided into an inner zone in which damage is controlled principally by earthquake rupture processes and an outer zone in which damage reflects coseismic shaking, strain accumulation and release on interseismic timescales, and inherited fracturing related to exhumation.

Assessment of the quality of harms reporting in non-randomised studies and randomised controlled studies of topiramate for the treatment of epilepsy using CONSORT criteria.

PubMed

Carmichael, Katie; Nolan, Sarah J; Weston, Jennifer; Tudur Smith, Catrin; Marson, Anthony G

2015-08-01

Treatment decisions should be informed by high quality evidence of both the potential benefit and harms of treatment alternatives. Randomised controlled trials (RCTs) provide the best evidence regarding benefits; however information relating to serious, rare and long-term harms is usually available only from non-randomised studies (NRSs). The aim of this study was to use a checklist based on the CONSORT (Consolidating Standards for Reporting Trials) extension for harms recommendations to assess the quality of reporting of harms data in both NRSs and RCTs of antiepileptic drugs, using studies of topiramate as an example. Seventy-eight studies were included from an online search of seven databases. Harms data was extracted from each study using a 25-point checklist. The mean number of items met was 11.5 (SD 2.96) per study. Commercially funded studies met on average 12.7 items and non-commercially funded studies met 10.08 (p value < 0.001). RCTs met on average 13.0 items and NRSs met 10.8 (p = 0.001). Multi-centre studies and commercially funded studies met significantly more items than single centre and non-commercially funded studies respectively. There was no significant difference in the mean number of items met by studies that had included adult vs. child participants, or studies published pre- vs. post-CONSORT extension for harms in 2004. Reporting of harms is significantly better in RCTs than in NRSs of TPM, but is suboptimal overall and has not improved since the publication of CONSORT extension for harms in 2004. There is a need to improve the reporting of harms in order to better inform treatment decisions. Copyright © 2015 Elsevier B.V. All rights reserved.

Extensive Metoidioplasty as a Technique Capable of Creating a Compatible Analogue to a Natural Penis in Female Transsexuals.

PubMed

Cohanzad, Shahryar

2016-02-01

To introduce the operative technique of "extensive metoidioplasty" (EM) in female transsexual surgery, for achieving an effective reconstruction of a male-appearing, normally functioning, fully sensate and erectile external genitalia. Ten female transsexuals (46 xx karyotype) between the ages of 20 and 40 years underwent EM as their sex reassignment surgical procedure with the mean operative time of 171 min (45-211, SD 19.55 min) between 2007 and 2014 in a general hospital in Tehran, Iran. Subjects were closely followed for the mean time of 68.4 months. All participants were thoroughly rehearsed about the nature of their surgical procedure and an informed written consent was obtained before surgery. We extensively detached the native clitoris to the point of a nearly complete detachment from its attachments to the pubic arch and approximated the originally divergent corporal bodies to each other. We were also able to increase the penile size by the application of PEP, a procedure which is in practice at our clinic. Postoperatively all ten patients achieved a mean penile length of 8.7 (6-12) cm and 7/10 (70 %) were capable of obtaining erection, rigid enough for intromission. We did not observe any significant postoperative complications. EM in association with the application of PEP could result in a natural-looking, erotically fully sensate and functional penis in majority of female transsexuals undergoing this procedure. This operative technique should be given serious considerations in well-informed female transsexual. Larger studies may be needed to validate this technique further. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

The Causal Effects of Cultural Relevance: Evidence from an Ethnic Studies Curriculum

ERIC Educational Resources Information Center

Dee, Thomas S.; Penner, Emily K.

2017-01-01

An extensive theoretical and qualitative literature stresses the promise of instructional practices and content aligned with minority students' experiences. Ethnic studies courses provide an example of such "culturally relevant pedagogy" (CRP). Despite theoretical support, quantitative evidence on the effectiveness of these courses is…

Canadian sedentary behaviour guidelines for children and youth.

PubMed

Tremblay, Mark S; Leblanc, Allana G; Janssen, Ian; Kho, Michelle E; Hicks, Audrey; Murumets, Kelly; Colley, Rachel C; Duggan, Mary

2011-02-01

The Canadian Society for Exercise Physiology (CSEP), in partnership with the Healthy Active Living and Obesity Research Group (HALO) at the Children's Hospital of Eastern Ontario Research Institute, and in collaboration with ParticipACTION, and others, has developed the Canadian Sedentary Behaviour Guidelines for Children (aged 5-11 years) and Youth (aged 12-17 years). The guidelines include a preamble to provide context, followed by the specific recommendations for sedentary behaviour. The entire development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process and the recommendations are based on evidence from a systematic review and interpretation of the research evidence. The final guidelines benefitted from an extensive online consultation process with 230 domestic and international stakeholders and key informants. The final guideline recommendations state that for health benefits, children (aged 5-11 years) and youth (aged 12-17 years) should minimize the time that they spend being sedentary each day. This may be achieved by (i) limiting recreational screen time to no more than 2 h per day - lower levels are associated with additional health benefits; and (ii) limiting sedentary (motorized) transport, extended sitting time, and time spent indoors throughout the day. These are the first evidence-based Canadian Sedentary Behaviour Guidelines for Children and Youth and provide important and timely recommendations for the advancement of public health based on a systematic synthesis, interpretation, and application of the current scientific evidence.

Evidence-based guidelines on the referral of visually impaired persons to low vision services.

PubMed

De Boer, M R; Langelaan, M; Jansonius, N M; Van Rens, G H M B

2005-01-01

One to two percent of the population in the Western world is visually impaired or blind. For most of these people there is no curative therapy. Therefore, the Dutch Ophthalmic Society has taken the initiative to develop an evidence-based guideline for the referral of visually impaired persons to low vision services. A systematic literature search was performed in the Embase (1991-2001) and Medline (1966-2003) databases. Literature was searched for definitions of visual impairment, for physician-patient communication, and for outcome of interventions for visually impaired persons. Results of the articles that were selected were summarized and rated according to the level of evidence. Other considerations such as the current organization of rehabilitation for visually impaired persons in the Netherlands were also taken into account. The World Health Organization criteria were slightly adapted in order to include all people who experience problems with reading and other daily life activities due to visual impairment. A large number of recommendations were devised. Among these is that the complete diagnosis should be communicated to the patient and that a second appointment should be offered in which the diagnosis and potential treatment options are discussed again. Another recommendation is that in general visually impaired adults eligible for referral should be referred for the provision of low vision aids and that patients with complex problems or extensive rehabilitative demand should be referred to a rehabilitation center. This article presents a summary of the first European evidence-based guideline for the referral of visually impaired persons.

Geothermal potential on Kirtland Air Force Base lands, Bernalillo County, New Mexico

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grant, P.R. Jr.

Extensive sampling and geochemical analysis of groundwater in and near the base disclosed no significant geothermal parameters. However, structural conditions and current hydrologic regimes strongly suggest that thermal waters would be masked by near surface, low temperature meteoric water originating as rain and snowfall in the nearby mountains. Controlled source audio-magnetotelluric (CSAMT) electromagnetic techniques, refraction seismic experiments, and gravity traverses were utilized on the base. These, together with published geohysical information that presents evidence for a shallow magma body beneath the Albuquerque Basin; favorable terrestrial heat flow, water chemistry, and shallow temperature gradient holes on the nearby mesa west ofmore » the Rio Grande; interpretation of regional gravity data; and geological data from nearby deep wells tend to confirm structural, stratigraphic, and hydrologic conditions favorable for developing an extensive intermediate to high-temperature hydrothermal regime on portions of Kirtland AFB lands where intensive land use occurs. Two possible exploration and development scenarios are presented. One involves drilling a well to a depth of 3000 to 5000 ft (914 to 1524 m) to test the possibility of encountering higher than normal water temperatures on the basinward side of the faults underlying the travertine deposits. The other is to conduct limited reflection seismograph surveys in defined areas on the base to determine the depth to basement (granite) and thickness of the overyling, unconfined, water filled, relatively unconsolidated sand and gravel aquifer.« less

How group-based emotions are shaped by collective emotions: evidence for emotional transfer and emotional burden.

PubMed

Goldenberg, Amit; Saguy, Tamar; Halperin, Eran

2014-10-01

Extensive research has established the pivotal role that group-based emotions play in shaping intergroup processes. The underlying implicit assumption in previous work has been that these emotions reflect what the rest of the group feels (i.e., collective emotions). However, one can experience an emotion in the name of her or his group, which is inconsistent with what the collective feels. The current research investigated this phenomenon of emotional nonconformity. Particularly, we proposed that when a certain emotional reaction is perceived as appropriate, but the collective is perceived as not experiencing this emotion, people would experience stronger levels of group-based emotion, placing their emotional experience farther away from that of the collective. We provided evidence for this process across 2 different emotions: group-based guilt and group-based anger (Studies 1 and 2) and across different intergroup contexts (Israeli-Palestinian relations in Israel, and Black-White relations in the United States). In Studies 3 and 4, we demonstrate that this process is moderated by the perceived appropriateness of the collective emotional response. Studies 4 and 5 further provided evidence for the mechanisms underlying this effect, pointing to a process of emotional burden (i.e., feeling responsible for carrying the emotion in the name of the group) and of emotional transfer (i.e., transferring negative feelings one has toward the ingroup, toward the event itself). This work brings to light processes that were yet to be studied regarding the relationship between group members, their perception of their group, and the emotional processes that connect them. 2014 APA, all rights reserved

Evidence of the non-extensive character of Earth's ambient noise.

NASA Astrophysics Data System (ADS)

Koutalonis, Ioannis; Vallianatos, Filippos

2017-04-01

Investigation of dynamical features of ambient seismic noise is one of the important scientific and practical research challenges. In the same time there isgrowing interest concerning an approach to study Earth Physics based on thescience of complex systems and non extensive statistical mechanics which is a generalization of Boltzmann-Gibbs statistical physics (Vallianatos et al., 2016).This seems to be a promising framework for studying complex systems exhibitingphenomena such as, long-range interactions, and memory effects. Inthis work we use non-extensive statistical mechanics and signal analysis methodsto explore the nature of ambient noise as measured in the stations of the HSNC in South Aegean (Chatzopoulos et al., 2016). In the present work we analyzed the de-trended increments time series of ambient seismic noise X(t), in time windows of 20 minutes to 10 seconds within "calm time zones" where the human-induced noise presents a minimum. Following the non extensive statistical physics approach, the probability distribution function of the increments of ambient noise is investigated. Analyzing the probability density function (PDF)p(X), normalized to zero mean and unit varianceresults that the fluctuations of Earth's ambient noise follows a q-Gaussian distribution asdefined in the frame of non-extensive statisticalmechanics indicated the possible existence of memory effects in Earth's ambient noise. References: F. Vallianatos, G. Papadakis, G. Michas, Generalized statistical mechanics approaches to earthquakes and tectonics. Proc. R. Soc. A, 472, 20160497, 2016. G. Chatzopoulos, I.Papadopoulos, F.Vallianatos, The Hellenic Seismological Network of Crete (HSNC): Validation and results of the 2013 aftershock,Advances in Geosciences, 41, 65-72, 2016.

Mariner 9 evidence for wind erosion in the equatorial and mid-latitude regions of Mars

NASA Technical Reports Server (NTRS)

Mccauley, J. F.

1973-01-01

Evidence for extensive wind erosion principally in the equatorial and mid-latitude regions of Mars is presented and compared with selected erosional landforms from the coastal desert of Peru known to be of eolian origin. The evidence for widespread erosion on Mars prompted an examination of certain aspects of its wind regime that are thought to be significant geologically.

Childhood Asthma Disparities in Chicago: Developing Approaches to Health Inequities.

PubMed

Martin, Molly A; Kapheim, Melissa Gutierrez; Erwin, Kim; Ignoffo, Stacy; McMahon, Kate; OʼRourke, Amy; Gerald, Lynn B; Barrett, Meredith; Press, Valerie G; Darabi, Houshang; Krishnan, Jerry A

We conducted a needs assessment to develop an evidence-based, locally tailored asthma care implementation plan for high-risk children with asthma in Chicago. Our team of health policy experts, clinicians, researchers, and designers included extensive stakeholder engagement (N = 162) in a mixed-methods community needs assessment. Results showed the lines of communication and collaboration across sectors were weak; caregivers were the only consistent force and could not always manage this burden. A series of recommendations for interventions and how to implement and measure them were generated. Cooperative, multidisciplinary efforts grounded in the community can target wicked problems such as asthma.

Promoting Simulation Globally: Networking with Nursing Colleagues Across Five Continents.

PubMed

Alfes, Celeste M; Madigan, Elizabeth A

Simulation education is gaining momentum internationally and may provide the opportunity to enhance clinical education while disseminating evidence-based practice standards for clinical simulation and learning. There is a need to develop a cohesive leadership group that fosters support, networking, and sharing of simulation resources globally. The Frances Payne Bolton School of Nursing at Case Western Reserve University has had the unique opportunity to establish academic exchange programs with schools of nursing across five continents. Although the joint and mutual simulation activities have been extensive, each international collaboration has also provided insight into the innovations developed by global partners.

The Halogen Bond

PubMed Central

2016-01-01

The halogen bond occurs when there is evidence of a net attractive interaction between an electrophilic region associated with a halogen atom in a molecular entity and a nucleophilic region in another, or the same, molecular entity. In this fairly extensive review, after a brief history of the interaction, we will provide the reader with a snapshot of where the research on the halogen bond is now, and, perhaps, where it is going. The specific advantages brought up by a design based on the use of the halogen bond will be demonstrated in quite different fields spanning from material sciences to biomolecular recognition and drug design. PMID:26812185

A model structure for an EBM program in a multihospital system.

PubMed

Schumacher, Dale N; Stock, Joseph R; Richards, Joan K

2003-01-01

Evidence-based medicine (EBM) offers a great opportunity to translate advances in medical science into advances in clinical practice. We describe the structure of a comprehensive EBM program in a multihospital community teaching system. This EBM model is distinct and separate from the peer review process and has achieved substantial physician involvement. The program emanates from the Board of Directors Quality of Care Committee and has strong administrative support. The approach relies extensively on physician involvement and expert physician panels to enhance existing EBM practice guidelines, with an explicit strategy of performance reports and feedback.

From the Editor: An Introduction to the JSLHR Supplement on Implementation Science.

PubMed

Paul, Rhea

2015-12-01

The JSLHR Supplement on Implementation Science is aimed at providing discussion and examples of research in implementation science, the study of methods designed to promote the incorporation of research findings into clinical practice. Practitioners in the language science area were invited to submit articles that address their experience with various aspects of implementation science. Six articles from several research groups comprise this supplement. Implementation science is an aspect of intervention research that merits consideration by communication disorders scientists. More extensive practice of implementation science will improve uptake of evidence-based practice in the clinical community.

Interlaminar stresses in composite laminates: A perturbation analysis

NASA Technical Reports Server (NTRS)

Hsu, P. W.; Herakovich, C. T.

1976-01-01

A general method of solution for an elastic balanced symmetric composite laminate subject to a uniaxial extension was developed based upon a perturbation analysis of a limiting free body containing an interfacial plane. The solution satisfies more physical requirements and boundary conditions than previous investigations, and predicts smooth continuous interlaminar stresses with no instabilities. It determines the finite maximum intensity for the interlaminar normal stress in all laminates, provides mathematical evidences for the singular stresses in angle-ply laminates, suggests the need for the experimental determination of an important problem parameter, and introduces a viable means for solving related problems of practical interest.

Analysis of aluminium in rat following administration of allergen immunotherapy using either aluminium or microcrystalline-tyrosine-based adjuvants.

PubMed

McDougall, Stuart A; Heath, Matthew D; Kramer, Matthias F; Skinner, Murray A

2016-03-01

Investigation into the absorption, distribution and elimination of aluminium in rat after subcutaneous aluminium adjuvant formulation administration using ICP-MS is described. Assays were verified under the principles of a tiered approach. There was no evidence of systemic exposure of aluminium, in brain or in kidney. Extensive and persistent retention of aluminium at the dose site was observed for at least 180 days after administration. This is the first published work that has quantified aluminium adjuvant retention based on the quantity of aluminium delivered in a typical allergy immunotherapy course. The results indicate that the repeated administration of aluminium-containing adjuvants will likely contribute directly and significantly to an individual's body burden of aluminium.

Appetitive Pavlovian Goal-Tracking Memories Reconsolidate Only under Specific Conditions

ERIC Educational Resources Information Center

Reichelt, Amy C.; Lee, Jonathan L. C.

2013-01-01

Despite extensive evidence that appetitive memories undergo reconsolidation, two notable failures to observe reconsolidation have been reported: instrumental responding and goal-tracking. However, these studies do not provide conclusive evidence for a lack of memory reconsolidation due to the numerous boundary conditions that dictate whether a…

Using Evidence-Centered Design to Create a Special Educator Observation System

ERIC Educational Resources Information Center

Johnson, Evelyn S.; Crawford, Angela R.; Moylan, Laura A.; Zheng, Yuzhu

2018-01-01

The Evidence-Centered Design (ECD) framework was used to create a special education teacher observation system, Recognizing Effective Special Education Teachers (RESET). Extensive reviews of research informed the domain analysis and modeling stages, and led to the conceptual framework in which effective special education teaching is…

Are There Benefits from Teaching Yoga at Schools? A Systematic Review of Randomized Control Trials of Yoga-Based Interventions

PubMed Central

Ferreira-Vorkapic, C.; Feitoza, J. M.; Marchioro, M.; Simões, J.; Telles, S.

2015-01-01

Introduction. Yoga is a holistic system of varied mind-body practices that can be used to improve mental and physical health and it has been utilized in a variety of contexts and situations. Educators and schools are looking to include yoga as a cost-effective, evidence-based component of urgently needed wellness programs for their students. Objectives. The primary goal of this study was to systematically examine the available literature for yoga interventions exclusively in school settings, exploring the evidence of yoga-based interventions on academic, cognitive, and psychosocial benefits. Methods. An extensive search was conducted for studies published between 1980 and October 31, 2014 (PubMed, PsycInfo, Embase, ISI, and the Cochrane Library). Effect size analysis, through standardized mean difference and Hedges'g, allowed for the comparison between experimental conditions. Results and Conclusions. Nine randomized control trials met criteria for inclusion in this review. Effect size was found for mood indicators, tension and anxiety in the POMS scale, self-esteem, and memory when the yoga groups were compared to control. Future research requires greater standardization and suitability of yoga interventions for children. PMID:26491461

Building National Capacity for Research Mentor Training: An Evidence-Based Approach to Training the Trainers

PubMed Central

Pfund, Christine; Spencer, Kimberly C.; Asquith, Pamela; House, Stephanie C.; Miller, Sarah; Sorkness, Christine A.

2015-01-01

Research mentor training (RMT), based on the published Entering Mentoring curricula series, has been shown to improve the knowledge and skills of research mentors across career stages, as self-reported by both the mentors engaged in training and their mentees. To promote widespread dissemination and empower others to implement this evidence-based training at their home institutions, we developed an extensive, interactive, multifaceted train-the-trainer workshop. The specific goals of these workshops are to 1) increase facilitator knowledge of an RMT curriculum, 2) increase facilitator confidence in implementing the curriculum, 3) provide a safe environment to practice facilitation of curricular activities, and 4) review implementation strategies and evaluation tools. Data indicate that our approach results in high satisfaction and significant confidence gains among attendees. Of the 195 diverse attendees trained in our workshops since Fall 2010, 44% report implementation at 39 different institutions, collectively training more than 500 mentors. Further, mentors who participated in the RMT sessions led by our trained facilitators report high facilitator effectiveness in guiding discussion. Implications and challenges to building the national capacity needed for improved research mentoring relationships are discussed. PMID:26033872

Mobile phones, mobile phone base stations and cancer: a review.

PubMed

Moulder, J E; Foster, K R; Erdreich, L S; McNamee, J P

2005-03-01

There have been reports in the media and claims in the courts that radiofrequency (RF) emissions from mobile phones are a cause of cancer, and there have been numerous public objections to the siting of mobile phone base antennas because of a fear of cancer. This review summarizes the current state of evidence concerning whether the RF energy used for wireless communication might be carcinogenic. Relevant studies were identified by searching MedLine with a combination of exposure and endpoint terms. This was supplemented by a review of the over 1700 citations assembled by the Institute of Electrical and Electronics Engineers (IEEE) International Committee on Electromagnetic Safety as part of their updating of the IEEE C95.1 RF energy safety guidelines. Where there were multiple studies, preference was given to recent reports, to positive reports of effects and to attempts to confirm such positive reports. Biophysical considerations indicate that there is little theoretical basis for anticipating that RF energy would have significant biological effects at the power levels used by modern mobile phones and their base station antennas. The epidemiological evidence for a causal association between cancer and RF energy is weak and limited. Animal studies have provided no consistent evidence that exposure to RF energy at non-thermal intensities causes or promotes cancer. Extensive in vitro studies have found no consistent evidence of genotoxic potential, but in vitro studies assessing the epigenetic potential of RF energy are limited. Overall, a weight-of-evidence evaluation shows that the current evidence for a causal association between cancer and exposure to RF energy is weak and unconvincing. However, the existing epidemiology is limited and the possibility of epigenetic effects has not been thoroughly evaluated, so that additional research in those areas will be required for a more thorough assessment of the possibility of a causal connection between cancer and the RF energy from mobile telecommunications.

Revenue sources for essential services in Florida: findings and implications for organizing and funding public health.

PubMed

Livingood, William C; Morris, Michael; Sorensen, Bonita; Chapman, Karen; Rivera, Lillian; Beitsch, Les; Street, Phil; Coughlin, Susan; Smotherman, Carmen; Wood, David

2013-01-01

The Florida Public Health Practice-Based Research Network conducted the study of Florida county health departments (CHDs) to assess relationships between self-assessed performance on essential services (ESs) and sources of funding. Primary data were collected using an online survey based on Public Health Accreditation Board standards for ES. Bivariate and multivariate analyses were conducted to assess the relationship of sources and amounts of revenue obtained from the Florida Department of Health financial system to responses to the survey of CHD capacity for ESs. Self-assessed CHD performance for each ES varied extensively among the CHDs and across the 10 ESs, ranging from a high of 98% CHDs completely or almost completely meeting the standards for ES 2 (Investigating Problems and Hazards) to a low of 32% completely or almost completely meeting standards for ES 10 (Research/Evidence). Medicaid revenue and fees were positively correlated with some ESs. Per capita revenue support varied extensively among the CHDs. Revenue for ES is decreasing and is heavily reliant on noncategorical (discretionary) revenue. This study has important implications for continued reliance on ES as an organizing construct for public health.

Dissemination of effective physical activity interventions: are we applying the evidence?

PubMed Central

Ballew, Paula; Brownson, Ross C.; Haire-Joshu, Debra; Heath, Gregory W.; Kreuter, Matthew W.

2010-01-01

Background. Given sparse knowledge on dissemination, this study sought to explore key benefits, barriers and contextual factors that are perceived to be important to the adoption and implementation of the ‘Community Guide's’ evidence-based physical activity recommendations. Design. We conducted case studies in two states where extensive adoption and implementation of the Guide's recommendations have occurred and in two states where widespread dissemination has lagged. Interviews (n = 76) were semi-structured and included both quantitative and qualitative methods. Participant perceptions from the following areas were examined: (i) priority of physical activity, (ii) awareness of and ability to define the term ‘evidence-based approaches’ and (iii) awareness, adoption, facilitators, benefits, challenges and barriers to Guide adoption. Results. Key enabling factors among high capacity states included: funds and direction from the Centers for Disease Control and Prevention; leadership support; capable staff; and successful partnerships and collaborations. Restraining forces among low capacity states included: the Guide recommendations being too new; participants being too new to current job; lack of time and training on how to use the Guide recommendations; limited funds and other resources and lack of leadership. Conclusion. To be effective, we must gain an understanding of contextual factors when designing for dissemination. PMID:20156839

Earliest evidence of dental caries manipulation in the Late Upper Palaeolithic

PubMed Central

Oxilia, Gregorio; Peresani, Marco; Romandini, Matteo; Matteucci, Chiara; Spiteri, Cynthianne Debono; Henry, Amanda G.; Schulz, Dieter; Archer, Will; Crezzini, Jacopo; Boschin, Francesco; Boscato, Paolo; Jaouen, Klervia; Dogandzic, Tamara; Broglio, Alberto; Moggi-Cecchi, Jacopo; Fiorenza, Luca; Hublin, Jean-Jacques; Kullmer, Ottmar; Benazzi, Stefano

2015-01-01

Prehistoric dental treatments were extremely rare, and the few documented cases are known from the Neolithic, when the adoption of early farming culture caused an increase of carious lesions. Here we report the earliest evidence of dental caries intervention on a Late Upper Palaeolithic modern human specimen (Villabruna) from a burial in Northern Italy. Using Scanning Electron Microscopy we show the presence of striations deriving from the manipulation of a large occlusal carious cavity of the lower right third molar. The striations have a “V”-shaped transverse section and several parallel micro-scratches at their base, as typically displayed by cutmarks on teeth. Based on in vitro experimental replication and a complete functional reconstruction of the Villabruna dental arches, we confirm that the identified striations and the associated extensive enamel chipping on the mesial wall of the cavity were produced ante-mortem by pointed flint tools during scratching and levering activities. The Villabruna specimen is therefore the oldest known evidence of dental caries intervention, suggesting at least some knowledge of disease treatment well before the Neolithic. This study suggests that primitive forms of carious treatment in human evolution entail an adaptation of the well-known toothpicking for levering and scratching rather than drilling practices. PMID:26179739

Major achievements of evidence-based traditional Chinese medicine in treating major diseases.

