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Sample records for imaging systematic review

  1. Computational microscopic imaging for malaria parasite detection: a systematic review.

    PubMed

    Das, D K; Mukherjee, R; Chakraborty, C

    2015-10-01

    Malaria, being an epidemic disease, demands its rapid and accurate diagnosis for proper intervention. Microscopic image-based characterization of erythrocytes plays an integral role in screening of malaria parasites. In practice, microscopic evaluation of blood smear image is the gold standard for malaria diagnosis; where the pathologist visually examines the stained slide under the light microscope. This visual inspection is subjective, error-prone and time consuming. In order to address such issues, computational microscopic imaging methods have been given importance in recent times in the field of digital pathology. Recently, such quantitative microscopic techniques have rapidly evolved for abnormal erythrocyte detection, segmentation and semi/fully automated classification by minimizing such diagnostic errors for computerized malaria detection. The aim of this paper is to present a review on enhancement, segmentation, microscopic feature extraction and computer-aided classification for malaria parasite detection.

  2. Magnetic resonance imaging in pediatric appendicitis: a systematic review.

    PubMed

    Moore, Michael M; Kulaylat, Afif N; Hollenbeak, Christopher S; Engbrecht, Brett W; Dillman, Jonathan R; Methratta, Sosamma T

    2016-05-01

    Magnetic resonance imaging for the evaluation of appendicitis in children has rapidly increased recently. This change has been primarily driven by the desire to avoid CT radiation dose. This meta-analysis reviews the diagnostic performance of MRI for pediatric appendicitis and discusses current knowledge of cost-effectiveness. We used a conservative Haldane correction statistical method and found pooled diagnostic parameters including a sensitivity of 96.5% (95% confidence interval [CI]: 94.3-97.8%), specificity of 96.1% (95% CI: 93.5-97.7%), positive predictive value of 92.0% (95% CI: 89.3-94.0%) and negative predictive value of 98.3% (95% CI: 97.3-99.0%), based on 11 studies. Assessment of patient outcomes associated with MRI use at two institutions indicates that time to antibiotics was 4.7 h and 8.2 h, time to appendectomy was 9.1 h and 13.9 h, and negative appendectomy rate was 3.1% and 1.4%, respectively. Alternative diagnoses were present in ~20% of cases, most commonly adnexal cysts and enteritis/colitis. Regarding technique, half-acquisition single-shot fast spin-echo (SSFSE) pulse sequences are crucial. While gadolinium-enhanced T1-weighted pulse sequences might be helpful, any benefit beyond non-contrast MRI has not been confirmed. Balanced steady-state free precession (SSFP) sequences are generally noncontributory. Protocols do not need to exceed five sequences; four-sequence protocols are commonly utilized. Sedation generally is not indicated; patients younger than 5 years might be attempted based on the child's ability to cooperate. A comprehensive pediatric cost-effectiveness analysis that includes both direct and indirect costs is needed. PMID:27229509

  3. Magnetic resonance imaging in pediatric appendicitis: a systematic review.

    PubMed

    Moore, Michael M; Kulaylat, Afif N; Hollenbeak, Christopher S; Engbrecht, Brett W; Dillman, Jonathan R; Methratta, Sosamma T

    2016-05-01

    Magnetic resonance imaging for the evaluation of appendicitis in children has rapidly increased recently. This change has been primarily driven by the desire to avoid CT radiation dose. This meta-analysis reviews the diagnostic performance of MRI for pediatric appendicitis and discusses current knowledge of cost-effectiveness. We used a conservative Haldane correction statistical method and found pooled diagnostic parameters including a sensitivity of 96.5% (95% confidence interval [CI]: 94.3-97.8%), specificity of 96.1% (95% CI: 93.5-97.7%), positive predictive value of 92.0% (95% CI: 89.3-94.0%) and negative predictive value of 98.3% (95% CI: 97.3-99.0%), based on 11 studies. Assessment of patient outcomes associated with MRI use at two institutions indicates that time to antibiotics was 4.7 h and 8.2 h, time to appendectomy was 9.1 h and 13.9 h, and negative appendectomy rate was 3.1% and 1.4%, respectively. Alternative diagnoses were present in ~20% of cases, most commonly adnexal cysts and enteritis/colitis. Regarding technique, half-acquisition single-shot fast spin-echo (SSFSE) pulse sequences are crucial. While gadolinium-enhanced T1-weighted pulse sequences might be helpful, any benefit beyond non-contrast MRI has not been confirmed. Balanced steady-state free precession (SSFP) sequences are generally noncontributory. Protocols do not need to exceed five sequences; four-sequence protocols are commonly utilized. Sedation generally is not indicated; patients younger than 5 years might be attempted based on the child's ability to cooperate. A comprehensive pediatric cost-effectiveness analysis that includes both direct and indirect costs is needed.

  4. A systematic review of visual image theory, assessment, and use in skin cancer and tanning research.

    PubMed

    McWhirter, Jennifer E; Hoffman-Goetz, Laurie

    2014-01-01

    Visual images increase attention, comprehension, and recall of health information and influence health behaviors. Health communication campaigns on skin cancer and tanning often use visual images, but little is known about how such images are selected or evaluated. A systematic review of peer-reviewed, published literature on skin cancer and tanning was conducted to determine (a) what visual communication theories were used, (b) how visual images were evaluated, and (c) how visual images were used in the research studies. Seven databases were searched (PubMed/MEDLINE, EMBASE, PsycINFO, Sociological Abstracts, Social Sciences Full Text, ERIC, and ABI/INFORM) resulting in 5,330 citations. Of those, 47 met the inclusion criteria. Only one study specifically identified a visual communication theory guiding the research. No standard instruments for assessing visual images were reported. Most studies lacked, to varying degrees, comprehensive image description, image pretesting, full reporting of image source details, adequate explanation of image selection or development, and example images. The results highlight the need for greater theoretical and methodological attention to visual images in health communication research in the future. To this end, the authors propose a working definition of visual health communication.

  5. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations

    PubMed Central

    Brinjikji, W.; Luetmer, P.H.; Comstock, B.; Bresnahan, B.W.; Chen, L.E.; Deyo, R.A.; Halabi, S.; Turner, J.A.; Avins, A.L.; James, K.; Wald, J.T.; Kallmes, D.F.; Jarvik, J.G.

    2015-01-01

    BACKGROUND AND PURPOSE Degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain. We sought to estimate the prevalence, by age, of common degenerative spine conditions by performing a systematic review studying the prevalence of spine degeneration on imaging in asymptomatic individuals. MATERIALS AND METHODS We performed a systematic review of articles reporting the prevalence of imaging findings (CT or MR imaging) in asymptomatic individuals from published English literature through April 2014. Two reviewers evaluated each manuscript. We selected age groupings by decade (20, 30, 40, 50, 60, 70, 80 years), determining age-specific prevalence estimates. For each imaging finding, we fit a generalized linear mixed-effects model for the age-specific prevalence estimate clustering in the study, adjusting for the midpoint of the reported age interval. RESULTS Thirty-three articles reporting imaging findings for 3110 asymptomatic individuals met our study inclusion criteria. The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age. CONCLUSIONS Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. These imaging findings must be interpreted in the context of the patient’s clinical condition. PMID:25430861

  6. Systematic reviews need systematic searchers

    PubMed Central

    McGowan, Jessie; Sampson, Margaret

    2005-01-01

    Purpose: This paper will provide a description of the methods, skills, and knowledge of expert searchers working on systematic review teams. Brief Description: Systematic reviews and meta-analyses are very important to health care practitioners, who need to keep abreast of the medical literature and make informed decisions. Searching is a critical part of conducting these systematic reviews, as errors made in the search process potentially result in a biased or otherwise incomplete evidence base for the review. Searches for systematic reviews need to be constructed to maximize recall and deal effectively with a number of potentially biasing factors. Librarians who conduct the searches for systematic reviews must be experts. Discussion/Conclusion: Expert searchers need to understand the specifics about data structure and functions of bibliographic and specialized databases, as well as the technical and methodological issues of searching. Search methodology must be based on research about retrieval practices, and it is vital that expert searchers keep informed about, advocate for, and, moreover, conduct research in information retrieval. Expert searchers are an important part of the systematic review team, crucial throughout the review process—from the development of the proposal and research question to publication. PMID:15685278

  7. Health technology assessment of image-guided radiotherapy (IGRT): A systematic review of current evidence

    PubMed Central

    Arabloo, Jalal; Hamouzadeh, Pejman; Mousavinezhad, Seyedeh Maryam; Mobinizadeh, Mohammadreza; Olyaeemanesh, Alireza; Pooyandjoo, Morvarid

    2016-01-01

    Background: Image-guided radiotherapy used multiple imaging during the radiation therapy course to improve the precision and accuracy of health care provider's treatment. Objectives: This study aims to assess the safety, effectiveness and economic aspects of image-guided radiation therapy for decision-making about this technology in Iran. Methods: In this study, the most important medical databases such as PubMed and Cochrane Library were searched until November 2014. The systematic reviews, health technology assessment reports and economic evaluation studies were included. The results of included studies were analyzed via the thematic synthesis. Results: Seven articles were included in the study. The results showed that image-guided radiation therapy, regardless of the imaging technique used in it, is associated with no major toxicity and has the potential to reduce the symptoms of poisoning. Using image-guided radiation therapy for prostate cancer resulted in substantial improvement in the quality of the received dose and optimal therapeutic dose of radiation to the targeted tumor while the radiation dose to the surrounding healthy tissues was minimal. Additionally, image-guided radiation therapy facilitated the diagnosis and management of exception deviations, including immediate changes and gross errors, weight loss, significant limbs deformity, systematic changes in the internal organs and changes in respiratory movements. Usage of image-guided radiation therapy for prostate cancer was associated with increased costs. Conclusion: Current available evidence suggests that the image-guided radiation therapy can reduce the amount of radiation to healthy tissue around the tumor and the toxicity associated with it. This can enhance the safe dose of radiation to the tumor and increase the likelihood of destruction of tumor. The current level of evidence required conducting further studies on the costs and effectiveness of this technology compared with conventional

  8. The impact of computerized provider order entry systems on medical-imaging services: a systematic review

    PubMed Central

    Prgomet, Mirela; Markewycz, Andrew; Adams, Edwina; Westbrook, Johanna I

    2011-01-01

    Background Computerized provider order entry (CPOE) systems have been strongly promoted as a means to improve the quality and efficiency of healthcare. Methods This systematic review aimed to assess the evidence of the impact of CPOE on medical-imaging services and patient outcomes. Results Fourteen studies met the inclusion criteria, most of which (10/14) used a pre-/postintervention comparison design. Eight studies demonstrated benefits, such as decreased test utilization, associated with decision-support systems promoting adherence to test ordering guidelines. Three studies evaluating medical-imaging ordering and reporting times showed statistically significant decreases in turnaround times. Conclusions The findings reveal the potential for CPOE to contribute to significant efficiency and effectiveness gains in imaging services. The diversity and scope of the research evidence can be strengthened through increased attention to the circumstances and mechanisms that contribute to the success (or otherwise) of CPOE and its contribution to the enhancement of patient care delivery. PMID:21385821

  9. Visual images for skin cancer prevention: a systematic review of qualitative studies.

    PubMed

    McWhirter, Jennifer E; Hoffman-Goetz, Laurie

    2012-06-01

    Visual images play an important role in educating the public about skin cancer prevention. The objectives of this systematic review were to: 1) determine how visual images are evaluated in skin cancer and tanning qualitative research studies (including theoretical and methodological approaches) and 2) summarize and discuss the image-related findings of the studies with respect to cancer education and public health. Seven databases were searched (PubMed-MEDLINE, EMBASE, PsycINFO, Sociological Abstracts, Social Sciences Full Text, ERIC, and ABI/INFORM) using multiple search terms, including MeSH terms, resulting in 5330 citations. Studies were included if they were in English, peer-reviewed, qualitative in design or methodology, dealt with skin cancer or UV exposure, used visual images, and had a focus on the public or patients (i.e., not medical professionals). Eight studies met the inclusion criteria: seven content analyses and one focus group study. Content analysis studies in this review suggest the mass media portray Caucasian men and women as unprotected from the sun and with tanned skin, and thus, may inform behaviors related to skin cancer risk. The focus group study suggests visible minorities may benefit from the incorporation of images of melanoma on ethnic skin in cancer education materials. None of the studies used visual communication theory to explicitly guide the research, nor were standardized tools used for image assessment. The lack of guiding theory and standardized assessment instruments can introduce bias in how images are selected and used in research on skin cancer education.

  10. Magnetic resonance imaging acquisition techniques intended to decrease movement artefact in paediatric brain imaging: a systematic review.

    PubMed

    Woodfield, Julie; Kealey, Susan

    2015-08-01

    Attaining paediatric brain images of diagnostic quality can be difficult because of young age or neurological impairment. The use of anaesthesia to reduce movement in MRI increases clinical risk and cost, while CT, though faster, exposes children to potentially harmful ionising radiation. MRI acquisition techniques that aim to decrease movement artefact may allow diagnostic paediatric brain imaging without sedation or anaesthesia. We conducted a systematic review to establish the evidence base for ultra-fast sequences and sequences using oversampling of k-space in paediatric brain MR imaging. Techniques were assessed for imaging time, occurrence of movement artefact, the need for sedation, and either image quality or diagnostic accuracy. We identified 24 relevant studies. We found that ultra-fast techniques had shorter imaging acquisition times compared to standard MRI. Techniques using oversampling of k-space required equal or longer imaging times than standard MRI. Both ultra-fast sequences and those using oversampling of k-space reduced movement artefact compared with standard MRI in unsedated children. Assessment of overall diagnostic accuracy was difficult because of the heterogeneous patient populations, imaging indications, and reporting methods of the studies. In children with shunt-treated hydrocephalus there is evidence that ultra-fast MRI is sufficient for the assessment of ventricular size.

  11. White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies

    PubMed Central

    Martin Monzon, Beatriz; Hay, Phillipa; Foroughi, Nasim; Touyz, Stephen

    2016-01-01

    AIM: To identify findings concerning white matter (WM) fibre microstructural alterations in anorexia nervosa (AN). METHODS: A systematic electronic search was undertaken in several databases up to April 2015. The search strategy aimed to locate all studies published in English or Spanish that included participants with AN and which investigated WM using diffusion tensor imaging (DTI). Trials were assessed for quality assessment according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and a published quality index guideline. RESULTS: A total of 6 studies met the inclusion criteria, four of people in the acute state of the illness, one included both recovered and unwell participants, and one included people who had recovered. Participants were female with ages ranging from 14 to 29 years. All studies but one measured a range of psychopathological features. Fractional anisotropy and mean diffusivity were the main DTI correlates reported. Alterations were reported in a range of WM structures of the limbic system, most often of the fornix and cingulum as well as the fronto-occipital fibre tracts, i.e., regions associated with anxiety, body image and cognitive function. Subtle abnormalities also appeared to persist after recovery. CONCLUSION: This diversity likely reflects the symptom complexity of AN. However, there were few studies, they applied different methodologies, and all were cross-sectional. PMID:27014606

  12. Systematic review automation technologies.

    PubMed

    Tsafnat, Guy; Glasziou, Paul; Choong, Miew Keen; Dunn, Adam; Galgani, Filippo; Coiera, Enrico

    2014-07-09

    Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects.We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time.

  13. Systematic review automation technologies

    PubMed Central

    2014-01-01

    Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128

  14. Body image of children and adolescents with cancer: A systematic review.

    PubMed

    Fan, Sheng-Yu; Eiser, Christine

    2009-09-01

    We report a systematic literature review to identify (1) differences in body image (BI) between children and adolescents with cancer and healthy controls; (2) relationships between BI and demographic or medical variables; (3) implications of BI for psychological adjustment; and (4) relationship between BI and social support. Thirty-two studies were identified from computerized databases including BNI (1985-March, 2008), CINAHL (1982-March, 2008), MEDLINE (1950-March, 2008), PsychInfo (1806-March, 2008), and PubMed (1950-March, 2008). There was no consistent evidence regarding BI differences between children and adolescents with cancer and healthy controls. Relations between BI and gender, disease characteristics, and psychological adjustment were found. Changes in BI have adverse implications for self-esteem and adjustment, but can be moderated by social support. Future research should also adopt broader definitions of BI, and cancer-specific age-appropriate BI measures are needed to increase sensitivity of this work.

  15. Systematic review of population-based studies on the impact of images on UV attitudes and behaviours.

    PubMed

    McWhirter, Jennifer E; Hoffman-Goetz, Laurie

    2015-06-01

    Visual images have been shown to influence health behaviours. The effectiveness of population interventions, which use visual images to influence skin cancer prevention behaviours, has not been systematically evaluated. We, therefore, undertook a systematic review of peer-reviewed, health education and health promotion research on skin cancer and tanning to examine the outcomes of studies, which used visual images as part of their methodology. Our objective was to describe the impact of visual images on UV protection and exposure attitudes and behaviours across the studies. Twenty-three studies met the inclusion criteria. Images positively impact knowledge, attitudes and behaviours related to UV exposure and UV protection. Images also influence the perceived attractiveness of untanned or tanned skin, which in turn, influences UV exposure attitudes and behaviours. Implications for future health promotion research and practice are discussed.

  16. Systematic Review of Digital Imaging Screening Strategies for Retinopathy of Prematurity

    PubMed Central

    Kemper, Alex R.; Wallace, David K.; Quinn, Graham E.

    2008-01-01

    BACKGROUND Retinal imaging with remote interpretation could decrease the number of diagnostic eye examinations that premature infants need for the detection of retinopathy of prematurity and thus decrease the time demand on the relatively small pool of ophthalmologists who perform retinopathy of prematurity examinations. OBJECTIVE Our goal was to review systematically the evidence regarding the reliability, validity, safety, costs, and benefits of retinal imaging to screen infants who are at risk for retinopathy of prematurity. METHODS We searched Medline, the Cochrane library, CINAHL, and the bibliographies of all relevant articles. All English-language studies regardless of design with primary data about our study questions were included. We excluded (1) studies that only included subjects with retinopathy of prematurity, (2) hypothetical models other than cost-effectiveness studies, and (3) validity studies without sufficient data to determine prevalence, sensitivity, and specificity or that only evaluated subjects for 1 component of retinopathy of prematurity (eg, plus disease only). RESULTS Studies of only 1 retinal imaging device (RetCam [Clarity Medical Systems, Inc, Pleasanton, CA]) met the inclusion criteria. There was a wide range in reported sensitivity, but specificity was high. There were several important limitations noted, including the eye as the unit of analysis instead of the individual or variations in the criteria for determining a true-positive or true-negative screening result. The risk of retinal hemorrhage resulting from imaging is low, and systemic effects (eg, bradycardia, hypertension, decreased oxygen saturation) are mild. No generalizable cost-effectiveness data were found. CONCLUSIONS The evidence base is not sufficient to recommend that retinal imaging be routinely adopted by NICUs to identify infants who have serious retinopathy of prematurity. PMID:18829807

  17. Diffusion tensor imaging findings of white matter changes in first episode schizophrenia: a systematic review.

    PubMed

    Kuswanto, Carissa Nadia; Teh, Irvin; Lee, Tih-Shih; Sim, Kang

    2012-04-01

    Earlier structural magnetic resonance imaging in schizophrenia have noted smaller white matter volumes in diverse brain regions and recent diffusion tensor imaging (DTI) studies have allowed better elucidation of changes in brain white matter integrity within the illness. As white matter abnormalities have been reported to occur early in the course of schizophrenia, we systematically review extant DTI studies of anomalies of white matter integrity in first episode schizophrenia (FES) up till October 2011. Overall, disruptions of white matter integrity were found in the cortical, subcortical brain regions and white matter associative and commissural tracts, suggesting that changes of cortical-subcortical white matter integrity were found at an early stage of the disorder. These changes in white matter integrity were correlated with specific cognitive deficits (verbal and spatial working memory) as well as psychopathology (positive more than negative symptoms) in patients with FES. The correlation of these white matter integrity changes with cognitive and phenomenological factors may shed light on neurobiological substrates underlying these clinical manifestations. Future studies need to validate these findings in larger samples of subjects and in different populations as well as chart the progress of these cerebral white matter changes over time so as to better appreciate their trajectory with illness course, treatment and chronicity.

  18. The incremental benefit of functional imaging in pheochromocytoma/paraganglioma: a systematic review.

    PubMed

    Brito, Juan P; Asi, Noor; Gionfriddo, Michael R; Norman, Catalina; Leppin, Aaron L; Zeballos-Palacios, Claudia; Undavalli, Chaitanya; Wang, Zhen; Domecq, Juan P; Prustsky, Gabriela; Elraiyah, Tarig A; Prokop, Larry J; Montori, Victor M; Murad, Mohammad Hassan

    2015-09-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are the major imaging modalities used for the localization of catecholamine-producing tumors (pheochromocytoma and paraganglioma). Functional imaging (FI) offers an alternative approach to localize, evaluate, and stage these tumors. Our objective was to describe the additive benefit of FI studies for patients with pheochromocytoma and paraganglioma (PPG) who have undergone MRI or CT scan evaluation. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus from database inception through June 2012 for studies that included patients with biochemically proven PPGs who underwent CT or MRI and additional FI for the localization of PPGs. We included 32 studies enrolling a total of 1,264 patients with a mean age of 43-years old. The studies were uncontrolled and evaluated six FI modalities. FI tests provided small additive value to CT/MRI, aiding in the localization of only 24/1,445 primary cases (1.4 %) and 28/805 metastatic cases (3.5 %). In metastatic cases, 6-[F-18]fluoro-L-dihydroxyphenylalanine (DOPA) and fluorodopamine-PET (FDA) were the FI tests most successful at identifying disease missed by CT/MRI, providing additional benefit in 6/60 (10 %) and 5/78 (6.4 %) cases, respectively. No clinically significant findings were observed in any of the predefined subgroups. No study evaluated the impact of FI on the completeness of surgical resection or other patient-important outcomes. Observational evidence suggests that FI tests have a limited additional role in patients with PPGs who have undergone CT/MRI evaluation. However, the role of FI tests in specific subgroups of patients with atypical presentations (metastatic, extra-adrenal) as well as the use of hybrid FI tests should be explored. Further research should also evaluate the impact of FI tests on patient-important outcomes. PMID:25663601

  19. Autism Spectrum Disorder: Does Neuroimaging Support the DSM-5 Proposal for a Symptom Dyad? A Systematic Review of Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Studies

    ERIC Educational Resources Information Center

    Pina-Camacho, Laura; Villero, Sonia; Fraguas, David; Boada, Leticia; Janssen, Joost; Navas-Sanchez, Francisco J.; Mayoral, Maria; Llorente, Cloe; Arango, Celso; Parellada, Mara

    2012-01-01

    A systematic review of 208 studies comprising functional magnetic resonance imaging and diffusion tensor imaging data in patients with "autism spectrum disorder" (ASD) was conducted, in order to determine whether these data support the forthcoming DSM-5 proposal of a social communication and behavioral symptom dyad. Studies consistently reported…

  20. Writing a systematic review.

    PubMed

    Ng, K H; Peh, W C

    2010-05-01

    Evidence-based medicine (EBM) aims to combine the best available scientific evidence with clinical experience and individual judgment of patient needs. In the hierarchy of scientific evidence, systematic reviews (along with meta-analyses) occupy the highest levels in terms of the quality of evidence. A systematic review is the process of searching, selecting, appraising, synthesising and reporting clinical evidence on a particular question or topic. It is currently considered the best, least biased and most rational way to organise, gather, evaluate and integrate scientific evidence from the rapidly-changing medical and healthcare literature. Systematic reviews could be used to present current concepts or serve as review articles and replace the traditional expert opinion or narrative review. This article explains the structure and content of a systematic review.

  1. Conventional and Nuclear Medicine Imaging in Ectopic Cushing's Syndrome: A Systematic Review

    PubMed Central

    Isidori, Andrea M.; Sbardella, Emilia; Zatelli, Maria Chiara; Boschetti, Mara; Vitale, Giovanni; Colao, Annamaria

    2015-01-01

    Context: Ectopic Cushing's Syndrome (ECS) can be a diagnostic challenge with the hormonal source difficult to find. This study analyzes the accuracy of imaging studies in ECS localization. Evidence Acquisition: Systematic review of medical literature for ECS case series providing individual patient data on at least one conventional imaging technique (computed tomography [CT]/magnetic resonance imaging) and one of the following: 111In-pentetreotide (OCT), 131I/123I-metaiodobenzylguanidine, 18F-fluoro-2-deoxyglucose-positron emission tomography (FDG-PET), 18F-fluorodopa-PET (F-DOPA-PET), 68Ga-DOTATATE-PET/CT or 68Ga-DOTATOC-PET/CT scan (68Gallium-SSTR-PET/CT). Evidence Summary: The analysis comprised 231 patients (females, 50.2%; age, 42.6 ± 17 y). Overall, 52.4% (121/231) had “overt” ECS, 18.6% had “occult” ECS, and 29% had “covert” ECS. Tumors were located in the lung (55.3%), mediastinum-thymus (7.9%), pancreas (8.5%), adrenal glands (6.4%), gastrointestinal tract (5.4%), thyroid (3.7%), and other sites (12.8%), and primary tumors were mostly bronchial neuroendocrine tumors (NETs) (54.8%), pancreatic NETs (8%), mediastinum-thymus NETs (6.9%), gastrointestinal NETs (5.3%), pheochromocytoma (6.4%), neuroblastoma (3.2%), and medullary thyroid carcinoma (3.2%). Tumors were localized by CT in 66.2% (137/207), magnetic resonance imaging in 51.5% (53/103), OCT in 48.9% (84/172), FDG-PET in 51.7% (46/89), F-DOPA-PET in 57.1% (12/21), 131/123I-metaiodobenzylguanidine in 30.8% (4/13), and 68Gallium-SSTR-PET/CT in 81.8% (18/22) of cases. Molecular imaging discovered 79.1% (53/67) of tumors unidentified by conventional radiology, with OCT the most commonly used, revealing the tumor in 64%, followed by FDG-PET in 59.4%. F-DOPA-PET was used in only seven covert cases (sensitivity, 85.7%). Notably, 68Gallium-SSTR-PET/CT had 100% sensitivity among covert cases. Conclusions: Nuclear medicine improves the sensitivity of conventional radiology when tumor site

  2. A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease

    PubMed Central

    Meghji, Jamilah; Simpson, Hope; Squire, S. Bertel; Mortimer, Kevin

    2016-01-01

    Background Tuberculosis is an important risk factor for chronic respiratory disease in resource poor settings. The persistence of abnormal spirometry and symptoms after treatment are well described, but the structural abnormalities underlying these changes remain poorly defined, limiting our ability to phenotype post-TB lung disease in to meaningful categories for clinical management, prognostication, and ongoing research. The relationship between post-TB lung damage and patient-centred outcomes including functional impairment, respiratory symptoms, and health related quality of life also remains unclear. Methods We performed a systematic literature review to determine the prevalence and pattern of imaging-defined lung pathology in adults after medical treatment for pleural, miliary, or pulmonary TB disease. Data were collected on study characteristics, and the modality, timing, and findings of thoracic imaging. The proportion of studies relating imaging findings to spirometry results and patient morbidity was recorded. Study quality was assessed using a modified Newcastle-Ottowa score. (Prospero Registration number CRD42015027958) Results We identified 37 eligible studies. The principle features seen on CXR were cavitation (8.3–83.7%), bronchiectasis (4.3–11.2%), and fibrosis (25.0–70.4%), but prevalence was highly variable. CT imaging identified a wider range of residual abnormalities than CXR, including nodules (25.0–55.8%), consolidation (3.7–19.2%), and emphysema (15.0–45.0%). The prevalence of cavitation was generally lower (7.4–34.6%) and bronchiectasis higher (35.0–86.0%) on CT vs. CXR imaging. A paucity of prospective data, and data from HIV-infected adults and sub-Saharan Africa (sSA) was noted. Few studies related structural damage to physiological impairment, respiratory symptoms, or patient morbidity. Conclusions Post-TB structural lung pathology is common. Prospective data are required to determine the evolution of this lung damage and

  3. Reviewing the literature, how systematic is systematic?

    PubMed

    MacLure, Katie; Paudyal, Vibhu; Stewart, Derek

    2016-06-01

    Introduction Professor Archibald Cochrane, after whom the Cochrane Collaboration is named, was influential in promoting evidence-based clinical practice. He called for "relevant, valid research" to underpin all aspects of healthcare. Systematic reviews of the literature are regarded as a high quality source of cumulative evidence but it is unclear how truly systematic they, or other review articles, are or 'how systematic is systematic?' Today's evidence-based review industry is a burgeoning mix of specialist terminology, collaborations and foundations, databases, portals, handbooks, tools, criteria and training courses. Aim of the review This study aims to identify uses and types of reviews, key issues in planning, conducting, reporting and critiquing reviews, and factors which limit claims to be systematic. Method A rapid review of review articles published in IJCP. Results This rapid review identified 17 review articles published in IJCP between 2010 and 2015 inclusive. It explored the use of different types of review article, the variation and widely available range of guidelines, checklists and criteria which, through systematic application, aim to promote best practice. It also identified common pitfalls in endeavouring to conduct reviews of the literature systematically. Discussion Although a limited set of IJCP reviews were identified, there is clear evidence of the variation in adoption and application of systematic methods. The burgeoning evidence industry offers the tools and guidelines required to conduct systematic reviews, and other types of review, systematically. This rapid review was limited to the database of one journal over a period of 6 years. Although this review was conducted systematically, it is not presented as a systematic review. Conclusion As a research community we have yet to fully engage with readily available guidelines and tools which would help to avoid the common pitfalls. Therefore the question remains, of not just IJCP but

  4. The meaning of body image experiences during the perinatal period: A systematic review of the qualitative literature.

    PubMed

    Watson, Brittany; Fuller-Tyszkiewicz, Matthew; Broadbent, Jaclyn; Skouteris, Helen

    2015-06-01

    Literature reporting body image disturbances across the perinatal period has produced inconsistent findings, owing to the complexity of body image experiences during pregnancy and the first year postpartum. Existing qualitative data might provide potential avenues to advance understanding of pregnancy-related body image experiences and guide future quantitative research. The present systematic review synthesised the findings of 10 qualitative studies exploring the body image experiences of women through the perinatal period, albeit the majority focused only on pregnancy. Themes emerging included malleability of body image ideals across pregnancy (including the shift from aesthetic to functional concerns about one's appearance), the salience of stomach and breasts for self-rated body satisfaction, and perceived pressure to limit weight gain across pregnancy in order to return quickly to pre-pregnancy figure following birth. These qualitative findings suggest greater complexity of body image experiences during perinatal period than can be captured by typically used self-report measures. PMID:25950953

  5. [Critical reading of systematic reviews and meta-analyses about diagnostic imaging].

    PubMed

    Plana, M N; Zamora, J; Abraira, V

    2015-11-01

    Systematic reviews of diagnostic validity have been proposed as the best methodological tool to integrate all the available evidence and to help physicians decide whether to use a given diagnostic test. These studies aim to synthesize the results obtained in different primary studies into a couple of indices, generally sensitivity and specificity, or into a summary receiver operating characteristic (ROC) curve. Although there is a certain parallelism with reviews about the efficacy of therapeutic interventions, reviews of diagnostic validity have certain peculiarities that add complexity to the analysis and interpretation of the results. This article emphasizes the methodological aspects that make it possible to critically assess the extent to which the results of a review of the validity of diagnostic tests are valid and provides rudimentary knowledge of the statistics necessary to understand the results.

  6. Image-assisted dietary assessment: a systematic review of the evidence.

    PubMed

    Gemming, Luke; Utter, Jennifer; Ni Mhurchu, Cliona

    2015-01-01

    Images captured during eating episodes provide objective information to assist in the assessment of dietary intake. Images are captured using handheld devices or wearable cameras, and can support traditional self-report or provide the primary record of dietary intake. A diverse range of image-assisted methods have been developed and evaluated but have not been previously examined together. Therefore, a review was undertaken to examine all studies that have evaluated or validated image-assisted methods of dietary assessment for assessing dietary energy intake. Identified image-assisted methods that employ similar methodologies were grouped for comparison. English-language full-text research articles published between January 1998 and November 2013 were searched using five electronic databases. A search of reference lists and associated websites was also conducted. Thirteen studies that evaluated 10 unique image-assisted methods among adults aged 18 to 70 years were included. Ten studies used handheld devices and three studies used wearable cameras. Eight studies evaluated image-based food records, two studies explored the use of images to enhance written food records, and three studies evaluated image-assisted 24-hour dietary recalls. Results indicate images enhance self-report by revealing unreported foods and identify misreporting errors not captured by traditional methods alone. Moreover, when used as the primary record of dietary intake, images can provide valid estimates of energy intake. However, image-assisted methods that rely on image analysis can be prone to underestimation if users do not capture images of satisfactory quality before all foods are consumed. Further validation studies using criterion measures are warranted. The validity among children, adolescents, and elderly persons as well as the feasibility of using image-assisted methods in large samples needs to be examined. Additional research is also needed to better understand the potential

  7. Appropriate Use of Cardiac Stress Testing with Imaging: A Systematic Review and Meta-Analysis

    PubMed Central

    Ladapo, Joseph A.; Blecker, Saul; O'Donnell, Michael; Jumkhawala, Saahil A.; Douglas, Pamela S.

    2016-01-01

    Background Appropriate use criteria (AUC) for cardiac stress tests address concerns about utilization growth and patient safety. We systematically reviewed studies of appropriateness, including within physician specialties; evaluated trends over time and in response to AUC updates; and characterized leading indications for inappropriate/rarely appropriate testing. Methods We searched PubMed (2005–2015) for English-language articles reporting stress echocardiography or myocardial perfusion imaging (MPI) appropriateness. Data were pooled using random-effects meta-analysis and meta-regression. Results Thirty-four publications of 41,578 patients were included, primarily from academic centers. Stress echocardiography appropriate testing rates were 53.0% (95% CI, 45.3%–60.7%) and 50.9% (42.6%–59.2%) and inappropriate/rarely appropriate rates were 19.1% (11.4%–26.8%) and 28.4% (23.9%–32.8%) using 2008 and 2011 AUC, respectively. Stress MPI appropriate testing rates were 71.1% (64.5%–77.7%) and 72.0% (67.6%–76.3%) and inappropriate/rarely appropriate rates were 10.7% (7.2%–14.2%) and 15.7% (12.4%–19.1%) using 2005 and 2009 AUC, respectively. There was no significant temporal trend toward rising rates of appropriateness for stress echocardiography or MPI. Unclassified stress echocardiograms fell by 79% (p = 0.04) with updated AUC. There were no differences between cardiac specialists and internists. Conclusions Rates of appropriate use tend to be lower for stress echocardiography compared to MPI, and updated AUC reduced unclassified stress echocardiograms. There is no conclusive evidence that AUC improved appropriate use over time. Further research is needed to determine if integration of appropriateness guidelines in academic and community settings is an effective approach to optimizing inappropriate/rarely appropriate use of stress testing and its associated costs and patient harms. PMID:27536775

  8. A systematic review of automated melanoma detection in dermatoscopic images and its ground truth data

    NASA Astrophysics Data System (ADS)

    Ali, Abder-Rahman A.; Deserno, Thomas M.

    2012-02-01

    Malignant melanoma is the third most frequent type of skin cancer and one of the most malignant tumors, accounting for 79% of skin cancer deaths. Melanoma is highly curable if diagnosed early and treated properly as survival rate varies between 15% and 65% from early to terminal stages, respectively. So far, melanoma diagnosis is depending subjectively on the dermatologist's expertise. Computer-aided diagnosis (CAD) systems based on epiluminescense light microscopy can provide an objective second opinion on pigmented skin lesions (PSL). This work systematically analyzes the evidence of the effectiveness of automated melanoma detection in images from a dermatoscopic device. Automated CAD applications were analyzed to estimate their diagnostic outcome. Searching online databases for publication dates between 1985 and 2011, a total of 182 studies on dermatoscopic CAD were found. With respect to the systematic selection criterions, 9 studies were included, published between 2002 and 2011. Those studies formed databases of 14,421 dermatoscopic images including both malignant "melanoma" and benign "nevus", with 8,110 images being available ranging in resolution from 150 x 150 to 1568 x 1045 pixels. Maximum and minimum of sensitivity and specificity are 100.0% and 80.0% as well as 98.14% and 61.6%, respectively. Area under the receiver operator characteristics (AUC) and pooled sensitivity, specificity and diagnostics odds ratio are respectively 0.87, 0.90, 0.81, and 15.89. So, although that automated melanoma detection showed good accuracy in terms of sensitivity, specificity, and AUC, but diagnostic performance in terms of DOR was found to be poor. This might be due to the lack of dermatoscopic image resources (ground truth) that are needed for comprehensive assessment of diagnostic performance. In future work, we aim at testing this hypothesis by joining dermatoscopic images into a unified database that serves as a standard reference for dermatology related research in

  9. An overview of systematic review.

    PubMed

    Baker, Kathy A; Weeks, Susan Mace

    2014-12-01

    Systematic review is an invaluable tool for the practicing clinician. A well-designed systematic review represents the latest and most complete information available on a particular topic or intervention. This article highlights the key elements of systematic review, what it is and is not, and provides an overview of several reputable organizations supporting the methodological development and conduct of systematic review. Important aspects for evaluating the quality of a systematic review are also included.

  10. Effectiveness of interventions designed to reduce the use of imaging for low-back pain: a systematic review

    PubMed Central

    Jenkins, Hazel J.; Hancock, Mark J.; French, Simon D.; Maher, Chris G.; Engel, Roger M.; Magnussen, John S.

    2015-01-01

    Background: Rates of imaging for low-back pain are high and are associated with increased health care costs and radiation exposure as well as potentially poorer patient outcomes. We conducted a systematic review to investigate the effectiveness of interventions aimed at reducing the use of imaging for low-back pain. Methods: We searched MEDLINE, Embase, CINAHL and the Cochrane Central Register of Controlled Trials from the earliest records to June 23, 2014. We included randomized controlled trials, controlled clinical trials and interrupted time series studies that assessed interventions designed to reduce the use of imaging in any clinical setting, including primary, emergency and specialist care. Two independent reviewers extracted data and assessed risk of bias. We used raw data on imaging rates to calculate summary statistics. Study heterogeneity prevented meta-analysis. Results: A total of 8500 records were identified through the literature search. Of the 54 potentially eligible studies reviewed in full, 7 were included in our review. Clinical decision support involving a modified referral form in a hospital setting reduced imaging by 36.8% (95% confidence interval [CI] 33.2% to 40.5%). Targeted reminders to primary care physicians of appropriate indications for imaging reduced referrals for imaging by 22.5% (95% CI 8.4% to 36.8%). Interventions that used practitioner audits and feedback, practitioner education or guideline dissemination did not significantly reduce imaging rates. Lack of power within some of the included studies resulted in lack of statistical significance despite potentially clinically important effects. Interpretation: Clinical decision support in a hospital setting and targeted reminders to primary care doctors were effective interventions in reducing the use of imaging for low-back pain. These are potentially low-cost interventions that would substantially decrease medical expenditures associated with the management of low-back pain. PMID

  11. Computer-aided diagnosis of breast cancer using cytological images: A systematic review.

    PubMed

    Saha, Monjoy; Mukherjee, Rashmi; Chakraborty, Chandan

    2016-10-01

    Cytological evaluation by microscopic image-based characterization [imprint cytology (IC) and fine needle aspiration cytology (FNAC)] plays an integral role in primary screening/detection of breast cancer. The sensitivity of IC and FNAC as a screening tool is dependent on the image quality and the pathologist's level of expertise. Computer-aided diagnosis (CAD) is used to assists the pathologists by developing various machine learning and image processing algorithms. This study reviews the various manual and computer-aided techniques used so far in breast cytology. Diagnostic applications were studied to estimate the role of CAD in breast cancer diagnosis. This paper presents an overview of image processing and pattern recognition techniques that have been used to address several issues in breast cytology-based CAD including slide preparation, staining, microscopic imaging, pre-processing, segmentation, feature extraction and diagnostic classification. This review provides better insights to readers regarding the state of the art the knowledge on CAD-based breast cancer diagnosis to date. PMID:27528421

  12. Computer-aided diagnosis of breast cancer using cytological images: A systematic review.

    PubMed

    Saha, Monjoy; Mukherjee, Rashmi; Chakraborty, Chandan

    2016-10-01

    Cytological evaluation by microscopic image-based characterization [imprint cytology (IC) and fine needle aspiration cytology (FNAC)] plays an integral role in primary screening/detection of breast cancer. The sensitivity of IC and FNAC as a screening tool is dependent on the image quality and the pathologist's level of expertise. Computer-aided diagnosis (CAD) is used to assists the pathologists by developing various machine learning and image processing algorithms. This study reviews the various manual and computer-aided techniques used so far in breast cytology. Diagnostic applications were studied to estimate the role of CAD in breast cancer diagnosis. This paper presents an overview of image processing and pattern recognition techniques that have been used to address several issues in breast cytology-based CAD including slide preparation, staining, microscopic imaging, pre-processing, segmentation, feature extraction and diagnostic classification. This review provides better insights to readers regarding the state of the art the knowledge on CAD-based breast cancer diagnosis to date.

  13. The use of thermal imaging to monitoring skin temperature during cryotherapy: A systematic review

    NASA Astrophysics Data System (ADS)

    Matos, Filipe; Neves, Eduardo Borba; Norte, Marco; Rosa, Claudio; Reis, Victor Machado; Vilaça-Alves, José

    2015-11-01

    Cryotherapy has been applied on clinical injuries and as a method for exercise recovery. It is aimed to reduce edema, nervous conduction velocity, and tissue metabolism, as well as to accelerate the recovery process of the muscle injury induced by exercise. Objective: This review aim to investigate the applicability of thermal imaging as a method for monitoring skin temperature during cryotherapy. Method: Search the Web of Science database using the terms "Cryotherapy", "Thermography", "Thermal Image" and "Cooling". Results: Nineteen studies met the inclusion criteria and pass the PEDro scale quality evaluation. Evidence support the use of thermal imaging as a method for monitoring the skin temperature during cryotherapy, and it is superior to other contact methods and subjective methods of assessing skin temperature. Conclusion: Thermography seems to be an efficient, trustworthy and secure method in order to monitoring skin temperature during cryotherapy application. Evidence supports the use of thermography in detriment of contact methods as well as other subjective ones.

  14. Radiological Imaging for Assessing the Respectability of Hilar Cholangiocarcinoma: A Systematic Review and Meta-Analysis

    PubMed Central

    Zhang, Hongchen; Zhu, Jian; Ke, Fayong; Weng, Mingzhe; Wu, Xiangsong; Li, Maolan; Quan, Zhiwei; Liu, Yingbin; Zhang, Yong; Gong, Wei

    2015-01-01

    Hilar cholangiocarcinoma (HCC) remains one of the most difficult tumors to stage and treat. The aim of the study was to assess the diagnostic efficiency of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computer tomography (PET/CT) in evaluating the resectability of HCC. A systematic search was performed of the PubMed, EMBASE, and Cochrane databases. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for individual studies and pooled data as well as test for heterogeneity and public bias. Our data showed that CT had the highest pooled sensitivity at 95% (95% CI: 91–97), whereas PET/CT had the highest pooled specificity at 81% (95% CI: 69–90). The area under the curve (AUC) of CT, MRI, and PET/CT was 0.9269, 0.9194, and 0.9218, respectively. In conclusion, CT is the most frequently used imaging modality to assess HCC resectability with a good sensitivity and specificity. MRI was generally comparable with that of CT and can be used as an alternative imaging technique. PET/CT appears to be the best technique in detecting lymph node and distant metastasis in HCC but has no clear role in helping to evaluate issues of local resectability. PMID:26448940

  15. A systematic review of studies comparing body image concerns among female college athletes and non-athletes, 1997-2012.

    PubMed

    Varnes, Julia R; Stellefson, Michael L; Janelle, Christopher M; Dorman, Steven M; Dodd, Virginia; Miller, M David

    2013-09-01

    Research prior to 2001 indicated that athletes experienced better body image than non-athletes, with no differences among sport types. Since then, female athletes have become increasingly sexually objectified in the media, and the sociocultural beauty ideal has shifted to emphasize appearing both athletic and thin. Part I of this paper explores the literature describing these changes. Part II presents a systematic and comprehensive literature review of 10 recent studies comparing body image concerns (BIC) among collegiate female athletes and non-athletes to identify the current status of BIC in female athletes. Findings indicate that involvement in collegiate athletics provides some protection from BIC; however, this protection appears attenuated for athletes in more feminine sports (e.g., gymnastics), and higher level athletes (Division I). Researchers should examine how sociocultural pressures unrelated to competition predict female athletes' BIC using measures that focus on objectification, positive body image, body functionality, and thin- and athletic-ideal internalization.

  16. A systematic review of studies comparing body image concerns among female college athletes and non-athletes, 1997-2012.

    PubMed

    Varnes, Julia R; Stellefson, Michael L; Janelle, Christopher M; Dorman, Steven M; Dodd, Virginia; Miller, M David

    2013-09-01

    Research prior to 2001 indicated that athletes experienced better body image than non-athletes, with no differences among sport types. Since then, female athletes have become increasingly sexually objectified in the media, and the sociocultural beauty ideal has shifted to emphasize appearing both athletic and thin. Part I of this paper explores the literature describing these changes. Part II presents a systematic and comprehensive literature review of 10 recent studies comparing body image concerns (BIC) among collegiate female athletes and non-athletes to identify the current status of BIC in female athletes. Findings indicate that involvement in collegiate athletics provides some protection from BIC; however, this protection appears attenuated for athletes in more feminine sports (e.g., gymnastics), and higher level athletes (Division I). Researchers should examine how sociocultural pressures unrelated to competition predict female athletes' BIC using measures that focus on objectification, positive body image, body functionality, and thin- and athletic-ideal internalization. PMID:23856303

  17. What works in secondary schools? A systematic review of classroom-based body image programs.

    PubMed

    Yager, Zali; Diedrichs, Phillippa C; Ricciardelli, Lina A; Halliwell, Emma

    2013-06-01

    Governments, schools, and curriculum authorities are increasingly recognizing that body image during adolescence is a public health issue that warrants attention in the school setting. After 30 years of eating disorder prevention research, and given the current interest in this area, it seems timely to review the research on interventions to improve body image in schools. We reviewed universal-selective, classroom-based programs that have been conducted since the year 2000, among adolescents, and found 16 eligible intervention programs. Seven of these programs were effective in improving body image on at least one measure, from pre to post test, though effect sizes were small (d=0.22-0.48). These effective programs were conducted among younger adolescents 12.33-13.62 years, and included activities focusing on media literacy, self esteem, and the influence of peers. Implications for school personnel and curriculum authorities are discussed, and we provide recommendations for a strategic approach to future research in this area. PMID:23683611

  18. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes.

    PubMed

    Holland, Grace; Tiggemann, Marika

    2016-06-01

    A large body of literature has demonstrated mass media effects on body image and disordered eating. More recently, research in this area has turned to 'new' forms of media, such as the Internet, and particularly Social Networking Sites (SNSs). A systematic search for peer-reviewed articles on SNS use and body image and eating disorders resulted in 20 studies meeting specific inclusion criteria. As a whole, these articles demonstrated that use of SNSs is associated with body image and disordered eating. Specific SNS activities, such as viewing and uploading photos and seeking negative feedback via status updates, were identified as particularly problematic. A small number of studies also addressed underlying processes and found that appearance-based social comparison mediated the relationship between SNS use and body image and eating concerns. Gender was not found to be a moderating factor. It was concluded that, although there is a good deal of correlational research supporting the maladaptive effect of SNS use on body image and disordered eating, more longitudinal and experimental studies are needed. PMID:26995158

  19. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes.

    PubMed

    Holland, Grace; Tiggemann, Marika

    2016-06-01

    A large body of literature has demonstrated mass media effects on body image and disordered eating. More recently, research in this area has turned to 'new' forms of media, such as the Internet, and particularly Social Networking Sites (SNSs). A systematic search for peer-reviewed articles on SNS use and body image and eating disorders resulted in 20 studies meeting specific inclusion criteria. As a whole, these articles demonstrated that use of SNSs is associated with body image and disordered eating. Specific SNS activities, such as viewing and uploading photos and seeking negative feedback via status updates, were identified as particularly problematic. A small number of studies also addressed underlying processes and found that appearance-based social comparison mediated the relationship between SNS use and body image and eating concerns. Gender was not found to be a moderating factor. It was concluded that, although there is a good deal of correlational research supporting the maladaptive effect of SNS use on body image and disordered eating, more longitudinal and experimental studies are needed.

  20. Predicting muscle mass from anthropometry using magnetic resonance imaging as reference: a systematic review.

    PubMed

    Al-Gindan, Yasmin Y; Hankey, Catherine R; Leslie, Wilma; Govan, Lindsay; Lean, Michael E J

    2014-02-01

    Identification and management of sarcopenia are limited by lack of reliable simple approaches to assess muscle mass. The aim of this review is to identify and evaluate simple methods to quantify muscle mass/volume of adults. Using Cochrane Review methodology, Medline (1946-2012), Embase (1974-2012), Web of Science (1898-2012), PubMed, and the Cochrane Library (to 08/2012) were searched for publications that included prediction equations (from anthropometric measurements) to estimate muscle mass by magnetic resonance imaging (MRI) in adults. Of 257 papers identified from primary search terms, 12 studies met the inclusion criteria. Most studies (n = 10) assessed only regional/limb muscle mass/volume. Many studies (n = 9) assessed limb circumference adjusted for skinfold thickness, which limits their practical applications. Only two included validation in separate subject-samples, and two reported relationships between whole-body MRI-measured muscle mass and anthropometry beyond linear correlations. In conclusion, one simple prediction equation shows promise, but it has not been validated in a separate population with different investigators. Furthermore, it did not incorporate widely available trunk/limb girths, which have offered valuable prediction of body composition in other studies.

  1. The Reporting of Observational Clinical Functional Magnetic Resonance Imaging Studies: A Systematic Review

    PubMed Central

    Guo, Qing; Parlar, Melissa; Truong, Wanda; Hall, Geoffrey; Thabane, Lehana; McKinnon, Margaret; Goeree, Ron; Pullenayegum, Eleanor

    2014-01-01

    Introduction Complete reporting assists readers in confirming the methodological rigor and validity of findings and allows replication. The reporting quality of observational functional magnetic resonance imaging (fMRI) studies involving clinical participants is unclear. Objectives We sought to determine the quality of reporting in observational fMRI studies involving clinical participants. Methods We searched OVID MEDLINE for fMRI studies in six leading journals between January 2010 and December 2011.Three independent reviewers abstracted data from articles using an 83-item checklist adapted from the guidelines proposed by Poldrack et al. (Neuroimage 2008; 40: 409–14). We calculated the percentage of articles reporting each item of the checklist and the percentage of reported items per article. Results A random sample of 100 eligible articles was included in the study. Thirty-one items were reported by fewer than 50% of the articles and 13 items were reported by fewer than 20% of the articles. The median percentage of reported items per article was 51% (ranging from 30% to 78%). Although most articles reported statistical methods for within-subject modeling (92%) and for between-subject group modeling (97%), none of the articles reported observed effect sizes for any negative finding (0%). Few articles reported justifications for fixed-effect inferences used for group modeling (3%) and temporal autocorrelations used to account for within-subject variances and correlations (18%). Other under-reported areas included whether and how the task design was optimized for efficiency (22%) and distributions of inter-trial intervals (23%). Conclusions This study indicates that substantial improvement in the reporting of observational clinical fMRI studies is required. Poldrack et al.'s guidelines provide a means of improving overall reporting quality. Nonetheless, these guidelines are lengthy and may be at odds with strict word limits for publication; creation of a

  2. Aromatherapy: a systematic review.

    PubMed Central

    Cooke, B; Ernst, E

    2000-01-01

    Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials. PMID:10962794

  3. Magnetic Resonance Imaging of the Small Bowel in Crohn's Disease: A Systematic Review and Meta-Analysis.

    PubMed

    Ahmed, Osman; Rodrigues, David Mario; Nguyen, Geoffrey C

    2016-01-01

    Introduction. Crohn's disease is most commonly found in the terminal ileum and colonic region. Magnetic resonance has become a useful modality for assessing small bowel activity. In this study, we performed a systematic review and meta-analysis on the use of MR in detecting small bowel activity as well as extramural complications in Crohn's patients. Methods. Two independent reviewers sorted through articles until October 2, 2014. We included both studies providing raw data for pooling and studies without raw data. Sensitivity, specificity, likelihood ratios, and 95% confidence intervals were calculated for each study. Results. There were 27 included studies, of which 19 were included in the pooled analysis. Pooled analysis of the 19 studies (1020 patients) with raw data revealed a sensitivity of 0.88 (95% CI 0.86 to 0.91) and specificity was 0.88 (95% CI 0.84 to 0.91). In regard to detecting stenosis, pooled sensitivity was 0.65 (95% CI 0.53 to 0.76) and specificity was 0.93 (95% CI 0.89 to 0.96). Conclusion. MR imaging provides a reliable alternative in detecting small bowel activity in patients with Crohn's disease. Its advantages include high diagnostic accuracy and no radiation exposure while its disadvantages include high cost and limited availability. PMID:27446869

  4. Magnetic Resonance Imaging of the Small Bowel in Crohn's Disease: A Systematic Review and Meta-Analysis

    PubMed Central

    Ahmed, Osman; Rodrigues, David Mario

    2016-01-01

    Introduction. Crohn's disease is most commonly found in the terminal ileum and colonic region. Magnetic resonance has become a useful modality for assessing small bowel activity. In this study, we performed a systematic review and meta-analysis on the use of MR in detecting small bowel activity as well as extramural complications in Crohn's patients. Methods. Two independent reviewers sorted through articles until October 2, 2014. We included both studies providing raw data for pooling and studies without raw data. Sensitivity, specificity, likelihood ratios, and 95% confidence intervals were calculated for each study. Results. There were 27 included studies, of which 19 were included in the pooled analysis. Pooled analysis of the 19 studies (1020 patients) with raw data revealed a sensitivity of 0.88 (95% CI 0.86 to 0.91) and specificity was 0.88 (95% CI 0.84 to 0.91). In regard to detecting stenosis, pooled sensitivity was 0.65 (95% CI 0.53 to 0.76) and specificity was 0.93 (95% CI 0.89 to 0.96). Conclusion. MR imaging provides a reliable alternative in detecting small bowel activity in patients with Crohn's disease. Its advantages include high diagnostic accuracy and no radiation exposure while its disadvantages include high cost and limited availability. PMID:27446869

  5. Neurophysiological effects of acute oxytocin administration: systematic review and meta-analysis of placebo-controlled imaging studies

    PubMed Central

    Wigton, Rebekah; Radua, Jocham; Allen, Paul; Averbeck, Bruno; Meyer-Lindenberg, Andreas; McGuire, Philip; Shergill, Sukhi S.; Fusar-Poli, Paolo

    2015-01-01

    Background Oxytocin (OXT) plays a prominent role in social cognition and may have clinical applications for disorders such as autism, schizophrenia and social anxiety. The neural basis of its mechanism of action remains unclear. Methods We conducted a systematic literature review of placebo-controlled imaging studies using OXT as a pharmacological manipulator of brain activity. Results We identified a total of 21 studies for inclusion in our review, and after applying additional selection criteria, 11 of them were included in our fMRI voxel-based meta-analysis. The results demonstrate consistent alterations in activation of brain regions, including the temporal lobes and insula, during the processing of social stimuli, with some variation dependent on sex and task. The meta-analysis revealed significant left insular hyperactivation after OXT administration, suggesting a potential modulation of neural circuits underlying emotional processing. Limitations This quantitative review included only a limited number of studies, thus the conclusions of our analysis should be interpreted cautiously. This limited sample size precluded a more detailed exploration of potential confounding factors, such as sex or other demographic factors, that may have affected our meta-analysis. Conclusion Oxytocin has a wide range of effects over neural activity in response to social and emotional processing, which is further modulated by sex and task specificity. The magnitude of this neural activation is largest in the temporal lobes, and a meta-analysis across all tasks and both sexes showed that the left insula demonstrated the most robust activation to OXT administration. PMID:25520163

  6. Quantification of Heterogeneity as a Biomarker in Tumor Imaging: A Systematic Review

    PubMed Central

    Alic, Lejla; Niessen, Wiro J.; Veenland, Jifke F.

    2014-01-01

    Background Many techniques are proposed for the quantification of tumor heterogeneity as an imaging biomarker for differentiation between tumor types, tumor grading, response monitoring and outcome prediction. However, in clinical practice these methods are barely used. This study evaluates the reported performance of the described methods and identifies barriers to their implementation in clinical practice. Methodology The Ovid, Embase, and Cochrane Central databases were searched up to 20 September 2013. Heterogeneity analysis methods were classified into four categories, i.e., non-spatial methods (NSM), spatial grey level methods (SGLM), fractal analysis (FA) methods, and filters and transforms (F&T). The performance of the different methods was compared. Principal Findings Of the 7351 potentially relevant publications, 209 were included. Of these studies, 58% reported the use of NSM, 49% SGLM, 10% FA, and 28% F&T. Differentiation between tumor types, tumor grading and/or outcome prediction was the goal in 87% of the studies. Overall, the reported area under the curve (AUC) ranged from 0.5 to 1 (median 0.87). No relation was found between the performance and the quantification methods used, or between the performance and the imaging modality. A negative correlation was found between the tumor-feature ratio and the AUC, which is presumably caused by overfitting in small datasets. Cross-validation was reported in 63% of the classification studies. Retrospective analyses were conducted in 57% of the studies without a clear description. Conclusions In a research setting, heterogeneity quantification methods can differentiate between tumor types, grade tumors, and predict outcome and monitor treatment effects. To translate these methods to clinical practice, more prospective studies are required that use external datasets for validation: these datasets should be made available to the community to facilitate the development of new and improved methods. PMID:25330171

  7. Relationship between brain structure on magnetic resonance imaging and motor outcomes in children with cerebral palsy: a systematic review.

    PubMed

    Arnfield, Evyn; Guzzetta, Andrea; Boyd, Roslyn

    2013-07-01

    Magnetic resonance imaging (MRI) is recommended in all children with cerebral palsy (CP) where the aetiology has not been established, and the major presenting problem in CP is reduced motor capacity. A systematic review of the literature was performed to investigate the relationship between brain structure on MRI and motor outcomes in children with CP. A total of 37 studies met inclusion criteria, and were analysed in terms of (a) population characteristics, (b) MRI data, (c) motor outcome data, and (d) the relationship between MRI data and motor outcomes. All studies used a qualitative system to classify brain lesions; however, few reported information about the location and extent of lesions. Valid and reliable classifications of motor abilities were not always used, and three studies did not link motor findings to MRI features. There was, however, a relationship between the type of brain lesion on MRI and two specific motor outcomes, namely gross motor functional classification (using GMFCS) and motor type. This relationship could aid in the prediction and optimisation of early interventions for children with CP. There is also need for a quantitative MRI classification measure which includes detailed information about the location and severity of lesions.

  8. Dural arteriovenous fistulas of the hypoglossal canal: systematic review on imaging anatomy, clinical findings, and endovascular management.

    PubMed

    Spittau, Björn; Millán, Diego San; El-Sherifi, Saad; Hader, Claudia; Singh, Tejinder Pal; Motschall, Edith; Vach, Werner; Urbach, Horst; Meckel, Stephan

    2015-04-01

    Dural arteriovenous fistulas (DAVFs) of the hypoglossal canal (HCDAVFs) are rare and display a complex angiographic anatomy. Hitherto, they have been referred to as various entities (for example, "marginal sinus DAVFs") solely described in case reports or small series. In this in-depth review of HCDAVF, the authors describe clinical and imaging findings, as well as treatment strategies and subsequent outcomes, based on a systematic literature review supplemented by their own cases (120 cases total). Further, the involved craniocervical venous anatomy with variable venous anastomoses is summarized. Hypoglossal canal DAVFs consist of a fistulous pouch involving the anterior condylar confluence and/or anterior condylar vein with a variable intraosseous component. Three major types of venous drainage are associated with distinct clinical patterns: Type 1, with anterograde drainage (62.5%), mostly presents with pulsatile tinnitus; Type 2, with retrograde drainage to the cavernous sinus and/or orbital veins (23.3%), is associated with ocular symptoms and may mimic cavernous sinus DAVF; and Type 3, with cortical and/or perimedullary drainage (14.2%), presents with either hemorrhage or cervical myelopathy. For Types 1 and 2 HCDAVF, transvenous embolization demonstrates high safety and efficacy (2.9% morbidity, 92.7% total occlusion). Understanding the complex venous anatomy is crucial for planning alternative approaches if standard transjugular access is impossible. Transarterial embolization or surgical disconnection (morbidity 13.3%-16.7%) should be reserved for Type 3 HCDAVFs or lesions with poor venous access. A conservative strategy could be appropriate in Type 1 HCDAVF for which spontaneous regression (5.8%) may be observed. PMID:25415064

  9. Global myocardial strain assessment by different imaging modalities to predict outcomes after ST-elevation myocardial infarction: A systematic review

    PubMed Central

    Shetye, Abhishek; Nazir, Sheraz A; Squire, Iain B; McCann, Gerald P

    2015-01-01

    AIM: To conduct a systematic review relating myocardial strain assessed by different imaging modalities for prognostication following ST-elevation myocardial infarction (STEMI). METHODS: An online literature search was performed in PubMed and OVID® electronic databases to identify any studies that assessed global myocardial strain parameters using speckle-tracking echocardiography (STE) and/or cardiac magnetic resonance imaging (CMR) techniques [either myocardial tagging or feature tracking (FT) software] in an acute STEMI cohort (days 0-14 post-event) to predict prognosis [either development of major adverse cardiac events (MACE)] or adverse left ventricular (LV) remodelling at follow-up (≥ 6 mo for MACE, ≥ 3 mo for remodelling). Search was restricted to studies within the last 20 years. All studies that matched the pre-defined search criteria were reviewed and their results interpreted. Due to considerable heterogeneity between studies, meta-analysis was not performed. RESULTS: A total of seven studies (n = 7) were identified that matched the search criteria. All studies used STE to evaluate strain parameters - five (n = 5) assessed global longitudinal strain (GLS) (n = 5), one assessed GLS rate (GLS-R) (n = 1) and one assessed both (n = 1). Three studies showed that GLS independently predicted the development of adverse LV remodelling by multivariate analysis - odds ratio between 1.19 (CI: 1.04-1.37, P < 0.05) and 10 (CI: 6.7-14, P < 0.001) depending on the study. Four studies showed that GLS predicted the development of MACE - hazard ratio (HR) between 1.1 (CI: 1-1.1, P = 0.006) and 2.34 (1.10-4.97, P < 0.05). One paper found that GLS-R could significantly predict MACE - HR 18 (10-35, P < 0.001) - whilst another showed it did not. GLS < -10.85% had sensitivity/specificity of 89.7%/91% respectively for predicting the development of remodelling whilst GLS < -13% could predict the development of MACE with sensitivity/specificity of 100%/89% respectively. No

  10. Body Image Change in Obese and Overweight Persons Enrolled in Weight Loss Intervention Programs: A Systematic Review and Meta-Analysis

    PubMed Central

    Chao, Hai-Lun

    2015-01-01

    To report the results of a systematic review and meta-analysis examining whether weight loss interventions improve body image in obese/overweight individuals. Medline, Current Contents, and the Cochrane database were searched to identify studies involving obese/overweight adults who were enrolled in weight loss interventions in which body image was quantitatively assessed. Outcomes assessed were changes in body shape concern, body size dissatisfaction, and body satisfaction (intervention vs comparator/control group). Seven studies were included in the systematic review (4 in the meta-analysis). All but 1 study involved female participants only. The type of weight loss intervention varied between studies as did the type of control/comparator group. In 3 studies, there was no significant difference in body image outcomes, whereas in 4 studies, improvement in body image was significantly more pronounced in the intervention vs the control/comparator group. Meta-analysis revealed that improvements in body shape concern (standardized difference: -0.52; 95% confidence interval [CI]: -1.04 to 0.00), body size dissatisfaction (standardized difference: -0.66; 95% CI: -0.88 to -0.45), and body satisfaction (standardized difference: 0.74; 95% CI: 0.09 to 1.38) significantly favored the intervention over the comparator/control group (P<0.05). The results of this systematic review/meta-analysis lend support to the notion that weight loss interventions may improve body image. This is a noteworthy finding that has clear clinical applicability because body image affects psychological well-being and the ability of an individual to maintain weight loss. Future research should determine which weigh loss interventions are associated with optimal improvements in body image and maintenance of weight loss. PMID:25946138

  11. Body image change in obese and overweight persons enrolled in weight loss intervention programs: a systematic review and meta-analysis.