PubMed

Chao, Jung; Dai, Yuntao; Verpoorte, Robert; Lam, Wing; Cheng, Yung-Chi; Pao, Li-Heng; Zhang, Wei; Chen, Shilin

2017-09-01

A long history of use and extensive documentation of the clinical practices of traditional Chinese medicine resulted in a considerable number of classical preparations, which are still widely used. This heritage of our ancestors provides a unique resource for drug discovery. Already, a number of important drugs have been developed from traditional medicines, which in fact form the core of Western pharmacotherapy. Therefore, this article discusses the differences in drug development between traditional medicine and Western medicine. Moreover, the article uses the discovery of artemisinin as an example that illustrates the "bedside-bench-bedside" approach to drug discovery to explain that the middle way for drug development is to take advantage of the best features of these two distinct systems and compensate for certain weaknesses in each. This article also summarizes evidence-based traditional medicines and discusses quality control and quality assessment, the crucial steps in botanical drug development. Herbgenomics may provide effective tools to clarify the molecular mechanism of traditional medicines in the botanical drug development. The totality-of-the-evidence approach used by the U.S. Food and Drug Administration for botanical products provides the directions on how to perform quality control from the field throughout the entire production process. Copyright © 2017 Elsevier Inc. All rights reserved.

The role of nutrition and body composition in peripheral arterial disease

PubMed Central

Brostow, Diana P.; Hirsch, Alan T.; Collins, Tracie C.; Kurzer, Mindy S.

2015-01-01

Peripheral arterial disease (PAD) has not been as extensively investigated as other cardiovascular diseases. However, the available data suggest that nutrition-based treatment strategies have the potential to reduce the cost-economic burden of PAD substantially. Abdominal obesity is associated with PAD and prospective and cross-sectional studies have shown that a low dietary intake of folate and reduced synthesis of vitamin D are associated with an increased risk of PAD and severe walking impairment in patients who have the disease. However, dietary patterns that are associated with decreased cardiovascular risk might protect against PAD. A small number of clinical trials have provided evidence that increased intakes of niacin and insoluble fiber might be associated with decreased levels of LDL cholesterol and thrombogenic biomarkers, as well as increased serum levels of HDL cholesterol in patients with PAD. However, little evidence that antioxidants, vitamins B6 and B12, or essential fatty acid supplements improve clinical outcomes in these patients exists. Overall, data on the effects of nutrition, body composition, and nutritional supplementation on the risk, progression, and prognosis of PAD are scarce. Further research into these areas is required to allow the development of evidence-based nutritional guidelines for the prevention and treatment of the disease. PMID:22922595

Male factor infertility and ART

PubMed Central

Tournaye, Herman

2012-01-01

For years, the management and treatment of male factor infertility has been ‘experience' and not ‘evidence' based. Although not evidence-based, current clinical practice involves extensive use of assisted reproductive techniques (ART). Where specific treatments are not indicated or have failed, ART have become popular adjunctive treatments for alleviating male factor infertility. According to the limited evidence available, intrauterine insemination (IUI) may be considered as a first-line treatment in a couple in which the female partner has a normal fertility status and at least 1×106 progressively motile spermatozoa are recovered after sperm preparation. If no pregnancy is achieved after 3–6 cycles of IUI, optimized in vitro fertilization (IVF) can be proposed. When less than 0.5×106 progressively motile spermatozoa are obtained after seminal fluid processing or sperm are recovered surgically from the testis or epididymis, intracytoplasmic sperm injection (ICSI) should be performed. Although the outcome of no other ART has ever been scrutinized as much before, no large-scale ‘macroproblems' have as yet been observed after ICSI. Yet, ICSI candidates should be rigorously screened before embarking on IVF or ICSI, and thoroughly informed of the limitations of our knowledge on the hereditary aspects of male infertility and the safety aspects of ART. PMID:22179511

Coconut-based biosorbents for water treatment--a review of the recent literature.

PubMed

Bhatnagar, Amit; Vilar, Vítor J P; Botelho, Cidália M S; Boaventura, Rui A R

2010-10-15

Biosorption is an emerging technique for water treatment utilizing abundantly available biomaterials (especially agricultural wastes). Among several agricultural wastes studied as biosorbents for water treatment, coconut has been of great importance as various parts of this tree (e.g. coir, shell, etc.) have been extensively studied as biosorbents for the removal of diverse type of pollutants from water. Coconut-based agricultural wastes have gained wide attention as effective biosorbents due to low-cost and significant adsorption potential for the removal of various aquatic pollutants. In this review, an extensive list of coconut-based biosorbents from vast literature has been compiled and their adsorption capacities for various aquatic pollutants as available in the literature are presented. Available abundantly, high biosorption capacity, cost-effectiveness and renewability are the important factors making these materials as economical alternatives for water treatment and waste remediation. This paper presents a state of the art review of coconut-based biosorbents used for water pollution control, highlighting and discussing key advancement on the preparation of novel adsorbents utilizing coconut wastes, its major challenges together with the future prospective. It is evident from the literature survey that coconut-based biosorbents have shown good potential for the removal of various aquatic pollutants. However, still there is a need to find out the practical utility of such developed adsorbents on commercial scale, leading to the superior improvement of pollution control and environmental preservation. Copyright © 2010 Elsevier B.V. All rights reserved.

Evidence for Terrane Accretion, Localized Rifting and Magmatism from the Crustal Velocity Structure of the Southeastern United States

NASA Astrophysics Data System (ADS)

Marzen, R. E.; Shillington, D. J.; Lizarralde, D.; Harder, S. H.

2017-12-01

The crustal structure in the Southeastern United States records a rich tectonic history, including multiple terrane accretion events, the formation of the supercontinent Pangea, widespread magmatism from the Central Atlantic Magmatic Province (CAMP), and crustal thinning before the breakup of Pangea. We use wide-angle refraction seismic data from Lines 1 and 2 of the SUGAR (SUwannee suture and GeorgiA Rift basin) seismic experiment to constrain crustal structure in order to better understand these tectonic events. The 320 and 420 km lines extend from the northwest to the southeast, crossing the Mesozoic rift basins that record crustal thinning prior to the breakup of Pangea and multiple potential suture zones between accreted terranes. We model crustal P-wave velocity structure with reflection/refraction tomography based on refractions through the sediments, crust and mantle and reflections from the base of the sediments, within the crust and the Moho. To the north on Line 2, we observe high Vp and Vs within the Inner Piedmont and Carolina accreted terranes underlain by a low velocity zone at 5 km depth. These observations are consistent with metamorphosed terranes accreting onto the Laurentian margin along a low velocity region that represents meta-sedimentary rocks and/or an Appalachian detachment. Additionally, differences in the basin structure, lower crustal velocities, and crustal thickness between Lines 1 and 2 reflect varying extension and magmatism between the two Mesozoic rift segments. Line 1 has thicker and more laterally extensive syn-rift sediments and a more pronounced region of crustal thinning. In contrast, syn-rift sediments along Line 2 are thinner and limited to a couple of smaller basins, and the crust of Line 2 gradually thins towards the coast. The thinned crust beneath Line 1 is characterized by high velocities of >7.0 km/s, which we interpret as mafic intrusions related to rifting or CAMP; in contrast, no evidence of elevated lower crustal velocities is observed on Line 2. Because intrusions into the lower crust increase both lower crustal velocities and crustal thickness, the correspondence of high lower crustal velocities with regions of greater crustal thinning suggests that extension and magmatism were more localized than one would infer based only on variations in crustal thickness.

76 FR 12073 - Extension of Web-Based TRICARE Assistance Program Demonstration Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Web-Based TRICARE Assistance Program Demonstration Program AGENCY: Department of Defense. ACTION: Notice of a Two Year Extension of the Web-Based..., entitled Web-Based TRICARE Assistance Program. This demonstration was effective August 1, 2009, as...

Perceptions and attitudes of clinicians in Spain toward clinical practice guidelines and grading systems: a protocol for a qualitative study and a national survey

PubMed Central

2010-01-01

Background Clinical practice guidelines (CPGs) have become a very popular tool for decision making in healthcare. While there is some evidence that CPGs improve outcomes, there are numerous factors that influence their acceptability and use by healthcare providers. While evidence of clinicians' knowledge, perceptions and attitudes toward CPGs is extensive, results are still disperse and not conclusive. Our study will evaluate these issues in a large and representative sample of clinicians in Spain. Methods/Design A mixed-method design combining qualitative and quantitative research techniques will evaluate general practitioners (GPs) and hospital-based specialists in Spain with the objective of exploring attitudes and perceptions about CPGs and evidence grading systems. The project will consist of two phases: during the first phase, group discussions will be carried out to gain insight into perceptions and attitudes of the participants, and during the second phase, this information will be completed by means of a survey, reaching a greater number of clinicians. We will explore these issues in GPs and hospital-based practitioners, with or without previous experience in guideline development. Discussion Our study will identify and gain insight into the perceived problems and barriers of Spanish practitioners in relation to guideline knowledge and use. The study will also explore beliefs and attitudes of clinicians towards CPGs and evidence grading systems used to rate the quality of the evidence and the strength of recommendations. Our results will provide guidance to healthcare researchers and healthcare decision makers to improve the use of guidelines in Spain and elsewhere. PMID:21129195

ACR Appropriateness Criteria Assessment of Fetal Well-Being.

PubMed

Simpson, Lynn; Khati, Nadia J; Deshmukh, Sandeep P; Dudiak, Kika M; Harisinghani, Mukesh G; Henrichsen, Tara L; Meyer, Benjamin J; Nyberg, David A; Poder, Liina; Shipp, Thomas D; Zelop, Carolyn M; Glanc, Phyllis

2016-12-01

Although there is limited evidence that antepartum testing decreases the risk for fetal death in low-risk pregnancies, women with high-risk factors for stillbirth should undergo antenatal fetal surveillance. The strongest evidence supporting antepartum testing pertains to pregnancies complicated by intrauterine fetal growth restriction secondary to uteroplacental insufficiency. The main ultrasound-based modalities to determine fetal health are the biophysical profile, modified biophysical profile, and duplex Doppler velocimetry. In patients at risk for cardiovascular compromise, fetal echocardiography may also be indicated to ensure fetal well-being. Although no single antenatal test has been shown to be superior, all have high negative predictive values. Weekly or twice-weekly fetal testing has become the standard practice in high-risk pregnancies. The timing for the initiation of assessments of fetal well-being should be tailored on the basis of the risk for stillbirth and the likelihood of survival with intervention. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (the RAND/UCLA Appropriateness Method and the Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Developing a Framework to Generate Evidence of Health Outcomes From Social Media Use in Chronic Disease Management

PubMed Central

Gray, Kathleen; Martin-Sanchez, Fernando

2013-01-01

Background While there is an abundance of evidence-based practice (EBP) recommendations guiding management of various chronic diseases, evidence suggesting best practice for using social media to improve health outcomes is inadequate. The variety of social media platforms, multiple potential uses, inconsistent definitions, and paucity of rigorous studies, make it difficult to measure health outcomes reliably in chronic disease management. Most published investigations report on an earlier generation of online tools, which are not as user-centered, participatory, engaging, or collaborative, and thus may work differently for health self-management. Objective The challenge to establish a sound evidence base for social media use in chronic disease starts with the need to define criteria and methods to generate and evaluate evidence. The authors’ key objective is to develop a framework for research and practice that addresses this challenge. Methods This paper forms part of a larger research project that presents a conceptual framework of how evidence of health outcomes can be generated from social media use, allowing social media to be utilized in chronic disease management more effectively. Using mixed methods incorporating a qualitative literature review, a survey and a pilot intervention, the research closely examines the therapeutic affordances of social media, people with chronic pain (PWCP) as a subset of chronic disease management, valid outcome measurement of patient-reported (health) outcomes (PRO), the individual needs of people living with chronic disease, and finally translation of the combined results to improve evidence-based decision making about social media use in this context. Results Extensive review highlights various affordances of social media that may prove valuable to understanding social media’s effect on individual health outcomes. However, without standardized PRO instruments, we are unable to definitively investigate these effects. The proposed framework that we offer outlines how therapeutic affordances of social media coupled with valid and reliable PRO measurement may be used to generate evidence of improvements in health outcomes, as well as guide evidence-based decision making in the future about social media use as part of chronic disease self-management. Conclusions The results will (1) inform a framework for conducting research into health outcomes from social media use in chronic disease, as well as support translating the findings into evidence of improved health outcomes, and (2) inform a set of recommendations for evidence-based decision making about social media use as part of chronic disease self-management. These outcomes will fill a gap in the knowledge and resources available to individuals managing a chronic disease, their clinicians and other researchers in chronic disease and the field of medicine 2.0. PMID:25075238

Developing a framework to generate evidence of health outcomes from social media use in chronic disease management.

PubMed

Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando

2013-01-01

While there is an abundance of evidence-based practice (EBP) recommendations guiding management of various chronic diseases, evidence suggesting best practice for using social media to improve health outcomes is inadequate. The variety of social media platforms, multiple potential uses, inconsistent definitions, and paucity of rigorous studies, make it difficult to measure health outcomes reliably in chronic disease management. Most published investigations report on an earlier generation of online tools, which are not as user-centered, participatory, engaging, or collaborative, and thus may work differently for health self-management. The challenge to establish a sound evidence base for social media use in chronic disease starts with the need to define criteria and methods to generate and evaluate evidence. The authors' key objective is to develop a framework for research and practice that addresses this challenge. This paper forms part of a larger research project that presents a conceptual framework of how evidence of health outcomes can be generated from social media use, allowing social media to be utilized in chronic disease management more effectively. Using mixed methods incorporating a qualitative literature review, a survey and a pilot intervention, the research closely examines the therapeutic affordances of social media, people with chronic pain (PWCP) as a subset of chronic disease management, valid outcome measurement of patient-reported (health) outcomes (PRO), the individual needs of people living with chronic disease, and finally translation of the combined results to improve evidence-based decision making about social media use in this context. Extensive review highlights various affordances of social media that may prove valuable to understanding social media's effect on individual health outcomes. However, without standardized PRO instruments, we are unable to definitively investigate these effects. The proposed framework that we offer outlines how therapeutic affordances of social media coupled with valid and reliable PRO measurement may be used to generate evidence of improvements in health outcomes, as well as guide evidence-based decision making in the future about social media use as part of chronic disease self-management. The results will (1) inform a framework for conducting research into health outcomes from social media use in chronic disease, as well as support translating the findings into evidence of improved health outcomes, and (2) inform a set of recommendations for evidence-based decision making about social media use as part of chronic disease self-management. These outcomes will fill a gap in the knowledge and resources available to individuals managing a chronic disease, their clinicians and other researchers in chronic disease and the field of medicine 2.0.

Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?

PubMed Central

Cook, J L; Rio, E; Purdam, C R; Docking, S I

2016-01-01

The pathogenesis of tendinopathy and the primary biological change in the tendon that precipitates pathology have generated several pathoaetiological models in the literature. The continuum model of tendon pathology, proposed in 2009, synthesised clinical and laboratory-based research to guide treatment choices for the clinical presentations of tendinopathy. While the continuum has been cited extensively in the literature, its clinical utility has yet to be fully elucidated. The continuum model proposed a model for staging tendinopathy based on the changes and distribution of disorganisation within the tendon. However, classifying tendinopathy based on structure in what is primarily a pain condition has been challenged. The interplay between structure, pain and function is not yet fully understood, which has partly contributed to the complex clinical picture of tendinopathy. Here we revisit and assess the merit of the continuum model in the context of new evidence. We (1) summarise new evidence in tendinopathy research in the context of the continuum, (2) discuss tendon pain and the relevance of a model based on structure and (3) describe relevant clinical elements (pain, function and structure) to begin to build a better understanding of the condition. Our goal is that the continuum model may help guide targeted treatments and improved patient outcomes. PMID:27127294

The three moments of skin cream application: an evidence-based proposal for use of skin creams in the prevention of irritant contact dermatitis in the workplace.

PubMed

Hines, J; Wilkinson, S M; John, S M; Diepgen, T L; English, J; Rustemeyer, T; Wassilew, S; Kezic, S; Maibach, H I

2017-01-01

Contact dermatitis is one of the most common occupational diseases, with serious impact on quality of life, lost days at work and a condition that may be chronically relapsing. Regular prophylactic skin cream application is widely acknowledged to be an effective prevention strategy against occupational contact dermatitis; however, compliance rates remain low. To present a simple programme for skin cream application in the workplace with focus on implementation to drive down the rate of occupational irritant contact dermatitis, an expert panel of eight international dermatologists combined personal experience with extensive literature review. The recommendations are based on clinical experience as supported by evidence-based data from interventional studies. The authors identified three moments for skin cream application in the work place: (i) before starting a work period; (ii) after washing hands; and (iii) after work. Affecting behaviour change requires systematic communications, monitoring and reporting, which is proposed through Kotter's principles of organizational change management. Measurement tools are provided in the appendix. Interventional data based on application of this proposal is required to demonstrate its effectiveness. © 2016 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Office-based spirometry for early detection of obstructive lung disease.

PubMed

Wallace, Laura D; Troy, Kenneth E

2006-09-01

To review the research-based evidence supporting smoking cessation as the only proven method to reduce chronic obstructive pulmonary disease (COPD) progression and to show that early detection of disease with office-based spirometry can lead to therapeutic intervention before physiologic symptoms arise. Extensive review of national and international scientific literature supplemented with drawings and algorithms. Early detection of COPD with spirometry, along with smoking cessation, and aggressive intervention can alter the insidious course of this highly preventable disease. It is imperative that nurse practitioners utilize this simple and inexpensive procedure to identify COPD in its earliest stages, so treatment can reduce individual and community disease burden, reduce morbidity and mortality, and help reduce healthcare costs. Determination of early airflow obstruction supports smoking cessation education, provides objective data for patient motivation, thereby doubling patient compliance and reducing further disease burden.

Physiotherapists' experiences of the management of anterior cruciate ligament injuries.

PubMed

von Aesch, Arlene V; Perry, Meredith; Sole, Gisela

2016-05-01

While extensive research has been reported for management of anterior cruciate ligament (ACL) injuries, variation in treatment by physiotherapists is evident. To explore physiotherapists' experiences regarding ACL injury rehabilitation and factors that influenced physiotherapists' decision making for ACL rehabilitation, and to elicit what research physiotherapists perceived would support their management of these patients. Qualitative study. Fifteen physiotherapists from six private clinics in New Zealand participated in semi-structured interviews. The interviews were recorded, transcribed verbatim and the general inductive approach was used to develop key themes. Participant's management strengths were evident by their intent and commitment to provide expert rehabilitation, using a biopsychosocial approach and evidence-informed practice. The lengthy management process (including prolonged rehabilitation and referral processes) and interprofessional disconnect concerned participants. Translational research was needed for clear directions for exercise prescription and milestones for return to sports and occupation following ACL injury. Participants provided a biopsychosocial and evidence-based approach to ACL injury management. Potential areas of improvement include simplifying the referral process and enhancing communication between physiotherapists and other health professionals. Future research should focus on clarifying areas of ACL rehabilitation uncertainty, or collating results in an accessible and usable format for clinical practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving the state of health programming by using diffusion theory.

PubMed

Dearing, James W

2004-01-01

Year by year, the gaps between what is known about behavior change and what is actually practiced in social programs grow larger, especially for community-based programs intended to help minority populations, the poor, and those living in inner-city and rural areas. Internationally, such gaps between the state of knowledge and the state of practice lead to disparities in health, education, and development among societal groups, demographic sub-populations, communities, and countries. Data about disparities are used as evidence of inequality. Here, I discuss uses of certain diffusion of innovation theory-based concepts to systematically redress problems of inequality and disparity by reducing the differences between evidence and practice in social programs that are implemented by intermediaries (practitioners) and communicated by them to needy populations. The emphasis here is on the integrated application of knowledge about innovation attributes, opinion leadership, and clustering from diffusion theory to achieve the objective of more extensive and more rapid diffusion of especially effective programs. A set of implementation steps are offered for researchers, funders of international health programs, and the intermediaries who implement health programs.

Thymoglobulin induction in heart transplantation: patient selection and implications for maintenance immunosuppression

PubMed Central

Zuckermann, Andreas; Schulz, Uwe; Deuse, Tobias; Ruhpawar, Arjang; Schmitto, Jan D; Beiras-Fernandez, Andres; Hirt, Stephan; Schweiger, Martin; Kopp-Fernandes, Laurenz; Barten, Markus J

2015-01-01

Clinical data relating to rabbit antithymocyte globulin (rATG) induction in heart transplantation are far less extensive than for other immunosuppressants, or indeed for rATG in other indications. This was highlighted by the low grade of evidence and the lack of detailed recommendations for prescribing rATG in the International Society for Heart and Lung Transplantation (ISHLT) guidelines. The heart transplant population includes an increasing frequency of patients on mechanical circulatory support (MCS), often with ongoing infection and/or presensitization, who are at high immunological risk but also vulnerable to infectious complications. The number of patients with renal impairment is also growing due to lengthening waiting times, intensifying the need for strategies that minimize calcineurin inhibitor (CNI) toxicity. Additionally, the importance of donor-specific antibodies (DSA) in predicting graft failure is influencing immunosuppressive regimens. In light of these developments, and in view of the lack of evidence-based prescribing criteria, experts from Germany, Austria, and Switzerland convened to identify indications for rATG induction in heart transplantation and to develop an algorithm for its use based on patient characteristics. PMID:25363471

Transition from in-hospital ventilation to home ventilation: process description and quality indicators

PubMed Central

Kastrup, Marc; Tittmann, Benjamin; Sawatzki, Tanja; Gersch, Martin; Vogt, Charlotte; Rosenthal, Max; Rosseau, Simone; Spies, Claudia

2017-01-01

The current demographic development of our society results in an increasing number of elderly patients with chronic diseases being treated in the intensive care unit. A possible long-term consequence of such a treatment is that patients remain dependent on certain invasive organ support systems, such as long-term ventilator dependency. The main goal of this project is to define the transition process between in-hospital and out of hospital (ambulatory) ventilator support. A further goal is to identify evidence-based quality indicators to help define and describe this process. This project describes an ideal sequence of processes (process chain), based on the current evidence from the literature. Besides the process chain, key data and quality indicators were described in detail. Due to the limited project timeline, these indicators were not extensively tested in the clinical environment. The results of this project may serve as a solid basis for proof of feasibility and proof of concept investigations, optimize the transition process of ventilator-dependent patients from a clinical to an ambulatory setting, as well as reduce the rate of emergency re-admissions. PMID:29308061

An illustration of the complexity of continent formation

NASA Technical Reports Server (NTRS)

Burke, Kevin

1988-01-01

It was pointed out that a consensus may be emerging in crustal growth models, considering the clustering of most growth curves and their uncertainties. Curves most distant from this clustering represent models involving extensive recycling of continental material back into the mantle, but the author wondered if geochemical signatures for this would be recognizable considering the lack of evidence from seismic tomography for discrete mantle reservoirs, and the likelihood of core-mantle interaction based on recent high pressure experiments. Unreactivated Archean rocks represent only 2 percent of present continental area, and the author was uncomfortable about basing inferences on what the early Earth was like on such a small amount of information. He feels that the hypothesis of continental assembly that needs testing is that of banging together of island arcs, such as in Indonesia today. As an example of how complex this process can be, the author described the geology of the Caribbean arc system, which shows evidence for reversals of subduction polarity, numerous collisional events, and substantial strike-slip movements. It seemed unlikely to the author that Archean examples would have been less complicated.

Turner syndrome and meningioma: support for a possible increased risk of neoplasia in Turner syndrome.

PubMed

Pier, Danielle B; Nunes, Fabio P; Plotkin, Scott R; Stemmer-Rachamimov, Anat O; Kim, James C; Shih, Helen A; Brastianos, Priscilla; Lin, Angela E

2014-01-01

Neoplasia is uncommon in Turner syndrome, although there is some evidence that brain tumors are more common in Turner syndrome patients than in the general population. We describe a woman with Turner syndrome (45,X) with a meningioma, in whom a second neoplasia, basal cell carcinomas of the scalp and nose, developed five years later in the absence of therapeutic radiation. Together with 7 cases of Turner syndrome with meningioma from a population-based survey in the United Kingdom, and 3 other isolated cases in the literature, we review this small number of patients for evidence of risk factors related to Turner syndrome, such as associated structural anomalies or prior treatment. We performed histological and fluorescent in situ hybridization (FISH) of 22q (NF2 locus) analyses of the meningeal tumor to search for possible molecular determinants. We are not able to prove causation between these two entities, but suggest that neoplasia may be a rare associated medical problem in Turner syndrome. Additional case reports and extension of population-based studies are needed. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Evidence for Sub-Chandrasekhar Mass Type Ia Supernovae from an Extensive Survey of Radiative Transfer Models

NASA Astrophysics Data System (ADS)

Goldstein, Daniel A.; Kasen, Daniel

2018-01-01

There are two classes of viable progenitors for normal Type Ia supernovae (SNe Ia): systems in which a white dwarf explodes at the Chandrasekhar mass ({M}{ch}), and systems in which a white dwarf explodes below the Chandrasekhar mass (sub-{M}{ch}). It is not clear which of these channels is dominant; observations and light-curve modeling have provided evidence for both. Here we use an extensive grid of 4500 time-dependent, multiwavelength radiation transport simulations to show that the sub-{M}{ch} model can reproduce the entirety of the width–luminosity relation, while the {M}{ch} model can only produce the brighter events (0.8< {{Δ }}{M}15(B)< 1.55), implying that fast-declining SNe Ia come from sub-{M}{ch} explosions. We do not assume a particular theoretical paradigm for the progenitor or explosion mechanism, but instead construct parameterized models that vary the mass, kinetic energy, and compositional structure of the ejecta, thereby realizing a broad range of possible outcomes of white dwarf explosions. We provide fitting functions based on our large grid of detailed simulations that map observable properties of SNe Ia, such as peak brightness and light-curve width, to physical parameters such as {}56{Ni} and total ejected mass. These can be used to estimate the physical properties of observed SNe Ia.

Prophylactic Cranial Irradiation (PCI) versus Active MRI Surveillance for Small Cell Lung Cancer: The Case for Equipoise.

PubMed

Rusthoven, Chad G; Kavanagh, Brian D

2017-12-01

Prophylactic cranial irradiation (PCI) for SCLC offers a consistent reduction in the incidence of brain metastases at the cost of measurable toxicity to neurocognitive function and quality of life, in the setting of characteristic pathologic changes to the brain. The sequelae of PCI have historically been justified by the perception of an overall survival advantage specific to SCLC. This rationale has now been challenged by a randomized trial in extensive-stage SCLC demonstrating equivalent progression-free survival and a trend toward improved overall survival with PCI omission in the context of modern magnetic resonance imaging (MRI) staging and surveillance. In this article, we critically examine the randomized trials of PCI in extensive-stage SCLC and discuss their implications on the historical data supporting PCI for limited-stage SCLC from the pre-MRI era. Further, we review the toxicity of moderate doses of radiation to the entire brain that underlie the growing interest in active MRI surveillance and PCI omission. Finally, the evidence supporting prospective investigation of radiosurgery for limited brain metastases in SCLC is reviewed. Overall, our aim is to provide an evidence-based assessment of the debate over PCI versus active MRI surveillance and to highlight the need for contemporary trials evaluating optimal central nervous system management in SCLC. Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

The role of metabolism (and the microbiome) in defining the clinical efficacy of dietary flavonoids1

PubMed Central

Cassidy, Aedín; Minihane, Anne-Marie

2017-01-01

At a population level, there is growing evidence of the beneficial effects of dietary flavonoids on health. However, there is extensive heterogeneity in the response to increased intake, which is likely mediated via wide interindividual variability in flavonoid absorption and metabolism. Flavonoids are extensively metabolized by phase I and phase II metabolism (which occur predominantly in the gastrointestinal tract and liver) and colonic microbial metabolism. A number of factors, including age, sex, and genotype, may affect these metabolic processes. In addition, food composition and flavonoid source are likely to affect bioavailability, and emerging data suggest a critical role for the microbiome. This review will focus on the current knowledge for the main subclasses of flavonoids, including anthocyanins, flavonols, flavan-3-ols, and flavanones, for which there is growing evidence from prospective studies of beneficial effects on health. The identification of key factors that govern metabolism and an understanding of how the differential capacity to metabolize these bioactive compounds affect health outcomes will help establish how to optimize intakes of flavonoids for health benefits and in specific subgroups. We identify research areas that need to be addressed to further understand important determinants of flavonoid bioavailability and metabolism and to advance the knowledge base that is required to move toward the development of dietary guidelines and recommendations for flavonoids and flavonoid-rich foods. PMID:27881391

The role of metabolism (and the microbiome) in defining the clinical efficacy of dietary flavonoids.

PubMed

Cassidy, Aedín; Minihane, Anne-Marie

2017-01-01

At a population level, there is growing evidence of the beneficial effects of dietary flavonoids on health. However, there is extensive heterogeneity in the response to increased intake, which is likely mediated via wide interindividual variability in flavonoid absorption and metabolism. Flavonoids are extensively metabolized by phase I and phase II metabolism (which occur predominantly in the gastrointestinal tract and liver) and colonic microbial metabolism. A number of factors, including age, sex, and genotype, may affect these metabolic processes. In addition, food composition and flavonoid source are likely to affect bioavailability, and emerging data suggest a critical role for the microbiome. This review will focus on the current knowledge for the main subclasses of flavonoids, including anthocyanins, flavonols, flavan-3-ols, and flavanones, for which there is growing evidence from prospective studies of beneficial effects on health. The identification of key factors that govern metabolism and an understanding of how the differential capacity to metabolize these bioactive compounds affect health outcomes will help establish how to optimize intakes of flavonoids for health benefits and in specific subgroups. We identify research areas that need to be addressed to further understand important determinants of flavonoid bioavailability and metabolism and to advance the knowledge base that is required to move toward the development of dietary guidelines and recommendations for flavonoids and flavonoid-rich foods.

Drug-resistant tuberculosis in two children in Greece: report of the first extensively drug-resistant case.

PubMed

Katragkou, Aspasia; Antachopoulos, Charalampos; Hatziagorou, Elpis; Sdougka, Maria; Roilides, Emmanuel; Tsanakas, John

2013-04-01

Extensively drug-resistant (XDR) tuberculosis (TB) represents a serious and growing problem in both endemic and non-endemic countries. We describe a 2.5-year-old girl with XDR-pulmonary TB and an 18-month-old boy with pre-XDR-central nervous system TB. Patients received individualized treatment with second-line anti-TB agents based on genotypic and phenotypic drug susceptibility testing results. Both children achieved culture conversion 3 months and 1 month after treatment initiation, respectively. The child with XDR-pulmonary TB showed evidence of cure while treatment adverse events were managed without treatment interruption. The child with pre-XDR-central nervous system TB after 6-month hospitalization with multiple infectious complications had a dismal end due to hepatic insufficiency possibly related to anti-TB treatment. This is the first report of children with pre-XDR and XDR TB in Greece, emphasizing the public health dimensions and management complexity of XDR TB.

Mindfulness: a fundamental skill for performance sustainment and enhancement.

PubMed

Deuster, Patricia A; Schoomaker, Eric

2015-01-01

The term "mindfulness" has become very fashionable within the military and across multiple sectors of civilian and first responder populations. Overall, the key concept of mindfulness is intentionally being acutely aware of what is going on internally as well as externally, without reacting. Mindfulness and the awareness that underlies it are inherent capabilities that can be honed through training. As such, classes in mindfulness are being offered in many venues and medical clinics are using mindfulness-based interventions for patients for a wide range of medical issues. The evidence behind the benefits of mindfulness is extensive and instructive. Importantly, evidence suggests that mindfulness can be helpful for many operational, leadership, and personal activities and is likely beneficial for enhancing resilience and overall health. Many current military leaders are using mindfulness as a tool to better prepare for a dynamic and uncertain future. 2015.

The two-process theory of face processing: modifications based on two decades of data from infants and adults.

PubMed

Johnson, Mark H; Senju, Atsushi; Tomalski, Przemyslaw

2015-03-01

Johnson and Morton (1991. Biology and Cognitive Development: The Case of Face Recognition. Blackwell, Oxford) used Gabriel Horn's work on the filial imprinting model to inspire a two-process theory of the development of face processing in humans. In this paper we review evidence accrued over the past two decades from infants and adults, and from other primates, that informs this two-process model. While work with newborns and infants has been broadly consistent with predictions from the model, further refinements and questions have been raised. With regard to adults, we discuss more recent evidence on the extension of the model to eye contact detection, and to subcortical face processing, reviewing functional imaging and patient studies. We conclude with discussion of outstanding caveats and future directions of research in this field. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

New insights on diabetes mellitus and obesity in Africa-part 1: prevalence, pathogenesis and comorbidities.

PubMed

Kengne, Andre Pascal; Echouffo-Tcheugui, Justin-Basile; Sobngwi, Eugene; Mbanya, Jean-Claude

2013-07-01

Evidence continues to accumulate on the rising burden of diabetes mellitus at a higher pace in Africa. In a series of two papers, we sought to summarise recent evidence on diabetes and obesity in Africa based on a systematic review of studies published between January 2002 and October 2012. This first paper on the prevalence, pathogenesis and comorbidities shows that the increase in diabetes prevalence has paralleled that of obesity in Africa. Recent surveys on diabetes and obesity have been largely suboptimal. Hence, the need for more representative and robust continent-wide prevalence figures, which may be somehow achieved through pooling of existing data. Prospective studies linking environmental risk factors to disease occurrence and outcomes remain scarce, and genetic factors for diabetes or obesity have not been extensively assessed. The health consequences of diabetes are manifold, and include a complex interaction with other conditions like HIV infection and sickle cell disease/trait.

The Hourglass Model: Are There Structural Problems with the Scarcity of Positive Results for Flexible ACT?

PubMed

Norlander, Torsten; Nordén, Tommy

2015-01-01

The aim of the present article was to discuss the commentary by van Veldhuizen, Delespaul and Mulder (2015) regarding the review by Nordén and Norlander (2014) based on five empirical articles about Flexible Assertive Community Treatment (FACT). Veldhuizen et al. agree on that there is insufficient evidence for the effectiveness of FACT. However, van Veldhuizen et al. avoid a discussion of the lack of positive results despite extensive research during several years and therefore an analysis of why FACT did not fare better is missing. According to FACT it is an advantage that one single team spans the entire chain of care and rehabilitation, but no evidence is given for such an opinion. Instead there may be difficulties for the staff to shift between psychiatric care and psychiatric rehabilitation and the clients perhaps don't want to encounter the same professional team during all phases of care and rehabilitation.

What physicians need to know about dreams and dreaming.

PubMed

Pagel, James F

2012-11-01

An overview of the current status of dream science is given, designed to provide a basic background of this field for the sleep-interested physician. No cognitive state has been more extensively studied and is yet more misunderstood than dreaming. Much older work is methodologically limited by lack of definitions, small sample size, and constraints of theoretical perspective, with evidence equivocal as to whether any special relationship exists between rapid eye movement (REM) sleep and dreaming. As the relationship between dreams and REM sleep is so poorly defined, evidence-based studies of dreaming require a dream report. The different aspects of dreaming that can be studied include dream and nightmare recall frequency, dream content, dreaming effect on waking behaviors, dream/nightmare associated medications, and pathophysiology affecting dreaming. Whether studied from behavioral, neuroanatomical, neurochemical, pathophysiological or electrophysiological perspectives, dreaming reveals itself to be a complex cognitive state affected by a wide variety of medical, psychological, sleep and social variables.

Topical negative pressure wound therapy: a review of its role and guidelines for its use in the management of acute wounds.

PubMed

Bovill, Estas; Banwell, Paul E; Teot, Luc; Eriksson, Elof; Song, Colin; Mahoney, Jim; Gustafsson, Ronny; Horch, Raymund; Deva, Anand; Whitworth, Ian

2008-10-01

Over the past two decades, topical negative pressure (TNP) wound therapy has gained wide acceptance as a genuine strategy in the treatment algorithm for a wide variety of acute and chronic wounds. Although extensive experimental and clinical evidence exists to support its use and despite the recent emergence of randomised control trials, its role and indications have yet to be fully determined. This article provides a qualitative overview of the published literature appertaining to the use of TNP therapy in the management of acute wounds by an international panel of experts using standard methods of appraisal. Particular focus is applied to the use of TNP for the open abdomen, sternal wounds, lower limb trauma, burns and tissue coverage with grafts and dermal substitutes. We provide evidence-based recommendations for indications and techniques in TNP wound therapy and, where studies are insufficient, consensus on best practice.

Bioactives from probiotics for dermal health: functions and benefits.

PubMed

Lew, L-C; Liong, M-T

2013-05-01

Probiotics have been extensively reviewed for decades, emphasizing on improving general gut health. Recently, more studies showed that probiotics may exert other health-promoting effects beyond gut well-being, attributed to the rise of the gut-brain axis correlations. Some of these new benefits include skin health such as improving atopic eczema, atopic dermatitis, healing of burn and scars, skin-rejuvenating properties and improving skin innate immunity. Increasing evidence has also showed that bacterial compounds such as cell wall fragments, their metabolites and dead bacteria can elicit certain immune responses on the skin and improve skin barrier functions. This review aimed to underline the mechanisms or the exact compounds underlying the benefits of bacterial extract on the skin based on evidences from in vivo and in vitro studies. This review could be of help in screening of probiotic strains with potential dermal enhancing properties for topical applications. © 2013 The Society for Applied Microbiology.

Macrofossil evidence for a rapid and severe Cretaceous-Paleogene mass extinction in Antarctica.

PubMed

Witts, James D; Whittle, Rowan J; Wignall, Paul B; Crame, J Alistair; Francis, Jane E; Newton, Robert J; Bowman, Vanessa C

2016-05-26

Debate continues about the nature of the Cretaceous-Paleogene (K-Pg) mass extinction event. An abrupt crisis triggered by a bolide impact contrasts with ideas of a more gradual extinction involving flood volcanism or climatic changes. Evidence from high latitudes has also been used to suggest that the severity of the extinction decreased from low latitudes towards the poles. Here we present a record of the K-Pg extinction based on extensive assemblages of marine macrofossils (primarily new data from benthic molluscs) from a highly expanded Cretaceous-Paleogene succession: the López de Bertodano Formation of Seymour Island, Antarctica. We show that the extinction was rapid and severe in Antarctica, with no significant biotic decline during the latest Cretaceous, contrary to previous studies. These data are consistent with a catastrophic driver for the extinction, such as bolide impact, rather than a significant contribution from Deccan Traps volcanism during the late Maastrichtian.

Macrofossil evidence for a rapid and severe Cretaceous-Paleogene mass extinction in Antarctica

NASA Astrophysics Data System (ADS)

Witts, James D.; Whittle, Rowan J.; Wignall, Paul B.; Crame, J. Alistair; Francis, Jane E.; Newton, Robert J.; Bowman, Vanessa C.

2016-05-01

Debate continues about the nature of the Cretaceous-Paleogene (K-Pg) mass extinction event. An abrupt crisis triggered by a bolide impact contrasts with ideas of a more gradual extinction involving flood volcanism or climatic changes. Evidence from high latitudes has also been used to suggest that the severity of the extinction decreased from low latitudes towards the poles. Here we present a record of the K-Pg extinction based on extensive assemblages of marine macrofossils (primarily new data from benthic molluscs) from a highly expanded Cretaceous-Paleogene succession: the López de Bertodano Formation of Seymour Island, Antarctica. We show that the extinction was rapid and severe in Antarctica, with no significant biotic decline during the latest Cretaceous, contrary to previous studies. These data are consistent with a catastrophic driver for the extinction, such as bolide impact, rather than a significant contribution from Deccan Traps volcanism during the late Maastrichtian.

Macrofossil evidence for a rapid and severe Cretaceous–Paleogene mass extinction in Antarctica

PubMed Central

Witts, James D.; Whittle, Rowan J.; Wignall, Paul B.; Crame, J. Alistair; Francis, Jane E.; Newton, Robert J.; Bowman, Vanessa C.

2016-01-01

Debate continues about the nature of the Cretaceous–Paleogene (K–Pg) mass extinction event. An abrupt crisis triggered by a bolide impact contrasts with ideas of a more gradual extinction involving flood volcanism or climatic changes. Evidence from high latitudes has also been used to suggest that the severity of the extinction decreased from low latitudes towards the poles. Here we present a record of the K–Pg extinction based on extensive assemblages of marine macrofossils (primarily new data from benthic molluscs) from a highly expanded Cretaceous–Paleogene succession: the López de Bertodano Formation of Seymour Island, Antarctica. We show that the extinction was rapid and severe in Antarctica, with no significant biotic decline during the latest Cretaceous, contrary to previous studies. These data are consistent with a catastrophic driver for the extinction, such as bolide impact, rather than a significant contribution from Deccan Traps volcanism during the late Maastrichtian. PMID:27226414

Characterization of Chemical Constituents of Human Sweat: A Study Based on Indian Population.

PubMed

Moulvi, Aafrinnaz; Minz, Pooja; Rath, Subrata; Ashma, Richa

2018-06-01

There is a strong evidence in the literature that human odor is unique to an individual; therefore, the focus of this study was to strengthen this evidence through the testing of sweat samples on unrelated individuals with the same ethnicity. Sweat samples were collected from 42 unrelated Indian males and females residing in the same city to determine the chemical constituents in human sweat. The volatile compounds of sweat were subsequently analyzed and identified using gas chromatography-mass spectrometry, and a National Institute of Standards and Technology library was used for individual profiling. A total of 78 compounds were identified in human sweat tested with 22 compounds found to be unique to the individual (frequency of occurrence one). A scent profile, or "chexmotype," unique to the sweat of each individual was obtained. This is the first extensive study on an Indian population with 36 new compounds detected in human sweat.

Exercise physiologists: essential players in interdisciplinary teams for noncommunicable chronic disease management.

PubMed

Soan, Esme J; Street, Steven J; Brownie, Sharon M; Hills, Andrew P

2014-01-01

Noncommunicable diseases (NCDs), such as obesity and type 2 diabetes mellitus, are a growing public health challenge in Australia, accounting for a significant and increasing cost to the health care system. Management of these chronic conditions is aided by interprofessional practice, but models of care require updating to incorporate the latest evidence-based practice. Increasing research evidence reports the benefits of physical activity and exercise on health status and the risk of inactivity to chronic disease development, yet physical activity advice is often the least comprehensive component of care. An essential but as yet underutilized player in NCD prevention and management is the "accredited exercise physiologist," a specialist in the delivery of clinical exercise prescriptions for the prevention or management of chronic and complex conditions. In this article, the existing role of accredited exercise physiologists in interprofessional practice is examined, and an extension of their role proposed in primary health care settings.

Consensus statement on diagnosis, treatment and follow-up of cow's milk protein allergy among infants and children in Turkey.

PubMed

Kansu, Aydan; Yüce, Aysel; Dalgıç, Buket; Şekerel, Bülent Enis; Çullu-Çokuğraş, Fügen; Çokuğraş, Haluk

2016-01-01

The present paper aims to provide experts' consensus on diagnosis and management of cow's milk protein allergy (CMPA) among infants and children in Turkey, based on review of available evidence-based guidelines, publications and experts' clinical experience. The experts agreed that CMPA diagnosis should be based on symptomatic evaluation and diagnostic elimination diet as followed by implementation of an open challenge test after disappearance of symptoms and confirmation of CMPA diagnosis in re-appearance of symptoms. For breastfed infants, differential diagnosis involves withdrawal of cow's milk-containing products from the mother's diet, while calcium supplements and appropriate dietary advice are given to mothers to prevent nutritional deficiency. For infants not breastfed exclusively, cow's milk-based formula and any complementary food containing cow's milk protein (CMP) should be avoided. The first line treatment should be extensively hydrolyzed formula (eHF) with use of amino acid-based formula (AAF) in severe cases such as anaphylaxis, enteropathy, eosinophilic esophagitis and food protein induced enterocolitis along with cases of multiple system involvement, multiple food allergies and intolerance to eHF. Introduction of supplementary foods should not be delayed in CMPA, while should be made one by one in small amounts and only after the infant is at least 17 weeks of age. Infants who are at-risk can be identified by family history of atopic disease. Exclusive breastfeeding for 4-6 months (17-27 weeks) is recommended as the best method of infant allergy prevention. There is no evidence that modifying the mother's diet during pregnancy and/or breast-feeding and delaying solid or even potentially allergic foods beyond 4-6 months in infants may be protective against allergy among at-risk infants. When exclusive breastfeeding is not possible, at-risk infants should get a partially or extensively hydrolyzed formula (pHF or eHF) to prevent allergy until risk evaluation by a health professional. In conclusion, the present consensus statement provides recommendations regarding diagnosis, prevention and management of CMPA in infants and children in Turkey, and thus expected to guide physicians to optimize their approach to CMPA and decrease burden of the disease on infants and their caregivers.

Efficacy of Web-Based Collection of Strength-Based Testimonials for Text Message Extension of Youth Suicide Prevention Program: Randomized Controlled Experiment.

PubMed

Thiha, Phyo; Pisani, Anthony R; Gurditta, Kunali; Cherry, Erin; Peterson, Derick R; Kautz, Henry; Wyman, Peter A

2016-11-09

Equipping members of a target population to deliver effective public health messaging to peers is an established approach in health promotion. The Sources of Strength program has demonstrated the promise of this approach for "upstream" youth suicide prevention. Text messaging is a well-established medium for promoting behavior change and is the dominant communication medium for youth. In order for peer 'opinion leader' programs like Sources of Strength to use scalable, wide-reaching media such as text messaging to spread peer-to-peer messages, they need techniques for assisting peer opinion leaders in creating effective testimonials to engage peers and match program goals. We developed a Web interface, called Stories of Personal Resilience in Managing Emotions (StoryPRIME), which helps peer opinion leaders write effective, short-form messages that can be delivered to the target population in youth suicide prevention program like Sources of Strength. To determine the efficacy of StoryPRIME, a Web-based interface for remotely eliciting high school peer leaders, and helping them produce high-quality, personal testimonials for use in a text messaging extension of an evidence-based, peer-led suicide prevention program. In a double-blind randomized controlled experiment, 36 high school students wrote testimonials with or without eliciting from the StoryPRIME interface. The interface was created in the context of Sources of Strength-an evidence-based youth suicide prevention program-and 24 ninth graders rated these testimonials on relatability, usefulness/relevance, intrigue, and likability. Testimonials written with the StoryPRIME interface were rated as more relatable, useful/relevant, intriguing, and likable than testimonials written without StoryPRIME, P=.054. StoryPRIME is a promising way to elicit high-quality, personal testimonials from youth for prevention programs that draw on members of a target population to spread public health messages. ©Phyo Thiha, Anthony R Pisani, Kunali Gurditta, Erin Cherry, Derick R Peterson, Henry Kautz, Peter A Wyman. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 09.11.2016.

Evidence for the Use of Hearing Assistive Technology by Adults: The Role of the FM System

PubMed Central

Chisolm, Theresa Hnath; Noe, Colleen M.; McArdle, Rachel; Abrams, Harvey

2007-01-01

Hearing assistive technologies include listening, alerting, and/or signaling devices that use auditory, visual, and/or tactile modalities to augment communication and/or facilitate awareness of environmental sounds. The importance of hearing assistive technologies in the management of adults with hearing loss was recently acknowledged in an evidence-based clinical practice guideline developed by the American Academy of Audiology. Most currently available evidence for hearing assistive technology use by adults focuses on frequency-modulated (FM) technology. Previous research is reviewed that demonstrates the efficacy of FM devices for adults in terms of laboratory measures of speech understanding in noise. Also reviewed are the outcomes from field trials of FM use by community-dwelling adults, which, to date, have been disappointing. Few to no individuals, in previous studies, elected to use FM devices at the end of the trial periods. Data are presented from a 1-group pretest-posttest study examining the role of extensive counseling, coaching, and instruction on FM use by adults. In addition, the potential influence of the cost of devices to the individual was eliminated by conducting the study with veterans who were eligible to receive FM systems through the Veterans Affairs National Hearing Aid Program. Positive outcomes were obtained at the end of a 6-week trial period and were found to remain 1 year after study completion. Implications for increasing the evidence base for the use of FM devices by adults are discussed. PMID:17494874

The Brazilian consensus for the clinical approach and treatment of subclinical hypothyroidism in adults: recommendations of the thyroid Department of the Brazilian Society of Endocrinology and Metabolism.

PubMed

Sgarbi, Jose A; Teixeira, Patrícia F S; Maciel, Lea M Z; Mazeto, Glaucia M F S; Vaisman, Mario; Montenegro Junior, Renan M; Ward, Laura S

2013-04-01

Subclinical hypothyroidism (SCH), defined as elevated concentrations of thyroid stimulating hormone (TSH) despite normal levels of thyroid hormones, is highly prevalent in Brazil, especially among women and the elderly. Although an increasing number of studies have related SCH to an increased risk of coronary artery disease and mortality, there have been no randomized clinical trials verifying the benefit of levothyroxine treatment in reducing these risks, and the treatment remains controversial. This consensus, sponsored by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism and developed by Brazilian experts with extensive clinical experience with thyroid diseases, presents these recommendations based on evidence for the clinical management of SCH patients in Brazil. After structuring the clinical questions, the search for evidence in the literature was initially performed in the MedLine-PubMed database and later in the Embase and SciELO - Lilacs databases. The strength of evidence was evaluated according to the Oxford classification system and established based on the experimental design used, considering the best available evidence for each question and the Brazilian experience. The topics covered included SCH definition and diagnosis, natural history, clinical significance, treatment and pregnancy, and the consensus issued 29 recommendations for the clinical management of adult patients with SCH. Treatment with levothyroxine was recommended for all patients with persistent SCH with serum TSH values > 10 mU/L and for certain patient subgroups.

Evidentiary, extraevidentiary, and deliberation process predictors of real jury verdicts.

PubMed

Devine, Dennis J; Krouse, Paige C; Cavanaugh, Caitlin M; Basora, Jaime Colon

2016-12-01

In contrast to the extensive literature based on mock jurors, large-sample studies of decision making by real juries are relatively rare. In this field study, we examined relationships between jury verdicts and variables representing 3 classes of potential determinants-evidentiary, extraevidentiary, and deliberation process-using a sample of 114 criminal jury trials. Posttrial data were collected from 11 presiding judges, 31 attorneys, and 367 jurors using a Web-based questionnaire. The strength of the prosecution's evidence was strongly related to the occurrence of a conviction, whereas most extraevidentiary and deliberation process variables were only weakly to modestly related in bivariate form and when the prosecution's evidence strength was controlled. Notable exceptions to this pattern were jury demographic diversity as represented by the number of different race-gender subgroups (e.g., Black males) present in the jury, and several deliberation process variables reflecting advocacy for acquittal (e.g., presence of an identifiable proacquittal faction within the jury and proacquittal advocacy by the foreperson). Variables reflecting advocacy for conviction were essentially unrelated to jury verdict. Sets of extraevidentiary and deliberation variables were each able to modestly improve the explanation of jury verdicts over prosecution evidence strength in multivariate models. This study highlights the predictive efficacy of prosecution evidence strength with respect to jury verdicts, as well as the potential importance of jury demographic diversity and advocacy for acquittal during deliberation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Best evidence on the educational effects of undergraduate portfolios.

PubMed

Buckley, Sharon; Coleman, Jamie; Khan, Khalid

2010-09-01

The great variety of portfolio types and schemes used in the education of health professionals is reflected in the extensive and diverse educational literature relating to portfolio use. We have recently completed a Best Evidence Medical Education (BEME) systematic review of the literature relating to the use of portfolios in the undergraduate setting that offers clinical teachers insights into both their effects on learning and issues to consider in portfolio implementation. Using a methodology based on BEME recommendations, we searched the literature relating to a range of health professions, identifying evidence for the effects of portfolios on undergraduate student learning, and assessing the methodological quality of each study. The higher quality studies in our review report that, when implemented appropriately, portfolios can improve students' ability to integrate theory with practice, can encourage their self-awareness and reflection, and can offer support for students facing difficult emotional situations. Portfolios can also enhance student-tutor relationships and prepare students for the rigours of postgraduate training. However, the time required to complete a portfolio may detract from students' clinical learning. An analysis of methodological quality against year of publication suggests that, across a range of health professions, the quality of the literature relating to the educational effects of portfolios is improving. However, further work is still required to build the evidence base for the educational effects of portfolios, particularly comparative studies that assess effects on learning directly. Our findings have implications for the design and implementation of portfolios in the undergraduate setting. © Blackwell Publishing Ltd 2010.

Peer Effects in College Academic Outcomes--Gender Matters!