    PubMed

    Chao, Hai-Lun

    2015-01-01

    To report the results of a systematic review and meta-analysis examining whether weight loss interventions improve body image in obese/overweight individuals. Medline, Current Contents, and the Cochrane database were searched to identify studies involving obese/overweight adults who were enrolled in weight loss interventions in which body image was quantitatively assessed. Outcomes assessed were changes in body shape concern, body size dissatisfaction, and body satisfaction (intervention vs comparator/control group). Seven studies were included in the systematic review (4 in the meta-analysis). All but 1 study involved female participants only. The type of weight loss intervention varied between studies as did the type of control/comparator group. In 3 studies, there was no significant difference in body image outcomes, whereas in 4 studies, improvement in body image was significantly more pronounced in the intervention vs the control/comparator group. Meta-analysis revealed that improvements in body shape concern (standardized difference: -0.52; 95% confidence interval [CI]: -1.04 to 0.00), body size dissatisfaction (standardized difference: -0.66; 95% CI: -0.88 to -0.45), and body satisfaction (standardized difference: 0.74; 95% CI: 0.09 to 1.38) significantly favored the intervention over the comparator/control group (P<0.05). The results of this systematic review/meta-analysis lend support to the notion that weight loss interventions may improve body image. This is a noteworthy finding that has clear clinical applicability because body image affects psychological well-being and the ability of an individual to maintain weight loss. Future research should determine which weigh loss interventions are associated with optimal improvements in body image and maintenance of weight loss.

  12. Digital three-dimensional image fusion processes for planning and evaluating orthodontics and orthognathic surgery. A systematic review.

    PubMed

    Plooij, Joanneke M; Maal, Thomas J J; Haers, Piet; Borstlap, Wilfred A; Kuijpers-Jagtman, Anne Marie; Bergé, Stefaan J

    2011-04-01

    The three important tissue groups in orthognathic surgery (facial soft tissues, facial skeleton and dentition) can be referred to as a triad. This triad plays a decisive role in planning orthognathic surgery. Technological developments have led to the development of different three-dimensional (3D) technologies such as multiplanar CT and MRI scanning, 3D photography modalities and surface scanning. An objective method to predict surgical and orthodontic outcome should be established based on the integration of structural (soft tissue envelope, facial skeleton and dentition) and photographic 3D images. None of the craniofacial imaging techniques can capture the complete triad with optimal quality. This can only be achieved by 'image fusion' of different imaging techniques to create a 3D virtual head that can display all triad elements. A systematic search of current literature on image fusion in the craniofacial area was performed. 15 articles were found describing 3D digital image fusion models of two or more different imaging techniques for orthodontics and orthognathic surgery. From these articles it is concluded, that image fusion and especially the 3D virtual head are accurate and realistic tools for documentation, analysis, treatment planning and long term follow up. This may provide an accurate and realistic prediction model.

  13. Three-dimensional Imaging Methods for Quantitative Analysis of Facial Soft Tissues and Skeletal Morphology in Patients with Orofacial Clefts: A Systematic Review

    PubMed Central

    Kuijpers, Mette A. R.; Chiu, Yu-Ting; Nada, Rania M.; Carels, Carine E. L.; Fudalej, Piotr S.

    2014-01-01

    Background Current guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D) evaluation, but three-dimensional (3D) imaging methods to assess treatment outcome are steadily rising. Objective To identify 3D imaging methods for quantitative assessment of soft tissue and skeletal morphology in patients with cleft lip and palate. Data sources Literature was searched using PubMed (1948–2012), EMBASE (1980–2012), Scopus (2004–2012), Web of Science (1945–2012), and the Cochrane Library. The last search was performed September 30, 2012. Reference lists were hand searched for potentially eligible studies. There was no language restriction. Study selection We included publications using 3D imaging techniques to assess facial soft tissue or skeletal morphology in patients older than 5 years with a cleft lip with/or without cleft palate. We reviewed studies involving the facial region when at least 10 subjects in the sample size had at least one cleft type. Only primary publications were included. Data extraction Independent extraction of data and quality assessments were performed by two observers. Results Five hundred full text publications were retrieved, 144 met the inclusion criteria, with 63 high quality studies. There were differences in study designs, topics studied, patient characteristics, and success measurements; therefore, only a systematic review could be conducted. Main 3D-techniques that are used in cleft lip and palate patients are CT, CBCT, MRI, stereophotogrammetry, and laser surface scanning. These techniques are mainly used for soft tissue analysis, evaluation of bone grafting, and changes in the craniofacial skeleton. Digital dental casts are used to evaluate treatment and changes over time. Conclusion Available evidence implies that 3D imaging methods can be used for documentation of CLP patients. No data are available yet showing that 3D methods are more informative than conventional 2D methods. Further research

  14. A systematic review of molecular imaging (PET and SPECT) in autism spectrum disorder: current state and future research opportunities.

    PubMed

    Zürcher, Nicole R; Bhanot, Anisha; McDougle, Christopher J; Hooker, Jacob M

    2015-05-01

    Non-invasive positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are techniques used to quantify molecular interactions, biological processes and protein concentration and distribution. In the central nervous system, these molecular imaging techniques can provide critical insights into neurotransmitter receptors and their occupancy by neurotransmitters or drugs. In recent years, there has been an increase in the number of studies that have investigated neurotransmitters in autism spectrum disorder (ASD), while earlier studies mostly focused on cerebral blood flow and glucose metabolism. The underlying and contributing mechanisms of ASD are largely undetermined and ASD diagnosis relies on the behavioral phenotype. Discovery of biochemical endophenotypes would represent a milestone in autism research that could potentially lead to ASD subtype stratification and the development of novel therapeutic drugs. This review characterizes the prior use of molecular imaging by PET and SPECT in ASD, addresses methodological challenges and highlights areas of future opportunity for contributions from molecular imaging to understand ASD pathophysiology.

  15. A systematic review of image segmentation methodology, used in the additive manufacture of patient-specific 3D printed models of the cardiovascular system

    PubMed Central

    Byrne, N; Velasco Forte, M; Tandon, A; Valverde, I

    2016-01-01

    Background Shortcomings in existing methods of image segmentation preclude the widespread adoption of patient-specific 3D printing as a routine decision-making tool in the care of those with congenital heart disease. We sought to determine the range of cardiovascular segmentation methods and how long each of these methods takes. Methods A systematic review of literature was undertaken. Medical imaging modality, segmentation methods, segmentation time, segmentation descriptive quality (SDQ) and segmentation software were recorded. Results Totally 136 studies met the inclusion criteria (1 clinical trial; 80 journal articles; 55 conference, technical and case reports). The most frequently used image segmentation methods were brightness thresholding, region growing and manual editing, as supported by the most popular piece of proprietary software: Mimics (Materialise NV, Leuven, Belgium, 1992–2015). The use of bespoke software developed by individual authors was not uncommon. SDQ indicated that reporting of image segmentation methods was generally poor with only one in three accounts providing sufficient detail for their procedure to be reproduced. Conclusions and implication of key findings Predominantly anecdotal and case reporting precluded rigorous assessment of risk of bias and strength of evidence. This review finds a reliance on manual and semi-automated segmentation methods which demand a high level of expertise and a significant time commitment on the part of the operator. In light of the findings, we have made recommendations regarding reporting of 3D printing studies. We anticipate that these findings will encourage the development of advanced image segmentation methods. PMID:27170842

  16. Conventional radiography and cross-sectional imaging when planning dental implants in the anterior edentulous mandible to support an overdenture: a systematic review.

    PubMed

    Shelley, A M; Glenny, A-M; Goodwin, M; Brunton, P; Horner, K

    2014-01-01

    The objectives for this systematic review were to determine if the pre-operative availability of cross-sectional imaging, such as cone beam CT, has a diagnostic impact, therapeutic impact or impact on patients' outcome when placing two dental implants in the anterior mandible to support an overdenture. The Cochrane Oral Health Group's Trials Register (CENTRAL), MEDLINE® and Embase were searched up to, and including, February 2013. Studies were considered eligible for inclusion if they compared the impact of conventional and cross-sectional imaging when placing dental implants in sites including the anterior mandible. An adapted quality assessment tool was used for the assessment of the risk of bias in included studies. Pooled quantitative analysis was not possible and, therefore, synthesis was qualitative. Of 2374 potentially eligible papers, 5 studies were included. Little can be determined from a synthesis of these studies because of their small number, clinical diversity and high risks of bias. Notwithstanding, it may be tentatively inferred that cross-sectional imaging has a therapeutic impact in the more challenging cases. In terms of impact, this review has found no evidence to support any specific imaging modality when planning dental implant placement in any region of the mouth. Therefore, those who argue that cross-sectional imaging should be used for the assessment of all dental implant sites are unsupported by evidence.

  17. Systematic Reviews Keep Arthroscopy Up to Date.

    PubMed

    Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T; Rossi, Michael J

    2016-02-01

    Sometimes systematic reviews seem overprevalent, and some systematic reviews can be "inconclusive," which does not improve clinical decision making. On the other hand, systematic reviews can make a positive impact on patient outcomes by summarizing clinically relevant literature for arthroscopic surgeons and related researchers.

  18. Searching for non-genetic molecular and imaging PTSD risk and resilience markers: Systematic review of literature and design of the German Armed Forces PTSD biomarker study.

    PubMed

    Schmidt, Ulrike; Willmund, Gerd-Dieter; Holsboer, Florian; Wotjak, Carsten T; Gallinat, Jürgen; Kowalski, Jens T; Zimmermann, Peter

    2015-01-01

    Biomarkers allowing the identification of individuals with an above average vulnerability or resilience for posttraumatic stress disorder (PTSD) would especially serve populations at high risk for trauma exposure like firefighters, police officers and combat soldiers. Aiming to identify the most promising putative PTSD vulnerability markers, we conducted the first systematic review on potential imaging and non-genetic molecular markers for PTSD risk and resilience. Following the PRISMA guidelines, we systematically screened the PubMed database for prospective longitudinal clinical studies and twin studies reporting on pre-trauma and post-trauma PTSD risk and resilience biomarkers. Using 25 different combinations of search terms, we retrieved 8151 articles of which we finally included and evaluated 9 imaging and 27 molecular studies. In addition, we briefly illustrate the design of the ongoing prospective German Armed Forces (Bundeswehr) PTSD biomarker study (Bw-BioPTSD) which not only aims to validate these previous findings but also to identify novel and clinically applicable molecular, psychological and imaging risk, resilience and disease markers for deployment-related psychopathology in a cohort of German soldiers who served in Afghanistan.

  19. Neural responses to visual food cues according to weight status: a systematic review of functional magnetic resonance imaging studies.

    PubMed

    Pursey, Kirrilly M; Stanwell, Peter; Callister, Robert J; Brain, Katherine; Collins, Clare E; Burrows, Tracy L

    2014-01-01

    Emerging evidence from recent neuroimaging studies suggests that specific food-related behaviors contribute to the development of obesity. The aim of this review was to report the neural responses to visual food cues, as assessed by functional magnetic resonance imaging (fMRI), in humans of differing weight status. Published studies to 2014 were retrieved and included if they used visual food cues, studied humans >18 years old, reported weight status, and included fMRI outcomes. Sixty studies were identified that investigated the neural responses of healthy weight participants (n = 26), healthy weight compared to obese participants (n = 17), and weight-loss interventions (n = 12). High-calorie food images were used in the majority of studies (n = 36), however, image selection justification was only provided in 19 studies. Obese individuals had increased activation of reward-related brain areas including the insula and orbitofrontal cortex in response to visual food cues compared to healthy weight individuals, and this was particularly evident in response to energy dense cues. Additionally, obese individuals were more responsive to food images when satiated. Meta-analysis of changes in neural activation post-weight loss revealed small areas of convergence across studies in brain areas related to emotion, memory, and learning, including the cingulate gyrus, lentiform nucleus, and precuneus. Differential activation patterns to visual food cues were observed between obese, healthy weight, and weight-loss populations. Future studies require standardization of nutrition variables and fMRI outcomes to enable more direct comparisons between studies.

  20. The Emergence of Systematic Review in Toxicology.

    PubMed

    Stephens, Martin L; Betts, Kellyn; Beck, Nancy B; Cogliano, Vincent; Dickersin, Kay; Fitzpatrick, Suzanne; Freeman, James; Gray, George; Hartung, Thomas; McPartland, Jennifer; Rooney, Andrew A; Scherer, Roberta W; Verloo, Didier; Hoffmann, Sebastian

    2016-07-01

    The Evidence-based Toxicology Collaboration hosted a workshop on "The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology," on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward. We conclude with a recommendation that as various agencies and organizations adapt systematic review methods, they continue to work together to ensure that there is a harmonized process for how the basic elements of systematic review methods are applied in toxicology. PMID:27208075

  1. The Emergence of Systematic Review in Toxicology

    PubMed Central

    Stephens, Martin L.; Betts, Kellyn; Beck, Nancy B.; Cogliano, Vincent; Dickersin, Kay; Fitzpatrick, Suzanne; Freeman, James; Gray, George; Hartung, Thomas; McPartland, Jennifer; Rooney, Andrew A.; Scherer, Roberta W.; Verloo, Didier; Hoffmann, Sebastian

    2016-01-01

    The Evidence-based Toxicology Collaboration hosted a workshop on “The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology,” on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward. We conclude with a recommendation that as various agencies and organizations adapt systematic review methods, they continue to work together to ensure that there is a harmonized process for how the basic elements of systematic review methods are applied in toxicology. PMID:27208075

  2. Telemedicine Security: A Systematic Review

    PubMed Central

    Garg, Vaibhav; Brewer, Jeffrey

    2011-01-01

    Telemedicine is a technology-based alternative to traditional health care delivery. However, poor security measures in telemedicine services can have an adverse impact on the quality of care provided, regardless of the chronic condition being studied. We undertook a systematic review of 58 journal articles pertaining to telemedicine security. These articles were selected based on a keyword search on 14 relevant journals. The articles were coded to evaluate the methodology and to identify the key areas of research in security that are being reviewed. Seventy-six percent of the articles defined the security problem they were addressing, and only 47% formulated a research question pertaining to security. Sixty-one percent proposed a solution, and 20% of these tested the security solutions that they proposed. Prior research indicates inadequate reporting of methodology in telemedicine research. We found that to be true for security research as well. We also identified other issues such as using outdated security standards. PMID:21722592

  3. Telemedicine security: a systematic review.

    PubMed

    Garg, Vaibhav; Brewer, Jeffrey

    2011-05-01

    Telemedicine is a technology-based alternative to traditional health care delivery. However, poor security measures in telemedicine services can have an adverse impact on the quality of care provided, regardless of the chronic condition being studied. We undertook a systematic review of 58 journal articles pertaining to telemedicine security. These articles were selected based on a keyword search on 14 relevant journals. The articles were coded to evaluate the methodology and to identify the key areas of research in security that are being reviewed. Seventy-six percent of the articles defined the security problem they were addressing, and only 47% formulated a research question pertaining to security. Sixty-one percent proposed a solution, and 20% of these tested the security solutions that they proposed. Prior research indicates inadequate reporting of methodology in telemedicine research. We found that to be true for security research as well. We also identified other issues such as using outdated security standards.

  4. MANAGEMENT OF ENDOCRINE DISEASE: Imaging for the diagnosis of malignancy in incidentally discovered adrenal masses: a systematic review and meta-analysis

    PubMed Central

    Dinnes, Jacqueline; Bancos, Irina; Ferrante di Ruffano, Lavinia; Chortis, Vasileios; Davenport, Clare; Bayliss, Susan; Sahdev, Anju; Guest, Peter; Fassnacht, Martin; Deeks, Jonathan J

    2016-01-01

    Objective Adrenal masses are incidentally discovered in 5% of CT scans. In 2013/2014, 81 million CT examinations were undertaken in the USA and 5 million in the UK. However, uncertainty remains around the optimal imaging approach for diagnosing malignancy. We aimed to review the evidence on the accuracy of imaging tests for differentiating malignant from benign adrenal masses. Design A systematic review and meta-analysis was conducted. Methods We searched MEDLINE, EMBASE, Cochrane CENTRAL Register of Controlled Trials, Science Citation Index, Conference Proceedings Citation Index, and ZETOC (January 1990 to August 2015). We included studies evaluating the accuracy of CT, MRI, or 18F-fluoro-deoxyglucose (FDG)-PET compared with an adequate histological or imaging-based follow-up reference standard. Results We identified 37 studies suitable for inclusion, after screening 5469 references and 525 full-text articles. Studies evaluated the accuracy of CT (n=16), MRI (n=15), and FDG-PET (n=9) and were generally small and at high or unclear risk of bias. Only 19 studies were eligible for meta-analysis. Limited data suggest that CT density >10HU has high sensitivity for detection of adrenal malignancy in participants with no prior indication for adrenal imaging, that is, masses with ≤10HU are unlikely to be malignant. All other estimates of test performance are based on too small numbers. Conclusions Despite their widespread use in routine assessment, there is insufficient evidence for the diagnostic value of individual imaging tests in distinguishing benign from malignant adrenal masses. Future research is urgently needed and should include prospective test validation studies for imaging and novel diagnostic approaches alongside detailed health economics analysis. PMID:27257145

  5. Diagnostic Performance of Breast Magnetic Resonance Imaging in Non-Calcified Equivocal Breast Findings: Results from a Systematic Review and Meta-Analysis

    PubMed Central

    Bennani-Baiti, Nabila

    2016-01-01

    Objectives To evaluate the performance of MRI for diagnosis of breast cancer in non-calcified equivocal breast findings. Materials and Methods We performed a systematic review and meta-analysis of peer-reviewed studies in PubMed from 01/01/1986 until 06/15/2015. Eligible were studies applying dynamic contrast-enhanced breast MRI as an adjunct to conventional imaging (mammography, ultrasound) to clarify equivocal findings without microcalcifications. Reference standard for MRI findings had to be established by histopathological sampling or imaging follow-up of at least 12 months. Number of true or false positives and negatives and other characteristics were extracted, and possible bias was determined using the QUADAS-2 applet. Statistical analyses included data pooling and heterogeneity testing. Results Fourteen out of 514 studies comprising 2,316 lesions met our inclusion criteria. Pooled diagnostic parameters were: sensitivity (99%, 95%-CI: 93–100%), specificity (89%, 95%-CI: 85–92%), PPV (56%, 95%-CI: 42–70%) and NPV (100%, 95%-CI: 99–100%). These estimates displayed significant heterogeneity (P<0.001). Conclusions Breast MRI demonstrates an excellent diagnostic performance in case of non-calcified equivocal breast findings detected in conventional imaging. However, considering the substantial heterogeneity with regard to prevalence of malignancy, problem solving criteria need to be better defined. PMID:27482715

  6. Structural and Functional Imaging Studies in Chronic Cannabis Users: A Systematic Review of Adolescent and Adult Findings

    PubMed Central

    Batalla, Albert; Bhattacharyya, Sagnik; Yücel, Murat; Fusar-Poli, Paolo; Crippa, Jose Alexandre; Nogué, Santiago; Torrens, Marta; Pujol, Jesús; Farré, Magí; Martin-Santos, Rocio

    2013-01-01

    Background The growing concern about cannabis use, the most commonly used illicit drug worldwide, has led to a significant increase in the number of human studies using neuroimaging techniques to determine the effect of cannabis on brain structure and function. We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents. Methods Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered. Results One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks both in adolescents and adults, which may indicate compensatory effects in response to chronic cannabis exposure. Limitations However, the results pointed out methodological limitations of the work conducted to date and considerable heterogeneity in the findings. Conclusion Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives. PMID:23390554

  7. Effect of Head and Tongue Posture on the Pharyngeal Airway Dimensions and Morphology in Three-Dimensional Imaging: a Systematic Review

    PubMed Central

    Gurani, Sirwan Fernandez; Di Carlo, Gabriele; Cattaneo, Paolo M.; Thorn, Jens Jørgen

    2016-01-01

    ABSTRACT Objectives Natural head position is recommended to be optimal at cone-beam computed tomography acquisition. For standardization purposes in control of treatment outcome, it is clinically relevant to discuss, if a change of posture from natural head position may have an effect on the pharyngeal airway dimensions and morphology, during computed tomography, cone-beam computed tomography or magnetic resonance imaging acquisition. This was the aim of the present literature review study for purposes of valid evidence, which was hypothesized, to be present. Material and Methods This systematic literature review has been registered in PROSPERO database with following number: CRD42015024567. A systematic literature search performed in PubMed, Embase and Cochrane was carried out in order to evaluate if the effect of human head or tongue posture has an effect on upper airway dimensions and morphology in CT, CBCT or MRI. Study quality assessment was performed. Predictor variable was head and tongue posture. Endpoints were numerical values of upper airway dimensions and morphology. Results Overall 1344 articles (Embase 1063, PubMed 269, and Cochrane 12) resulted in four included publications. Quality assessments revealed poor quality and low-level evidence by 46 - 67% of the maximum achievable score. Heterogeneous methodology made a meta-analysis impossible, consequently a narrative synthesis was performed. Conclusions Limited, poor quality and low evidence level literature is available on the effect of head posture on upper airway dimensions and morphology in three-dimensional imaging. Valid evidence requires a standardized method of head and tongue posture during image acquisition in future studies. PMID:27099695

  8. Childhood depression: a systematic review

    PubMed Central

    Lima, Nádia Nara Rolim; do Nascimento, Vânia Barbosa; de Carvalho, Sionara Melo Figueiredo; de Abreu, Luiz Carlos; Neto, Modesto Leite Rolim; Brasil, Aline Quental; Junior, Francisco Telésforo Celestino; de Oliveira, Gislene Farias; Reis, Alberto Olavo Advíncula

    2013-01-01

    As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH]), “child” (MeSH), and “childhood depression” (keyword). Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children’s quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs concerning childhood depression are not always taken into consideration. In this context, this review demonstrated that childhood-onset depression commonly leads to other psychiatric disorders and co-morbidities. Many of the retrieved studies also confirmed the hypothesis that human resources (eg, health care team in general) are not yet adequately trained to address childhood depression. Thus, further research on the development of programs to prepare health care professionals to deal with childhood depression is needed, as well as complementary studies, with larger and more homogeneous samples, centered on prevention

  9. Systematic Review Methodology in Higher Education

    ERIC Educational Resources Information Center

    Bearman, Margaret; Smith, Calvin D.; Carbone, Angela; Slade, Susan; Baik, Chi; Hughes-Warrington, Marnie; Neumann, David L.

    2012-01-01

    Systematic review methodology can be distinguished from narrative reviews of the literature through its emphasis on transparent, structured and comprehensive approaches to searching the literature and its requirement for formal synthesis of research findings. There appears to be relatively little use of the systematic review methodology within the…

  10. Computed tomography versus magnetic resonance imaging for diagnosing cervical lymph node metastasis of head and neck cancer: a systematic review and meta-analysis

    PubMed Central

    Sun, J; Li, B; Li, CJ; Li, Y; Su, F; Gao, QH; Wu, FL; Yu, T; Wu, L; Li, LJ

    2015-01-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN) and specificity (SPE) data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73–0.87]) than MRI (0.72 [95% CI 0.70–0.74]) when node was considered as unit of analysis (P<0.05); MRI had a higher SPE (0.81 [95% CI 0.80–0.82]) than CT (0.72 [95% CI 0.69–0.74]) when neck level was considered as unit of analysis (P<0.05) and MRI had a higher area under concentration-time curve than CT when the patient was considered as unit of analysis (P<0.05). With regards to diagnostic criteria, for MRI, the results showed that the minimal axial diameter of 10 mm could be considered as the best size criterion, compared to 12 mm for CT. Overall, MRI conferred significantly higher SPE while CT demonstrated higher SEN. The diagnostic criteria for MRI and CT on size of metastatic lymph nodes were suggested as 10 and 12 mm, respectively. PMID:26089682

  11. Computed tomography versus magnetic resonance imaging for diagnosing cervical lymph node metastasis of head and neck cancer: a systematic review and meta-analysis.

    PubMed

    Sun, J; Li, B; Li, C J; Li, Y; Su, F; Gao, Q H; Wu, F L; Yu, T; Wu, L; Li, L J

    2015-01-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN) and specificity (SPE) data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73-0.87]) than MRI (0.72 [95% CI 0.70-0.74]) when node was considered as unit of analysis (P<0.05); MRI had a higher SPE (0.81 [95% CI 0.80-0.82]) than CT (0.72 [95% CI 0.69-0.74]) when neck level was considered as unit of analysis (P<0.05) and MRI had a higher area under concentration-time curve than CT when the patient was considered as unit of analysis (P<0.05). With regards to diagnostic criteria, for MRI, the results showed that the minimal axial diameter of 10 mm could be considered as the best size criterion, compared to 12 mm for CT. Overall, MRI conferred significantly higher SPE while CT demonstrated higher SEN. The diagnostic criteria for MRI and CT on size of metastatic lymph nodes were suggested as 10 and 12 mm, respectively.

  12. The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy platforms in prostate cancer detection: a systematic review.

    PubMed

    Gayet, Maudy; van der Aa, Anouk; Beerlage, Harrie P; Schrier, Bart Ph; Mulders, Peter F A; Wijkstra, Hessel

    2016-03-01

    Despite limitations considering the presence, staging and aggressiveness of prostate cancer, ultrasonography (US)-guided systematic biopsies (SBs) are still the 'gold standard' for the diagnosis of prostate cancer. Recently, promising results have been published for targeted prostate biopsies (TBs) using magnetic resonance imaging (MRI) and ultrasonography (MRI/US)-fusion platforms. Different platforms are USA Food and Drug Administration registered and have, mostly subjective, strengths and weaknesses. To our knowledge, no systematic review exists that objectively compares prostate cancer detection rates between the different platforms available. To assess the value of the different MRI/US-fusion platforms in prostate cancer detection, we compared platform-guided TB with SB, and other ways of MRI TB (cognitive fusion or in-bore MR fusion). We performed a systematic review of well-designed prospective randomised and non-randomised trials in the English language published between 1 January 2004 and 17 February 2015, using PubMed, Embase and Cochrane Library databases. Search terms included: 'prostate cancer', 'MR/ultrasound(US) fusion' and 'targeted biopsies'. Extraction of articles was performed by two authors (M.G. and A.A.) and were evaluated by the other authors. Randomised and non-randomised prospective clinical trials comparing TB using MRI/US-fusion platforms and SB, or other ways of TB (cognitive fusion or MR in-bore fusion) were included. In all, 11 of 1865 studies met the inclusion criteria, involving seven different fusion platforms and 2626 patients: 1119 biopsy naïve, 1433 with prior negative biopsy, 50 not mentioned (either biopsy naïve or with prior negative biopsy) and 24 on active surveillance (who were disregarded). The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of included articles. No clear advantage of MRI/US fusion-guided TBs was seen for cancer detection rates (CDRs) of all prostate

  13. How to read a systematic review.

    PubMed

    Hunt, D L; Haynes, R B

    2000-01-01

    A systematic review is a carefully planned and conducted study designed to answer a specific focused clinical question. A systematic review differs from the frequently encountered narrative review article. Systematic review must be completed using a prespecified methodology. The reader must ask eight important questions when reading a systematic review: (i) did the review address a focused clinical question (ii) is it likely that important, relevant studies are missed (iii) were the inclusion criteria used to select appropriate articles (iv) was the validity of the included studies assessed (v) were the assessments of studies reproducible (vi) were the results similar from study to study (vii) what were the overall results and how precise are they and (viii) will the results help in caring for patients. The article also provides sources for systematic reviews.

  14. Videoconferencing psychotherapy: a systematic review.

    PubMed

    Backhaus, Autumn; Agha, Zia; Maglione, Melissa L; Repp, Andrea; Ross, Bridgett; Zuest, Danielle; Rice-Thorp, Natalie M; Lohr, James; Thorp, Steven R

    2012-05-01

    Individuals with mental health problems may face barriers to accessing effective psychotherapies. Videoconferencing technology, which allows audio and video information to be shared concurrently across geographical distances, offers an alternative that may improve access. We conducted a systematic literature review of the use of videoconferencing psychotherapy (VCP), designed to address 10 specific questions, including therapeutic types/formats that have been implemented, the populations with which VCP is being used, the number and types of publications related to VCP, and available satisfaction, feasibility, and outcome data related to VCP. After electronic searches and reviews of reference lists, 821 potential articles were identified, and 65 were selected for inclusion. The results indicate that VCP is feasible, has been used in a variety of therapeutic formats and with diverse populations, is generally associated with good user satisfaction, and is found to have similar clinical outcomes to traditional face-to-face psychotherapy. Although the number of articles being published on VCP has increased in recent years, there remains a need for additional large-scale clinical trials to further assess the efficacy and effectiveness of VCP.

  15. Retinal implants: a systematic review.

    PubMed

    Chuang, Alice T; Margo, Curtis E; Greenberg, Paul B

    2014-07-01

    Retinal implants present an innovative way of restoring sight in degenerative retinal diseases. Previous reviews of research progress were written by groups developing their own devices. This systematic review objectively compares selected models by examining publications describing five representative retinal prostheses: Argus II, Boston Retinal Implant Project, Epi-Ret 3, Intelligent Medical Implants (IMI) and Alpha-IMS (Retina Implant AG). Publications were analysed using three criteria for interim success: clinical availability, vision restoration potential and long-term biocompatibility. Clinical availability: Argus II is the only device with FDA approval. Argus II and Alpha-IMS have both received the European CE Marking. All others are in clinical trials, except the Boston Retinal Implant, which is in animal studies. Vision restoration: resolution theoretically correlates with electrode number. Among devices with external cameras, the Boston Retinal Implant leads with 100 electrodes, followed by Argus II with 60 electrodes and visual acuity of 20/1262. Instead of an external camera, Alpha-IMS uses a photodiode system dependent on natural eye movements and can deliver visual acuity up to 20/546. Long-term compatibility: IMI offers iterative learning; Epi-Ret 3 is a fully intraocular device; Alpha-IMS uses intraocular photosensitive elements. Merging the results of these three criteria, Alpha-IMS is the most likely to achieve long-term success decades later, beyond current clinical availability. PMID:24403565

  16. Heterotopic ossification: a systematic review.

    PubMed

    Edwards, Dafydd S; Clasper, J C

    2015-12-01

    Heterotopic ossification (HO) is the formation of mature lamellar bone in extraskeletal soft tissues. It was first described 1000 years ago in the healing of fractures, and in relation to military wounds, texts from the American Civil War and World War I refer to HO specifically. It continues to cause problems to injured service personnel; the consequences of wound and soft tissue complications in traumatic amputations pose particular problems to rehabilitation and prosthetic use. While HO is seen in rare genetic conditions, it is most prevalent after joint replacement surgery and trauma. In the civilian setting HO has been commonly described in patients after traumatic brain injuries, spinal cord injuries and burns. Militarily, as a consequence of recent operations, and the characteristic injury of blast-related amputations, a renewed interest in HO has emerged due to an increased incidence seen in casualties. The heterogeneous nature of a blast related amputation makes it difficult for a single aetiological event to be identified, although it is now accepted that blast, amputation through the zone of injury, increased injury severity and associated brain injuries are significant risk factors in HO formation. The exact cellular event leading to HO has yet to be identified, and as a consequence its prevention is restricted to the use of anti-inflammatory medication and radiation, which is often contraindicated in the acute complex military casualty. A systematic review in PubMed and the Cochrane Database identified research articles related to HO to illustrate the military problem of HO and its management, current research concepts and experimental theories regarding HO. This also served as a gap analysis providing the researchers detail of any knowledge deficit in this field, in particular to the military aspects of HO; 637 out of 7891 articles initially identified that referenced HO were relevant to this review. PMID:25015927

  17. Heterotopic ossification: a systematic review.

    PubMed

    Edwards, Dafydd S; Clasper, J C

    2015-12-01

    Heterotopic ossification (HO) is the formation of mature lamellar bone in extraskeletal soft tissues. It was first described 1000 years ago in the healing of fractures, and in relation to military wounds, texts from the American Civil War and World War I refer to HO specifically. It continues to cause problems to injured service personnel; the consequences of wound and soft tissue complications in traumatic amputations pose particular problems to rehabilitation and prosthetic use. While HO is seen in rare genetic conditions, it is most prevalent after joint replacement surgery and trauma. In the civilian setting HO has been commonly described in patients after traumatic brain injuries, spinal cord injuries and burns. Militarily, as a consequence of recent operations, and the characteristic injury of blast-related amputations, a renewed interest in HO has emerged due to an increased incidence seen in casualties. The heterogeneous nature of a blast related amputation makes it difficult for a single aetiological event to be identified, although it is now accepted that blast, amputation through the zone of injury, increased injury severity and associated brain injuries are significant risk factors in HO formation. The exact cellular event leading to HO has yet to be identified, and as a consequence its prevention is restricted to the use of anti-inflammatory medication and radiation, which is often contraindicated in the acute complex military casualty. A systematic review in PubMed and the Cochrane Database identified research articles related to HO to illustrate the military problem of HO and its management, current research concepts and experimental theories regarding HO. This also served as a gap analysis providing the researchers detail of any knowledge deficit in this field, in particular to the military aspects of HO; 637 out of 7891 articles initially identified that referenced HO were relevant to this review.

  18. Telehealth Remote Monitoring Systematic Review

    PubMed Central

    Young, Heather M.; Quinn, Charlene C.

    2014-01-01

    The aim was to summarize research on telehealth remote patient monitoring interventions that incorporate key elements of structured self-monitoring of blood glucose (SMBG) identified as essential for improving A1C. A systematic review was conducted using the Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and OVID Medline databases with search terms “Telemedicine” AND “Monitoring, Physiologic” AND “Diabetes Mellitus, Type 2.” Study selection criteria included original randomized clinical trials evaluating the impact of telehealth remote patient monitoring on A1C among adults with type 2 diabetes and incorporated 1 or more essential elements of SMBG identified by the International Diabetes Federation (patient education, provider education, structured SMBG profile, SMBG goals, feedback, data used to modify treatment, interactive communication or shared decision making). Fifteen studies were included, with interventions ranging from 3 to 12 months (mean 8 months) with sample sizes from 30 to 1665. Key SMBG elements were grouped into 3 categories: education, SMBG protocols, and feedback. Research incorporating 5 of the 7 elements consistently achieved significant A1C improvements between study groups. Interventions using more SMBG elements are associated with an improvement in A1C. Studies with the largest A1C decrease incorporated 6 of the 7 elements and computer decision support. Two studies with 5 of the 7 elements and active medication management achieved significant A1C decreases. Telehealth remote patient monitoring interventions in type 2 diabetes have not included all structured monitoring elements recommended by the IDF. Incorporating more elements of structured SMBG is associated with improved A1C. PMID:24876591

  19. A Systematic Method for Search Term Selection in Systematic Reviews

    ERIC Educational Resources Information Center

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-01-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a…

  20. A systematic integrated literature review of systematic integrated literature reviews in nursing.

    PubMed

    Im, Eun-Ok; Chang, Sun Ju

    2012-11-01

    As faculty members, we frequently find that first-year doctoral students in nursing are confused about how to conduct a systematic integrated literature review. This could be due to its vague definition and a lack of recent literature that provides directions for conducting a systematic integrated literature review. This article aims to provide directions for conducting a systematic integrated literature review by identifying the essential components of published literature reviews in nursing. To achieve this goal, the literature was searched by using the keywords nursing, systematic, and review in multiple databases. A total of 267 articles were selected and are included in this systematic integrated literature review. The articles were then sorted by study design and analyzed in six areas of interests. Finally, a practical guideline for conducting systematic integrated literature reviews is proposed based on the analysis of the literature.

  1. Accuracy of imaging parameters in the prediction of lethal pulmonary hypoplasia secondary to mid-trimester prelabor rupture of fetal membranes: a systematic review and meta-analysis.

    PubMed

    van Teeffelen, A S P; Van Der Heijden, J; Oei, S G; Porath, M M; Willekes, C; Opmeer, B; Mol, B W J

    2012-05-01

    In women who have suffered mid-trimester prelabor rupture of membranes (PPROM), prediction of pulmonary hypoplasia is important for optimal management. We performed a systematic review to assess the capacity of imaging parameters to predict pulmonary hypoplasia. We searched for published articles that reported on biometric parameters and allowed the construction of a 2 × 2 table, comparing at least one of these parameters with the occurrence of pulmonary hypoplasia. The selected studies were scored on methodological quality and we calculated sensitivity and specificity of the tests in the prediction of pulmonary hypoplasia and lethal pulmonary hypoplasia. Overall performance was assessed by summary receiver-operating characteristics (sROC) analyses that were performed with bivariate meta-analysis. We detected 13 studies that reported on the prediction of lethal pulmonary hypoplasia. The quality of the included studies was poor to mediocre. The estimated sROC curves for the chest circumference/abdominal circumference ratio and other parameters showed limited accuracy in the prediction of pulmonary hypoplasia. In women with mid-trimester PPROM, the available evidence indicates limited accuracy of biometric parameters in the prediction of pulmonary hypoplasia.

  2. Systematic reviews in the field of nutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Systematic reviews are valuable tools for staying abreast of evolving nutrition and aging -related topics, formulating dietary guidelines, establishing nutrient reference intakes, formulating clinical practice guidance, evaluating health claims, and setting research agendas. Basic steps of conductin...

  3. A systematic method for search term selection in systematic reviews.

    PubMed

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-06-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a solution to this problem as they aim to synthesize all current information on a particular topic and present a balanced and unbiased summary of the findings. They are fast becoming an important method of research across a number of fields, yet only a small number of guidelines exist on how to define and select terms for a systematic search. This article presents a replicable method for selecting terms in a systematic search using the semantic concept recognition software called leximancer (Leximancer, University of Queensland, Brisbane, Australia). We use this software to construct a set of terms from a corpus of literature pertaining to transborder interventions for drug control and discuss the applicability of this method to systematic reviews in general. This method aims to contribute a more 'systematic' approach for selecting terms in a manner that is entirely replicable for any user. PMID:26052649

  4. A systematic method for search term selection in systematic reviews.

    PubMed

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-06-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a solution to this problem as they aim to synthesize all current information on a particular topic and present a balanced and unbiased summary of the findings. They are fast becoming an important method of research across a number of fields, yet only a small number of guidelines exist on how to define and select terms for a systematic search. This article presents a replicable method for selecting terms in a systematic search using the semantic concept recognition software called leximancer (Leximancer, University of Queensland, Brisbane, Australia). We use this software to construct a set of terms from a corpus of literature pertaining to transborder interventions for drug control and discuss the applicability of this method to systematic reviews in general. This method aims to contribute a more 'systematic' approach for selecting terms in a manner that is entirely replicable for any user.

  5. Worldwide inequality in production of systematic reviews

    PubMed Central

    Jamali, Arsia; Nedjat, Saharnaz; Heidari, Kazem; Jamali, Raika; Hassanpour, Kiana; Nedjat, Sima; Anvari, Pasha; Majdzadeh, Reza

    2015-01-01

    Background: Investment in science is vital for the development and well-being of societies. This study aims to assess the scientific productivity of countries by quantifying their publication of systematic reviews taking the gross national income per capita (GNIPC) into account. Methods: Medline and ISI Web of Science were searched for systematic reviews published between 1st January 2006 and 31st December 2010. The productivity of each country was quantified by exploring the authors’ affiliation. The GNIPC was used according to the World Bank Report. Concentration index (CI) was calculated as the index of inequality. Results: CI of percentage of systematic reviews as a function of percentage of countries ranked by GNIPC was 0.82 which indicates inequality in production of systematic reviews in pro rich countries. Countries with high income produced 206.23 times more systematic reviews than low income countries, while this ratio for lower middle and upper middle countries was 9.67 and 12.97, respectively. The highest concentration index was observed in clinical sciences (0.76) and the lowest in public health (0.61). Conclusion: This study demonstrates a significant gap between industrialized and nonindustrialized countries in the production of systematic reviews. Addressing this gap needs tremendous national and international efforts. PMID:26913272

  6. Oral manifestations of lymphoma: a systematic review

    PubMed Central

    Silva, Taísa Domingues Bernardes; Ferreira, Camila Belo Tavares; Leite, Gustavo Boehmer; de Menezes Pontes, José Roberto; Antunes, Héliton S

    2016-01-01

    Lymphoma is a malignant disease with two forms: Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL). Non-Hodgkin’s lymphoma is diagnosed in extranodal sites in 40% of cases, and the head and neck region is the second most affected, with an incidence of 11–33%, while HL has a very low incidence in extranodal sites (1–4%). The aim of this study was to identify the oral manifestations of lymphoma through a systematic literature review, which we conducted using the PubMed, Lilacs, Embase, and Cochrane Library databases. We found 1456 articles, from which we selected 73. Among the intraoral findings, the most frequent were ulcerations, pain, swelling, and tooth mobility, while the extraoral findings included facial asymmetry and cervical, submandibular, and submental lymphadenopathy. Among the few studies reporting imaging findings, the most cited lesions included hypodense lesions with diffuse boundaries, bone resorptions, and tooth displacements. The publications reviewed highlight gaps in the areas of early detection, diagnosis, and proper treatment. PMID:27594910

  7. Oral manifestations of lymphoma: a systematic review

    PubMed Central

    Silva, Taísa Domingues Bernardes; Ferreira, Camila Belo Tavares; Leite, Gustavo Boehmer; de Menezes Pontes, José Roberto; Antunes, Héliton S

    2016-01-01

    Lymphoma is a malignant disease with two forms: Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL). Non-Hodgkin’s lymphoma is diagnosed in extranodal sites in 40% of cases, and the head and neck region is the second most affected, with an incidence of 11–33%, while HL has a very low incidence in extranodal sites (1–4%). The aim of this study was to identify the oral manifestations of lymphoma through a systematic literature review, which we conducted using the PubMed, Lilacs, Embase, and Cochrane Library databases. We found 1456 articles, from which we selected 73. Among the intraoral findings, the most frequent were ulcerations, pain, swelling, and tooth mobility, while the extraoral findings included facial asymmetry and cervical, submandibular, and submental lymphadenopathy. Among the few studies reporting imaging findings, the most cited lesions included hypodense lesions with diffuse boundaries, bone resorptions, and tooth displacements. The publications reviewed highlight gaps in the areas of early detection, diagnosis, and proper treatment.

  8. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2014-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  9. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2013-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  10. Oral manifestations of lymphoma: a systematic review.

    PubMed

    Silva, Taísa Domingues Bernardes; Ferreira, Camila Belo Tavares; Leite, Gustavo Boehmer; de Menezes Pontes, José Roberto; Antunes, Héliton S

    2016-01-01

    Lymphoma is a malignant disease with two forms: Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). Non-Hodgkin's lymphoma is diagnosed in extranodal sites in 40% of cases, and the head and neck region is the second most affected, with an incidence of 11-33%, while HL has a very low incidence in extranodal sites (1-4%). The aim of this study was to identify the oral manifestations of lymphoma through a systematic literature review, which we conducted using the PubMed, Lilacs, Embase, and Cochrane Library databases. We found 1456 articles, from which we selected 73. Among the intraoral findings, the most frequent were ulcerations, pain, swelling, and tooth mobility, while the extraoral findings included facial asymmetry and cervical, submandibular, and submental lymphadenopathy. Among the few studies reporting imaging findings, the most cited lesions included hypodense lesions with diffuse boundaries, bone resorptions, and tooth displacements. The publications reviewed highlight gaps in the areas of early detection, diagnosis, and proper treatment. PMID:27594910

  11. Contribution of systematic reviews to management decisions.

    PubMed

    Cook, Carly N; Possingham, Hugh P; Fuller, Richard A

    2013-10-01

    Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions.

  12. Borderline Intellectual Functioning: A Systematic Literature Review

    ERIC Educational Resources Information Center

    Peltopuro, Minna; Ahonen, Timo; Kaartinen, Jukka; Seppälä, Heikki; Närhi, Vesa

    2014-01-01

    The literature related to people with borderline intellectual functioning (BIF) was systematically reviewed in order to summarize the present knowledge. Database searches yielded 1,726 citations, and 49 studies were included in the review. People with BIF face a variety of hardships in life, including neurocognitive, social, and mental health…

  13. Help Options in CALL: A Systematic Review

    ERIC Educational Resources Information Center

    Cardenas-Claros, Monica S.; Gruba, Paul A.

    2009-01-01

    This paper is a systematic review of research investigating help options in the different language skills in computer-assisted language learning (CALL). In this review, emerging themes along with is-sues affecting help option research are identified and discussed. We argue that help options in CALL are application resources that do not only seem…

  14. The Need for Systematic Reviews of Reasons

    PubMed Central

    Sofaer, Neema; Strech, Daniel

    2012-01-01

    There are many ethical decisions in the practice of health research and care, and in the creation of policy and guidelines. We argue that those charged with making such decisions need a new genre of review. The new genre is an application of the systematic review, which was developed over decades to inform medical decision-makers about what the totality of studies that investigate links between smoking and cancer, for example, implies about whether smoking causes cancer. We argue that there is a need for similarly inclusive and rigorous reviews of reason-based bioethics, which uses reasoning to address ethical questions. After presenting a brief history of the systematic review, we reject the only existing model for writing a systematic review of reason-based bioethics, which holds that such a review should address an ethical question. We argue that such a systematic review may mislead decision-makers when a literature is incomplete, or when there are mutually incompatible but individually reasonable answers to the ethical question. Furthermore, such a review can be written without identifying all the reasons given when the ethical questions are discussed, their alleged implications for the ethical question, and the attitudes taken to the reasons. The reviews we propose address instead the empirical question of which reasons have been given when addressing a specified ethical question, and present such detailed information on the reasons. We argue that this information is likely to improve decision-making, both directly and indirectly, and also the academic literature. We explain the limitations of our alternative model for systematic reviews. PMID:21521251

  15. Dental insurance: A systematic review.

    PubMed

    Garla, Bharath Kumar; Satish, G; Divya, K T

    2014-12-01

    To review uses of finance in dentistry. A search of 25 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Insurance has come of ages and has become the mainstay of payment in many developed countries. So much so that all the alternative forms of payment which originated as an alternative to fee for service now depend on insurance at one point or the other. Fee for service is still the major form of payment in many developing countries including India. It is preferred in many instances since the payment is made immediately. PMID:25558454

  16. Dental insurance: A systematic review

    PubMed Central

    Garla, Bharath Kumar; Satish, G.; Divya, K. T.

    2014-01-01

    To review uses of finance in dentistry. A search of 25 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Insurance has come of ages and has become the mainstay of payment in many developed countries. So much so that all the alternative forms of payment which originated as an alternative to fee for service now depend on insurance at one point or the other. Fee for service is still the major form of payment in many developing countries including India. It is preferred in many instances since the payment is made immediately. PMID:25558454

  17. Systematic reviews and knowledge translation.

    PubMed Central

    Tugwell, Peter; Robinson, Vivian; Grimshaw, Jeremy; Santesso, Nancy

    2006-01-01

    Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence. We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies. We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings. PMID:16917652

  18. Composite inlays: a systematic review.

    PubMed

    Grivas, E; Roudsari, R V; Satterthwaite, J D

    2014-09-01

    The purpose of this study is to review the available literature related to composite inlays. Electronic databases published up to November 2013 were searched. Studies that evaluate composite resin inlays for the restoration of posterior teeth were selected. The studies should compare composite inlays against gold inlays, ceramic inlays and direct composite fillings regarding longevity, aesthetic quality and postoperative sensitivity or comparing the clinical effectiveness of them on premolars versus molars or on 1-2 surface preparations versus multi-surface preparations. Despite the heterogeneity of the available clinical trials composite inlays seem to be an effective method for the restoration of posterior teeth. PMID:25831713

  19. Composite inlays: a systematic review.

    PubMed

    Grivas, E; Roudsari, R V; Satterthwaite, J D

    2014-09-01

    The purpose of this study is to review the available literature related to composite inlays. Electronic databases published up to November 2013 were searched. Studies that evaluate composite resin inlays for the restoration of posterior teeth were selected. The studies should compare composite inlays against gold inlays, ceramic inlays and direct composite fillings regarding longevity, aesthetic quality and postoperative sensitivity or comparing the clinical effectiveness of them on premolars versus molars or on 1-2 surface preparations versus multi-surface preparations. Despite the heterogeneity of the available clinical trials composite inlays seem to be an effective method for the restoration of posterior teeth.

  20. A systematic review of busways

    SciTech Connect

    Martinelli, D.R.

    1996-05-01

    Busways are controlled-access facilities dedicated for bus service separated from general traffic. The concept of busways was first given serious consideration in the 1960s; however, only a few of them have been constructed in North America. This paper examines the potential of busway transit in providing urban environments with cost-effective mobility. The review makes the case that there are some misconceptions concerning the cost and level-of-service characteristics of busways. In the final section, a comparison is made between busways and their most prominent competitor, light rail. The comparison is done in the framework of the four most cited advantages of light rail, and concludes that busways, in most cases, are likely to be a superior mode of transit to light rail.

  1. Systematic review of water fluoridation

    PubMed Central

    McDonagh, Marian S; Whiting, Penny F; Wilson, Paul M; Sutton, Alex J; Chestnutt, Ivor; Cooper, Jan; Misso, Kate; Bradley, Matthew; Treasure, Elizabeth; Kleijnen, Jos

    2000-01-01

    Objective To review the safety and efficacy of fluoridation of drinking water. Design Search of 25 electronic databases and world wide web. Relevant journals hand searched; further information requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Main outcome measures Decayed, missing, and filled primary/permanent teeth. Proportion of children without caries. Measure of effect was the difference in change in prevalence of caries from baseline to final examination in fluoridated compared with control areas. For potential adverse effects, all outcomes reported were used. Results 214 studies were included. The quality of studies was low to moderate. Water fluoridation was associated with an increased proportion of children without caries and a reduction in the number of teeth affected by caries. The range (median) of mean differences in the proportion of children without caries was −5.0% to 64% (14.6%). The range (median) of mean change in decayed, missing, and filled primary/permanent teeth was 0.5 to 4.4 (2.25) teeth. A dose-dependent increase in dental fluorosis was found. At a fluoride level of 1 ppm an estimated 12.5% (95% confidence interval 7.0% to 21.5%) of exposed people would have fluorosis that they would find aesthetically concerning. Conclusions The evidence of a beneficial reduction in caries should be considered together with the increased prevalence of dental fluorosis. There was no clear evidence of other potential adverse effects. PMID:11021861

  2. Challenges of Systematic Reviewing Integrative Health Care

    PubMed Central

    Coulter, Ian D.; Khorsan, Raheleh; Crawford, Cindy; Hsiao, An-Fu

    2013-01-01

    This article is based on an extensive review of integrative medicine (IM) and integrative health care (IHC). Since there is no general agreement of what constitutes IM/IHC, several major problems were identified that make the review of work in this field problematic. In applying the systematic review methodology, we found that many of those captured articles that used the term integrative medicine were in actuality referring to adjunctive, complementary, or supplemental medicine. The objective of this study was to apply a sensitivity analysis to demonstrate how the results of a systematic review of IM and IHC will differ according to what inclusion criteria is used based on the definition of IM/IHC. By analyzing 4 different scenarios, the authors show that, due to unclear usage of these terms, results vary dramatically, exposing an inconsistent literature base for this field. PMID:23843689

  3. Systematic reviews: gatekeepers of nursing knowledge.

    PubMed

    Evans, D; Pearson, A

    2001-09-01

    The past few decades have seen a considerable increase in the number of available health care products and interventions. This growth has been matched by a similar expansion in the health care literature. As a result of these factors, the demand for evidence to support practice is growing, but finding the best evidence is becoming increasingly difficult. In response, the use of systematic reviews is increasing and they are starting to replace the primary research as the basis for health care decisions. To date, these reviews have focused predominantly on effectiveness and so have been limited to randomized controlled trials. As a result of this, the interpretive, observational and descriptive research methods that are utilized by nursing have commonly been either excluded from the review or are classified as 'low level' evidence. To address this, nursing must participate in the development of systematic review methods that better answer the questions posed by the profession.

  4. Ostomy care and management: a systematic review.

    PubMed

    Recalla, Stacy; English, Kim; Nazarali, Rishma; Mayo, Samantha; Miller, Debbie; Gray, Mikel

    2013-01-01

    The frequency of ostomy surgery in Canada is not known, but it is estimated that approximately 13,000 ostomy surgeries are performed annually in Canada. This systematic review incorporates evidence for the assessment and management of colostomies, ileostomies, and urostomies, as well as the peristomal skin. The review was completed as part of a best practice guideline document generated by a task force appointed by the Registered Nurses' Association of Ontario.

  5. Treatment of Childhood Obesity: A Systematic Review

    ERIC Educational Resources Information Center

    Staniford, Leanne J.; Breckon, Jeff D.; Copeland, Robert J.

    2012-01-01

    Childhood obesity trends have increased dramatically over the past three decade's. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment…

  6. Mobile text messaging for health: a systematic review of reviews.

    PubMed

    Hall, Amanda K; Cole-Lewis, Heather; Bernhardt, Jay M

    2015-03-18

    The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness.

  7. [Medical indications for acupuncture: Systematic review].

    PubMed

    Muñoz-Ortego, Juan; Solans-Domènech, Maite; Carrion, Carme

    2016-09-16

    Acupuncture is a medical procedure with a very wide range of indications according to the WHO. However the indications require robust scientific evidence to support them. We have conducted a systematic review (2010-2015) in order to define in which pathologies acupuncture can be an effective strategy, STRICTA criteria that aim to set up acupuncture clinical trials standard criteria were defined in 2010. Only systematic reviews and meta-analyses of good or very good methodological quality according to SIGN criteria were selected. Its main objective was to evaluate the effectiveness of acupuncture in the management of any disease. Most of the final 31 selected reviews focus on chronic pain-related diseases, mainly in the disciplines of Neurology, Orthopaedics and Rheumatology. Current evidence supports the use of acupuncture in the treatment of headaches, migraines, back pain, cervical pain and osteoarthritis. The remaining pathologies still require further good quality studies.

  8. [Medical indications for acupuncture: Systematic review].

    PubMed

    Muñoz-Ortego, Juan; Solans-Domènech, Maite; Carrion, Carme

    2016-09-16

    Acupuncture is a medical procedure with a very wide range of indications according to the WHO. However the indications require robust scientific evidence to support them. We have conducted a systematic review (2010-2015) in order to define in which pathologies acupuncture can be an effective strategy, STRICTA criteria that aim to set up acupuncture clinical trials standard criteria were defined in 2010. Only systematic reviews and meta-analyses of good or very good methodological quality according to SIGN criteria were selected. Its main objective was to evaluate the effectiveness of acupuncture in the management of any disease. Most of the final 31 selected reviews focus on chronic pain-related diseases, mainly in the disciplines of Neurology, Orthopaedics and Rheumatology. Current evidence supports the use of acupuncture in the treatment of headaches, migraines, back pain, cervical pain and osteoarthritis. The remaining pathologies still require further good quality studies. PMID:27080096

  9. Ideal timing of orchiopexy: a systematic review.

    PubMed

    Chan, Emily; Wayne, Carolyn; Nasr, Ahmed

    2014-01-01

    The ideal management of cryptorchidism is a highly debated topic within the field of pediatric surgery. The optimal timing of orchiopexy is particularly unclear, as existing literature reports mixed recommendations. The aim of this study was to determine, based on a systematic review, the most favorable age at which orchiopexy should be performed. We conducted a systematic search of MEDLINE, Embase, CINAHL, and the Cochrane Library to find relevant articles. Two researchers quality assessed each study using the following tools: AMSTAR (systematic reviews), Jadad (RCTs), and MINORS (non-RCTs). We developed a conclusion based on the highest quality studies. We found one relevant systematic review, one RCT, and 30 non-RCTs. Fertility potential was greatest when orchiopexy was performed before 1 year of age. Additionally, orchiopexy before 10–11 years may protect against the increased risk of testicular cancer associated with cryptorchidism. Orchiopexy should not be performed before 6 months of age, as testes may descend spontaneously during the first few months of life. The highest quality evidence recommends orchiopexy between 6 and 12 months of age. Surgery during this timeframe may optimize fertility potential and protect against testicular malignancy in children with cryptorchidism. PMID:24232174

  10. Aging techniques for deep vein thrombosis: a systematic review.

    PubMed

    Dharmarajah, B; Sounderajah, V; Rowland, S P; Leen, E L S; Davies, A H

    2015-03-01

    Deep vein thrombosis is common with an incidence of 1 in 1000. Acute thrombus removal for extensive proximal deep vein thrombosis using catheter-directed techniques highlights the need for accurate assessment of thrombus age. This systematic review summarises experimental and clinical evidence of imaging techniques for aging deep vein thrombosis. Ultrasound elastography and magnetic resonance imaging were highlighted as the most studied imaging modalities. Elastography was shown to distinguish between acute and chronic clots, despite demonstrating difficulty in accurate aging of clots older than 10 days in rat models. Elastography is noted as a feasible adjunct to current first-line imaging for deep vein thrombosis using duplex ultrasonography. Combinations of magnetic resonance imaging techniques can identify acute, sub-acute and chronic thrombi using endogenous contrast agents and provide objective standardisation of the diagnostic process, with reduced onus upon operator dependency. Further validation is required of these novel imaging techniques prior to clinical implementation for deep vein thrombosis aging.

  11. Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis Describing the Diagnostic Accuracy of History, Physical Exam, Imaging, and Lumbar Puncture with an Exploration of Test Thresholds

    PubMed Central

    Carpenter, Christopher R.; Hussain, Adnan M.; Ward, Michael J.; Zipfel, Gregory J.; Fowler, Susan; Pines, Jesse M.; Sivilotti, Marco L.A.

    2016-01-01

    Background Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic. Objectives To perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH. A secondary objective was to delineate probability of disease thresholds for imaging and lumbar puncture (LP). Methods PUBMED, EMBASE, SCOPUS, and research meeting abstracts were searched up to June 2015 for studies of emergency department (ED) patients with acute headache clinically concerning for spontaneous SAH. QUADAS-2 was used to assess study quality and, when appropriate, meta-analysis was conducted using random effects models. Outcomes were sensitivity, specificity, positive (LR+) and negative (LR−) likelihood ratios. To identify test- and treatment-thresholds, we employed the Pauker-Kassirer method with Bernstein test-indication curves using the summary estimates of diagnostic accuracy. Results A total of 5,022 publications were identified, of which 122 underwent full text-review; 22 studies were included (average SAH prevalence 7.5%). Diagnostic studies differed in assessment of history and physical exam findings, CT technology, analytical techniques used to identify xanthochromia, and criterion standards for SAH. Study quality by QUADAS-2 was variable; however, most had a relatively low-risk of biases. A history of neck pain (LR+ 4.1 [95% CI 2.2-7.6]) and neck stiffness on physical exam (LR+ 6.6 [4.0-11.0]) were the individual findings most strongly associated with SAH. Combinations of findings may rule out SAH, yet promising clinical decision rules await external validation. Non-contrast cranial CT within 6 hours of headache onset accurately ruled-in (LR+ 230 [6-8700]) and ruled-out SAH (LR− 0

  12. Systematic reviews of complex interventions: framing the review question.

    PubMed

    Squires, Janet E; Valentine, Jeffrey C; Grimshaw, Jeremy M

    2013-11-01

    The first and most important decision in preparing any systematic review is to clearly frame the question the review team seeks to answer. However, this is not always straightforward, particularly if synthesis teams are interested in the effects of complex interventions. In this article, we discuss how to formulate good systematic review questions of complex interventions. We describe the rationale for developing well-formulated review questions and review the existing guidance on formulating review questions. We discuss that complex interventions can contain a mix of effective and ineffective (or even harmful) actions, which may interact synergistically or dysynergistically or be interdependent, and how these interactions and interdependencies need to be considered when formulating systematic review questions. We discuss complexity specifically in terms of how it relates to the type of question, the scope of the review (i.e., lumping vs. splitting debate), and specification of the intervention. We offer several recommendations to assist review authors in developing a definition for their complex intervention of interest, which is an essential first step in formulating the review question. We end by identifying areas in which future methodological research aimed at improving question formulation, especially as it relates to complex interventions, is needed.

  13. Sarcopenia in lung transplantation: a systematic review.

    PubMed

    Rozenberg, Dmitry; Wickerson, Lisa; Singer, Lianne G; Mathur, Sunita

    2014-12-01

    Lung transplant candidates and recipients have significant impairments in skeletal muscle mass, strength and function--individual measures of sarcopenia. Skeletal muscle dysfunction has been observed in the pre-transplant and post-transplant period and could have an important effect on transplant outcomes. A systematic review was performed to characterize the techniques used to study sarcopenia and assess the level of impairment throughout the transplant process. Electronic databases were searched (inception to July 2013) for prospective studies measuring at least 1 element of sarcopenia (muscle mass, strength, or function) in lung transplant patients. Eighteen studies were included, and study quality was assessed using the Downs and Black scale. A variety of measurements were used to evaluate sarcopenia in 694 lung transplant patients. Muscle mass in 7 studies was assessed using bioelectrical impedance (n = 4), computed tomography or magnetic resonance imaging (n = 2), or skin folds (n = 1), and was significantly reduced. Quadriceps strength was examined in 14 studies with computerized dynamometer (n = 10) and hand-held dynamometer (n = 4). Quadriceps strength was reduced in the pre-transplant period (mean range, 49%-86% predicted; n = 455 patients), further reduced immediately after transplant (51%-72%, n = 126), and improved beyond 3 months after transplant (58%-101%, n = 164). Only 2 studies measured lower extremity function (sit-to-stand test). A multitude of measurement techniques have been used to assess individual measures of sarcopenia, with reduced muscle mass and quadriceps strength observed in the pre-transplant and post-transplant period. Further standardization of measurement techniques is needed to assess the clinical effect of sarcopenia in lung transplantation.

  14. 10 CFR 1045.43 - Systematic review for declassification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Systematic review for declassification. 1045.43 Section... Systematic review for declassification. (a) The Secretary shall ensure that RD documents, and the DoD shall... Classification (and with the DoD for FRD) to ensure the systematic review of RD and FRD documents. (c) Review...