ERIC Educational Resources Information Center

Ficano, Carlena Cochi

2012-01-01

An extensive literature exploring a range of peer influences on both academic and non-academic outcomes continues to produce contradictory evidence regarding the existence and magnitude of peer effects. Our results provide no evidence of peer effects in models where peer academic ability is measured in the aggregate. However, models that control…

The Causal Effects of Cultural Relevance: Evidence from an Ethnic Studies Curriculum. CEPA Working Paper No. 16-01

ERIC Educational Resources Information Center

Dee, Thomas; Penner, Emily

2016-01-01

An extensive theoretical and qualitative literature stresses the promise of instructional practices and content aligned with the cultural experiences of minority students. Ethnic studies courses provide a growing but controversial example of such "culturally relevant pedagogy." However, the empirical evidence on the effectiveness of…

Evaluating the Complementary Roles of an SJT and Academic Assessment for Entry into Clinical Practice

ERIC Educational Resources Information Center

Cousans, Fran; Patterson, Fiona; Edwards, Helena; Walker, Kim; McLachlan, John C.; Good, David

2017-01-01

Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the…

Measurement Directiveness as a Cause of Response Bias: Evidence From Two Survey Experiments

ERIC Educational Resources Information Center

Brenner, Philip S.; DeLamater, John

2016-01-01

Extant research comparing survey self-reports of normative behavior to direct observations and time diary data have yielded evidence of extensive measurement bias. However, most of this research program has relied on observational data, comparing independent samples from the same target population, rather than comparing survey self-reports to a…

The influence of lower limb impairments on RaceRunning performance in athletes with hypertonia, ataxia or athetosis.

PubMed

van der Linden, Marietta L; Jahed, Sadaf; Tennant, Nicola; Verheul, Martine H G

2018-03-01

RaceRunning enables athletes with limited or no walking ability to propel themselves independently using a three-wheeled running bike that has a saddle and a chest plate for support but no pedals. For RaceRunning to be included as a Para athletics event, an evidence-based classification system is required. Therefore, the aim of this study was to assess the association between a range of impairment measures and RaceRunning performance. The following impairment measures were recorded: lower limb muscle strength assessed using Manual Muscle Testing (MMT), selective voluntary motor control assessed using the Selective Control Assessment of the Lower Extremity (SCALE), spasticity recorded using both the Australian Spasticity Assessment Score (ASAS) and Modified Ashworth Scale (MAS), passive range of motion (ROM) of the lower extremities and the maximum static step length achieved on a stationary bike (MSSL). Associations between impairment measures and 100-meter race speed were assessed using Spearman's correlation coefficients. Sixteen male and fifteen female athletes (27 with cerebral palsy), aged 23 (SD = 7) years, Gross Motor Function Classification System levels ranging from II to V, participated. The MSSL averaged over both legs and the ASAS, MAS, SCALE, and MMT summed over all joints and both legs, significantly correlated with 100 m race performance (rho: 0.40-0.54). Passive knee extension was the only ROM measure that was significantly associated with race speed (rho = 0.48). These results suggest that lower limb spasticity, isometric leg strength, selective voluntary motor control and passive knee extension impact performance in RaceRunning athletes. This supports the potential use of these measures in a future evidence-based classification system. Copyright © 2018 Elsevier B.V. All rights reserved.

Eskers and other evidence of wet-based glaciation in Phlegra Montes, Mars.

NASA Astrophysics Data System (ADS)

Gallagher, Colman; Balme, Matt

2016-04-01

Although glacial landsystems produced under warm/wet based conditions are very common on Earth, glaciological and landform evidence indicates that glaciation on Mars during the Amazonian period (3 Ga to present) has been characterised by cold/dry based glaciers, consistent with the prevailing cold, hyperarid conditions. However, this presentation describes a system of sinuous ridges, interpreted as eskers (1), emerging from the degraded piedmont terminus of a Late Amazonian (˜150 Ma) glacier in the southern Phlegra Montes region of Mars. This is probably the first identification of martian eskers that can be directly linked to their parent glacier. Together with their contextual landform assemblage, the eskers are indicative of glacial melting and subglacial meltwater routing but the confinement of the system to a well-defined, regionally significant graben, and the absence of eskers elsewhere in the region, suggests that melting was a response to locally enhanced geothermal heat flux, rather than regional, climate-induced warming. Now, however, new observations reveal the presence of many assemblages of glacial abrasion forms and associated channels that could be evidence of more widespread wet-based glaciation in Phlegra Montes, including the collapse of several distinct ice domes. This landform assemblage has not been described in other glaciated, mid-latitude regions of the martian northern hemisphere. Moreover, Phlegra Montes are flanked by lowlands displaying evidence of extensive volcanism, including contact between plains lava and piedmont glacial ice. These observations suggest that the glaciation of Phlegra Montes might have been strongly conditioned by both volcanism and more restricted forms of ground-heating. These are important new insights both to the forcing of glacial dynamic and melting behaviour on Mars by factors other than climate and to the production of liquid water on Mars during the Late Amazonian. (1) Gallagher, C. and Balme, M. (2015). Eskers in a complete, wet-based glacial system in the Phlegra Montes region, Mars, Earth and Planetary Science Letters, 431, 96-109.

SU-E-I-17: Evaluation of Commercially Available Extension Plates for the ACR CT Accreditation Phantom

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greene-Donnelly, K; Ogden, K

Purpose: To evaluate the impact of commercially available extension plates on Hounsfield Unit (HU) values in the ACR CT accreditation phantom (Model 464, Gammex Inc., Middleton, Wi). The extension plates are intended to improve water HU values in scanners where the traditional solution involves scanning the phantom with an adjacent water or CTDI phantom. Methods: The Model 464 phantom was scanned on 9 different CT scanners at 8 separate sites representing 16 and 64 slice MDCT technology from four CT manufacturers. The phantom was scanned with and without the extension plates (Gammex 464 EXTPLT-KIT) in helical and axial modes. Amore » water phantom was also scanned to verify water HU calibration. Technique was 120 kV tube potential, 350 mAs, and 210 mm display field of view. Slice thickness and reconstruction algorithm were based on site clinical protocols. The widest available beam collimation was used. Regions of interest were drawn on the HU test objects in Module 1 of the phantom and mean values recorded. Results: For all axial mode scans, water HU values were within limits with or without the extension plates. For two scanners (both Lightspeed VCT, GE Medical Systems, Waukesha WI), axial mode bone HU values were above the specified range both with and without the extension plates though they were closer to the specified range with the plates installed. In helical scan mode, two scanners (both GE Lightspeed VCT) had water HU values above the specified range without the plates installed. With the plates installed, the water HU values were within range for all scanners in all scan modes. Conclusion: Using the plates, the Lightspeed VCT scanners passed the water HU test when scanning in helical mode. The benefit of the extension plates was evident in helical mode scanning with GE scanners using a nominal 4 cm beam. Disclosure: The extension plates evaluated in this work were provided free of charge to the authors. The authors have no other financial interest in Gammex Inc.« less

Genome-wide linkage scan for maximum and length-dependent knee muscle strength in young men: significant evidence for linkage at chromosome 14q24.3.

PubMed

De Mars, G; Windelinckx, A; Huygens, W; Peeters, M W; Beunen, G P; Aerssens, J; Vlietinck, R; Thomis, M A I

2008-05-01

Maintenance of high muscular fitness is positively related to bone health, functionality in daily life and increasing insulin sensitivity, and negatively related to falls and fractures, morbidity and mortality. Heritability of muscle strength phenotypes ranges between 31% and 95%, but little is known about the identity of the genes underlying this complex trait. As a first attempt, this genome-wide linkage study aimed to identify chromosomal regions linked to muscle and bone cross-sectional area, isometric knee flexion and extension torque, and torque-length relationship for knee flexors and extensors. In total, 283 informative male siblings (17-36 years old), belonging to 105 families, were used to conduct a genome-wide SNP-based multipoint linkage analysis. The strongest evidence for linkage was found for the torque-length relationship of the knee flexors at 14q24.3 (LOD = 4.09; p<10(-5)). Suggestive evidence for linkage was found at 14q32.2 (LOD = 3.00; P = 0.005) for muscle and bone cross-sectional area, at 2p24.2 (LOD = 2.57; p = 0.01) for isometric knee torque at 30 degrees flexion, at 1q21.3, 2p23.3 and 18q11.2 (LOD = 2.33, 2.69 and 2.21; p<10(-4) for all) for the torque-length relationship of the knee extensors and at 18p11.31 (LOD = 2.39; p = 0.0004) for muscle-mass adjusted isometric knee extension torque. We conclude that many small contributing genes rather than a few important genes are involved in causing variation in different underlying phenotypes of muscle strength. Furthermore, some overlap in promising genomic regions were identified among different strength phenotypes.

Late Pleistocene (MIS5-3) environmental reconstruction from north-eastern Iberia through microvertebrate and palaeobotanical records

NASA Astrophysics Data System (ADS)

Allue, Ethel; Bennàssar, Maria; Biltekin, Demet; Blain, Hugues-Alexandre; Burjachs, Francesc; Euba, Itxaso; Expósito, Isabel; Fernández-García, Mónica; López-García, Juan Manuel

2014-05-01

The aim of this work is to analyze the environmental changes during the Late Pleistocene on the basis of a multi-approach study based on natural and archaeological deposits from NE Iberian Peninsula. The focussed area, although having a small extension (some 32.000 square kilometres), covers a large range of ecosystems and bioclimatic conditions from the Mediterranean seashore to the summit of the Pyrenean mountain ranges (up to 2000 masl). This synthetical approach includes materials from various contexts including 10 archaeological deposits and a single natural deposit. In this work, plant (pollen and charcoals) and animal (small mammals, amphibians and reptiles) records are being analysed and compared in order to present an overview of the environmental changes occurred from the MIS5 to MIS3. On the first hand, we are using the small-vertebrate records recovered from archaeological deposits. These proxies are mainly the product of pellets from birds of prey and are key ecological markers. On the second hand, palaeobotanical evidences, pollen and charcoal, have different formation processes. Charcoal remains are mostly from archaeological deposits and are due to human activities related to fire showing evidences of the local vegetation. Pollen evidences from archaeological and natural contexts are deposited through natural processes (wind, insects, etc.) and show regional scale vegetation record. Results indicate the presence of temperate elements during all these periods (especially at the seashore area), with a more important representation and extension southwards or changes in altitude from taxa with eurosiberian affinities during coldest periods. Forest coverage, plant and vertebrate distribution along the territory point out a mosaic landscape formed by open areas and forests. These landscapes have probably a more or less Mediterranean or Eurosiberian character depending on the climatic moment and their location with variations along the sequence.

The impact of clinical nurse specialists on clinical pathways in the application of evidence-based practice.

PubMed

Gurzick, Martha; Kesten, Karen S

2010-01-01

The purpose of this article was to address the call for evidence-based practice through the development of clinical pathways and to assert the role of the clinical nurse specialist (CNS) as a champion in clinical pathway implementation. In the current health care system, providing quality of care while maintaining cost-effectiveness is an ever-growing battle that institutions face. The CNS's role is central to meeting these demands. An extensive literature review has been conducted to validate the use of clinical pathways as a means of improving patient outcomes. This literature also suggests that clinical pathways must be developed, implemented, and evaluated utilizing validated methods including the use of best practice standards. Execution of clinical pathways should include a clinical expert, who has the ability to look at the system as a whole and can facilitate learning and change by employing a multitude of competencies while maintaining a sphere of influence over patient and families, nurses, and the system. The CNS plays a pivotal role in influencing effective clinical pathway development, implementation, utilization, and ongoing evaluation to ensure improved patient outcomes and reduced costs. This article expands upon the call for evidence-based practice through the utilization of clinical pathways to improve patient outcomes and reduce costs and stresses the importance of the CNS as a primary figure for ensuring proper pathway development, implementation, and ongoing evaluation. Copyright 2010 Elsevier Inc. All rights reserved.

Treating reading comprehension deficits in sub-acute brain injury rehabilitation: Identifying clinical practice and management.

PubMed

Watter, Kerrin; Copley, Anna; Finch, Emma

There is limited evidence for cognitive-communication reading comprehension (CCRC) interventions for adults following acquired brain injury (ABI), particularly during sub-acute rehabilitation. The purpose of this study was to investigate the clinical practice of speech-language pathologists (SLPs) with CCRC deficits during sub-acute ABI rehabilitation and compare it to the best available evidence. An electronic survey was used to gather information from clinicians across Australia regarding clinical practice in the areas of assessment, intervention, treatment hierarchies and service delivery; survey questions were developed from an extensive review of the literature and expert clinician opinion. Survey findings were then compared with the literature in the form of a systematic review. Surveyed clinicians provided multiple interventions for CCRC rehabilitation, including impairment based (94.7%), activity based (94.7%) and reading strategy interventions (100.0%). Five strategies were used by >94% of SLPs (highlighting, identifying main points/wh- questioning, re-reading, summarising, reducing visual load). When compared with the literature, strong similarities were found for strategy-based interventions and individual service delivery, with broad similarities for functional and impairment-based interventions, and impairment based treatment hierarchies. Strong differences in assessment were identified. Strategy use reported in clinical practice (100.0% SLPs) was higher than in the literature. Further investigation into the effectiveness of specific reading strategies for people with ABI is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical studies of fiber posts: a literature review.

PubMed

Cagidiaco, Maria C; Goracci, Cecilia; Garcia-Godoy, Franklin; Ferrari, Marco

2008-01-01

This literature review aimed to find answers to relevant questions regarding the clinical outcome of endontically treated teeth restored with fiber posts. All clinical studies published since 1990 in journals indexed in MEDLINE were retrieved by searching PubMed with the query terms "fiber posts and clinical studies." The reference list of the collected articles was also screened for further relevant citations. The strength of the evidence provided by the reviewed papers was assessed according to the criteria of evidence-based dentistry. Five randomized controlled trials (RCTs) on fiber posts have been published in peer-reviewed journals. A meta-analysis is not applicable to these studies since they do not address the same specific clinical question. Retrospective and prospective trials without controls are also available. Two RCTs indicate that fiber-reinforced composite posts outperform metal posts in the restoration of endontically treated teeth. However, this evidence cannot be considered as conclusive. Longer-term RCTs would be desirable. The placement of a fiber-reinforced composite post protects against failure, especially under conditions of extensive coronal destruction. The most common type of failure with fiber-reinforced composite posts is debonding.

The Case for Chronic Disease Management for Addiction

PubMed Central

Saitz, Richard; Larson, Mary Jo; LaBelle, Colleen; Richardson, Jessica; Samet, Jeffrey H.

2009-01-01

Chronic disease (care) management (CDM) is a patient-centered model of care that involves longitudinal care delivery; integrated, and coordinated primary medical and specialty care; patient and clinician education; explicit evidence-based care plans; and expert care availability. The model, incorporating mental health and specialty addiction care, holds promise for improving care for patients with substance dependence who often receive no care or fragmented ineffective care. We describe a CDM model for substance dependence and discuss a conceptual framework, the extensive current evidence for component elements, and a promising strategy to reorganize primary and specialty health care to facilitate access for people with substance dependence. The CDM model goes beyond integrated case management by a professional, colocation of services, and integrated medical and addiction care—elements that individually can improve outcomes. Supporting evidence is presented that: 1) substance dependence is a chronic disease requiring longitudinal care, although most patients with addictions receive no treatment (eg, detoxification only) or short-term interventions, and 2) for other chronic diseases requiring longitudinal care (eg, diabetes, congestive heart failure), CDM has been proven effective. PMID:19809579

Vitamin E in Sarcopenia: Current Evidences on Its Role in Prevention and Treatment

PubMed Central

Abdul Karim, Norwahidah; Wan Ngah, Wan Zurinah

2014-01-01

Sarcopenia is a geriatric syndrome that is characterized by gradual loss of muscle mass and strength with increasing age. Although the underlying mechanism is still unknown, the contribution of increased oxidative stress in advanced age has been recognized as one of the risk factors of sarcopenia. Thus, eliminating reactive oxygen species (ROS) can be a strategy to combat sarcopenia. In this review, we discuss the potential role of vitamin E in the prevention and treatment of sarcopenia. Vitamin E is a lipid soluble vitamin, with potent antioxidant properties and current evidence suggesting a role in the modulation of signaling pathways. Previous studies have shown its possible beneficial effects on aging and age-related diseases. Although there are evidences suggesting an association between vitamin E and muscle health, they are still inconclusive compared to other more extensively studied chronic diseases such as neurodegenerative diseases and cardiovascular diseases. Therefore, we reviewed the role of vitamin E and its potential protective mechanisms on muscle health based on previous and current in vitro and in vivo studies. PMID:25097722

Expanded secondary craters in the Arcadia Planitia region, Mars: evidence for tens of Myr-old shallow subsurface ice

USGS Publications Warehouse

Viola, Donna; McEwen, Alfred S.; Dundas, Colin M.; Byrne, Shane

2015-01-01

A range of observations indicates widespread subsurface ice throughout the mid and high latitudes of Mars in the form of both pore-filling and excess ice. It is generally thought that this ice was recently emplaced and is not older than a hundred thousand to a few millions of years old based on ice stability and orbital-induced climate change. We analyze the distribution of subsurface ice in Arcadia Planitia, located in the northern mid latitudes, by mapping thermokarstically expanded secondary craters, providing additional evidence for extensive excess ice down to fairly low latitudes (less than 40°N). We further infer the minimum age of this subsurface ice based on the ages of the four primary craters that are thought to be the source of a large portion of these secondaries, which yields estimates on the order of tens of millions of years old – much more ancient than anticipated. This estimated ancient age suggests that ice can be preserved in the shallow subsurface for long periods of time, at least in some parts of Arcadia Planitia where expanded secondary craters are especially abundant. We estimate the amount of ice lost to sublimation during crater expansion based on measurements of expanded secondary craters in HiRISE Digital Terrain Models. The loss is equivalent to a volume of ice between ∼140 and 360 km3, which would correspond to a global layer of 1–2.5 mm thick. We further argue that much more ice (at least 6000 km3) is likely preserved beneath the un-cratered regions of Arcadia Planitia since significant loss of this excess ice would have caused extensive terrain dissection and the removal of the expanded secondary craters. Both the loss of ice due to secondary crater expansion and the presence of this ice today have implications for the martian climate.

Should we be looking for and treating isolated calf vein thrombosis?

PubMed

Horner, Daniel; Hogg, Kerstin; Body, Richard

2016-06-01

Management of isolated calf deep vein thrombosis is an area of significant international debate and variable clinical practice. Both therapeutic anticoagulation and conservative management carry risk. As clinical care of suspected and confirmed venous thromboembolic disease increasingly becomes the remit of emergency medicine, complex decisions are left to practising clinicians at the front door. We aim to provide a contemporary overview of recent evidence on this topic and associated challenges facing clinicians. Given the lack of high-level evidence, we present this work as a narrative review, based on structured literature review and expert opinion. A decision to manage calf thrombosis is principally dependent on the risk of complications without treatment balanced against the risks of therapeutic anticoagulation. Estimates of the former risks taken from systematic review, meta-analysis, observational cohort and recent pilot trial evidence include proximal propagation 7%-10%, pulmonary embolism 2%-3% and death <1%. Fatal bleeding with therapeutic anticoagulation stands at <0.5%, and major bleeding at approximately 2%. Estimates of haemorrhagic risk are based on robust data from large prospective management studies of venous thromboembolic disease; the risks of untreated calf deep vein thrombosis are based on small cohorts and therefore less exact. Pending further trial evidence, these risks should be discussed with patients openly, in the context of personal preference and shared decision-making. Anticoagulation may maximally benefit those patients with extensive and/or symptomatic disease or those with higher risk for complication (unprovoked, cancer-associated or pregnancy). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Cardiovascular, diabetes, and cancer strips: evidences, mechanisms, and classifications

PubMed Central

Wu, Qing-Hua; Hu, Da-Yi

2014-01-01

Objectives To report and name firstly that there are cardiovascular disease (CVD), diabetes mellitus (DM) and cancers (CDC) strips; and disclose their mechanisms, classifications, and clinical significances. Study design Narrative and systematic review study and interpretive analysis. Methods Data sources and study selection: to collect and present related evidences on CDC strips from evidence-based, open-access, both Chinese- and English-language literatures in recent 10 years on clinical trials from PubMed according to keywords “CVD, DM and cancers” as well as authors’ extensive clinical experience with the treatment of more than fifty thousands of patients with CVD, diabetes and cancers over the past decades, and analyze their related mechanisms and categories which based on authors’ previous works. Data extraction: data were mainly extracted from 48 articles which are listed in the reference section of this review. Qualitative, quantitative and mixed data were included, narratively and systematically reviewed. Results With several conceptual and technical breakthrough, authors present related evidences on CDC strips, these are, CVD and DM, DM and cancers, cancers and CVD linked, respectively; And “Bad SEED” +/– “bad soil” theory or doctrine may explain this phenomenon due to “internal environmental injure, abnormal or unbalance” in human body resulting from the role of risk factors (RFs) related multi-pathways and multi-targets, which including organ & tissue (e.g., vascular-specific), cell and gene-based mechanisms. Their classifications include main strips/type B, and Branches/type A as showed by tables and figures in this article. Conclusions There are CDC strips and related mechanisms and classifications. CDC strips may help us to understand, prevent, and control related common non-communicable diseases (NCDs) as well as these high risk strips. PMID:25276377

The first step in the development of text mining technology for cancer risk assessment: identifying and organizing scientific evidence in risk assessment literature

PubMed Central

Korhonen, Anna; Silins, Ilona; Sun, Lin; Stenius, Ulla

2009-01-01

Background One of the most neglected areas of biomedical Text Mining (TM) is the development of systems based on carefully assessed user needs. We have recently investigated the user needs of an important task yet to be tackled by TM -- Cancer Risk Assessment (CRA). Here we take the first step towards the development of TM technology for the task: identifying and organizing the scientific evidence required for CRA in a taxonomy which is capable of supporting extensive data gathering from biomedical literature. Results The taxonomy is based on expert annotation of 1297 abstracts downloaded from relevant PubMed journals. It classifies 1742 unique keywords found in the corpus to 48 classes which specify core evidence required for CRA. We report promising results with inter-annotator agreement tests and automatic classification of PubMed abstracts to taxonomy classes. A simple user test is also reported in a near real-world CRA scenario which demonstrates along with other evaluation that the resources we have built are well-defined, accurate, and applicable in practice. Conclusion We present our annotation guidelines and a tool which we have designed for expert annotation of PubMed abstracts. A corpus annotated for keywords and document relevance is also presented, along with the taxonomy which organizes the keywords into classes defining core evidence for CRA. As demonstrated by the evaluation, the materials we have constructed provide a good basis for classification of CRA literature along multiple dimensions. They can support current manual CRA as well as facilitate the development of an approach based on TM. We discuss extending the taxonomy further via manual and machine learning approaches and the subsequent steps required to develop TM technology for the needs of CRA. PMID:19772619

Thrombolysis in Acute Ischaemic Stroke: An Update

PubMed Central

Robinson, Thompson; Zaheer, Zahid; Mistri, Amit K.

2011-01-01

Stroke is a major cause of mortality and morbidity, and thrombolysis has served as a catalyst for major changes in the management of acute ischaemic stroke. Intravenous alteplase (recombinant tissue plasminogen activator) is the only approved thrombolytic agent at present indicated for acute ischaemic stoke. While the licensed time window extends to 3h from symptom onset, recent data suggest that the trial window can be extended up to 4.5 h with overall benefit. Nonetheless, 'time is brain' and every effort must be made to reduce the time delay to thrombolysis. Intracranial haemorrhage is the major complication associated with thrombolysis, and key factors increasing risk of haemorrhage include increasing age, high blood pressure, diabetes and stroke severity. Currently, there is no direct evidence to support thrombolysis in patients >80 years of age, with a few case series indicating no overt harm. Identification of viable penumbra based on computed tomography/magnetic resonance imaging may allow future extension of the time window. Adjuvant transcranial Doppler ultrasound has the potential to improve reperfusion rates. While intra-arterial thrombolysis has been in vogue for a few decades, there is no clear advantage over intravenous thrombolysis. The evidence base for thrombolysis in specific situations (e.g. dissection, pregnancy) is inadequate, and individualized decisions are needed, with a clear indication to the patient/carer about the lack of direct evidence, and the risk-benefit balance. Patient-friendly information leaflets may facilitate the process of consent for thrombolysis. This article summarizes the recent advances in thrombolysis for acute ischaemic stroke. Key questions faced by clinicians during the decision-making process are answered based on the evidence available. PMID:23251746

PORTAAL: A Classroom Observation Tool Assessing Evidence-Based Teaching Practices for Active Learning in Large Science, Technology, Engineering, and Mathematics Classes.

PubMed

Eddy, Sarah L; Converse, Mercedes; Wenderoth, Mary Pat

2015-01-01

There is extensive evidence that active learning works better than a completely passive lecture. Despite this evidence, adoption of these evidence-based teaching practices remains low. In this paper, we offer one tool to help faculty members implement active learning. This tool identifies 21 readily implemented elements that have been shown to increase student outcomes related to achievement, logic development, or other relevant learning goals with college-age students. Thus, this tool both clarifies the research-supported elements of best practices for instructor implementation of active learning in the classroom setting and measures instructors' alignment with these practices. We describe how we reviewed the discipline-based education research literature to identify best practices in active learning for adult learners in the classroom and used these results to develop an observation tool (Practical Observation Rubric To Assess Active Learning, or PORTAAL) that documents the extent to which instructors incorporate these practices into their classrooms. We then use PORTAAL to explore the classroom practices of 25 introductory biology instructors who employ some form of active learning. Overall, PORTAAL documents how well aligned classrooms are with research-supported best practices for active learning and provides specific feedback and guidance to instructors to allow them to identify what they do well and what could be improved. © 2015 S. L. Eddy et al. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

PRIORITIZING FUTURE RESEACH ON OFF-LABEL PRESCRIBING: RESULTS OF A QUANTITATIVE EVALUATION

PubMed Central

Walton, Surrey M.; Schumock, Glen T.; Lee, Ky-Van; Alexander, G. Caleb; Meltzer, David; Stafford, Randall S.

2015-01-01

Background Drug use for indications not approved by the Food and Drug Administration exceeds 20% of prescribing. Available compendia indicate that a minority of off-label uses are well supported by evidence. Policy makers, however, lack information to identify where systematic reviews of the evidence or other research would be most valuable. Methods We developed a quantitative model for prioritizing individual drugs for future research on off-label uses. The base model incorporated three key factors, 1) the volume of off-label use with inadequate evidence, 2) safety, and 3) cost and market considerations. Nationally representative prescribing data were used to estimate the number of off-label drug uses by indication from 1/2005 through 6/2007 in the United States, and these indications were then categorized according to the adequacy of scientific support. Black box warnings and safety alerts were used to quantify drug safety. Drug cost, date of market entry, and marketing expenditures were used to quantify cost and market considerations. Each drug was assigned a relative value for each factor, and the factors were then weighted in the final model to produce a priority score. Sensitivity analyses were conducted by varying the weightings and model parameters. Results Drugs that were consistently ranked highly in both our base model and sensitivity analyses included quetiapine, warfarin, escitalopram, risperidone, montelukast, bupropion, sertraline, venlafaxine, celecoxib, lisinopril, duloxetine, trazodone, olanzapine, and epoetin alfa. Conclusion Future research into off-label drug use should focus on drugs used frequently with inadequate supporting evidence, particularly if further concerns are raised by known safety issues, high drug cost, recent market entry, and extensive marketing. Based on quantitative measures of these factors, we have prioritized drugs where targeted research and policy activities have high potential value. PMID:19025425

The thioredoxin TRX-1 regulates adult lifespan extension induced by dietary restriction in Caenorhabditis elegans.

PubMed

Fierro-González, Juan Carlos; González-Barrios, María; Miranda-Vizuete, Antonio; Swoboda, Peter

2011-03-18

Dietary restriction (DR) is the only environmental intervention known to extend adult lifespan in a wide variety of animal models. However, the genetic and cellular events that mediate the anti-aging programs induced by DR remain elusive. Here, we used the nematode Caenorhabditis elegans to provide the first in vivo evidence that a thioredoxin (TRX-1) regulates adult lifespan extension induced by DR. We found that deletion of the gene trx-1 completely suppressed the lifespan extension caused by mutation of eat-2, a genetic surrogate of DR in the worm. However, trx-1 deletion only partially suppressed the long lifespan caused by mutation of the insulin-like receptor gene daf-2 or by mutation of the sensory cilia gene osm-5. A trx-1::GFP translational fusion expressed from its own promoter in ASJ neurons (Ptrx-1::trx-1::GFP) rescued the trx-1 deletion-mediated suppression of the lifespan extension caused by mutation of eat-2. This rescue was not observed when trx-1::GFP was expressed from the ges-1 promoter in the intestine. In addition, overexpression of Ptrx-1::trx-1::GFP extended lifespan in wild type, but not in eat-2 mutants. trx-1 deletion almost completely suppressed the lifespan extension induced by dietary deprivation (DD), a non-genetic, nutrient-based model of DR in the worm. Moreover, DD upregulated the expression of a trx-1 promoter-driven GFP reporter gene (Ptrx-1::GFP) in ASJ neurons of aging adults, but not that of control Pgpa-9::GFP (which is also expressed in ASJ neurons). We propose that DR activates TRX-1 in ASJ neurons during aging, which in turn triggers TRX-1-dependent mechanisms to extend adult lifespan in the worm. Copyright © 2011 Elsevier Inc. All rights reserved.

Decoupling factors affecting plant diversity and cover on extensive green roofs.

PubMed

MacIvor, J Scott; Margolis, Liat; Puncher, Curtis L; Carver Matthews, Benjamin J

2013-11-30

Supplemental irrigation systems are often specified on green roofs to ensure plant cover and growth, both important components of green roof performance and aesthetics. Properties of the growing media environment too can alter the assemblage of plant species able to thrive. In this study we determine how plant cover, above ground biomass and species diversity are influenced by irrigation and growing media. Grass and forb vegetative cover and biomass were significantly greater in organic based growing media but there was no effect of supplemental irrigation, with two warm season grasses dominating in those treatments receiving no supplemental irrigation. On the other hand, plant diversity declined without irrigation in organic media, and having no irrigation in inorganic growing media resulted in almost a complete loss of cover. Sedum biomass was less in inorganic growing media treatments and species dominance shifted when growing media organic content increased. Our results demonstrate that supplemental irrigation is required to maintain plant diversity on an extensive green roof, but not necessarily plant cover or biomass. These results provide evidence that planting extensive green roofs with a mix of plant species can ensure the survival of some species; maintaining cover and biomass when supplemental irrigation is turned off to conserve water, or during extreme drought. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Extension Online: Utilizing Technology to Enhance Educational Outreach

ERIC Educational Resources Information Center

Green, Stephen

2012-01-01

Extension Online is an Internet-based online course platform that enables the Texas AgriLife Extension Service's Family Development and Resource Management (FDRM) unit to reach tens of thousands of users across the U.S. annually with research-based information. This article introduces readers to Extension Online by describing the history of its…

The Impact of Tour-Based Diversity Programming on County Extension Personnel and Programs

ERIC Educational Resources Information Center

Shaklee, Harriet; Luckey, Brian; Tifft, Kathee

2014-01-01

This article explores the effect that planning and conducting an intensive multi-day, tour-based diversity workshop can have on the professional development and Extension work of the county Extension educators involved. Survey data was collected from the county Extension educators who planned workshops throughout Idaho. Educators reported that the…

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

PubMed

Demaerschalk, Bart M; Kleindorfer, Dawn O; Adeoye, Opeolu M; Demchuk, Andrew M; Fugate, Jennifer E; Grotta, James C; Khalessi, Alexander A; Levy, Elad I; Palesch, Yuko Y; Prabhakaran, Shyam; Saposnik, Gustavo; Saver, Jeffrey L; Smith, Eric E

2016-02-01

To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administration under selected commonly and uncommonly encountered clinical circumstances and to identify future research priorities concerning these eligibility criteria, which could potentially expand the safe and judicious use of alteplase and improve outcomes after stroke. Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge and, when appropriate, formulated recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive American Heart Association internal peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. After a review of the current literature, it was clearly evident that the levels of evidence supporting individual exclusion criteria for intravenous alteplase vary widely. Several exclusionary criteria have already undergone extensive scientific study such as the clear benefit of alteplase treatment in elderly stroke patients, those with severe stroke, those with diabetes mellitus and hyperglycemia, and those with minor early ischemic changes evident on computed tomography. Some exclusions such as recent intracranial surgery are likely based on common sense and sound judgment and are unlikely to ever be subjected to a randomized, clinical trial to evaluate safety. Most other contraindications or warnings range somewhere in between. However, the differential impact of each exclusion criterion varies not only with the evidence base behind it but also with the frequency of the exclusion within the stroke population, the probability of coexistence of multiple exclusion factors in a single patient, and the variation in practice among treating clinicians. © 2015 American Heart Association, Inc.

Meckel's cave access: anatomic study comparing the endoscopic transantral and endonasal approaches.

PubMed

Van Rompaey, Jason; Suruliraj, Anand; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo

2014-04-01

Recent advances in endonasal endoscopy have facilitated the surgical access to the lateral skull base including areas such as Meckel's cave. This approach has been well documented, however, few studies have outlined transantral specific access to Meckel's. A transantral approach provides a direct pathway to this region obviating the need for extensive endonasal and transsphenoidal resection. Our aim in this study is to compare the anatomical perspectives obtained in endonasal and transantral approaches. We prepared 14 cadaveric specimens with intravascular injections of colored latex. Eight cadavers underwent endoscopic endonasal transpterygoid approaches to Meckel's cave. Six additional specimens underwent an endoscopic transantral approach to the same region. Photographic evidence was obtained for review. 30 CT scans were analyzed to measure comparative distances to Meckel's cave for both approaches. The endoscopic approaches provided a direct access to the anterior and inferior portions of Meckel's cave. However, the transantral approach required shorter instrumentation, and did not require clearing of the endonasal corridor. This approach gave an anterior view of Meckel's cave making posterior dissection more difficult. A transantral approach to Meckel's cave provides access similar to the endonasal approach with minimal invasiveness. Some of the morbidity associated with extensive endonasal resection could possibly be avoided. Better understanding of the complex skull base anatomy, from different perspectives, helps to improve current endoscopic skull base surgery and to develop new alternatives, consequently, leading to improvements in safety and efficacy.

Adolescent preventive health and team-games-tournaments: five decades of evidence for an empirically based paradigm.

PubMed

Wodarski, John S; Feit, Marvin D

2011-01-01

The problematic behaviors of teenagers and the subsequent negative consequences are extensive and well documented: unwanted pregnancy, substance abuse, violent behavior, depression, and social and psychological consequences of unemployment. In this article, the authors review an approach that uses a cooperative learning, empirically based intervention that employs peers as teachers. This intervention of choice is Teams-Games-Tournaments (TGT), a paradigm backed by five decades of empirical support. The application of TGT in preventive health programs incorporates elements in common with other prevention programs that are based on a public health orientation and constitute the essential components of health education, that is, skills training and practice in applying skills. The TGT intervention supports the idea that children and adolescents from various socioeconomic classes, between the ages of 8 and 18 and in classrooms or groups ranging in size from 4 to 17 members, can work together for one another. TGT has been applied successfully in such diverse areas as adolescent development, sexuality education, psychoactive substance abuse education, anger control, coping with depression and suicide, nutrition, comprehensive employment preparation, and family intervention. This article reviews the extensive research on TGT using examples of successful projects in substance abuse, violence, and nutrition. Issues are raised that relate to the implementation of preventive health strategies for adolescents, including cognitive aspects, social and family networks, and intervention components.

The Partisan Brain: An Identity-Based Model of Political Belief.

PubMed

Van Bavel, Jay J; Pereira, Andrea

2018-03-01

Democracies assume accurate knowledge by the populace, but the human attraction to fake and untrustworthy news poses a serious problem for healthy democratic functioning. We articulate why and how identification with political parties - known as partisanship - can bias information processing in the human brain. There is extensive evidence that people engage in motivated political reasoning, but recent research suggests that partisanship can alter memory, implicit evaluation, and even perceptual judgments. We propose an identity-based model of belief for understanding the influence of partisanship on these cognitive processes. This framework helps to explain why people place party loyalty over policy, and even over truth. Finally, we discuss strategies for de-biasing information processing to help to create a shared reality across partisan divides. Copyright © 2018 Elsevier Ltd. All rights reserved.

Probiotics and oral health: an update.

PubMed

Pradeep, K; Kuttappa, M A; Prasana, K R

2014-02-01

Probiotics are micro-organisms, principally bacteria, which, when ingested, confer health benefits beyond basic nutrition. Probiotics have been extensively studied for their health promoting effects. The main feld of research has been focussed on the gastro-intestinal tract. However, in the past few years probiotics have also been investigated from an oral health perspective and their use has shown promising results with respect to control of chronic conditions, such as dental caries, periodontitis, halitosis and candidial infections. Despite the immense potential of probiotics, hardly any randomised, controlled trials have been conducted on their action and application and studies on their effects on oral health are still in early stages. Hence, more research is needed before any evidence-based conclusions can be drawn. This paper considers some recent literature and insights on which further investigations could be based.

Health information technology needs help from primary care researchers.

PubMed

Krist, Alex H; Green, Lee A; Phillips, Robert L; Beasley, John W; DeVoe, Jennifer E; Klinkman, Michael S; Hughes, John; Puro, Jon; Fox, Chester H; Burdick, Tim

2015-01-01

While health information technology (HIT) efforts are beginning to yield measurable clinical benefits, more is needed to meet the needs of patients and clinicians. Primary care researchers are uniquely positioned to inform the evidence-based design and use of technology. Research strategies to ensure success include engaging patient and clinician stakeholders, working with existing practice-based research networks, and using established methods from other fields such as human factors engineering and implementation science. Policies are needed to help support primary care researchers in evaluating and implementing HIT into everyday practice, including expanded research funding, strengthened partnerships with vendors, open access to information systems, and support for the Primary Care Extension Program. Through these efforts, the goal of improved outcomes through HIT can be achieved. © Copyright 2015 by the American Board of Family Medicine.

Drive: Theory and Construct Validation

PubMed Central

Petrides, K. V.

2016-01-01

This article explicates the theory of drive and describes the development and validation of two measures. A representative set of drive facets was derived from an extensive corpus of human attributes (Study 1). Operationalised using an International Personality Item Pool version (the Drive:IPIP), a three-factor model was extracted from the facets in two samples and confirmed on a third sample (Study 2). The multi-item IPIP measure showed congruence with a short form, based on single-item ratings of the facets, and both demonstrated cross-informant reliability. Evidence also supported the measures’ convergent, discriminant, concurrent, and incremental validity (Study 3). Based on very promising findings, the authors hope to initiate a stream of research in what is argued to be a rather neglected niche of individual differences and non-cognitive assessment. PMID:27409773

Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash

PubMed Central

Anderson-Peacock, Elizabeth; Blouin, Jean-Sébastien; Bryans, Roland; Danis, Normand; Furlan, Andrea; Marcoux, Henri; Potter, Brock; Ruegg, Rick; Gross Stein, Janice; White, Eleanor

2005-01-01

OBJECTIVE To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized. OPTIONS Cervical treatments: manipulation, mobilization, ischemic pressure, clinic- and home-based exercise, traction, education, low-power laser, massage, transcutaneous electrical nerve stimulation, pillows, pulsed electromagnetic therapy, and ultrasound. OUTCOMES The primary outcomes considered were improved (reduced and less intrusive) pain and improved (increased and easier) ranges of motion (ROM) of the adult cervical spine. EVIDENCE An “extraction” team recorded evidence from articles found by literature search teams using 4 separate literature searches, and rated it using a Table adapted from the Oxford Centre for Evidence-based Medicine. The searches were 1) Treatment; August, 2003, using MEDLINE, CINAHL, AMED, MANTIS, ICL, The Cochrane Library (includes CENTRAL), and EBSCO, identified 182 articles. 2) Risk management (adverse events); October, 2004, identified 230 articles and 2 texts. 3) Risk management (dissection); September, 2003, identified 79 articles. 4) Treatment update; a repeat of the treatment search for articles published between September, 2003 and November, 2004 inclusive identified 121 articles. VALUES To enable the search of the literature, the authors (Guidelines Development Committee [GDC]) regarded chiropractic treatment as including elements of “conservative” care in the search strategies, but not in the consideration of the range of chiropractic practice. Also, knowledge based only on clinical experience was considered less valid and reliable than good-caliber evidence, but where the caliber of the relevant evidence was low or it was non-existent, unpublished clinical experience was considered to be equivalent to, or better than the published evidence. REPORTED BENEFITS, HARMS AND COSTS The expected benefits from the recommendations include more rapid recovery from pain, impairment and disability (improved pain and ROM). The GDC identified evidence-based pain benefits from 10 unimodal treatments and more than 7 multimodal treatments. There were no pain benefits from magnets in necklaces, education or relaxation alone, occipital release alone, or head retraction-extension exercise combinations alone. The specificity of the studied treatments meant few studies could be generalized to more than a minority of patients. Adverse events were not addressed in most studies, but where they were, there were none or they were minor. The theoretic harm of vertebral artery dissection (VAD) was not reported, but an analysis suggested that 1 VAD may occur subsequent to 1 million cervical manipulations. Costs were not analyzed in this guideline, but it is the understanding of the GDC that recommendations limiting ineffective care and promoting a more rapid return of patients to full functional capacity will reduce patient costs, as well as increase patient safety and satisfaction. For simplicity, this version of the guideline includes primarily data synthesized across studies (evidence syntheses), whereas the technical and the interactive versions of this guideline (http://ccachiro.org/cpg) also include relevant data from individual studies (evidence extractions). RECOMMENDATIONS The GDC developed treatment, risk-management and research recommendations using the available evidence. Treatment recommendations addressing 13 treatment modalities revolved around a decision algorithm comprising diagnosis (or assessment leading to diagnosis), treatment and reassessment. Several specific variations of modalities of treatment were not recommended. For adverse events not associated with a treatment modality, but that occur in the clinical setting, there was evidence to recommend reconsideration of treatment options or referral to the appropriate health services. For adverse events associated with a treatment modality, but not a known or observable risk factor, there was evidence to recommend heightened vigilance when a relevant treatment is planned or administered. For adverse events associated with a treatment modality and predicted by an observable risk factor, there was evidence to recommend absolute contraindications, and requirements for treatment modality modification or caution to minimize harm and maximize benefit. For managing the theoretic risk of dissection, there was evidence to recommend a systematic risk-management approach. For managing the theoretic risk of stroke, there was support to recommend minimal rotation in administering any modality of upper-cervical spine treatment, and to recommend caution in treating a patient with hyperhomocysteinemia, although the evidence was especially ambiguous in both of these areas. Research recommendations addressed the poor caliber of many of the studies; the GDC concluded that the scientific base for chiropractic cervical treatment of neck pain was not of sufficient quality or scope to “cover” current chiropractic practice comprehensively, although this should not suggest other disciplines are more evidence-based. VALIDATION This guideline was authored by the 10 members of the GDC (Elizabeth Anderson-Peacock, Jean-Sébastien Blouin, Roland Bryans, Normand Danis, Andrea Furlan, Henri Marcoux, Brock Potter, Rick Ruegg, Janice Gross Stein, Eleanor White) based on the work of 3 literature search teams and an evidence extraction team, and in light of feedback from a commentator (Donald R Murphy), a 5-person review panel (Robert R Burton, Andrea Furlan, Richard Roy, Steven Silk, Roy Till), a 6-person Task Force (Grayden Bridge, H James Duncan, Wanda Lee MacPhee, Bruce Squires, Greg Stewart, Dean Wright), and 2 national profession-wide critiques of complete drafts. Two professional editors with extensive guidelines experience were contracted (Thor Eglington, Bruce P Squires). Key contributors to the guideline included individuals with specialties or expert knowledge in chiropractic, medicine, research processes, literature analysis processes, clinical practice guideline processes, protective association affairs, regulatory affairs, and the public interest. This guideline has been formally peer reviewed. PMID:17549134

Effect of testing for cancer on cancer- and venous thromboembolism (VTE)-related mortality and morbidity in people with unprovoked VTE.

PubMed

Robertson, Lindsay; Yeoh, Su Ern; Stansby, Gerard; Agarwal, Roshan

2017-08-23

Venous thromboembolism (VTE) is a collective term for two conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). A proportion of people with VTE have no underlying or immediately predisposing risk factors and the VTE is referred to as unprovoked. Unprovoked VTE can often be the first clinical manifestation of an underlying malignancy. This has raised the question of whether people with an unprovoked VTE should be investigated for an underlying cancer. Treatment for VTE is different in cancer and non-cancer patients and a correct diagnosis would ensure that people received the optimal treatment for VTE to prevent recurrence and further morbidity. Furthermore, an appropriate cancer diagnosis at an earlier, potentially curative stage could avoid the risk of cancer progression and thus lead to improvements in cancer-related mortality and morbidity. This is an update of a review first published in 2015. To determine whether testing for undiagnosed cancer in people with a first episode of unprovoked VTE (DVT of the lower limb or PE) is effective in reducing cancer and VTE-related mortality and morbidity and to determine which tests for cancer are best at identifying treatable cancers early. For this update, the Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (16 February 2017). In addition, the CIS searched the Cochrane Register of Studies CENTRAL (2017, Issue 1). We searched trials registries (February 2017) and checked the reference lists of relevant articles. Randomised and quasi-randomised trials in which people with an unprovoked VTE were allocated to receive specific tests for cancer or clinically indicated tests only were eligible for inclusion in this review. Primary outcomes included all-cause mortality, cancer-related mortality and VTE-related mortality. Two review authors independently selected studies, assessed quality and extracted data. We resolved any disagreements by discussion. Four studies with 1644 participants met the inclusion criteria (two studies in the original review and two in this update). Two studies assessed the effect of extensive tests versus tests at the physician's discretion) while the other two studies assessed the effect of standard testing plus positron emission tomography (PET)/computed tomography (CT) scanning versus standard testing alone. For extensive tests versus tests at the physician's discretion, the quality of the evidence was low due to risk of bias (early termination of the studies). When comparing standard testing plus PET/CT scanning versus standard testing alone, the quality of evidence was moderate due to a risk of detection bias. The quality of the evidence was downgraded further when detection bias was present in one study with a low number of events.When comparing extensive tests versus tests at the physician's discretion, pooled analysis on two studies showed that testing for cancer was consistent with either a benefit or no benefit on cancer-related mortality (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.15 to 1.67; 396 participants; 2 studies; P = 0.26; low quality evidence). One study (201 participants) showed that, overall, malignancies were less advanced in extensively tested participants than in participants in the control group. In total, 9/13 participants diagnosed with cancer in the extensively tested group had a T1 or T2 stage malignancy compared to 2/10 participants diagnosed with cancer in the control group (OR 5.00, 95% CI 1.05 to 23.76; P = 0.04; low quality evidence). There was no clear difference in detection of advanced stages between extensive tests versus tests at the physician's discretion: one participant in the extensively tested group had stage T3 compared with four participants in the control group (OR 0.25, 95% CI 0.03 to 2.28; P = 0.22; low quality evidence). In addition, extensively tested participants were diagnosed earlier than control group (mean: 1 month with extensive tests versus 11.6 months with tests at physician's discretion to cancer diagnosis from the time of diagnosis of VTE). Extensive testing did not increase the frequency of an underlying cancer diagnosis (OR 1.32, 95% CI 0.59 to 2.93; 396 participants; 2 studies; P = 0.50; low quality evidence). Neither study measured all-cause mortality, VTE-related morbidity and mortality, complications of anticoagulation, adverse effects of cancer tests, participant satisfaction or quality of life.When comparing standard testing plus PET/CT screening versus standard testing alone, standard testing plus PET/CT screening was consistent with either a benefit or no benefit on all-cause mortality (OR 1.22, 95% CI 0.49 to 3.04; 1248 participants; 2 studies; P = 0.66; moderate quality evidence), cancer-related mortality (OR 0.55, 95% CI 0.20 to 1.52; 1248 participants; 2 studies; P = 0.25; moderate quality evidence) or VTE-related morbidity (OR 1.02, 95% CI 0.48 to 2.17; 854 participants; 1 study; P = 0.96; moderate quality evidence). With regards to stage of cancer, there was no clear difference for detection of early (OR 1.78, 95% 0.51 to 6.17; 394 participants; 1 study; P = 0.37; low quality evidence) or advanced (OR 1.00, 95% CI 0.14 to 7.17; 394 participants; 1 study; P = 1.00; low quality evidence) stages of cancer. There was also no clear difference in the frequency of an underlying cancer diagnosis (OR 1.71, 95% CI 0.91 to 3.20; 1248 participants; 2 studies; P = 0.09; moderate quality evidence). Time to cancer diagnosis was 4.2 months in the standard testing group and 4.0 months in the standard testing plus PET/CT group (P = 0.88). Neither study measured VTE-related mortality, complications of anticoagulation, adverse effects of cancer tests, participant satisfaction or quality of life. Testing for cancer in people with unprovoked VTE may lead to earlier diagnosis of cancer at an earlier stage of the disease. However, there is currently insufficient evidence to draw definitive conclusions concerning the effectiveness of testing for undiagnosed cancer in people with a first episode of unprovoked VTE (DVT or PE) in reducing cancer and VTE-related morbidity and mortality. The results could be consistent with either benefit or no benefit. Further good-quality large-scale randomised controlled trials are required before firm conclusions can be made.

Rape shield laws and sexual behavior evidence: effects of consent level and women's sexual history on rape allegations.

PubMed

Flowe, Heather D; Ebbesen, Ebbe B; Putcha-Bhagavatula, Anila

2007-04-01

Rape shield laws, which limit the introduction of sexual history evidence in rape trials, challenge the view that women with extensive sexual histories more frequently fabricate charges of rape than other women. The present study examined the relationship between women's actual sexual history and their reporting rape in hypothetical scenarios. Female participants (college students and a community sample, which included women working as prostitutes and topless dancers, and women living in a drug and alcohol rehabilitation center) imagined themselves in dating scenarios that described either a legally definable act of rape or consensual sexual intercourse. Additionally, within the rape scenarios, level of consensual intimate contact (i.e., foreplay) preceding rape was examined to determine its influence on rape reporting. Women were less likely to say that they would take legal action in response to the rape scenarios if they had extensive sexual histories, or if they had consented to an extensive amount of intimate contact before the rape. In response to the consensual sexual intercourse scenarios, women with more extensive sexual histories were not more likely to say that they would report rape, even when the scenario provided them with a motive for seeking revenge against their dating partner.

The Quality of Evidence in Tablet-Assisted Interventions for Students with Disabilities

ERIC Educational Resources Information Center

Kim, Min Kyung; Park, Yujeong; Coleman, Mari Beth

2017-01-01

The purpose of this review is to weigh the evidence of the effectiveness of tablet-assisted instructions (TAIs) at improving academic outcomes of students with disabilities. An extensive search process with inclusion and exclusion criteria yielded a total of 17 studies to be included in the present study: three group design studies and 14…

Local isotropy and refractive index fluctuations in the surface layer of the atmosphere

NASA Technical Reports Server (NTRS)

Portman, D. J.

1969-01-01

Theoretical and experimental evidence for the existence of local isotropy is briefly examined and conflicting results are found. Recent measurements of temperature spectra support earlier hot wire anemometer and optical scintillation measurements that show little evidence of local isotropy at 1 to 1.5 meters over an extensive uniform and level grass covered field.

Risk Comprehension and Judgments of Statistical Evidentiary Appeals: When a Picture Is Not Worth a Thousand Words

ERIC Educational Resources Information Center

Parrott, Roxanne; Silk, Kami; Dorgan, Kelly; Condit, Celeste; Harris, Tina

2005-01-01

Too little theory and research has considered the effects of communicating statistics in various forms on comprehension, perceptions of evidence quality, or evaluations of message persuasiveness. In a considered extension of Subjective Message Construct Theory (Morley, 1987), we advance a rationale relating evidence form to the formation of…

7 CFR 1488.9a - Evidence of export for commodities delivered before export.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Stocks Under CCC Export Credit Sales Program (GSM-5) Documents Required for Financing § 1488.9a Evidence... certification to the Treasurer, CCC, within 60 days from the date of delivery or such extension of time as may be granted by the Treasurer or Assistant Treasurer, CCC, certifying that the commodities have been...