  15. Public health interventions in midwifery: a systematic review of systematic reviews

    PubMed Central

    2012-01-01

    Background Maternity care providers, particularly midwives, have a window of opportunity to influence pregnant women about positive health choices. This aim of this paper is to identify evidence of effective public health interventions from good quality systematic reviews that could be conducted by midwives. Methods Relevant databases including MEDLINE, Pubmed, EBSCO, CRD, MIDIRS, Web of Science, The Cochrane Library and Econlit were searched to identify systematic reviews in October 2010. Quality assessment of all reviews was conducted. Results Thirty-six good quality systematic reviews were identified which reported on effective interventions. The reviews were conducted on a diverse range of interventions across the reproductive continuum and were categorised under: screening; supplementation; support; education; mental health; birthing environment; clinical care in labour and breast feeding. The scope and strength of the review findings are discussed in relation to current practice. A logic model was developed to provide an overarching framework of midwifery public health roles to inform research policy and practice. Conclusions This review provides a broad scope of high quality systematic review evidence and definitively highlights the challenge of knowledge transfer from research into practice. The review also identified gaps in knowledge around the impact of core midwifery practice on public health outcomes and the value of this contribution. This review provides evidence for researchers and funders as to the gaps in current knowledge and should be used to inform the strategic direction of the role of midwifery in public health in policy and practice. PMID:23134701

  16. Nasal Septal Deviations: A Systematic Review of Classification Systems

    PubMed Central

    Teixeira, Jeffrey; Certal, Victor; Chang, Edward T.; Camacho, Macario

    2016-01-01

    Objective. To systematically review the international literature for internal nasal septal deviation classification systems and summarize them for clinical and research purposes. Data Sources. Four databases (including PubMed/MEDLINE) were systematically searched through December 16, 2015. Methods. Systematic review, adhering to PRISMA. Results. After removal of duplicates, this study screened 952 articles for relevance. A final comprehensive review of 50 articles identified that 15 of these articles met the eligibility criteria. The classification systems defined in these articles included C-shaped, S-shaped, reverse C-shaped, and reverse S-shaped descriptions of the septal deviation in both the cephalocaudal and anteroposterior dimensions. Additional studies reported use of computed tomography and categorized deviation based on predefined locations. Three studies graded the severity of septal deviations based on the amount of deflection. The systems defined in the literature also included an evaluation of nasal septal spurs and perforations. Conclusion. This systematic review ascertained that the majority of the currently published classification systems for internal nasal septal deviations can be summarized by C-shaped or reverse C-shaped, as well as S-shaped or reverse S-shaped deviations in the anteroposterior and cephalocaudal dimensions. For imaging studies, predefined points have been defined along the septum. Common terminology can facilitate future research. PMID:26933510

  17. Medical Imaging: A Review

    NASA Astrophysics Data System (ADS)

    Ganguly, Debashis; Chakraborty, Srabonti; Balitanas, Maricel; Kim, Tai-Hoon

    The rapid progress of medical science and the invention of various medicines have benefited mankind and the whole civilization. Modern science also has been doing wonders in the surgical field. But, the proper and correct diagnosis of diseases is the primary necessity before the treatment. The more sophisticate the bio-instruments are, better diagnosis will be possible. The medical images plays an important role in clinical diagnosis and therapy of doctor and teaching and researching etc. Medical imaging is often thought of as a way to represent anatomical structures of the body with the help of X-ray computed tomography and magnetic resonance imaging. But often it is more useful for physiologic function rather than anatomy. With the growth of computer and image technology medical imaging has greatly influenced medical field. As the quality of medical imaging affects diagnosis the medical image processing has become a hotspot and the clinical applications wanting to store and retrieve images for future purpose needs some convenient process to store those images in details. This paper is a tutorial review of the medical image processing and repository techniques appeared in the literature.

  18. Adipokines and Migraine: A Systematic Review

    PubMed Central

    Peterlin, B. Lee; Sacco, Simona; Bernecker, Claudia; Scher, Ann I.

    2016-01-01

    Background Migraine is comorbid with obesity. Recent research suggests an association between migraine and adipocytokines, proteins that are predominantly secreted from adipose tissue and which participate in energy homeostasis and inflammatory processes. Objectives In this review, we first briefly discuss the association between migraine and obesity and the importance of adipose tissue as a neuroendocrine organ. We then present a systematic review of the extant literature evaluating circulating levels of adiponectin and leptin in those with migraine. Methods A search of the PubMed database was conducted using the keywords “migraine,” “adiponectin,” and “leptin.” In addition reference lists of relevant articles were reviewed for possible inclusion. English language studies published between 2005 and 2015 evaluating circulating blood concentration of adiponectin or leptin in those with migraine were included. Conclusions While the existing data are suggestive that adipokines may be associated with migraine, substantial study design differences and conflicting results limit definitive conclusions. Future research utilizing carefully considered designs and methodology is warranted. In particular careful and systematic characterization of pain states at the time of samples, as well as systematic consideration of demographic (eg, age, sex) and other vital covariates (eg, obesity status, lipids) are needed to determine if adipokines play a role in migraine pathophysiology and if any adipokine represents a viable, novel migraine biomarker, or drug target. PMID:27012149

  19. Educational attainment and obesity: A systematic review

    PubMed Central

    Cohen, Alison K.; Rai, Manisha; Rehkopf, David H.; Abrams, Barbara

    2013-01-01

    Background Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. Methods The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese, and Spanish were included. Results This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables, and/or attempted to assess causality through the use of quasi-experimental designs. Conclusions Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention. PMID:23889851

  20. Evidence-based interventions to reduce adverse events in hospitals: a systematic review of systematic reviews

    PubMed Central

    Zegers, Marieke; Hesselink, Gijs; Geense, Wytske; Vincent, Charles; Wollersheim, Hub

    2016-01-01

    Objective To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. Design Systematic review of systematic reviews. Data sources PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October 2015. Study selection English-language systematic reviews of interventions aimed at reducing adverse events in hospitals, including studies with an experimental design and reporting adverse event rates, were included. Two reviewers independently assessed each study's quality and extracted data on the study population, study design, intervention characteristics and adverse patient outcomes. Results Sixty systematic reviews with moderate to high quality were included. Statistically significant pooled effect sizes were found for 14 types of interventions, including: (1) multicomponent interventions to prevent delirium; (2) rapid response teams to reduce cardiopulmonary arrest and mortality rates; (3) pharmacist interventions to reduce adverse drug events; (4) exercises and multicomponent interventions to prevent falls; and (5) care bundle interventions, checklists and reminders to reduce infections. Most (82%) of the significant effect sizes were based on 5 or fewer primary studies with an experimental study design. Conclusions The evidence for patient-safety interventions implemented in hospitals worldwide is weak. The findings address the need to invest in high-quality research standards in order to identify interventions that have a real impact on patient safety. Interventions to prevent delirium, cardiopulmonary arrest and mortality, adverse drug events, infections and falls are most effective and should therefore be prioritised by clinicians. PMID:27687901

  1. Systematic reviews in bioethics: types, challenges, and value.

    PubMed

    McDougall, Rosalind

    2014-02-01

    There has recently been interest in applying the techniques of systematic review to bioethics literature. In this paper, I identify the three models of systematic review proposed to date in bioethics: systematic reviews of empirical bioethics research, systematic reviews of normative bioethics literature, and systematic reviews of reasons. I argue that all three types yield information useful to scholarship in bioethics, yet they also face significant challenges particularly in relation to terminology and time. Drawing on my recent experience conducting a systematic review, I suggest that complete comprehensiveness may not always be an appropriate goal of a literature review in bioethics, depending on the research question. In some cases, all the relevant ideas may be captured without capturing all the relevant literature. I conclude that systematic reviews in bioethics have an important role to play alongside the traditional broadbrush approach to reviewing literature in bioethics.

  2. 12 CFR 403.6 - Systematic review for declassification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Systematic review for declassification. 403.6..., AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION § 403.6 Systematic review for declassification... permanent retention will be subject to systematic declassification review by the Archivist in...

  3. 32 CFR 2400.20 - Systematic review for declassification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Systematic review for declassification. 2400.20... SECURITY PROGRAM Declassification and Downgrading § 2400.20 Systematic review for declassification. (a) Permanent records. Systematic review is applicable only to those classified records, and presidential...

  4. 32 CFR 2001.31 - Systematic declassification review.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Systematic declassification review. 2001.31... Declassification § 2001.31 Systematic declassification review. (a) General. Agencies shall establish systematic review programs for those records containing information exempted from automatic declassification....

  5. Health effects of indebtedness: a systematic review

    PubMed Central

    2014-01-01

    Background In the aftermath of the global financial crisis, millions of households have been left with debts that they are unable to manage. Indebtedness may impair the wellbeing of those affected by it for years to come. This systematic review focuses on the long-term consequences of indebtedness on health. Methods The method used in the paper is a systematic review. First, bibliographic databases were searched for peer-reviewed articles. Second, the references and citations of the included articles were searched for additional articles. Results The results from our sample of 33 peer-reviewed studies demonstrate serious health effects related to indebtedness. Individuals with unmet loan payments had suicidal ideation and suffered from depression more often than those without such financial problems. Unpaid financial obligations were also related to poorer subjective health and health-related behaviour. Debt counselling and other programmes to mitigate debt-related stress are needed to alleviate the adverse effects of indebtedness on health. Conclusions The results demonstrate that indebtedness has serious effects on health. PMID:24885280

  6. Latino Veterans with PTSD: A Systematic Review

    PubMed Central

    Pittman, James O. E.

    2014-01-01

    Latinos have a long history of military service with recent service including combat conditions and multiple deployments, which are highly associated with posttraumatic stress disorder (PTSD). Clinical acumen underscores the importance of culture in assessment and treatment, but there has been little scientific literature that investigates the unique needs of veteran Latinos with PTSD. The primary goal of this systematic review was to analyze the existing literature on Latino veterans with PTSD and to critically evaluate attention to cultural issues. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to guide this review. Peer-reviewed, research reports written in English on Latino Veterans with PTSD since 1980 were included; 20 were assessment related, and nine were treatment related. All studies were quantitative. Only 13 studies mentioned culture as part of the context for Latino veterans, and only seven included cultural factors as part of the study design. Present findings highlight a lack of research focused on understanding cultural factors related to the assessment and treatment of Latino veterans with PTSD. Culturally-informed research on Latino veterans from current wars, Latina veterans and Latino veteran treatment outcomes are necessary to provide culturally-appropriate care to this growing veteran subgroup. PMID:25379284

  7. Vending machine assessment methodology. A systematic review.

    PubMed

    Matthews, Melissa A; Horacek, Tanya M

    2015-07-01

    The nutritional quality of food and beverage products sold in vending machines has been implicated as a contributing factor to the development of an obesogenic food environment. How comprehensive, reliable, and valid are the current assessment tools for vending machines to support or refute these claims? A systematic review was conducted to summarize, compare, and evaluate the current methodologies and available tools for vending machine assessment. A total of 24 relevant research studies published between 1981 and 2013 met inclusion criteria for this review. The methodological variables reviewed in this study include assessment tool type, study location, machine accessibility, product availability, healthfulness criteria, portion size, price, product promotion, and quality of scientific practice. There were wide variations in the depth of the assessment methodologies and product healthfulness criteria utilized among the reviewed studies. Of the reviewed studies, 39% evaluated machine accessibility, 91% evaluated product availability, 96% established healthfulness criteria, 70% evaluated portion size, 48% evaluated price, 52% evaluated product promotion, and 22% evaluated the quality of scientific practice. Of all reviewed articles, 87% reached conclusions that provided insight into the healthfulness of vended products and/or vending environment. Product healthfulness criteria and complexity for snack and beverage products was also found to be variable between the reviewed studies. These findings make it difficult to compare results between studies. A universal, valid, and reliable vending machine assessment tool that is comprehensive yet user-friendly is recommended.

  8. A systematic review of school drug education.

    PubMed

    McBride, Nyanda

    2003-12-01

    This paper provides an up-to-date systematic review of the school drug education literature (to June 2001) and identifies components that have the potential for creating effective drug education programmes in schools. This paper is a summary of a 150-page review. The review adopts a well-defined search methodology, specific selection criteria, and has made a series of recommendations based on the findings of past reviews and recent primary studies that met the selection criteria. The review is inclusive of reviews and recent primary studies that involved young people in school settings that encompassed a classroom intervention, included drug-related behavioural measures and had a positive impact on students' drug-related behaviours. The review identifies several areas that should be the focus of future programmes. These include timing and programming issues, content and delivery issues, teacher training, and dissemination. There is much refinement that can occur in school drug education implementation and research. The way forward is to continue to create and test interventions that bring together all components of the development, implementation and evaluation of school drug education that are effective in creating behaviour change, and that are practical to the school setting. PMID:14654505

  9. Identifying Lesbian, Gay, Bisexual, and Transgender Search Terminology: A Systematic Review of Health Systematic Reviews.

    PubMed

    Lee, Joseph G L; Ylioja, Thomas; Lackey, Mellanye

    2016-01-01

    Research on the health of lesbian, gay, bisexual, and transgender (LGBT) populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28-29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching.

  10. Child maltreatment prevention: a systematic review of reviews

    PubMed Central

    Butchart, Alexander

    2009-01-01

    Abstract Objective To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence. Methods A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures. Findings The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven – home-visiting, parent education, abusive head trauma prevention and multi-component interventions – show promise in preventing actual child maltreatment. Three of them – home visiting, parent education and child sexual abuse prevention – appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base. Conclusion Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries. PMID:19551253

  11. The prevalence of stillbirths: a systematic review

    PubMed Central

    Say, Lale; Donner, Allan; Gülmezoglu, A Metin; Taljaard, Monica; Piaggio, Gilda

    2006-01-01

    Background Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. Obtaining overall estimates across various regions of the world is not straightforward due to variation in definitions, data collection methods and reporting. Methods We conducted a systematic review of a range of pregnancy-related conditions including stillbirths and performed meta-analysis of the subset of studies reporting stillbirth rates. We examined variation across rates and used meta-regression techniques to explain observed variation. Results We identified 389 articles on stillbirth prevalence among the 2580 included in the systematic review. We included 70 providing 80 data sets from 50 countries in the meta-analysis. Pooled prevalence rates show variation across various subgroup categories. Rates per 100 births are higher in studies conducted in less developed country settings as compared to more developed (1.17 versus 0.50), of inadequate quality as compared to adequate (1.12 versus 0.66), using sub-national sample as compared to national (1.38 versus 0.68), reporting all stillbirths as compared to late stillbirths (0.95 versus 0.63), published in non-English as compared to English (0.91 versus 0.59) and as journal articles as compared to non-journal (1.37 versus 0.67). The results of the meta-regression show the significance of two predictor variables – development status of the setting and study quality – on stillbirth prevalence. Conclusion Stillbirth prevalence at the community level is typically less than 1% in more developed parts of the world and could exceed 3% in less developed regions. Regular reviews of stillbirth rates in appropriately designed and reported studies are useful in monitoring the adequacy of care. Systematic reviews of prevalence studies are helpful in explaining sources of variation across rates. Exploring these methodological issues will lead to improved standards for assessing the burden of reproductive ill

  12. Improving the uptake of systematic reviews: a systematic review of intervention effectiveness and relevance

    PubMed Central

    Wallace, John; Byrne, Charles; Clarke, Mike

    2014-01-01

    Objective Little is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved. Selection criteria Studies were included if they addressed interventions enhancing the uptake of systematic reviews. Reports in any language were included. All decisionmakers were eligible. Studies could be randomised trials, cluster-randomised trials, controlled-clinical trials and before-and-after studies. Data sources We searched 19 databases including PubMed, EMBASE and The Cochrane Library, covering the full range of publication years from inception to December 2010. Two reviewers independently extracted data and assessed quality according to the Effective Practice and Organisation of Care criteria. Results 10 studies from 11 countries, containing 12 interventions met our criteria. Settings included a hospital, a government department and a medical school. Doctors, nurses, mid-wives, patients and programme managers were targeted. Six of the studies were geared to improving knowledge and attitudes while four targeted clinical practice. Synthesis of results Three studies of low-to-moderate risk of bias, identified interventions that showed a statistically significant improvement: educational visits, short summaries of systematic reviews and targeted messaging. Promising interventions include e-learning, computer-based learning, inactive workshops, use of knowledge brokers and an e-registry of reviews. Juxtaposing barriers and facilitators alongside the identified interventions, it was clear that the three effective approaches addressed a wide range of barriers and facilitators. Discussion A limited number of studies were found for inclusion. However, the extensive literature search is one of the strengths of this review. Conclusions Targeted messaging, educational visits and summaries are recommended to enhance systematic review uptake. Identified

  13. Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal

    PubMed Central

    Wiysonge, Charles Shey; Kamadjeu, Raoul; Tsague, Landry

    2016-01-01

    Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment. In each case, one study would rarely yield sufficient evidence on which to reliably base a healthcare decision. An unbiased and transparent summary of all existing studies on a given question (i.e. a systematic review) tells a better story than any one of the included studies taken separately. A systematic review enables producers and users of research to gauge what a new study has contributed to knowledge by setting the study’s findings in the context of all previous studies investigating the same question. It is therefore inappropriate to initiate a new study without first conducting a systematic review to find out what can be learnt from existing studies. There is nothing new in taking account of earlier studies in either the design or interpretation of new studies. For example, in the 18th century James Lind conducted a clinical trial followed by a systematic review of contemporary treatments for scurvy; which showed fruits to be an effective treatment for the disease. However, surveys of the peer-reviewed literature continue to provide empirical evidence that systematic reviews are seldom used in the design and interpretation of the findings of new studies. Such indifference to systematic reviews as a research function is unethical, unscientific, and uneconomical. Without systematic reviews, limited resources are very likely to be squandered on ill-conceived research and policies. In order to

  14. Reporting and Handling Missing Outcome Data in Mental Health: A Systematic Review of Cochrane Systematic Reviews and Meta-Analyses

    ERIC Educational Resources Information Center

    Spineli, Loukia M.; Pandis, Nikolaos; Salanti, Georgia

    2015-01-01

    Objectives: The purpose of the study was to provide empirical evidence about the reporting of methodology to address missing outcome data and the acknowledgement of their impact in Cochrane systematic reviews in the mental health field. Methods: Systematic reviews published in the Cochrane Database of Systematic Reviews after January 1, 2009 by…

  15. Advanced nursing roles: a systematic review.

    PubMed

    Jokiniemi, Krista; Pietilä, Anna-Maija; Kylmä, Jari; Haatainen, Kaisa

    2012-09-01

    In this systematic literature review, we analyzed and synthesized the literature on one specialized advance practice nursing role in three countries for the purpose of describing and comparing these roles, as well as discussing whether an international consensus of the advance practice nursing definition is possible. A systematic search on CINAHL and PubMed Medline was conducted in 2011 to search the literature on the nurse consultant in the UK, the clinical nurse specialist in the USA, and the clinical nurse consultant in Australia. The studies (n = 42) were analyzed and combined using qualitative content analysis method. The roles of the nurse consultant, clinical nurse specialist, and clinical nurse consultant were similar. The variation in the roles appears to derive from organizational or individual choices, not the country in question. The study process comprised a synthesized representation of one specialized advance practice nursing role. More work is needed to further define the concept of the advance practice nursing, as well as its implementation on other cultures beyond this review. Based on this review, an international consensus regarding the definition of advance practice nursing and its subroles is possible. PMID:22950621

  16. Melatonin influence in ovary transplantation: systematic review.

    PubMed

    Shiroma, M E; Botelho, N M; Damous, L L; Baracat, E C; Soares-Jr, J M

    2016-01-01

    Melatonin is an indolamine produced by the pineal gland and it can exert a potent antioxidant effect. Its free radical scavenger properties have been used to advantage in different organ transplants in animal experiments. Several concentrations and administration pathways have been tested and melatonin has shown encouraging beneficial results in many transplants of organs such as the liver, lungs, heart, pancreas, and kidneys. The objective of the present study was to review the scientific literature regarding the use of melatonin in ovary transplantation. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was carried out using the Cochrane and Pubmed databases and employing the terms 'melatonin' AND 'ovary' AND 'transplantation.' After analysis, 5 articles were extracted addressing melatonin use in ovary transplants and involving 503 animals. Melatonin enhanced various graft aspects like morphology, apoptosis, immunological reaction, revascularization, oxidative stress, and survival rate. Melatonin's antioxidative and antiapoptotic properties seemingly produce positive effects on ovarian graft activity. Despite the promising results, further studies in humans need to be conducted to consolidate its use, as ovary transplantation for fertility preservation is gradually being moved from the experimental stage to a clinical setting. PMID:27287621

  17. Inuit Elderly: A Systematic Review of Peer Reviewed Journal Articles.

    PubMed

    Somogyi, Balvinder K; Barker, Melanie; MacLean, Calvin; Grischkan, Pamela

    2015-01-01

    Over the last century, Inuit have experienced rapid social changes that have greatly impacted their way of life, health, and intergenerational traditions. Although there is a growing body of research concerning Inuit youth, relatively little is known about elderly Inuit. In an effort to bridge this knowledge gap, a systematic review of peer-reviewed journal articles was conducted. This review identified a dearth of research on older Inuit, and highlighted limitations in service provision to this primarily rural and isolated population. Implications for policy and practice and recommendations for future research are also discussed.

  18. Genetic variation and dopamine D2 receptor availability: a systematic review and meta-analysis of human in vivo molecular imaging studies

    PubMed Central

    Gluskin, B S; Mickey, B J

    2016-01-01

    The D2 dopamine receptor mediates neuropsychiatric symptoms and is a target of pharmacotherapy. Inter-individual variation of D2 receptor density is thought to influence disease risk and pharmacological response. Numerous molecular imaging studies have tested whether common genetic variants influence D2 receptor binding potential (BP) in humans, but demonstration of robust effects has been limited by small sample sizes. We performed a systematic search of published human in vivo molecular imaging studies to estimate effect sizes of common genetic variants on striatal D2 receptor BP. We identified 21 studies examining 19 variants in 11 genes. The most commonly studied variant was a single-nucleotide polymorphism in ANKK1 (rs1800497, Glu713Lys, also called ‘Taq1A'). Fixed- and random-effects meta-analyses of this variant (5 studies, 194 subjects total) revealed that striatal BP was significantly and robustly lower among carriers of the minor allele (Lys713) relative to major allele homozygotes. The weighted standardized mean difference was −0.57 under the fixed-effect model (95% confidence interval=(−0.87, −0.27), P=0.0002). The normal relationship between rs1800497 and BP was not apparent among subjects with neuropsychiatric diseases. Significant associations with baseline striatal D2 receptor BP have been reported for four DRD2 variants (rs1079597, rs1076560, rs6277 and rs1799732) and a PER2 repeat polymorphism, but none have yet been tested in more than two independent samples. Our findings resolve apparent discrepancies in the literature and establish that rs1800497 robustly influences striatal D2 receptor availability. This genetic variant is likely to contribute to important individual differences in human striatal function, neuropsychiatric disease risk and pharmacological response. PMID:26926883

  19. Tinnitus and arterial hypertension: a systematic review.

    PubMed

    Figueiredo, Ricardo Rodrigues; de Azevedo, Andréia Aparecida; Penido, Norma de Oliveira

    2015-11-01

    Tinnitus is considered a multi-factorial symptom. Arterial hypertension has been cited as a tinnitus etiological factor. To assess the scientific evidence on the associations between arterial hypertension and tinnitus. A systematic review was performed using PubMed, ISI Web, Lilacs and SciELO scientific databases. This review included articles published in Portuguese, Spanish, French and English correlating tinnitus with hypertension. Letters to editors and case reports were excluded. A total of 424 articles were identified, of which only 20 met the inclusion criteria. Studies that analyzed the incidence of hypertension in tinnitus patients tended to show an association, while those that evaluated the incidence of tinnitus in hypertensive patients did not. There is evidence of an association between tinnitus and hypertension, although a cause and effect relationship is uncertain. Changes in the cochlear microcirculation, resulting in hearing loss, may be an adjuvant factor in tinnitus pathophysiology.

  20. Effectiveness of Reablement: A Systematic Review

    PubMed Central

    Beaulieu, Marie-Dominique; Mcginn, Carrie Anna; Latulippe, Renée

    2016-01-01

    The ageing of the population and the increasing need for long-term care services are global issues. Some countries have adapted homecare programs by introducing an intervention called reablement, which is aimed at optimizing independence. The effectiveness of reablement, as well as its different service models, was examined. A systematic literature review was conducted using MEDLINE, CINAHL, PsycINFO and EBM Reviews to search from 2001 to 2014. Core characteristics and facilitators of reablement implementation were identified from international experiences. Ten studies comprising a total of 14,742 participants (including four randomized trials, most of excellent or good quality) showed a positive impact of reablement, especially on health-related quality of life and service utilization. The implementation of reablement was studied in three regions, and all observed a reduction in healthcare service utilization. Considering its effectiveness and positive impact observed in several countries, the implementation of reablement is a promising avenue to be pursued by policy makers. PMID:27232236

  1. Pharmaceutical supply chain risks: a systematic review

    PubMed Central

    2013-01-01

    Introduction Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. Objective In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Methods Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Results Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. Conclusion It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies. PMID:24355166

  2. Enteral nutrition in dementia: a systematic review.

    PubMed

    Brooke, Joanne; Ojo, Omorogieva

    2015-04-03

    The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

  3. Systematic Review of Breastfeeding and Herbs

    PubMed Central

    Budzynska, Katarzyna; Gardner, Zoë E.; Dugoua, Jean-Jacques; Low Dog, Tieraona

    2012-01-01

    Abstract Objectives Despite popular and historical use, there has been little modern research conducted to determine the safety and efficacy of herb use during breastfeeding. The purpose of this study was to systematically review the clinical literature on herbal medicine and lactation. Methods The databases PubMed, CAB Abstracts, Cochrane Central Register of Controlled Trials, HealthSTAR, Cumulative Index to Nursing and Allied Health Literature, and Reprotox were systematically searched for human trials from 1970 until 2010. Reference lists from relevant articles were hand-searched. Results Thirty-two studies met the inclusion criteria. Clinical studies were divided into three categories: survey studies (n=11), safety studies (n=8), and efficacy studies (n=13). Six studies were randomized controlled trials. The most common herbs studied were St. John's wort (Hypericum perforatum L.) (n=3), garlic (Allium sativum L.) extract (n=2), and senna (Cassia senna L.) (n=2). Studies were very heterogeneous with regard to study design, herbal intervention, and outcome measures. Overall, poor methodological quality predominated among the studies. Conclusions Our review concludes that further research is needed to assess the prevalence, efficacy, and safety of commonly used herbs during breastfeeding. PMID:22686865

  4. How to conduct systematic reviews more expeditiously?

    PubMed

    Tsertsvadze, Alexander; Chen, Yen-Fu; Moher, David; Sutcliffe, Paul; McCarthy, Noel

    2015-01-01

    Healthcare consumers, researchers, patients and policy makers increasingly use systematic reviews (SRs) to aid their decision-making process. However, the conduct of SRs can be a time-consuming and resource-intensive task. Often, clinical practice guideline developers or other decision-makers need to make informed decisions in a timely fashion (e.g. outbreaks of infection, hospital-based health technology assessments). Possible approaches to address the issue of timeliness in the production of SRs are to (a) implement process parallelisation, (b) adapt and apply innovative technologies, and/or (c) modify SR processes (e.g. study eligibility criteria, search sources, data extraction or quality assessment). Highly parallelised systematic reviewing requires substantial resources to support a team of experienced information specialists, reviewers and methodologists working alongside with clinical content experts to minimise the time for completing individual review steps while maximising the parallel progression of multiple steps. Effective coordination and management within the team and across external stakeholders are essential elements of this process. Emerging innovative technologies have a great potential for reducing workload and improving efficiency of SR production. The most promising areas of application would be to allow automation of specific SR tasks, in particular if these tasks are time consuming and resource intensive (e.g. language translation, study selection, data extraction). Modification of SR processes involves restricting, truncating and/or bypassing one or more SR steps, which may risk introducing bias to the review findings. Although the growing experiences in producing various types of rapid reviews (RR) and the accumulation of empirical studies exploring potential bias associated with specific SR tasks have contributed to the methodological development for expediting SR production, there is still a dearth of research examining the actual

  5. Work-related leukemia: a systematic review

    PubMed Central

    2013-01-01

    Leukemia is a complex disease, which only became better understood during the last decades following the development of new laboratory techniques and diagnostic methods. Despite our improved understanding of the physiology of the disease, little is yet known about the causes of leukemia. A variety of potential risk factors have been suggested so far, including personal habits and lifestyle, and a wide range of occupational or environmental exposures. A causal association with leukemia has only been documented to date for ionizing radiation, benzene and treatment with cytostatic drugs, but there is an ongoing scientific debate on the possible association of leukemia with a number of other work-related hazards. In this article, we have reviewed scientific studies, published over the past 5 years, which investigated potential associations between leukemia and exposure to occupational risk factors. The systematic literature review took place via electronic databases, using specific search criteria, and independent reviewers have further filtered the search results to identify the number of articles, presented in our paper. A large number of studies included in the review referred to the effects of ionizing radiation, where new data suggest that the effects of exposure to small doses of ionizing radiation should probably be reevaluated. Some other works appear to substantiate a potential association of the disease with certain pesticides. Further research is also suggested regarding the role of infectious agents or exposure to certain chemicals like formaldehyde or butadiene in the pathogenesis of leukemia. PMID:23697536

  6. Processing of food, body and emotional stimuli in anorexia nervosa: a systematic review and meta-analysis of functional magnetic resonance imaging studies.

    PubMed

    Zhu, Yikang; Hu, Xiaochen; Wang, Jijun; Chen, Jue; Guo, Qian; Li, Chunbo; Enck, Paul

    2012-11-01

    The characteristics of the cognitive processing of food, body and emotional information in patients with anorexia nervosa (AN) are debatable. We reviewed functional magnetic resonance imaging studies to assess whether there were consistent neural basis and networks in the studies to date. Searching PubMed, Ovid, Web of Science, The Cochrane Library and Google Scholar between January 1980 and May 2012, we identified 17 relevant studies. Activation likelihood estimation was used to perform a quantitative meta-analysis of functional magnetic resonance imaging studies. For both food stimuli and body stimuli, AN patients showed increased hemodynamic response in the emotion-related regions (frontal, caudate, uncus, insula and temporal) and decreased activation in the parietal region. Although no robust brain activation has been found in response to emotional stimuli, emotion-related neural networks are involved in the processing of food and body stimuli among AN. It suggests that negative emotional arousal is related to cognitive processing bias of food and body stimuli in AN.

  7. Interventions to delay functional decline in people with dementia: a systematic review of systematic reviews

    PubMed Central

    Laver, Kate; Dyer, Suzanne; Whitehead, Craig; Clemson, Lindy; Crotty, Maria

    2016-01-01

    Objective To summarise existing systematic reviews that assess the effects of non-pharmacological, pharmacological and alternative therapies on activities of daily living (ADL) function in people with dementia. Design Overview of systematic reviews. Methods A systematic search in the Cochrane Database of Systematic Reviews, DARE, Medline, EMBASE and PsycInfo in April 2015. Systematic reviews of randomised controlled trials conducted in people with Alzheimer's disease or dementia measuring the impact on ADL function were included. Methodological quality of the systematic reviews was independently assessed by two authors using the AMSTAR tool. The quality of evidence of the primary studies for each intervention was assessed using GRADE. Results A total of 23 systematic reviews were included in the overview. The quality of the reviews varied; however most (65%) scored 8/11 or more on the AMSTAR tool, indicating high quality. Interventions that were reported to be effective in minimising decline in ADL function were: exercise (6 studies, 289 participants, standardised mean difference (SMD) 0.68, 95% CI 0.08 to 1.27; GRADE: low), dyadic interventions (8 studies, 988 participants, SMD 0.37, 95% CI 0.05 to 0.69; GRADE: low) acetylcholinesterase inhibitors and memantine (12 studies, 4661 participants, donepezil 10 mg SMD 0.18, 95% CI 0.03 to 0.32; GRADE: moderate), selegiline (7 studies, 810 participants, SMD 0.27, 95% CI 0.13 to 0.41; GRADE: low), huperzine A (2 studies, 70 participants, SMD 1.48, 95% CI 0.95 to 2.02; GRADE: very low) and Ginkgo biloba (7 studies, 2530 participants, SMD 0.36, 95% CI 0.28 to 0.44; GRADE: very low). Conclusions Healthcare professionals should ensure that people with dementia are encouraged to exercise and that primary carers are trained and supported to provide safe and effective care for the person with dementia. Acetylcholinesterase inhibitors or memantine should be trialled unless contraindicated. Trial registration number CRD

  8. Maternal Intensive Care’: a systematic literature review

    PubMed Central

    Van Parys, A.S.; Verstraelen, H.; Roelens, K.; Temmerman, M.

    2010-01-01

    Objective: The objective of this systematic literature review is to review current scientific knowledge on the definition of and the indications for maternal/obstetric intensive care (MIC). Methods: We conducted a extensive search in OVID MEDLINE, EMBASE, COCHRANE, CINHAL and CEBAM using the keywords: maternal/obstetric intensive care, subacute care, intermediate care, postacute care, critical care, sub intensive care, progressive patient care, postnatal care, perinatal care, obstetrical nursing, neonatology, pregnancy, maternal mortality/morbidity and pregnancy complication. A total of 180 articles and one guideline were identified and supplemented by a hand search. After title, abstract and full text evaluation, the articles and guideline were subjected to critical appraisal. Results: Out of 180 potentially relevant articles, we identified 44 eligible articles of which 14 relevant MIC-articles of relatively good quality were selected. The concept ‘maternal intensive care’ was not found elsewhere, “high-dependency care” and “obstetrical intermediate care” appeared to be best comparable to what is understood as a MIC-service in Belgium. This thorough literature search resulted in a limited amount of scientific literature, with most studies retrospective observational tertiary centre based. No clear definition and admission criteria for maternal intensive care were found. Conclusion: This systematic literature review revealed that 1) there is no standard definition of maternal intensive care and 2) that admission criteria to a MIC unit differ widely. Further research is needed to create an evidence-based triage system to help clinicians attribute women to the appropriate level of care and thus stimulate an efficient utilization of maternal/obstetric intensive care services. PMID:25013706

  9. Determinants of patient adherence: a review of systematic reviews

    PubMed Central

    Kardas, Przemyslaw; Lewek, Pawel; Matyjaszczyk, Michal

    2013-01-01

    Purpose: A number of potential determinants of medication non-adherence have been described so far. However, the heterogenic quality of existing publications poses the need for the use of a rigorous methodology in building a list of such determinants. The purpose of this study was a systematic review of current research on determinants of patient adherence on the basis of a recently agreed European consensus taxonomy and terminology. Methods: MEDLINE, EMBASE, CINAHL, Cochrane Library, IPA, and PsycINFO were systematically searched for systematic reviews published between 2000/01/01 and 2009/12/31 that provided determinants on non-adherence to medication. The searches were limited to reviews having adherence to medication prescribed by health professionals for outpatient as a major topic. Results: Fifty-one reviews were included in this review, covering 19 different disease categories. In these reviews, exclusively assessing non-adherence to chronic therapies, 771 individual factor items were identified, of which most were determinants of implementation, and only 47—determinants of persistence with medication. Factors with an unambiguous effect on adherence were further grouped into 8 clusters of socio-economic-related factors, 6 of healthcare team- and system-related factors, 6 of condition-related factors, 6 of therapy-related factors, and 14 of patient-related factors. The lack of standardized definitions and use of poor measurement methods resulted in many inconsistencies. Conclusions: This study provides clear evidence that medication non-adherence is affected by multiple determinants. Therefore, the prediction of non-adherence of individual patients is difficult, and suitable measurement and multifaceted interventions may be the most effective answer toward unsatisfactory adherence. The limited number of publications assessing determinants of persistence with medication, and lack of those providing determinants of adherence to short-term treatment identify

  10. Identifying Lesbian, Gay, Bisexual, and Transgender Search Terminology: A Systematic Review of Health Systematic Reviews

    PubMed Central

    Lee, Joseph G. L.; Ylioja, Thomas; Lackey, Mellanye

    2016-01-01

    Research on the health of lesbian, gay, bisexual, and transgender (LGBT) populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28–29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching. PMID:27219460

  11. Identifying Lesbian, Gay, Bisexual, and Transgender Search Terminology: A Systematic Review of Health Systematic Reviews.

    PubMed

    Lee, Joseph G L; Ylioja, Thomas; Lackey, Mellanye

    2016-01-01

    Research on the health of lesbian, gay, bisexual, and transgender (LGBT) populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28-29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching. PMID:27219460

  12. Surgery for epilepsy: a systematic review of current evidence.

    PubMed

    West, Siobhan; Nolan, Sarah J; Newton, Richard

    2016-06-01

    This seminar discusses the history and development of techniques for surgical intervention for people with refractory focal epilepsy. Published surgical success rates and prognostic factors associated with post-operative seizure freedom from individual studies have been variable and contradictory. We present here the key findings of a Cochrane systematic review of all evidence published since the introduction of magnetic resonance imaging (MRI) to pre-operative surgical assessment in 1984. Our findings show the usefulness of uncontrolled case series is now past. Future studies with a prospective controlled design should focus on specific research questions to help improve results and provide better-informed advice. PMID:27193634

  13. Systematic reviews of research in science education: rigour or rigidity?

    NASA Astrophysics Data System (ADS)

    Bennett, Judith; Lubben, Fred; Hogarth, Sylvia; Campbell, Bob

    2005-04-01

    This paper explores the role of systematic reviews of research literature and considers what they have to offer research in science education. The origins of systematic reviews are described, together with the reasons why they are currently attracting considerable attention in the research literature. An overview is presented of the key features of systematic review methods, illustrating with examples from two systematic reviews undertaken in science education -- one on aspects of small-group work in science lessons, and the other on the effects on pupils of context-based and Science-Technology-Society approaches. Issues raised by systematic reviews in terms of characterizing research studies and making judgements about their quality are then discussed. Finally, systematic reviews are compared with more traditional narrative reviews to identify ways in which they can contribute to the undertaking of research studies in a science education.

  14. Contribution of Systematic Reviews to Management Decisions

    PubMed Central

    COOK, CARLY N; POSSINGHAM, HUGH P; FULLER, RICHARD A

    2014-01-01

    Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions. Contribuciones de las Revisiones Sistemáticas a las

  15. Systematic review on cashew nut allergy.

    PubMed

    van der Valk, J P M; Dubois, A E J; Gerth van Wijk, R; Wichers, H J; de Jong, N W

    2014-06-01

    Recent studies on cashew nut allergy suggest that the prevalence of cashew nut allergy is increasing. Cashew nut consumption by allergic patients can cause severe reactions, including anaphylaxis. This review summarizes current knowledge on cashew nut allergy to facilitate timely clinical recognition and to promote awareness of this emerging food allergy amongst clinicians. The goal of this study is to present a systematic review focused on the clinical aspects of allergy to cashew nut including the characteristics of cashew nut, the prevalence, allergenic components, cross-reactivity, diagnosis and management of cashew nut allergy. The literature search yielded 255 articles of which 40 met our selection criteria and were considered to be relevant for this review. The 40 articles included one prospective study, six retrospective studies and seven case reports. The remaining 26 papers were not directly related to cashew nut allergy. The literature suggests that the prevalence of cashew nut allergy is increasing, although the level of evidence for this is low. A minimal amount of cashew nut allergen may cause a severe allergic reaction, suggesting high potency comparable with other tree nuts and peanuts. Cashew allergy is clearly an underestimated important healthcare problem, especially in children. PMID:24734868

  16. Systematic review on cashew nut allergy.

    PubMed

    van der Valk, J P M; Dubois, A E J; Gerth van Wijk, R; Wichers, H J; de Jong, N W

    2014-06-01

    Recent studies on cashew nut allergy suggest that the prevalence of cashew nut allergy is increasing. Cashew nut consumption by allergic patients can cause severe reactions, including anaphylaxis. This review summarizes current knowledge on cashew nut allergy to facilitate timely clinical recognition and to promote awareness of this emerging food allergy amongst clinicians. The goal of this study is to present a systematic review focused on the clinical aspects of allergy to cashew nut including the characteristics of cashew nut, the prevalence, allergenic components, cross-reactivity, diagnosis and management of cashew nut allergy. The literature search yielded 255 articles of which 40 met our selection criteria and were considered to be relevant for this review. The 40 articles included one prospective study, six retrospective studies and seven case reports. The remaining 26 papers were not directly related to cashew nut allergy. The literature suggests that the prevalence of cashew nut allergy is increasing, although the level of evidence for this is low. A minimal amount of cashew nut allergen may cause a severe allergic reaction, suggesting high potency comparable with other tree nuts and peanuts. Cashew allergy is clearly an underestimated important healthcare problem, especially in children.

  17. Systematic review of public health branding.

    PubMed

    Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L

    2008-12-01

    Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

  18. Triterpenes with healing activity: A systematic review.

    PubMed

    Agra, Lais C; Ferro, Jamylle N S; Barbosa, Fabiano T; Barreto, Emiliano

    2015-10-01

    The purpose of this review was to systematically evaluate the literature on the efficacy of triterpenes for wound healing. We searched for original studies in the Medline, SCIDIRECT and LILACS databases published from 1910 to 2013. For each study, the title, abstract and full article were evaluated by two reviewers. We identified 2181 studies; however, after application of the inclusion and exclusion criteria, only 12 studies were subjected to further review. In surgical wounds, the triterpenes induced a reduction in time to closure, and this effect was reported in virtually all wound types. Triterpenes also modulate the production of ROS in the wound microenvironment, accelerating the process of tissue repair. Triterpenes may also induce cell migration, cell proliferation and collagen deposition. Although the pharmacological effects of triterpenes are well characterized, little is known about their effects in cells involved in healing, such as keratinocytes and fibroblasts. In addition, the lack of studies on the risks associated with the therapeutic use of triterpenes is worrisome. Our study reveals that triterpenes seem to favor wound healing; however, toxicological studies with these compounds are required. Taken together, these findings show that the triterpenes are a class of molecules with significant promise that leads for the development of new drugs to treat skin injury.

  19. Cognitive impairment in COPD: a systematic review*

    PubMed Central

    Torres-Sánchez, Irene; Rodríguez-Alzueta, Elisabeth; Cabrera-Martos, Irene; López-Torres, Isabel; Moreno-Ramírez, Maria Paz; Valenza, Marie Carmen

    2015-01-01

    The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD. PMID:25909154

  20. Triterpenes with healing activity: A systematic review.

    PubMed

    Agra, Lais C; Ferro, Jamylle N S; Barbosa, Fabiano T; Barreto, Emiliano

    2015-10-01

    The purpose of this review was to systematically evaluate the literature on the efficacy of triterpenes for wound healing. We searched for original studies in the Medline, SCIDIRECT and LILACS databases published from 1910 to 2013. For each study, the title, abstract and full article were evaluated by two reviewers. We identified 2181 studies; however, after application of the inclusion and exclusion criteria, only 12 studies were subjected to further review. In surgical wounds, the triterpenes induced a reduction in time to closure, and this effect was reported in virtually all wound types. Triterpenes also modulate the production of ROS in the wound microenvironment, accelerating the process of tissue repair. Triterpenes may also induce cell migration, cell proliferation and collagen deposition. Although the pharmacological effects of triterpenes are well characterized, little is known about their effects in cells involved in healing, such as keratinocytes and fibroblasts. In addition, the lack of studies on the risks associated with the therapeutic use of triterpenes is worrisome. Our study reveals that triterpenes seem to favor wound healing; however, toxicological studies with these compounds are required. Taken together, these findings show that the triterpenes are a class of molecules with significant promise that leads for the development of new drugs to treat skin injury. PMID:25893368

  1. Subthreshold depression in adolescence: a systematic review.

    PubMed

    Bertha, Eszter A; Balázs, Judit

    2013-10-01

    In adolescence, the number of depressive symptoms is rising notably. Individuals may have relevant depressive symptoms without meeting the full criteria of a major depressive episode (MDE), a condition referred to as subthreshold depression (sD). This article presents a review on adolescent sD examining the prevalence, the quality of life (QoL), the risk of developing MDE, and preventive programs available for adolescents living with sD. A systematic literature search from the year of the introduction of Diagnostic and Statistic Manual for Mental Disorders Fourth Edition (DSM-IV) until 2012 (18 years) was conducted with a special focus on adolescent sD. Data from 27 studies were included into this review. The results show high prevalence of sD among adolescents, with a negative impact on QoL, and provide evidence that sD is a significant risk indicator of later MDE; therefore, individuals with sD represent good targets for preventive interventions. Our review highlights the fact that sD is a significant health problem among adolescents indeed, and adolescents with sD could be a subgroup of youth, who need further help to reduce their clinically significant depressive symptoms for the successful prevention of a later MDE.

  2. Topiramate and the vision: a systematic review

    PubMed Central

    Abtahi, Mohammad-Ali; Abtahi, Seyed-Hossein; Fazel, Farhad; Roomizadeh, Peyman; Etemadifar, Masoud; Jenab, Keivan; Akbari, Mojtaba

    2012-01-01

    Background and purpose Topiramate (TPM) is a sulfa-derivative monosaccharide that is used mainly for treating epilepsy and preventing migraine. Within the gamut of side effects attributable to this drug, ophthalmologic manifestations are of crucial importance. In this study, for the first time, the aim was to provide a systematic literature review regarding this issue. Methods For the time period 1996–2011, a PubMed search was made for the studies concerning the adverse/beneficial effects of TPM on vision. Overall, 404 citations out of a total of 2756 TPM-related studies were examined for relevance. Results A total of 74 relevant studies were reviewed, 65 of which comprise small observational studies describing the ophthalmic side effects of TPM in 84 patients. Of these patients, 66 were affected by ciliochoroidal effusion syndrome as the cardinal ocular side effect of TPM (17 cases of myopic shift and 49 cases of angle closure glaucoma). A comprehensive statistical analysis is provided on these 66 subjects. Other rare side effects of TPM on the vision were also reviewed, including massive choroidal effusion, ocular inflammatory reactions, visual field defects, probable effects on retina, cornea, and sclera, and neuroophthalmologic complications. In addition, a framework is provided to classify these results. Discussion Due to the expanding spectrum of indications for the administration of TPM, neurologists and psychiatrists should be aware of its diverse ocular side effects. In conclusion, ocular complications following this drug should be taken seriously and be subjected to ophthalmic counseling. PMID:22275816

  3. Speed Management Strategies; A Systematic Review

    PubMed Central

    Sadeghi-Bazargani, Homayoun; Saadati, Mohammad

    2016-01-01

    Objective: To systematically identify the various methods of speed management and their effects. Methods: A systematic search was performed in Science Direct, Ovid Medline, Scopus, PubMed and ProQuest databases from April to June 2015. Hand searching and reference of selected articles were used to improve article identification. Articles published after 1990 which had reported on efficacy/effectiveness of speed management strategies were included. Data were extracted using pre-defined extraction table. Results: Of the 803 retrieved articles, 22 articles were included in this review. Most of the included articles (63%) had before-after design and were done in European countries. Speed cameras, engineering schemes, intelligent speed adaption (ISA), speed limits and zones, vehicle activated sign and integrated strategies were the most common strategies reported in the literature. Various strategies had different effects on mean speed of the vehicles ranging from 1.6 to 10 km/h. Moreover, 8-65% and 11-71% reduction was reported in person injured accidents and fatal accidents, respectively as a result of employing various strategies. Conclusion: Literature revealed positive effects of various speed management strategies. Using various strategies was mostly dependent on road characteristics, driver’s attitude about the strategy as well as economic and technological capabilities of the country. Political support is considered as a main determinant in selecting speed management strategies. PMID:27540546

  4. Suicide in Children: A Systematic Review.

    PubMed

    Soole, Rebecca; Kõlves, Kairi; De Leo, Diego

    2015-01-01

    The objective of this study was to provide a review of studies on suicide in children aged 14 years and younger. Articles were identified through a systematic search of Scopus, MEDLINE, and PsychINFO. Key words were "children, suicide, psychological autopsy, and case-study." Additional articles were identified through manual search of reference lists and discussion with colleagues. Fifteen published articles were identified, 8 psychological autopsy studies (PA), and 7 retrospective case-study series. Suicide incidence and gender asymmetry increases with age. Hanging is the most frequent method. Lower rates of psychopathology are evident among child suicides compared to adolescents. Previous suicide attempts were an important risk factor. Children were less likely to consume alcohol prior to suicide. Parent-child conflicts were the most common precipitant.

  5. Therapeutic strategies for epiphrenic diverticula: systematic review.

    PubMed

    Zaninotto, Giovanni; Portale, Giuseppe; Costantini, Mario; Zanatta, Lisa; Salvador, Renato; Ruol, Alberto

    2011-07-01

    Most patients with epiphrenic diverticula are asymptomatic. When dysphagia or regurgitation is limited and respiratory complaints are absent, these patients usually can live with the diverticulum left in place. Fewer than one-third of the diverticula produce symptoms severe enough to seek medical attention or to warrant surgery. The purpose of this systematic review was to analyze the therapeutic strategies for epiphrenic diverticula-from a nonsurgical alternative such as endoscopic dilatation for symptomatic patients unfit for surgery, to the traditional approach of surgical resection (left thoracotomy), and finally to the minimally invasive techniques (thoracoscopy, laparoscopy) used more recently. Whatever treatment and approach are used for the patient with epiphrenic diverticula, a tailored protocol always involves detailed study of the esophageal morphology and function.

  6. [Nursing audit: systematic review of the literature].

    PubMed

    Dias, Teresa Cristina Lyporage; Santos, José Luís Guedes dos; Cordenuzzi, Onélia da Costa Pedro; Prochnow, Adelina Giacomelli

    2011-01-01

    This study aimed to analyze the scientific production about audit in nursing, published in national papers, between 1998 and 2008. A systematic review of the literature was conducted, with articles being searched in the databases LILACS and SciELO, from the key words: audit, nursing, quality health care and nursing supervision. The sample consisted of ten works. The analyzed publications describe the main distortions and non-conformities found in nursing records, relating them mainly with the quality of nursing care and with the financial damage to the institutions. The publications also include the administrative role of the nurse, especially her/his leadership role in the team of nursing; and nursing audit as an educational process. PMID:22460497

  7. Religion and Suicide Risk: A Systematic Review.

    PubMed

    Lawrence, Ryan E; Oquendo, Maria A; Stanley, Barbara

    2016-01-01

    Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.

  8. Obesity and lung function: a systematic review

    PubMed Central

    Melo, Luciana Costa; da Silva, Maria Alayde Mendonça; Calles, Ana Carolina do Nascimento

    2014-01-01

    ABSTRACT Obesity is a chronic disease characterized by the excessive accumulation of body fat that is harmful to the individuals. Respiratory disorders are among the comorbidities associated with obesity. This study had the objective of investigating the alterations in respiratory function that affect obese individuals. A systematic review was performed, by selecting publications in the science databases MEDLINE and LILACS, using PubMed and SciELO. The articles that assessed pulmonary function by plethysmography and/or spirometry in obese individuals aged under 18 years were included. The results demonstrated that the obese individuals presented with a reduction in lung volume and capacity as compared to healthy individuals. Reduction of total lung capacity and reduction of forced vital capacity, accompanied by reduction of the forced expiratory volume after one second were the most representative findings in the samples. The articles analyzed proved the presence of a restrictive respiratory pattern associated with obesity. PMID:24728258

  9. Pertuzumab in breast cancer: a systematic review.

    PubMed

    Zagouri, Flora; Sergentanis, Theodoros N; Chrysikos, Dimosthenis; Zografos, Constantine G; Filipits, Martin; Bartsch, Rupert; Dimopoulos, Meletios-Athanassios; Psaltopoulou, Theodora

    2013-10-01

    Pertuzumab is a monoclonal antibody that represents the first among a new class of agents known as human epidermal growth factor receptor (HER) dimerization inhibitors. This is the first systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to synthesize all available data of pertuzumab in breast cancer. The search strategy retrieved 11 studies that evaluated pertuzumab. One study was conducted in the neoadjuvant setting (417 patients), whereas all the others dealt with patients with recurrent, metastatic, or refractory disease (1023 patients). Six studies were conducted in HER2(+) breast cancer population (1354 patients), whereas 5 studies (86 patients) were conducted in HER2(-) (or unknown HER2 status) disease. Pertuzumab is the most recent agent approved by the US Food and Drug Administration in combination with trastuzumab and docetaxel for the treatment of patients with HER2(+) metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease. This approval has been based on data from a phase III Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) study. The antitumor activity with the significant reduction in the risk of progression or death, as reflected upon the increase of 6.1 months in median progression-free survival, indicates that pertuzumab may provide an avenue for achieving additional benefit for patients with HER2(+). Moreover, pertuzumab seems to have a putative role in the management of patients with HER2 who are resistant to trastuzumab. The promising role of pertuzumab in the neoadjuvant and adjuvant settings remains to be further investigated and established in the future.

  10. Multiple Pituitary Adenomas: A Systematic Review

    PubMed Central

    Budan, Renata M.; Georgescu, Carmen E.

    2016-01-01

    PubMed, Scopus, and Web of Science Core Collection databases were systematically searched for studies reporting synchronous double or multiple pituitary adenomas (MPA), a rare clinical condition, with a vague pathogenesis. Multiple adenomas of the pituitary gland are referred to as morphologically and/or immunocytochemically distinct tumors that are frequently small-sized and hormonally non-functional, to account for the low detection rate. There is no general agreement on how to classify MPA, various criteria, such as tumor contiguity, immunoreactivity, and clonality analysis are being used. Among the component tumors, prolactin (PRL)-immunopositive adenomas are highly prevalent, albeit mute in the majority of cases. The most frequent clinical presentation of MPA is Cushing’s syndrome, given the fact that in more than 50% of reported cases at least one lesion stains for adrenocorticotrophic hormone (ACTH). Plurihormonal hyperactivity may be diagnosed in a patient with MPA when more than one tumor is clinically active (e.g., ACTH and PRL) or in cases with at least one composite tumor (e.g., GH and PRL), to complicate the clinical scenario. Specific challenges associated with MPA include high surgical failure rates, enforcing second-look surgery in certain cases, and difficult preoperative neuroradiological imaging evaluation, with an overall sensitivity of only 25% for magnetic resonance imaging to detect distinct multiple tumors. Alternatively, minor pituitary imaging abnormalities may raise suspicion, as these are not uncommon. Postoperative immunohistochemistry is mandatory and in conjunction to electron microscopy scanning and testing for transcription factors (i.e., Pit-1, T-pit, and SF-1) accurately define and classify the distinct cytodifferentiation of MPA. PMID:26869991

  11. Centralization and directional preference: a systematic review.

    PubMed

    May, Stephen; Aina, Alessandro

    2012-12-01

    Centralization is a symptom response to repeated movements that can be used to classify patients into sub-groups, determine appropriate management strategies, and prognosis. The aim of this study was to systematically review the literature relating to centralization and directional preference, and specifically report on prevalence, prognostic validity, reliability, loading strategies, and diagnostic implications. Search was conducted to June 2011; multiple study designs were considered. 62 studies were included in the review; 54 related to centralization and 8 to directional preference. The prevalence of centralization was 44.4% (range 11%-89%) in 4745 patients with back and neck pain in 29 studies; it was more prevalent in acute (74%) than sub-acute or chronic (42%) symptoms. The prevalence of directional preference was 70% (range 60%-78%) in 2368 patients with back or neck pain in 5 studies. Twenty-one of 23 studies supported the prognostic validity of centralization, including 3 high quality studies and 4 of moderate quality; whereas 2 moderate quality studies showed evidence that did not support the prognostic validity of centralization. Data on the prognostic validity of directional preference was limited to one study. Centralization and directional preference appear to be useful treatment effect modifiers in 7 out of 8 studies. Levels of reliability were very variable (kappa 0.15-0.9) in 5 studies. Findings of centralization or directional preference at baseline would appear to be useful indicators of management strategies and prognosis, and therefore warrant further investigation. PMID:22695365

  12. Acupuncture for Lateral Epicondylitis: A Systematic Review

    PubMed Central

    Tang, Hongzhi; Fan, Huaying; Chen, Jiao; Yang, Mingxiao; Yi, Xuebing; Dai, Guogang; Chen, Junrong; Tang, Liugang; Rong, Haibo; Wu, Junhua; Liang, Fanrong

    2015-01-01

    Objective. This systematic review aimed to assess the effectiveness and safety of acupuncture for lateral epicondylitis (LE). Methods. Seven databases and the WHO International Clinical Trials Registry Platform Search Portal were searched to identify relevant studies. The data were extracted and assessed by two independent authors, and Review Manager Software (V.5.3) was used for data synthesis with effect estimate presented as standard mean difference (SMD) and mean difference (MD) with a 95% confidence interval. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the level of evidence. Results. Four RCTs with 309 participants were included with poor methodological quality. Participants who received acupuncture and acupuncture plus moxibustion with material insulation were likely to have an improvement in elbow functional status and/or myodynamia. The overall quality rated by GRADE was from very low to low. Two studies reported that the needle pain would be the main reason for the dropout. Conclusion. For the small number of included studies with poor methodological quality, no firm conclusion can be drawn regarding the effect of acupuncture of elbow functional status and myodynamia for LE. This trial is registered with CRD42015016199. PMID:26843886

  13. Orthokeratinized odontogenic cyst: a systematic review

    PubMed Central

    MacDonald-Jankowski, D S

    2010-01-01

    Objectives The aims of the review were to evaluate the principal clinical and conventional radiographic features of orthokeratinized odontogenic cyst (OOC) by systematic review (SR), and to compare the frequency of OOC between four global groups. Methods The databases searched were the PubMed interface of MEDLINE and LILACS. Only those reports of OOCs that occurred in a consecutive series of OOCs in the reporting authors' caseload were considered. Results 37 reports on 36 case series were included in the SR. OOC affected males twice as frequently and the mandible almost 2.5 times as frequently. Although the mean age at first presentation was 35 years, the largest proportion of cases first presented in the third decade for the Western, East Asian and Latin American global groups. Seven reports included details of at least one clinical finding. 11 reported case series included at least 1 radiological feature. All OOCs were radiolucent, 93% were unilocular and 68% were associated with unerupted teeth. 28% of the reported case series included follow up. 4% of OCC recurred and all of these were in the Western global group. Conclusions Although one feature of OOCs is that they are unlikely to recur, some do. Not only is there a lack of long-term follow up of large series with long-term outcomes of OOC, but there is a paucity of clinical and radiological details of OOC at initial presentation. PMID:21062939

  14. [Systematic review of near miss maternal morbidity].

    PubMed

    Souza, João Paulo; Cecatti, José Guilherme; Parpinelli, Mary Angela; de Sousa, Maria Helena; Serruya, Suzanne Jacob

    2006-02-01

    This systematic literature review on maternal near miss aims to evaluate data on the incidence and different operational definitions of near miss. An electronic search was performed in databases of scientific journals and also in the references of the identified studies. Initially, 1,247 studies were identified, 35 of which were comprehensively assessed, with 17 excluded and 18 included. Review of reference lists from these articles identified an additional 20 articles, thus completing 38 studies included: 20 adopting definitions of near miss related to management complexity, 6 to organ dysfunction, 2 with a mixed definition, and 10 according to symptoms, signs, or specific clinical entities. The mean near miss ratio was 8.2/1,000 live births, the maternal mortality index was 6.3%, and the case/fatality ratio was 16:1. The study concluded that there was a trend towards higher incidence of near miss in developing countries and when using near miss definitions by organ dysfunction. The study of near miss maternal morbidity can help improve obstetric care and support the struggle against maternal mortality.

  15. Floods and human health: a systematic review.

    PubMed

    Alderman, Katarzyna; Turner, Lyle R; Tong, Shilu

    2012-10-15

    Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004-2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs.

  16. Floods and human health: a systematic review.

    PubMed

    Alderman, Katarzyna; Turner, Lyle R; Tong, Shilu

    2012-10-15

    Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004-2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs. PMID:22750033

  17. Biofeedback for psychiatric disorders: a systematic review.

    PubMed

    Schoenberg, Poppy L A; David, Anthony S

    2014-06-01

    Biofeedback potentially provides non-invasive, effective psychophysiological interventions for psychiatric disorders. The encompassing purpose of this review was to establish how biofeedback interventions have been used to treat select psychiatric disorders [anxiety, autistic spectrum disorders, depression, dissociation, eating disorders, schizophrenia and psychoses] to date and provide a useful reference for consultation by clinicians and researchers planning to administer a biofeedback treatment. A systematic search of EMBASE, MEDLINE, PsycINFO, and WOK databases and hand searches in Applied Psychophysiology and Biofeedback, and Journal of Neurotherapy, identified 227 articles; 63 of which are included within this review. Electroencephalographic neurofeedback constituted the most investigated modality (31.7%). Anxiety disorders were the most commonly treated (68.3%). Multi-modal biofeedback appeared most effective in significantly ameliorating symptoms, suggesting that targeting more than one physiological modality for bio-regulation increases therapeutic efficacy. Overall, 80.9% of articles reported some level of clinical amelioration related to biofeedback exposure, 65.0% to a statistically significant (p < .05) level of symptom reduction based on reported standardized clinical parameters. Although the heterogeneity of the included studies warrants caution before explicit efficacy statements can be made. Further development of standardized controlled methodological protocols tailored for specific disorders and guidelines to generate comprehensive reports may contribute towards establishing the value of biofeedback interventions within mainstream psychiatry. PMID:24806535

  18. Collagenous gastritis: reports and systematic review.

    PubMed

    Brain, Oliver; Rajaguru, Chandima; Warren, Bryan; Booth, Jonathan; Travis, Simon

    2009-12-01

    Collagenous gastritis is a rare disorder first described in 1989. After encountering two cases, we decided to review the literature and evaluate the collagen band. A systematic review of PubMed and EMBASE databases was performed. Twenty-eight cases have been previously described and two patterns of presentations are identifiable: children or young adults (median age 12 years, range 2-22 years) presenting with symptoms attributable to the gastritis (anaemia and pain); and older adults (median age 52 years, range 35-77 years) presenting with loose stools, often associated with collagenous colitis or coeliac disease. Our two cases (one child and one adult) matched this pattern. Immunostaining of the collagen band for collagens II, III, IV and VI, and tenascin showed that the band in our cases was predominantly tenascin. In conclusion, collagenous gastritis is a rare entity whose presentation depends on the age of the patient. An autoimmune aetiology seems possible given its associations. Treatment is empirical. The 30 cases now reported show that the disorder can relapse or persist for years. PMID:19730387

  19. Fetal deaths in Brazil: a systematic review

    PubMed Central

    Barbeiro, Fernanda Morena dos Santos; Fonseca, Sandra Costa; Tauffer, Mariana Girão; Ferreira, Mariana de Souza Santos; da Silva, Fagner Paulo; Ventura, Patrícia Mendonça; Quadros, Jesirée Iglesias

    2015-01-01

    OBJECTIVE To review the frequency of and factors associated with fetal death in the Brazilian scientific literature. METHODS A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners. RESULTS The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history. CONCLUSIONS Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary. PMID:25902565

  20. Acupuncture for Lateral Epicondylitis: A Systematic Review.

    PubMed

    Tang, Hongzhi; Fan, Huaying; Chen, Jiao; Yang, Mingxiao; Yi, Xuebing; Dai, Guogang; Chen, Junrong; Tang, Liugang; Rong, Haibo; Wu, Junhua; Liang, Fanrong

    2015-01-01

    Objective. This systematic review aimed to assess the effectiveness and safety of acupuncture for lateral epicondylitis (LE). Methods. Seven databases and the WHO International Clinical Trials Registry Platform Search Portal were searched to identify relevant studies. The data were extracted and assessed by two independent authors, and Review Manager Software (V.5.3) was used for data synthesis with effect estimate presented as standard mean difference (SMD) and mean difference (MD) with a 95% confidence interval. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the level of evidence. Results. Four RCTs with 309 participants were included with poor methodological quality. Participants who received acupuncture and acupuncture plus moxibustion with material insulation were likely to have an improvement in elbow functional status and/or myodynamia. The overall quality rated by GRADE was from very low to low. Two studies reported that the needle pain would be the main reason for the dropout. Conclusion. For the small number of included studies with poor methodological quality, no firm conclusion can be drawn regarding the effect of acupuncture of elbow functional status and myodynamia for LE. This trial is registered with CRD42015016199. PMID:26843886

  1. Radiation costing methods: a systematic review

    PubMed Central

    Rahman, F.; Seung, S.J.; Cheng, S.Y.; Saherawala, H.; Earle, C.C.; Mittmann, N.

    2016-01-01

    Objective Costs for radiation therapy (rt) and the methods used to cost rt are highly diverse across the literature. To date, no study has compared various costing methods in detail. Our objective was to perform a thorough review of the radiation costing literature to identify sources of costs and methods used. Methods A systematic review of Ovid medline, Ovid oldmedline, embase, Ovid HealthStar, and EconLit from 2005 to 23 March 2015 used search terms such as “radiation,” “radiotherapy,” “neoplasm,” “cost,” “ cost analysis,” and “cost benefit analysis” to locate relevant articles. Original papers were reviewed for detailed costing methods. Cost sources and methods were extracted for papers investigating rt modalities, including three-dimensional conformal rt (3D-crt), intensity-modulated rt (imrt), stereotactic body rt (sbrt), and brachytherapy (bt). All costs were translated into 2014 U.S. dollars. Results Most of the studies (91%) reported in the 33 articles retrieved provided rt costs from the health system perspective. The cost of rt ranged from US$2,687.87 to US$111,900.60 per treatment for imrt, followed by US$5,583.28 to US$90,055 for 3D-crt, US$10,544.22 to US$78,667.40 for bt, and US$6,520.58 to US$19,602.68 for sbrt. Cost drivers were professional or personnel costs and the cost of rt treatment. Most studies did not address the cost of rt equipment (85%) and institutional or facility costs (66%). Conclusions Costing methods and sources were widely variable across studies, highlighting the need for consistency in the reporting of rt costs. More work to promote comparability and consistency across studies is needed. PMID:27536189

  2. What is orthopaedic triage? A systematic review

    PubMed Central

    Morris, Joanne H; James, Rebecca E; Davey, Rachel; Waddington, Gordon

    2015-01-01

    Rationale, aims and objectives Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as ‘triage’ services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on ‘best practice’ to assist health care facilities. Method A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. Results 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. Conclusions This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics. PMID:25410703

  3. Neurophysiology of action anticipation in athletes: A systematic review.

    PubMed

    Smith, Daniel M

    2016-01-01

    The purpose of this study was to provide a systematic review of action anticipation studies using functional neuroimaging or brain stimulation during a sport-specific anticipation task. A total of 15 studies from 2008 to 2014 were evaluated and are reported in four sections: expert-novice samples, action anticipation tasks, neuroimaging and stimulation techniques, and key findings. Investigators examined a wide range of action anticipation scenarios specific to eight different sports and utilized functional magnetic resonance imaging (fMRI), electroencephalogram (EEG), and transcranial magnetic stimulation (TMS). Expert-novice comparisons were commonly used to investigate differences in action anticipation performance and neurophysiology. Experts tended to outperform novices, and an extensive array of brain structures were reported to be involved differently for experts and novices during action anticipation. However, these neurophysiological findings were generally inconsistent across the studies reviewed. The discussion focuses on strengths and four key limitations. The conclusion posits remaining questions and recommendations for future research.

  4. Optical coherence tomography of the pulmonary arteries: A systematic review.

    PubMed

    Jorge, Elisabete; Baptista, Rui; Calisto, João; Faria, Henrique; Monteiro, Pedro; Pan, Manuel; Pêgo, Mariano

    2016-01-01

    Optical coherence tomography (OCT) is an imaging technique extensively used for visualizing the coronary circulation, where it assists clinical decision-making. Along with the new interventional procedures being introduced for pulmonary vascular disease, there is an increasing need for intravascular imaging of the pulmonary arteries. Additionally, measurements of the wall thickness of the pulmonary arteries of patients with various types of pulmonary hypertension (PH) may provide relevant diagnostic and prognostic information. The aim of this review is to summarize all the available evidence on the use of OCT for imaging the pulmonary bed and to describe a simple protocol for OCT image acquisition. We conducted a systematic review of the literature using electronic reference databases through February 2015 (MEDLINE, Cochrane Library, Web of Knowledge, and references cited in other studies) and the search terms "optical coherence tomography," "pulmonary hypertension," and "pulmonary arteries." Studies in which OCT was used to image the pulmonary vessels were considered for inclusion. We identified 14 studies reporting OCT imaging data from the pulmonary arteries. OCT was able to identify intravascular thrombi in patients with chronic thromboembolic PH (CTEPH), and an increase in vessel wall thickness was found in most patients with PH, compared with the controls. OCT has also been reported to be useful for the selection of balloon size in the setting of balloon pulmonary angioplasty for CTEPH. The main limitations include lack of standardization, little data on outcomes, cost, and the technical limitations involved in visualizing small-diameter (<1mm) pulmonary vessels. OCT has become a potential tool for the in vivo study of vascular changes in the pulmonary arteries, and may provide additional information in the assessment of patients with PH. Prospective high-quality studies assessing the safety, validity, and clinical impact of OCT imaging for pulmonary vessels

  5. Amputees and sports: a systematic review.

    PubMed

    Bragaru, Mihail; Dekker, Rienk; Geertzen, Jan H B; Dijkstra, Pieter U

    2011-09-01

    Amputation of a limb may have a negative impact on the psychological and physical well-being, mobility and social life of individuals with limb amputations. Participation in sports and/or regular physical activity has a positive effect on the above mentioned areas in able-bodied individuals. Data concerning participation in sports or regular physical activity together with its benefits and risks for individuals with limb amputations are scarce. No systematic review exists that addresses a wide range of outcomes such as biomechanics, cardiopulmonary function, psychology, sport participation and sport injuries. Therefore, the aim of this article is to systematically review the literature about individuals with limb amputations and sport participation. MEDLINE (PubMed), EMBASE, CINAHL® and SportDiscus® were searched without time or language restrictions using free text words and MeSH terms. The last search date was 31 March 2010. Books, internet sites and references of included papers were checked for papers relevant to the topic under review. Papers were included if the research topic concerned sports and a minimum of ten individuals with limb amputations were part of the study population. Papers were excluded if they included individuals with amputations of body parts other than upper or lower limbs or more distal than the wrist or ankle, or if they consisted of case reports, narrative reviews, books, notes or letters to the editor. Title, abstract and full-text assessments were performed by two independent observers following a list of preset criteria. Of the 3689 papers originally identified, 47 were included in the review. Most of the included studies were older than 10 years and had cross-sectional designs. Study participants were generally younger and often had more traumatic amputations than the general population of individuals with limb amputations. Heterogeneity in population characteristics, intervention types and main outcomes made data pooling

  6. [Improving practice and organisation of care: methodology for systematic reviews].

    PubMed

    Zaugg, Vincent; Savoldelli, Virginie; Sabatier, Brigitte; Durieux, Pierre

    2014-01-01

    The number of intervention studies designed to improve quality of care is increasing exponentially, making it difficult to access all available information on a given subject. Systematic reviews are tools that provide health professionals with comprehensive and objective information. This article describes the main phases of a systematic review: formulating the research question, search and selection of studies, data extraction and analysis, assessment of the methodological quality of studies, and synthesis of the results. Interventions designed to improve professional practices and organisation of care have specific characteristics that determine the methodology of systematic reviews. For example, the often substantial heterogeneity between populations, organisations, and intervention settings among studies must be taken into account, which makes meta-analysis more difficult. Knowledge on specific features of systematic reviews designed to improve quality of care is essential to ensure a good review of the literature, or to evaluate the level of evidence of published systematic reviews.

  7. Brain Structure and Executive Functions in Children with Cerebral Palsy: A Systematic Review

    ERIC Educational Resources Information Center

    Weierink, Lonneke; Vermeulen, R. Jeroen; Boyd, Roslyn N.

    2013-01-01

    This systematic review aimed to establish the current knowledge about brain structure and executive function (EF) in children with cerebral palsy (CP). Five databases were searched (up till July 2012). Six articles met the inclusion criteria, all included structural brain imaging though no functional brain imaging. Study quality was assessed using…

  8. On the benefits of systematic reviews for wildlife parasitology.

    PubMed

    Haddaway, Neal R; Watson, Maggie J

    2016-08-01

    Systematic reviews and meta-analyses are widely accepted as the best means to synthesise quantitative or qualitative scientific evidence. Many scientific fields have embraced these more rigorous review techniques as a means to bring together large and complex bodies of literature and their data. Unfortunately, due to perceived difficulties and unfamiliarity with processes, other fields are not using these options to review their literature. One way to provide guidance for a specific field is to examine critically recent reviews and meta-analyses and to explain the advantages and disadvantages of the various review techniques. In this paper, we examine review papers in the emerging field of wildlife parasitology and compare five different literature review types-configurative narrative review, aggregative scoping review, aggregative literature review, aggregative meta-analysis, and aggregative systematic review. We found that most literature reviews did not adequately explain the methodology used to find the literature under review. We also found that most literature reviews were not comprehensive nor did they critically appraise the literature under review. Such a lack severely reduces the reliability of the reviews. We encourage all authors to consider using systematic reviews in the future, and for authors and peer-reviewers to be aware of the limitations of non-systematic reviews. PMID:27617203

  9. Chronic Pain and Mortality: A Systematic Review

    PubMed Central

    Smith, Diane; Wilkie, Ross; Uthman, Olalekan; Jordan, Joanne L.; McBeth, John

    2014-01-01

    Background Chronic pain is common, often widespread and has a substantial impact on health and quality of life. The relationship between chronic pain and mortality is unclear. This systematic review aimed to identify and evaluate evidence for a relationship between chronic pain and mortality. Methods A search of ten electronic databases including EMBASE and MEDLINE was conducted in March 2012, and updated until March 2014. Observational studies investigating the association between chronic or widespread pain (including fibromyalgia) and mortality were included. Risk of bias was assessed and a meta-analysis was undertaken to quantify heterogeneity and pool results. A narrative review was undertaken to explore similarities and differences between the included studies. Results Ten studies were included in the review. Three reported significant associations between chronic or widespread pain and mortality in unadjusted results. In adjusted analyses, four studies reported a significant association. The remaining studies reported no statistically significant association. A meta-analysis showed statistically significant heterogeneity of results from studies using comparable outcome measures (n = 7)(I2 = 78.8%) and a modest but non-significant pooled estimate (MRR1.14,95%CI 0.95–1.37) for the relationship between chronic pain and all-cause mortality. This association was stronger when analysis was restricted to studies of widespread pain (n = 5,I2 = 82.3%) MRR1.22(95%CI 0.93–1.60). The same pattern was observed with deaths from cancer and cardiovascular diseases. Heterogeneity is likely to be due to differences in study populations, follow-up time, pain phenotype, methods of analysis and use of confounding factors. Conclusion This review showed a mildly increased risk of death in people with chronic pain, particularly from cancer. However, the small number of studies and methodological differences prevented clear conclusions from being drawn

  10. Latent Tuberculosis in Pregnancy: A Systematic Review

    PubMed Central

    Malhamé, Isabelle; Cormier, Maxime; Sugarman, Jordan; Schwartzman, Kevin

    2016-01-01

    Background In countries with low tuberculosis (TB) incidence, immigrants from higher incidence countries represent the major pool of individuals with latent TB infection (LTBI). The antenatal period represents an opportunity for immigrant women to access the medical system, and hence for potential screening and treatment of LTBI. However, such screening and treatment during pregnancy remains controversial. Objectives In order to further understand the prevalence, natural history, screening and management of LTBI in pregnancy, we conducted a systematic literature review addressing the screening and treatment of LTBI, in pregnant women without known HIV infection. Methods A systematic review of 4 databases (Embase, Embase Classic, Medline, Cochrane Library) covering articles published from January 1st 1980 to April 30th 2014. Articles in English, French or Spanish with relevant information on prevalence, natural history, screening tools, screening strategies and treatment of LTBI during pregnancy were eligible for inclusion. Articles were excluded if (1) Full text was not available (2) they were case series or case studies (3) they focused exclusively on prevalence, diagnosis and treatment of active TB (4) the study population was exclusively HIV-infected. Results Of 4,193 titles initially identified, 208 abstracts were eligible for review. Of these, 30 articles qualified for full text review and 22 were retained: 3 cohort studies, 2 case-control studies, and 17 cross-sectional studies. In the USA, the estimated prevalence of LTBI ranged from 14 to 48% in women tested, and tuberculin skin test (TST) positivity was associated with ethnicity. One study suggested that incidence of active TB was significantly increased during the 180 days postpartum (Incidence rate ratio, 1.95 (95% CI 1.24–3.07). There was a high level of adherence with both skin testing (between 90–100%) and chest radiography (93–100%.). In three studies from low incidence settings, concordance

  11. Volatile Metabolites of Pathogens: A Systematic Review

    PubMed Central

    Bos, Lieuwe D. J.; Sterk, Peter J.; Schultz, Marcus J.

    2013-01-01

    Ideally, invading bacteria are detected as early as possible in critically ill patients: the strain of morbific pathogens is identified rapidly, and antimicrobial sensitivity is known well before the start of new antimicrobial therapy. Bacteria have a distinct metabolism, part of which results in the production of bacteria-specific volatile organic compounds (VOCs), which might be used for diagnostic purposes. Volatile metabolites can be investigated directly in exhaled air, allowing for noninvasive monitoring. The aim of this review is to provide an overview of VOCs produced by the six most abundant and pathogenic bacteria in sepsis, including Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli. Such VOCs could be used as biological markers in the diagnostic approach of critically ill patients. A systematic review of existing literature revealed 31 articles. All six bacteria of interest produce isopentanol, formaldehyde, methyl mercaptan, and trimethylamine. Since humans do not produce these VOCs, they could serve as biological markers for presence of these pathogens. The following volatile biomarkers were found for identification of specific strains: isovaleric acid and 2-methyl-butanal for Staphylococcus aureus; 1-undecene, 2,4-dimethyl-1-heptane, 2-butanone, 4-methyl-quinazoline, hydrogen cyanide, and methyl thiocyanide for Pseudomonas aeruginosa; and methanol, pentanol, ethyl acetate, and indole for Escherichia coli. Notably, several factors that may effect VOC production were not controlled for, including used culture media, bacterial growth phase, and genomic variation within bacterial strains. In conclusion, VOCs produced by bacteria may serve as biological markers for their presence. Goal-targeted studies should be performed to identify potential sets of volatile biological markers and evaluate the diagnostic accuracy of these markers in critically ill patients. PMID

  12. Antidepressants in pregnancy: a systematic review.

    PubMed

    Udechuku, Adaobi; Nguyen, Tram; Hill, Rebecca; Szego, Klara

    2010-11-01

    Part of three systematic reviews on the effects of psychotropic medication exposure in pregnancy, this paper critically reviews the literature on adverse effects of antidepressant use during pregnancy, and derives recommendations for clinical practice. Electronic databases were searched for original research studies examining the effects of gestational exposure to antidepressants on pregnancy, neonatal and longer-term developmental outcomes. Most results were derived from cohort (prospective and retrospective) and casecontrol studies. There were no randomized controlled trials. Congenital malformations: 35 studies identified, 12 demonstrated a significant association between antidepressant use in early pregnancy and congenital malformations. Pregnancy outcomes: 35 articles identified, outcomes measured rates of spontaneous abortion (4 out of 7 studies reporting elevated risk), preterm birth (15 out of 19 reporting elevated risk) and abnormal birth weight (8 out of 23 reporting elevated risk). Neonatal outcomes: 17 controlled studies including one meta-analysis were identified concerning neonatal adaptation. 15 studies showed an association between gestational exposure to antidepressants and neonatal adaptation difficulties. Three studies examined an association between selective serotonin reuptake inhibitor (SSRI) exposure and persistent pulmonary hypertension in the neonate with conflicting results. Longer-term developmental outcomes: 6 of 7 studies comparing developmental outcomes of children exposed to antidepressants in utero with non- exposed children reported no significant differences. Most of these medications remain relatively safe in pregnancy, but some significant areas of concern exist, particularly some evidence of higher risk of preterm birth, neonatal adaptation difficulties and congenital cardiac malformations (with paroxetine). The impact of these findings on the risk-benefit analysis when treating pregnant women with antidepressants is discussed.

  13. Phenobarbital for childhood epilepsy: systematic review

    PubMed Central

    Pal, Deb K

    2006-01-01

    Introduction Against a background of concern about the safety of new pharmaceutical products, there has been renewed interest in one of the oldest antiepileptic drugs (AEDs), phenobarbital. Although still in widespread use in developing countries, its popularity has slipped in Western countries over the past century, partly because of controversy about its adverse effect profile. This critical review examines the evidence supporting its effectiveness and its associated behavioural adverse effects for febrile convulsions and childhood epilepsy. Methods Relevant randomised controlled trials (RCTs) of phenobarbital vs other antiepileptic drugs or placebo between 1970-2005 were identified through a comprehensive manual and computer database search of the world biomedical literature. Eleven RCTs of febrile convulsions and nine RCTs of childhood epilepsy were systematically reviewed against a conventional set of quality criteria. Results With a few exceptions, the overall quality of clinical trial methodology, especially in the early studies conducted in the 1970s and 1980s, was poor. There is no evidence for a difference in antiepileptic efficacy between phenobarbital and any other compared AED, yet no evidence for absolute efficacy. No convincing evidence exists for an excess of behavioural adverse effects, over other AEDs, attributable to phenobarbital. Masked studies of phenobarbital in childhood epilepsy have shown no significant differences in behavioural or cognitive adverse effects compared to other AEDs. This is in contrast to the excess of such adverse effects reported in studies open to observer bias. However, the one finding of reduction in cognitive ability associated with phenobarbital treatment for febrile convulsions remains a concern. Future areas of clinical and genetic epidemiological research are outlined. PMID:17356688

  14. Clinical trials in zirconia: a systematic review.

    PubMed

    Al-Amleh, B; Lyons, K; Swain, M

    2010-08-01

    Zirconia is unique in its polymorphic crystalline makeup, reported to be sensitive to manufacturing and handling processes, and there is debate about which processing method is least harmful to the final product. Currently, zirconia restorations are manufactured by either soft or hard-milling processes, with the manufacturer of each claiming advantages over the other. Chipping of the veneering porcelain is reported as a common problem and has been labelled as its main clinical setback. The objective of this systematic review is to report on the clinical success of zirconia-based restorations fabricated by both milling processes, in regard to framework fractures and veneering porcelain chipping. A comprehensive review of the literature was completed for in vivo trials on zirconia restorations in MEDLINE and PubMed between 1950 and 2009. A manual hand search of relevant dental journals was also completed. Seventeen clinical trials involving zirconia-based restorations were found, 13 were conducted on fixed partial dentures, two on single crowns and two on zirconia implant abutments, of which 11 were based on soft-milled zirconia and six on hard-milled zirconia. Chipping of the veneering porcelain was a common occurrence, and framework fracture was only observed in soft-milled zirconia. Based on the limited number of short-term in vivo studies, zirconia appears to be suitable for the fabrication of single crowns, and fixed partial dentures and implant abutments providing strict protocols during the manufacturing and delivery process are adhered to. Further long-term prospective studies are necessary to establish the best manufacturing process for zirconia-based restorations. PMID:20406352

  15. Smartphone Apps for Schizophrenia: A Systematic Review

    PubMed Central

    2015-01-01

    Background There is increasing interest in using mobile technologies such as smartphones for improving the care of patients with schizophrenia. However, less is known about the current clinical evidence for the feasibility and effectiveness of smartphone apps in this population. Objective To review the published literature of smartphone apps applied for the care of patients with schizophrenia and other psychotic disorders. Methods An electronic database search of Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, Allied and Complementary Medicine, Health and Psychosocial Instruments, PsycINFO, and Embase was conducted on May 24, 2015. All eligible studies were systematically reviewed, and proportional meta-analyses were applied to pooled data on recruitment, retention, and adherence to examine the overall feasibility of smartphone interventions for schizophrenia. Results Our search produced 226 results from which 7 eligible articles were identified, reporting on 5 studies of smartphone apps for patients with schizophrenia. All examined feasibility, and one assessed the preliminary efficacy of a smartphone intervention for schizophrenia. Study lengths varied between 6 and 130 days. Overall retention was 92% (95% CI 82-98%). Participants consistently used the smartphone apps on more than 85% of days during the study period, averaging 3.95 interactions per person per day. Furthermore, participants responded to 71.9% of automated prompts (95% CI 65.7-77.8%). Participants reported a range of potential benefits from the various interventions, and user experience was largely positive. Conclusions Although small, the current published literature demonstrates strong evidence for the feasibility of using smartphones to enhance the care of people with schizophrenia. High rates of engagement and satisfaction with a broad range of apps suggest the nascent potential of this mobile technology. However, there remains limited

  16. Dietary patterns in India: a systematic review.

    PubMed

    Green, Rosemary; Milner, James; Joy, Edward J M; Agrawal, Sutapa; Dangour, Alan D

    2016-07-01

    Dietary patterns analysis is an emerging area of research. Identifying distinct patterns within a large dietary survey can give a more accurate representation of what people are eating. Furthermore, it allows researchers to analyse relationships between non-communicable diseases (NCD) and complete diets rather than individual food items or nutrients. However, few such studies have been conducted in developing countries including India, where the population has a high burden of diabetes and CVD. We undertook a systematic review of published and grey literature exploring dietary patterns and relationships with diet-related NCD in India. We identified eight studies, including eleven separate models of dietary patterns. Most dietary patterns were vegetarian with a predominance of fruit, vegetables and pulses, as well as cereals; dietary patterns based on high-fat, high-sugar foods and more meat were also identified. There was large variability between regions in dietary patterns, and there was some evidence of change in diets over time, although no evidence of different diets by sex or age was found. Consumers of high-fat dietary patterns were more likely to have greater BMI, and a dietary pattern high in sweets and snacks was associated with greater risk of diabetes compared with a traditional diet high in rice and pulses, but other relationships with NCD risk factors were less clear. This review shows that dietary pattern analyses can be highly valuable in assessing variability in national diets and diet-disease relationships. However, to date, most studies in India are limited by data and methodological shortcomings. PMID:27146890

  17. Neuroimaging essentials in essential tremor: A systematic review

    PubMed Central

    Sharifi, Sarvi; Nederveen, Aart J.; Booij, Jan; van Rootselaar, Anne-Fleur

    2014-01-01

    Background Essential tremor is regarded to be a disease of the central nervous system. Neuroimaging is a rapidly growing field with potential benefits to both diagnostics and research. The exact role of imaging techniques with respect to essential tremor in research and clinical practice is not clear. A systematic review of the different imaging techniques in essential tremor is lacking in the literature. Methods We performed a systematic literature search combining the terms essential tremor and familial tremor with the following keywords: imaging, MRI, VBM, DWI, fMRI, PET and SPECT, both in abbreviated form as well as in full form. We summarize and discuss the quality and the external validity of each study and place the results in the context of existing knowledge regarding the pathophysiology of essential tremor. Results A total of 48 neuroimaging studies met our search criteria, roughly divided into 19 structural and 29 functional and metabolic studies. The quality of the studies varied, especially concerning inclusion criteria. Functional imaging studies indicated cerebellar hyperactivity during rest and during tremor. The studies also pointed to the involvement of the thalamus, the inferior olive and the red nucleus. Structural studies showed less consistent results. Discussion and conclusion Neuroimaging techniques in essential tremor give insight into the pathophysiology of essential tremor indicating the involvement of the cerebellum as the most consistent finding. GABAergic dysfunction might be a major premise in the pathophysiological hypotheses. Inconsistencies between studies can be partly explained by the inclusion of heterogeneous patient groups. Improvement of scientific research requires more stringent inclusion criteria and application of advanced analysis techniques. Also, the use of multimodal neuroimaging techniques is a promising development in movement disorders research. Currently, the role of imaging techniques in essential tremor in daily

  18. Cyberbullying and adolescent mental health: systematic review.

    PubMed

    Bottino, Sara Mota Borges; Bottino, Cássio M C; Regina, Caroline Gomez; Correia, Aline Villa Lobo; Ribeiro, Wagner Silva

    2015-03-01

    Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS). The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrators of cyberbullying. Daily use of three or more hours of Internet, web camera, text messages, posting personal information and harassing others online were associated with cyberbullying. Cybervictims and cyberbullies had more emotional and psychosomatic problems, social difficulties and did not feel safe and cared for in school. Cyberbullying was associated with moderate to severe depressive symptoms, substance use, ideation and suicide attempts. Health professionals should be aware of the violent nature of interactions occurring in the virtual environment and its harm to the mental health of adolescents.

  19. Systematic Review of Pears and Health

    PubMed Central

    Reiland, Holly; Slavin, Joanne

    2015-01-01

    Fruit consumption is universally promoted, yet consumption of fruit remains low in the United States. We conducted a systematic review on pear consumption and health outcomes searching both PubMed and Agricola from 1970 to present. The genus Pyrus L. consists of species of pears cultivated in Europe, parts of Asia, South America, and North America. Like most fruit, pears are concentrated in water and sugar. Pears are high in dietary fiber, containing 6 g per serving. Pears, similar to apples, are concentrated in fructose, and the high fiber and fructose in pears probably explain the laxative properties. Pears contain antioxidants and provide between 27 and 41 mg of phenolics per 100 g. Animal studies with pears suggest that pears may regulate alcohol metabolism, protect against ulcers, and lower plasma lipids. Human feeding studies with pears have not been conducted. In epidemiological studies, pears are combined with all fresh fruits or with apples, because they are most similar in composition. The high content of dietary fiber in pears and their effects on gut health set pears apart from other fruit and deserves study. PMID:26663955

  20. Mucormycosis in Iran: a systematic review.

    PubMed

    Vaezi, Afsane; Moazeni, Maryam; Rahimi, Mohammad Taghi; de Hoog, Sybren; Badali, Hamid

    2016-07-01

    Fungi in the order Mucorales cause acute, invasive and frequently fatal infections in susceptible patients. This study aimed to perform a systematic review of all reported mucormycosis cases during the last 25 years in Iran. After a comprehensive literature search, we identified 98 cases in Iran from 1990-2015. The mean patient age was 39.8 ± 19.2 years. Diabetes was the most common underlying condition (47.9%), and 22.4% of the patients underwent solid organ or bone marrow transplantation. The most common clinical forms of mucormycosis were rhinocerebral (48.9%), pulmonary (9.2%) and cutaneous (9.2%). Eight cases of disseminated disease were identified. Overall mortality in the identified cases was 40.8%, with the highest mortality rate in patients diagnosed with disseminated infection (75%). The mortality rate in rhinocerebral infection patients was significantly lower (45.8%). Rhinocerebral infection was the most common clinical manifestation in diabetes patients (72.9%). Patients were diagnosed using various methods including histopathology (85.7%), microscopy (12.3%) and culture (2.0%). Rhizopus species were the most prevalent (51.7%), followed by Mucor species (17.2%). Sixty-nine patients were treated with a combination of surgery and antifungal therapy (resulting survival rate, 66.7%). Owing to the high mortality rate of advanced mucormycosis, early diagnosis and treatment may significantly improve survival rates. Therefore, increased monitoring and awareness of this life-threatening disease is critical. PMID:26906121

  1. Parkinson's disease in Arabs: a systematic review.

    PubMed

    Benamer, Hani T S; de Silva, Rajith; Siddiqui, Khurram A; Grosset, Donald G

    2008-07-15

    Studies of specific populations have provided invaluable knowledge about Parkinson's disease (PD), especially in the field of genetics. The present report systematically reviews the medical literature on PD in Arabs. Medline and Embase were searched, and 24 article were identified: genetic (n = 17), epidemiological (n = 3), and clinical series (n = 5). Both autosomal dominant and recessive forms of inherited PD are described, associated with four genes (Parkin, PINK1, LRRK2, and PARK9). The G2019S LRRK2 mutation is more common in both familial (37-42%) and apparently sporadic PD (41%) in North African Arabs than in Europeans and North Americans (2-3%). The incidence of PD is reported at 4.5 per 100,000 person-years and reported prevalence at 27 to 43 per 100,000 persons. Hospital-based clinical series suggest that parkinsonism is the commonest movement disorder. Clinical features of PD in Arabs are not significantly different from those reported elsewhere. PD was reported as the cause of dementia in around 7% of Arabs. The majority of studies relate to the role of genes in the etiology of PD in North African Arabs. Further genetic, epidemiological and clinical studies from the majority of Arabic countries may enhance our understanding of PD.

  2. Autism and social robotics: A systematic review.

    PubMed

    Pennisi, Paola; Tonacci, Alessandro; Tartarisco, Gennaro; Billeci, Lucia; Ruta, Liliana; Gangemi, Sebastiano; Pioggia, Giovanni

    2016-02-01

    Social robotics could be a promising method for Autism Spectrum Disorders (ASD) treatment. The aim of this article is to carry out a systematic literature review of the studies on this topic that were published in the last 10 years. We tried to address the following questions: can social robots be a useful tool in autism therapy? We followed the PRISMA guidelines, and the protocol was registered within PROSPERO database (CRD42015016158). We found many positive implications in the use of social robots in therapy as for example: ASD subjects often performed better with a robot partner rather than a human partner; sometimes, ASD patients had, toward robots, behaviors that TD patients had toward human agents; ASDs had a lot of social behaviors toward robots; during robotic sessions, ASDs showed reduced repetitive and stereotyped behaviors and, social robots manage to improve spontaneous language during therapy sessions. Therefore, robots provide therapists and researchers a means to connect with autistic subjects in an easier way, but studies in this area are still insufficient. It is necessary to clarify whether sex, intelligence quotient, and age of participants affect the outcome of therapy and whether any beneficial effects only occur during the robotic session or if they are still observable outside the clinical/experimental context. PMID:26483270

  3. Autism and social robotics: A systematic review.

    PubMed

    Pennisi, Paola; Tonacci, Alessandro; Tartarisco, Gennaro; Billeci, Lucia; Ruta, Liliana; Gangemi, Sebastiano; Pioggia, Giovanni

    2016-02-01

    Social robotics could be a promising method for Autism Spectrum Disorders (ASD) treatment. The aim of this article is to carry out a systematic literature review of the studies on this topic that were published in the last 10 years. We tried to address the following questions: can social robots be a useful tool in autism therapy? We followed the PRISMA guidelines, and the protocol was registered within PROSPERO database (CRD42015016158). We found many positive implications in the use of social robots in therapy as for example: ASD subjects often performed better with a robot partner rather than a human partner; sometimes, ASD patients had, toward robots, behaviors that TD patients had toward human agents; ASDs had a lot of social behaviors toward robots; during robotic sessions, ASDs showed reduced repetitive and stereotyped behaviors and, social robots manage to improve spontaneous language during therapy sessions. Therefore, robots provide therapists and researchers a means to connect with autistic subjects in an easier way, but studies in this area are still insufficient. It is necessary to clarify whether sex, intelligence quotient, and age of participants affect the outcome of therapy and whether any beneficial effects only occur during the robotic session or if they are still observable outside the clinical/experimental context.

  4. Acupuncture for Erectile Dysfunction: A Systematic Review

    PubMed Central

    Cui, Xiaoming; Zhou, Jing; Qin, Zongshi; Liu, Zhishun

    2016-01-01

    Background. Acupuncture is increasingly used to treat patients with erectile dysfunction (ED), and our systematic review aimed to evaluate the current evidence for the efficacy and safety of acupuncture in treating ED. Methods. An electronic search was conducted in eight databases to identify randomized controlled trials (RCTs) of acupuncture for treating erectile dysfunction that were published in English and Chinese. The Cochrane Risk of Bias tool was used to assess the risk of bias. Results. Three RCTs with a total of 183 participants met the inclusion criteria. One trial showed the beneficial effects of acupuncture compared with sham acupuncture while the others did not. One trial suggested that acupuncture combined with psychological therapy was superior to psychological therapy alone. However, the overall methodological and reporting quality of the studies was low. The safety of acupuncture for ED was unclear because there were too few reports on this topic. Conclusion. The available evidence supporting that acupuncture alone improves ED was insufficient and the available studies failed to show the specific therapeutic effect of acupuncture. Future well-designed and rigorous RCTs with a large sample size are required. This trial is registered with CRD42014013575. PMID:26885501

  5. Childhood asthma prediction models: a systematic review.

    PubMed

    Smit, Henriette A; Pinart, Mariona; Antó, Josep M; Keil, Thomas; Bousquet, Jean; Carlsen, Kai H; Moons, Karel G M; Hooft, Lotty; Carlsen, Karin C Lødrup

    2015-12-01

    Early identification of children at risk of developing asthma at school age is crucial, but the usefulness of childhood asthma prediction models in clinical practice is still unclear. We systematically reviewed all existing prediction models to identify preschool children with asthma-like symptoms at risk of developing asthma at school age. Studies were included if they developed a new prediction model or updated an existing model in children aged 4 years or younger with asthma-like symptoms, with assessment of asthma done between 6 and 12 years of age. 12 prediction models were identified in four types of cohorts of preschool children: those with health-care visits, those with parent-reported symptoms, those at high risk of asthma, or children in the general population. Four basic models included non-invasive, easy-to-obtain predictors only, notably family history, allergic disease comorbidities or precursors of asthma, and severity of early symptoms. Eight extended models included additional clinical tests, mostly specific IgE determination. Some models could better predict asthma development and other models could better rule out asthma development, but the predictive performance of no single model stood out in both aspects simultaneously. This finding suggests that there is a large proportion of preschool children with wheeze for which prediction of asthma development is difficult.

  6. Religiousness and Mental Health: Systematic Review Study.

    PubMed

    AbdAleati, Naziha S; Mohd Zaharim, Norzarina; Mydin, Yasmin Othman

    2016-12-01

    Many people use religious beliefs and practices to cope with stressful life events and derive peace of mind and purpose in life. The goal of this paper was to systematically review the recent psychological literature to assess the role of religion in mental health outcomes. A comprehensive literature search was conducted using medical and psychological databases on the relationship between religiosity and mental health. Seventy-four articles in the English and Arabic languages published between January 2000 and March 2012 were chosen. Despite the controversial relationship between religion and psychiatry, psychology, and medical care, there has been an increasing interest in the role which spirituality and religion play in mental health. The findings of past research showed that religion could play an important role in many situations, as religious convictions and rules influence the believer's life and health care. Most of the past literature in this area reported that there is a significant connection between religious beliefs and practices and mental health. PMID:27654836

  7. Olfaction in allergic rhinitis: A systematic review.

    PubMed

    Stuck, Boris A; Hummel, Thomas

    2015-12-01

    Olfactory dysfunction is a key symptom in patients with allergic rhinitis (AR). Despite the implications for quality of life, relatively few articles have tested olfactory function in their investigations. The current systematic review aimed to investigate the following 2 questions: (1) What does AR do to human olfaction? (2) How effective is the treatment of AR in restoring the sense of smell? A comprehensive literature search was performed, and human studies of any design were included. A total of 420 articles were identified, and 36 articles were considered relevant. Data indicate that the frequency of olfactory dysfunction increases with the duration of the disorder, and most studies report a frequency in the range of 20% to 40%. Although olfactory dysfunction does not appear to be very severe in patients with AR, its presence seems to increase with the severity of the disease. There is very limited evidence that antihistamines improve olfactory function. In addition, there is limited evidence that topical steroids improve the sense of smell, especially in patients with seasonal AR. This is also the case for specific immunotherapy. However, many questions remain unanswered because randomized controlled trials are infrequent and only a few studies rely on quantitative measurement of olfactory function.

  8. Cyberbullying and adolescent mental health: systematic review.

    PubMed

    Bottino, Sara Mota Borges; Bottino, Cássio M C; Regina, Caroline Gomez; Correia, Aline Villa Lobo; Ribeiro, Wagner Silva

    2015-03-01

    Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS). The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrators of cyberbullying. Daily use of three or more hours of Internet, web camera, text messages, posting personal information and harassing others online were associated with cyberbullying. Cybervictims and cyberbullies had more emotional and psychosomatic problems, social difficulties and did not feel safe and cared for in school. Cyberbullying was associated with moderate to severe depressive symptoms, substance use, ideation and suicide attempts. Health professionals should be aware of the violent nature of interactions occurring in the virtual environment and its harm to the mental health of adolescents. PMID:25859714

  9. 5 CFR 1312.10 - Systematic review guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Systematic review guidelines. 1312.10 Section 1312.10 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION... Declassification of National Security Information § 1312.10 Systematic review guidelines. The EOP Security...

  10. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Systematic declassification review. 9.11 Section 9.11 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.11 Systematic declassification review. The Information and Privacy Coordinator shall be responsible...

  11. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Systematic declassification review. 9.11 Section 9.11 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.11 Systematic declassification review. The Information and Privacy Coordinator shall be responsible...

  12. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Systematic declassification review. 9.11 Section 9.11 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.11 Systematic declassification review. The Information and Privacy Coordinator shall be responsible...

  13. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Systematic declassification review. 9.11 Section 9.11 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.11 Systematic declassification review. The Information and Privacy Coordinator shall be responsible...

  14. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Systematic declassification review. 9.11 Section 9.11 Foreign Relations DEPARTMENT OF STATE GENERAL SECURITY INFORMATION REGULATIONS § 9.11 Systematic declassification review. The Information and Privacy Coordinator shall be responsible...

  15. The Alameda County Study: A Systematic, Chronological Review

    ERIC Educational Resources Information Center

    Housman, Jeff; Dorman, Steve

    2005-01-01

    This study is a systematic review of the Alameda County study findings and their importance in establishing a link between lifestyle and health outcomes. A systematic review of literature was performed and data indicating important links between lifestyle and health were synthesized. Although initial studies focused on the associations between…

  16. Assessing the Strengths of Mental Health Consumers: A Systematic Review

    ERIC Educational Resources Information Center

    Bird, Victoria J.; Le Boutillier, Clair; Leamy, Mary; Larsen, John; Oades, Lindsay G.; Williams, Julie; Slade, Mike

    2012-01-01

    Strengths assessments focus on the individual's talents, abilities, resources, and strengths. No systematic review of strengths assessments for use within mental health populations has been published. The aims of this study were to describe and evaluate strengths assessments for use within mental health services. A systematic review identified 12…

  17. Systematic Reviews of Research in Science Education: Rigour or Rigidity?

    ERIC Educational Resources Information Center

    Bennett, Judith; Lubben, Fred; Hogarth, Sylvia; Campbell, Bob

    2005-01-01

    This paper explores the role of systematic reviews of research literature and considers what they have to offer research in science education. The origins of systematic reviews are described, together with the reasons why they are currently attracting considerable attention in the research literature. An overview is presented of the key features…

  18. 14 CFR 1203.603 - Systematic review for declassification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Systematic review for declassification. 1203.603 Section 1203.603 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Declassification and Downgrading § 1203.603 Systematic review for declassification....

  19. 14 CFR 1203.603 - Systematic review for declassification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Systematic review for declassification. 1203.603 Section 1203.603 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Declassification and Downgrading § 1203.603 Systematic review...

  20. 14 CFR § 1203.603 - Systematic review for declassification:

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Systematic review for declassification: § 1203.603 Section § 1203.603 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Declassification and Downgrading § 1203.603 Systematic review...

  1. 14 CFR 1203.603 - Systematic review for declassification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Systematic review for declassification. 1203.603 Section 1203.603 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Declassification and Downgrading § 1203.603 Systematic review...

  2. 14 CFR 1203.603 - Systematic review for declassification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Systematic review for declassification. 1203.603 Section 1203.603 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Declassification and Downgrading § 1203.603 Systematic review...

  3. Genetic Association Studies in Lumbar Disc Degeneration: A Systematic Review

    PubMed Central

    Eskola, Pasi J.; Lemmelä, Susanna; Kjaer, Per; Solovieva, Svetlana; Männikkö, Minna; Tommerup, Niels; Lind-Thomsen, Allan; Husgafvel-Pursiainen, Kirsti; Cheung, Kenneth M. C.; Chan, Danny

    2012-01-01

    Objective Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI) in humans. Methods A systematic literature search was conducted in MEDLINE, MEDLINE In-Process, SCOPUS, ISI Web of Science, The Genetic Association Database and The Human Genome Epidemiology Network for information published between 1990–2011 addressing genes and lumbar disc degeneration. Two investigators independently identified studies to determine inclusion, after which they performed data extraction and analysis. The level of cumulative genetic association evidence was analyzed according to The HuGENet Working Group guidelines. Results Fifty-two studies were included for review. Forty-eight studies reported at least one positive association between a genetic marker and lumbar disc degeneration. The phenotype definition of lumbar disc degeneration was highly variable between the studies and replications were inconsistent. Most of the associations presented with a weak level of evidence. The level of evidence was moderate for ASPN (D-repeat), COL11A1 (rs1676486), GDF5 (rs143383), SKT (rs16924573), THBS2 (rs9406328) and MMP9 (rs17576). Conclusions Based on this first extensive systematic review on the topic, the credibility of reported genetic associations is mostly weak. Clear definition of lumbar disc degeneration phenotypes and large population-based cohorts are needed. An international consortium is needed to standardize genetic association studies in relation to disc degeneration. PMID:23185509

  4. Innovations in data collection, management, and archiving for systematic reviews.

    PubMed

    Li, Tianjing; Vedula, S Swaroop; Hadar, Nira; Parkin, Christopher; Lau, Joseph; Dickersin, Kay

    2015-02-17

    Data abstraction is a key step in conducting systematic reviews because data collected from study reports form the basis of appropriate conclusions. Recent methodological standards and expectations highlight several principles for data collection. To support implementation of these standards, this article provides a step-by-step tutorial for selecting data collection tools; constructing data collection forms; and abstracting, managing, and archiving data for systematic reviews. Examples are drawn from recent experience using the Systematic Review Data Repository for data collection and management. If it is done well, data collection for systematic reviews only needs to be done by 1 team and placed into a publicly accessible database for future use. Technological innovations, such as the Systematic Review Data Repository, will contribute to finding trustworthy answers for many health and health care questions.

  5. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

    PubMed Central

    2013-01-01

    Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small

  6. Laparoscopic surgery: A qualified systematic review

    PubMed Central

    Buia, Alexander; Stockhausen, Florian; Hanisch, Ernst

    2015-01-01

    AIM: To review current applications of the laparoscopic surgery while highlighting the standard procedures across different fields. METHODS: A comprehensive search was undertaken using the PubMed Advanced Search Builder. A total of 321 articles were found in this search. The following criteria had to be met for the publication to be selected: Review article, randomized controlled trials, or meta-analyses discussing the subject of laparoscopic surgery. In addition, publications were hand-searched in the Cochrane database and the high-impact journals. A total of 82 of the findings were included according to matching the inclusion criteria. Overall, 403 full-text articles were reviewed. Of these, 218 were excluded due to not matching the inclusion criteria. RESULTS: A total of 185 relevant articles were identified matching the search criteria for an overview of the current literature on the laparoscopic surgery. Articles covered the period from the first laparoscopic application through its tremendous advancement over the last several years. Overall, the biggest advantage of the procedure has been minimizing trauma to the abdominal wall compared with open surgery. In the case of cholecystectomy, fundoplication, and adrenalectomy, the procedure has become the gold standard without being proven as a superior technique over the open surgery in randomized controlled trials. Faster recovery, reduced hospital stay, and a quicker return to normal activities are the most evident advantages of the laparoscopic surgery. Positive outcomes, efficiency, a lower rate of wound infections, and reduction in the perioperative morbidity of minimally invasive procedures have been shown in most indications. CONCLUSION: Improvements in surgical training and developments in instruments, imaging, and surgical techniques have greatly increased safety and feasibility of the laparoscopic surgical procedures. PMID:26713285

  7. The detectability of brain metastases using contrast-enhanced spin-echo or gradient-echo images: a systematic review and meta-analysis.

    PubMed

    Suh, Chong Hyun; Jung, Seung Chai; Kim, Kyung Won; Pyo, Junhee

    2016-09-01

    This study aimed to compare the detectability of brain metastases using contrast-enhanced spin-echo (SE) and gradient-echo (GRE) T1-weighted images. The Ovid-MEDLINE and EMBASE databases were searched for studies on the detectability of brain metastases using contrast-enhanced SE or GRE images. The pooled proportions for the detectability of brain metastases were assessed using random-effects modeling. Heterogeneity among studies was determined using χ (2) statistics for the pooled estimates and the inconsistency index, I (2) . To overcome heterogeneity, subgroup analyses according to slice thickness and lesion size were performed. A total of eight eligible studies, which included a sample size of 252 patients and 1413 brain metastases, were included. The detectability of brain metastases using SE images (89.2 %) was higher than using GRE images (81.6 %; adjusted 84.0 %), but this difference was not statistically significant (p = 0.2385). In subgroup analysis of studies with 1-mm-thick slices and small metastases (<5 mm in diameter), 3-dimensional (3D) SE images demonstrated a higher detectability in comparison to 3D GRE images (93.7 % vs 73.1 % in 1-mm-thick slices; 89.5 % vs 59.4 % for small metastases) (p < 0.0001). Although both SE or GRE images are acceptable for detecting brain metastases, contrast-enhanced 3D SE images using 1-mm-thick slices are preferred for detecting brain metastases, especially small lesions (<5 mm in diameter).

  8. Acupuncture for low back pain: an overview of systematic reviews.

    PubMed

    Liu, Lizhou; Skinner, Margot; McDonough, Suzanne; Mabire, Leon; Baxter, George David

    2015-01-01

    Objective. As evidence of the effectiveness of acupuncture for low back pain (LBP) is inconsistent, we aimed to critically appraise the evidence from relevant systematic reviews. Methods. Systematic reviews of randomized controlled trials (RCTs) concerning acupuncture and LBP were searched in seven databases. Internal validity and external validity of systematic reviews were assessed. Systematic reviews were categorized and high quality reviews assigned greater weightings. Conclusions were generated from a narrative synthesis of the outcomes of subgroup comparisons. Results. Sixteen systematic reviews were appraised. Overall, the methodological quality was low and external validity weak. For acute LBP, evidence that acupuncture has a more favorable effect than sham acupuncture in relieving pain was inconsistent; it had a similar effect on improving function. For chronic LBP, evidence consistently demonstrated that acupuncture provides short-term clinically relevant benefits for pain relief and functional improvement compared with no treatment or acupuncture plus another conventional intervention. Conclusion. Systematic reviews of variable quality showed that acupuncture, either used in isolation or as an adjunct to conventional therapy, provides short-term improvements in pain and function for chronic LBP. More efforts are needed to improve both internal and external validity of systematic reviews and RCTs in this area. PMID:25821485

  9. Acupuncture for Low Back Pain: An Overview of Systematic Reviews

    PubMed Central

    Liu, Lizhou; Skinner, Margot; McDonough, Suzanne; Mabire, Leon; Baxter, George David

    2015-01-01

    Objective. As evidence of the effectiveness of acupuncture for low back pain (LBP) is inconsistent, we aimed to critically appraise the evidence from relevant systematic reviews. Methods. Systematic reviews of randomized controlled trials (RCTs) concerning acupuncture and LBP were searched in seven databases. Internal validity and external validity of systematic reviews were assessed. Systematic reviews were categorized and high quality reviews assigned greater weightings. Conclusions were generated from a narrative synthesis of the outcomes of subgroup comparisons. Results. Sixteen systematic reviews were appraised. Overall, the methodological quality was low and external validity weak. For acute LBP, evidence that acupuncture has a more favorable effect than sham acupuncture in relieving pain was inconsistent; it had a similar effect on improving function. For chronic LBP, evidence consistently demonstrated that acupuncture provides short-term clinically relevant benefits for pain relief and functional improvement compared with no treatment or acupuncture plus another conventional intervention. Conclusion. Systematic reviews of variable quality showed that acupuncture, either used in isolation or as an adjunct to conventional therapy, provides short-term improvements in pain and function for chronic LBP. More efforts are needed to improve both internal and external validity of systematic reviews and RCTs in this area. PMID:25821485

  10. Cardiorespiratory fitness after stroke: a systematic review.

    PubMed

    Smith, Alexandra C; Saunders, David H; Mead, Gillian

    2012-08-01

    Cardiorespiratory fitness programs are increasingly used in stroke rehabilitation. Maximal oxygen uptake is the gold standard measurement of cardiorespiratory fitness; however, no recent publications have collated evidence about maximal oxygen uptake levels following stroke. We therefore performed a systematic review of maximal oxygen uptake in stroke survivors, aiming to observe changes in levels over time, and associations with severity of stroke. We searched Medline and Embase until April 2011, and included cross-sectional studies, longitudinal studies, and baseline data from intervention trials. Studies had to recruit at least 10 stroke survivors, and report direct measurement of maximal/peak oxygen uptake. We then compared maximal oxygen uptake with published data from age and gender-matched controls. The search identified 3357 articles. Seventy-two full texts were retrieved, of which 41 met the inclusion criteria. Time since stroke ranged from 10 days to over seven-years. Peak oxygen uptake ranged from 8 to 22 ml/kg/min, which was 26-87% of that of healthy age- and gender-matched individuals. Stroke severity was mild in most studies. Three studies reported longitudinal changes; there was no clear evidence of change in peak oxygen uptake over time. Most studies recruited participants with mild stroke, and it is possible that cardiorespiratory fitness is even more impaired after severe stroke. Maximal oxygen uptake might have been overestimated, as less healthy and older stroke survivors may not tolerate maximal exercise testing. More studies are needed describing mechanisms of impaired cardiorespiratory fitness and longitudinal changes over time to inform the optimal 'prescription' of cardiorespiratory fitness programs for stroke survivors. PMID:22568786

  11. Suicide in India: a systematic review

    PubMed Central

    RANE, Anil; NADKARNI, Abhijit

    2014-01-01

    Background Suicide is an important cause of death in India but estimated suicide rates based on data from India’s National Crime Records Bureau are unreliable. Aim Systematically review existing literature on suicide and the factors associated with suicide in India. Methods PubMed, PsycINFO, EMBASE, Global Health, Google Scholar and IndMED were searched using appropriate search terms. The abstracts of relevant papers were independently examined by both authors for possible inclusion. A standardized set of data items were abstracted from the full text of the selected papers. Results Thirty-six papers met inclusion criteria for the analysis. The heterogeneity of sampling procedures and methods of the studies made meta-analysis of the results infeasible. Verbal autopsy studies in several rural locations in India report high suicide rates, from 82 to 95 per 100,000 population – up to 8-fold higher than the official national suicide rates. Suicide rates are highest in persons 20 to 29 years of age. Female suicide rates are higher than male rates in persons under 30 years of age but the opposite is true in those 30 years of age or older. Hanging and ingestion of organophosphate pesticides are the most common methods of suicide. Among women, self-immolation is also a relatively common method of suicide. Low socioeconomic status, mental illness (especially alcohol misuse) and inter-personal difficulties are the factors that are most closely associated with suicide. Conclusion The quality of the information about suicide in India is quite limited, but it is clearly an important and growing public health problem. Compared to suicides in high-income countries, suicide in India is more prevalent in women (particularly young women), is much more likely to involve ingestion of pesticides, is more closely associated with poverty, and is less closely associated with mental illness. PMID:25092952

  12. Probiotics for infantile colic: a systematic review

    PubMed Central

    2013-01-01

    Background Infantile colic is a common paediatric condition which causes significant parental distress. Increased intestinal coliform colonization in addition to alteration in Lactobacillus abundance and distribution may play an important role in its pathogenesis. The objectives of this systematic review are to evaluate the efficacy of probiotic supplementation in the reduction of crying time and successful treatment of infantile colic. Methods Literature searches were conducted of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. Only randomized controlled trials enrolling term, healthy infants with colic were included. A meta-analysis of included trials was performed utilizing the Cochrane Collaboration methodology. Results Three trials that enrolled 220 breastfed infants met inclusion criteria, of which 209 infants were available for analysis. Two of the studies were assessed as good quality. Lactobacillus reuteri (strains-American Type Culture Collection Strain 55730 and DSM 17 938) was the only species utilized in the therapeutic intervention. Two of the trials were industry funded. Probiotic supplementation compared to simethicone or placebo significantly and progressively shortened crying times to 7 days reaching a plateau at three weeks post initiation of therapy [mean difference −56.03 minutes; 95% CI (−59.92, -52.15)]. Similarly, probiotics compared to placebo significantly increased the treatment success of infantile colic with a relative risk (RR) of 0.06; 95% CI (0.01, 0.25) and a number needed to treat of 2. Conclusions Although L. reuteri may be effective as a treatment strategy for crying in exclusively breastfed infants with colic, the evidence supporting probiotic use for the treatment of infant colic or crying in formula-fed infants remains unresolved. Results from larger rigorously designed studies will help draw more definitive conclusions. PMID:24238101

  13. Patient engagement in research: a systematic review

    PubMed Central

    2014-01-01

    Background A compelling ethical rationale supports patient engagement in healthcare research. It is also assumed that patient engagement will lead to research findings that are more pertinent to patients’ concerns and dilemmas. However; it is unclear how to best conduct this process. In this systematic review we aimed to answer 4 key questions: what are the best ways to identify patient representatives? How to engage them in designing and conducting research? What are the observed benefits of patient engagement? What are the harms and barriers of patient engagement? Methods We searched MEDLINE, EMBASE, PsycInfo, Cochrane, EBSCO, CINAHL, SCOPUS, Web of Science, Business Search Premier, Academic Search Premier and Google Scholar. Included studies were published in English, of any size or design that described engaging patients or their surrogates in research design. We conducted an environmental scan of the grey literature and consulted with experts and patients. Data were analyzed using a non-quantitative, meta-narrative approach. Results We included 142 studies that described a spectrum of engagement. In general, engagement was feasible in most settings and most commonly done in the beginning of research (agenda setting and protocol development) and less commonly during the execution and translation of research. We found no comparative analytic studies to recommend a particular method. Patient engagement increased study enrollment rates and aided researchers in securing funding, designing study protocols and choosing relevant outcomes. The most commonly cited challenges were related to logistics (extra time and funding needed for engagement) and to an overarching worry of a tokenistic engagement. Conclusions Patient engagement in healthcare research is likely feasible in many settings. However, this engagement comes at a cost and can become tokenistic. Research dedicated to identifying the best methods to achieve engagement is lacking and clearly needed. PMID

  14. Systematic Review Checklist: A Standardized Technique for Assessing and Reporting Reviews of Life Cycle Assessment Data

    PubMed Central

    Zumsteg, Jennifer M.; Cooper, Joyce S.; Noon, Michael S.

    2015-01-01

    Summary Systematic review, including meta-analysis, is increasingly utilized in life cycle assessment (LCA). There are currently no widely recognized guidelines for designing, conducting, or reporting systematic reviews in LCA. Other disciplines such as medicine, ecology, and software engineering have both recognized the utility of systematic reviews and created standardized protocols for conducting and reporting systematic reviews. Based largely on the 2009 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, which updated the preferred format for reporting of such reviews in biomedical research, we provide an introduction to the topic and a checklist to guide the reporting of future LCA reviews in a standardized format. The standardized technique for assessing and reporting reviews of LCA (STARR-LCA) checklist is a starting point for improving the utility of systematic reviews in LCA. PMID:26069437

  15. Population attributable fraction of modifiable risk factors for Alzheimer disease: A systematic review of systematic reviews

    PubMed Central

    Hazar, Narjes; Seddigh, Leila; Rampisheh, Zahra; Nojomi, Marzieh

    2016-01-01

    Background: Alzheimer’s disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable cardiovascular risk factors of AD using existing data and determine their contribution in AD development in Iran and the world. Methods: The systematic search was done in Medline, Scopus, and Cochrane databases from inception to May 2014 to find systematic reviews or meta-analyses about association between AD and cardiovascular modifiable risk factors included diabetes, hypertension (HTN), physical inactivity, smoking, hypercholesterolemia, and overweight and obesity. The population attributable fraction (PAF) was calculated for these risk factors in Iran and the world. Results: Of 2651 articles, 11 were eligible for data extraction after assessing relevancy and quality. Diabetes mellitus (DM) type 2, smoking, physical inactivity, overweight and obesity were significantly associated with increased risk of AD. Physical inactivity with 22.0% and smoking with 15.7% had the highest PAF for AD in Iran and the world, respectively. Conclusion: Our findings demonstrated that modifiable cardiovascular risk factors could increase the risk of AD. Moreover, about one-third of AD cases were attributed to five modifiable risk factors. PMID:27648178

  16. Population attributable fraction of modifiable risk factors for Alzheimer disease: A systematic review of systematic reviews

    PubMed Central

    Hazar, Narjes; Seddigh, Leila; Rampisheh, Zahra; Nojomi, Marzieh

    2016-01-01

    Background: Alzheimer’s disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable cardiovascular risk factors of AD using existing data and determine their contribution in AD development in Iran and the world. Methods: The systematic search was done in Medline, Scopus, and Cochrane databases from inception to May 2014 to find systematic reviews or meta-analyses about association between AD and cardiovascular modifiable risk factors included diabetes, hypertension (HTN), physical inactivity, smoking, hypercholesterolemia, and overweight and obesity. The population attributable fraction (PAF) was calculated for these risk factors in Iran and the world. Results: Of 2651 articles, 11 were eligible for data extraction after assessing relevancy and quality. Diabetes mellitus (DM) type 2, smoking, physical inactivity, overweight and obesity were significantly associated with increased risk of AD. Physical inactivity with 22.0% and smoking with 15.7% had the highest PAF for AD in Iran and the world, respectively. Conclusion: Our findings demonstrated that modifiable cardiovascular risk factors could increase the risk of AD. Moreover, about one-third of AD cases were attributed to five modifiable risk factors.

  17. Feverfew (Tanacetum parthenium L.): A systematic review

    PubMed Central

    Pareek, Anil; Suthar, Manish; Rathore, Garvendra S.; Bansal, Vijay

    2011-01-01

    Feverfew (Tanacetum parthenium L.) (Asteraceae) is a medicinal plant traditionally used for the treatment of fevers, migraine headaches, rheumatoid arthritis, stomach aches, toothaches, insect bites, infertility, and problems with menstruation and labor during childbirth. The feverfew herb has a long history of use in traditional and folk medicine, especially among Greek and early European herbalists. Feverfew has also been used for psoriasis, allergies, asthma, tinnitus, dizziness, nausea, and vomiting. The plant contains a large number of natural products, but the active principles probably include one or more of the sesquiterpene lactones known to be present, including parthenolide. Other potentially active constituents include flavonoid glycosides and pinenes. It has multiple pharmacologic properties, such as anticancer, anti-inflammatory, cardiotonic, antispasmodic, an emmenagogue, and as an enema for worms. In this review, we have explored the various dimensions of the feverfew plant and compiled its vast pharmacologic applications to comprehend and synthesize the subject of its potential image of multipurpose medicinal agent. The plant is widely cultivated to large regions of the world and its importance as a medicinal plant is growing substantially with increasing and stronger reports in support of its multifarious therapeutic uses. PMID:22096324

  18. A Systematic Summary of Systematic Reviews on the Topic of the Anterior Cruciate Ligament

    PubMed Central

    Anderson, Michael J.; Browning, William M.; Urband, Christopher E.; Kluczynski, Melissa A.; Bisson, Leslie J.

    2016-01-01

    Background: There has been a substantial increase in the amount of systematic reviews and meta-analyses published on the anterior cruciate ligament (ACL). Purpose: To quantify the number of systematic reviews and meta-analyses published on the ACL in the past decade and to provide an overall summary of this literature. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of all ACL-related systematic reviews and meta-analyses published between January 2004 and September 2014 was performed using PubMed, MEDLINE, and the Cochrane Database. Narrative reviews and non-English articles were excluded. Results: A total of 1031 articles were found, of which 240 met the inclusion criteria. Included articles were summarized and divided into 17 topics: anatomy, epidemiology, prevention, associated injuries, diagnosis, operative versus nonoperative management, graft choice, surgical technique, fixation methods, computer-assisted surgery, platelet-rich plasma, rehabilitation, return to play, outcomes assessment, arthritis, complications, and miscellaneous. Conclusion: A summary of systematic reviews on the ACL can supply the surgeon with a single source for the most up-to-date synthesis of the literature. PMID:27047983

  19. Introduction to systematic reviews in animal agriculture and veterinary medicine.

    PubMed

    Sargeant, J M; O'Connor, A M

    2014-06-01

    This article is the first in a series of six articles related to systematic reviews in animal agriculture and veterinary medicine. In this article, we overview the methodology of systematic reviews and provide a discussion of their use. Systematic reviews differ qualitatively from traditional reviews by explicitly defining a specific review question, employing methods to reduce bias in the selection and inclusion of studies that address the review question (including a systematic and specified search strategy, and selection of studies based on explicit eligibility criteria), an assessment of the risk of bias for included studies and objectively summarizing the results qualitatively or quantitatively (i.e. via meta-analysis). Systematic reviews have been widely used to address human healthcare questions and are increasingly being used in veterinary medicine. Systematic reviews can provide veterinarians and other decision-makers with a scientifically defensible summary of the current state of knowledge on a topic without the need for the end-user to read the vast amount of primary research related to that topic.

  20. Searching for grey literature for systematic reviews: challenges and benefits.

    PubMed

    Mahood, Quenby; Van Eerd, Dwayne; Irvin, Emma

    2014-09-01

    There is ongoing interest in including grey literature in systematic reviews. Including grey literature can broaden the scope to more relevant studies, thereby providing a more complete view of available evidence. Searching for grey literature can be challenging despite greater access through the Internet, search engines and online bibliographic databases. There are a number of publications that list sources for finding grey literature in systematic reviews. However, there is scant information about how searches for grey literature are executed and how it is included in the review process. This level of detail is important to ensure that reviews follow explicit methodology to be systematic, transparent and reproducible. The purpose of this paper is to provide a detailed account of one systematic review team's experience in searching for grey literature and including it throughout the review. We provide a brief overview of grey literature before describing our search and review approach. We also discuss the benefits and challenges of including grey literature in our systematic review, as well as the strengths and limitations to our approach. Detailed information about incorporating grey literature in reviews is important in advancing methodology as review teams adapt and build upon the approaches described.