7 CFR 1488.9a - Evidence of export for commodities delivered before export.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Stocks Under CCC Export Credit Sales Program (GSM-5) Documents Required for Financing § 1488.9a Evidence... certification to the Treasurer, CCC, within 60 days from the date of delivery or such extension of time as may be granted by the Treasurer or Assistant Treasurer, CCC, certifying that the commodities have been...

Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care.

PubMed

Quanbeck, Andrew; Brown, Randall T; E Zgierska, Aleksandra; A Johnson, Roberta; Robinson, James M; Jacobson, Nora

2016-01-27

Adoption of evidence-based practices takes place at a glacial place in healthcare. This research will pilot test an innovative implementation strategy - systems consultation -intended to speed the adoption of evidence-based practice in primary care. The strategy is based on tenets of systems engineering and has been extensively tested in addiction treatment. Three innovations have been included in the strategy - translation of a clinical practice guideline into a checklist-based implementation guide, the use of physician peer coaches ('systems consultants') to help clinics implement the guide, and a focus on reducing variation in practices across prescribers and clinics. The implementation strategy will be applied to improving opioid prescribing practices in primary care, which may help ultimately mitigate the increasing prevalence of opioid abuse and addiction. The pilot test will compare four intervention clinics to four control clinics in a matched-pairs design. A leading clinical guideline for opioid prescribing has been translated into a checklist-based implementation guide in a systematic process that involved experts who wrote the guideline in consultation with implementation experts and primary care physicians. Two physicians with expertise in family and addiction medicine are serving as the systems consultants. Each systems consultant will guide two intervention clinics, using two site visits and follow-up communication by phone and email, to implement the translated guideline. Mixed methods will be used to test the feasibility, acceptability, and preliminary effectiveness of the implementation strategy in an evaluation that meets standards for 'fully developed use' of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The clinic will be the primary unit of analysis. The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines. This pilot test is intended to prepare for a large randomized clinical trial that will test the strategy against other implementation strategies, such as audit/feedback and academic detailing, used to close the gap between knowledge and practice. The systems consultation approach has the potential to shorten the famously long time it takes to implement evidence-based practices and clinical guidelines in healthcare.

Group-Based Learning in an Authoritarian Setting? Novel Extension Approaches in Vietnam's Northern Uplands

ERIC Educational Resources Information Center

Schad, Iven; Roessler, Regina; Neef, Andreas; Zarate, Anne Valle; Hoffmann, Volker

2011-01-01

This study aims to analyze the potential and constraints of group-based extension approaches as an institutional innovation in the Vietnamese agricultural extension system. Our analysis therefore unfolds around the challenges of how to foster this kind of approach within the hierarchical extension policy setting and how to effectively shape and…

Prophylatic treatment of migraine and migraine clinical variants with topiramate: an update

PubMed Central

Carmona, Sergio; Bruera, Osvaldo

2009-01-01

Migraine and migraine variants are common, chronic and incapacitating neurovascular disorders with a high impact on health resources. There is an extensive evidence base provided by double-blind, placebo-controlled trials showing that topiramate is a safe, effective and well tolerated drug in the management of migraine and its variants, being especially promising in the management of migraine-vertigo syndrome. Models both in the US and the UK have also shown that it offers a cost benefit when direct and indirect costs are evaluated, by reducing work loss, improving quality of life and reducing the use of increasingly scarce health resources. PMID:19707282

Geophysical investigations of the tectonic boundary between East and West Antarctica

USGS Publications Warehouse

ten Brink, Uri S.; Bannister, S.; Beaudoin, B.C.; Stern, T.A.

1993-01-01

The Transantarctic Mountains (TAM), which separate the West Antarctic rift system from the stable shield of East Antarctica, are the largest mountains developed adjacent to a rift. The cause of uplift of mountains bordering rifts is poorly understood. One notion based on observations of troughs next to many uplifted blocks is that isostatic rebound produces a coeval uplift and subsidence. The results of an over-snow seismic experiment in Antarctica do not show evidence for a trough next to the TAM but indicate the extension of rifted mantle lithosphere under the TAM. Furthermore, stretching preceded the initiation of uplift, which suggests thermal buoyancy as the cause for uplift.

Molecular Fingerprints in the Electronic Properties of Crystalline Organic Semiconductors: From Experiment to Theory

NASA Astrophysics Data System (ADS)

Ciuchi, S.; Hatch, R. C.; Höchst, H.; Faber, C.; Blase, X.; Fratini, S.

2012-06-01

By comparing photoemission spectroscopy with a nonperturbative dynamical mean field theory extension to many-body ab initio calculations, we show in the prominent case of pentacene crystals that an excellent agreement with experiment for the bandwidth, dispersion, and lifetime of the hole carrier bands can be achieved in organic semiconductors, provided that one properly accounts for the coupling to molecular vibrational modes and the presence of disorder. Our findings rationalize the growing experimental evidence that even the best band structure theories based on a many-body treatment of electronic interactions cannot reproduce the experimental photoemission data in this important class of materials.

An evidential reasoning extension to quantitative model-based failure diagnosis

NASA Technical Reports Server (NTRS)

Gertler, Janos J.; Anderson, Kenneth C.

1992-01-01

The detection and diagnosis of failures in physical systems characterized by continuous-time operation are studied. A quantitative diagnostic methodology has been developed that utilizes the mathematical model of the physical system. On the basis of the latter, diagnostic models are derived each of which comprises a set of orthogonal parity equations. To improve the robustness of the algorithm, several models may be used in parallel, providing potentially incomplete and/or conflicting inferences. Dempster's rule of combination is used to integrate evidence from the different models. The basic probability measures are assigned utilizing quantitative information extracted from the mathematical model and from online computation performed therewith.

How Strong Is the Evidence that Illicit Drug Use by Young People Is an Important Cause of Psychological or Social Harm? Methodological and Policy Implications of a Systematic Review of Longitudinal, General Population Studies

ERIC Educational Resources Information Center

MacLeod, John; Oakes, Rachel; Oppenkowski, Thomas; Stokes-Lampard, Helen; Copello, Alex; Crome, Ilana; Davey Smith, George; Egger, Matthias; Hickman, Mathew; Judd, Ali

2004-01-01

Recreational use of illicit drugs (i.e. use not associated with a diagnosed drug problem) may cause psychological and social harm. A recent systematic review found that evidence for this was equivocal. Extensive evidence was only available in relation to cannabis use. This was relatively consistently associated with lower educational attainment…

[The Study of Health in Pomerania (SHIP) reference values for cardiopulmonary exercise testing].

PubMed

Gläser, S; Ittermann, T; Schäper, C; Obst, A; Dörr, M; Spielhagen, T; Felix, S B; Völzke, H; Bollmann, T; Opitz, C F; Warnke, C; Koch, B; Ewert, R

2013-01-01

The interpretation of gas exchange measured by cardiopulmonary exercise testing (CPET) depends on reliable reference values. Within the population based Study of Health in Pomerania (SHIP) CPET was assessed in 1706 volunteers. The assessment based on symptom limited exercise tests on a bicycle in a sitting position according to a modified Jones protocol. CPET was embedded in an extensive examination program. After the exclusion of active smokers and volunteers with evidence of cardiopulmonary and musculoskeletal disorders the reference population comprised 616 healthy subjects (333 women) aged 25 to 85 years. Reference equations including upper and/or lower limits based on quantile regression were assessed. All values were corrected for the most important influencing factors.This study provides reference equations for gas exchange and exercise capacity assessed within a population in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

On the nature and dynamics of the seismogenetic systems of North California, USA: An analysis based on Non-Extensive Statistical Physics

NASA Astrophysics Data System (ADS)

Efstathiou, Angeliki; Tzanis, Andreas; Vallianatos, Filippos

2017-09-01

We examine the nature of the seismogenetic system in North California, USA, by searching for evidence of complexity and non-extensivity in the earthquake record. We attempt to determine whether earthquakes are generated by a self-excited Poisson process, in which case they obey Boltzmann-Gibbs thermodynamics, or by a Critical process, in which long-range interactions in non-equilibrium states are expected (correlation) and the thermodynamics deviate from the Boltzmann-Gibbs formalism. Emphasis is given to background seismicity since it is generally agreed that aftershock sequences comprise correlated sets. We use the complete and homogeneous earthquake catalogue published by the North California Earthquake Data Centre, in which aftershocks are either included, or have been removed by a stochastic declustering procedure. We examine multivariate cumulative frequency distributions of earthquake magnitudes, interevent time and interevent distance in the context of Non-Extensive Statistical Physics, which is a generalization of extensive Boltzmann-Gibbs thermodynamics to non-equilibrating (non-extensive) systems. Our results indicate that the seismogenetic systems of North California are generally sub-extensive complex and non-Poissonian. The background seismicity exhibits long-range interaction as evidenced by the overall increase of correlation observed by declustering the earthquake catalogues, as well as by the high correlation observed for earthquakes separated by long interevent distances. It is also important to emphasize that two subsystems with rather different properties appear to exist. The correlation observed along the Sierra Nevada Range - Walker Lane is quasi-stationary and indicates a Self-Organized Critical fault system. Conversely, the north segment of the San Andreas Fault exhibits changes in the level of correlation with reference to the large Loma Prieta event of 1989 and thus has attributes of Critical Point behaviour albeit without acceleration of seismic release rates. SOC appears to be a likely explanation of complexity mechanisms but since there are other ways by which complexity may emerge, additional work is required before assertive conclusions can be drawn.

Science and alcohol policy: a case study of the EU Strategy on Alcohol.

PubMed

Gordon, Rebecca; Anderson, Peter

2011-03-01

To describe the extent to which the content of the European Commission's Communication on alcohol reflects public health-based scientific evidence. Document retrieval and content analysis. European Union. Background documents leading up to the European Commission's Communication on alcohol, the Communication itself and implementation actions following the Communication. Documents were read and analyzed for evidence-based alcohol policy content. Although the Communication acknowledges and supports existing interventions which have high evidence for effectiveness, such as enforcing blood alcohol concentration (BAC) limits for drivers, it extensively promotes other interventions which have been shown to be ineffective; for example, recommending education and persuasion strategies as a measure across all its five priority areas. Measures to influence price are mentioned only once in relation to sales in drinking venues limiting two-for-one drinks offers. Measures to control physical availability are mentioned infrequently. The Communication reflects the science, in that it acknowledges the significance of alcohol as a social and health determinant in Europe. However, it places more emphasis on policy actions with less evidence for effectiveness than on those with strong evidence. It also focuses its efforts more on mapping member state actions and coordinating knowledge exchange than on providing concrete recommendations for action or developing Europe-wide policy measures. This may be a compromise between the rights of Member States to develop national policy and legislation and the obligation of the European Union as a collaborative body to protect health. Furthermore, it has been suggested that the European Union's roots as a trading block emphasizes collaboration with industry stakeholders and this influences the ability to prioritize health over trade considerations. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Evidence for subduction-related magmatism during the Cretaceous and Cenozoic in Myanmar

NASA Astrophysics Data System (ADS)

Sevastjanova, Inga; Sagi, David Adam; Webb, Peter; Masterton, Sheona; Hill, Catherine; Davies, Clare

2017-04-01

Myanmar's complex geological history, numerous controversies around its tectonic evolution and the presence of prospective hydrocarbon basins make it a key area of interest for geologists. Understanding whether a passive or an active margin existed in the region during the Cenozoic is particularly important for the production of accurate basin models; active Cenozoic subduction would imply that hydrocarbon basins in the forearc experienced extension due to slab rollback. The geology of Myanmar was influenced by the regional tectonics associated with the Cretaceous and Cenozoic closure of the Neotethys Ocean. During this time, India travelled rapidly from Gondwana to Asia at speeds up to 20 cm/yr. To accommodate the north-eastward motion of India, the Neotethys Ocean was consumed at the subduction zone along the southern margin of Eurasia. Based on our Global Plate Model, this subduction zone can reasonably be expected to extend for the entire width of the Neotethys Ocean as far as Myanmar and Southeast Asia at their eastern extent. Moreover, a) Cretaceous volcanism onshore Myanmar, b) the middle Cenozoic arc-related extension in the Present Day eastern Andaman Sea and c) the late Cenozoic uplift of the Indo-Burman Ranges are all contemporaneous with the subduction ages predicted by the global plate motions. However, because of the geological complexity of the area, additional evidence would augment interpretations that are based on structural data. In an attempt to reduce the uncertainty in the existing interpretations, we have compiled published zircon geochronological data from detrital and igneous rocks in the region. We have used published zircon U-Pb ages and, where available, published Hf isotope data and CL images (core/rim) in order to distinguish 'juvenile' mantle-derived zircons from those of reworked crustal origin. The compilation shows that Upper Cretaceous and Cenozoic zircons, which are interpreted to have a volcanic provenance, are common across the Wuntho-Popa Arc and in the sedimentary basins onshore Myanmar (including the onshore Rakhine Basin and the Myanmar Central Basin), providing evidence for ongoing, although non-continuous, subduction in the region.

Raising the Level of Awareness of Nurse-to-Nurse Lateral Violence in a Critical Access Hospital.

PubMed

Embree, Jennifer L; Bruner, Deborah A; White, Ann

2013-01-01

Background/Significance of Problem. Nurse-to-nurse lateral violence (NNLV) has been internationally reported for greater than two decades and results in new nurse turnover and serious negative outcomes. Clinical Question/Project Objective. Will NNLV and cognitive rehearsal (CR) education result in a decrease in perceived nurse-to-nurse lateral violence in a critical access hospital (CAH)? The scope of this project was to determine perceived extent and increase awareness of NNLV through an educational project about NNLV and CR. Clinical Appraisal of Literature/Best Evidence. Trends of NNLV were assessed through an extensive literature review from Health Source, CINAHL, ProQuest Health, and Medical Complete. An educational forum about NNLV with CR was advocated for newly licensed nurses and current nurses (potential perpetrators of NNLV) with the goal of liberation of oppressed individuals. Integration into Practice/Discussion of Results. An interventional study with one group and pre-/postintervention was used to determine NNLV and CR education on perceived levels of lateral violence. Evidence-based measurement occurred through use of the Nurse Workplace Scale and the Silencing the Self-Work Scale. Outcomes were analyzed quantitatively through independent t-tests. Awareness of NNLV was increased. Evaluation of Evidence-Based Practice/Implications. Organizations must learn to eliminate NNLV. With increased levels of awareness of NNLV, nurses requested additional assistance in dealing with inappropriate behavior.

Raising the Level of Awareness of Nurse-to-Nurse Lateral Violence in a Critical Access Hospital

PubMed Central

Embree, Jennifer L.; Bruner, Deborah A.; White, Ann

2013-01-01

Background/Significance of Problem. Nurse-to-nurse lateral violence (NNLV) has been internationally reported for greater than two decades and results in new nurse turnover and serious negative outcomes. Clinical Question/Project Objective. Will NNLV and cognitive rehearsal (CR) education result in a decrease in perceived nurse-to-nurse lateral violence in a critical access hospital (CAH)? The scope of this project was to determine perceived extent and increase awareness of NNLV through an educational project about NNLV and CR. Clinical Appraisal of Literature/Best Evidence. Trends of NNLV were assessed through an extensive literature review from Health Source, CINAHL, ProQuest Health, and Medical Complete. An educational forum about NNLV with CR was advocated for newly licensed nurses and current nurses (potential perpetrators of NNLV) with the goal of liberation of oppressed individuals. Integration into Practice/Discussion of Results. An interventional study with one group and pre-/postintervention was used to determine NNLV and CR education on perceived levels of lateral violence. Evidence-based measurement occurred through use of the Nurse Workplace Scale and the Silencing the Self-Work Scale. Outcomes were analyzed quantitatively through independent t-tests. Awareness of NNLV was increased. Evaluation of Evidence-Based Practice/Implications. Organizations must learn to eliminate NNLV. With increased levels of awareness of NNLV, nurses requested additional assistance in dealing with inappropriate behavior. PMID:23991337

An Additional Baurusuchid from the Cretaceous of Brazil with Evidence of Interspecific Predation among Crocodyliformes

PubMed Central

Godoy, Pedro L.; Montefeltro, Felipe C.; Norell, Mark A.; Langer, Max C.

2014-01-01

A new Baurusuchidae (Crocodyliformes, Mesoeucrocodylia), Aplestosuchus sordidus, is described based on a nearly complete skeleton collected in deposits of the Adamantina Formation (Bauru Group, Late Cretaceous) of Brazil. The nesting of the new taxon within Baurusuchidae can be ensured based on several exclusive skull features of this clade, such as the quadrate depression, medial approximation of the prefrontals, rostral extension of palatines (not reaching the level of the rostral margin of suborbital fenestrae), cylindrical dorsal portion of palatine bar, ridge on the ectopterygoid-jugal articulation, and supraoccipital with restricted thin transversal exposure in the caudalmost part of the skull roof. A newly proposed phylogeny of Baurusuchidae encompasses A. sordidus and recently described forms, suggesting its sixter-taxon relationship to Baurusuchus albertoi, within Baurusuchinae. Additionally, the remains of a sphagesaurid crocodyliform were preserved in the abdominal cavity of the new baurusuchid. Direct fossil evidence of behavioral interaction among fossil crocodyliforms is rare and mostly restricted to bite marks resulting from predation, as well as possible conspecific male-to-male aggression. This is the first time that a direct and unmistaken evidence of predation between different taxa of this group is recorded as fossils. This discovery confirms that baurusuchids were top predators of their time, with sphagesaurids occupying a lower trophic position, possibly with a more generalist diet. PMID:24809508

Consensus statement: Palliative and supportive care in advanced heart failure.

PubMed

Goodlin, Sarah J; Hauptman, Paul J; Arnold, Robert; Grady, Kathleen; Hershberger, Ray E; Kutner, Jean; Masoudi, Frederick; Spertus, John; Dracup, Kathleen; Cleary, James F; Medak, Ruth; Crispell, Kathy; Piña, Ileana; Stuart, Brad; Whitney, Christy; Rector, Thomas; Teno, Joan; Renlund, Dale G

2004-06-01

A consensus conference was convened to define the current state and important gaps in knowledge and needed research on "Palliative and Supportive Care in Advanced Heart Failure." Evidence was drawn from expert opinion and from extensive review of the medical literature, evidence-based guidelines, and reviews. The conference identified gaps in current knowledge, practice, and research relating to prognostication, symptom management, and supportive care for advanced heart failure (HF). Specific conclusions include: (1) although supportive care should be integrated throughout treatment of patients with advanced HF, data are needed to understand how to best decrease physical and psychosocial burdens of advanced HF and to meet patient and family needs; (2) prognostication in advanced HF is difficult and data are needed to understand which patients will benefit from which interventions and how best to counsel patients with advanced HF; (3) research is needed to identify which interventions improve quality of life and best achieve the outcomes desired by patients and family members; (4) care should be coordinated between sites of care, and barriers to evidence-based practice must be addressed programmatically; and (5) more research is needed to identify the content and technique of communicating prognosis and treatment options with patients with advanced HF; physicians caring for patients with advanced HF must develop skills to better integrate the patient's preferences into the goals of care.

Comparative phylogeography and population genetics within Buteo lineatus reveals evidence of distinct evolutionary lineages

USGS Publications Warehouse

Hull, J.M.; Strobel, Bradley N.; Boal, C.W.; Hull, A.C.; Dykstra, C.R.; Irish, A.M.; Fish, A.M.; Ernest, H.B.

2008-01-01

Traditional subspecies classifications may suggest phylogenetic relationships that are discordant with evolutionary history and mislead evolutionary inference. To more accurately describe evolutionary relationships and inform conservation efforts, we investigated the genetic relationships and demographic histories of Buteo lineatus subspecies in eastern and western North America using 21 nuclear microsatellite loci and 375-base pairs of mitochondrial control region sequence. Frequency based analyses of mitochondrial sequence data support significant population distinction between eastern (B. l. lineatus/alleni/texanus) and western (B. l. elegans) subspecies of B. lineatus. This distinction was further supported by frequency and Bayesian analyses of the microsatellite data. We found evidence of differing demographic histories between regions; among eastern sites, mitochondrial data suggested that rapid population expansion occurred following the end of the last glacial maximum, with B. l. texanus population expansion preceding that of B. l. lineatus/alleni. No evidence of post-glacial population expansion was detected among western samples (B. l. elegans). Rather, microsatellite data suggest that the western population has experienced a recent bottleneck, presumably associated with extensive anthropogenic habitat loss during the 19th and 20th centuries. Our data indicate that eastern and western populations of B. lineatus are genetically distinct lineages, have experienced very different demographic histories, and suggest management as separate conservation units may be warranted. ?? 2008 Elsevier Inc. All rights reserved.

Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations.

PubMed

Oddo, Mauro; Poole, Daniele; Helbok, Raimund; Meyfroidt, Geert; Stocchetti, Nino; Bouzat, Pierre; Cecconi, Maurizio; Geeraerts, Thomas; Martin-Loeches, Ignacio; Quintard, Hervé; Taccone, Fabio Silvio; Geocadin, Romergryko G; Hemphill, Claude; Ichai, Carole; Menon, David; Payen, Jean-François; Perner, Anders; Smith, Martin; Suarez, José; Videtta, Walter; Zanier, Elisa R; Citerio, Giuseppe

2018-04-01

To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients. A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles generated. The consensus focused on three main topics: (1) general fluid resuscitation and maintenance in neurointensive care patients, (2) hyperosmolar fluids for intracranial pressure control, (3) fluid management in delayed cerebral ischemia after subarachnoid haemorrhage. After an extensive literature search, the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were applied to assess the quality of evidence (from high to very low), to formulate treatment recommendations as strong or weak, and to issue best practice statements when applicable. A modified Delphi process based on the integration of evidence provided by the literature and expert opinions-using a sequential approach to avoid biases and misinterpretations-was used to generate the final consensus statement. The final consensus comprises a total of 32 statements, including 13 strong recommendations and 17 weak recommendations. No recommendations were provided for two statements. We present a consensus statement and clinical practice recommendations on fluid therapy for neurointensive care patients.

Anti-tau oligomers passive vaccination for the treatment of Alzheimer disease.

PubMed

Kayed, Rakez

2010-11-01

The aggregation and accumulation of the microtubule-associated protein (Tau) is a pathological hallmark of Alzheimer's disease (AD) and many neurodegenerative diseases. Despite the poor correlation between neurofirillary tangles (NFTs) and disease progression, and evidence showing, that neuronal loss in AD actually precedes NFTs formation research until recently focused on them and other large meta-stable inclusions composed of aggregated hyperphosphorylated tau protein. Lately, the significance and toxicity of NFTs has been challenged and new aggregated tau entity has emerged as the true pathogenic species in tauopathies and a possible mediator of Aβ toxicity in AD. Tau intermediate aggregate (tau oligomers; aggregates of an intermediate that is between monomers and NFTs in size) can cause neurodegeneration and memory impairment in the absence of Aβ. This exciting body of evidence includes results from human brain samples, transgenic mouse and cell-based studies. Despite extensive efforts to develop a safe and efficacious vaccine for AD using Aβ peptide as an immunogen in active vaccination approaches or anti Aβ antibodies for passive vaccination, success has been modest. Nonetheless, these studies have produced a wealth of fundamental knowledge that has potential to application to the development of a tau-based immunotherapy. Herein, I discuss the evidence supporting the critical role of tau oligomers in AD, the potential and challenges for targeting them by immunotherapy as a novel approach for AD treatment.

A Mediterranean Diet Model in Australia: Strategies for Translating the Traditional Mediterranean Diet into a Multicultural Setting

PubMed Central

Kucianski, Teagan; Moschonis, George; Tierney, Audrey C.; Itsiopoulos, Catherine

2018-01-01

Substantial evidence supports the effect of the Mediterranean Diet (MD) for managing chronic diseases, although trials have been primarily conducted in Mediterranean populations. The efficacy and feasibility of the Mediterranean dietary pattern for the management of chronic diseases has not been extensively evaluated in non-Mediterranean settings. This paper aims to describe the development of a MD model that complies with principles of the traditional MD applied in a multiethnic context. Optimal macronutrient and food-based composition was defined, and a two-week menu was devised incorporating traditional ingredients with evidence based on improvements in chronic disease management. Strategies were developed for the implementation of the diet model in a multiethnic population. Consistent with the principles of a traditional MD, the MD model was plant-based and high in dietary fat, predominantly monounsaturated fatty acids from extra virgin olive oil. Fruits, vegetables and wholegrains were a mainstay, and moderate amounts of nuts and seeds, fish, dairy and red wine were recommended. The diet encompassed key features of the MD including cuisine, biodiversity and sustainability. The MD model preserved traditional dietary components likely to elicit health benefits for individuals with chronic diseases, even with the adaptation to an Australian multiethnic population. PMID:29642557

A Mediterranean Diet Model in Australia: Strategies for Translating the Traditional Mediterranean Diet into a Multicultural Setting.

PubMed

George, Elena S; Kucianski, Teagan; Mayr, Hannah L; Moschonis, George; Tierney, Audrey C; Itsiopoulos, Catherine

2018-04-09

Substantial evidence supports the effect of the Mediterranean Diet (MD) for managing chronic diseases, although trials have been primarily conducted in Mediterranean populations. The efficacy and feasibility of the Mediterranean dietary pattern for the management of chronic diseases has not been extensively evaluated in non-Mediterranean settings. This paper aims to describe the development of a MD model that complies with principles of the traditional MD applied in a multiethnic context. Optimal macronutrient and food-based composition was defined, and a two-week menu was devised incorporating traditional ingredients with evidence based on improvements in chronic disease management. Strategies were developed for the implementation of the diet model in a multiethnic population. Consistent with the principles of a traditional MD, the MD model was plant-based and high in dietary fat, predominantly monounsaturated fatty acids from extra virgin olive oil. Fruits, vegetables and wholegrains were a mainstay, and moderate amounts of nuts and seeds, fish, dairy and red wine were recommended. The diet encompassed key features of the MD including cuisine, biodiversity and sustainability. The MD model preserved traditional dietary components likely to elicit health benefits for individuals with chronic diseases, even with the adaptation to an Australian multiethnic population.