  1. Searching for grey literature for systematic reviews: challenges and benefits.

    PubMed

    Mahood, Quenby; Van Eerd, Dwayne; Irvin, Emma

    2014-09-01

    There is ongoing interest in including grey literature in systematic reviews. Including grey literature can broaden the scope to more relevant studies, thereby providing a more complete view of available evidence. Searching for grey literature can be challenging despite greater access through the Internet, search engines and online bibliographic databases. There are a number of publications that list sources for finding grey literature in systematic reviews. However, there is scant information about how searches for grey literature are executed and how it is included in the review process. This level of detail is important to ensure that reviews follow explicit methodology to be systematic, transparent and reproducible. The purpose of this paper is to provide a detailed account of one systematic review team's experience in searching for grey literature and including it throughout the review. We provide a brief overview of grey literature before describing our search and review approach. We also discuss the benefits and challenges of including grey literature in our systematic review, as well as the strengths and limitations to our approach. Detailed information about incorporating grey literature in reviews is important in advancing methodology as review teams adapt and build upon the approaches described. PMID:26052848

  2. Class II functional orthopaedic treatment: a systematic review of systematic reviews.

    PubMed

    D'Antò, V; Bucci, R; Franchi, L; Rongo, R; Michelotti, A; Martina, R

    2015-08-01

    This Systematic Review (SR) aims to assess the quality of SRs and Meta-Analyses (MAs) on functional orthopaedic treatment of Class II malocclusion and to summarise and rate the reported effects. Electronic and manual searches were conducted until June 2014. SRs and MAs focusing on the effects of functional orthopaedic treatment of Class II malocclusion in growing patients were included. The methodological quality of the included papers was assessed using the AMSTAR (Assessment of Multiple Systematic Reviews). The design of the primary studies included in each SR was assessed with Level of Research Design scoring. The evidence of the main outcomes was summarised and rated according to a scale of statements. 14 SRs fulfilled the inclusion criteria. The appliances evaluated were as follows: Activator (2 studies), Twin Block (4 studies), headgear (3 studies), Herbst (2 studies), Jasper Jumper (1 study), Bionator (1 study) and Fränkel-2 (1 study). Four studies reviewed several functional appliances, as a group. The mean AMSTAR score was 6 (ranged 2-10). Six SRs included only controlled clinical trials (CCTs), three SRs included only randomised controlled trials (RCTs), four SRs included both CCTs and RCTs and one SR included also expert opinions. There was some evidence of reduction of the overjet, with different appliances except from headgear; there was some evidence of small maxillary growth restrain with Twin Block and headgear; there was some evidence of elongation of mandibular length, but the clinical relevance of this results is still questionable; there was insufficient evidence to determine an effect on soft tissues.

  3. Class II functional orthopaedic treatment: a systematic review of systematic reviews.

    PubMed

    D'Antò, V; Bucci, R; Franchi, L; Rongo, R; Michelotti, A; Martina, R

    2015-08-01

    This Systematic Review (SR) aims to assess the quality of SRs and Meta-Analyses (MAs) on functional orthopaedic treatment of Class II malocclusion and to summarise and rate the reported effects. Electronic and manual searches were conducted until June 2014. SRs and MAs focusing on the effects of functional orthopaedic treatment of Class II malocclusion in growing patients were included. The methodological quality of the included papers was assessed using the AMSTAR (Assessment of Multiple Systematic Reviews). The design of the primary studies included in each SR was assessed with Level of Research Design scoring. The evidence of the main outcomes was summarised and rated according to a scale of statements. 14 SRs fulfilled the inclusion criteria. The appliances evaluated were as follows: Activator (2 studies), Twin Block (4 studies), headgear (3 studies), Herbst (2 studies), Jasper Jumper (1 study), Bionator (1 study) and Fränkel-2 (1 study). Four studies reviewed several functional appliances, as a group. The mean AMSTAR score was 6 (ranged 2-10). Six SRs included only controlled clinical trials (CCTs), three SRs included only randomised controlled trials (RCTs), four SRs included both CCTs and RCTs and one SR included also expert opinions. There was some evidence of reduction of the overjet, with different appliances except from headgear; there was some evidence of small maxillary growth restrain with Twin Block and headgear; there was some evidence of elongation of mandibular length, but the clinical relevance of this results is still questionable; there was insufficient evidence to determine an effect on soft tissues. PMID:25824331

  4. Incorporating Qualitative Evidence in Systematic Reviews: Strategies and Challenges

    ERIC Educational Resources Information Center

    Caracelli, Valerie J.; Cooksy, Leslie J.

    2013-01-01

    The quality of mixed methods systematic reviews relies on the quality of primary-level studies. The synthesis of qualitative evidence and the recent development of synthesizing mixed methods studies hold promise, but also pose challenges to evidence synthesis.

  5. Medical hyperspectral imaging: a review

    PubMed Central

    Lu, Guolan; Fei, Baowei

    2014-01-01

    Abstract. Hyperspectral imaging (HSI) is an emerging imaging modality for medical applications, especially in disease diagnosis and image-guided surgery. HSI acquires a three-dimensional dataset called hypercube, with two spatial dimensions and one spectral dimension. Spatially resolved spectral imaging obtained by HSI provides diagnostic information about the tissue physiology, morphology, and composition. This review paper presents an overview of the literature on medical hyperspectral imaging technology and its applications. The aim of the survey is threefold: an introduction for those new to the field, an overview for those working in the field, and a reference for those searching for literature on a specific application. PMID:24441941

  6. Shooting Mechanisms in Nature: A Systematic Review

    PubMed Central

    Sakes, Aimée; van der Wiel, Marleen; Henselmans, Paul W. J.; van Leeuwen, Johan L.; Dodou, Dimitra; Breedveld, Paul

    2016-01-01

    Background In nature, shooting mechanisms are used for a variety of purposes, including prey capture, defense, and reproduction. This review offers insight into the working principles of shooting mechanisms in fungi, plants, and animals in the light of the specific functional demands that these mechanisms fulfill. Methods We systematically searched the literature using Scopus and Web of Knowledge to retrieve articles about solid projectiles that either are produced in the body of the organism or belong to the body and undergo a ballistic phase. The shooting mechanisms were categorized based on the energy management prior to and during shooting. Results Shooting mechanisms were identified with projectile masses ranging from 1·10−9 mg in spores of the fungal phyla Ascomycota and Zygomycota to approximately 10,300 mg for the ballistic tongue of the toad Bufo alvarius. The energy for shooting is generated through osmosis in fungi, plants, and animals or muscle contraction in animals. Osmosis can be induced by water condensation on the system (in fungi), or water absorption in the system (reaching critical pressures up to 15.4 atmospheres; observed in fungi, plants, and animals), or water evaporation from the system (reaching up to −197 atmospheres; observed in plants and fungi). The generated energy is stored as elastic (potential) energy in cell walls in fungi and plants and in elastic structures in animals, with two exceptions: (1) in the momentum catapult of Basidiomycota the energy is stored in a stalk (hilum) by compression of the spore and droplets and (2) in Sphagnum energy is mainly stored in compressed air. Finally, the stored energy is transformed into kinetic energy of the projectile using a catapult mechanism delivering up to 4,137 J/kg in the osmotic shooting mechanism in cnidarians and 1,269 J/kg in the muscle-powered appendage strike of the mantis shrimp Odontodactylus scyllarus. The launch accelerations range from 6.6g in the frog Rana pipiens to 5

  7. Systematic Review of Focal Prostate Brachytherapy and the Future Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion.

    PubMed

    Peach, M Sean; Trifiletti, Daniel M; Libby, Bruce

    2016-01-01

    Prostate cancer is the most common malignancy found in North American and European men and the second most common cause of cancer related death. Since the practice of PSA screening has become common the disease is most often found early and can have a long indolent course. Current definitive therapy treats the whole gland but has considerable long-term side effects. Focal therapies may be able to target the cancer while decreasing dose to organs at risk. Our objective was to determine if focal prostate brachytherapy could meet target objectives while permitting a decrease in dose to organs at risk in a way that would allow future salvage treatments. Further, we wanted to determine if focal treatment results in less toxicity. Utilizing the Medline repository, dosimetric papers comparing whole gland to partial gland brachytherapy and clinical papers that reported toxicity of focal brachytherapy were selected. A total of 9 dosimetric and 6 clinical papers met these inclusion criteria. Together, these manuscripts suggest that focal brachytherapy may be employed to decrease dose to organs at risk with decreased toxicity. Of current technology, image-guided HDR brachytherapy using MRI registered to transrectal ultrasound offers the flexibility and efficiency to achieve such focal treatments. PMID:27293899

  8. A systematic review of strong gravitational lens modeling software

    NASA Astrophysics Data System (ADS)

    Lefor, Alan T.; Futamase, Toshifumi; Akhlaghi, Mohammad

    2013-07-01

    Despite expanding research activity in gravitational lens modeling, there is no particular software which is considered a standard. Much of the gravitational lens modeling software is written by individual investigators for their own use. Some gravitational lens modeling software is freely available for download but is widely variable with regard to ease of use and quality of documentation. This review of 13 software packages was undertaken to provide a single source of information. Gravitational lens models are classified as parametric models or non-parametric models, and can be further divided into research and educational software. Software used in research includes the GRAVLENS package (with both gravlens and lensmodel), Lenstool, LensPerfect, glafic, PixeLens, SimpLens, Lensview, and GRALE. In this review, GravLensHD, G-Lens, Gravitational Lensing, lens and MOWGLI are categorized as educational programs that are useful for demonstrating various aspects of lensing. Each of the 13 software packages is reviewed with regard to software features (installation, documentation, files provided, etc.) and lensing features (type of model, input data, output data, etc.) as well as a brief review of studies where they have been used. Recent studies have demonstrated the utility of strong gravitational lensing data for mass mapping, and suggest increased use of these techniques in the future. Coupled with the advent of greatly improved imaging, new approaches to modeling of strong gravitational lens systems are needed. This is the first systematic review of strong gravitational lens modeling software, providing investigators with a starting point for future software development to further advance gravitational lens modeling research. http://www.ephysics.org/mowgli/

  9. Therapeutic role of systematic lymphadenectomy in early-stage endometrial cancer: A systematic review

    PubMed Central

    LI, MEI-YI; HU, XIAO-XIA; ZHONG, JIAN-HONG; CHEN, LU-LU; LIN, YONG-XIU

    2016-01-01

    The purpose of the current review was to examine whether systematic lymphadenectomy is safe and effective for treating early-stage endometrial cancer. PubMed, Embase, the Cochrane Library and the China National Knowledge Infrastructure databases were systematically searched during April 2014 to identify studies comparing the use of systematic lymphadenectomy and no systematic lymphadenectomy in parallel for the treatment of early-stage endometrial cancer. A total of 13 eligible studies involving 51,155 patients were included in this review. The median overall survival (OS) rate at 5 years following lymphadenectomy was 90% (range, 73.1–98.3%) for patients undergoing the systematic procedure and 88.2% (range, 68–98.4%) for patients not undergoing the systematic procedure. For the two types of lymphadenectomy, OS has tended to improve over the last 20 years. The combined rate of disease-free and progression-free survival was higher in patients who underwent systematic lymphadenectomy, and the recurrence rate was lower. In particular, systematic lymphadenectomy was associated with markedly higher OS than the non-systematic procedure for patients with intermediate- and high-risk endometrial cancer when ≥11 lymph nodes were removed. Systematic lymphadenectomy demonstrates clinical benefit in patients with early-stage endometrial cancer and should thus be a standard treatment option. In conclusion, systematic lymphadenectomy leads to higher OS than no systematic lymphadenectomy in intermediate- and high-risk patients with early-stage endometrial cancer, particularly when the procedure removes ≥11 lymph nodes. PMID:27313706

  10. Integration of existing systematic reviews into new reviews: identification of guidance needs

    PubMed Central

    2014-01-01

    Background An exponential increase in the number of systematic reviews published, and constrained resources for new reviews, means that there is an urgent need for guidance on explicitly and transparently integrating existing reviews into new systematic reviews. The objectives of this paper are: 1) to identify areas where existing guidance may be adopted or adapted, and 2) to suggest areas for future guidance development. Methods We searched documents and websites from healthcare focused systematic review organizations to identify and, where available, to summarize relevant guidance on the use of existing systematic reviews. We conducted informational interviews with members of Evidence-based Practice Centers (EPCs) to gather experiences in integrating existing systematic reviews, including common issues and challenges, as well as potential solutions. Results There was consensus among systematic review organizations and the EPCs about some aspects of incorporating existing systematic reviews into new reviews. Current guidance may be used in assessing the relevance of prior reviews and in scanning references of prior reviews to identify studies for a new review. However, areas of challenge remain. Areas in need of guidance include how to synthesize, grade the strength of, and present bodies of evidence composed of primary studies and existing systematic reviews. For instance, empiric evidence is needed regarding how to quality check data abstraction and when and how to use study-level risk of bias assessments from prior reviews. Conclusions There remain areas of uncertainty for how to integrate existing systematic reviews into new reviews. Methods research and consensus processes among systematic review organizations are needed to develop guidance to address these challenges. PMID:24956937

  11. Conducting systematic reviews of diagnostic studies: didactic guidelines

    PubMed Central

    Devillé, Walter L; Buntinx, Frank; Bouter, Lex M; Montori, Victor M; de Vet, Henrica CW; van der Windt, Danielle AWM; Bezemer, P Dick

    2002-01-01

    Background Although guidelines for critical appraisal of diagnostic research and meta-analyses have already been published, these may be difficult to understand for clinical researchers or do not provide enough detailed information. Methods Development of guidelines based on a systematic review of the evidence in reports of systematic searches of the literature for diagnostic research, of methodological criteria to evaluate diagnostic research, of methods for statistical pooling of data on diagnostic accuracy, and of methods for exploring heterogeneity. Results Guidelines for conducting diagnostic systematic reviews are presented in a stepwise fashion and are followed by comments providing further information. Examples are given using the results of two systematic reviews on the accuracy of the urine dipstick in the diagnosis of urinary tract infections, and on the accuracy of the straight-leg-raising test in the diagnosis of intervertebral disc hernia. PMID:12097142

  12. Should All Literature Reviews Be Systematic?

    ERIC Educational Resources Information Center

    Badger, D.; Nursten, J.; Williams, P.; Woodward, M.

    2000-01-01

    Provides an outline of the framework for conducting a literature review based on experiences in reviewing the literature on the epidemiology of mentally disordered offenders. The approach covers the key areas of: (1) definition of the problem and criteria for inclusion and exclusion; (2) the search strategy; (3) criteria for the evaluation of…

  13. Natural Language Processing in Radiology: A Systematic Review.

    PubMed

    Pons, Ewoud; Braun, Loes M M; Hunink, M G Myriam; Kors, Jan A

    2016-05-01

    Radiological reporting has generated large quantities of digital content within the electronic health record, which is potentially a valuable source of information for improving clinical care and supporting research. Although radiology reports are stored for communication and documentation of diagnostic imaging, harnessing their potential requires efficient and automated information extraction: they exist mainly as free-text clinical narrative, from which it is a major challenge to obtain structured data. Natural language processing (NLP) provides techniques that aid the conversion of text into a structured representation, and thus enables computers to derive meaning from human (ie, natural language) input. Used on radiology reports, NLP techniques enable automatic identification and extraction of information. By exploring the various purposes for their use, this review examines how radiology benefits from NLP. A systematic literature search identified 67 relevant publications describing NLP methods that support practical applications in radiology. This review takes a close look at the individual studies in terms of tasks (ie, the extracted information), the NLP methodology and tools used, and their application purpose and performance results. Additionally, limitations, future challenges, and requirements for advancing NLP in radiology will be discussed. PMID:27089187

  14. Systematic Reviews of Animal Models: Methodology versus Epistemology

    PubMed Central

    Greek, Ray; Menache, Andre

    2013-01-01

    Systematic reviews are currently favored methods of evaluating research in order to reach conclusions regarding medical practice. The need for such reviews is necessitated by the fact that no research is perfect and experts are prone to bias. By combining many studies that fulfill specific criteria, one hopes that the strengths can be multiplied and thus reliable conclusions attained. Potential flaws in this process include the assumptions that underlie the research under examination. If the assumptions, or axioms, upon which the research studies are based, are untenable either scientifically or logically, then the results must be highly suspect regardless of the otherwise high quality of the studies or the systematic reviews. We outline recent criticisms of animal-based research, namely that animal models are failing to predict human responses. It is this failure that is purportedly being corrected via systematic reviews. We then examine the assumption that animal models can predict human outcomes to perturbations such as disease or drugs, even under the best of circumstances. We examine the use of animal models in light of empirical evidence comparing human outcomes to those from animal models, complexity theory, and evolutionary biology. We conclude that even if legitimate criticisms of animal models were addressed, through standardization of protocols and systematic reviews, the animal model would still fail as a predictive modality for human response to drugs and disease. Therefore, systematic reviews and meta-analyses of animal-based research are poor tools for attempting to reach conclusions regarding human interventions. PMID:23372426

  15. Systematic reviews of animal models: methodology versus epistemology.

    PubMed

    Greek, Ray; Menache, Andre

    2013-01-01

    Systematic reviews are currently favored methods of evaluating research in order to reach conclusions regarding medical practice. The need for such reviews is necessitated by the fact that no research is perfect and experts are prone to bias. By combining many studies that fulfill specific criteria, one hopes that the strengths can be multiplied and thus reliable conclusions attained. Potential flaws in this process include the assumptions that underlie the research under examination. If the assumptions, or axioms, upon which the research studies are based, are untenable either scientifically or logically, then the results must be highly suspect regardless of the otherwise high quality of the studies or the systematic reviews. We outline recent criticisms of animal-based research, namely that animal models are failing to predict human responses. It is this failure that is purportedly being corrected via systematic reviews. We then examine the assumption that animal models can predict human outcomes to perturbations such as disease or drugs, even under the best of circumstances. We examine the use of animal models in light of empirical evidence comparing human outcomes to those from animal models, complexity theory, and evolutionary biology. We conclude that even if legitimate criticisms of animal models were addressed, through standardization of protocols and systematic reviews, the animal model would still fail as a predictive modality for human response to drugs and disease. Therefore, systematic reviews and meta-analyses of animal-based research are poor tools for attempting to reach conclusions regarding human interventions.

  16. Involving the public in systematic reviews: a narrative review of organizational approaches and eight case examples.

    PubMed

    Boote, Jonathan; Baird, Wendy; Sutton, Anthea

    2012-09-01

    This paper reviews the recent literature on public involvement in the systematic review process. We examine how relevant organizations involve the public in their review processes and how the public are involved in individual reviews. We identified nine surveys or reports of public involvement in systematic reviews at an organizational level and eight examples of public involvement in individual reviews. The public was found to be involved in the following stages of the review process: topic prioritization; refining the scope of the review; suggesting, locating and appraising the literature; interpreting findings; and writing up the review. Numerous tensions, facilitating strategies and recommendations for good practice were identified. Future research directions are delineated.

  17. Teaching Reading for Students with Intellectual Disabilities: A Systematic Review

    ERIC Educational Resources Information Center

    Alnahdi, Ghaleb Hamad

    2015-01-01

    A systematic review of the literature related to instructional strategies to improve reading skills for students with intellectual disabilities was conducted. Studies reviewed were within three categories; early reading approaches, comprehensive approaches, and one method approach. It was concluded that students with intellectual disabilities are…

  18. Creative Learning Environments in Education--A Systematic Literature Review

    ERIC Educational Resources Information Center

    Davies, Dan; Jindal-Snape, Divya; Collier, Chris; Digby, Rebecca; Hay, Penny; Howe, Alan

    2013-01-01

    This paper reports on a systematic review of 210 pieces of educational research, policy and professional literature relating to creative environments for learning in schools, commissioned by Learning and Teaching Scotland (LTS). Despite the volume of academic literature in this field, the team of six reviewers found comparatively few empirical…

  19. Family Adjustment to Childhood Cancer: A Systematic Review

    ERIC Educational Resources Information Center

    Long, Kristin A.; Marsland, Anna L.

    2011-01-01

    This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer,…

  20. Evidence-Based Health Policy: A Preliminary Systematic Review

    ERIC Educational Resources Information Center

    Morgan, Gareth

    2010-01-01

    Objective: The development of evidence-based health policy is challenging. This study has attempted to identify some of the underpinning factors that promote the development of evidence based health policy. Methods: A preliminary systematic literature review of published reviews with "evidence based health policy" in their title was conducted…

  1. Research on Teaching Practicum--A Systematic Review

    ERIC Educational Resources Information Center

    Lawson, Tony; Çakmak, Melek; Gündüz, Müge; Busher, Hugh

    2015-01-01

    The aim of the present study is to conduct a systematic review research which focuses on research studies into the school practicum. In order to identify the main issues and also to provide a contemporary picture of practicum, 114 studies published on the topic are reviewed and analysed in terms of: (i) aims, (ii) main participants, (iii)…

  2. Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations

    PubMed Central

    Greenhalgh, Trisha; Robert, Glenn; Macfarlane, Fraser; Bate, Paul; Kyriakidou, Olivia

    2004-01-01

    This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts. PMID:15595944

  3. Research results have expiration dates: ensuring timely systematic reviews.

    PubMed

    Barroso, Julie; Sandelowski, Margarete; Voils, Corrine I

    2006-08-01

    Time and timeliness are key issues in appraising and ensuring the clinical relevance of systematic reviews. Time considerations entering the systematic review process include the history of the clinical problem, disease, or treatment that is the target of the review, and the history of the research conducted to address it. These considerations guide: (i) formulation of the research problems and questions; (ii) setting of parameters for the search and retrieval of studies; (iii) determination of inclusion and exclusion criteria; (iv) appraisal of the clinical relevance of findings; (v) selection of the findings that will be synthesized; and (vi) interpretation of the results of that synthesis. PMID:16907690

  4. Cutaneous lichen planus: A systematic review of treatments.

    PubMed

    Fazel, Nasim

    2015-06-01

    Various treatment modalities are available for cutaneous lichen planus. Pubmed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Health Technology Assessment Database were searched for all the systematic reviews and randomized controlled trials related to cutaneous lichen planus. Two systematic reviews and nine relevant randomized controlled trials were identified. Acitretin, griseofulvin, hydroxychloroquine and narrow band ultraviolet B are demonstrated to be effective in the treatment of cutaneous lichen planus. Sulfasalazine is effective, but has an unfavorable safety profile. KH1060, a vitamin D analogue, is not beneficial in the management of cutaneous lichen planus. Evidence from large scale randomized trials demonstrating the safety and efficacy for many other treatment modalities used to treat cutaneous lichen planus is simply not available. PMID:24916211

  5. Issues and challenges for systematic reviews in indigenous health.

    PubMed

    McDonald, E; Priest, N; Doyle, J; Bailie, R; Anderson, I; Waters, E

    2010-07-01

    This essay outlines key issues raised during a project that aimed to (1) identify the gaps in the international evidence base of systematic reviews of intervention effectiveness relevant to public health decision making to address health inequalities experienced by indigenous people, and (2) identify priority areas and topics for future reviews. A number of indigenous researchers and clinicians invited to participate in the project expressed reservations about the appropriateness and value of conventional systematic reviews of intervention evidence to indigenous health. Ensuring that systematic review methods for indigenous health research meet the needs of those that use them, including indigenous communities themselves, needs to be a key area of ongoing work. The public health group within the Cochrane Collaboration has recognised this as a priority area and initiated exploration of these issues.

  6. Testing Scientific Software: A Systematic Literature Review

    PubMed Central

    Kanewala, Upulee; Bieman, James M.

    2014-01-01

    Context Scientific software plays an important role in critical decision making, for example making weather predictions based on climate models, and computation of evidence for research publications. Recently, scientists have had to retract publications due to errors caused by software faults. Systematic testing can identify such faults in code. Objective This study aims to identify specific challenges, proposed solutions, and unsolved problems faced when testing scientific software. Method We conducted a systematic literature survey to identify and analyze relevant literature. We identified 62 studies that provided relevant information about testing scientific software. Results We found that challenges faced when testing scientific software fall into two main categories: (1) testing challenges that occur due to characteristics of scientific software such as oracle problems and (2) testing challenges that occur due to cultural differences between scientists and the software engineering community such as viewing the code and the model that it implements as inseparable entities. In addition, we identified methods to potentially overcome these challenges and their limitations. Finally we describe unsolved challenges and how software engineering researchers and practitioners can help to overcome them. Conclusions Scientific software presents special challenges for testing. Specifically, cultural differences between scientist developers and software engineers, along with the characteristics of the scientific software make testing more difficult. Existing techniques such as code clone detection can help to improve the testing process. Software engineers should consider special challenges posed by scientific software such as oracle problems when developing testing techniques. PMID:25125798

  7. Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews

    PubMed Central

    Costa, Marcelle Barrueco; Melnik, Tamara

    2016-01-01

    ABSTRACT Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. PMID:27462898

  8. The quality of nutrition and cancer reviews: a systematic assessment.

    PubMed

    Weed, Douglas L

    2013-01-01

    The methodological quality of published reviews of nutrition and cancer (2008-2009) and of the carcinogenicity of acrylamide (1999-2009) was systematically assessed. Each review was examined with respect to four characteristics: whether the purpose of the review was explicitly stated, whether a methods section (detailing the methods used to "weigh" the evidence) was included, whether "weight of evidence" methods were described elsewhere in the paper (e.g., in the discussion), and finally, whether references to recognized "weight of evidence" methods were included. In this study, ninety per cent of a systematically selected sample of recent reviews on nutrition and cancer published in 2008-2009 and 74% of reviews on acrylamide on cancer published in 1999-2009 were found to be methodologically troublesome or frankly unsound. Failure of peer review and editorial oversight are possible explanations, suggesting a broad lack of concern about this issue in the scientific community. If peer reviewers in the nutrition and cancer community do not require "weight of evidence" methods, then these methods may not appear in the published reviews. Similarly, if journal editors (or editorial policies) do not require methods sections in literature reviews, then these sections may not appear. The prerogative of the author(s) seems the most likely determinant of whether a systematic approach is used or not in nutrition and cancer reviews.

  9. Oral Implant Imaging: A Review

    PubMed Central

    GUPTA, Sarika; PATIL, Neelkant; SOLANKI, Jitender; SINGH, Ravinder; LALLER, Sanjeev

    2015-01-01

    Selecting an appropriate implant imaging technique has become a challenging task since the advent of advanced imaging modalities, and many of these are used for implant imaging. On imaging, the modality should not only consider the anatomy but should also provide dimensional accuracy. Many dentists use the conventional method, mostly orthopantograph (OPG), in their routine practice of implant placement. However, because of the drawbacks associated with OPG, higher technologies, such as computed tomography (CT) and cone beam computed tomography (CBCT), are better accepted. These help improve image sharpness and reduce distortion. These techniques are not used widely due to the cost effect. Therefore, to decide on the type of imaging technique, all associated advantages and disadvantages should be considered, which will be broadly discussed in this review. PMID:26715891

  10. Diffusion tensor imaging of nigral degeneration in Parkinson's disease: A region-of-interest and voxel-based study at 3 T and systematic review with meta-analysis.

    PubMed

    Schwarz, Stefan T; Abaei, Maryam; Gontu, Vamsi; Morgan, Paul S; Bajaj, Nin; Auer, Dorothee P

    2013-01-01

    There is increasing interest in developing a reliable, affordable and accessible disease biomarker of Parkinson's disease (PD) to facilitate disease modifying PD-trials. Imaging biomarkers using magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) can describe parameters such as fractional anisotropy (FA), mean diffusivity (MD) or apparent diffusion coefficient (ADC). These parameters, when measured in the substantia nigra (SN), have not only shown promising but also varying and controversial results. To clarify the potential diagnostic value of nigral DTI in PD and its dependency on selection of region-of-interest, we undertook a high resolution DTI study at 3 T. 59 subjects (32 PD patients, 27 age and sex matched healthy controls) were analysed using manual outlining of SN and substructures, and voxel-based analysis (VBA). We also performed a systematic literature review and meta-analysis to estimate the effect size (DES) of disease related nigral DTI changes. We found a regional increase in nigral mean diffusivity in PD (mean ± SD, PD 0.80 ± 0.10 vs. controls 0.73 ± 0.06 · 10(- 3) mm(2)/s, p = 0.002), but no difference using a voxel based approach. No significant disease effect was seen using meta-analysis of nigral MD changes (10 studies, DES = + 0.26, p = 0.17, I(2) = 30%). None of the nigral regional or voxel based analyses of this study showed altered fractional anisotropy. Meta-analysis of 11 studies on nigral FA changes revealed a significant PD induced FA decrease. There was, however, a very large variation in results (I(2) = 86%) comparing all studies. After exclusion of five studies with unusual high values of nigral FA in the control group, an acceptable heterogeneity was reached, but there was non-significant disease effect (DES = - 0.5, p = 0.22, I(2) = 28%). The small PD related nigral MD changes in conjunction with the negative findings on VBA and meta-analysis limit the usefulness of nigral MD

  11. Resilience through the lens of interactionism: a systematic review.

    PubMed

    Pangallo, Antonio; Zibarras, Lara; Lewis, Rachel; Flaxman, Paul

    2015-03-01

    This systematic review presents findings from a conceptual and methodological review of resilience measures using an interactionist theoretical framework. The review is also intended to update findings from previous systematic reviews. Two databases (EBSCOHost and Scopus) were searched to retrieve empirical studies published up until 2013, with no lower time limit. All articles had to meet specific inclusion criteria, which resulted in 17 resilience measures selected for full review. Measures were conceptually evaluated against an interactionist framework and methodologically reviewed using Skinner's (1981) validity evidence framework. We conclude that inconsistencies associated with the definition and operationalization of resilience warrant further conceptual development to explain resilience as a dynamic and interactive phenomenon. In particular, measures of resilience may benefit from a greater focus on within-person variance typically associated with behavioral consistency across situations. The use of alternative measurement modalities to self-report scales, such as situational judgment tests, is proposed as a way of advancing knowledge in this area. PMID:25222438

  12. Midfacial Reconstruction – A Systematic Review

    PubMed Central

    Emara, Aala; ElFetouh, Adel Abou; Hakam, Maha; Mostafa, Basma

    2016-01-01

    AIM: Different lesions affecting the midfacial regions require surgical reconstruction. The aim of this study was to assess the different methods used in midfacial reconstruction after maxillectomy procedures. The various reported surgical reconstructive techniques focusing on the esthetic and functional outcomes are to be reviewed in this article. MATERIAL AND METHODS: A thorough PUBMED and hand-search of journals of relevance was performed on related terms and yielded 772 titles of which 45 abstracts were selected and obtained as full articles for further evaluation while the rest were excluded by title/abstract. According to the inclusion criteria; 14 of these studies were used to complete this article. RESULTS: In this review we showed that fibular and radial vascularized grafts were the most commonly reported methods in literature with a few other options. Computer aided design and surgical planning has been also reviewed and seems to be a rapidly evolving option for maxillofacial reconstruction. Lack of RCTs (randomized controlled trials) and large scale case series was noticed in this review making the evidence of poor quality. CONCLUSION: Methods of evaluation of reconstruction options mainly qualitative and subjective made the evaluation of the techniques in this review difficult. PMID:27703577

  13. Quality assessment of systematic reviews on alveolar socket preservation.

    PubMed

    Moraschini, V; Barboza, E Dos S P

    2016-09-01

    The aim of this overview was to evaluate and compare the quality of systematic reviews, with or without meta-analysis, that have evaluated studies on techniques or biomaterials used for the preservation of alveolar sockets post tooth extraction in humans. An electronic search was conducted without date restrictions using the Medline/PubMed, Cochrane Library, and Web of Science databases up to April 2015. Eligibility criteria included systematic reviews, with or without meta-analysis, focused on the preservation of post-extraction alveolar sockets in humans. Two independent authors assessed the quality of the included reviews using AMSTAR and the checklist proposed by Glenny et al. in 2003. After the selection process, 12 systematic reviews were included. None of these reviews obtained the maximum score using the quality assessment tools implemented, and the results of the analyses were highly variable. A significant statistical correlation was observed between the scores of the two checklists. A wide structural and methodological variability was observed between the systematic reviews published on the preservation of alveolar sockets post tooth extraction. None of the reviews evaluated obtained the maximum score using the two quality assessment tools implemented.

  14. A systematic review of aperture shapes

    NASA Astrophysics Data System (ADS)

    Schultz, A. B.; Frazier, T. V.

    The paper discusses the application of apodization to reflecting telescopes. The diffraction pattern of a telescope, which is the image of a star, can be changed considerably by using different aperture shapes in combination with appropriately shaped occulting masks on the optical axis. Aperture shapes studied were the circular, square, and hexagonal. Polaris (α-UMin) was used as the test system.

  15. Recent advancements in fluoride: A systematic review.

    PubMed

    Bansal, Ankita; Ingle, Navin Anand; Kaur, Navpreet; Ingle, Ekta

    2015-01-01

    To review advancements of fluoride in dentistry, a search of 21 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Fluoride has become an important tool in preventive dentistry. Current research is focused on the development of strategies to improve fluoride efficacy. Fluoride therapy in the form of varnish, gel, mouth rinse, or toothpaste has been used extensively as a caries-preventive intervention for over three decades. The purpose of this review is to inform the reader about new research related to the use of fluoride for the prevention of dental caries. PMID:26539383

  16. Recent advancements in fluoride: A systematic review

    PubMed Central

    Bansal, Ankita; Ingle, Navin Anand; Kaur, Navpreet; Ingle, Ekta

    2015-01-01

    To review advancements of fluoride in dentistry, a search of 21 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Fluoride has become an important tool in preventive dentistry. Current research is focused on the development of strategies to improve fluoride efficacy. Fluoride therapy in the form of varnish, gel, mouth rinse, or toothpaste has been used extensively as a caries-preventive intervention for over three decades. The purpose of this review is to inform the reader about new research related to the use of fluoride for the prevention of dental caries. PMID:26539383

  17. Systematic review of suicide in economic recession

    PubMed Central

    Oyesanya, Mayowa; Lopez-Morinigo, Javier; Dutta, Rina

    2015-01-01

    AIM: To provide a systematic update of the evidence concerning the relationship between economic recession and suicide. METHODS: A keyword search of Ovid Medline, Embase, Embase Classic, PsycINFO and PsycARTICLES was performed to identify studies that had investigated the association between economic recession and suicide. RESULTS: Thirty-eight studies met predetermined selection criteria and 31 of them found a positive association between economic recession and increased suicide rates. Two studies reported a negative association, two articles failed to find such an association, and three studies were inconclusive. CONCLUSION: Economic recession periods appear to increase overall suicide rates, although further research is warranted in this area, particularly in low income countries. PMID:26110126

  18. A systematic review: perivascular epithelioid cell tumor of gastrointestinal tract

    PubMed Central

    Chen, Zehong; Han, Siqi; Wu, Jialin; Xiong, Minmin; Huang, Yanqiao; Chen, Jianhui; Yuan, Yujie; Peng, Jianjun; Song, Wu

    2016-01-01

    Abstract Perivascular epithelioid cell tumor (PEComa) is a rare entity with distinctive morphology and of expressing myomelanocytic markers. Gastrointestinal tract (GI) is one of the most common anatomic sites of origin and counts for 20% to 25% of all reported cases of perivascular epithelioid cell tumors not otherwise specified (PEComas-NOS). However, the biologic behavior of perivascular epithelioid cell tumors of gastrointestinal tract (GI PEComas-NOS) is still unclear. The aim of conducting this systematic review is to sum up what is known so far of the epidemiology, natural history, management and prognosis of GI PEComas-NOS. A systematic research was performed on PubMed and EMBASE using the following terms: (“perivascular epithelioid cell tumor” or “PEComa”) and (“gastrointestinal tract” or “GI” or “oral ” or “mouth” or “esophagus” or “gullet” or “gastric” or “stomach” or “duodenum” or “jejunum” or “ileum” or “cecum” or “colon” or “colorectal” or “sigmoid” or “rectum” or “anus” or “mesentery”) up to December 1, 2015. Retrieved GI PEComas-NOS publications, which included these terms, contains case reports, case series to case characteristic researches. A total of 168 articles were reviewed, 41 GI PEComa-NOS English studies among which were retrieved for analysis. We reviewed epidemiology, natural history, management and prognosis of GI PEComa-NOS. Generally GI PEComa-NOS is believed to have women predomination. The most frequently involved location is colon with non-specific clinical signs. Pathologically, GI PEComas-NOS shows epithelioid predominance (70%), meanwhile coexpresses melanocytic and muscle markers characteristically, while immunohistochemistry is a useful tool for identify, which indicates that HMB-45 is regarded as the most sensitive reagent. Complete resection served as mainstay of treatment, while chemotherapy should be unanimously considered to apply in malignant

  19. A systematic review: perivascular epithelioid cell tumor of gastrointestinal tract.

    PubMed

    Chen, Zehong; Han, Siqi; Wu, Jialin; Xiong, Minmin; Huang, Yanqiao; Chen, Jianhui; Yuan, Yujie; Peng, Jianjun; Song, Wu

    2016-07-01

    Perivascular epithelioid cell tumor (PEComa) is a rare entity with distinctive morphology and of expressing myomelanocytic markers. Gastrointestinal tract (GI) is one of the most common anatomic sites of origin and counts for 20% to 25% of all reported cases of perivascular epithelioid cell tumors not otherwise specified (PEComas-NOS). However, the biologic behavior of perivascular epithelioid cell tumors of gastrointestinal tract (GI PEComas-NOS) is still unclear. The aim of conducting this systematic review is to sum up what is known so far of the epidemiology, natural history, management and prognosis of GI PEComas-NOS.A systematic research was performed on PubMed and EMBASE using the following terms: ("perivascular epithelioid cell tumor" or "PEComa") and ("gastrointestinal tract" or "GI" or "oral " or "mouth" or "esophagus" or "gullet" or "gastric" or "stomach" or "duodenum" or "jejunum" or "ileum" or "cecum" or "colon" or "colorectal" or "sigmoid" or "rectum" or "anus" or "mesentery") up to December 1, 2015. Retrieved GI PEComas-NOS publications, which included these terms, contains case reports, case series to case characteristic researches.A total of 168 articles were reviewed, 41 GI PEComa-NOS English studies among which were retrieved for analysis. We reviewed epidemiology, natural history, management and prognosis of GI PEComa-NOS. Generally GI PEComa-NOS is believed to have women predomination. The most frequently involved location is colon with non-specific clinical signs. Pathologically, GI PEComas-NOS shows epithelioid predominance (70%), meanwhile coexpresses melanocytic and muscle markers characteristically, while immunohistochemistry is a useful tool for identify, which indicates that HMB-45 is regarded as the most sensitive reagent. Complete resection served as mainstay of treatment, while chemotherapy should be unanimously considered to apply in malignant cases. Eventually, it is necessary for closed and long-term follow-up with endoscope and

  20. Statistical Inference Models for Image Datasets with Systematic Variations

    PubMed Central

    Kim, Won Hwa; Bendlin, Barbara B.; Chung, Moo K.; Johnson, Sterling C.; Singh, Vikas

    2016-01-01

    Statistical analysis of longitudinal or cross sectional brain imaging data to identify effects of neurodegenerative diseases is a fundamental task in various studies in neuroscience. However, when there are systematic variations in the images due to parameter changes such as changes in the scanner protocol, hardware changes, or when combining data from multi-site studies, the statistical analysis becomes problematic. Motivated by this scenario, the goal of this paper is to develop a unified statistical solution to the problem of systematic variations in statistical image analysis. Based in part on recent literature in harmonic analysis on diffusion maps, we propose an algorithm which compares operators that are resilient to the systematic variations. These operators are derived from the empirical measurements of the image data and provide an efficient surrogate to capturing the actual changes across images. We also establish a connection between our method to the design of wavelets in non-Euclidean space. To evaluate the proposed ideas, we present various experimental results on detecting changes in simulations as well as show how the method offers improved statistical power in the analysis of real longitudinal PIB-PET imaging data acquired from participants at risk for Alzheimer’s disease (AD). PMID:26989336

  1. Meta-Review: Systematic Assessment of Program Review

    ERIC Educational Resources Information Center

    Harlan, Brian

    2012-01-01

    Over 20 years ago, Robert J. Barak and Barbara E. Breier suggested incorporating a regular assessment of the entire program review system into the review schedule in order to ensure that the system itself is as efficient and effective as the programs under review. Barak and Breier's seminal book on the goals and processes of program review has…

  2. Acupuncture for Tourette Syndrome: A Systematic Review

    PubMed Central

    Yu, Jinna; Ye, Yongming; Liu, Jun; Wang, Yang; Peng, Weina

    2016-01-01

    Tourette syndrome (TS) is a neuropsychiatric disorder that affects both children and adults. We searched for randomised controlled trials (RCTs) using acupuncture to treat TS written in English or Chinese without restrictions on publication status. Study selection, data extraction, and assessment of study quality were conducted independently by two reviewers. Meta-analyses were performed using Review Manager (RevMan) 5.3 software from the Cochrane Collaboration. Data were combined with the fixed-effect model based on a heterogeneity test. Results were presented as risk ratios for dichotomous data and mean differences (MDs) for continuous data. This review included 7 RCTs with a total of 564 participants. The combined results showed that acupuncture may have better short-term effect than Western medicine for TS and that acupuncture may be an effective adjuvant therapy in improving the effect of Western medicine on TS, but the evidence is limited because of existing biases. Rigorous high-quality RCTs are needed to verify these findings. PMID:27725839

  3. Histopathological Image Analysis: A Review

    PubMed Central

    Gurcan, Metin N.; Boucheron, Laura; Can, Ali; Madabhushi, Anant; Rajpoot, Nasir; Yener, Bulent

    2010-01-01

    Over the past decade, dramatic increases in computational power and improvement in image analysis algorithms have allowed the development of powerful computer-assisted analytical approaches to radiological data. With the recent advent of whole slide digital scanners, tissue histopathology slides can now be digitized and stored in digital image form. Consequently, digitized tissue histopathology has now become amenable to the application of computerized image analysis and machine learning techniques. Analogous to the role of computer-assisted diagnosis (CAD) algorithms in medical imaging to complement the opinion of a radiologist, CAD algorithms have begun to be developed for disease detection, diagnosis, and prognosis prediction to complement to the opinion of the pathologist. In this paper, we review the recent state of the art CAD technology for digitized histopathology. This paper also briefly describes the development and application of novel image analysis technology for a few specific histopathology related problems being pursued in the United States and Europe. PMID:20671804

  4. A Systematic Review of Audiology Terminology

    PubMed Central

    Oh, Soo Hee

    2016-01-01

    The present report provides an overview of terminology studies in audiology including topics and study characteristics, as well as categorizing the main issues. The goals are to improve the understanding of the current issues for terminology in audiology and to provide some basic information that will be useful to develop an international standard. Search procedures were completed over two phases. Phase 1 included a systematic electronic searches using MEDLINE (PubMed), Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, and International Organization for Standardization with keywords related to terminology of audiology. The studies were initially identified according to the titles of 2921 publications following careful abstract examination. Of these, whole texts of 16 publications were retrieved. Five papers met the inclusion criteria were further investigated. In phase 2, a manual search was conducted to collect additional publications with keywords related to terminology project in audiology. A total of 16 papers were found. The essential terminology issues classified included 'appropriateness,' 'classification/framework,' 'inconsistency of terminology,' 'multilingual and international aspects,' and 'service quality/delivery including communication and accessibility.' This was indicative of the paucity of terminology research in audiology, despite recurring terminology issues. Establishment of standardized terminology in audiology may minimize current challenging terminology issues by improving appropriateness and consistency of terminology as well as communication among relevant stakeholders at national and international levels.

  5. A Systematic Review of Audiology Terminology

    PubMed Central

    Oh, Soo Hee

    2016-01-01

    The present report provides an overview of terminology studies in audiology including topics and study characteristics, as well as categorizing the main issues. The goals are to improve the understanding of the current issues for terminology in audiology and to provide some basic information that will be useful to develop an international standard. Search procedures were completed over two phases. Phase 1 included a systematic electronic searches using MEDLINE (PubMed), Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, and International Organization for Standardization with keywords related to terminology of audiology. The studies were initially identified according to the titles of 2921 publications following careful abstract examination. Of these, whole texts of 16 publications were retrieved. Five papers met the inclusion criteria were further investigated. In phase 2, a manual search was conducted to collect additional publications with keywords related to terminology project in audiology. A total of 16 papers were found. The essential terminology issues classified included 'appropriateness,' 'classification/framework,' 'inconsistency of terminology,' 'multilingual and international aspects,' and 'service quality/delivery including communication and accessibility.' This was indicative of the paucity of terminology research in audiology, despite recurring terminology issues. Establishment of standardized terminology in audiology may minimize current challenging terminology issues by improving appropriateness and consistency of terminology as well as communication among relevant stakeholders at national and international levels. PMID:27626085

  6. Hypodontia and ovarian cancer: A systematic review

    PubMed Central

    Iavazzo, Christos; Papakiritsis, Matthaios; Gkegkes, Ioannis D.

    2016-01-01

    Hypodontia can be defined as the non-formation of one or more teeth during the developmental period. Mutation in several genes related to tooth formation has previously been correlated with cancer. Regarding the ovarian cancer, there are few studies that associate the presence of hypodontia with ovarian cancer. A systematic literature search was performed in PubMed and Scopus. In total, 385 patients were included in this study. Control group was present in 3 out of 4 studies (340 patients). Hypodontia was present in 56 out of 290 patients (incidence of 19.3%). Only in 2 out of 4 studies, the number of missing teeth was mentioned (47 teeth), while the majority of them were either maxillary second premolars or maxillary lateral incisors. Unilateral distribution of the missing teeth was present in 28 out of 46 patients, while bilateral distribution of the missing teeth was present in 18 out of 46 patients. The presence of ovarian cancer in the family medical history occurred in 12 out of 33 patients. Only 1 out of 4 studies examined the presence of genes with mutations in the included patients. Based on our findings, the lack of clinical studies was the principal obstacle to clarify the possible predictive value of hypodontia in the early prediction of patients with higher risk of ovarian cancer. PMID:27026778

  7. A Systematic Review of Audiology Terminology.

    PubMed

    Oh, Soo Hee; Lee, Junghak

    2016-09-01

    The present report provides an overview of terminology studies in audiology including topics and study characteristics, as well as categorizing the main issues. The goals are to improve the understanding of the current issues for terminology in audiology and to provide some basic information that will be useful to develop an international standard. Search procedures were completed over two phases. Phase 1 included a systematic electronic searches using MEDLINE (PubMed), Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, and International Organization for Standardization with keywords related to terminology of audiology. The studies were initially identified according to the titles of 2921 publications following careful abstract examination. Of these, whole texts of 16 publications were retrieved. Five papers met the inclusion criteria were further investigated. In phase 2, a manual search was conducted to collect additional publications with keywords related to terminology project in audiology. A total of 16 papers were found. The essential terminology issues classified included 'appropriateness,' 'classification/framework,' 'inconsistency of terminology,' 'multilingual and international aspects,' and 'service quality/delivery including communication and accessibility.' This was indicative of the paucity of terminology research in audiology, despite recurring terminology issues. Establishment of standardized terminology in audiology may minimize current challenging terminology issues by improving appropriateness and consistency of terminology as well as communication among relevant stakeholders at national and international levels. PMID:27626085

  8. How to write a systematic review of reasons.

    PubMed

    Strech, Daniel; Sofaer, Neema

    2012-02-01

    Systematic reviews, which were developed to improve policy-making and clinical decision-making, answer an empirical question based on a minimally biased appraisal of all the relevant empirical studies. A model is presented here for writing systematic reviews of argument-based literature: literature that uses arguments to address conceptual questions, such as whether abortion is morally permissible or whether research participants should be legally entitled to compensation for sustaining research-related injury. Such reviews aim to improve ethically relevant decisions in healthcare, research or policy. They are better tools than informal reviews or samples of literature with respect to the identification of the reasons relevant to a conceptual question, and they enable the setting of agendas for conceptual and empirical research necessary for sound policy-making. This model comprises prescriptions for writing the systematic review's review question and eligibility criteria, the identification of the relevant literature, the type of data to extract on reasons and publications, and the derivation and presentation of results. This paper explains how to adapt the model to the review question, literature reviewed and intended readers, who may be decision-makers or academics. Obstacles to the model's application are described and addressed, and limitations of the model are identified.

  9. How to write a systematic review of reasons

    PubMed Central

    Sofaer, Neema

    2011-01-01

    Systematic reviews, which were developed to improve policy-making and clinical decision-making, answer an empirical question based on a minimally biased appraisal of all the relevant empirical studies. A model is presented here for writing systematic reviews of argument-based literature: literature that uses arguments to address conceptual questions, such as whether abortion is morally permissible or whether research participants should be legally entitled to compensation for sustaining research-related injury. Such reviews aim to improve ethically relevant decisions in healthcare, research or policy. They are better tools than informal reviews or samples of literature with respect to the identification of the reasons relevant to a conceptual question, and they enable the setting of agendas for conceptual and empirical research necessary for sound policy-making. This model comprises prescriptions for writing the systematic review's review question and eligibility criteria, the identification of the relevant literature, the type of data to extract on reasons and publications, and the derivation and presentation of results. This paper explains how to adapt the model to the review question, literature reviewed and intended readers, who may be decision-makers or academics. Obstacles to the model's application are described and addressed, and limitations of the model are identified. PMID:22080465

  10. Broadening Public Participation in Systematic Reviews: A Case Example Involving Young People in Two Configurative Reviews

    ERIC Educational Resources Information Center

    Oliver, Kathryn; Rees, Rebecca; Brady, Louca-Mai; Kavanagh, Josephine; Oliver, Sandy; Thomas, James

    2015-01-01

    Background: Arguments supporting the involvement of users in research have even more weight when involving the public in systematic reviews of research. We aimed to explore the potential for public involvement in systematic reviews of observational and qualitative studies. Methods: Two consultative workshops were carried out with a group of young…

  11. Effect of different insoles on postural balance: a systematic review.

    PubMed

    Christovão, Thaluanna Calil Lourenço; Neto, Hugo Pasini; Grecco, Luanda André Collange; Ferreira, Luiz Alfredo Braun; Franco de Moura, Renata Calhes; Eliege de Souza, Maria; Franco de Oliveira, Luis Vicente; Oliveira, Claudia Santos

    2013-10-01

    [Purpose] The aim of the present study was to perform a systematic review of the literature on the effect of different insoles on postural balance. [Subjects and Methods] A systematic review was conducted of four databases. The papers retrieved were evaluated based on the following inclusion criteria: 1) design: controlled clinical trial; 2) intervention: insole; 3) outcome: change in static postural balance; and 4) year of publication: 2005 to 2012. [Results] Twelve controlled trials were found comparing the effects of different insoles on postural balance. The papers had methodological quality scores of 3 or 4 on the PEDro scale. [Conclusion] Insoles have benefits that favor better postural balance and control.

  12. Systematic Review Evidence Methodology: Providing Quality Family Planning Services.

    PubMed

    Tregear, Stephen J; Gavin, Loretta E; Williams, Jessica R

    2015-08-01

    From 2010 to 2014, CDC and the Office of Population Affairs at the USDHHS collaborated on the development of clinical recommendations for providing quality family planning services. A high priority was placed on the use of existing scientific evidence in developing the recommendations, in accordance with IOM guidelines for how to develop "trustworthy" clinical practice guidelines. Consequently, a series of systematic reviews were developed using a transparent and reproducible methodology aimed at ensuring that the clinical practice guidelines would be based on evidence collected in the most unbiased manner possible. This article describes the methodology used in conducting these systematic reviews, which occurred from mid-2011 through 2012. PMID:26190844

  13. Systematic Calibration for a Backpacked Spherical Photogrammetry Imaging System

    NASA Astrophysics Data System (ADS)

    Rau, J. Y.; Su, B. W.; Hsiao, K. W.; Jhan, J. P.

    2016-06-01

    A spherical camera can observe the environment for almost 720 degrees' field of view in one shoot, which is useful for augmented reality, environment documentation, or mobile mapping applications. This paper aims to develop a spherical photogrammetry imaging system for the purpose of 3D measurement through a backpacked mobile mapping system (MMS). The used equipment contains a Ladybug-5 spherical camera, a tactical grade positioning and orientation system (POS), i.e. SPAN-CPT, and an odometer, etc. This research aims to directly apply photogrammetric space intersection technique for 3D mapping from a spherical image stereo-pair. For this purpose, several systematic calibration procedures are required, including lens distortion calibration, relative orientation calibration, boresight calibration for direct georeferencing, and spherical image calibration. The lens distortion is serious on the ladybug-5 camera's original 6 images. Meanwhile, for spherical image mosaicking from these original 6 images, we propose the use of their relative orientation and correct their lens distortion at the same time. However, the constructed spherical image still contains systematic error, which will reduce the 3D measurement accuracy. Later for direct georeferencing purpose, we need to establish a ground control field for boresight/lever-arm calibration. Then, we can apply the calibrated parameters to obtain the exterior orientation parameters (EOPs) of all spherical images. In the end, the 3D positioning accuracy after space intersection will be evaluated, including EOPs obtained by structure from motion method.

  14. Characteristics of Stabilizer Muscles: A Systematic Review

    PubMed Central

    Green, Rodney A.; Taylor, Nicholas F.

    2014-01-01

    ABSTRACT Purpose: To identify the main characteristics, based on available evidence, of stabilizer muscles to inform the development of a definition of stabilizer muscles. Methods: Electronic databases were systematically searched for relevant literature from the databases' inception to June 2013 using keywords related to stability, muscles, and characteristics of stabilizer muscles. Studies that provided at least one characteristic of a stabilizer muscle were included. For the quality assessment, all included articles were categorized as either experimental or opinion-based studies. Methodological quality was assessed using a customized checklist, and data were analyzed with a narrative synthesis involving content analysis. The number of articles providing either direct evidence supporting a link between the characteristic and joint stability or indirect evidence that a muscle considered to be a stabilizer has that characteristic determined the level of significance of that characteristic for stabilizer muscles. Results: A total of 77 studies met the inclusion criteria. The highest number of articles providing supporting evidence that a particular muscle characteristic plays a stabilizing role related to biomechanical characteristics (27 articles), followed by neurological characteristics (22 articles) and anatomical/physiological characteristics (4 articles). Conclusion: Based on a synthesis of supporting evidence from the literature, stabilizer muscles can be defined as muscles that contribute to joint stiffness by co-contraction and show an early onset of activation in response to perturbation via either a feed-forward or a feedback control mechanism. These results may guide researchers to investigate which muscles exhibit these characteristics to determine whether particular muscles have a stabilizer rather than a prime mover role during normal functioning. PMID:25922556

  15. Patient-based radiographic exposure factor selection: a systematic review

    SciTech Connect

    Ching, William; Robinson, John; McEntee, Mark

    2014-09-15

    Digital technology has wider exposure latitude and post-processing algorithms which can mask the evidence of underexposure and overexposure. Underexposure produces noisy, grainy images which can impede diagnosis and overexposure results in a greater radiation dose to the patient. These exposure errors can result from inaccurate adjustment of exposure factors in response to changes in patient thickness. This study aims to identify all published radiographic exposure adaptation systems which have been, or are being, used in general radiography and discuss their applicability to digital systems. Studies in EMBASE, MEDLINE, CINAHL and SCOPUS were systematically reviewed. Some of the search terms used were exposure adaptation, exposure selection, exposure technique, 25% rule, 15% rule, DuPont™ Bit System and radiography. A manual journal-specific search was also conducted in The Radiographer and Radiologic Technology. Studies were included if they demonstrated a system of altering exposure factors to compensate for variations in patients for general radiography. Studies were excluded if they focused on finding optimal exposures for an ‘average’ patient or focused on the relationship between exposure factors and dose. The database search uncovered 11 articles and the journal-specific search uncovered 13 articles discussing systems of exposure adaptation. They can be categorised as simple one-step guidelines, comprehensive charts and computer programs. Only two papers assessed the efficacy of exposure adjustment systems. No literature compares the efficacy of exposure adaptations system for film/screen radiography with digital radiography technology nor is there literature on a digital specific exposure adaptation system.

  16. Reported Outcome Measures in Degenerative Cervical Myelopathy: A Systematic Review

    PubMed Central

    McHugh, Maire; Elgheriani, Ali; Kolias, Angelos G.; Tetreault, Lindsay A.; Hutchinson, Peter J. A.; Fehlings, Michael G.; Kotter, Mark R. N.

    2016-01-01

    Objective Degenerative cervical myelopathy [DCM] is a disabling and increasingly prevalent group of diseases. Heterogeneous reporting of trial outcomes limits effective inter-study comparison and optimisation of treatment. This is recognised in many fields of healthcare research. The present study aims to assess the heterogeneity of outcome reporting in DCM as the premise for the development of a standardised reporting set. Methods A systematic review of MEDLINE and EMBASE databases, registered with PROSPERO (CRD42015025497) was conducted in accordance with PRISMA guidelines. Full text articles in English, with >50 patients (prospective) or >200 patients (retrospective), reporting outcomes of DCM were eligible. Results 108 studies, assessing 23,876 patients, conducted world-wide, were identified. Reported outcome themes included function (reported by 97, 90% of studies), complications (reported by 56, 52% of studies), quality of life (reported by 31, 29% of studies), pain (reported by 29, 27% of studies) and imaging (reported by 59, 55% of studies). Only 7 (6%) studies considered all of domains in a single publication. All domains showed variability in reporting. Conclusions Significant heterogeneity exists in the reporting of outcomes in DCM. The development of a consensus minimum dataset will facilitate future research synthesis. PMID:27482710

  17. Performance of radiographers in mammogram interpretation: a systematic review.

    PubMed

    van den Biggelaar, F J H M; Nelemans, P J; Flobbe, K

    2008-02-01

    Radiologists may be relieved from work that could be performed by radiographers. This systematic literature review focuses on the performance of radiographers (also referring to technologists and physician assistants) compared with radiologists in the interpretation of mammograms; the effect of training; and the question whether there are any studies evaluating the effects of involving radiographers in the interpretation of diagnostic mammograms in daily clinical practice on the sensitivity and specificity of cancer detection in breast imaging. Six studies met the inclusion criteria (primary aim of the study has to be the evaluation of the performance of radiographers, sensitivity and specificity have to be reported or calculable and there has to be a sufficient gold standard). The results showed that, in a screening setting, radiographers scored higher false positive rates with a similar sensitivity in the detection of malignancies, compared with radiologists. Furthermore, results suggested that training could improve their performance. No studies were reported assessing the performance of radiographers interpreting diagnostic mammograms in a consecutive patient population in a daily clinical setting. This indicates a need for a well-designed diagnostic study using an adequate gold standard, in order to evaluate the feasibility of deploying radiographers in the interpretation of diagnostic mammograms in a clinical setting. PMID:17764941

  18. Fluoropyrimidine and platinum toxicity pharmacogenetics: an umbrella review of systematic reviews and meta-analyses.

    PubMed

    Campbell, Jared M; Bateman, Emma; Peters, Micah Dj; Bowen, Joanne M; Keefe, Dorothy M; Stephenson, Matthew D

    2016-03-01

    Fluoropyrimidine (FU) and platinum-based chemotherapies are greatly complicated by their associated toxicities. This umbrella systematic review synthesized all systematic reviews that investigated associations between germline variations and toxicity, with the aim of informing personalized medicine. Systematic reviews are important in pharmacogenetics where false positives are common. Four systematic reviews were identified for FU-induced toxicity and three for platinum. Polymorphisms of DPYD and TYMS, but not MTHFR, were statistically significantly associated with FU-induced toxicity (although only DPYD had clinical significance). For platinum, GSTP1 was found to not be associated with toxicity. This umbrella systematic review has synthesized the best available evidence on the pharmacogenetics of FU and platinum toxicity. It provides a useful reference for clinicians and identifies important research gaps.

  19. Resveratrol and liver: A systematic review

    PubMed Central

    Faghihzadeh, Forouzan; Hekmatdoost, Azita; Adibi, Payman

    2015-01-01

    Background: Recent studies demonstrated that resveratrol has many therapeutic effects on liver disorders. Resveratrol significantly increased survival after liver transplantation, decreased fat deposition, necrosis, and apoptosis which induced by ischemia in Wistar rats. It provided liver protection against chemical, cholestatic, and alcohol injury. Resveratrol can improve glucose metabolism and lipid profile and decrease liver fibrosis and steatosis. Furthermore, it was able to alter hepatic cell fatty acid composition. According to extension of liver disease around the world and necessity of finding new threat, this review critically examines the current preclinical in vitro and in vivo studies on the preventive and therapeutic effects of resveratrol in liver disorders. Materials and Methods: A search in PubMed, Google Scholar, and Scopus was undertaken to identify relevant literature using search terms, including “liver,” “hepatic,” and “Resveratrol.” Both in vivo and in vitro studies were included. No time limiting considered for this search. Results: A total of 76 articles were eligible for this review. In these articles, resveratrol shows antioxidative properties in different models of hepatitis resulting in reducing of hepatic fibrosis. Conclusion: Resveratrol could reduce hepatic steatosis through modulating the insulin resistance and lipid profile in animals. These high quality preclinical studies propose the potential therapeutic implication of resveratrol in liver disorders especially those with hepatic steatosis. Resveratrol can play a pivotal role in prevention and treatment of liver disorders by reducing hepatic fibrosis. PMID:26664429

  20. Campylobacter Reactive Arthritis: A Systematic Review

    PubMed Central

    Pope, Janet E.; Krizova, Adriana; Garg, Amit X.; Thiessen-Philbrook, Heather; Ouimet, Janine M.

    2010-01-01

    Objective To review the literature on the epidemiology of Campylobacter associated ReA. Methods A Medline (PubMed) search identified studies from 1966–2006 that investigated the epidemiology of Campylobacter associated ReA. Search terms included: “reactive arthritis”, “spondyloarthropathy”, “Reiter’s syndrome”, “gastroenteritis”, “diarrhea”, “epidemiology”, “incidence”, “prevalence”, and “Campylobacter”. Results The literature available to date suggests that the incidence of Campylobacter reactive arthritis may occur in 1 to 5% of those infected. The annual incidence of ReA after Campylobacter or Shigella may be 4.3 and 1.3 respectively per 100,000. The duration of acute ReA varies considerably between reports, and the incidence and impact of chronic reactive arthritis from Campylobacter infection is virtually unknown. Conclusions Campylobacter associated ReA incidence and prevalence varies widely from reviews such as: case ascertainment differences, exposure differences, lack of diagnostic criteria for ReA and perhaps genetics and ages of exposed individuals. At the population level it may not be associated with HLA-B27 and inflammatory back involvement is uncommon. Follow up for long-term sequelae is largely unknown. Five percent of Campylobacter ReA may be chronic or relapsing (with respect to musculoskeletal symptoms). PMID:17360026

  1. Primary Thyroid Sarcoma: A Systematic Review.

    PubMed

    Surov, Alexey; Gottschling, Sebastian; Wienke, Andreas; Meyer, Hans Jonas; Spielmann, Rolf Peter; Dralle, Henning

    2015-10-01

    Different types of malignant tumors can occur within the thyroid. Primary cancer is the most common type of thyroid malignancy. Non-epithelial malignancies can also arise within the thyroid. The aim of the present study was to analyze clinical and radiological characteristics of reported primary thyroid sarcomas (PTS), based on a large sample of cases. The PubMed database was screened for articles from between 1990 and 2014. Overall, 86 articles with 142 patients were identified. Ultrasound evaluation was reported for 36 patients. Data regarding computed tomography of the neck were available for 29 cases. Magnetic resonance imaging was performed for eight patients. The following data were retrieved for the identified sarcomas: localization, size, homogeneity, internal texture, and margin characteristics. In most cases, PTS occurred in patients over 40 years of age, with a peak incidence for the group aged 60-79 years. Angiosarcoma was diagnosed in 29 cases (20.4%), followed by malignant hemangioendothelioma (n=23, 16.3%), malignant fibrous histiocytoma (n=20, 14.1%), leiomyosarcoma (n=16, 11.3%), and fibrosarcoma (n=13, 9.2%). In most patients (n=113, 79.6%), PTS manifested clinically as a painless goiter. On ultrasound, PTS were predominantly mixed hypo-to-hyperechoic in comparison to the normal thyroid tissue. On non-contrast computed tomography, most sarcomas were inhomogeneous hypo-to-hyperdense. On post-contrast magnetic resonance images, most sarcomas showed marked non-homogenous enhancement. In 26.8%, infiltration of the adjacent organs was seen. The trachea or esophagus was affected more frequently in patients with malignant histiocytoma and liposarcoma. Different strategies were used in the treatment of PTS. Our analysis provides clinical and radiological characteristics of PTS. The described features should be taken into consideration in the differential diagnosis of thyroid tumors. PMID:26408676

  2. Curcumin and Diabetes: A Systematic Review

    PubMed Central

    Zhang, Dong-wei; Fu, Min; Gao, Si-Hua; Liu, Jun-Li

    2013-01-01

    Turmeric (Curcuma longa), a rhizomatous herbaceous perennial plant of the ginger family, has been used for the treatment of diabetes in Ayurvedic and traditional Chinese medicine. The active component of turmeric, curcumin, has caught attention as a potential treatment for diabetes and its complications primarily because it is a relatively safe and inexpensive drug that reduces glycemia and hyperlipidemia in rodent models of diabetes. Here, we review the recent literature on the applications of curcumin for glycemia and diabetes-related liver disorders, adipocyte dysfunction, neuropathy, nephropathy, vascular diseases, pancreatic disorders, and other complications, and we also discuss its antioxidant and anti-inflammatory properties. The applications of additional curcuminoid compounds for diabetes prevention and treatment are also included in this paper. Finally, we mention the approaches that are currently being sought to generate a “super curcumin” through improvement of the bioavailability to bring this promising natural product to the forefront of diabetes therapeutics. PMID:24348712

  3. Interventions in exclusive breastfeeding: a systematic review.

    PubMed

    Bevan, Gillian; Brown, Michelle

    Now recognised as a worldwide public health issue, the significance of promoting and encouraging exclusive breastfeeding (EBF) has been acknowledged by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Documented policies about the importance of facilitating the support of breastfeeding women is currently receiving worldwide recognition (WHO, 2011; WHO and UNICEF, 2003). This literature review will examine provision of support mechanisms for breastfeeding mothers, focusing on peer support in encouraging the starting and maintaining of EBF. Consideration will also be given to any barriers that may prevent higher success rates, as cultural and educational factors may have a significant impact on the starting and maintaining of EBF. These factors must be considered when starting support groups, networks or activities that aim to address this significant public health issue. PMID:24464112

  4. Probiotics as potential antioxidants: a systematic review.

    PubMed

    Mishra, Vijendra; Shah, Chandni; Mokashe, Narendra; Chavan, Rupesh; Yadav, Hariom; Prajapati, Jashbhai

    2015-04-15

    Probiotics are known for their health beneficial effects and are established as dietary adjuncts. Probiotics have been known for many beneficial health effects. In this view, there is interest to find the potential probiotic strains that can exhibit antioxidant properties along with health benefits. In vitro and in vivo studies indicate that probiotics exhibit antioxidant potential. In this view, consumption of probiotics alone or foods supplemented with probiotics may reduce oxidative damage, free radical scavenging rate, and modification in activity of crucial antioxidative enzymes in human cells. Incorporation of probiotics in foods can provide a good strategy to supply dietary antioxidants, but more studies are needed to standardize methods and evaluate antioxidant properties of probiotics before they can be recommended for antioxidant potential. In this paper, the literature related to known antioxidant potential of probiotics and proposing future perspectives to conduct such studies has been reviewed. PMID:25808285

  5. Metacognitive training for schizophrenia: a systematic review

    PubMed Central

    JIANG, Jiangling; ZHANG, Li; ZHU, Zhipei; LI, Wei; LI, Chunbo

    2015-01-01

    Background Metacognitive training (MCT) is a novel group psychotherapy method for schizophrenia, but there is, as yet, no conclusive evidence of its efficacy. Aims Conduct a meta-analysis to assess the effectiveness of MCT in schizophrenia. Methods Electronic and hand searches were conducted to identify randomized controlled trials about the effects of MCT in schizophrenia that met pre-defined inclusion criteria. The Cochrane Risk of Bias tool was employed to assess of risk of biases, and Cochrane Review Manager version 5.3 and R version 3.1.1 were used to conduct the data synthesis. Results Ten trials from 54 unduplicated reports were included in the review, but differences in the methods of assessing outcomes limited the number of studies that could be included in the meta-analysis. Pooling four studies that assessed the positive symptom subscale of the Positive and Negative Syndrome Scale (PANSS) at the end of the trial identified a small but statistically significant greater reduction in the MCT group than in the control group. But pooling four studies that assessed the delusion subscale of the Psychotic Symptom Rating Scales (PSYRATS) at the end of the trial found no significant difference between the groups. Results from the qualitative assessment of the other results that could not be pooled across studies were mixed, some showed a trend in favor of MCT but many found no difference between the groups. Conclusions The limited number of RCT trials, the variability of the method and time of the outcome evaluation, and methodological problems in the trials make it impossible to come to a conclusion about the effectiveness of MCT for schizophrenia. More randomized trials that use standardized outcome measures, that use intention-to-treat (ITT) analyses, and that follow-up participants at regular intervals after the intervention are needed to determine whether or not MCT should become a recommended adjunctive treatment for schizophrenia. PMID:26300597

  6. Radiographic diagnosis of dental restoration misfit: a systematic review.

    PubMed

    Liedke, G S; Spin-Neto, R; da Silveira, H E D; Wenzel, A

    2014-12-01

    The objective of this study was to perform a systematic review on the use of radiographic methods for the diagnosis of misfit in dental prostheses and restorations. The MEDLINE bibliographic database was searched from 1950 to February 2014 for reports on the radiographic diagnosis of misfits. The search strategy was limited to English-language publications using the following combined MeSH terms in the search strategy: (Dental Restoration OR Dental Prosthesis OR Crown OR Inlays OR Dental Abutments) and (Dental Leakage OR Prosthesis Fitting OR Dental Marginal Adaptation OR Surface Properties) and (Radiography, Dental OR Radiography, Dental, Digital OR Cone-Beam Computed Tomography). Twenty-eight publications were identified and read in full text, and 14 studies fulfilled criteria for inclusion. Information regarding the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations, and in which the methodology/results comprised information regarding how the sample was collected/prepared, the method, imaging protocol, presence of a reference test and the outcomes were evaluated. QUADAS criteria was used to rate the studies in high, moderate or low quality. The evidence supporting the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations is limited to low-/moderate-quality studies. The well-established intra-oral orthogonal projection is still under investigation and considered the most appropriate method, both when evaluating the relation between dental restoration to tooth and abutment to implant. Studies using digital radiographs have not evaluated the effect of image post-processing, and tomography has not been evaluated. PMID:25142004

  7. Radiographic diagnosis of dental restoration misfit: a systematic review.

    PubMed

    Liedke, G S; Spin-Neto, R; da Silveira, H E D; Wenzel, A

    2014-12-01

    The objective of this study was to perform a systematic review on the use of radiographic methods for the diagnosis of misfit in dental prostheses and restorations. The MEDLINE bibliographic database was searched from 1950 to February 2014 for reports on the radiographic diagnosis of misfits. The search strategy was limited to English-language publications using the following combined MeSH terms in the search strategy: (Dental Restoration OR Dental Prosthesis OR Crown OR Inlays OR Dental Abutments) and (Dental Leakage OR Prosthesis Fitting OR Dental Marginal Adaptation OR Surface Properties) and (Radiography, Dental OR Radiography, Dental, Digital OR Cone-Beam Computed Tomography). Twenty-eight publications were identified and read in full text, and 14 studies fulfilled criteria for inclusion. Information regarding the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations, and in which the methodology/results comprised information regarding how the sample was collected/prepared, the method, imaging protocol, presence of a reference test and the outcomes were evaluated. QUADAS criteria was used to rate the studies in high, moderate or low quality. The evidence supporting the use of radiographic methods for the diagnosis of misfits in dental prosthesis and restorations is limited to low-/moderate-quality studies. The well-established intra-oral orthogonal projection is still under investigation and considered the most appropriate method, both when evaluating the relation between dental restoration to tooth and abutment to implant. Studies using digital radiographs have not evaluated the effect of image post-processing, and tomography has not been evaluated.

  8. A systematic review of best practices in HIV care

    PubMed Central

    Maina, Geoffrey; Mill, Judy; Chaw-Kant, Jean; Caine, Vera

    2016-01-01

    Best practices in HIV care have the potential to improve patient outcomes and inform practice. We conducted a systematic review of best practices in HIV care that were published from 2003 to 2013. Practices that demonstrated success in achieving desired results based on their objectives were included in the review. Two themes emerged from the eight articles reviewed: (a) the importance of linking newly diagnosed people living with HIV to care and (b) the role of integrated and comprehensive service provision in improving patient outcomes. Inconsistencies in reporting and arbitrary use of the term “best practices” were hurdles in this review. PMID:27152102

  9. [Medical image compression: a review].

    PubMed

    Noreña, Tatiana; Romero, Eduardo

    2013-01-01

    Modern medicine is an increasingly complex activity , based on the evidence ; it consists of information from multiple sources : medical record text , sound recordings , images and videos generated by a large number of devices . Medical imaging is one of the most important sources of information since they offer comprehensive support of medical procedures for diagnosis and follow-up . However , the amount of information generated by image capturing gadgets quickly exceeds storage availability in radiology services , generating additional costs in devices with greater storage capacity . Besides , the current trend of developing applications in cloud computing has limitations, even though virtual storage is available from anywhere, connections are made through internet . In these scenarios the optimal use of information necessarily requires powerful compression algorithms adapted to medical activity needs . In this paper we present a review of compression techniques used for image storage , and a critical analysis of them from the point of view of their use in clinical settings. PMID:23715317

  10. [Medical image compression: a review].

    PubMed

    Noreña, Tatiana; Romero, Eduardo

    2013-01-01

    Modern medicine is an increasingly complex activity , based on the evidence ; it consists of information from multiple sources : medical record text , sound recordings , images and videos generated by a large number of devices . Medical imaging is one of the most important sources of information since they offer comprehensive support of medical procedures for diagnosis and follow-up . However , the amount of information generated by image capturing gadgets quickly exceeds storage availability in radiology services , generating additional costs in devices with greater storage capacity . Besides , the current trend of developing applications in cloud computing has limitations, even though virtual storage is available from anywhere, connections are made through internet . In these scenarios the optimal use of information necessarily requires powerful compression algorithms adapted to medical activity needs . In this paper we present a review of compression techniques used for image storage , and a critical analysis of them from the point of view of their use in clinical settings.

  11. Systematic review of forsterite dissolution rate data

    NASA Astrophysics Data System (ADS)

    Rimstidt, J. Donald; Brantley, Susan L.; Olsen, Amanda A.

    2012-12-01

    This paper demonstrates a method for systematic analysis of published mineral dissolution rate data using forsterite dissolution as an example. The steps of the method are: (1) identify the data sources, (2) select the data, (3) tabulate the data, (4) analyze the data to produce a model, and (5) report the results. This method allows for a combination of critical selection of data, based on expert knowledge of theoretical expectations and experimental pitfalls, and meta-analysis of the data using statistical methods. Application of this method to all currently available forsterite dissolution rates (0 < pH < 14, and 0 < T < 150 °C) normalized to geometric surface area produced the following rate equations: For pH < 5.6 and 0° < T < 150 °C, based on 519 data logr=6.05(0.22)-0.46(0.02)pH-3683.0(63.6)1/T(R2=0.88) For pH > 5.6 and 0° < T < 150 °C, based on 125 data logr=4.07(0.38)-0.256(0.023)pH-3465(139)1/T(R2=0.92) The R2 values show that ˜10% of the variance in r is not explained by variation in 1/T and pH. Although the experimental error for rate measurements should be ± ˜30%, the observed error associated with the log r values is ˜0.5 log units (±300% relative error). The unexplained variance and the large error associated with the reported rates likely arises from the assumption that the rates are directly proportional to the mineral surface area (geometric or BET) when the rate is actually controlled by the concentration and relative reactivity of surface sites, which may be a function of duration of reaction. Related to these surface area terms are other likely sources of error that include composition and preparation of mineral starting material. Similar rate equations were produced from BET surface area normalized rates. Comparison of rate models based on geometric and BET normalized rates offers no support for choosing one normalization method over the other. However, practical considerations support the use of geometric surface area normalization

  12. Surgical treatment in spine Paget's disease: a systematic review.

    PubMed

    Jorge-Mora, Alberto; Amhaz-Escanlar, Samer; Lois-Iglesias, Ana; Leborans-Eiris, Susana; Pino-Minguez, Jesús

    2016-01-01

    Paget's disease of bone (PDB) is a disease characterized by a disorder in the bone metabolism. The spine is the second region affected after the pelvis. Surgical treatment is reserved for cases refractory to medical treatment. We performed a systematic review of patients with Paget disease of bone affecting the spine, treated surgically in the last 30 years. The main objective of the review is to find out indications for surgery, outcomes of these patients and also the standard perioperative management.

  13. Nomograms for colorectal cancer: A systematic review

    PubMed Central

    Kawai, Kazushige; Sunami, Eiji; Yamaguchi, Hironori; Ishihara, Soichiro; Kazama, Shinsuke; Nozawa, Hiroaki; Hata, Keisuke; Kiyomatsu, Tomomichi; Tanaka, Junichiro; Tanaka, Toshiaki; Nishikawa, Takeshi; Kitayama, Joji; Watanabe, Toshiaki

    2015-01-01

    AIM: To assist in the selection of suitable nomograms for obtaining desired predictions in daily clinical practice. METHODS: We conducted electronic searches for journal articles on colorectal cancer (CRC)-associated nomograms using the search terms colon/rectal/colorectal/nomogram. Of 174 articles initially found, we retrieved 28 studies in which a nomogram for CRC was developed. RESULTS: We discuss the currently available CRC-associated nomograms, including those that predict the oncological prognosis, the short-term outcome of treatments, such as surgery or neoadjuvant chemoradiotherapy, and the future development of CRC. Developing nomograms always presents a dilemma. On the one hand, the desire to cover as wide a patient range as possible tends to produce nomograms that are too complex and yet have C-indexes that are not sufficiently high. Conversely, confining the target patients might impair the clinical applicability of constructed nomograms. CONCLUSION: The information provided in this review should be of use in selecting a nomogram suitable for obtaining desired predictions in daily clinical practice. PMID:26557011

  14. Cycling and bone health: a systematic review

    PubMed Central

    2012-01-01

    Background Cycling is considered to be a highly beneficial sport for significantly enhancing cardiovascular fitness in individuals, yet studies show little or no corresponding improvements in bone mass. Methods A scientific literature search on studies discussing bone mass and bone metabolism in cyclists was performed to collect all relevant published material up to April 2012. Descriptive, cross-sectional, longitudinal and interventional studies were all reviewed. Inclusion criteria were met by 31 studies. Results Heterogeneous studies in terms of gender, age, data source, group of comparison, cycling level or modality practiced among others factors showed minor but important differences in results. Despite some controversial results, it has been observed that adult road cyclists participating in regular training have low bone mineral density in key regions (for example, lumbar spine). Conversely, other types of cycling (such as mountain biking), or combination with other sports could reduce this unsafe effect. These results cannot yet be explained by differences in dietary patterns or endocrine factors. Conclusions From our comprehensive survey of the current available literature it can be concluded that road cycling does not appear to confer any significant osteogenic benefit. The cause of this may be related to spending long hours in a weight-supported position on the bike in combination with the necessary enforced recovery time that involves a large amount of time sitting or lying supine, especially at the competitive level. PMID:23256921

  15. A systematic review of aluminium phosphide poisoning.

    PubMed

    Mehrpour, Omid; Jafarzadeh, Mostafa; Abdollahi, Mohammad

    2012-03-01

    Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide (AlP) in particular. AlP is known as a suicide poison that can easily be bought and has no effective antidote. Its toxicity results from the release of phosphine gas as the tablet gets into contact with moisture. Phosphine gas primarily affects the heart, lungs, gastrointestinal tract, and kidneys. Poisoning signs and symptoms include nausea, vomiting, restlessness, abdominal pain, palpitation, refractory shock, cardiac arrhythmias, pulmonary oedema, dyspnoea, cyanosis, and sensory alterations. Diagnosis is based on clinical suspicion, positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination with coconut oil and sodium bicarbonate, administration of charcoal, and palliative care. Specific therapy includes intravenous magnesium sulphate and oral coconut oil. Moreover, acidosis can be treated with early intravenous administration of sodium bicarbonate, cardiogenic shock with fluid, vasopresor, and refractory cardiogenic shock with intra-aortic baloon pump or digoxin. Trimetazidine may also have a useful role in the treatment, because it can stop ventricular ectopic beats and bigeminy and preserve oxidative metabolism. This article reviews the epidemiological, toxicological, and clinical/pathological aspects of AlP poisoning and its management.

  16. Rugby and Shoulder Trauma: A Systematic Review

    PubMed Central

    Papalia, R.; Tecame, A.; Torre, G.; Narbona, P.; Maffulli, N.; Denaro, V.

    2015-01-01

    Rugby is a popular contact sport worldwide. Collisions and tackles during matches and practices often lead to traumatic injuries of the shoulder. This review reports on the epidemiology of injuries, type of lesions and treatment of shoulder injuries, risk factors, such as player position, and return to sport activities. Electronic searches through PubMed (Medline), EMBASE, and Cochrane Library retrieved studies concerning shoulder injuries in rugby players. Data regarding incidence, type and mechanisms of lesion, risk factors and return to sport were extracted and analyzed. The main reported data were incidence, mechanism of injury and type of lesion. Most of the studies report tackle as the main event responsible for shoulder trauma (between 50% and 85%), while the main lesions reported were Bankart lesions, Superior Labral tear from Anterior to Posterior (SLAP tears), anterior dislocation and rotator cuff tears. Open or arthroscopic repair improve clinical outcomes. Shoulder lesions are common injuries in rugby players. Surgical treatment seems to be effective in for rotator cuff tears and shoulder instability. More and better designed studies are needed for a higher Level of Evidence analysis of this topic. PMID:26535182

  17. Investigating asthma comorbidities: a systematic scoping review protocol

    PubMed Central

    El Ferkh, Karim; Nwaru, Bright; Griffiths, Chris; Sheikh, Aziz

    2016-01-01

    Introduction Asthma is a common long-term disorder with a number of related comorbid conditions, which may affect asthma outcomes. There is a need for greater appreciation for understanding how these comorbidities interact with asthma in order to improve asthma outcomes. Objectives To systematically identify and map out key asthma comorbidities. Methods We will systematically search the following electronic databases: MEDLINE, EMBASE, ISI Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and Google Scholar. Additional literature will be identified by searching the reference list of identified eligible studies and by searching the repositories of international conference proceedings, including ISI Conference Proceeding Citation Index, and ZETOC (British Library). Dissemination The findings from this systematic scoping review will be reported at scientific meetings and published in a peer-reviewed journal. PMID:27558899

  18. A systematic guide for peer reviewers for a medical journal.

    PubMed

    Garfield, Joseph M; Kaye, Alan David; Kolinsky, Daniel C; Urman, Richard D

    2015-01-01

    Performing a peer review of an article under consideration for publication requires not only an understanding of the subject matter, but also a systematic approach that includes screening for conflicts of interest; determining whether the manuscript is within or outside the reviewer's area of expertise; properly classifying the manuscript; and writing a detailed, organized review. Although some journals may provide guidelines for the reviewers, the guidelines usually are not detailed and do not take into consideration the variability in reviewer experience. This article is meant to serve as a guideline for peer reviewers and provide concrete information on how to write a comprehensive, unbiased review that will serve both the author and the journal well.

  19. Second line therapy in malignant pleural mesothelioma: A systematic review.

    PubMed

    Buikhuisen, Wieneke A; Hiddinga, Birgitta I; Baas, Paul; van Meerbeeck, Jan P

    2015-09-01

    After the implementation of standard first line chemotherapy with platinum and antifolates in pleural mesothelioma, patients are confronted with a need for second line treatment at relapse or progression. We conducted a systematic review of the literature for the activity, effectiveness and toxicity of second line treatment. The results are presented according to the class of drugs: chemotherapy and targeted or biological agent.

  20. Understanding Listening Competency: A Systematic Review of Research Scales

    ERIC Educational Resources Information Center

    Fontana, Peter C.; Cohen, Steven D.; Wolvin, Andrew D.

    2015-01-01

    To better understand what constitutes listening competency, we perform a systematic review of listening scales. Our goal was twofold: to determine the most commonly appearing listening traits and to determine if listening scales are similar to one other. As part of our analysis, we identified 53 relevant scales and analyzed the scales…

  1. Student Online Readiness Assessment Tools: A Systematic Review Approach

    ERIC Educational Resources Information Center

    Farid, Alem

    2014-01-01

    Although there are tools to assess student's readiness in an "online learning context," little is known about the "psychometric" properties of the tools used or not. A systematic review of 5107 published and unpublished papers identified in a literature search on student online readiness assessment tools between 1990 and…

  2. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    PubMed

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a "gold standard" for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable. PMID:26322307

  3. The Effectiveness of Intensive Interaction, A Systematic Literature Review

    ERIC Educational Resources Information Center

    Hutchinson, Nick; Bodicoat, Anna

    2015-01-01

    Background: Intensive Interaction is an approach used for communicating with people with profound and multiple intellectual disabilities [PMID] or autism. It has gained increased recognition as a helpful technique, but the evidence has not been systematically reviewed. Method: Computerized and hand searches of the literature were conducted using…

  4. Predictors of Complicated Grief: A Systematic Review of Empirical Studies

    ERIC Educational Resources Information Center

    Lobb, Elizabeth A.; Kristjanson, Linda J.; Aoun, Samar M.; Monterosso, Leanne; Halkett, Georgia K. B.; Davies, Anna

    2010-01-01

    A systematic review of the literature on predictors of complicated grief (CG) was undertaken with the aim of clarifying the current knowledge and to inform future planning and work in CG following bereavement. Predictors of CG prior to the death include previous loss, exposure to trauma, a previous psychiatric history, attachment style, and the…

  5. Parenting Training for Intellectually Disabled Parents: A Cochrane Systematic Review

    ERIC Educational Resources Information Center

    Coren, Esther; Thomae, Manuela; Hutchfield, Jemeela

    2011-01-01

    Objectives: This article presents a Cochrane/Campbell systematic review of the evidence on the effect of parent training to support the parenting of parents with intellectual disabilities. Method: Randomized controlled trials (RCTs) comparing parent training interventions for parents with intellectual disability with usual care or with a control…

  6. Psychological Distress in Refugee Children: A Systematic Review

    ERIC Educational Resources Information Center

    Bronstein, Israel; Montgomery, Paul

    2011-01-01

    Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style…

  7. Facial Emotion Recognition in Child Psychiatry: A Systematic Review

    ERIC Educational Resources Information Center

    Collin, Lisa; Bindra, Jasmeet; Raju, Monika; Gillberg, Christopher; Minnis, Helen

    2013-01-01

    This review focuses on facial affect (emotion) recognition in children and adolescents with psychiatric disorders other than autism. A systematic search, using PRISMA guidelines, was conducted to identify original articles published prior to October 2011 pertaining to face recognition tasks in case-control studies. Used in the qualitative…

  8. Anger Management and Intellectual Disabilities: A Systematic Review

    ERIC Educational Resources Information Center

    Hamelin, Jeffery; Travis, Robert; Sturmey, Peter

    2013-01-01

    We conducted a systematic literature review of anger management in people with intellectual disabilities (ID). We identified 2 studies that used randomized controlled trials and 6 that used pretest-posttest nonequivalent control group designs. The mean between-group effect size was 1.52 for randomized controlled trials and 0.89 for the other…

  9. Brief Report: Systematic Review of Rett Syndrome in Males

    ERIC Educational Resources Information Center

    Reichow, Brian; George-Puskar, Annie; Lutz, Tara; Smith, Isaac C.; Volkmar, Fred R.

    2015-01-01

    Rett syndrome (RTT) is a neurogenetic disorder in which a period of typical development is followed by loss of previously acquired skills. Once thought to occur exclusively in females, increasing numbers of male cases of RTT have been reported. This systematic review included 36 articles describing 57 cases of RTT in males. Mutations of the MECP2…

  10. Effective Early Childhood Education Programs: A Systematic Review

    ERIC Educational Resources Information Center

    Chambers, Bette; Cheung, Alan; Slavin, Robert E.; Smith, Dewi; Laurenzano, Mary

    2010-01-01

    This report systematically reviews research on the outcomes of programs that teach young children in a group setting before they begin kindergarten. Study inclusion criteria included the use of randomized or matched control groups, evidence of initial equality, and study duration of at least 12 weeks. Studies included valid measures of language,…

  11. 15 CFR 2008.13 - Systematic review guidelines.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Systematic review guidelines. 2008.13 Section 2008.13 Commerce and Foreign Trade Regulations Relating to Foreign Trade Agreements OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE REGULATIONS TO IMPLEMENT E.O. 12065; OFFICE OF THE UNITED STATES...

  12. 15 CFR 2008.13 - Systematic review guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Systematic review guidelines. 2008.13 Section 2008.13 Commerce and Foreign Trade Regulations Relating to Foreign Trade Agreements OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE REGULATIONS TO IMPLEMENT E.O. 12065; OFFICE OF THE UNITED STATES...

  13. 15 CFR 2008.13 - Systematic review guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Systematic review guidelines. 2008.13 Section 2008.13 Commerce and Foreign Trade Regulations Relating to Foreign Trade Agreements OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE REGULATIONS TO IMPLEMENT E.O. 12065; OFFICE OF THE UNITED STATES...

  14. 15 CFR 2008.13 - Systematic review guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Systematic review guidelines. 2008.13 Section 2008.13 Commerce and Foreign Trade Regulations Relating to Foreign Trade Agreements OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE REGULATIONS TO IMPLEMENT E.O. 12065; OFFICE OF THE UNITED STATES...

  15. 15 CFR 2008.13 - Systematic review guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Systematic review guidelines. 2008.13 Section 2008.13 Commerce and Foreign Trade Regulations Relating to Foreign Trade Agreements OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE REGULATIONS TO IMPLEMENT E.O. 12065; OFFICE OF THE UNITED STATES...

  16. Communication Intervention in Rett Syndrome: A Systematic Review

    ERIC Educational Resources Information Center

    Sigafoos, Jeff; Green, Vanessa A.; Schlosser, Ralf; O'eilly, Mark F.; Lancioni, Giulio E.; Rispoli, Mandy; Lang, Russell

    2009-01-01

    We reviewed communication intervention studies involving people with Rett syndrome. Systematic searches of five electronic databases, selected journals, and reference lists identified nine studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participant characteristics, (b) target skills, (c) procedures, (d) main…

  17. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    PubMed Central

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a “gold standard” for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable. PMID:26322307

  18. Native American Youth and Culturally Sensitive Interventions: A Systematic Review

    ERIC Educational Resources Information Center

    Jackson, Kelly F.; Hodge, David R.

    2010-01-01

    Objective: A systematic evaluation of the effectiveness of culturally sensitive interventions (CSIs) with Native American youth was conducted. Method: Electronic bibliographic databases, Web sites, and manual searches were used to identify 11 outcome studies that examined CSI effectiveness with Native American youth. Results: This review found…

  19. Crohn’s disease complicated by strictures: a systematic review

    PubMed Central

    Rieder, Florian; Zimmermann, Ellen M; Remzi, Feza H; Sandborn, William J

    2016-01-01

    The occurrence of strictures as a complication of Crohn’s disease is a significant clinical problem. No specific antifibrotic therapies are available. This systematic review comprehensively addresses the pathogenesis, epidemiology, prediction, diagnosis and therapy of this disease complication. We also provide specific recommendations for clinical practice and summarise areas that require future investigation. PMID:23626373

  20. Searching for Grey Literature for Systematic Reviews: Challenges and Benefits

    ERIC Educational Resources Information Center

    Mahood, Quenby; Van Eerd, Dwayne; Irvin, Emma

    2014-01-01

    There is ongoing interest in including grey literature in systematic reviews. Including grey literature can broaden the scope to more relevant studies, thereby providing a more complete view of available evidence. Searching for grey literature can be challenging despite greater access through the Internet, search engines and online bibliographic…

  1. Higher Education for Sustainable Development: A Systematic Review

    ERIC Educational Resources Information Center

    Wu, Yen-Chun Jim; Shen, Ju-Peng

    2016-01-01

    Purpose: This study aims to provide a complete understanding of academic research into higher education for sustainable development (HESD). Design/methodology/approach: This study utilizes a systematic review of four scientific literature databases to outline topics of research during the UN's Decade of Education for Sustainable Development…

  2. A Systematic Review of the Relationship between Rumination and Suicidality

    ERIC Educational Resources Information Center

    Morrison, Rebecca; O'Connor, Rory C.

    2008-01-01

    Rumination has been persistently implicated in the etiology of hopelessness and depression, which are proximal predictors of suicidality. As a result, researchers have started to examine the role of rumination in suicidality. This systematic review provides a concise synopsis of the current progress in examining the relationship between rumination…

  3. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    PubMed

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a "gold standard" for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  4. Physical Activity and Social Support in Adolescents: A Systematic Review

    ERIC Educational Resources Information Center

    Mendonça, Gerfeson; Cheng, Luanna Alexandra; Mélo, Edilânea Nunes; de Farias, José Cazuza, Jr.

    2014-01-01

    The objective of this review was to systematically synthesize the results of original studies on the association between physical activity and social support in adolescents, published until April 2011. Searches were carried out in Adolec, ERIC, Lilacs, Medline, SciELO, Scopus, SportsDiscus and Web of Science electronic databases and the reference…

  5. The Relations between Perfectionism and Suicidality: A Systematic Review

    ERIC Educational Resources Information Center

    O'Connor, Rory C.

    2007-01-01

    Since the 1980s, there has been a 300 percent increase in the number of published papers on perfectionism. Given the inconsistent findings in the literature, this systematic review examines, for the first time, the nature of the relationship between perfectionism and suicidality. To this end, the three main psychological and medical databases…

  6. Classroom Dialogue: A Systematic Review across Four Decades of Research

    ERIC Educational Resources Information Center

    Howe, Christine; Abedin, Manzoorul

    2013-01-01

    Recognizing that empirical research into classroom dialogue has been conducted for about 40?years, a review is reported of 225 studies published between 1972 and 2011. The studies were identified through systematic search of electronic databases and scrutiny of publication reference lists. They focus on classroom dialogue in primary and secondary…

  7. Communication Assessment for Individuals with Rett Syndrome: A Systematic Review

    ERIC Educational Resources Information Center

    Sigafoos, Jeff; Kagohara, Debora; van der Meer, Larah; Green, Vanessa A.; O'Reilly, Mark F.; Lancioni, Giulio E.; Lang, Russell; Rispoli, Mandy; Zisimopoulos, Dimitrios

    2011-01-01

    We reviewed studies that aimed to determine whether behaviors, such as body movements, vocalizations, eye gaze, and facial expressions, served a communicative function for individuals with Rett syndrome. A systematic search identified eight studies, which were summarized in terms of (a) participants, (b) assessment targets, (c) assessment…

  8. Designs and Methods in School Improvement Research: A Systematic Review

    ERIC Educational Resources Information Center

    Feldhoff, Tobias; Radisch, Falk; Bischof, Linda Marie

    2016-01-01

    Purpose: The purpose of this paper is to focus on challenges faced by longitudinal quantitative analyses of school improvement processes and offers a systematic literature review of current papers that use longitudinal analyses. In this context, the authors assessed designs and methods that are used to analyze the relation between school…

  9. Does Being Overweight Impede Academic Attainment? A Systematic Review

    ERIC Educational Resources Information Center

    Caird, Jennifer; Kavanagh, Josephine; O'Mara-Eves, Alison; Oliver, Kathryn; Oliver, Sandy; Stansfield, Claire; Thomas, James

    2014-01-01

    Objectives: To examine evidence from studies exploring the relationship between childhood obesity and educational attainment. Design: A systematic review of secondary analyses and observational studies published in English after 1997 examining attainment as measured by grade point average or other validated measure, in children aged 6 to 16 years,…

  10. The Use of Mobile Learning in Science: A Systematic Review

    ERIC Educational Resources Information Center

    Crompton, Helen; Burke, Diane; Gregory, Kristen H.; Gräbe, Catharina

    2016-01-01

    The use of mobile learning in education is growing at an exponential rate. To best understand how mobile learning is being used, it is crucial to gain a collective understanding of the research that has taken place. This systematic review reveals the trends in mobile learning in science with a comprehensive analysis and synthesis of studies from…

  11. Discrimination and sleep: a systematic review.

    PubMed

    Slopen, Natalie; Lewis, Tené T; Williams, David R

    2016-02-01

    An increasing body of literature indicates that discrimination has a negative impact on health; poor sleep may be an underlying mechanism. The primary objective of this review was to examine existing studies on the relationship between discrimination and sleep to clarify (a) the potential role of discrimination in shaping population patterns of sleep and sleep disparities, and (b) the research needed to develop interventions at individual and institutional levels. We identified articles from English-language publications in PubMed and EBSCO databases from inception through July 2014. We employed a broad definition of discrimination to include any form of unfair treatment and all self-reported and objectively assessed sleep outcomes, including duration, difficulties, and sleep architecture. Seventeen studies were identified: four prospective, 12 cross-sectional, and one that utilized a daily-diary design. Fifteen of the 17 studies evaluated interpersonal discrimination as the exposure and the majority of studies included self-reported sleep as the outcome. Only four studies incorporated objective sleep assessments. All 17 studies identified at least one association between discrimination and a measure of poorer sleep, although studies with more detailed consideration of either discrimination or sleep architecture revealed some inconsistencies. Taken together, existing studies demonstrate consistent evidence that discrimination is associated with poorer sleep outcomes. This evidence base can be strengthened with additional prospective studies that incorporate objectively measured aspects of sleep. We outline important extensions for this field of inquiry that can inform the development of interventions to improve sleep outcomes, and consequently promote well-being and reduce health inequities across the life course.

  12. Systematic review: conservative treatments for secondary lymphedema

    PubMed Central

    2012-01-01

    Background Several conservative (i.e., nonpharmacologic, nonsurgical) treatments exist for secondary lymphedema. The optimal treatment is unknown. We examined the effectiveness of conservative treatments for secondary lymphedema, as well as harms related to these treatments. Methods We searched MEDLINE®, EMBASE®, Cochrane Central Register of Controlled Trials®, AMED, and CINAHL from 1990 to January 19, 2010. We obtained English- and non-English-language randomized controlled trials or observational studies (with comparison groups) that reported primary effectiveness data on conservative treatments for secondary lymphedema. For English-language studies, we extracted data in tabular form and summarized the tables descriptively. For non-English-language studies, we summarized the results descriptively and discussed similarities with the English-language studies. Results Thirty-six English-language and eight non-English-language studies were included in the review. Most of these studies involved upper-limb lymphedema secondary to breast cancer. Despite lymphedema's chronicity, lengths of follow-up in most studies were under 6 months. Many trial reports contained inadequate descriptions of randomization, blinding, and methods to assess harms. Most observational studies did not control for confounding. Many studies showed that active treatments reduced the size of lymphatic limbs, although extensive between-study heterogeneity in areas such as treatment comparisons and protocols, and outcome measures, prevented us from assessing whether any one treatment was superior. This heterogeneity also precluded us from statistically pooling results. Harms were rare (< 1% incidence) and mostly minor (e.g., headache, arm pain). Conclusions The literature contains no evidence to suggest the most effective treatment for secondary lymphedema. Harms are few and unlikely to cause major clinical problems. PMID:22216837

  13. Aluminium in parenteral nutrition: a systematic review.

    PubMed

    Hernández-Sánchez, A; Tejada-González, P; Arteta-Jiménez, M

    2013-03-01

    Aluminium (Al) toxicity problem in parenteral nutrition solutions (PNS) is decades old and is still unresolved. The aim of this review is to gather updated information about this matter, regarding legislation, manifestations, diagnostics and treatment, patient population at risk and the actions to be taken to limit its accumulation. A structured search using MeSH vocabulary and Title/Abstract searches was conducted in PubMed (http://www.pubmed.gov) up to November 2012. Al is ubiquitous, facilitating its potential for exposure. Nevertheless, humans have several mechanisms to prevent significant absorption and to aid its elimination; therefore, the vast majority of the population is not at risk for Al toxicity. However, when protective gastrointestinal mechanisms are bypassed (for example, parenteral fluids), renal function is impaired (for example, adult patients with renal compromise and neonates) or exposure is high (for example, long-term PNS), Al is prone to accumulate in the body, including manifestations such as impaired neurological development, Alzheimer's disease, metabolic bone disease, dyslipemia and even genotoxic activity. A high Al content in PNS is largely the result of three parenteral nutrient additives: calcium gluconate, inorganic phosphates and cysteine hydrochloride. Despite the legislative efforts, some factors make difficult to comply with the rule and, therefore, to limit the Al toxicity. Unfortunately, manufacturers have not universally changed their processes to obtain a lower Al content of parenteral drug products (PDP). In addition, the imprecise information provided by PDP labels and the high lot-to-lot variation make the prediction of Al content rather inaccurate.

  14. Electroacupuncture for Tinnitus: A Systematic Review

    PubMed Central

    Liu, Yang; Zhong, Juan; Jiang, Luyun; Liu, Ying; Chen, Qing; Xie, Yan; Zhang, Qinxiu

    2016-01-01

    Background Treatment effects of electroacupuncture for patients with subjective tinnitus has yet to be clarified. Objectives To assess the effect of electroacupuncutre for alleviating the symptoms of subjective tinnitus. Methods Extensive literature searches were carried out in three English and four Chinese databases (PubMed, EMBASE, Cochrane Library, CNKI, Wanfang Chinese Digital Periodical and Conference Database, VIP, and ChiCTR).The date of the most recent search was 1 June 2014. Randomized controlled trials (RCTs) or quasi-RCTs were included. The titles, abstracts, and keywords of all records were reviewed by two authors independently. The data were collected and extracted by three authors. The risk of bias in the trials was assessed in accordance with the Cochrane Handbook, version 5.1.0. (http://www.handbook.cochrane.org). Eighty-nine studies were retrieved. After discarding 84 articles, five studies with 322 participants were identified. Assessment of the methodological quality of the studies identified weaknesses in all five studies. All studies were judged as having a high risk of selection and performance bias. The attrition bias was high in four studies. Incompleteness bias was low in all studies. Reporting bias was unclear in all studies. Because of the limited number of trials included and the various types of interventions and outcomes, we were unable to conduct pooled analyses. Conclusions Due to the poor methodological quality of the primary studies and the small sample sizes, no convincing evidence that electroacupuncture is beneficial for treating tinnitus could be found. There is an urgent need for more high-quality trials with large sample sizes for the investigation of electroacupuncture treatment for tinnitus. PMID:26938213

  15. A Systematic Map of Systematic Reviews in Pediatric Dentistry—What Do We Really Know?

    PubMed Central

    Mejàre, Ingegerd A.; Klingberg, Gunilla; Mowafi, Frida K.; Stecksén-Blicks, Christina; Twetman, Svante H. A.; Tranæus, Sofia H.

    2015-01-01

    Objectives To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. Methods A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. Results Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. Conclusion There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry. PMID:25706629

  16. 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.

  17. 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. PMID:26329027

  18. Prenatal Depression and Adverse Birth Outcomes: An Updated Systematic Review

    PubMed Central

    Accortt, Eynav Elgavish; Cheadle, Alyssa C. D.; Schetter, Christine Dunkel

    2015-01-01

    Complications related to preterm birth (PTB) and low birth weight (LBW) are leading causes of infant morbidity and mortality. Prenatal depression is a hypothesized psychosocial risk factor for both birth outcomes. The purpose of this systematic review was to examine evidence published between 1977 and 2013 on prenatal depression and risks of these primary adverse birth outcomes. A systematic search of the PUBMED and PsycINFO databases was conducted to identify studies testing the associations between prenatal depressive symptoms, or diagnoses of depression, and risk of PTB or LBW. We systematically selected 50 published reports on PTB and length of gestation, and 33 reports on LBW and BW. Results were reviewed by two independent reviewers and we evaluated the quality of the evidence with an established systematic review method, the Newcastle Ottawa Scale. We then undertook a narrative synthesis of the results following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Less than a quarter of 50 published reports found that prenatal depression was significantly associated with PTB or gestational age. In contrast, slightly more than half of the 33 reports found that prenatal depression was associated with LBW or BW. When weighing methodological features, we determined that the effects of prenatal depression on LBW are more consistent than effects on length of gestation or PTB. Although the evidence may not be strong enough to support routine depression screening for risk of adverse outcomes, screening to enable detection and timely treatment to reduce risk of postpartum depression is warranted. Further rigorous research on prenatal depression and adverse birth outcomes is needed. PMID:25452215

  19. Acupuncture for erectile dysfunction: a systematic review protocol

    PubMed Central

    Cui, Xiaoming; Li, Xiaoli; Peng, Weina; Zhou, Jing; Yu, Jinna; Ye, Yongming; Liu, Zhishun

    2015-01-01

    Introduction This systematic review protocol aims to provide a protocol for assessing the safety and effectiveness of acupuncture for the treatment of erectile dysfunction(ED). Previous systematic reviews did not draw convincing conclusions owing to high heterogeneity and few included randomised controlled trials, so it is necessary to reassess the efficacy and safety of acupuncture for ED. Methods and analysis Eight electronic databases will be searched: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed, EMBASE, PsycInfo, the Chinese Biomedical Literature Database (CBM), the Chinese Medical Current Content (CMCC) and the China National Knowledge Infrastructure (CNKI). Related Chinese literature will be searched in other Chinese databases. All relevant randomised controlled trials in English or Chinese without any restrictions of publication type will be included. The main outcome measure will be improvements in sexual activity assessed by validated questionnaires. Assessment of risk of bias, data synthesis and subgroup analysis will be carried out using Review Manager 5.3. Ethics and dissemination The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. The data we will use do not include individual patient data, so ethical approval is not required. Trial registration number PROSPERO CRD42014013575. PMID:25805531

  20. Tai Chi for stroke rehabilitation: protocol for a systematic review

    PubMed Central

    Wang, Shanshan; Chen, Pei; Zhu, Xiaoshu; Li, Zongheng

    2016-01-01

    Introduction Stroke is a major cause of death and disability, and imposes a huge burden and significant workload for patients, their families and society. As a special form of physical activity, Tai Chi is may be useful for stroke rehabilitation. The objective of this review is to systematically evaluate the efficacy and safety of Tai Chi for rehabilitation in stroke patients. Methods and analysis We will conduct a systematic search of the following electronic databases from their inception to 31 October 2015: MEDLINE, EMBASE, the Cochrane Library, the Chinese BioMedical Literature Database (CBM), the Chinese National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP), Wanfang and the Chinese Dissertation Database. All relevant randomised controlled trials (RCTs) in English and Chinese will be included. The main outcomes will be changes in the neurological function of patients and in independence in activities of daily living. Adverse events, adherence, costs and the cost effectiveness of Tai Chi will also be assessed. Two independent reviewers will select studies, extract data and assess quality. Review Manager 5.3 will be used for assessment of risk of bias, data synthesis and subgroup analysis. Ethics and dissemination This systematic review does not require formal ethical approval because all data will be analysed anonymously. Results will provide a general overview and evidence concerning the efficacy and safety of Tai Chi for stroke rehabilitation. Findings will be disseminated through peer-reviewed publications. Trial registration number CRD42015026999. PMID:27311906

  1. Comparative Effectiveness of Dental Anatomy Carving Pedagogy: A Systematic Review.

    PubMed

    de Azevedo, Renato de A; da Rosa, Wellington Luiz de O; da Silva, Adriana F; Correa, Marcos B; Torriani, Marcos A; Lund, Rafael G

    2015-08-01

    The aim of this study was to review the effectiveness of methods used for teaching dental anatomy carving to dental students in operative dentistry as evaluated in published studies. This systematic review is described in accordance with the PRISMA statement. Two independent reviewers performed a systematic literature search of research published from January 1945 until May 2014. Seven databases were screened: MedLine (PubMed), Lilacs, IBECS, Web of Science, Scopus, SciELO, and The Cochrane Library. After removing duplicates, only studies using dental carving to assess the practical knowledge of anatomy were selected. The tabulated data were organized by title of article, names of authors, number of students assessed, assessment method, material used, groups tested, main results, and conclusions. The methodology quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Initially, 2,258 studies were identified in all databases. Five articles met the eligibility criteria and were included in this review. According to these studies, the geometric method, teaching step-by-step along with the teacher, and adjuvant methods such as the use of tutors and teaching through digital media with DVDs proved to be effective in improving learning. There is no standard technique that is widely accepted for the teaching of dental carving, nor is there an appropriately validated method of evaluation to verify whether the teaching methods used are effective for the acquisition of skills and expertise in dental anatomy by students.

  2. Systematic review of EBPs for SMI in rural America.

    PubMed

    Weaver, Addie; Capobianco, Jeff; Ruffolo, Mary

    2015-01-01

    This systematic review of the implementation of evidence-based practices (EBPs) for adults with severe mental illnesses (SMI) in rural mental health settings examined peer-reviewed literature, grey literature, and public information. Included articles had to report implementation efforts of EBP(s) for SMI in rural settings or adaptations for rural service delivery. Only three peer-reviewed articles and two publicly available reports met inclusion criteria. Findings suggest little attention is focused on studying factors affecting implementation of EBPs for SMI in rural areas. Adaptations are occurring in rural settings, though rarely documented or tested; their impact on fidelity and consumer outcomes is unclear.

  3. Publication bias in dermatology systematic reviews and meta-analyses.

    PubMed

    Atakpo, Paul; Vassar, Matt

    2016-05-01

    Systematic reviews and meta-analyses in dermatology provide high-level evidence for clinicians and policy makers that influence clinical decision making and treatment guidelines. One methodological problem with systematic reviews is the under representation of unpublished studies. This problem is due in part to publication bias. Omission of statistically non-significant data from meta-analyses may result in overestimation of treatment effect sizes which may lead to clinical consequences. Our goal was to assess whether systematic reviewers in dermatology evaluate and report publication bias. Further, we wanted to conduct our own evaluation of publication bias on meta-analyses that failed to do so. Our study considered systematic reviews and meta-analyses from ten dermatology journals from 2006 to 2016. A PubMed search was conducted, and all full-text articles that met our inclusion criteria were retrieved and coded by the primary author. 293 articles were included in our analysis. Additionally, we formally evaluated publication bias in meta-analyses that failed to do so using trim and fill and cumulative meta-analysis by precision methods. Publication bias was mentioned in 107 articles (36.5%) and was formally evaluated in 64 articles (21.8%). Visual inspection of a funnel plot was the most common method of evaluating publication bias. Publication bias was present in 45 articles (15.3%), not present in 57 articles (19.5%) and not determined in 191 articles (65.2%). Using the trim and fill method, 7 meta-analyses (33.33%) showed evidence of publication bias. Although the trim and fill method only found evidence of publication bias in 7 meta-analyses, the cumulative meta-analysis by precision method found evidence of publication bias in 15 meta-analyses (71.4%). Many of the reviews in our study did not mention or evaluate publication bias. Further, of the 42 articles that stated following PRISMA reporting guidelines, 19 (45.2%) evaluated for publication bias. In

  4. Imaging of neuroinflammation in dementia: a review.

    PubMed

    Stefaniak, James; O'Brien, John

    2016-01-01

    We are still very limited in management strategies for dementia, and establishing effective disease modifying therapies based on amyloid or tau remains elusive. Neuroinflammation has been increasingly implicated as a pathological mechanism in dementia and demonstration that it is a key event accelerating cognitive or functional decline would inform novel therapeutic approaches, and may aid diagnosis. Much research has therefore been done to develop technology capable of imaging neuroinflammation in vivo. The authors performed a systematic search of the literature and found 28 studies that used in vivo neuroimaging of one or more markers of neuroinflammation on human patients with dementia. The majority of the studies used positron emission tomography (PET) imaging of the TSPO microglial marker and found increased neuroinflammation in at least one neuroanatomical region in dementia patients, most usually Alzheimer's disease, relative to controls, but the published evidence to date does not indicate whether the regional distribution of neuroinflammation differs between dementia types or even whether it is reproducible within a single dementia type between individuals. It is less clear that neuroinflammation is increased relative to controls in mild cognitive impairment than it is for dementia, and therefore it is unclear whether neuroinflammation is part of the pathogenesis in early stages of dementia. Despite its great potential, this review demonstrates that imaging of neuroinflammation has not thus far clearly established brain inflammation as an early pathological event. Further studies are required, including those of different dementia subtypes at early stages, and newer, more sensitive, PET imaging probes need to be developed.

  5. Uterine arteriovenous malformations following gestational trophoblastic neoplasia: a systematic review.

    PubMed

    Touhami, Omar; Gregoire, Jean; Noel, Patricia; Trinh, Xuan Bich; Plante, Marie

    2014-10-01

    Uterine arteriovenous malformation (AVM) following gestational trophoblastic neoplasia (GTN) is a rare condition. It can be associated with chronic vaginal bleeding or life-threatening heavy bleeding, even after complete resolution of the tumor following chemotherapy. This analysis aimed to perform an extensive systematic review highlighting clinical symptoms, imaging, management and prognosis of this rare complication of GTN. We also describe an additional case of uterine AVM following GTN. We conducted a literature search using Medline, Embase and Cochrane library to analyze the clinical data of 49 published cases of uterine AVM following GTN. Median age of the women diagnosed with AVM was 29 years (range 15-49). Median gravidity was 2 (range 1-8) and 50% of women were nulligravida. Complete molar pregnancy was the most common initial gestational trophoblastic diagnosis (48%). Overall, 44 patients (88%) were symptomatic and presented with chronic or acute abnormal vaginal bleeding. Only 3 patients had an undetectable HCG level at the time of uterine AVM diagnosis. Hypo-echoic space in the myometrium is the most relevant finding on ultrasonography but the gold standard for the definitive diagnosis of AVMs is angiographic examination. Uterine artery embolization was the most common treatment option performed in 82% of the patients and was successful in controlling the bleeding in 85% of cases. We identified 20 pregnancies after successful embolization of uterine AVM following a GTN and 90% of them were successful. Because of the risk of life-threatening heavy bleeding, the diagnosis of uterine AVM should always be considered in patients with a history of recurrent unexplained vaginal bleeding after gestational trophoblastic neoplasia. Angiographic embolization is successful in the majority of cases and does not appear to compromise future pregnancy.

  6. Patient-based radiographic exposure factor selection: a systematic review

    PubMed Central

    Ching, William; Robinson, John; McEntee, Mark

    2014-01-01

    Introduction Digital technology has wider exposure latitude and post-processing algorithms which can mask the evidence of underexposure and overexposure. Underexposure produces noisy, grainy images which can impede diagnosis and overexposure results in a greater radiation dose to the patient. These exposure errors can result from inaccurate adjustment of exposure factors in response to changes in patient thickness. This study aims to identify all published radiographic exposure adaptation systems which have been, or are being, used in general radiography and discuss their applicability to digital systems. Methods Studies in EMBASE, MEDLINE, CINAHL and SCOPUS were systematically reviewed. Some of the search terms used were exposure adaptation, exposure selection, exposure technique, 25% rule, 15% rule, DuPont™ Bit System and radiography. A manual journal-specific search was also conducted in The Radiographer and Radiologic Technology. Studies were included if they demonstrated a system of altering exposure factors to compensate for variations in patients for general radiography. Studies were excluded if they focused on finding optimal exposures for an ‘average’ patient or focused on the relationship between exposure factors and dose. Results The database search uncovered 11 articles and the journal-specific search uncovered 13 articles discussing systems of exposure adaptation. They can be categorised as simple one-step guidelines, comprehensive charts and computer programs. Conclusion Only two papers assessed the efficacy of exposure adjustment systems. No literature compares the efficacy of exposure adaptations system for film/screen radiography with digital radiography technology nor is there literature on a digital specific exposure adaptation system. PMID:26229654

  7. Kefir and Cancer: A Systematic Review of Literatures.

    PubMed

    Rafie, Nahid; Golpour Hamedani, Sahar; Ghiasvand, Reza; Miraghajani, Maryam

    2015-12-01

    Some studies have suggested chemopreventive effects of kefir, a fermented milk product, on carcinogenesis. The aim of this review study was to evaluate the scientific evidence for effects of kefir on cancer prevention and treatment. We systematically searched for all relevant studies published before June 2015, using PubMed, Google scholar, Cochrane and Science Direct, SID, MedLib and Srlst databases. Relevant studies were reviewed based on systematic review (PRISMA) guidelines. From a total of 2208 papers obtained at the initial database search, 11 publications including 7 in vitro and 4 experimental studies were eligible. In vitro studies on breast, colon, skin and gastric cancers and leukemia cell lines and experimental studies on different sarcomas consistently showed beneficial effects of kefir on cancer prevention and treatment. The results of this systematic review suggest that kefir may be associated with cancer prevention and it also has beneficial effects in cancer treatment. This protection may be associated with kefir bioactive components including peptides, polysaccharides and sphingolipids. PMID:26621019

  8. Psychosexual care in prostate cancer survivorship: a systematic review

    PubMed Central

    Persad, Raj

    2015-01-01

    Background Prostate cancer (PC) is the most common cancer in men. Due to improvements in medical care, the number of PC survivors is increasing. Current literature demonstrates survivors have significant unmet needs including psychosexual care. We assess patients psychosexual needs by systematic review of literature over the past 20 years up to May 2015 in order to see what issues need to be addressed within psychosexual care. Methods A systematic review was conducted on PC survivorship and psychosexual care. The search strategy aimed to identify all references related to PC survivorship programme components (parts of survivorship programmes) AND survivorship AND psychosexual concerns. Search terms used were as follows: (PC OR prostate neoplasms) AND (survivorship OR survivor*) OR [psychosexual impairment or sexual dysfunction or erectile dysfunction (ED)] AND [comorbidity or quality of life (QoL)]. Results The systematic review identified 17 papers, examining unmet needs in psychosexual care post PC therapy. Conclusions These findings of this review may change psychosexual care of PC survivors, as national and international guidance is needed. PMID:26816840

  9. Prophylactic treatment of retinal breaks--a systematic review.

    PubMed

    Blindbaek, Søren; Grauslund, Jakob

    2015-02-01

    Prophylactic treatment of retinal breaks has been examined in several studies and reviews, but so far, no studies have successfully applied a systematic approach. In the present systematic review, we examined the need of follow-up after posterior vitreous detachment (PVD) - diagnosed by slit-lamp biomicroscopy or Goldmann 3-mirror examination - with regard to retinal breaks as well as the indication of prophylactic treatment in asymptomatic and symptomatic breaks. A total of 2941 publications were identified with PubMed and Medline searches. Two manual search strategies were used for papers in English published before 2012. Four levels of screening identified 13 studies suitable for inclusion in this systematic review. No meta-analysis was conducted as no data suitable for statistical analysis were identified. In total, the initial examination after symptomatic PVD identified 85-95% of subsequent retinal breaks. Additional retinal breaks were only revealed at follow-up in patients where a full retinal examination was compromised at presentation by, for example, vitreous haemorrhage. Asymptomatic and symptomatic retinal breaks progressed to rhegmatogenous retinal detachment (RRD) in 0-13.8% and 35-47% of cases, respectively. The cumulated incidence of RRD despite prophylactic treatment was 2.1-8.8%. The findings in this review suggest that follow-up after symptomatic PVD is only necessary in cases of incomplete retinal examination at presentation. Prophylactic treatment of symptomatic retinal breaks must be considered, whereas no unequivocal conclusion could be reached with regard to prophylactic treatment of asymptomatic retinal breaks.

  10. Kefir and Cancer: A Systematic Review of Literatures.

    PubMed

    Rafie, Nahid; Golpour Hamedani, Sahar; Ghiasvand, Reza; Miraghajani, Maryam

    2015-12-01

    Some studies have suggested chemopreventive effects of kefir, a fermented milk product, on carcinogenesis. The aim of this review study was to evaluate the scientific evidence for effects of kefir on cancer prevention and treatment. We systematically searched for all relevant studies published before June 2015, using PubMed, Google scholar, Cochrane and Science Direct, SID, MedLib and Srlst databases. Relevant studies were reviewed based on systematic review (PRISMA) guidelines. From a total of 2208 papers obtained at the initial database search, 11 publications including 7 in vitro and 4 experimental studies were eligible. In vitro studies on breast, colon, skin and gastric cancers and leukemia cell lines and experimental studies on different sarcomas consistently showed beneficial effects of kefir on cancer prevention and treatment. The results of this systematic review suggest that kefir may be associated with cancer prevention and it also has beneficial effects in cancer treatment. This protection may be associated with kefir bioactive components including peptides, polysaccharides and sphingolipids.

  11. Gestational Diabetes Mellitus in Africa: A Systematic Review

    PubMed Central

    Macaulay, Shelley; Dunger, David B.; Norris, Shane A.

    2014-01-01

    Background Gestational diabetes mellitus (GDM) is any degree of impaired glucose tolerance first recognised during pregnancy. Most women with GDM revert to normal glucose metabolism after delivery of their babies; however, they are at risk of developing type 2 diabetes later in life as are their offspring. Determining a country’s GDM prevalence can assist with policy guidelines regarding GDM screening and management, and can highlight areas requiring research. This systematic review assesses GDM prevalence in Africa. Methods and Findings Three electronic databases were searched without language restrictions; PubMed, Scopus and the Cochrane Library. Thirty-one search terms were searched. Eligible articles defined GDM, stated what GDM screening approaches were employed and reported GDM prevalence. The reporting quality and risk of bias within each study was assessed. The PRISMA guidelines for systematic reviews were followed. The literature search identified 466 unique records. Sixty full text articles were reviewed of which 14 were included in the systematic review. One abstract, for which the full text article could not be obtained, was also included. Information regarding GDM classification, screening methods and prevalence was obtained for six African countries; Ethiopia (n = 1), Morocco (n = 1), Mozambique (n = 1), Nigeria (n = 6), South Africa (n = 4) and Tanzania (n = 1). Prevalence figures ranged from 0% (Tanzania) to 13.9% (Nigeria) with some studies focussing on women with GDM risk factors. Most studies utilised the two hour 75 g oral glucose tolerance test and applied the World Health Organization’s diagnostic criteria. Conclusions Six countries, equating to 11% of the African continent, were represented in this systematic review. This indicates how little is known about GDM in Africa and highlights the need for further research. Considering the increasing public health burden of obesity and type 2 diabetes, it is essential that

  12. TOPICAL REVIEW: Anatomical imaging for radiotherapy

    NASA Astrophysics Data System (ADS)

    Evans, Philip M.

    2008-06-01

    scans is taken on different days. Both allow planning to account for variability intrinsic to the patient. Treatment verification has been carried out using a variety of technologies including: MV portal imaging, kV portal/fluoroscopy, MVCT, conebeam kVCT, ultrasound and optical surface imaging. The various methods have their pros and cons. The four x-ray methods involve an extra radiation dose to normal tissue. The portal methods may not generally be used to visualize soft tissue, consequently they are often used in conjunction with implanted fiducial markers. The two CT-based methods allow measurement of inter-fraction variation only. Ultrasound allows soft-tissue measurement with zero dose but requires skilled interpretation, and there is evidence of systematic differences between ultrasound and other data sources, perhaps due to the effects of the probe pressure. Optical imaging also involves zero dose but requires good correlation between the target and the external measurement and thus is often used in conjunction with an x-ray method. The use of anatomical imaging in radiotherapy allows treatment uncertainties to be determined. These include errors between the mean position at treatment and that at planning (the systematic error) and the day-to-day variation in treatment set-up (the random error). Positional variations may also be categorized in terms of inter- and intra-fraction errors. Various empirical treatment margin formulae and intervention approaches exist to determine the optimum strategies for treatment in the presence of these known errors. Other methods exist to try to minimize error margins drastically including the currently available breath-hold techniques and the tracking methods which are largely in development. This paper will review anatomical imaging techniques in radiotherapy and how they are used to boost the therapeutic benefit of the treatment.

  13. Review of chart recognition in document images

    NASA Astrophysics Data System (ADS)

    Liu, Yan; Lu, Xiaoqing; Qin, Yeyang; Tang, Zhi; Xu, Jianbo

    2013-01-01

    As an effective information transmitting way, chart is widely used to represent scientific statistics datum in books, research papers, newspapers etc. Though textual information is still the major source of data, there has been an increasing trend of introducing graphs, pictures, and figures into the information pool. Text recognition techniques for documents have been accomplished using optical character recognition (OCR) software. Chart recognition techniques as a necessary supplement of OCR for document images are still an unsolved problem due to the great subjectiveness and variety of charts styles. This paper reviews the development process of chart recognition techniques in the past decades and presents the focuses of current researches. The whole process of chart recognition is presented systematically, which mainly includes three parts: chart segmentation, chart classification, and chart Interpretation. In each part, the latest research work is introduced. In the last, the paper concludes with a summary and promising future research direction.

  14. A composite likelihood method for bivariate meta-analysis in diagnostic systematic reviews

    PubMed Central

    Liu, Yulun; Ning, Jing; Nie, Lei; Zhu, Hongjian; Chu, Haitao

    2014-01-01

    Diagnostic systematic review is a vital step in the evaluation of diagnostic technologies. In many applications, it involves pooling pairs of sensitivity and specificity of a dichotomized diagnostic test from multiple studies. We propose a composite likelihood method for bivariate meta-analysis in diagnostic systematic reviews. This method provides an alternative way to make inference on diagnostic measures such as sensitivity, specificity, likelihood ratios and diagnostic odds ratio. Its main advantages over the standard likelihood method are the avoidance of the non-convergence problem, which is non-trivial when the number of studies are relatively small, the computational simplicity and some robustness to model mis-specifications. Simulation studies show that the composite likelihood method maintains high relative efficiency compared to that of the standard likelihood method. We illustrate our method in a diagnostic review of the performance of contemporary diagnostic imaging technologies for detecting metastases in patients with melanoma. PMID:25512146

  15. Body dissatisfaction and disordered eating in trans people: A systematic review of the literature.

    PubMed

    Jones, Bethany Alice; Haycraft, Emma; Murjan, Sarah; Arcelus, Jon

    2016-01-01

    Body dissatisfaction plays a prominent role in gender dysphoria. In some individuals body dissatisfaction appears to manifest disordered eating in order to suppress bodily features of natal gender and accentuate features of gender identity. To date, there has been no systematic review of the literature pertaining to body dissatisfaction and disordered eating in trans individuals. Such a review may highlight important implications for clinicians working with trans people. Therefore, the aim was to critically and systematically review the available literature examining body dissatisfaction or disordered eating in a trans population, and also the literature pertaining to how body dissatisfaction and disordered eating are related in trans people. This review found three studies that explored disordered eating in trans people, five studies that explored body image and disordered eating in trans people, and 18 studies that explored body image in trans people. The findings from this review suggest that body dissatisfaction is core to the distress trans people experience and that this dissatisfaction may also put some individuals at risk of developing disordered eating. Additionally, the findings appear to suggest that gender dysphoria treatment is successful at increasing body satisfaction and improving body image. The clinical implications are discussed. PMID:26618239

  16. Body dissatisfaction and disordered eating in trans people: A systematic review of the literature.

    PubMed

    Jones, Bethany Alice; Haycraft, Emma; Murjan, Sarah; Arcelus, Jon

    2016-01-01

    Body dissatisfaction plays a prominent role in gender dysphoria. In some individuals body dissatisfaction appears to manifest disordered eating in order to suppress bodily features of natal gender and accentuate features of gender identity. To date, there has been no systematic review of the literature pertaining to body dissatisfaction and disordered eating in trans individuals. Such a review may highlight important implications for clinicians working with trans people. Therefore, the aim was to critically and systematically review the available literature examining body dissatisfaction or disordered eating in a trans population, and also the literature pertaining to how body dissatisfaction and disordered eating are related in trans people. This review found three studies that explored disordered eating in trans people, five studies that explored body image and disordered eating in trans people, and 18 studies that explored body image in trans people. The findings from this review suggest that body dissatisfaction is core to the distress trans people experience and that this dissatisfaction may also put some individuals at risk of developing disordered eating. Additionally, the findings appear to suggest that gender dysphoria treatment is successful at increasing body satisfaction and improving body image. The clinical implications are discussed.