USAF Summer Research Program - 1993 Summer Research Extension Program Final Reports, Volume 2, Phillips Laboratory

DTIC Science & Technology

1994-11-01

Research Extension Program Phillips Laboratory Kirtland Air Force Base Sponsored by: Air Force Office of Scientific Research Boiling Air Force Base...Program Phillips Laboratory Sponsored by: Air Force Office of Scientific Research Bolling Air Force Base, Washington, D.C. and Arkansas Tech University...Summer Research Extension Program (SREP) Phillips

Local health care expenditure plans and their opportunity costs.

PubMed

Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

2015-09-01

In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The case for nearly continuous extension of the West Antarctic Rift System, 105-25 Ma (Invited)

NASA Astrophysics Data System (ADS)

Wilson, D. S.; Luyendyk, B. P.

2010-12-01

It is a common perception that extension in the West Antarctic Rift System (WARS) was a two-phase process, with a Cretaceous phase ending when the Campbell Plateau rifted from West Antarctica (~80 Ma), and a mid-Cenozoic phase synchronous with sea floor spreading in the Adare trough (~45-25 Ma). Several lines of evidence indicate that significant extension probably occurred in the intervening 80-45 Ma interval. The strongest evidence comes from subsidence rates on the Central High and Coulman High structures in the central-western Ross Sea, where DSDP Site 270 and other areas with shallow basement have subsided 1 km or more since Oligocene time. With sediment load, these subsidence rates are reasonable for thermal subsidence resulting from extension with a stretching factor of about 2.0-2.5 at about 50-70 Ma, but are hard to reconcile with an extension age around 90 Ma. The seismic velocity structure of the WARS inferred from global surface-wave dispersion is similar to that of oceanic lithosphere of age 40-60 Ma [Ritzwoller et al., 2001 JGR]. Geometric relations of sea floor between Adare Trough and Iselen Bank, northwest Ross Sea, suggest sea floor spreading of about 130 km during early Cenozoic, before the Adare Trough spreading episode started. Numerous cooling ages in the Transantarctic Mountains in the range of 55-45 Ma [Fitzgerald, 1992 Tectonics; Miller et al., 2010 Tectonics] support the interpretation of significant extension prior to 45 Ma. Present crustal thickness of about 22 km near DSDP Site 270 [Trey et al., 1999 Tectonophysics] suggests a pre-extension crustal thickness exceeding 50 km. A simple overall interpretation follows that the WARS has a tectonic history similar to the Basin and Range of western North America: a thick-crust orogenic highland extended for many tens of million years. The main difference between the WARS and the Basin and Range is the post-tectonic cooling and subsidence in the WARS.

Developing an electronic health record (EHR) for methadone treatment recording and decision support

PubMed Central

2011-01-01

Background In this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR. Methods A set of archetypes has been designed in line with the current best practice and clinical guidelines which guide the information-gathering process. A web-based data entry system has been implemented, incorporating elements of the paper-based prescription form, while at the same time facilitating the decision support function. Results The use of archetypes was found to capture the ever changing requirements in the healthcare domain and externalises them in constrained data structures. The solution is extensible enabling the EHR to cover medicine management in general as per the programme of the HRB Centre for Primary Care Research. Conclusions The data collected via this Irish system can be aggregated into a larger dataset, if necessary, for analysis and evidence-gathering, since we adopted the openEHR standard. It will be later extended to include the functionalities of prescribing drugs other than methadone along with the research agenda at the HRB Centre for Primary Care Research in Ireland. PMID:21284849

Elastin: a representative ideal protein elastomer.

PubMed Central

Urry, D W; Hugel, T; Seitz, M; Gaub, H E; Sheiba, L; Dea, J; Xu, J; Parker, T

2002-01-01

During the last half century, identification of an ideal (predominantly entropic) protein elastomer was generally thought to require that the ideal protein elastomer be a random chain network. Here, we report two new sets of data and review previous data. The first set of new data utilizes atomic force microscopy to report single-chain force-extension curves for (GVGVP)(251) and (GVGIP)(260), and provides evidence for single-chain ideal elasticity. The second class of new data provides a direct contrast between low-frequency sound absorption (0.1-10 kHz) exhibited by random-chain network elastomers and by elastin protein-based polymers. Earlier composition, dielectric relaxation (1-1000 MHz), thermoelasticity, molecular mechanics and dynamics calculations and thermodynamic and statistical mechanical analyses are presented, that combine with the new data to contrast with random-chain network rubbers and to detail the presence of regular non-random structural elements of the elastin-based systems that lose entropic elastomeric force upon thermal denaturation. The data and analyses affirm an earlier contrary argument that components of elastin, the elastic protein of the mammalian elastic fibre, and purified elastin fibre itself contain dynamic, non-random, regularly repeating structures that exhibit dominantly entropic elasticity by means of a damping of internal chain dynamics on extension. PMID:11911774

Observed Local Impacts of Global Irrigation on Surface Temperature

NASA Astrophysics Data System (ADS)

Chen, L.; Dirmeyer, P.

2017-12-01

Agricultural irrigation has significant potential for altering local climate through reducing soil albedo, increasing evapotranspiration, and enabling greater leaf area. Numerous studies using regional or global climate models have demonstrated the cooling effects of irrigation on mean and extreme temperature, especially over regions where irrigation is extensive. However, these model-based results have not been validated due to the limitations of observational datasets. In this study, multiple satellite-based products, including the Moderate Resolution Imaging Spectroradiometer (MODIS) and Soil Moisture Active Passive (SMAP) data sets, are used to isolate and quantify the local impacts of irrigation on surface climate over the irrigated regions, which are derived from the Global Map of Irrigation Areas (GMIA). The relationships among soil moisture, albedo, evapotranspiration, and surface temperature are explored. Strong evaporative cooling of irrigation on daytime surface temperature is found over the arid and semi-arid regions, such as California's Central Valley, the Great Plains, and central Asia. However, the cooling effects are less evident in most areas of eastern China, India, and the Lower Mississippi River Basin in spite of extensive irrigation over these regions. Results are also compared with irrigation experiments using the Community Earth System Model (CESM) to assess the model's ability to represent land-atmosphere interactions in regards to irrigation.

A proteomic analysis of the chromoplasts isolated from sweet orange fruits [Citrus sinensis (L.) Osbeck].

PubMed

Zeng, Yunliu; Pan, Zhiyong; Ding, Yuduan; Zhu, Andan; Cao, Hongbo; Xu, Qiang; Deng, Xiuxin

2011-11-01

Here, a comprehensive proteomic analysis of the chromoplasts purified from sweet orange using Nycodenz density gradient centrifugation is reported. A GeLC-MS/MS shotgun approach was used to identify the proteins of pooled chromoplast samples. A total of 493 proteins were identified from purified chromoplasts, of which 418 are putative plastid proteins based on in silico sequence homology and functional analyses. Based on the predicted functions of these identified plastid proteins, a large proportion (∼60%) of the chromoplast proteome of sweet orange is constituted by proteins involved in carbohydrate metabolism, amino acid/protein synthesis, and secondary metabolism. Of note, HDS (hydroxymethylbutenyl 4-diphosphate synthase), PAP (plastid-lipid-associated protein), and psHSPs (plastid small heat shock proteins) involved in the synthesis or storage of carotenoid and stress response are among the most abundant proteins identified. A comparison of chromoplast proteomes between sweet orange and tomato suggested a high level of conservation in a broad range of metabolic pathways. However, the citrus chromoplast was characterized by more extensive carotenoid synthesis, extensive amino acid synthesis without nitrogen assimilation, and evidence for lipid metabolism concerning jasmonic acid synthesis. In conclusion, this study provides an insight into the major metabolic pathways as well as some unique characteristics of the sweet orange chromoplasts at the whole proteome level.

Disaster nephrology: medical perspective.

PubMed

Atef-Zafarmand, Alireza; Fadem, Steve

2003-04-01

Disaster medicine is an extension of emergency medicine involving mass casualties and use of the best available techniques in search and rescue. To achieve the best results extensive predisaster preparedness is mandatory. Earthquakes have caused the loss of more than 1 million lives in the 20th century. Evidence-based medicine confirms that these deaths were mostly preventable based on experience in developed countries. The key to success is implementing building codes and structural reinforcement. In earthquakes as well as in collapse of buildings in bomb blasts, loss of life is either because of the direct effect of trauma or to the metabolic consequences of rhabdomyolysis and complications of its management. Hyperkalemia and infection are the commonest causes of death in victims who survive the direct effect of trauma. Acute renal failure, a grave complication of rhabdomyolysis, is mostly preventable by timely rehydration and bicarbonate therapy. Mannitol therapy can be very efficient in reducing the severity of muscle damage and its sequelae. Fasciotomy can be limb saving if it is done in the early hours, although a firm guideline is still lacking. Although each country is responsible for improving the structure of buildings and organizing an efficient disaster response, national and international organizations in developed countries should give high priority to communicating with developing countries to encourage their preparedness. Copyright 2003 by the National Kidney Foundation, Inc.

Trichloroethylene: Mechanistic, epidemiologic and other supporting evidence of carcinogenic hazard.

PubMed

Rusyn, Ivan; Chiu, Weihsueh A; Lash, Lawrence H; Kromhout, Hans; Hansen, Johnni; Guyton, Kathryn Z

2014-01-01

The chlorinated solvent trichloroethylene (TCE) is a ubiquitous environmental pollutant. The carcinogenic hazard of TCE was the subject of a 2012 evaluation by a Working Group of the International Agency for Research on Cancer (IARC). Information on exposures, relevant data from epidemiologic studies, bioassays in experimental animals, and toxicity and mechanism of action studies was used to conclude that TCE is carcinogenic to humans (Group 1). This article summarizes the key evidence forming the scientific bases for the IARC classification. Exposure to TCE from environmental sources (including hazardous waste sites and contaminated water) is common throughout the world. While workplace use of TCE has been declining, occupational exposures remain of concern, especially in developing countries. The strongest human evidence is from studies of occupational TCE exposure and kidney cancer. Positive, although less consistent, associations were reported for liver cancer and non-Hodgkin lymphoma. TCE is carcinogenic at multiple sites in multiple species and strains of experimental animals. The mechanistic evidence includes extensive data on the toxicokinetics and genotoxicity of TCE and its metabolites. Together, available evidence provided a cohesive database supporting the human cancer hazard of TCE, particularly in the kidney. For other target sites of carcinogenicity, mechanistic and other data were found to be more limited. Important sources of susceptibility to TCE toxicity and carcinogenicity were also reviewed by the Working Group. In all, consideration of the multiple evidence streams presented herein informed the IARC conclusions regarding the carcinogenicity of TCE. © 2013.

Trichloroethylene: Mechanistic, Epidemiologic and Other Supporting Evidence of Carcinogenic Hazard

PubMed Central

Rusyn, Ivan; Chiu, Weihsueh A.; Lash, Lawrence H.; Kromhout, Hans; Hansen, Johnni; Guyton, Kathryn Z.

2013-01-01

The chlorinated solvent trichloroethylene (TCE) is a ubiquitous environmental pollutant. The carcinogenic hazard of TCE was the subject of a 2012 evaluation by a Working Group of the International Agency for Research on Cancer (IARC). Information on exposures, relevant data from epidemiologic studies, bioassays in experimental animals, and toxicity and mechanism of action studies was used to conclude that TCE is carcinogenic to humans (Group 1). This article summarizes the key evidence forming the scientific bases for the IARC classification. Exposure to TCE from environmental sources (including from hazardous waste sites and contaminated water) is common throughout the world. While workplace use of TCE has been declining, occupational exposures remain of concern, especially in developing countries. Strongest human evidence is from studies of occupational TCE exposure and kidney cancer. Positive, although less consistent, associations were reported for liver cancer and non-Hodgkin's lymphoma. TCE is carcinogenic at multiple sites in multiple species and strains of experimental animals. The mechanistic evidence includes extensive data on the toxicokinetics and genotoxicity of TCE and its metabolites. Together, available evidence provided a cohesive database supporting the human cancer hazard of TCE, particularly in the kidney. For other target sites of carcinogenicity, mechanistic and other data were found to be more limited. Important sources of susceptibility to TCE toxicity and carcinogenicity were also reviewed by the Working Group. In all, consideration of the multiple evidence streams presented herein informed the IARC conclusions regarding the carcinogenicity of TCE. PMID:23973663

The Great British Medalists Project: A Review of Current Knowledge on the Development of the World's Best Sporting Talent.

PubMed

Rees, Tim; Hardy, Lew; Güllich, Arne; Abernethy, Bruce; Côté, Jean; Woodman, Tim; Montgomery, Hugh; Laing, Stewart; Warr, Chelsea

2016-08-01

The literature base regarding the development of sporting talent is extensive, and includes empirical articles, reviews, position papers, academic books, governing body documents, popular books, unpublished theses and anecdotal evidence, and contains numerous models of talent development. With such a varied body of work, the task for researchers, practitioners and policy makers of generating a clear understanding of what is known and what is thought to be true regarding the development of sporting talent is particularly challenging. Drawing on a wide array of expertise, we address this challenge by avoiding adherence to any specific model or area and by providing a reasoned review across three key overarching topics: (a) the performer; (b) the environment; and (c) practice and training. Within each topic sub-section, we review and calibrate evidence by performance level of the samples. We then conclude each sub-section with a brief summary, a rating of the quality of evidence, a recommendation for practice and suggestions for future research. These serve to highlight both our current level of understanding and our level of confidence in providing practice recommendations, but also point to a need for future studies that could offer evidence regarding the complex interactions that almost certainly exist across domains.

Taphonomic evidence for high-speed adapted fins in thunniform ichthyosaurs.

PubMed

Lingham-Soliar, Theagarten; Plodowski, Gerhard

2007-01-01

Ichthyosaurs have been compared with the fast-swimming thunniform groups of marine vertebrates, tuna, lamnid sharks, and dolphins, based on similarity of shape of the body and locomotory organs. In addition to shape, high-tensile stiffness of the control surfaces has been shown to be essential in maximizing hydrodynamic efficiency in extant thunniform swimmers. To date, there has been no evidence of a stiffening support system for the dorsal fin and dorsal lobe of the caudal fin in ichthyosaurs, the sole stiffening structure of the ventral lobe being an extension of the vertebral column along its leading edge. Stenopterygius SMF 457 is arguably the best soft-tissue preserved ichthyosaur specimen known. Here, we examine soft-tissue preservation in this specimen in the control surfaces and provide the first evidence of a complex architecture of stiff fibers in the dorsal and caudal fins. We find by comparisons and by analogy that these fibers provided a remarkable mechanism for high tensile stiffness and efficiency of the locomotory organs virtually identical to that of the great white shark, Carcharodon carcharias. It is the first mechanostructural study of the control surfaces of a Jurassic ichthyosaur that adds essential evidence in support of the view that these forms were high-speed thunniform swimmers.

Taphonomic evidence for high-speed adapted fins in thunniform ichthyosaurs

NASA Astrophysics Data System (ADS)

Lingham-Soliar, Theagarten; Plodowski, Gerhard

2007-01-01

Ichthyosaurs have been compared with the fast-swimming thunniform groups of marine vertebrates, tuna, lamnid sharks, and dolphins, based on similarity of shape of the body and locomotory organs. In addition to shape, high-tensile stiffness of the control surfaces has been shown to be essential in maximizing hydrodynamic efficiency in extant thunniform swimmers. To date, there has been no evidence of a stiffening support system for the dorsal fin and dorsal lobe of the caudal fin in ichthyosaurs, the sole stiffening structure of the ventral lobe being an extension of the vertebral column along its leading edge. Stenopterygius SMF 457 is arguably the best soft-tissue preserved ichthyosaur specimen known. Here, we examine soft-tissue preservation in this specimen in the control surfaces and provide the first evidence of a complex architecture of stiff fibers in the dorsal and caudal fins. We find by comparisons and by analogy that these fibers provided a remarkable mechanism for high tensile stiffness and efficiency of the locomotory organs virtually identical to that of the great white shark, Carcharodon carcharias. It is the first mechanostructural study of the control surfaces of a Jurassic ichthyosaur that adds essential evidence in support of the view that these forms were high-speed thunniform swimmers.

Height conditions salary expectations: Evidence from large-scale data in China

NASA Astrophysics Data System (ADS)

Yang, Xiao; Gao, Jian; Liu, Jin-Hu; Zhou, Tao

2018-07-01

Height premium has been revealed by extensive literature, however, evidence from China based on large-scale data remains still lacking. In this paper, we study how height conditions salary expectations by exploring a dataset covering over 140,000 Chinese job seekers. By using graphical and regression models, we find evidence in support of height premium that tall people expect a significantly higher salary in career development. In particular, regression results suggest stronger effects of height premium on female than on male, however, the gender differences decrease as the education level increases and become insignificant after holding all control variables fixed. Further, results from graphical models suggest three promising ways in helping short people: (i) to accumulate more working experiences, since one year seniority can respectively make up about 3 cm and 7 cm shortness for female and male; (ii) to increase the level of education, since one higher academic degree may eliminate all disadvantages that brought by shortness; (iii) to target jobs in regions with a higher level of development. Our work provides a cross-culture supportive evidence of height premium and contributes two novel features to the literature: the compensation story in helping short people, and the focus on salary expectations in isolation from discrimination channels.

Mastery Motivation in Children with Intellectual Disability: Is There Evidence for a Down Syndrome Behavioural Phenotype?

ERIC Educational Resources Information Center

Gilmore, Linda; Cuskelly, Monica; Browning, Melissa

2015-01-01

The main purpose of the current study was to provide empirical evidence to support or refute assumptions of phenotypic deficits in motivation for children with Down syndrome (DS). Children with moderate intellectual disability (MID) associated with etiologies other than DS were recruited in an extension of a previous study that involved children…

Evidence for subduction in the ice shell of Europa

NASA Astrophysics Data System (ADS)

Kattenhorn, Simon A.; Prockter, Louise M.

2014-10-01

Jupiter’s icy moon Europa has one of the youngest planetary surfaces in the Solar System, implying rapid recycling by some mechanism. Despite ubiquitous extension and creation of new surface area at dilational bands that resemble terrestrial mid-ocean spreading zones, there is little evidence of large-scale contraction to balance the observed extension or to recycle ageing terrains. We address this enigma by presenting several lines of evidence that subduction may be recycling surface material into the interior of Europa’s ice shell. Using Galileo spacecraft images, we produce a tectonic reconstruction of geologic features across a 134,000 km2 region of Europa and find, in addition to dilational band spreading, evidence for transform motions along prominent strike-slip faults, as well as the removal of approximately 20,000 km2 of the surface along a discrete tabular zone. We interpret this zone as a subduction-like convergent boundary that abruptly truncates older geological features and is flanked by potential cryolavas on the overriding ice. We propose that Europa’s ice shell has a brittle, mobile, plate-like system above convecting warmer ice. Hence, Europa may be the only Solar System body other than Earth to exhibit a system of plate tectonics.

Chronic pleuritic pain in four patients with asbestos induced pleural fibrosis.

PubMed Central

Miller, A

1990-01-01

Four patients occupationally exposed to asbestos, each suffering at least eight years of disabling, persistent, and often bilateral pleuritic pain are described. Radiographic evidence of pleural disease ranged from plaques seen only on computed tomography to typical bilateral plaques or diffuse thickening to extensive diffuse and circumscribed pleural fibrosis and calcification. There was no history or evidence of acute pleuritis or pleural effusion in three patients. Intermittent pleural friction rubs have been present in all four; one patient showed pleural uptake of gallium-67. Extensive workups including repeated pulmonary ventilation-perfusion scans and cardiac catheterisation have not yielded other diagnoses to explain the pain. It is proposed that persistent pleuritic pain be added to the manifestations of benign asbestos induced pleural disease. Images PMID:2328221

Chicken-based formula is better tolerated than extensively hydrolyzed casein formula for the management of cow milk protein allergy in infants.

PubMed

Jirapinyo, Pipop; Densupsoontorn, Narumon; Kangwanpornsiri, Channagan; Wongarn, Renu

2012-01-01

The effective treatment of cow milk allergy in infants consists of elimination of cow milk protein and the introduction of formulas based on an extensively hydrolyzed protein formula or an amino acid-based formula. However, about 10% of these infants are still allergic to an extensively hydrolyzed protein formula and an amino acid-based formula is very expensive. We conducted a study to verify whether the new chicken-based formula will be better tolerated than an extensively hydrolyzed protein formula for the treatment of cow milk allergy in infants. One hundred infants, diagnosed with cow milk allergy by double-blind, placebo-controlled food challenge tests, were enrolled in a double-blind, randomized, cross-over study to compare a response to an extensively hydrolyzed protein formula and the chicken-based formula. Subjects were randomly given one of the two formulas for 2 weeks. There was a 2-week washout period of taking an amino acid-based formula before being switched to the other formula for another 2 weeks. If the subjects showed allergic symptoms during the 2 weeks of test formula, they would be announced as intolerance or allergic to that formula. Sixty seven of 80 confirmed subjects agreed to enroll their infants. Fifty-eight subjects completed the study. Twenty and 33 infants were tolerant whereas and 38 and 25 infants were intolerant to an extensively hydrolyzed protein formula and the chicken-based formula, respectively. The chicken-based formula showed significantly better tolerance than an extensively hydrolyzed protein formula in the management of cow milk allergy in infants.

Regional subsidence history and 3D visualization with MATLAB of the Vienna Basin, central Europe

NASA Astrophysics Data System (ADS)

Lee, E.; Novotny, J.; Wagreich, M.

2013-12-01

This study reconstructed the subsidence history by the backstripping and 3D visualization techniques, to understand tectonic evolution of the Neogene Vienna Basin. The backstripping removes the compaction effect of sediment loading and quantifies the tectonic subsidence. The amount of decompaction was calculated by porosity-depth relationships evaluated from seismic velocity data acquired from two boreholes. About 100 wells have been investigated to quantify the subsidence history of the Vienna Basin. The wells have been sorted into 10 groups; N1-4 in the northern part, C1-4 in the central part and L1-2 in the northernmost and easternmost parts, based on their position within the same block bordered by major faults. To visualize 3D subsidence maps, the wells were arranged to a set of 3D points based on their map location (x, y) and depths (z1, z2, z3 ...). The division of the stratigraphic column and age range was arranged based on the Central Paratethys regional Stages. In this study, MATLAB, a numerical computing environment, was used to calculate the TPS interpolation function. The Thin-Plate Spline (TPS) can be employed to reconstruct a smooth surface from a set of 3D points. The basic physical model of the TPS is based on the bending behavior of a thin metal sheet that is constrained only by a sparse set of fixed points. In the Lower Miocene, 3D subsidence maps show strong evidence that the pre-Neogene basement of the Vienna Basin was subsiding along borders of the Alpine-Carpathian nappes. This subsidence event is represented by a piggy-back basin developed on top of the NW-ward moving thrust sheets. In the late Lower Miocene, Group C and N display a typical subsidence pattern for the pull-apart basin with a very high subsidence event (0.2 - 1.0 km/Ma). After the event, Group N shows remarkably decreasing subsidence, following the thin-skinned extension which was regarded as the extension model of the Vienna Basin in the literature. But the subsidence in Group C decreases gradually, which demonstrates a trend of increasing thermal subsidence during the Middle to Upper Miocene. The traditional model cannot explain the thermal subsidence observed in the central part. This study supports a non-uniform extension model changing from the thin-skinned extension in the northern part to the thick-skinned extension in the central part. And 3D subsidence maps propose the existence of a decoupling between lithospheric and crustal extensions along the Steinberg Fault. Group L shows very different subsidence trends compared to Group C and N. In this Group a subsidence halt occurred in the late Lower Miocene. After the halt, Group L1 shows small tectonic and subsidence events. Some former studies presented that the area of Group L1 uplifted during the early Middle Miocene. It can be concluded that the missing sediments were eroded by the local uplift. But the subsidence of Group L2 stopped completely. It suggests that Group L2 was not influenced by the extension of the strike-slip fault system.

The marketing of responsible drinking: competing voices and interests.

PubMed

Wettlaufer, Ashley; Cukier, Samantha; Giesbrecht, Norman; Greenfield, Thomas K

2012-03-01

This paper contrasts health-oriented low-risk drinking guidelines (LRDGs) with social drinking marketing and popular advice on the amount of alcohol to be provided for social occasions. The questions addressed include:What is the underlying evidence base and rationale for health-oriented versus socially oriented drinking guidelines?What are the recommended amounts of alcohol per person from the LRDGs and from popular advice? This paper draws on existing research, archival data, websites, print media and key informant interviews. The focus is on recent information on LRDGs and social drinking indicators in Canada, the USA, Australia and the UK. There is extensive epidemiological research indicating the associations between drinking pattern and risk for chronic disease and trauma as well as certain potential health benefits from drinking small amounts regularly. This body of evidence is one resource for government or medically sanctioned LRDGs in many jurisdictions. In contrast, for those planning social events where liquor is served, information is available from the hospitality industry, retailers and liquor control boards.While some overlap exists between these two sources of information, in some contexts normative recommendations support drinking at potentially dangerous levels. The inconsistency among the different guidelines highlights one of the challenges of conveying health information on a drug that is integrated into social life and used extensively. It also reflects a siloed approach to alcohol policy—where retailing and harm reduction practices are managed by different sectors of government that seldom reflect a coordinated response.

The Marketing of Responsible Drinking: Competing Voices and Interests

PubMed Central

Wettlaufer, Ashley; Cukier, Samantha; Giesbrecht, Norman; Greenfield, Thomas K.