  17. Conflicts of interest and spin in reviews of psychological therapies: a systematic review

    PubMed Central

    Lieb, Klaus; von der Osten-Sacken, Jan; Stoffers-Winterling, Jutta; Reiss, Neele; Barth, Jürgen

    2016-01-01

    Objective To explore conflicts of interest (COI) and their reporting in systematic reviews of psychological therapies, and to evaluate spin in the conclusions of the reviews. Methods MEDLINE and PsycINFO databases were searched for systematic reviews published between 2010 and 2013 that assessed effects of psychological therapies for anxiety, depressive or personality disorders, and included at least one randomised controlled trial. Required COI disclosure by journal, disclosed COI by review authors, and the inclusion of own primary studies by review authors were extracted. Researcher allegiance, that is, that researchers concluded favourably about the interventions they have studied, as well as spin, that is, differences between results and conclusions of the reviews, were rated by 2 independent raters. Results 936 references were retrieved, 95 reviews fulfilled eligibility criteria. 59 compared psychological therapies with other forms of psychological therapies, and 36 psychological therapies with pharmacological interventions. Financial, non-financial, and personal COI were disclosed in 22, 4 and 1 review, respectively. 2 of 86 own primary studies of review authors included in 34 reviews were disclosed by review authors. In 15 of the reviews, authors showed an allegiance effect to the evaluated psychological therapy that was never disclosed. Spin in review conclusions was found in 27 of 95 reviews. Reviews with a conclusion in favour of psychological therapies (vs pharmacological interventions) were at high risk for a spin in conclusions (OR=8.31 (1.41 to 49.05)). Spin was related in trend to the inclusion of own primary studies in the systematic review (OR=2.08 (CI 0.83 to 5.18) p=0.11) and researcher allegiance (OR=2.63 (0.84 to 8.16) p=0.16). Conclusions Non-financial COI, especially the inclusion of own primary studies into reviews and researcher allegiance, are frequently seen in systematic reviews of psychological therapies and need more transparency and

  18. Hypnosis before diagnostic or therapeutic medical procedures: a systematic review.

    PubMed

    Cheseaux, Nicole; de Saint Lager, Alix Juillet; Walder, Bernhard

    2014-01-01

    The aim of this systematic review was to estimate the efficiency of hypnosis prior to medical procedures. Different databases were analyzed to identify randomized controlled trials (RCTs) comparing hypnosis to control interventions. All RCTs had to report pain or anxiety. Eighteen RCTs with a total of 968 patients were included; study size was from 20 to 200 patients (14 RCTs ≤ 60 patients). Fourteen RCTs included 830 adults and 4 RCTs included 138 children. Twelve of 18 RCTs had major quality limitations related to unclear allocation concealments, provider's experience in hypnosis, patient's adherence to hypnotic procedures, and intention-to-treat design. This systematic review observed major methodological limitations in RCTs on hypnosis prior to medical procedures.

  19. Identifying and removing duplicate records from systematic review searches

    PubMed Central

    Kwon, Yoojin; Lemieux, Michelle; McTavish, Jill; Wathen, Nadine

    2015-01-01

    Objective The purpose of this study was to compare effectiveness of different options for de-duplicating records retrieved from systematic review searches. Methods Using the records from a published systematic review, five de-duplication options were compared. The time taken to de-duplicate in each option and the number of false positives (were deleted but should not have been) and false negatives (should have been deleted but were not) were recorded. Results The time for each option varied. The number of positive and false duplicates returned from each option also varied greatly. Conclusion The authors recommend different de-duplication options based on the skill level of the searcher and the purpose of de-duplication efforts. PMID:26512216

  20. Psychopathology in Young People Experiencing Homelessness: A Systematic Review

    PubMed Central

    Shelton, Katherine H.; van den Bree, Marianne B. M.; Los, Férenc J.

    2013-01-01

    Understanding mental health issues faced by young homeless persons is instrumental to the development of successful targeted interventions. No systematic review of recent published literature on psychopathology in this group has been completed. We conducted a systematic review of published research examining the prevalence of psychiatric problems among young homeless people. We examined the temporal relationship between homelessness and psychopathology. We collated 46 articles according to the PRISMA Statement. All studies that used a full psychiatric assessment consistently reported a prevalence of any psychiatric disorder from 48% to 98%. Although there was a lack of longitudinal studies of the temporal relationship between psychiatric disorders and homelessness, findings suggested a reciprocal link. Supporting young people at risk for homelessness could reduce homelessness incidence and improve mental health. PMID:23597340

  1. Satisfaction measurement instruments for healthcare service users: a systematic review.

    PubMed

    Almeida, Renato Santos de; Bourliataux-Lajoinie, Stephane; Martins, Mônica

    2015-01-01

    Patient satisfaction surveys can be an interesting way to improve quality and discuss the concept of patient-centered care. This study aimed to conduct a systematic review of the validated patient satisfaction measurement instruments applied in healthcare. The systematic review searched the MEDLINE/PubMed, LILACS, SciELO, Scopus and Web of Knowledge. The search strategy used the terms: "Patient Satisfaction" AND "Patient centered care" AND "Healthcare survey OR Satisfaction questionnaire" AND "Psychometric properties". 37 studies were included and almost all studies showed that satisfaction is a multidimensional construct. In these studies, 34 different instruments were used and most surveys contained the dimension patient-healthcare professional interactions, physical environment and management process. The COSMIN score for methodological quality showed that most of them scored a good or fair average. We can conclude that there is not a gold standard instrument for patient satisfaction assessment but some dimensions are essential for this construct. PMID:25715288

  2. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain

    PubMed Central

    Hauser, Ross A.; Lackner, Johanna B.; Steilen-Matias, Danielle; Harris, David K.

    2016-01-01

    OBJECTIVE The aim of this study was to systematically review dextrose (d-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. DATA SOURCES Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. STUDY SELECTION Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. DATA EXTRACTION Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. DATA SYNTHESIS Fourteen RCTs, 1 case–control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8) and found dextrose injection superior to controls in Osgood–Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive

  3. Systematic reviews of the effectiveness of quality improvement strategies and programmes

    PubMed Central

    Grimshaw, J; McAuley, L; Bero, L; Grilli, R; Oxman, A; Ramsay, C; Vale, L; Zwarenstein, M

    2003-01-01

    

 Systematic reviews provide the best evidence on the effectiveness of healthcare interventions including quality improvement strategies. The methods of systematic review of individual patient randomised trials of healthcare interventions are well developed. We discuss methodological and practice issues that need to be considered when undertaking systematic reviews of quality improvement strategies including developing a review protocol, identifying and screening evidence sources, quality assessment and data abstraction, analytical methods, reporting systematic reviews, and appraising systematic reviews. This paper builds on our experiences within the Cochrane Effective Practice and Organisation of Care (EPOC) review group. PMID:12897365

  4. Care transitions: a systematic review of best practices.

    PubMed

    Dusek, Brenda; Pearce, Nancy; Harripaul, Anastasia; Lloyd, Monique

    2015-01-01

    This article reports results from a systematic review used to inform the development of a best practice guideline to assist nurses in understanding their roles and responsibilities in promoting safe and effective client care transitions. A care transition is a set of actions designed to ensure safe and effective coordination and continuity of care as clients experience a change in health status, care needs, health care providers, or location.

  5. Systematic Omics Analysis Review (SOAR) tool to support risk assessment.

    PubMed

    McConnell, Emma R; Bell, Shannon M; Cote, Ila; Wang, Rong-Lin; Perkins, Edward J; Garcia-Reyero, Natàlia; Gong, Ping; Burgoon, Lyle D

    2014-01-01

    Environmental health risk assessors are challenged to understand and incorporate new data streams as the field of toxicology continues to adopt new molecular and systems biology technologies. Systematic screening reviews can help risk assessors and assessment teams determine which studies to consider for inclusion in a human health assessment. A tool for systematic reviews should be standardized and transparent in order to consistently determine which studies meet minimum quality criteria prior to performing in-depth analyses of the data. The Systematic Omics Analysis Review (SOAR) tool is focused on assisting risk assessment support teams in performing systematic reviews of transcriptomic studies. SOAR is a spreadsheet tool of 35 objective questions developed by domain experts, focused on transcriptomic microarray studies, and including four main topics: test system, test substance, experimental design, and microarray data. The tool will be used as a guide to identify studies that meet basic published quality criteria, such as those defined by the Minimum Information About a Microarray Experiment standard and the Toxicological Data Reliability Assessment Tool. Seven scientists were recruited to test the tool by using it to independently rate 15 published manuscripts that study chemical exposures with microarrays. Using their feedback, questions were weighted based on importance of the information and a suitability cutoff was set for each of the four topic sections. The final validation resulted in 100% agreement between the users on four separate manuscripts, showing that the SOAR tool may be used to facilitate the standardized and transparent screening of microarray literature for environmental human health risk assessment. PMID:25531884

  6. A brief overview of systematic reviews and meta-analyses

    PubMed Central

    Sriganesh, Kamath; Shanthanna, Harsha; Busse, Jason W

    2016-01-01

    Systematic reviews (SRs) are performed to acquire all evidence to address a specific clinical question and involve a reproducible and thorough search of the literature and critical appraisal of eligible studies. When combined with a meta-analysis (quantitatively pooling of results of individual studies), a rigorously conducted SR provides the best available evidence for informing clinical practice. In this article, we provide a brief overview of SRs and meta-analyses for anaesthesiologists. PMID:27729699

  7. Malarial pancreatitis: Case report and systematic review of the literature

    PubMed Central

    Sehgal, Inderpaul Singh; Agarwal, Ritesh; Behera, Digambar; Dhooria, Sahajal

    2015-01-01

    Malaria can cause a wide spectrum of clinical manifestations ranging from uncomplicated febrile illness to multiorgan failure. Pancreatitis is a rare complication of malaria with only a few reported cases. Herein, we describe a case of acute pancreatitis with multiorgan failure due to Plasmodium falciparum managed successfully with antimalarials and conservative treatment. We also perform a systematic review of literature for reports of acute pancreatitis due to Plasmodium infection. PMID:26816452

  8. Gastrostomy feeding in cerebral palsy: a systematic review

    PubMed Central

    Sleigh, G; Brocklehurst, P

    2004-01-01

    Aims: To determine benefits and risks for gastrostomy or jejunostomy feeding compared with oral feeding for children with cerebral palsy. Methods: Systematic review. Search strategy: electronic databases—Cochrane Library, Medline, Embase, Cinahl, Lilacs, databases of theses, grey literature. Included: relevant systematic reviews, randomised controlled trials, observational studies, case reports. Excluded: non-systematic reviews and qualitative research. Participants: children with cerebral palsy. Intervention: use of gastrostomy or jejunostomy tube to provide nutrition. Outcome: evaluated outcome measures included death, growth, gastro-oesophageal reflux, other complications, psychosocial aspects, and caregiver wellbeing. Results: No relevant systematic reviews or randomised controlled trials were found. Two cohort studies, 15 case series, and eight case reports met the inclusion criteria. Eight studies specifically described percutaneous endoscopic gastrostomy as the intervention. Weight gain resulted from gastrostomy feeding in most cases. There was an approximately fourfold increased risk of death reported in one cohort study for the gastrostomy fed children. Many complications were reported, including potential for increased gastro-oesophageal reflux and fluid aspiration into the lungs. Conclusions: Benefits associated with gastrostomy or jejunostomy feeding are difficult to assess from the available evidence. Risks of gastrostomy, particularly in relation to surgical complications, have been described but the size of the risk could not be quantified. The finding of a higher death rate for children fed by gastrostomy may merely reflect the greater disability of these compared with orally fed children. Lack of available evidence and the substantial risk of bias in observational studies suggests that a well conducted randomised controlled trial of sufficient size will be needed to answer these problems. PMID:15155398

  9. The Effectiveness of Public Health Interventions to Reduce the Health Impact of Climate Change: A Systematic Review of Systematic Reviews

    PubMed Central

    Bouzid, Maha; Hooper, Lee; Hunter, Paul R.

    2013-01-01

    Background Climate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases. Methods and Findings For each disease, we performed a systematic search with no restriction on date or language of publication on Medline, Web of Knowledge, Cochrane CENTRAL and SCOPUS up to December 2010 to identify systematic reviews of public health interventions. We retrieved some 3176 records of which 85 full papers were assessed and 33 included in the review. The included papers investigated the effect of public health interventions on various outcome measures. All interventions were GRADE assessed to determine the strength of evidence. In addition we developed a systematic review quality score. The interventions included environmental interventions to control vectors, chemoprophylaxis, immunization, household and community water treatment, greening cities and community advice. For most reviews, GRADE showed low quality of evidence because of poor study design and high heterogeneity. Also for some key areas such as floods, droughts and other weather extremes, there are no adequate systematic reviews of potential public health interventions. Conclusion In conclusion, we found the evidence base to be mostly weak for environmental interventions that could have the most value in a warmer world. Nevertheless, such interventions should not be dismissed. Future research on public health interventions for climate change adaptation needs to be concerned about quality in study design and should address the gap for floods, droughts and other extreme weather events that pose a risk to health. PMID:23634220

  10. Surface electromyography in animal biomechanics: A systematic review.

    PubMed

    Valentin, Stephanie; Zsoldos, Rebeka R

    2016-06-01

    The study of muscle activity using surface electromyography (sEMG) is commonly used for investigations of the neuromuscular system in man. Although sEMG has faced methodological challenges, considerable technical advances have been made in the last few decades. Similarly, the field of animal biomechanics, including sEMG, has grown despite being confronted with often complex experimental conditions. In human sEMG research, standardised protocols have been developed, however these are lacking in animal sEMG. Before standards can be proposed in this population group, the existing research in animal sEMG should be collated and evaluated. Therefore the aim of this review is to systematically identify and summarise the literature in animal sEMG focussing on (1) species, breeds, activities and muscles investigated, and (2) electrode placement and normalisation methods used. The databases PubMed, Web of Science, Scopus, and Vetmed Resource were searched systematically for sEMG studies in animals and 38 articles were included in the final review. Data on methodological quality was collected and summarised. The findings from this systematic review indicate the divergence in animal sEMG methodology and as a result, future steps required to develop standardisation in animal sEMG are proposed.

  11. Internalized Homonegativity: A Systematic Mapping Review of Empirical Research

    PubMed Central

    Berg, Rigmor C.; Munthe-Kaas, Heather M.; Ross, Michael W.

    2016-01-01

    ABSTRACT Internalized homonegativity (IH) is an important variable affecting the wellbeing of lesbian, gay, and bisexual (LGB) persons. We included 201 studies in a systematic mapping review of IH. Most studies were conducted in North America and examined IH as a predictor of poor health. The primary focus of 14 studies was IH scale measurement, and, in total, these studies detailed nine distinct scales. Eighteen studies compared levels of IH in LGB populations, four described prevention programs, and one investigated IH using qualitative methods. Our review indicates that further research is needed, particularly qualitative research and ways to ameliorate IH. PMID:26436322

  12. Nutraceutical supplements for weight loss: a systematic review.

    PubMed

    Poddar, Kavita; Kolge, Sanjivani; Bezman, Lena; Mullin, Gerard E; Cheskin, Lawrence J

    2011-10-01

    Obesity is a global public health issue. Although the etiology of this global epidemic is multifactorial, most sufferers would be delighted to find a relatively effortless way to lose weight. Herbal "weight loss pills" can fit the bill. The authors systematically review the scientific evidence concerning various weight loss agents that are available over the counter or in food stores. The review provides a starting point to make informed choices among nutraceutical agents promoted for weight loss, as well as advice for incorporating healthy alternatives in the diet. PMID:21947637

  13. Internalized Homonegativity: A Systematic Mapping Review of Empirical Research.

    PubMed

    Berg, Rigmor C; Munthe-Kaas, Heather M; Ross, Michael W

    2016-01-01

    Internalized homonegativity (IH) is an important variable affecting the wellbeing of lesbian, gay, and bisexual (LGB) persons. We included 201 studies in a systematic mapping review of IH. Most studies were conducted in North America and examined IH as a predictor of poor health. The primary focus of 14 studies was IH scale measurement, and, in total, these studies detailed nine distinct scales. Eighteen studies compared levels of IH in LGB populations, four described prevention programs, and one investigated IH using qualitative methods. Our review indicates that further research is needed, particularly qualitative research and ways to ameliorate IH. PMID:26436322

  14. Systematic Review to Inform Dual Tobacco Use Prevention.

    PubMed

    Evans, William Douglas; Horn, Kimberly A; Gray, Tiffany

    2015-10-01

    With more tobacco products now available and heavily marketed, dual tobacco use is increasing among youth. We systematically reviewed literature on dual tobacco use interventions, with an emphasis on mass health communication strategies. The review identified 46 articles meeting initial criteria and ultimately included 8 articles. Included studies reported a mix of health communication and social marketing techniques. Although there is a body of research on dual tobacco use, there is limited literature describing interventions aimed at controlling it. Design and evaluation of such interventions showing reductions in dual use of cigarettes, smokeless, and alternative products would advance the field.

  15. Systematic Review to Inform Dual Tobacco Use Prevention.

    PubMed

    Evans, William Douglas; Horn, Kimberly A; Gray, Tiffany

    2015-10-01

    With more tobacco products now available and heavily marketed, dual tobacco use is increasing among youth. We systematically reviewed literature on dual tobacco use interventions, with an emphasis on mass health communication strategies. The review identified 46 articles meeting initial criteria and ultimately included 8 articles. Included studies reported a mix of health communication and social marketing techniques. Although there is a body of research on dual tobacco use, there is limited literature describing interventions aimed at controlling it. Design and evaluation of such interventions showing reductions in dual use of cigarettes, smokeless, and alternative products would advance the field. PMID:26318945

  16. Brief report: systematic review of Rett syndrome in males.

    PubMed

    Reichow, Brian; George-Puskar, Annie; Lutz, Tara; Smith, Isaac C; Volkmar, Fred R

    2015-10-01

    Rett syndrome (RTT) is a neurogenetic disorder in which a period of typical development is followed by loss of previously acquired skills. Once thought to occur exclusively in females, increasing numbers of male cases of RTT have been reported. This systematic review included 36 articles describing 57 cases of RTT in males. Mutations of the MECP2 gene were present in 56 % of cases, and 68 % of cases reported other genetic abnormalities. This is the first review of published reports of RTT in male patients.

  17. Internalized Homonegativity: A Systematic Mapping Review of Empirical Research.

    PubMed

    Berg, Rigmor C; Munthe-Kaas, Heather M; Ross, Michael W

    2016-01-01

    Internalized homonegativity (IH) is an important variable affecting the wellbeing of lesbian, gay, and bisexual (LGB) persons. We included 201 studies in a systematic mapping review of IH. Most studies were conducted in North America and examined IH as a predictor of poor health. The primary focus of 14 studies was IH scale measurement, and, in total, these studies detailed nine distinct scales. Eighteen studies compared levels of IH in LGB populations, four described prevention programs, and one investigated IH using qualitative methods. Our review indicates that further research is needed, particularly qualitative research and ways to ameliorate IH.

  18. Imaging radar polarimetry - A review

    NASA Technical Reports Server (NTRS)

    Zebker, Howard A.; Van Zyl, Jakob J.

    1991-01-01

    The authors present a tutorial review of the broad sweep of topics relating to imaging radar polarimetry, ranging from mathematical foundations to hardware and from implementation approaches to signal processing and calibration. The authors examine current developments in sensor technology and implementation for recording polarimetric measurements, and describe techniques and areas of application for this form of remotely sensed data. Those aspects of ground signal processing and calibration peculiar to the polarimetric signals are addressed. Several of the currently operating instruments and some of the implementations planned for future use are discussed.

  19. A Systematic Review of Personality Disorders and Health Outcomes

    PubMed Central

    Dixon-Gordon, Katherine L.; Whalen, Diana J.; Layden, Brianne K.; Chapman, Alexander L.

    2015-01-01

    Personality disorders have been associated with a wide swath of adverse health outcomes and correspondingly high costs to healthcare systems. To date, however, there has not been a systematic review of the literature on health conditions among individuals with personality disorders. The primary aim of this article is to review research documenting the associations between personality disorders and health conditions. A systematic review of the literature revealed 78 unique empirical English-language peer-reviewed articles examining the association of personality disorders and health outcomes over the past 15 years. Specifically, we reviewed research examining the association of personality disorders with sleep disturbance, obesity, pain conditions, and other chronic health conditions. In addition, we evaluated research on candidate mechanisms underlying health problems in personality disorders and potential treatments for such disorders. Results underscore numerous deleterious health outcomes associated with PD features and PD diagnoses, and suggest potential biological and behavioural factors that may account for these relations. Guidelines for future research in this area are discussed. PMID:26456998

  20. Psychological Profile of Sasang Typology: A Systematic Review

    PubMed Central

    Park, Soo Hyun; Lee, Soo Jin; Kim, Myoung-geun; Wedding, Danny; Kwon, Young-Kyu

    2009-01-01

    A systematic review of studies related to the psychological characteristics of Sasang types was conducted with the goal of delineating generalizable psychological profiles based on Sasang typology, a traditional Korean medical typology with medical herbs and acupuncture that is characterized as personalized medicine. Journal articles pertaining to Sasang typology were collected using five electronic database systems in Korea and in the USA. As a result, 64 potentially relevant studies were identified and 21 peer-reviewed research articles that employed psychometric inventories were included. Beginning with the use of the Minnesota Multiphasic Personality Inventory in 1992, Myers-Briggs Type Indicator, NEO-Personality Inventory, Temperament and Character Inventory and other personality assessment tools were employed in the identified studies. Because data synthesis could not be carried out due to the heterogeneity of the studies, the present review article sought to delineate the mutual relevance of the studies based on research results pertaining to the correlation between the aforementioned psychological assessment instruments. Results of the review indicate that two super-factors, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension, while the So-Eum type scored low on the Extraversion dimension and high on the Neuroticism dimension. The present systematic review indicates that Sasang typology shares similarities with the Western psychological tradition. PMID:19745008

  1. A review of systematic reviews on anterior cruciate ligament reconstruction rehabilitation.

    PubMed

    Lobb, Ryan; Tumilty, Steve; Claydon, Leica S

    2012-11-01

    The aim of this systematic review of systematic reviews was to critically appraise systematic reviews on Anterior Cruciate Ligament (ACL) reconstruction rehabilitation to determine which interventions are supported by the highest quality evidence. Electronic searches were undertaken, of MEDLINE, AMED, EMBASE, EBM reviews, PEDro, Scopus, and Web of Science to identify systematic reviews of ACL rehabilitation. Two reviewers independently selected the studies, extracted data, and applied quality criteria. Study quality was assessed using PRISMA and a best evidence synthesis was performed. Five systematic reviews were included assessing eight rehabilitation components. There was strong evidence (consistent evidence from multiple high quality randomised controlled trials (RCTs)) of no added benefit of bracing (0-6 weeks post-surgery) compared to standard treatment in the short term. Moderate evidence (consistent evidence from multiple low quality RCTs and/or one high quality RCT) supported no added benefit of continuous passive motion to standard treatment for increasing range of motion. There was moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions. Recommendations for clinical practice are made at specific time points for specific outcomes. PMID:23068905

  2. Overview of Evidence in Prevention and Aetiology of Food Allergy: A Review of Systematic Reviews

    PubMed Central

    Lodge, Caroline J.; Allen, Katrina J.; Lowe, Adrian J.; Dharmage, Shyamali C.

    2013-01-01

    The worldwide prevalence of food allergy appears to be increasing. Early life environmental factors are implicated in the aetiology of this global epidemic. The largest burden of disease is in early childhood, where research efforts aimed at prevention have been focused. Evidence synthesis from good quality systematic reviews is needed. We performed an overview of systematic reviews concerning the prevention and aetiology of food allergy, retrieving 14 systematic reviews, which covered three broad topics: formula (hydrolysed or soy) for the prevention of food allergy or food sensitization; maternal and infant diet and dietary supplements for the prevention of food allergy or food sensitization and hygiene hypothesis-related interventions. Using the AMSTAR criteria for assessment of methodological quality, we found five reviews to be of high quality, seven of medium quality and two of low quality. Overall we found no compelling evidence that any of the interventions that had been systematically reviewed were related to the risk of food allergy. Updating of existing reviews, and production of new systematic reviews, are needed in areas where evidence is emerging for interventions and environmental associations. Furthermore, additional primary studies, with greater numbers of participants and objective food allergy definitions are urgently required. PMID:24192789

  3. Interventions to enhance work participation of workers with a chronic disease: a systematic review of reviews.

    PubMed

    Vooijs, Marloes; Leensen, Monique C J; Hoving, Jan L; Wind, Haije; Frings-Dresen, Monique H W

    2015-11-01

    The aim of this systematic review was to provide an overview of the available effective interventions that enhance work participation of people with a chronic disease, irrespective of their diagnosis. A search was conducted in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library, searching for systematic reviews published between 2004 and February 2015. Systematic reviews were eligible for inclusion if they described an intervention aimed at enhancing work participation and included participants of working age (18-65 years) with a chronic disease. Reviews had to include populations having different chronic diseases. The quality of the included reviews was evaluated using the quality instrument AMSTAR. Results of reviews of medium and high quality were described in this review. The search resulted in 9 reviews, 5 of which were of medium quality. No high quality reviews were retrieved. 1 review reported inconclusive evidence for policy-based return to work initiatives. The 4 other reviews described interventions focused on changes at work, such as changes in work organisation, working conditions and work environment. Of these 4 reviews, 3 reported beneficial effects of the intervention on work participation. Interventions examined in populations having different chronic diseases were mainly focused on changes at work. The majority of the included interventions were reported to be effective in enhancing work participation of people with a chronic disease, indicating that interventions directed at work could be considered for a generic approach in order to enhance work participation in various chronic diseases.

  4. The Sport Concussion Assessment Tool: a systematic review.

    PubMed

    Yengo-Kahn, Aaron M; Hale, Andrew T; Zalneraitis, Brian H; Zuckerman, Scott L; Sills, Allen K; Solomon, Gary S

    2016-04-01

    OBJECTIVE Over the last 2 decades, sport-related concussion (SRC) has garnered significant attention. Even with increased awareness and athlete education, sideline recognition and real-time diagnosis remain crucial. The need for an objective and standardized assessment of concussion led to the eventual development of the Sport Concussion Assessment Tool (SCAT) during the Second International Conference on Concussion in Sport in 2004, which is now in its third iteration (SCAT3). In an effort to update our understanding of the most well-known sideline concussion assessment, the authors conducted a systematic review of the SCAT and the evidence supporting its use to date. METHODS English-language titles and abstracts published between 1995 and October 2015 were searched systematically across 4 electronic databases and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for the review of a heterogeneous collection of study designs. Peer-reviewed journal articles were included if they reported quantitative data on any iteration of the SCAT, Standardized Assessment of Concussion (SAC), or modified Balance Error Scoring System (mBESS) data at baseline or following concussion in an exclusively athlete population with any portion older than 13 years of age. Studies that included nonathletes, only children less than 13 years old, exclusively BESS data, exclusively symptom scale data, or a non-SCAT-related assessment were excluded. RESULTS The database search process yielded 549 abstracts, and 105 full-text articles were reviewed with 36 meeting criteria for inclusion. Nineteen studies were associated with the SAC, 1 was associated with the mBESS exclusively, and 16 studies were associated with a full iteration of the SCAT. The majority of these studies (56%) were prospective cohort studies. Male football players were the most common athletes studied. An analysis of the studies focused on

  5. Nonadherence to Medication Therapy in Haemodialysis Patients: A Systematic Review

    PubMed Central

    Ghimire, Saurav; Castelino, Ronald L.; Lioufas, Nicole M.; Peterson, Gregory M.; Zaidi, Syed Tabish R.

    2015-01-01

    Background End-stage kidney disease (ESKD) patients are often prescribed multiple medications. Together with a demanding weekly schedule of dialysis sessions, increased number of medicines and associated regimen complexity pre-dispose them at high risk of medication nonadherence. This review summarizes existing literature on nonadherence and identifies factors associated with nonadherence to medication therapy in patients undergoing haemodialysis. Methods A comprehensive search of PubMed, Embase, CINAHL, PsycInfo, and Cochrane Database of Systematic Reviews covering the period from 1970 through November 2014 was performed following a predefined inclusion and exclusion criteria. Reference lists from relevant materials were reviewed. Data on study characteristics, measures of nonadherence, prevalence rates and factors associated with nonadherence were collected. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was followed in conducting this systematic review. Results Of 920 relevant publications, 44 were included. The prevalence of medication nonadherence varied from 12.5% to 98.6%, with widespread heterogeneity in measures and definitions employed. Most common patient-related factors significantly associated with nonadherence were younger age, non-Caucasian ethnicity, illness interfering family life, being a smoker, and living single and being divorced or widowed. Similarly, disease-related factors include longevity of haemodialysis, recurrent hospitalization, depressive symptoms and having concomitant illness like diabetes and hypertension. Medication-related factors such as daily tablet count, total pill burden, number of phosphate binders prescribed and complexity of medication regimen were also associated with poor adherence. Conclusions A number of patient-, disease-, and medication-related factors are associated with medication nonadherence in haemodialysis patients. Clinicians should be aware of such factors so that

  6. Systematic review of 3D mammography for breast cancer screening.

    PubMed

    Hodgson, Robert; Heywang-Köbrunner, Sylvia H; Harvey, Susan C; Edwards, Mary; Shaikh, Javed; Arber, Mick; Glanville, Julie

    2016-06-01

    This review investigated the relative performance of digital breast tomosynthesis (DBT) (alone or with full field digital mammography (FFDM) or synthetic digital mammography) compared with FFDM alone for detecting breast cancer lesions in asymptomatic women. A systematic review was carried out according to systematic reviewing principles provided in the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. A protocol was developed a priori. The review was registered with PROSPERO (number CRD42014013949). Searches were undertaken in October 2014. Following selection, five studies were eligible. Higher cancer detection rates were observed when comparing DBT + FFDM with FFDM in two European studies: the summary difference per 1000 screens was 2.43 (95% CI: 1.8 to 3.1). Both European studies found lower false positive rates for individual readers. One found a lower recall rate based on conditional recall. The second study was not designed to compare post-arbitration recall rates between FFDM and DBT + FFDM. One European study presented data on interval cancer rates; sensitivity and specificity for DBT + FFDM were both higher compared to FFDM. One large multicentre US study showed a higher cancer detection rate for DBT + FFDM, while two smaller US studies did not find statistically significant differences. Reductions in recall and false positive rates were observed in the US studies in favour of DBT + FFDM. In comparison to FFDM, DBT, as an adjunct to FFDM, has a higher cancer detection rate, increasing the effectiveness of breast cancer screening. Additional benefits of DBT may also include reduced recalls and, consequently, reduced costs and distress caused to women who would have been recalled. PMID:27212700

  7. What implementation interventions increase cancer screening rates? a systematic review

    PubMed Central

    2011-01-01

    Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as

  8. PREVENTING CHILD AND ADOLESCENT ANXIETY DISORDERS: OVERVIEW OF SYSTEMATIC REVIEWS.

    PubMed

    Bennett, Kathryn; Manassis, Katharina; Duda, Stephanie; Bagnell, Alexa; Bernstein, Gail A; Garland, E Jane; Miller, Lynn D; Newton, Amanda; Thabane, Lehana; Wilansky, Pamela

    2015-12-01

    Overviews of systematic reviews (OSRs) provide rapid access to high quality, consolidated research evidence about prevention intervention options, supporting evidence-informed decision-making, and the identification of fruitful areas of new research. This OSR addressed three questions about prevention strategies for child and adolescent anxiety: (1) Does the intervention prevent anxiety diagnosis and/or reduce anxiety symptoms compared to passive controls? (2) Is the intervention equal to or more effective than active controls? (3) What is the evidence quality (EQ) for the intervention? Prespecified inclusion criteria identified systematic reviews and meta-analyses (2000-2014) with an AMSTAR quality score ≥ 3/5. EQ was rated using Oxford evidence levels EQ1 (highest) to EQ5 (lowest). Three reviews met inclusion criteria. One narrative systematic review concluded school-based interventions reduce anxiety symptoms. One meta-analysis pooled 65 randomized controlled trials (RCTs; any intervention) and reported a small, statistically significant reduction in anxiety symptoms and diagnosis incidence. Neither review provided pooled effect size estimates for specific intervention options defined by type (i.e., universal/selective/indicated), intervention content, or comparison group (i.e., passive/active control), thus precluding EQ ratings. One meta-analysis pooled trials of vigorous exercise and reported small, nonstatistically significant reductions in anxiety symptoms for comparisons against passive and active controls (EQ1). Better use of primary studies in meta-analyses, including program-specific pooled effect size estimates and network meta-analysis is needed to guide evidence-informed anxiety prevention program choices. RCTs of innovative community/primary care based interventions and web-based strategies can fill knowledge gaps.

  9. Use of Systematic Review and Meta-Analysis in Environmental Health Epidemiology: a Systematic Review and Comparison with Guidelines.

    PubMed

    Sheehan, Mary C; Lam, Juleen

    2015-09-01

    Systematic review (SR) and meta-analysis (MA) have potential to contribute substantially to environmental health (EH) risk assessment and policy-making, provided study questions are clear and methods sound. We undertook a systematic review of the published epidemiological literature for studies using both SR and MA examining associations between chronic low-dose chemical exposures and adverse health outcomes in general populations and compared actual methods and reporting with a checklist based on available published guidelines. We identified 48 EH SRMAs meeting these criteria. Associations were mainly positive and statistically significant, often involving large populations. A majority of studies followed most general SRMA guidance, although we identified weaknesses in problem formulation, study search, selection and data extraction, and integrating policy implications. Fewer studies followed EH-specific SRMA recommendations, particularly regarding exposure heterogeneity and other risks of bias. Development and adoption of EH-specific SRMA guidelines would contribute to strengthening these tools for public health decision-making.

  10. Boolean versus ranked querying for biomedical systematic reviews

    PubMed Central

    2010-01-01

    Background The process of constructing a systematic review, a document that compiles the published evidence pertaining to a specified medical topic, is intensely time-consuming, often taking a team of researchers over a year, with the identification of relevant published research comprising a substantial portion of the effort. The standard paradigm for this information-seeking task is to use Boolean search; however, this leaves the user(s) the requirement of examining every returned result. Further, our experience is that effective Boolean queries for this specific task are extremely difficult to formulate and typically require multiple iterations of refinement before being finalized. Methods We explore the effectiveness of using ranked retrieval as compared to Boolean querying for the purpose of constructing a systematic review. We conduct a series of experiments involving ranked retrieval, using queries defined methodologically, in an effort to understand the practicalities of incorporating ranked retrieval into the systematic search task. Results Our results show that ranked retrieval by itself is not viable for this search task requiring high recall. However, we describe a refinement of the standard Boolean search process and show that ranking within a Boolean result set can improve the overall search performance by providing early indication of the quality of the results, thereby speeding up the iterative query-refinement process. Conclusions Outcomes of experiments suggest that an interactive query-development process using a hybrid ranked and Boolean retrieval system has the potential for significant time-savings over the current search process in the systematic reviewing. PMID:20937152

  11. Prevention of childhood poisoning in the home: overview of systematic reviews and a systematic review of primary studies.

    PubMed

    Wynn, Persephone M; Zou, Kun; Young, Ben; Majsak-Newman, Gosia; Hawkins, Adrian; Kay, Bryony; Mhizha-Murira, Jacqueline; Kendrick, Denise

    2016-01-01

    Unintentional poisoning is a significant child public health problem. This systematic overview of reviews, supplemented with a systematic review of recently published primary studies synthesizes evidence on non-legislative interventions to reduce childhood poisonings in the home with particular reference to interventions that could be implemented by Children's Centres in England or community health or social care services in other high income countries. Thirteen systematic reviews, two meta-analyses and 47 primary studies were identified. The interventions most commonly comprised education, provision of cupboard/drawer locks, and poison control centre (PCC) number stickers. Meta-analyses and primary studies provided evidence that interventions improved poison prevention practices. Twenty eight per cent of studies reporting safe medicine storage (OR from meta-analysis 1.57, 95% CI 1.22-2.02), 23% reporting safe storage of other products (OR from meta-analysis 1.63, 95% CI 1.22-2.17) and 46% reporting availability of PCC numbers (OR from meta-analysis 3.67, 95% CI 1.84-7.33) demonstrated significant effects favouring the intervention group. There was a lack of evidence that interventions reduced poisoning rates. Parents should be provided with poison prevention education, cupboard/drawer locks and emergency contact numbers to use in the event of a poisoning. Further research is required to determine whether improving poison prevention practices reduces poisoning rates.

  12. Post-traumatic stress disorder following disasters: a systematic review

    PubMed Central

    Neria, Y.; Nandi, A.; Galea, S.

    2016-01-01

    Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed. PMID:17803838

  13. The Healthy Immigrant Paradox and Child Maltreatment: A Systematic Review.

    PubMed

    Millett, Lina S

    2016-10-01

    Prior studies suggest that foreign-born individuals have a health advantage, referred to as the Healthy Immigrant Paradox, when compared to native-born persons of the same socio-economic status. This systematic review examined whether the immigrant advantage found in health literature is mirrored by child maltreatment in general and its forms in particular. The author searched Academic Search Premier, CINAHL, CINAHL PLUS, Family and Society Studies Worldwide, MEDLINE, PsychINFO, Social Work Abstracts, and SocINdex for published literature through December 2015. The review followed an evidence-based Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. The author identified 822 unique articles, of which 19 met the inclusion criteria. The reviewed data showed strong support for the healthy immigrant paradox for a general form of maltreatment and physical abuse. The evidence for emotional and sexual abuse was also suggestive of immigrant advantage though relatively small sample size and lack of multivariate controls make these findings tentative. The evidence for neglect was mixed: immigrants were less likely to be reported to Child Protective Services; however, they had higher rates of physical neglect and lack of supervision in the community data. The study results warrant confirmation with newer data possessing strong external validity for immigrant samples.

  14. Health Worker mHealth Utilization: A Systematic Review.

    PubMed

    White, Alice; Thomas, Deborah S K; Ezeanochie, Nnamdi; Bull, Sheana

    2016-05-01

    This systematic review describes mHealth interventions directed at healthcare workers in low-resource settings from the PubMed database from March 2009 to May 2015. Thirty-one articles were selected for final review. Four categories emerged from the reviewed articles: data collection during patient visits, communication between health workers and patients, communication between health workers, and public health surveillance. Most studies used a combination of quantitative and qualitative methods to assess acceptability of use, barriers to use, changes in healthcare delivery, and improved health outcomes. Few papers included theory explicitly to guide development and evaluation of their mHealth programs. Overall, evidence indicated that mobile technology tools, such as smartphones and tablets, substantially benefit healthcare workers, their patients, and healthcare delivery. Limitations to mHealth tools included insufficient program use and sustainability, unreliable Internet and electricity, and security issues. Despite these limitations, this systematic review demonstrates the utility of using mHealth in low-resource settings and the potential for widespread health system improvements using technology. PMID:26955009

  15. Reducing systematic review workload through certainty-based screening.

    PubMed

    Miwa, Makoto; Thomas, James; O'Mara-Eves, Alison; Ananiadou, Sophia

    2014-10-01

    In systematic reviews, the growing number of published studies imposes a significant screening workload on reviewers. Active learning is a promising approach to reduce the workload by automating some of the screening decisions, but it has been evaluated for a limited number of disciplines. The suitability of applying active learning to complex topics in disciplines such as social science has not been studied, and the selection of useful criteria and enhancements to address the data imbalance problem in systematic reviews remains an open problem. We applied active learning with two criteria (certainty and uncertainty) and several enhancements in both clinical medicine and social science (specifically, public health) areas, and compared the results in both. The results show that the certainty criterion is useful for finding relevant documents, and weighting positive instances is promising to overcome the data imbalance problem in both data sets. Latent dirichlet allocation (LDA) is also shown to be promising when little manually-assigned information is available. Active learning is effective in complex topics, although its efficiency is limited due to the difficulties in text classification. The most promising criterion and weighting method are the same regardless of the review topic, and unsupervised techniques like LDA have a possibility to boost the performance of active learning without manual annotation.

  16. Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident.

    PubMed

    Martín-Valero, Rocío; De La Casa Almeida, Maria; Casuso-Holgado, Maria Jesus; Heredia-Madrazo, Alfonso

    2015-11-01

    This systematic review examines levels of evidence and recommendation grades of various therapeutic interventions of inspiratory muscle training in people who have had a stroke. Benefits from different levels of force and resistance in respiratory muscles are shown in this population. This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) directives and was completed in November 2014. The search limits were studies published in English between 2004 and 2014. Relevant studies were searched for in MEDLINE, PEDro, OAIster, Scopus, PsycINFO, Web of Knowledge, CINAHL, SPORTDiscus, DOAJ, Cochrane, Embase, Academic Search Complete, Fuente Académica, and MedicLatina. Initially, 20 articles were identified. After analyzing all primary documents, 14 studies were excluded. Only 6 studies were relevant to this review. Three different types of interventions were found (maximum inspiratory training, controlled training, and nonintervention) in 3 different groups. One specific study compared 3 inspiratory muscle training groups with a group of breathing exercises (diaphragmatic exercises with pursed lips) and a control group. Future long-term studies with larger sample sizes are needed. It is necessary to apply respiratory muscle training as a service of the national health system and to consider its inclusion in the conventional neurological program. PMID:26493591

  17. Instruments measuring blunted affect in schizophrenia: a systematic review.

    PubMed

    Kilian, Sanja; Asmal, Laila; Goosen, Anneke; Chiliza, Bonginkosi; Phahladira, Lebogang; Emsley, Robin

    2015-01-01

    Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their emotions. The work of Abrams and Taylor and their development of the Rating Scale for Emotional Blunting in the late 1970's was an early indicator that blunted affect could indeed be assessed reliably. Since then, several new instruments assessing negative symptoms with subscales measuring blunted affect have been developed. In light of this, we aim to provide researchers and clinicians with a systematic review of the different instruments used to assess blunted affect by providing a comparison of the type, characteristics, administration and psychometric properties of these instruments. Studies reporting on the psychometric properties of instruments assessing blunted affect in patients with schizophrenia were included. Reviews and case studies were excluded. We reviewed 30 full-text articles and included 15 articles and 10 instruments in this systematic review. On average the instruments take 15-30 minutes to administer. We found that blunted affect items common across all instruments assess: gestures, facial expressions and vocal expressions. The CAINS Self-report Expression Subscale, had a low internal consistency score. This suggests that this sub-scale does not reliably assess patients' self-reported blunted affect symptoms and is likely due to the nature of blunted affect. Instruments correlated minimally with instruments measuring positive symptoms and more importantly with depression suggesting that the instruments distinguish between seemingly similar symptoms.

  18. Return to work after burn injury: a systematic review.

    PubMed

    Mason, Shawn T; Esselman, Peter; Fraser, Robert; Schomer, Katherine; Truitt, Anjali; Johnson, Kurt

    2012-01-01

    Consequences of major burn injuries often include losing the ability to engage in basic life functions such as work or employment. As this is a developing area of importance in burn care, the goal of this study was to perform a systematic review of the burn literature to ascertain a comprehensive view of the literature and identify return to work (RTW) factors where possible. A search was conducted and peer-reviewed studies that investigated predictors and barriers of returning to work of those with burn injuries, published since 1970 and written in English, were examined. From the 216 articles initially identified in the search, 26 studies were determined to meet inclusion criteria. Across studies, the mean age was 33.63 years, the mean TBSA was 18.94%, and the average length of stay was 20 days. After 3.3 years (41 months) postburn, 72.03% of previously employed participants had returned to some form of work. Important factors of RTW were identified as burn location, burn size, treatment variables, age, pain, psychosocial factors, job factors, and barriers. This systematic review suggests multiple conclusions. First, there is a significant need for attention to this area of study given that nearly 28% of all burn survivors never return to any form of employment. Second, the RTW literature is in need of coherent and consistent methodological practices, such as a sound system of measurement. Finally, this review calls for increased attention to interventions designed to assist survivors' ability to function in an employed capacity.

  19. The Use and Reporting of the Cross-Over Study Design in Clinical Trials and Systematic Reviews: A Systematic Assessment

    PubMed Central

    Hambleton, Ian; Dwan, Kerry

    2016-01-01

    Background Systematic reviews of treatment interventions in stable or chronic conditions often require the synthesis of clinical trials with a cross-over design. Previous work has indicated that methodology for analysing cross-over data is inadequate in trial reports and in systematic reviews assessing trials with this design. Objective We assessed systematic review methodology for synthesising cross-over trials among Cochrane Cystic Fibrosis and Genetic Disorders Group reviews published to July 2015, and assessed the quality of reporting among the cross-over trials included in these reviews. Methodology We performed data extraction of methodology and reporting in reviews, trials identified and trials included within reviews. Principal Findings We reviewed a total of 142 Cochrane systematic reviews including 53 reviews which synthesised evidence from 218 cross-over trials. Thirty-three (63%) Cochrane reviews described a clear and appropriate method for the inclusion of cross-over data, and of these 19 (56%) used the same method to analyse results. 145 cross-over trials were described narratively or treated as parallel trials in reviews but in 30 (21%) of these trials data existed in the trial reports to account for the cross-over design. At the trial level, the analysis and presentation of results were often inappropriate or unclear, with only 69 (32%) trials presenting results that could be included in meta-analysis. Conclusions Despite development of accessible, technical guidance and training for Cochrane systematic reviewers, statistical analysis and reporting of cross-over data is inadequate at both the systematic review and the trial level. Plain language and practical guidance for the inclusion of cross-over data in meta-analysis would benefit systematic reviewers, who come from a wide range of health specialties. Minimum reporting standards for cross-over trials are needed. PMID:27409076

  20. SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

    SciTech Connect

    Pollock, S; Keall, P; Keall, R

    2015-06-15

    Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

  1. Mapping vulnerability to bipolar disorder: a systematic review and meta-analysis of neuroimaging studies

    PubMed Central

    Fusar-Poli, Paolo; Howes, Oliver; Bechdolf, Andreas; Borgwardt, Stefan

    2012-01-01

    Background Although early interventions in individuals with bipolar disorder may reduce the associated personal and economic burden, the neurobiologic markers of enhanced risk are unknown. Methods Neuroimaging studies involving individuals at enhanced genetic risk for bipolar disorder (HR) were included in a systematic review. We then performed a region of interest (ROI) analysis and a whole-brain meta-analysis combined with a formal effect-sizes meta-analysis in a subset of studies. Results There were 37 studies included in our systematic review. The overall sample for the systematic review included 1258 controls and 996 HR individuals. No significant differences were detected between HR individuals and controls in the selected ROIs: striatum, amygdala, hippocampus, pituitary and frontal lobe. The HR group showed increased grey matter volume compared with patients with established bipolar disorder. The HR individuals showed increased neural response in the left superior frontal gyrus, medial frontal gyrus and left insula compared with controls, independent from the functional magnetic resonance imaging task used. There were no publication biases. Sensitivity analysis confirmed the robustness of these results. Limitations As the included studies were cross-sectional, it remains to be determined whether the observed neurofunctional and structural alterations represent risk factors that can be clinically used in preventive interventions for prodromal bipolar disorder. Conclusion Accumulating structural and functional imaging evidence supports the existence of neurobiologic trait abnormalities in individuals at genetic risk for bipolar disorder at various scales of investigation. PMID:22297067

  2. Chronic traumatic encephalopathy and suicide: a systematic review.

    PubMed

    Wortzel, Hal S; Shura, Robert D; Brenner, Lisa A

    2013-01-01

    Traumatic brain injury (TBI) is a global health concern, and the recent literature reports that a single mild TBI can result in chronic traumatic encephalopathy (CTE). It has been suggested that CTE may lead to death by suicide, raising important prevention, treatment, and policy implications. Thus, we conducted a systematic review of the medical literature to answer the key question: What is the existing evidence in support of a relationship between CTE and suicide? Systematic searches of CTE and suicide yielded 85 unique abstracts. Seven articles were identified for full text review. Only two case series met inclusion criteria and included autopsies from 17 unique cases, 5 of whom died by suicide. Neither studies used blinding, control cases, or systematic data collection regarding TBI exposure and/or medical/neuropsychiatric history. The identified CTE literature revealed divergent opinions regarding neuropathological elements of CTE and heterogeneity regarding clinical manifestations. Overall quality of evidence regarding a relationship between CTE and suicide was rated as very low using Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) criteria. Further studies of higher quality and methodological rigor are needed to determine the existence and nature of any relationship between CTE and suicide. PMID:24328030

  3. Chronic Traumatic Encephalopathy and Suicide: A Systematic Review

    PubMed Central

    Wortzel, Hal S.; Shura, Robert D.; Brenner, Lisa A.

    2013-01-01

    Traumatic brain injury (TBI) is a global health concern, and the recent literature reports that a single mild TBI can result in chronic traumatic encephalopathy (CTE). It has been suggested that CTE may lead to death by suicide, raising important prevention, treatment, and policy implications. Thus, we conducted a systematic review of the medical literature to answer the key question: What is the existing evidence in support of a relationship between CTE and suicide? Systematic searches of CTE and suicide yielded 85 unique abstracts. Seven articles were identified for full text review. Only two case series met inclusion criteria and included autopsies from 17 unique cases, 5 of whom died by suicide. Neither studies used blinding, control cases, or systematic data collection regarding TBI exposure and/or medical/neuropsychiatric history. The identified CTE literature revealed divergent opinions regarding neuropathological elements of CTE and heterogeneity regarding clinical manifestations. Overall quality of evidence regarding a relationship between CTE and suicide was rated as very low using Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) criteria. Further studies of higher quality and methodological rigor are needed to determine the existence and nature of any relationship between CTE and suicide. PMID:24328030

  4. Treatment of eosinophilic cellulitis (Wells syndrome) - a systematic review.

    PubMed

    Räßler, F; Lukács, J; Elsner, P

    2016-09-01

    Eosinophilic cellulitis (Wells syndrome) is a rare inflammatory skin disease defined by erythematous, tender, sometimes urticarial plaques, possibly with vesicles and bullae, and granulomatous eosinophilic infiltrates in the dermis. Usually the disease has a benign course with spontaneous remission within a few weeks. Nevertheless, recurrences are quite frequent and may occur for several years. The objective of this study was to review the so far reported treatment options for Wells syndrome in a systematic manner. This systematic review is based on a search on Medline, Embase and Cochrane Central Register for English and German articles from 1970 to 2015. Advices on the treatment of Wells syndrome are limited predominately to case reports or to small case series. There are no randomized controlled trials, and control groups are missing. A variety of treatment options for Wells syndrome were reported including topical and systemic corticosteroids, antihistamines, cyclosporine, dapsone, azathioprine, griseofulvin, doxycycline, minocycline, antimalarial medications, oral tacrolimus/topical tacrolimus, sulfasalazine, interferon alpha and gamma, TNF alpha inhibitors, colchicine and PUVA therapy. As well-designed, randomized controlled trials are missing, no guidelines for the treatment of this disease can be given. Due to the small number of patients and the frequent misdiagnosis of this clinical entity, the aim of this systematic overview is to call attention to this rare condition and to help clinicians to diagnose and treat Wells syndrome effectively. Due to the good prognosis and tendency to resolve, systemic treatment should be limited to cases resistant to local therapy or with widespread lesions. PMID:27357601

  5. Correlates of Physical Activity of Children and Adolescents: A Systematic Review of Reviews

    ERIC Educational Resources Information Center

    Sterdt, Elena; Liersch, Sebastian; Walter, Ulla

    2014-01-01

    Objective: The aim of this study was to identify promoting and inhibiting correlates associated with the physical activity (PA) of children and adolescents (aged 3-18). The intention was to demonstrate the complexity of correlates of PA and to determine possible influencing factors. Design: A systematic review of reviews. Methods: Systematic…

  6. Investigating clinical heterogeneity in systematic reviews: a methodologic review of guidance in the literature

    PubMed Central

    2012-01-01

    Background While there is some consensus on methods for investigating statistical and methodological heterogeneity, little attention has been paid to clinical aspects of heterogeneity. The objective of this study is to summarize and collate suggested methods for investigating clinical heterogeneity in systematic reviews. Methods We searched databases (Medline, EMBASE, CINAHL, Cochrane Library, and CONSORT, to December 2010) and reference lists and contacted experts to identify resources providing suggestions for investigating clinical heterogeneity between controlled clinical trials included in systematic reviews. We extracted recommendations, assessed resources for risk of bias, and collated the recommendations. Results One hundred and one resources were collected, including narrative reviews, methodological reviews, statistical methods papers, and textbooks. These resources generally had a low risk of bias, but there was minimal consensus among them. Resources suggested that planned investigations of clinical heterogeneity should be made explicit in the protocol of the review; clinical experts should be included on the review team; a set of clinical covariates should be chosen considering variables from the participant level, intervention level, outcome level, research setting, or others unique to the research question; covariates should have a clear scientific rationale; there should be a sufficient number of trials per covariate; and results of any such investigations should be interpreted with caution. Conclusions Though the consensus was minimal, there were many recommendations in the literature for investigating clinical heterogeneity in systematic reviews. Formal recommendations for investigating clinical heterogeneity in systematic reviews of controlled trials are required. PMID:22846171

  7. The Quality of Systematic Reviews of Effectiveness in Literacy Learning in English: A "Tertiary" Review

    ERIC Educational Resources Information Center

    Torgerson, Carole J.

    2007-01-01

    Recent governments in the United Kingdom have introduced a number of initiatives aimed at improving the literacy levels of children. Policy and practice should be informed by rigorous evidence, and this evidence should be subjected to critical scrutiny. In the present paper the results of a "tertiary" review of systematic reviews in literacy…

  8. Flooding and Mental Health: A Systematic Mapping Review

    PubMed Central

    Fernandez, Ana; Black, John; Jones, Mairwen; Wilson, Leigh; Salvador-Carulla, Luis; Astell-Burt, Thomas; Black, Deborah

    2015-01-01

    Background Floods are the most common type of global natural disaster. Floods have a negative impact on mental health. Comprehensive evaluation and review of the literature are lacking. Objective To systematically map and review available scientific evidence on mental health impacts of floods caused by extended periods of heavy rain in river catchments. Methods We performed a systematic mapping review of published scientific literature in five languages for mixed studies on floods and mental health. PUBMED and Web of Science were searched to identify all relevant articles from 1994 to May 2014 (no restrictions). Results The electronic search strategy identified 1331 potentially relevant papers. Finally, 83 papers met the inclusion criteria. Four broad areas are identified: i) the main mental health disorders—post-traumatic stress disorder, depression and anxiety; ii] the factors associated with mental health among those affected by floods; iii) the narratives associated with flooding, which focuses on the long-term impacts of flooding on mental health as a consequence of the secondary stressors; and iv) the management actions identified. The quantitative and qualitative studies have consistent findings. However, very few studies have used mixed methods to quantify the size of the mental health burden as well as exploration of in-depth narratives. Methodological limitations include control of potential confounders and short-term follow up. Limitations Floods following extreme events were excluded from our review. Conclusions Although the level of exposure to floods has been systematically associated with mental health problems, the paucity of longitudinal studies and lack of confounding controls precludes strong conclusions. Implications We recommend that future research in this area include mixed-method studies that are purposefully designed, using more rigorous methods. Studies should also focus on vulnerable groups and include analyses of policy and practical

  9. Nutrition Informatics Applications in Clinical Practice: a Systematic Review

    PubMed Central

    North, Jennifer C.; Jordan, Kristine C.; Metos, Julie; Hurdle, John F.

    2015-01-01

    Nutrition care and metabolic control contribute to clinical patient outcomes. Biomedical informatics applications represent a way to potentially improve quality and efficiency of nutrition management. We performed a systematic literature review to identify clinical decision support and computerized provider order entry systems used to manage nutrition care. Online research databases were searched using a specific set of keywords. Additionally, bibliographies were referenced for supplemental citations. Four independent reviewers selected sixteen studies out of 364 for review. These papers described adult and neonatal nutrition support applications, blood glucose management applications, and other nutrition applications. Overall, results indicated that computerized interventions could contribute to improved patient outcomes and provider performance. Specifically, computer systems in the clinical setting improved nutrient delivery, rates of malnutrition, weight loss, blood glucose values, clinician efficiency, and error rates. In conclusion, further investigation of informatics applications on nutritional and performance outcomes utilizing rigorous study designs is recommended. PMID:26958233

  10. A Systematic Review of Risk Factors for Intimate Partner Violence

    PubMed Central

    Capaldi, Deborah M.; Knoble, Naomi B.; Shortt, Joann Wu; Kim, Hyoun K.

    2012-01-01

    A systematic review of risk factors for intimate partner violence was conducted. Inclusion criteria included publication in a peer-reviewed journal, a representative community sample or a clinical sample with a control-group comparison, a response rate of at least 50%, use of a physical or sexual violence outcome measure, and control of confounding factors in the analyses. A total of 228 articles were included (170 articles with adult and 58 with adolescent samples). Organized by levels of a dynamic developmental systems perspective, risk factors included: (a) contextual characteristics of partners (demographic, neighborhood, community and school factors), (b) developmental characteristics and behaviors of the partners (e.g., family, peer, psychological/behavioral, and cognitive factors), and (c) relationship influences and interactional patterns. Comparisons to a prior review highlight developments in the field in the past 10 years. Recommendations for intervention and policy along with future directions for intimate partner violence (IPV) risk factor research are presented. PMID:22754606

  11. Exercise as Treatment for Anxiety: Systematic Review and Analysis

    PubMed Central

    Stonerock, Gregory L.; Hoffman, Benson M.; Smith, Patrick J.; Blumenthal, James A.

    2015-01-01

    Background Exercise has been shown to reduce symptoms of anxiety, but few studies have studied exercise in individuals pre-selected because of their high anxiety. Purpose To review and critically evaluate studies of exercise training in adults with either high levels of anxiety or an anxiety disorder. Methods We conducted a systematic review of randomized clinical trials (RCTs) in which anxious adults were randomized to an exercise or non-exercise control condition. Data were extracted concerning anxiety outcomes and study design. Existing meta-analyses were also reviewed. Results Evidence from 12 RCTs suggested benefits of exercise, for select groups, similar to established treatments and greater than placebo. However, most studies had significant methodological limitations, including small sample sizes, concurrent therapies, and inadequate assessment of adherence and fitness levels. Conclusions Exercise may be a useful treatment for anxiety, but lack of data from rigorous, methodologically sound RCTs precludes any definitive conclusions about its effectiveness. PMID:25697132

  12. Characteristics of an Effective International Humanitarian Assistance: A Systematic Review

    PubMed Central

    Moslehi, Shandiz; Ardalan, Ali; Waugh, William; Tirone, Daniel C.; Akbarisari, Ali

    2016-01-01

    Introduction: The objective of this study is to identify the effectiveness characteristics, review the definition of them, and develop a conceptual mapping of existing domains in the field of International Humanitarian Assistance (IHA). Methods: We conducted a systematic review and searched the major databases (Science Direct, Scopus, Springer and Pubmed) and grey literature, including references of potentially eligible articles and conference proceedings through March 2015. Articles were included if they focused on IHA effectiveness. Reviewers independently identified the eligible studies and extracted data. Results: 10 studies were included and 48 characteristics were identified. There is a lack of scientific studies and agreement on the characteristics of IHA effectiveness.  Conclusion: This study could be the step toward an understanding of IHA effectiveness characteristics and its definitions with the findings making a base line for more research in this area.  PMID:26981325

  13. Information technologies to improve public health: a systematic review.

    PubMed

    Manhas, Melissa; Kuo, Mu-Hsing

    2015-01-01

    This systematic review examines a total of eighteen studies on the use of health information technologies to improve public health. Health information technologies are tools that allow for the management of health information in computerized systems. Health information technology, including electronic health records, computers/emails, social media, and cellphones/text messaging are becoming widespread and readily accessible to populations around the globe. In this review, the use of these technologies and interventions are discussed and evaluated for their potential to improve public health. This review found some good-quality evidence on the use of electronic health records and little good-quality evidence on the use of email, social media, cell phones and text messaging to improve healthcare, illustrating the need for further study in these areas. PMID:25676984

  14. Socioeconomic inequalities and diabetes: A systematic review from Iran.

    PubMed

    Peykari, Niloofar; Djalalinia, Shirin; Qorbani, Mostafa; Sobhani, Sahar; Farzadfar, Farshad; Larijani, Bagher

    2015-01-01

    Socioeconomic factor is a determinant of health may contribute to diabetes. We conducted a systematic review to summarizing evidences on associations between socioeconomic factors and diabetes in Iranian population. We systematically searched international databeses; ISI, PubMed/Medline, Scopus, and national databases Iranmedex, Irandoc, and Scientific Information Database (SID) to retrieve relevant articles to socioeconomic factors and diabetes without limitation on time. All identified articles were screened, quality assessed and data extracted by two authors independently. From 74 retrieved articles, 15 cases were relevant. We found increased diabetes prevalence among female sex, over 50 years' old age, illiterate population, retired status, unemployed, urban residents, and low economic status. There was a negative association between social capital and diabetes control. Diabetes complications were more frequent in upper age group, higher education levels and low income populations. Socioeconomic factors were associated with diabetes that leads to inequality. Improving modifiable factors through priority based interventions helps to diabetes prevention and control.