2011-01-01

Aim This paper contrasts health-oriented low-risk drinking guidelines (LRDG) with social drinking marketing and popular advice on the amount of alcohol to be provided for social occasions. The questions addressed include: What is the underlying evidence base and rationale for health-oriented vs. socially-oriented drinking guidelines? What are the recommended amounts of alcohol per person from the LRDGs and from popular advice? Method This paper draws on existing research, archival data, web sites, print media, and key informant interviews. The focus is on recent information on LRDGs and social drinking indicators in Canada, the U.S., Australia, and the U.K. Results There is extensive epidemiological research indicating the associations between drinking pattern and risk for chronic disease and trauma as well as certain potential health benefits from drinking small amounts regularly. This body of evidence is one resource for government or medically-sanctioned LRDGs in many jurisdictions. In contrast, for those planning social events where liquor is served, information is available from the hospitality industry, retailers, and liquor control boards. While some overlap exists between these two sources of information, in some contexts normative recommendations support drinking at potentially dangerous levels. Discussion The inconsistency among the different guidelines highlights one of the challenges of conveying health information on a drug that is integrated into social life and used extensively. It also reflects a siloed approach to alcohol policy – where retailing and harm reduction practices are managed by different sectors of government that seldom reflect a coordinated response. PMID:22489309

Genetic Addiction Risk Score (GARS): molecular neurogenetic evidence for predisposition to Reward Deficiency Syndrome (RDS).

PubMed

Blum, Kenneth; Oscar-Berman, Marlene; Demetrovics, Zsolt; Barh, Debmalya; Gold, Mark S

2014-12-01

We have published extensively on the neurogenetics of brain reward systems with reference to the genes related to dopaminergic function in particular. In 1996, we coined "Reward Deficiency Syndrome" (RDS), to portray behaviors found to have gene-based association with hypodopaminergic function. RDS as a useful concept has been embraced in many subsequent studies, to increase our understanding of Substance Use Disorder (SUD), addictions, and other obsessive, compulsive, and impulsive behaviors. Interestingly, albeit others, in one published study, we were able to describe lifetime RDS behaviors in a recovering addict (17 years sober) blindly by assessing resultant Genetic Addiction Risk Score (GARS™) data only. We hypothesize that genetic testing at an early age may be an effective preventive strategy to reduce or eliminate pathological substance and behavioral seeking activity. Here, we consider a select number of genes, their polymorphisms, and associated risks for RDS whereby, utilizing GWAS, there is evidence for convergence to reward candidate genes. The evidence presented serves as a plausible brain-print providing relevant genetic information that will reinforce targeted therapies, to improve recovery and prevent relapse on an individualized basis. The primary driver of RDS is a hypodopaminergic trait (genes) as well as epigenetic states (methylation and deacetylation on chromatin structure). We now have entered a new era in addiction medicine that embraces the neuroscience of addiction and RDS as a pathological condition in brain reward circuitry that calls for appropriate evidence-based therapy and early genetic diagnosis and that requires further intensive investigation.

Best practices recommendations for chiropractic care for infants, children, and adolescents: results of a consensus process.

PubMed

Hawk, Cheryl; Schneider, Michael; Ferrance, Randy J; Hewitt, Elise; Van Loon, Meghan; Tanis, Lora

2009-10-01

There has been much discussion about the role of chiropractic care in the evaluation, management, and treatment of pediatric patients. To date, no specific guidelines have been adopted that address this issue from an evidence based perspective. Previous systematic reviews of the chiropractic literature concluded that there is not yet a substantial body of high quality evidence from which to develop standard clinical guidelines. The purpose of this project was to develop recommendations on "best practices" related primarily to the evaluation and spinal manipulation aspects of pediatric chiropractic care; nonmanipulative therapies were not addressed in detail. Based on both clinical experience and the results of an extensive literature search, a set of seed documents was compiled to inform development of the seed statements. These were circulated electronically to the Delphi panel until consensus was reached, which was considered to be present when there was agreement by at least 80% of the panelists. A multidisciplinary panel of 37 was made up primarily of doctors of chiropractic with a mean of 18 years in practice, many with post-graduate training in pediatrics. The panel represented 5 countries and 17 states; there were members of the American Chiropractic Association, the International Chiropractors Association, and the International Chiropractic Pediatric Association. The panel reached a minimum of 80% consensus on the 51 seed statements after 4 rounds. A broad-based panel of experienced chiropractors was able to reach a high level (80%) of consensus regarding specific aspects of the chiropractic approach to clinical evaluation, management, and manual treatment for pediatric patients, based on both scientific evidence and clinical experience.

Pharmacoeconomic evaluations of pharmacogenetic and genomic screening programmes: a systematic review on content and adherence to guidelines.

PubMed

Vegter, Stefan; Boersma, Cornelis; Rozenbaum, Mark; Wilffert, Bob; Navis, Gerjan; Postma, Maarten J

2008-01-01

The fields of pharmacogenetics and pharmacogenomics have become important practical tools to progress goals in medical and pharmaceutical research and development. As more screening tests are being developed, with some already used in clinical practice, consideration of cost-effectiveness implications is important. A systematic review was performed on the content of and adherence to pharmacoeconomic guidelines of recent pharmacoeconomic analyses performed in the field of pharmacogenetics and pharmacogenomics. Economic analyses of screening strategies for genetic variations, which were evidence-based and assumed to be associated with drug efficacy or safety, were included in the review. The 20 papers included cover a variety of healthcare issues, including screening tests on several cytochrome P450 (CYP) enzyme genes, thiopurine S-methyltransferase (TMPT) and angiotensin-converting enzyme (ACE) insertion deletion (ACE I/D) polymorphisms. Most economic analyses reported that genetic screening was cost effective and often even clearly dominated existing non-screening strategies. However, we found a lack of standardization regarding aspects such as the perspective of the analysis, factors included in the sensitivity analysis and the applied discount rates. In particular, an important limitation of several studies related to the failure to provide a sufficient evidence-based rationale for an association between genotype and phenotype. Future economic analyses should be conducted utilizing correct methods, with adherence to guidelines and including extensive sensitivity analyses. Most importantly, genetic screening strategies should be based on good evidence-based rationales. For these goals, we provide a list of recommendations for good pharmacoeconomic practice deemed useful in the fields of pharmacogenetics and pharmacogenomics, regardless of country and origin of the economic analysis.

Unmet needs in the management of schizophrenia.

PubMed

Torres-González, Francisco; Ibanez-Casas, Inmaculada; Saldivia, Sandra; Ballester, Dinarte; Grandón, Pamela; Moreno-Küstner, Berta; Xavier, Miguel; Gómez-Beneyto, Manuel

2014-01-01

Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Within this block, the effects of the current economic difficulties shown in recent literature have been considered as well. Because no patient is static, a third block has reviewed evolving needs according to the clinical staging model. The fourth block has been dedicated to integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental health specialist, and other specialists.

Evidence-based risk assessment and recommendations for physical activity: arthritis, osteoporosis, and low back pain.

PubMed

Chilibeck, Philip D; Vatanparast, Hassanali; Cornish, Stephen M; Abeysekara, Saman; Charlesworth, Sarah

2011-07-01

We systematically reviewed the safety of physical activity (PA) for people with arthritis, osteoporosis, and low back pain. We searched PubMed, MEDLINE, Sport Discus, and the Cochrane Central Register of Controlled Trials (1966 through March 2008) for relevant articles on PA and adverse events. A total of 111 articles met our inclusion criteria. The incidence for adverse events during PA was 3.4%-11% (0.06%-2.4% serious adverse events) and included increased joint pain, fracture, and back pain for those with arthritis, osteoporosis, and low back pain, respectively. Recommendations were based on the Appraisal of Guidelines for Research and Evaluation, which applies Levels of Evidence based on type of study ranging from high-quality randomized controlled trials (Level 1) to anecdotal evidence (Level 4) and Grades from A (strong) to C (weak). Our main recommendations are that (i) arthritic patients with highly progressed forms of disease should avoid heavy load-bearing activities, but should participate in non-weight-bearing activities (Level 2, Grade A); and (ii) patients with osteoporosis should avoid trunk flexion (Level 2, Grade A) and powerful twisting of the trunk (Level 3, Grade C); (iii) patients with acute low back pain can safely do preference-based PA (i.e., PA that does not induce pain), including low back extension and flexion (Level 2, Grade B); (iv) arthritic patients with stable disease without progressive joint damage and patients with stable osteoporosis or low back pain can safely perform a variety of progressive aerobic or resistance-training PAs (Level 2, Grades A and B). Overall, the adverse event incidence from reviewed studies was low. PA can safely be done by most individuals with musculoskeletal conditions.

Unmet needs in the management of schizophrenia

PubMed Central

Torres-González, Francisco; Ibanez-Casas, Inmaculada; Saldivia, Sandra; Ballester, Dinarte; Grandón, Pamela; Moreno-Küstner, Berta; Xavier, Miguel; Gómez-Beneyto, Manuel

2014-01-01

Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Within this block, the effects of the current economic difficulties shown in recent literature have been considered as well. Because no patient is static, a third block has reviewed evolving needs according to the clinical staging model. The fourth block has been dedicated to integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental health specialist, and other specialists. PMID:24476630

Inhibitory control efficiency in a Piaget-like class-inclusion task in school-age children and adults: a developmental negative priming study.

PubMed

Borst, G; Poirel, N; Pineau, A; Cassotti, M; Houdé, O

2013-07-01

Most children under 7 years of age presented with 10 daisies and 2 roses fail to indicate that there are more flowers than daisies. Instead of the appropriate comparison of the relative numerosities of the superordinate class (flowers) to its subordinate class (daisies), they perform a direct perceptual comparison of the extensions of the 2 subordinate classes (daisies vs. roses). In our experiment, we investigated whether increasing efficiency in solving the Piagetian class-inclusion task is related to increasing efficiency in the ability to resist (inhibit) this direct comparison of the subordinate classes' extensions. Ten-year-old and young adult participants performed a computerized priming version of a Piaget-like class-inclusion task. The experimental design was such that the misleading perceptual strategy to inhibit on the prime (in which a superordinate class had to be compared with a subordinate class) became a congruent strategy to activate on the probe (in which the two subordinate classes' extensions were directly compared). We found a negative priming effect of 291 ms in children and 129 ms in adults. These results provide evidence for the first time (a) that adults still need to inhibit the comparison of the subordinate classes' extensions in class-inclusion tasks and (b) that the ability to inhibit this heuristic increases with age (resulting in a lower executive cost). Taken together, these findings provide additional support for the neo-Piagetian approach of cognitive development that suggests that the acquisition of increasingly complex knowledge is based on the ability to resist (inhibit) heuristics and previously acquired knowledge.

Evidence of non-extensivity and complexity in the seismicity observed during 2011-2012 at the Santorini volcanic complex, Greece

NASA Astrophysics Data System (ADS)

Vallianatos, F.; Tzanis, A.; Michas, G.; Papadakis, G.

2012-04-01

Since the middle of summer 2011, an increase in the seismicity rates of the volcanic complex system of Santorini Island, Greece, was observed. In the present work, the temporal distribution of seismicity, as well as the magnitude distribution of earthquakes, have been studied using the concept of Non-Extensive Statistical Physics (NESP; Tsallis, 2009) along with the evolution of Shanon entropy H (also called information entropy). The analysis is based on the earthquake catalogue of the Geodynamic Institute of the National Observatory of Athens for the period July 2011-January 2012 (http://www.gein.noa.gr/). Non-Extensive Statistical Physics, which is a generalization of Boltzmann-Gibbs statistical physics, seems a suitable framework for studying complex systems. The observed distributions of seismicity rates at Santorini can be described (fitted) with NESP models to exceptionally well. This implies the inherent complexity of the Santorini volcanic seismicity, the applicability of NESP concepts to volcanic earthquake activity and the usefulness of NESP in investigating phenomena exhibiting multifractality and long-range coupling effects. Acknowledgments. This work was supported in part by the THALES Program of the Ministry of Education of Greece and the European Union in the framework of the project entitled "Integrated understanding of Seismicity, using innovative Methodologies of Fracture mechanics along with Earthquake and non extensive statistical physics - Application to the geodynamic system of the Hellenic Arc. SEISMO FEAR HELLARC". GM and GP wish to acknowledge the partial support of the Greek State Scholarships Foundation (ΙΚΥ).

Bahía de Banderas, Mexico: Morphology, Magnetic Anomalies and Shallow Structure

NASA Astrophysics Data System (ADS)

Mortera Gutiérrez, Carlos A.; Bandy, William L.; Ponce Núñez, Francisco; Pérez Calderón, Daniel A.

2016-10-01

The Bahía de Banderas lies within a tectonically complex area at the northern end of the Middle America Trench. The structure, morphology, subsurface geology and tectonic history of the bay are essential for unraveling the complex tectonic processes occurring in this area. With this focus, marine geophysical data (multi-beam bathymetry, high resolution seismic reflection and total field magnetic data) were collected within the bay and adjacent areas during four campaigns aboard the B.O. EL PUMA conducted in 2006 and 2009. These data image the detailed morphology of, and sedimentation patterns within, the Banderas Canyon (a prominent submarine canyon situated on the south side of the bay) as well as the shallow subsurface structure of the northern part of the bay and the submarine Marietas Ridge, which bounds the bay to the west. We find that the Marietas Ridge is presently a transtensional feature; the course of the Banderas Canyon is controlled by extensive turbidite fan sedimentation in its eastern extremity and by structural lineaments to the west; the canyon floor is filled by sediments and exhibits almost no evidence for recent tectonic movements; the southern canyon wall is quite steep and a few sediments are deposited as submarine fans at the base of the southern wall; and extensive turbidite fans form the lower part of the northern canyon wall, producing a gently sloping lower northern wall. We find no evidence for a regional east-west striking lineament between the bay and the Middle America Trench, which casts doubts on the previous assertion that the Banderas Canyon is unequivocally related to the presence of a regional half-graben. Finally, a N71°E oriented normal fault offsets the seafloor reflector by 15 m within the central part of the bay, suggesting that the bay is currently being subjected to NNW-SSE extension.

Summary of tectonic and structural evidence for stress orientation at the Nevada Test Site

USGS Publications Warehouse

Carr, Wilfred James

1974-01-01

A tectonic synthesis of the NTS (Nevada Test Site) region, when combined with seismic data and a few stress and strain measurements, suggests a tentative model for stress orientation. This model proposes that the NTS is undergoing extension in a N. 50 ? W.-S. 50 ? E. direction coincident with the minimum principal stress direction. The model is supported by (1) a tectonic similarity between a belt of NTS Quaternary faulting and part of the Nevada-California seismic belt, for which northwest-southeast extension has been suggested; (2) historic northeast- trending natural- and explosion-produced fractures in the NTS; (3) the virtual absence in the NTS of northwest-trending Quaternary faults; (4) the character of north-trending faults and basin configuration in the Yucca Flat area, which suggest a component of right-lateral displacement and post-10 m.y. (million year) oblique separation of the sides of the north-trending depression; (5) seismic evidence suggesting a north- to northwest-trending tension axis; (6) strain measurements, which indicate episodes of northwest-southeast extension within a net northeast-southwest compression; (7) a stress estimate based on tectonic cracking that indicates near-surface northwest-southeast-directed tension, and two stress measurements indicating an excess (tectonic) maximum principal compressive stress in a northeast-southwest direction at depths of about 1,000 feet (305 m); and (8) enlargement of some drill holes in Yucca Flat in a northwest-southeast direction. It is inferred that the stress episode resulting in the formation of deep alluvium-filled trenches began somewhere between 10 and possibly less than 4 m.y. ago in the NTS and is currently active. In the Walker Lane of western Nevada, crystallization of plutons associated with Miocene volcanism may have increased the competency and thickness of the crust and its ability to propagate stress, thereby modulating the frequency (spacing) of basin-range faults.

Managing Osteoporosis Patients after Long-Term Bisphosphonate Treatment

PubMed Central

Adler, Robert A.; Fuleihan, Ghada El-Hajj; Bauer, Douglas C.; Camacho, Pauline M.; Clarke, Bart L.; Clines, Gregory A.; Compston, Juliet E.; Drake, Matthew T.; Edwards, Beatrice J.; Favus, Murray J.; Greenspan, Susan L.; McKinney, Ross; Pignolo, Robert J.; Sellmeyer, Deborah E.

2016-01-01

Bisphosphonates (BPs) are the most commonly used medications for osteoporosis, but optimal duration of therapy is unknown. This ASBMR report provides guidance on BP therapy duration with a risk benefit perspective. Two trials provided evidence for long-term BP use. In the Fracture Intervention Trial Long-term Extension (FLEX), postmenopausal women receiving alendronate for 10 years had fewer clinical vertebral fractures than those switched to placebo after 5 years. In the HORIZON extension, women who received 6 annual infusions of zoledronic acid had fewer morphometric vertebral fractures compared with those switched to placebo after 3 years. Low hip T-score between −2 and −2.5 in FLEX and below −2.5 in HORIZON extension predicted a beneficial response to continued therapy. Hence, the Task Force suggests that after 5 years of oral BP or 3 years of intravenous BP, women should be reassessed. Women with previous major osteoporotic fracture, those who fracture on therapy, or others at high risk should generally continue therapy for up to 10 years (oral) or 6 years (intravenous), with periodic risk-benefit evaluation. Older women, those with a low hip T-score or high fracture risk score are considered high risk. The risk of osteonecrosis of the jaw and atypical femoral fracture increases with BP therapy duration, but such rare events are far outweighed by fracture risk reduction with BPs in high risk patients. For women not at high fracture risk after 3–5 years of BP treatment, a drug holiday of 2–3 years can be considered, with periodic reassessment. The algorithm provided for long term BP use is based on limited evidence in mostly Caucasian postmenopausal women and only for vertebral fracture reduction. It is probably applicable to men and patients with glucocorticoid-induced osteoporosis, with some adaptations. It is unlikely that future osteoporosis trials will provide data for formulating definitive recommendations. PMID:26350171

Fusion set selection with surrogate metric in multi-atlas based image segmentation

NASA Astrophysics Data System (ADS)

Zhao, Tingting; Ruan, Dan

2016-02-01

Multi-atlas based image segmentation sees unprecedented opportunities but also demanding challenges in the big data era. Relevant atlas selection before label fusion plays a crucial role in reducing potential performance loss from heterogeneous data quality and high computation cost from extensive data. This paper starts with investigating the image similarity metric (termed ‘surrogate’), an alternative to the inaccessible geometric agreement metric (termed ‘oracle’) in atlas relevance assessment, and probes into the problem of how to select the ‘most-relevant’ atlases and how many such atlases to incorporate. We propose an inference model to relate the surrogates and the oracle geometric agreement metrics. Based on this model, we quantify the behavior of the surrogates in mimicking oracle metrics for atlas relevance ordering. Finally, analytical insights on the choice of fusion set size are presented from a probabilistic perspective, with the integrated goal of including the most relevant atlases and excluding the irrelevant ones. Empirical evidence and performance assessment are provided based on prostate and corpus callosum segmentation.

Hot carrier multiplication on graphene/TiO2 Schottky nanodiodes

PubMed Central

Lee, Young Keun; Choi, Hongkyw; Lee, Hyunsoo; Lee, Changhwan; Choi, Jin Sik; Choi, Choon-Gi; Hwang, Euyheon; Park, Jeong Young

2016-01-01

Carrier multiplication (i.e. generation of multiple electron–hole pairs from a single high-energy electron, CM) in graphene has been extensively studied both theoretically and experimentally, but direct application of hot carrier multiplication in graphene has not been reported. Here, taking advantage of efficient CM in graphene, we fabricated graphene/TiO2 Schottky nanodiodes and found CM-driven enhancement of quantum efficiency. The unusual photocurrent behavior was observed and directly compared with Fowler’s law for photoemission on metals. The Fowler’s law exponent for the graphene-based nanodiode is almost twice that of a thin gold film based diode; the graphene-based nanodiode also has a weak dependence on light intensity—both are significant evidence for CM in graphene. Furthermore, doping in graphene significantly modifies the quantum efficiency by changing the Schottky barrier. The CM phenomenon observed on the graphene/TiO2 nanodiodes can lead to intriguing applications of viable graphene-based light harvesting. PMID:27271245

Documenting research with transgender and gender diverse people: protocol for an evidence map and thematic analysis.

PubMed

Marshall, Zack; Welch, Vivian; Thomas, James; Brunger, Fern; Swab, Michelle; Shemilt, Ian; Kaposy, Chris

2017-02-20

There is limited information about how transgender, gender diverse, and Two-Spirit (trans) people have been represented and studied by researchers. The objectives of this study are to (1) map and describe trans research in the social sciences, sciences, humanities, health, education, and business, (2) identify evidence gaps and opportunities for more responsible research with trans people, (3) assess the use of text mining for study identification, and (4) increase access to trans research for key stakeholders through the creation of a web-based evidence map. Study design was informed by community consultations and pilot searches. Eligibility criteria were established to include all original research of any design, including trans people or their health information, and published in English in peer-reviewed journals. A complex electronic search strategy based on relevant concepts in 15 databases was developed to obtain a broad range of results linked to transgender, gender diverse, and Two-Spirit individuals and communities. Searches conducted in early 2015 resulted in 25,242 references after removal of duplicates. Based on the number of references, resources, and an objective to capture upwards of 90% of the existing literature, this study is a good candidate for text mining using Latent Dirichlet Allocation to improve efficiency of the screening process. The following information will be collected for evidence mapping: study topic, study design, methods and data sources, recruitment strategies, sample size, sample demographics, researcher name and affiliation, country where research was conducted, funding source, and year of publication. The proposed research incorporates an extensive search strategy, text mining, and evidence map; it therefore has the potential to build on knowledge in several fields. Review results will increase awareness of existing trans research, identify evidence gaps, and inform strategic research prioritization. Publishing the map online will improve access to research for key stakeholders including community members, policy makers, and healthcare providers. This study will also contribute to knowledge in the area of text mining for study identification by providing an example of how semi-automation performs for screening on title and abstract and on full text.

The neural basis of visual word form processing: a multivariate investigation.

PubMed

Nestor, Adrian; Behrmann, Marlene; Plaut, David C

2013-07-01

Current research on the neurobiological bases of reading points to the privileged role of a ventral cortical network in visual word processing. However, the properties of this network and, in particular, its selectivity for orthographic stimuli such as words and pseudowords remain topics of significant debate. Here, we approached this issue from a novel perspective by applying pattern-based analyses to functional magnetic resonance imaging data. Specifically, we examined whether, where and how, orthographic stimuli elicit distinct patterns of activation in the human cortex. First, at the category level, multivariate mapping found extensive sensitivity throughout the ventral cortex for words relative to false-font strings. Secondly, at the identity level, the multi-voxel pattern classification provided direct evidence that different pseudowords are encoded by distinct neural patterns. Thirdly, a comparison of pseudoword and face identification revealed that both stimulus types exploit common neural resources within the ventral cortical network. These results provide novel evidence regarding the involvement of the left ventral cortex in orthographic stimulus processing and shed light on its selectivity and discriminability profile. In particular, our findings support the existence of sublexical orthographic representations within the left ventral cortex while arguing for the continuity of reading with other visual recognition skills.

Range extension of Myotis midastactus​ (Chiroptera, Vespertilionidae) to Paraguay

PubMed Central

Idárraga, Liu; Wilson, Don Ellis

2015-01-01

Abstract Background Myotis midastactus Moratelli and Wilson, 2014 (Vespertilionidae, Myotinae) was described from the Myotis simus Thomas, 1901 complex based on collections from the Bolivian Savannah. New information Four vouchers previously assigned to M. simus from the Alto Chaco in Paraguay (West of the Paraguay River) are reassigned here to M. midastactus. These specimens extend the geographic distribution of M. midastactus 1200 km southward, and constitute the first evidence of the species in the country. Based on other material from the Brazilian Pantanal and Cerrado, Central Paraguay and north-eastern Argentina, we also discuss the identity of simus-like populations south of the Amazon Basin. The status of these populations is still unclear, but the little evidence we have at hand indicates that these populations may represent another taxon—M. guaycuru Proença, 1943; whereas M. simus seems to be restricted to the Amazon basin. This hypothesis is still very speculative and requires further investigation. With the assignment of material from Alto Chaco to M. midastactus, seven species of Myotis are confirmed for Paraguay: M. albescens, M. lavali, M. levis, M. midastactus, M. nigricans, M. riparius, and M. ruber. PMID:26379462

Cost effectiveness of brief interventions for reducing alcohol consumption.

PubMed

Wutzke, S E; Shiell, A; Gomel, M K; Conigrave, K M

2001-03-01

The direct costs and health effects of a primary-care-based brief intervention for hazardous alcohol consumption were examined. The total cost of the intervention was calculated from costs associated with: marketing the intervention programme; providing training and support in the use of the intervention materials; physician time required for providing brief advice for 'at-risk' drinkers. The effect of the intervention on health outcomes was expressed in terms of number of life years saved by preventing alcohol-related deaths. This was derived by combining estimates of the impact of the programme if it were implemented nationally with available evidence on the health effects of excess alcohol consumption. Results are based on international trial evidence showing the physical resources required by the intervention and its effectiveness combined with Australian price data. The costs associated with screening and brief advice using the current intervention programme range from Aus$19.14 to Aus$21.50. The marginal costs per additional life year saved were below Aus$1873. The robustness of the model used is supported by an extensive sensitivity analysis. In comparison with existing health promotion strategies the costs and effects of the current intervention are highly encouraging.

The effects of negative emotions on sensory perception: fear but not anger decreases tactile sensitivity.

PubMed

Kelley, Nicholas J; Schmeichel, Brandon J

2014-01-01

Emotions and sensory perceptions are closely intertwined. Of the five senses, sight has been by far the most extensively studied sense in emotion research. Relatively less is known about how emotions influence the other four senses. Touch is essential for nonverbal communication in both humans and other animals. The current investigation tested competing hypotheses about the effect of fear on tactile perception. One hypothesis based on evolutionary considerations predicts that fear enhances sensory perception, including tactile sensitivity. A competing hypothesis based on research on peripheral psychophysiology predicts that fear should decrease tactile sensitivity. Two experiments that induced negative emotional states and measured two-point discrimination ability at the fingertip found that fear reduces tactile sensitivity relative to anger or a neutral control condition (Studies 1 and 2). These findings did not appear to be driven by participants' naïve beliefs about the influence of emotions on touch (Study 3). The results represent the first evidence of the causal impact of emotional states on tactile sensitivity, are consistent with prior evidence for the peripheral physiological effects of fear, and offer novel empirical grounds for developing and advancing theories of emotional influences on sensory perception.