  15. Sarcoidosis and Antiphospholipid Syndrome: A Systematic Review of Cases

    PubMed Central

    Pathak, Ranjan; Khanal, Raju; Aryal, Madan Raj; Giri, Smith; Karmacharya, Paras; Pathak, Basanta; Acharya, Upasana; Bhatt, Vijaya Raj

    2015-01-01

    Association between sarcoidosis and antiphospholipid syndrome (APS) is rare with few reported cases. We sought to systematically review the published cases of APS with sarcoidosis to better characterize the demographics, clinical characteristics, treatment, and the outcome of this association. Systematic electronic search for case report, case series, and related articles published until May 2014 was carried out and relevant data were extracted and analyzed. Four cases of APS with sarcoidosis were identified exclusively in females. These cases were seen in the sixth decade of life. Pulmonary embolism and central retinal artery occlusion were the presenting thrombotic events. All the patients were treated with lifelong anticoagulation with warfarin. During the median follow-up period of 5.5 months, additional thrombotic events were not observed. Although rare, sarcoidosis may be associated with APS. Further reporting of the cases will help to better establish this association, elucidate pathogenesis, and define clinical characteristics and outcomes. PMID:26605200

  16. Landslide Susceptibility Statistical Methods: A Critical and Systematic Literature Review

    NASA Astrophysics Data System (ADS)

    Mihir, Monika; Malamud, Bruce; Rossi, Mauro; Reichenbach, Paola; Ardizzone, Francesca

    2014-05-01

    Landslide susceptibility assessment, the subject of this systematic review, is aimed at understanding the spatial probability of slope failures under a set of geomorphological and environmental conditions. It is estimated that about 375 landslides that occur globally each year are fatal, with around 4600 people killed per year. Past studies have brought out the increasing cost of landslide damages which primarily can be attributed to human occupation and increased human activities in the vulnerable environments. Many scientists, to evaluate and reduce landslide risk, have made an effort to efficiently map landslide susceptibility using different statistical methods. In this paper, we do a critical and systematic landslide susceptibility literature review, in terms of the different statistical methods used. For each of a broad set of studies reviewed we note: (i) study geography region and areal extent, (ii) landslide types, (iii) inventory type and temporal period covered, (iv) mapping technique (v) thematic variables used (vi) statistical models, (vii) assessment of model skill, (viii) uncertainty assessment methods, (ix) validation methods. We then pulled out broad trends within our review of landslide susceptibility, particularly regarding the statistical methods. We found that the most common statistical methods used in the study of landslide susceptibility include logistic regression, artificial neural network, discriminant analysis and weight of evidence. Although most of the studies we reviewed assessed the model skill, very few assessed model uncertainty. In terms of geographic extent, the largest number of landslide susceptibility zonations were in Turkey, Korea, Spain, Italy and Malaysia. However, there are also many landslides and fatalities in other localities, particularly India, China, Philippines, Nepal and Indonesia, Guatemala, and Pakistan, where there are much fewer landslide susceptibility studies available in the peer-review literature. This

  17. Sudden cardiac death in marathons: a systematic review.

    PubMed

    Waite, Oliver; Smith, Andy; Madge, Luke; Spring, Hannah; Noret, Nathalie

    2016-01-01

    The aim of this systematic review is to summarise the results of cohort studies that examined the incidence of SCD in marathons and to assess the quality of the methods used. A search of the PROSPERO international database revealed no prospective or published systematic reviews investigating SCD in marathons. The review was conducted using studies that reported and characterised the incidence of SCD in people participating in marathons. Studies were identified via electronic database searches (Medline, CINAHL, SPORTDiscus and Google Scholar) from January 1, 1966 to October 1, 2014 and through manual literature searches. 7 studies met the inclusion criteria and were included in this review. 6 of the studies were conducted in the USA and 1 in the UK. These studies covered a 34-year period involving between 215,413 and 3,949,000 runners. The SCD of between 4 and 28 people are recorded in the papers and the reported estimates of the incidence of SCD in marathons ranged widely from 0.6 to 1.9 per 100,000 runners. The proportion of those suffering SCD who were male ranged from 57.1% to 100% and the mean age reported in the papers, ranged from 37 to 48. This review raises 4 methodological concerns over i) collating reports of SCD in marathons; ii) time of death in relation to the marathon; iii) the use of registrants rather than runners in the estimates of sample size and iv) limited detail on runners exercise history. These four concerns all threaten the reliability and interpretation of any estimate of SCD incidence rates in marathons.  This review recommends that the methods used to collect data on SCD in marathons be improved and that a central reporting system be established. PMID:26765272

  18. Strategies for Increasing Recruitment to Randomised Controlled Trials: Systematic Review

    PubMed Central

    Caldwell, Patrina H. Y.; Hamilton, Sana; Tan, Alvin; Craig, Jonathan C.

    2010-01-01

    Background Recruitment of participants into randomised controlled trials (RCTs) is critical for successful trial conduct. Although there have been two previous systematic reviews on related topics, the results (which identified specific interventions) were inconclusive and not generalizable. The aim of our study was to evaluate the relative effectiveness of recruitment strategies for participation in RCTs. Methods and Findings A systematic review, using the PRISMA guideline for reporting of systematic reviews, that compared methods of recruiting individual study participants into an actual or mock RCT were included. We searched MEDLINE, Embase, The Cochrane Library, and reference lists of relevant studies. From over 16,000 titles or abstracts reviewed, 396 papers were retrieved and 37 studies were included, in which 18,812 of at least 59,354 people approached agreed to participate in a clinical RCT. Recruitment strategies were broadly divided into four groups: novel trial designs (eight studies), recruiter differences (eight studies), incentives (two studies), and provision of trial information (19 studies). Strategies that increased people's awareness of the health problem being studied (e.g., an interactive computer program [relative risk (RR) 1.48, 95% confidence interval (CI) 1.00–2.18], attendance at an education session [RR 1.14, 95% CI 1.01–1.28], addition of a health questionnaire [RR 1.37, 95% CI 1.14–1.66]), or a video about the health condition (RR 1.75, 95% CI 1.11–2.74), and also monetary incentives (RR1.39, 95% CI 1.13–1.64 to RR 1.53, 95% CI 1.28–1.84) improved recruitment. Increasing patients' understanding of the trial process, recruiter differences, and various methods of randomisation and consent design did not show a difference in recruitment. Consent rates were also higher for nonblinded trial design, but differential loss to follow up between groups may jeopardise the study findings. The study's main limitation was the necessity of

  19. MRI in Chronic Aortic Dissection: A Systematic Review and Future Directions

    PubMed Central

    Sherrah, Andrew G.; Grieve, Stuart M.; Jeremy, Richmond W.; Bannon, Paul G.; Vallely, Michael P.; Puranik, Rajesh

    2015-01-01

    The acute event of thoracic aortic dissection carries with it high mortality and morbidity. Despite optimal initial surgical or medical management strategies, the risk of further complications in the long-term, including aneurysmal dilatation and false lumen (FL) expansion, are not insignificant. Adequate follow-up of such conditions requires dedicated imaging where relevant prognostic indicators are accurately assessed. We perform a systematic review of the literature and report the current evidence for the use of magnetic resonance imaging (MRI) in assessment of chronic aortic dissection. We then make a comparison with traditional imaging modalities including computed tomography and echocardiography. We discuss new ways in which MRI may extend existing aortic assessment, including identification of blood-flow dynamics within the TL and FL using phase-contrast imaging. PMID:26664877

  20. Quality of Pharmaceutical Advertisements in Medical Journals: A Systematic Review

    PubMed Central

    Othman, Noordin; Vitry, Agnes; Roughead, Elizabeth E.

    2009-01-01

    Background Journal advertising is one of the main sources of medicines information to doctors. Despite the availability of regulations and controls of drug promotion worldwide, information on medicines provided in journal advertising has been criticized in several studies for being of poor quality. However, no attempt has been made to systematically summarise this body of research. We designed this systematic review to assess all studies that have examined the quality of pharmaceutical advertisements for prescription products in medical and pharmacy journals. Methods and Findings Studies were identified via searching electronic databases, web library, search engine and reviewing citations (1950 – February 2006). Only articles published in English and examined the quality of information included in pharmaceutical advertisements for prescription products in medical or pharmacy journals were included. For each eligible article, a researcher independently extracted the data on the study methodology and outcomes. The data were then reviewed by a second researcher. Any disagreements were resolved by consensus. The data were analysed descriptively. The final analysis included 24 articles. The studies reviewed advertisements from 26 countries. The number of journals surveyed in each study ranged from four to 24 journals. Several outcome measures were examined including references and claims provided in advertisements, availability of product information, adherence to codes or guidelines and presentation of risk results. The majority of studies employed a convenience-sampling method. Brand name, generic name and indications were usually provided. Journal articles were commonly cited to support pharmaceutical claims. Less than 67% of the claims were supported by a systematic review, a meta-analysis or a randomised control trial. Studies that assessed misleading claims had at least one advertisement with a misleading claim. Two studies found that less than 28% of claims

  1. Reviewing Literature in Bioethics Research: Increasing Rigour in Non-Systematic Reviews.

    PubMed

    McDougall, Rosalind

    2015-09-01

    The recent interest in systematic review methods in bioethics has highlighted the need for greater transparency in all literature review processes undertaken in bioethics projects. In this article, I articulate features of a good bioethics literature review that does not aim to be systematic, but rather to capture and analyse the key ideas relevant to a research question. I call this a critical interpretive literature review. I begin by sketching and comparing three different types of literature review conducted in bioethics scholarship. Then, drawing on Dixon-Wood's concept of critical interpretive synthesis, I put forward six features of a good critical interpretive literature review in bioethics: answering a research question, capturing the key ideas relevant to the research question, analysing the literature as a whole, generating theory, not excluding papers based on rigid quality assessment criteria, and reporting the search strategy.

  2. Systematic review of health branding: growth of a promising practice.

    PubMed

    Evans, W Douglas; Blitstein, Jonathan; Vallone, Donna; Post, Samantha; Nielsen, Wendy

    2015-03-01

    Brands are marketing tools that create mental representations in the minds of consumers about products, services, and organizations. Brands create schema that help consumers decide whether to initiate or continue use of a product or service. Health branding determines behavioral choice by building consumer relationships and identification with health behaviors and their benefits. Health branding can be measured by the associations individuals form with health behaviors. In 2008, Evans and colleagues systematically reviewed the literature on health brands, reported on branded health messages and campaigns worldwide, and examined specific branding strategies in multiple subject areas. This paper extends that review. We replicated the comprehensive online literature search strategy from 2008. We screened a total of 311 articles and included 130 for full-text review. This included both articles from the 2008 review and new articles. After excluding those new articles that did not meet full-text inclusion criteria, we reviewed 69 in total. Of these, 32 were new articles since the 2008 review. Branded health campaigns cover most major domains of public health and appear worldwide. Since 2008, we observed improvement in evaluation, application of theory, and description of campaign strategies in published work. We recommend enhanced education of public health practitioners and researchers on the use and evaluation of branding.

  3. Systematic review of health branding: growth of a promising practice.

    PubMed

    Evans, W Douglas; Blitstein, Jonathan; Vallone, Donna; Post, Samantha; Nielsen, Wendy

    2015-03-01

    Brands are marketing tools that create mental representations in the minds of consumers about products, services, and organizations. Brands create schema that help consumers decide whether to initiate or continue use of a product or service. Health branding determines behavioral choice by building consumer relationships and identification with health behaviors and their benefits. Health branding can be measured by the associations individuals form with health behaviors. In 2008, Evans and colleagues systematically reviewed the literature on health brands, reported on branded health messages and campaigns worldwide, and examined specific branding strategies in multiple subject areas. This paper extends that review. We replicated the comprehensive online literature search strategy from 2008. We screened a total of 311 articles and included 130 for full-text review. This included both articles from the 2008 review and new articles. After excluding those new articles that did not meet full-text inclusion criteria, we reviewed 69 in total. Of these, 32 were new articles since the 2008 review. Branded health campaigns cover most major domains of public health and appear worldwide. Since 2008, we observed improvement in evaluation, application of theory, and description of campaign strategies in published work. We recommend enhanced education of public health practitioners and researchers on the use and evaluation of branding. PMID:25729450

  4. Systemic Redox Imbalance in Chronic Kidney Disease: A Systematic Review.

    PubMed

    Poulianiti, Konstantina P; Kaltsatou, Antonia; Mitrou, Georgia I; Jamurtas, Athanasios Z; Koutedakis, Yiannis; Maridaki, Maria; Stefanidis, Ioannis; Sakkas, Giorgos K; Karatzaferi, Christina

    2016-01-01

    Patients with chronic kidney disease (CKD) experience imbalance between oxygen reactive species (ROS) production and antioxidant defenses leading to cell and tissue damage. However, it remains unclear at which stage of renal insufficiency the redox imbalance becomes more profound. The aim of this systematic review was to provide an update on recent advances in our understanding of how the redox status changes in the progression of renal disease from predialysis stages 1 to 4 to end stage 5 and whether the various treatments and dialysis modalities influence the redox balance. A systematic review was conducted searching PubMed and Scopus by using the Cochrane and PRISMA guidelines. In total, thirty-nine studies met the inclusion criteria and were reviewed. Even from an early stage, imbalance in redox status is evident and as the kidney function worsens it becomes more profound. Hemodialysis therapy per se seems to negatively influence the redox status by the elevation of lipid peroxidation markers, protein carbonylation, and impairing erythrocyte antioxidant defense. However, other dialysis modalities do not so far appear to confer advantages. Supplementation with antioxidants might assist and should be considered as an early intervention to halt premature atherogenesis development at an early stage of CKD. PMID:27563376

  5. Methods for biomimetic remineralization of human dentine: a systematic review.

    PubMed

    Cao, Chris Ying; Mei, May Lei; Li, Quan-Li; Lo, Edward Chin Man; Chu, Chun Hung

    2015-01-01

    This study aimed to review the laboratory methods on biomimetic remineralization of demineralized human dentine. A systematic search of the publications in the PubMed, TRIP, and Web of Science databases was performed. Titles and abstracts of initially identified publications were screened. Clinical trials, reviews, non-English articles, resin-dentine interface studies, hybrid layer studies, hybrid scaffolds studies, and irrelevant studies were excluded. The remaining papers were retrieved with full texts. Manual screening was conducted on the bibliographies of remaining papers to identify relevant articles. A total of 716 studies were found, and 690 were excluded after initial screening. Two articles were identified from the bibliographies of the remaining papers. After retrieving the full text, 23 were included in this systematic review. Sixteen studies used analogues to mimic the functions of non-collagenous proteins in biomineralization of dentine, and four studies used bioactive materials to induce apatite formation on demineralized dentine surface. One study used zinc as a bioactive element, one study used polydopamine, and another study constructed an agarose hydrogel system for biomimetic mineralization of dentine. Many studies reported success in biomimetic mineralization of dentine, including the use of non-collagenous protein analogues, bioactive materials, or elements and agarose hydrogel system. PMID:25739078

  6. Systemic Redox Imbalance in Chronic Kidney Disease: A Systematic Review

    PubMed Central

    Kaltsatou, Antonia; Jamurtas, Athanasios Z.; Koutedakis, Yiannis; Stefanidis, Ioannis; Sakkas, Giorgos K.

    2016-01-01

    Patients with chronic kidney disease (CKD) experience imbalance between oxygen reactive species (ROS) production and antioxidant defenses leading to cell and tissue damage. However, it remains unclear at which stage of renal insufficiency the redox imbalance becomes more profound. The aim of this systematic review was to provide an update on recent advances in our understanding of how the redox status changes in the progression of renal disease from predialysis stages 1 to 4 to end stage 5 and whether the various treatments and dialysis modalities influence the redox balance. A systematic review was conducted searching PubMed and Scopus by using the Cochrane and PRISMA guidelines. In total, thirty-nine studies met the inclusion criteria and were reviewed. Even from an early stage, imbalance in redox status is evident and as the kidney function worsens it becomes more profound. Hemodialysis therapy per se seems to negatively influence the redox status by the elevation of lipid peroxidation markers, protein carbonylation, and impairing erythrocyte antioxidant defense. However, other dialysis modalities do not so far appear to confer advantages. Supplementation with antioxidants might assist and should be considered as an early intervention to halt premature atherogenesis development at an early stage of CKD. PMID:27563376

  7. Computer-tailored dietary behaviour change interventions: a systematic review

    PubMed Central

    Neville, Leonie M.; O'Hara, Blythe; Milat, Andrew J.

    2009-01-01

    Improving dietary behaviours such as increasing fruit and vegetable consumption and reducing saturated fat intake are important in the promotion of better health. Computer tailoring has shown promise as a strategy to promote such behaviours. A narrative systematic review was conducted to describe the available evidence on ‘second’-generation computer-tailored primary prevention interventions for dietary behaviour change and to determine their effectiveness and key characteristics of success. Systematic literature searches were conducted through five databases: Medline, Embase, PsycINFO, CINAHL and All EBM Reviews and by examining the reference lists of relevant articles to identify studies published in English from January 1996 to 2008. Randomized controlled trials or quasi-experimental designs with pre-test and post-test behavioural outcome data were included. A total of 13 articles were reviewed, describing the evaluation of 12 interventions, seven of which found significant positive effects of the computer-tailored interventions for dietary behaviour outcomes, one also for weight reduction outcomes. Although the evidence of short-term efficacy for computer-tailored dietary behaviour change interventions is fairly strong, the uncertainty lies in whether the reported effects are generalizable and sustained long term. Further research is required to address these limitations of the evidence. PMID:19286893

  8. Rural, Pregnant, and Opioid Dependent: A Systematic Review

    PubMed Central

    Jumah, Naana Afua

    2016-01-01

    The nature, impact, and treatment of substance use during pregnancy are well described for women living in urban settings. Less is known about pregnant substance-using women living in rural communities. The objective of this review is to describe the existing evidence for the management of substance use in pregnant women living in rural areas. A systematic review of the literature was conducted using PubMed, Embase, and the Cochrane Database of Systematic Reviews, and the quality of the evidence was assessed using the GRADE system. Twenty-two articles that met the inclusion criteria were identified. Descriptive studies document high rates of smoking, marijuana, and polysubstance use among rural, substance-using pregnant women compared to their urban counterparts. Management of substance use disorders is limited by access to and acceptability of treatment modalities. Several innovative, integrated addiction and prenatal care programs have been developed, which may serve as models for management of substance use during pregnancy in rural settings. PMID:27375357

  9. Expressive writing interventions in cancer patients: a systematic review.

    PubMed

    Merz, Erin L; Fox, Rina S; Malcarne, Vanessa L

    2014-01-01

    Decades of research have suggested that expressive writing produces physical and psychological benefits in controlled laboratory experiments among healthy college students. This work has been extended to clinical and medical populations, including cancer patients. Although expressive writing could be a promising and inexpensive intervention for this population, the effects have not been systematically examined in oncology samples. A systematic review using PRISMA guidelines was conducted for experimental trials of cancer patients who participated in an expressive writing intervention. PsycINFO and PubMed/Medline were searched for peer-reviewed studies. Thirteen articles met the inclusion/exclusion criteria. Although the majority of the intervention effects were null, there were several main effects for expressive writing on sleep, pain, and general physical and psychological symptoms. Several moderators were identified, suggesting that expressive writing may be more or less beneficial based on individual characteristics such as social constraints. The reviewed studies were limited due to representativeness of the samples, performance, detection and patient-reported outcomes biases, and heterogeneity of the intervention protocol and writing prompts. Future studies with rigorous designs are needed to determine whether expressive writing is therapeutically effective in cancer patients.

  10. Methods for Biomimetic Remineralization of Human Dentine: A Systematic Review

    PubMed Central

    Cao, Chris Ying; Mei, May Lei; Li, Quan-Li; Lo, Edward Chin Man; Chu, Chun Hung

    2015-01-01

    This study aimed to review the laboratory methods on biomimetic remineralization of demineralized human dentine. A systematic search of the publications in the PubMed, TRIP, and Web of Science databases was performed. Titles and abstracts of initially identified publications were screened. Clinical trials, reviews, non-English articles, resin-dentine interface studies, hybrid layer studies, hybrid scaffolds studies, and irrelevant studies were excluded. The remaining papers were retrieved with full texts. Manual screening was conducted on the bibliographies of remaining papers to identify relevant articles. A total of 716 studies were found, and 690 were excluded after initial screening. Two articles were identified from the bibliographies of the remaining papers. After retrieving the full text, 23 were included in this systematic review. Sixteen studies used analogues to mimic the functions of non-collagenous proteins in biomineralization of dentine, and four studies used bioactive materials to induce apatite formation on demineralized dentine surface. One study used zinc as a bioactive element, one study used polydopamine, and another study constructed an agarose hydrogel system for biomimetic mineralization of dentine. Many studies reported success in biomimetic mineralization of dentine, including the use of non-collagenous protein analogues, bioactive materials, or elements and agarose hydrogel system. PMID:25739078

  11. Sunscreen use and melanocytic nevi in children: a systematic review.

    PubMed

    de Maleissye, Marie-Florence; Beauchet, Alain; Saiag, Phillippe; Corrêa, Marcelo; Godin-Beeckmann, Sophie; Haeffelin, Martial; Mahé, Emmanuel

    2013-01-01

    We conducted a systematic review of the association between melanocytic nevi (MN) in childhood and sunscreen use. A bibliographic search was conducted between November 2008 and January 2009 using the following key words on MEDLINE and EMBASE: child*, in combination with naevi, nevi, naevus, nevus and sunscreen, sun protection. We also used Medical Subject Headings [sunscreening agents], or [radiation protection] with [nevus, pigmented]. A first screening was done on title and abstract reading. Randomized trials and cohort and cross-sectional studies analyzing the relationship between the use of sunscreen and MN in children were selected. Three reviewers abstracted data from each article. The three sets of results were compared for concordance and rereviewed if necessary. Fifteen articles were included (20,743 children). The studies were not consistent in terms of the ages of the children, MN count methods, or sunscreen use assessment. Owing to this heterogeneity, we were unable to pool the studies and conduct a meta-analysis. Twelve studies did not report that the use of sunscreen had a protective effect against MN development. Three studies reported a lower MN count when sunscreen was applied. This systematic review underlines the methodologic differences between studies. Eight of 15 studies reported a positive association between sunscreen application and MN count. Differences in MN counts, overexposure to sun, and inadequate sunscreen application on fair-skinned children could explain the disparity in the results. There is still no evidence of a protective effect of sunscreen against MN development in children.

  12. Rural, Pregnant, and Opioid Dependent: A Systematic Review.

    PubMed

    Jumah, Naana Afua

    2016-01-01

    The nature, impact, and treatment of substance use during pregnancy are well described for women living in urban settings. Less is known about pregnant substance-using women living in rural communities. The objective of this review is to describe the existing evidence for the management of substance use in pregnant women living in rural areas. A systematic review of the literature was conducted using PubMed, Embase, and the Cochrane Database of Systematic Reviews, and the quality of the evidence was assessed using the GRADE system. Twenty-two articles that met the inclusion criteria were identified. Descriptive studies document high rates of smoking, marijuana, and polysubstance use among rural, substance-using pregnant women compared to their urban counterparts. Management of substance use disorders is limited by access to and acceptability of treatment modalities. Several innovative, integrated addiction and prenatal care programs have been developed, which may serve as models for management of substance use during pregnancy in rural settings. PMID:27375357

  13. Indicators of healthy work environments--a systematic review.

    PubMed

    Lindberg, Per; Vingård, Eva

    2012-01-01

    The purpose of this study was to systematically review the scientific literature and search for indicators of healthy work environments. A number of major national and international databases for scientific publication were searched for research addressing indicators of healthy work environments. Altogether 19,768 publications were found. After excluding duplicates, non-relevant publications, or publications that did not comply with the inclusion criteria 24 peer-reviewed publications remained to be included in this systematic review. Only one study explicitly addressing indicators of healthy work environments was found. That study suggested that the presence of stress management programs in an organization might serve as indicator of a 'good place to work', as these organizations were more likely to offer programs that encouraged employee well-being, safety and skill development than those without stress management programs. The other 23 studies either investigated employee's views of what constitute a healthy workplace or were guidelines for how to create such a workplace. Summarizing, the nine most pronounced factors considered as important for a healthy workplace that emerged from these studies were, in descending order: collaboration/teamwork: growth and development of the individual; recognition; employee involvement; positive, accessible and fair leader; autonomy and empowerment; appropriate staffing; skilled communication; and safe physical work. PMID:22317181

  14. Factors affecting the duration of orthodontic treatment: a systematic review.

    PubMed

    Mavreas, Dimitrios; Athanasiou, Athanasios E

    2008-08-01

    The aim of this study was to systematically investigate the literature for articles referring exclusively to the duration of orthodontic therapy and to explore the various factors that could affect this. A Medline search from 1990 to the first week of March 2005 was conducted, the Cochrane Database for Systematic Reviews was utilized, five orthodontic journals were hand searched, the abstracts of related articles were reviewed to search for any relevant studies that might have been missed, and the reference lists of the retrieved articles were hand assessed. Eligibility was determined by reading the reports identified by the search. The end result of this search provided 41 articles. Although there is a need for more conclusive research, the present review revealed several conclusions concerning the duration of orthodontic treatment: (1) there are indications that extraction treatment lasts longer than the non-extraction therapy; (2) age does not seem to play a role provided the patients are in the permanent dentition; (3) when Class II division 1 malocclusions are considered, there is evidence that the earlier the orthodontic treatment begins the longer its duration; (4) there is conflicting information regarding treatment duration within public health systems; (5) combined orthodontic-surgical treatment duration is variable and appears to be operator sensitive; (6) various factors, such as the technique employed, the skill and number of operators involved, the compliance of the patients, and the severity of the initial malocclusion, all seem to play a role; and (7) impacted maxillary canines appear to prolong treatment.

  15. Indicators of healthy work environments--a systematic review.

    PubMed

    Lindberg, Per; Vingård, Eva

    2012-01-01

    The purpose of this study was to systematically review the scientific literature and search for indicators of healthy work environments. A number of major national and international databases for scientific publication were searched for research addressing indicators of healthy work environments. Altogether 19,768 publications were found. After excluding duplicates, non-relevant publications, or publications that did not comply with the inclusion criteria 24 peer-reviewed publications remained to be included in this systematic review. Only one study explicitly addressing indicators of healthy work environments was found. That study suggested that the presence of stress management programs in an organization might serve as indicator of a 'good place to work', as these organizations were more likely to offer programs that encouraged employee well-being, safety and skill development than those without stress management programs. The other 23 studies either investigated employee's views of what constitute a healthy workplace or were guidelines for how to create such a workplace. Summarizing, the nine most pronounced factors considered as important for a healthy workplace that emerged from these studies were, in descending order: collaboration/teamwork: growth and development of the individual; recognition; employee involvement; positive, accessible and fair leader; autonomy and empowerment; appropriate staffing; skilled communication; and safe physical work.

  16. Acupuncture for treating sciatica: a systematic review protocol

    PubMed Central

    Qin, Zongshi; Liu, Xiaoxu; Yao, Qin; Zhai, Yanbing; Liu, Zhishun

    2015-01-01

    Introduction This systematic review aims to assess the effectiveness and safety of acupuncture for treating sciatica. Methods The following nine databases will be searched from their inception to 30 October 2014: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Biomedical Literature Database (CBM), the Chinese Medical Current Content (CMCC), the Chinese Scientific Journal Database (VIP database), the Wan-Fang Database, the China National Knowledge Infrastructure (CNKI) and Citation Information by National Institute of Informatics (CiNii). Randomised controlled trials (RCTs) of acupuncture for sciatica in English, Chinese or Japanese without restriction of publication status will be included. Two researchers will independently undertake study selection, extraction of data and assessment of study quality. Meta-analysis will be conducted after screening of studies. Data will be analysed using risk ratio for dichotomous data, and standardised mean difference or weighted mean difference for continuous data. Dissemination This systematic review will be disseminated electronically through a peer-reviewed publication or conference presentations. Trial registration number PROSPERO CRD42014015001. PMID:25922105

  17. Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

    PubMed Central

    Gee, Edward C.A.; Hanson, Emma K.; Saithna, Adnan

    2015-01-01

    Background: Anatomical shoulder replacement for rheumatoid arthritis (RA) is complicated by a high incidence of rotator cuff tears and glenoid erosion. This can lead to poor function and early failure. Reverse shoulder arthroplasty (RSA) has gained popularity as an alternative. This systematic review attempts to further define the role of RSA in RA. Methods: A systematic review identified seven studies reporting outcomes of RSA in RA patients. Studies were critically appraised, and data on outcomes, complications and technical considerations were extracted and analysed. Results: One hundred and twenty one shoulders were included (mean follow up 46.9 months). Consistent improvements in the main outcome measures were noted between studies. Ninety five percent of patients described excellent to satisfactory outcomes. The minimum mean forward elevation reported in each study was 115 degrees. Symptomatic glenoid loosening (1.7%), deep infection (3.3%) and revision surgery (5%) rates were no higher than for a population of mixed aetiologies. Discussion: Previous concerns regarding high pre- and peri-operative complication and revision rates in RA patients were not shown to be valid by the results of this review. Although associated cuff tears are common and glenoid bone loss can increase the technical complexity of surgery, RSA provides consistent and predictable improvements in key outcome measures and the revision and complication rates do not appear to be higher than reported in a large population of mixed aetiologies. Conclusion: The contemporary literature shows that RSA is a safe, effective and reliable treatment option in RA patients. PMID:26448802

  18. Automatic endpoint detection to support the systematic review process.

    PubMed

    Blake, Catherine; Lucic, Ana

    2015-08-01

    Preparing a systematic review can take hundreds of hours to complete, but the process of reconciling different results from multiple studies is the bedrock of evidence-based medicine. We introduce a two-step approach to automatically extract three facets - two entities (the agent and object) and the way in which the entities are compared (the endpoint) - from direct comparative sentences in full-text articles. The system does not require a user to predefine entities in advance and thus can be used in domains where entity recognition is difficult or unavailable. As with a systematic review, the tabular summary produced using the automatically extracted facets shows how experimental results differ between studies. Experiments were conducted using a collection of more than 2million sentences from three journals Diabetes, Carcinogenesis and Endocrinology and two machine learning algorithms, support vector machines (SVM) and a general linear model (GLM). F1 and accuracy measures for the SVM and GLM differed by only 0.01 across all three comparison facets in a randomly selected set of test sentences. The system achieved the best performance of 92% for objects, whereas the accuracy for both agent and endpoints was 73%. F1 scores were higher for objects (0.77) than for endpoints (0.51) or agents (0.47). A situated evaluation of Metformin, a drug to treat diabetes, showed system accuracy of 95%, 83% and 79% for the object, endpoint and agent respectively. The situated evaluation had higher F1 scores of 0.88, 0.64 and 0.62 for object, endpoint, and agent respectively. On average, only 5.31% of the sentences in a full-text article are direct comparisons, but the tabular summaries suggest that these sentences provide a rich source of currently underutilized information that can be used to accelerate the systematic review process and identify gaps where future research should be focused.

  19. Psychological Interventions for Poor Oral Health: A Systematic Review.

    PubMed

    Werner, H; Hakeberg, M; Dahlström, L; Eriksson, M; Sjögren, P; Strandell, A; Svanberg, T; Svensson, L; Wide Boman, U

    2016-05-01

    The aim of this systematic review and meta-analysis was to study the effectiveness of psychological interventions in adults and adolescents with poor oral health. The review follows the PRISMA guidelines for systematic reviews. The PICO format (population, intervention, comparison, and outcome) was used to define eligible studies. The populations were adults or adolescents (≥13 y of age and independent of others) with poor oral health (defined as dental caries, periodontal disease, and/or peri-implantitis). The interventions were psychological and/or behavioral models and theories, in comparison with traditional oral health education/information. The primary outcomes were dental caries, periodontitis, gingivitis, and peri-implantitis. Secondary outcomes were dental plaque, oral health-related behavior, health-related quality of life, health beliefs and attitudes, self-perceived oral health, and complications/risks. The systematic literature search identified 846 articles in December 2013 and 378 articles in July 2015. In total, 11 articles on 9 randomized controlled trials were found to meet the inclusion criteria. These reported on adults with periodontal disease, and several used motivational interviewing (MI) as their mode of intervention. The CONSORT guidelines and the GRADE approach were used for study appraisal and rating of evidence. The meta-analysis showed no statistically significant differences in gingivitis or plaque presence. In addition, a meta-analysis on MI compared with education/information found no statistically significant differences in gingivitis presence. Only 1 meta-analysis-on psychological interventions versus education/information regarding the plaque index-showed a small but statistically significant difference. There were also statistically significant differences reported in favor of psychological interventions in oral health behavior and self-efficacy in toothbrushing. However, the clinical relevance of these differences is

  20. The optimal organization of gynecologic oncology services: a systematic review

    PubMed Central

    Fung-Kee-Fung, M.; Kennedy, E.B.; Biagi, J.; Colgan, T.; D’Souza, D.; Elit, L.M.; Hunter, A.; Irish, J.; McLeod, R.; Rosen, B.

    2015-01-01

    Background A system-level organizational guideline for gynecologic oncology was identified by a provincial cancer agency as a key priority based on input from stakeholders, data showing more limited availability of multidisciplinary or specialist care in lower-volume than in higher-volume hospitals in the relevant jurisdiction, and variable rates of staging for ovarian and endometrial cancer patients. Methods A systematic review assessed the relationship of the organization of gynecologic oncology services with patient survival and surgical outcomes. The electronic databases medline and embase (ovid: 1996 through 9 January 2015) were searched using terms related to gynecologic malignancies combined with organization of services, patterns of care, and various facility and physician characteristics. Outcomes of interest included overall or disease-specific survival, short-term survival, adequate staging, and degree of cytoreduction or optimal cytoreduction (or both) for ovarian cancer patients by hospital or physician type, and rate of discrepancy in initial diagnoses and intraoperative consultation between non-specialist pathologists and gyne-oncology–specialist pathologists. Results One systematic review and sixteen additional primary studies met the inclusion criteria. The evidence base as a whole was judged to be of lower quality; however, a trend toward improved outcomes with centralization of gynecologic oncology was found, particularly with respect to the gynecologic oncology care of patients with advanced-stage ovarian cancer. Conclusions Improvements in outcomes with centralization of gynecologic oncology services can be attributed to a number of factors, including access to specialist care and multidisciplinary team management. Findings of this systematic review should be used with caution because of the limitations of the evidence base; however, an expert consensus process made it possible to create recommendations for implementation. PMID:26300679

  1. Automatic endpoint detection to support the systematic review process.

    PubMed

    Blake, Catherine; Lucic, Ana

    2015-08-01

    Preparing a systematic review can take hundreds of hours to complete, but the process of reconciling different results from multiple studies is the bedrock of evidence-based medicine. We introduce a two-step approach to automatically extract three facets - two entities (the agent and object) and the way in which the entities are compared (the endpoint) - from direct comparative sentences in full-text articles. The system does not require a user to predefine entities in advance and thus can be used in domains where entity recognition is difficult or unavailable. As with a systematic review, the tabular summary produced using the automatically extracted facets shows how experimental results differ between studies. Experiments were conducted using a collection of more than 2million sentences from three journals Diabetes, Carcinogenesis and Endocrinology and two machine learning algorithms, support vector machines (SVM) and a general linear model (GLM). F1 and accuracy measures for the SVM and GLM differed by only 0.01 across all three comparison facets in a randomly selected set of test sentences. The system achieved the best performance of 92% for objects, whereas the accuracy for both agent and endpoints was 73%. F1 scores were higher for objects (0.77) than for endpoints (0.51) or agents (0.47). A situated evaluation of Metformin, a drug to treat diabetes, showed system accuracy of 95%, 83% and 79% for the object, endpoint and agent respectively. The situated evaluation had higher F1 scores of 0.88, 0.64 and 0.62 for object, endpoint, and agent respectively. On average, only 5.31% of the sentences in a full-text article are direct comparisons, but the tabular summaries suggest that these sentences provide a rich source of currently underutilized information that can be used to accelerate the systematic review process and identify gaps where future research should be focused. PMID:26003938

  2. Effects of liver transplantation on endocrine function: a systematic review.

    PubMed

    Gariani, Karim; Toso, Christian; Philippe, Jacques; Orci, Lorenzo A

    2016-10-01

    Patients with chronic liver disease (CLD) often experience secondary endocrine dysfunction. Therefore, because the liver plays a major role in endocrine function, liver transplantation (LT) may also be beneficial for the restoration of hormonal regulation. This systematic review collects and interprets the available literature on the effect of LT on endocrine and sexual function in adult patients. A systematic review was conducted by searching Pubmed (including Medline) and EMBASE for studies published from database inception until November 2015. We collected all relevant studies that discussed changes in hormonal and sexual function after LT. Studies were included if they assessed the effect of LT on sexual function or one of the following components of the hormone/endocrine axis: the hypothalamus-pituitary-gonadal axis, growth hormone (GH), insulin-like growth factor-1 (IGF-1) or thyroid function. The results are reported according to the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Twenty-one studies with a total of 1274 patients were included. The results collected from the included studies suggested that LT improves the hormonal perturbation associated with CLD by restoring physiological levels of circulating GH, IGF-1, testosterone, estradiol, prolactin, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Thyroid function was not affected by LT, and sexual function was partially improved after LT. This systematic review suggests that LT is associated with an improvement in endocrine and sexual function in patients with CLD. This information should encourage clinicians who treat CLD patients to identify endocrine disturbances in this population, inform their patients of the effects of LT and assess post-transplantation improvements. PMID:27163168

  3. Occupational risk factors for shoulder pain: a systematic review

    PubMed Central

    van der Windt, D. A W M; Thomas, E.; Pope, D.; de Winter, A. F; Macfarlane, G.; Bouter, L.; Silman, A.

    2000-01-01

    OBJECTIVES—To systematically evaluate the available evidence on occupational risk factors of shoulder pain.
METHODS—Relevant reports were identified by a systematic search of Medline, Embase, Psychlit, Cinahl, and Current Contents. The quality of the methods of all selected publications was assessed by two independent reviewers using a standardised checklist. Details were extracted on the study population, exposures (physical load and psychosocial work environment), and results for the association between exposure variables and shoulder pain.
RESULTS—29 Studies were included in the review; three case-control studies and 26 cross sectional designs. The median method score was 60% of the maximum attainable score. Potential risk factors related to physical load and included heavy work load, awkward postures, repetitive movements, vibration, and duration of employment. Consistent findings were found for repetitive movements, vibration, and duration of employment (odds ratio (OR) 1.4-46 in studies with method scores ⩾ 60%). Nearly all studies that assessed psychosocial risk factors reported at least one positive association with shoulder pain, but the results were not consistent across studies for either high psychological demands, poor control at work, poor social support, or job dissatisfaction. Studies with a method score ⩾60% reported ORs between 1.3 and 4.0. Substantial heterogeneity across studies for methods used for exposure assessment and data analysis impeded statistical pooling of results.
CONCLUSIONS—It seems likely that shoulder pain is the result of many factors, including physical load and the psychosocial work environment. The available evidence was not consistent across studies, however, and the associations were generally not strong. Future longitudinal research should evaluate the relative importance of each individual risk factor and the role of potential confounding variables—such as exposure during leisure time—to set

  4. Readability of medicinal package leaflets: a systematic review

    PubMed Central

    Pires, Carla; Vigário, Marina; Cavaco, Afonso

    2015-01-01

    OBJECTIVE To review studies on the readability of package leaflets of medicinal products for human use. METHODS We conducted a systematic literature review between 2008 and 2013 using the keywords “Readability and Package Leaflet” and “Readability and Package Insert” in the academic search engine Biblioteca do Conhecimento Online, comprising different bibliographic resources/databases. The preferred reporting items for systematic reviews and meta-analyses criteria were applied to prepare the draft of the report. Quantitative and qualitative original studies were included. Opinion or review studies not written in English, Portuguese, Italian, French, or Spanish were excluded. RESULTS We identified 202 studies, of which 180 were excluded and 22 were enrolled [two enrolling healthcare professionals, 10 enrolling other type of participants (including patients), three focused on adverse reactions, and 7 descriptive studies]. The package leaflets presented various readability problems, such as complex and difficult to understand texts, small font size, or few illustrations. The main methods to assess the readability of the package leaflet were usability tests or legibility formulae. Limitations with these methods included reduced number of participants; lack of readability formulas specifically validated for specific languages (e.g., Portuguese); and absence of an assessment on patients literacy, health knowledge, cognitive skills, levels of satisfaction, and opinions. CONCLUSIONS Overall, the package leaflets presented various readability problems. In this review, some methodological limitations were identified, including the participation of a limited number of patients and healthcare professionals, the absence of prior assessments of participant literacy, humor or sense of satisfaction, or the predominance of studies not based on role-plays about the use of medicines. These limitations should be avoided in future studies and be considered when interpreting the

  5. Global prevalence of childhood cataract: a systematic review.

    PubMed

    Sheeladevi, S; Lawrenson, J G; Fielder, A R; Suttle, C M

    2016-09-01

    Childhood cataract is an avoidable cause of visual disability worldwide and is a priority for VISION 2020: The Right to Sight. There is a paucity of information about the burden of cataract in children and the aim of this review is to assess the global prevalence of childhood cataract. The methodology for the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a literature search for studies reporting estimates of prevalence or incidence of cataract among children (aged<18 years) at any global location using the Cochrane Library, Medline and Embase up to January 2015. No restrictions were imposed based on language or year of publication. Study quality was assessed using a critical appraisal tool designed for systematic reviews of prevalence. Twenty prevalence and four incidence studies of childhood cataract from five different geographical regions were included. The overall prevalence of childhood cataract and congenital cataract was in the range from 0.32 to 22.9/10000 children (median=1.03) and 0.63 to 9.74/10000 (median=1.71), respectively. The incidence ranged from 1.8 to 3.6/10000 per year. The prevalence of childhood cataract in low-income economies was found to be 0.42 to 2.05 compared with 0.63 to 13.6/10000 in high-income economies. There was no difference in the prevalence based on laterality or gender. This review highlights substantial gaps in the epidemiological knowledge of childhood cataract worldwide, particularly from low and lower middle-income economies. More studies are needed using standard definitions and case ascertainment methods with large enough sample sizes. PMID:27518543

  6. Readability of medicinal package leaflets: a systematic review.

    PubMed

    Pires, Carla; Vigário, Marina; Cavaco, Afonso

    2015-01-01

    OBJECTIVE To review studies on the readability of package leaflets of medicinal products for human use. METHODS We conducted a systematic literature review between 2008 and 2013 using the keywords "Readability and Package Leaflet" and "Readability and Package Insert" in the academic search engine Biblioteca do Conhecimento Online, comprising different bibliographic resources/databases. The preferred reporting items for systematic reviews and meta-analyses criteria were applied to prepare the draft of the report. Quantitative and qualitative original studies were included. Opinion or review studies not written in English, Portuguese, Italian, French, or Spanish were excluded. RESULTS We identified 202 studies, of which 180 were excluded and 22 were enrolled [two enrolling healthcare professionals, 10 enrolling other type of participants (including patients), three focused on adverse reactions, and 7 descriptive studies]. The package leaflets presented various readability problems, such as complex and difficult to understand texts, small font size, or few illustrations. The main methods to assess the readability of the package leaflet were usability tests or legibility formulae. Limitations with these methods included reduced number of participants; lack of readability formulas specifically validated for specific languages (e.g., Portuguese); and absence of an assessment on patients literacy, health knowledge, cognitive skills, levels of satisfaction, and opinions. CONCLUSIONS Overall, the package leaflets presented various readability problems. In this review, some methodological limitations were identified, including the participation of a limited number of patients and healthcare professionals, the absence of prior assessments of participant literacy, humor or sense of satisfaction, or the predominance of studies not based on role-plays about the use of medicines. These limitations should be avoided in future studies and be considered when interpreting the results.

  7. Readability of medicinal package leaflets: a systematic review.

    PubMed

    Pires, Carla; Vigário, Marina; Cavaco, Afonso

    2015-01-01

    OBJECTIVE To review studies on the readability of package leaflets of medicinal products for human use. METHODS We conducted a systematic literature review between 2008 and 2013 using the keywords "Readability and Package Leaflet" and "Readability and Package Insert" in the academic search engine Biblioteca do Conhecimento Online, comprising different bibliographic resources/databases. The preferred reporting items for systematic reviews and meta-analyses criteria were applied to prepare the draft of the report. Quantitative and qualitative original studies were included. Opinion or review studies not written in English, Portuguese, Italian, French, or Spanish were excluded. RESULTS We identified 202 studies, of which 180 were excluded and 22 were enrolled [two enrolling healthcare professionals, 10 enrolling other type of participants (including patients), three focused on adverse reactions, and 7 descriptive studies]. The package leaflets presented various readability problems, such as complex and difficult to understand texts, small font size, or few illustrations. The main methods to assess the readability of the package leaflet were usability tests or legibility formulae. Limitations with these methods included reduced number of participants; lack of readability formulas specifically validated for specific languages (e.g., Portuguese); and absence of an assessment on patients literacy, health knowledge, cognitive skills, levels of satisfaction, and opinions. CONCLUSIONS Overall, the package leaflets presented various readability problems. In this review, some methodological limitations were identified, including the participation of a limited number of patients and healthcare professionals, the absence of prior assessments of participant literacy, humor or sense of satisfaction, or the predominance of studies not based on role-plays about the use of medicines. These limitations should be avoided in future studies and be considered when interpreting the results

  8. Methods of induction of labour: a systematic review

    PubMed Central

    2011-01-01

    Background Rates of labour induction are increasing. We conducted this systematic review to assess the evidence supporting use of each method of labour induction. Methods We listed methods of labour induction then reviewed the evidence supporting each. We searched MEDLINE and the Cochrane Library between 1980 and November 2010 using multiple terms and combinations, including labor, induced/or induction of labor, prostaglandin or prostaglandins, misoprostol, Cytotec, 16,16,-dimethylprostaglandin E2 or E2, dinoprostone; Prepidil, Cervidil, Dinoprost, Carboprost or hemabate; prostin, oxytocin, misoprostol, membrane sweeping or membrane stripping, amniotomy, balloon catheter or Foley catheter, hygroscopic dilators, laminaria, dilapan, saline injection, nipple stimulation, intercourse, acupuncture, castor oil, herbs. We performed a best evidence review of the literature supporting each method. We identified 2048 abstracts and reviewed 283 full text articles. We preferentially included high quality systematic reviews or large randomised trials. Where no such studies existed, we included the best evidence available from smaller randomised or quasi-randomised trials. Results We included 46 full text articles. We assigned a quality rating to each included article and a strength of evidence rating to each body of literature. Prostaglandin E2 (PGE2) and vaginal misoprostol were more effective than oxytocin in bringing about vaginal delivery within 24 hours but were associated with more uterine hyperstimulation. Mechanical methods reduced uterine hyperstimulation compared with PGE2 and misoprostol, but increased maternal and neonatal infectious morbidity compared with other methods. Membrane sweeping reduced post-term gestations. Most included studies were too small to evaluate risk for rare adverse outcomes. Conclusions Research is needed to determine benefits and harms of many induction methods. PMID:22032440

  9. Palliative hip surgery in severe cerebral palsy: a systematic review.

    PubMed

    Boldingh, Eric J; Bouwhuis, Carola B; van der Heijden-Maessen, Hélène C M; Bos, Cees F; Lankhorst, Guustaaf J

    2014-01-01

    We performed a systematic review of the results of palliative hip surgery in severe cerebral palsy. Individuals with severe cerebral palsy frequently suffer from pain and other impairments because of dislocation or malformation of the hips. When preventive or reconstructive surgery fails, palliative intervention is performed. A number of salvage interventions have been described. We found articles on resection surgery of the femoral head, arthrodesis of the hip joint, and total hip replacement. The published literature does not clearly favor one procedure over the others. The resection arthroplasty technique developed by Castle is reported to yield the best results and fewer complications, and seems to eventually lead to a good outcome.

  10. Central nervous system manifestations of neonatal lupus: a systematic review.

    PubMed

    Chen, C C; Lin, K-L; Chen, C-L; Wong, A May-Kuen; Huang, J-L

    2013-12-01

    Neonatal lupus is a rare and acquired autoimmune disease. Central nervous system abnormalities are potential manifestations in neonatal lupus. Through a systematic literature review, we analyzed the clinical features of previously reported neonatal lupus cases where central nervous system abnormalities had been identified. Most reported neonatal lupus patients with central nervous system involvement were neuroimaging-determined and asymptomatic. Only seven neonatal lupus cases were identified as having a symptomatic central nervous system abnormality which caused physical disability or required neurosurgery. A high percentage of these neurosymptomatic neonatal lupus patients had experienced a transient cutaneous skin rash and had no maternal history of autoimmune disease before pregnancy.

  11. Food selectivity in autism spectrum disorders: a systematic review.

    PubMed

    Marí-Bauset, Salvador; Zazpe, Itziar; Mari-Sanchis, Amelia; Llopis-González, Agustín; Morales-Suárez-Varela, María

    2014-11-01

    Autism spectrum disorders are characterized by difficulties with reciprocal social interactions and restricted patterns of behavior and interest; one of these characteristic behaviors is food selectivity. The objective of this study was to perform a systematic review of the literature published between 1970 and 2013 concerning this eating behavior. The articles identified were analyzed in terms of sample size, study design, and criteria for assessment and intervention, as well as the results, level of evidence and grade of recommendation. The main search was conducted in Medline, Cochrane Library, Scielo, ScienceDirect, and Embase). There is empirical evidence and an overall scientific consensus supporting an association between food selectivity and autism spectrum disorders.

  12. Cognitive Behavioural Therapy for anorexia nervosa: a systematic review.

    PubMed

    Galsworthy-Francis, Lisa; Allan, Steven

    2014-02-01

    Evidence for the effectiveness of psychological therapies for anorexia nervosa (AN) is inconsistent. There have been no systematic reviews solely on the effectiveness for Cognitive Behavioural Therapy (CBT) for AN. This review aimed to synthesise and appraise the recent evidence for CBT as a treatment for AN. Using specific search criteria, 16 relevant articles were identified which evaluated CBT alone or as part of a broader randomised/non-randomised trial. Various formats of CBT were utilised in the reviewed papers. Studies were evaluated using established quality criteria. The evidence reviewed suggested that CBT demonstrated effectiveness as a means of improving treatment adherence and minimising dropout amongst patients with AN. While CBT appeared to demonstrate some improvements in key outcomes (body mass index, eating-disorder symptoms, broader psychopathology), it was not consistently superior to other treatments (including dietary counselling, non-specific supportive management, interpersonal therapy, behavioural family therapy). Numerous methodological limitations apply to the available evidence. Further research and ongoing review is needed to evaluate the settings, patient groups and formats in which CBT may be effective as a treatment for AN.

  13. Acupuncture for benign prostatic hyperplasia: a systematic review protocol

    PubMed Central

    Zhang, Wei; Yu, Jinna; Liu, Zhishun; Peng, Weina

    2015-01-01

    Introduction Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate commonly encountered in older men. BPH has been treated with acupuncture inside and outside China, but its effects are uncertain. This review aims to assess the efficacy and safety of acupuncture therapy for BPH. Methods and analysis Seven databases will be searched from their inception: the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Chinese Biomedical Database, the China National Knowledge Infrastructure, the VIP Database and Wanfang Database. Randomised controlled clinical trials using acupuncture to treat BPH will be included. Outcome measures included urological symptom scores, urodynamic measures and quality-of-life scales. Adverse events will be assessed and reported for safety evaluation. Study selection and data extraction will be performed by two independent reviewers. Quality assessment (assessment of risk of bias) and data synthesis will be implemented using Review Manager (RevMan) software (V.5.2.3). Ethics and dissemination Ethical approval is not necessary because this systematic review will not include specific patient data. Updates will be conducted if there is enough new evidence that may cause any change in review conclusions. Trial registration number PROSPERO CRD42014013645. PMID:25838507

  14. Impact of dementia on marriage: a qualitative systematic review.

    PubMed

    Evans, David; Lee, Emmanuel

    2014-05-01

    This qualitative review explored the impact of dementia on marriage. The method was informed by systematic review and qualitative research methodologies. A comprehensive search of major databases was undertaken. The search identified 115 studies on the topic; 23 met the inclusion criteria and 19 were appraised as being of good methodological quality. Two major themes and five sub-themes emerged from the analysis of included studies, transition and loss. The theme of transition encompassed the three sub-themes of relationship, roles and intimacy and reflected the changes in the marriage and marital relationship that accompanied dementia. The theme of loss encompassed the two sub-themes of loss of a partner and loss of a marriage, which reflected the many losses that accompanied dementia. However, transition and loss were inter-related, because each change was accompanied by loss and each loss produced another change in the marriage. PMID:24339060

  15. Induction of lucid dreams: a systematic review of evidence.

    PubMed

    Stumbrys, Tadas; Erlacher, Daniel; Schädlich, Melanie; Schredl, Michael

    2012-09-01

    In lucid dreams the dreamer is aware of dreaming and often able to influence the ongoing dream content. Lucid dreaming is a learnable skill and a variety of techniques is suggested for lucid dreaming induction. This systematic review evaluated the evidence for the effectiveness of induction techniques. A comprehensive literature search was carried out in biomedical databases and specific resources. Thirty-five studies were included in the analysis (11 sleep laboratory and 24 field studies), of which 26 employed cognitive techniques, 11 external stimulation and one drug application. The methodological quality of the included studies was relatively low. None of the induction techniques were verified to induce lucid dreams reliably and consistently, although some of them look promising. On the basis of the reviewed studies, a taxonomy of lucid dream induction methods is presented. Several methodological issues are discussed and further directions for future studies are proposed. PMID:22841958

  16. Impact of dementia on marriage: a qualitative systematic review.

    PubMed

    Evans, David; Lee, Emmanuel

    2014-05-01

    This qualitative review explored the impact of dementia on marriage. The method was informed by systematic review and qualitative research methodologies. A comprehensive search of major databases was undertaken. The search identified 115 studies on the topic; 23 met the inclusion criteria and 19 were appraised as being of good methodological quality. Two major themes and five sub-themes emerged from the analysis of included studies, transition and loss. The theme of transition encompassed the three sub-themes of relationship, roles and intimacy and reflected the changes in the marriage and marital relationship that accompanied dementia. The theme of loss encompassed the two sub-themes of loss of a partner and loss of a marriage, which reflected the many losses that accompanied dementia. However, transition and loss were inter-related, because each change was accompanied by loss and each loss produced another change in the marriage.

  17. Budget impact analysis of medicines: updated systematic review and implications.

    PubMed

    Faleiros, Daniel Resende; Álvares, Juliana; Almeida, Alessandra Maciel; de Araújo, Vânia Eloisa; Andrade, Eli Iola Gurgel; Godman, Brian B; Acurcio, Francisco A; Guerra Júnior, Augusto A

    2016-01-01

    This evaluation determines whether published studies to date meet the key characteristics identified for budget impact analyses (BIA) for medicines, accomplished through a systematic review and assessment against identified key characteristics. Studies from 2001-2015 on 'budget impact analysis' with 'drug' interventions were assessed, selected based on their titles/abstracts and full texts, and their characteristics checked according to key criteria. Out of 1,984 studies, 92 were subsequently identified for review. Of these, 95% were published in Europe and the USA. 2012 saw the largest number of publications (16%) with a decline thereafter. 48% met up to 7 out of the 9 key characteristics. Only 22% stated no conflict of interest. The results indicate low adherence to the key characteristics that should be considered for BIAs and strong conflict of interest. This is an issue since BIAs can be of fundamental importance in managing the entry of new medicines including reimbursement decisions.

  18. Mindfulness meditation for substance use disorders: a systematic review.

    PubMed

    Zgierska, Aleksandra; Rabago, David; Chawla, Neharika; Kushner, Kenneth; Koehler, Robert; Marlatt, Alan

    2009-01-01

    Relapse is common in substance use disorders (SUDs), even among treated individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for SUDs. The comprehensive search for and review of literature found over 2000 abstracts and resulted in 25 eligible manuscripts (22 published, 3 unpublished: 8 randomized controlled trials, 7 controlled nonrandomized, 6 noncontrolled prospective, and 2 qualitative studies, and 1 case report). When appropriate, methodological quality, absolute risk reduction, number needed to treat, and effect size were assessed. Overall, although preliminary evidence suggests MM efficacy and safety, conclusive data for MM as a treatment of SUDs are lacking. Significant methodological limitations exist in most studies. Further, it is unclear which persons with SUDs might benefit most from MM. Future trials must be of sufficient sample size to answer a specific clinical question and should target both assessment of effect size and mechanisms of action.

  19. Strategies to prevent injury in adolescent sport: a systematic review

    PubMed Central

    Abernethy, Liz; Bleakley, Chris

    2007-01-01

    This systematic review set out to identify randomised controlled trials and controlled intervention studies that evaluated the effectiveness of preventive strategies in adolescent sport and to draw conclusions on the strength of the evidence. A literature search in seven databases (Medline, SportDiscus, EMBASE, CINAHL, PEDro, Cochrane Review and DARE) was carried out using four keywords: adolescent, sport, injury and prevention (expanded to capture any relevant literature). Assessment of 154 papers found 12 studies eligible for inclusion. It can be concluded that injury prevention strategies that focus on preseason conditioning, functional training, education, balance and sport‐specific skills, which should be continued throughout the sporting season, are effective. The evidence for the effectiveness of protective equipment in injury prevention is inconclusive and requires further assessment. PMID:17496070

  20. Substance use in young persons in Ireland, a systematic review.

    PubMed

    Murphy, Kevin; Sahm, Laura; McCarthy, Suzanne; Lambert, Sharon; Byrne, Stephen

    2013-08-01

    Adolescence is a time of physical and mental development when small changes can impact on the rest of a person's life. Substance use in this crucial period can have long-lasting consequences for the individual and for society. The prevalence of substance use in young people is an area of concern for policy makers and health workers. This systematic review looked at prevalence for four substances: alcohol, tobacco, cannabis, and benzodiazepines, across the Republic of Ireland for persons between the ages of 13 and 24, and compared usage between 2000 and 2012. Eighteen articles were included in the review. It was seen that tobacco, alcohol, and cannabis use has fallen in the lifetime and previous month use. The level of benzodiazepine use has remained similar in the period of study. Future work should redress the imbalance in substance use research that sees the majority of researchers looking at a few substances while little work is done on the others.

  1. Agent-Based Modeling of Noncommunicable Diseases: A Systematic Review

    PubMed Central

    Arah, Onyebuchi A.

    2015-01-01

    We reviewed the use of agent-based modeling (ABM), a systems science method, in understanding noncommunicable diseases (NCDs) and their public health risk factors. We systematically reviewed studies in PubMed, ScienceDirect, and Web of Sciences published from January 2003 to July 2014. We retrieved 22 relevant articles; each had an observational or interventional design. Physical activity and diet were the most-studied outcomes. Often, single agent types were modeled, and the environment was usually irrelevant to the studied outcome. Predictive validation and sensitivity analyses were most used to validate models. Although increasingly used to study NCDs, ABM remains underutilized and, where used, is suboptimally reported in public health studies. Its use in studying NCDs will benefit from clarified best practices and improved rigor to establish its usefulness and facilitate replication, interpretation, and application. PMID:25602871

  2. Treatment Modalities of Necrobiosis Lipoidica: A Concise Systematic Review

    PubMed Central

    Feily, Amir; Mehraban, Shadi

    2015-01-01

    Necrobiosis lipoidica (NL) is a rare inflammatory granulomatous skin disorder closely associated with diabetes mellitus. The aim of this paper is to review and discuss all the treatment modalities proposed and tested for this disease. A systematic review of the existing literature was conducted to investigate all the available data and summarize all the clinical trials, case reports and original articles on NL. Two major databases (PubMed and Google Scholar) were used. We have examined about 70 articles. Numerous treatment modalities have been currently investigated to compare recalcitrant NL. Being rare, most of the studies regarding this disease are case reports or small-scale clinical trials. We have found that, in spite of plentiful investigations carried out during the years, there is no treatment modality that has proved to be utterly satisfactory in treating NL. PMID:26236446

  3. A systematic review of impulsivity in eating disorders.

    PubMed

    Waxman, Samantha E

    2009-11-01

    The purpose of this paper is to conduct a systematic review of the current literature that examines impulsivity in individuals with eating disorders (ED). Studies were obtained from Embase, Pubmed and Psycinfo, and were included if they assessed impulsivity in individuals over 18 years of age with an ED diagnosis and published in the last 10 years. The methodological quality of the studies was rated. Twelve studies were included in this review, with methodological quality varying across studies. Findings suggest that impulsivity is best assessed multi-modally, with a combination of self-report, behavioural and physiological measures. In general, impulsivity was found to differentiate individuals with EDs from controls, as well as across diagnostic subtypes. The current findings have important clinical implications for our understanding and treatment of both impulsivity and eating disorders.

  4. Induction of lucid dreams: a systematic review of evidence.

    PubMed

    Stumbrys, Tadas; Erlacher, Daniel; Schädlich, Melanie; Schredl, Michael

    2012-09-01

    In lucid dreams the dreamer is aware of dreaming and often able to influence the ongoing dream content. Lucid dreaming is a learnable skill and a variety of techniques is suggested for lucid dreaming induction. This systematic review evaluated the evidence for the effectiveness of induction techniques. A comprehensive literature search was carried out in biomedical databases and specific resources. Thirty-five studies were included in the analysis (11 sleep laboratory and 24 field studies), of which 26 employed cognitive techniques, 11 external stimulation and one drug application. The methodological quality of the included studies was relatively low. None of the induction techniques were verified to induce lucid dreams reliably and consistently, although some of them look promising. On the basis of the reviewed studies, a taxonomy of lucid dream induction methods is presented. Several methodological issues are discussed and further directions for future studies are proposed.

  5. Meditation Interventions for Chronic Disease Populations: A Systematic Review.

    PubMed

    Chan, Roxane Raffin; Larson, Janet L

    2015-12-01

    The rapidly growing body of research regarding the use of meditation interventions in chronic disease presents an opportunity to compare outcomes based on intervention content. For this review, meditation interventions were described as those interventions delivered to persons with chronic disease where sitting meditation was the main or only content of the intervention with or without the addition of mindful movement. This systematic review identified 45 individual research studies that examined meditations effect on levels of anxiety, depression, and chronic disease symptoms in persons with chronic disease. Individual studies were assessed based on interventional content, the consistency with which interventions were applied, and the research quality. This study identified seven categories of meditation interventions based on the meditation skills and mindful movement practices that were included in the intervention. Overall, half of the interventions had clearly defined and specific meditation interventions (25/45) and half of the studies were conducted using randomized control trials (24/45).

  6. Oropharyngeal dysphagia in myotonic dystrophy type 1: a systematic review.

    PubMed

    Pilz, Walmari; Baijens, Laura W J; Kremer, Bernd

    2014-06-01

    A systematic review was conducted to investigate the pathophysiology of and diagnostic procedures for oropharyngeal dysphagia in myotonic dystrophy (MD). The electronic databases Embase, PubMed, and The Cochrane Library were used. The search was limited to English, Dutch, French, German, Spanish, and Portuguese publications. Sixteen studies met the inclusion criteria. Two independent reviewers assessed the methodological quality of the included articles. Swallowing assessment tools, the corresponding protocols, the studies' outcome measurements, and main findings are summarized and presented. The body of literature on pathophysiology of swallowing in dysphagic patients with MD type 1 remains scant. The included studies are heterogeneous with respect to design and outcome measures and hence are not directly comparable. More importantly, most studies had methodological problems. These are discussed in detail and recommendations for further research on diagnostic examinations for swallowing disorders in patients with MD type 1 are provided.

  7. Monoterpenes with analgesic activity--a systematic review.

    PubMed

    Guimarães, Adriana G; Quintans, Jullyana S S; Quintans, Lucindo J

    2013-01-01

    There is still the need for efficacious therapies for pain. In the search for new therapeutic options, plants are a major source of novel biomolecules. Monoterpenes constitute 90% of essential oils, and there is a growing interest in understanding the mechanisms underlying their pharmacological activity. This systematic review reports what is so far known about the analgesic activity of monoterpenes and also provides an overview of their mechanisms of action. The search terms analgesia, anti-inflammatory, anaesthetic and antioxidant were used to retrieve English language articles in SCOPUS, PUBMED and EMBASE published between 1990 and 2012. Forty-five papers were found concerning the potential analgesic activity of 27 monoterpenes. The data reviewed here suggest these compounds are possible candidates for the treatment of painful conditions. PMID:23296806

  8. Family perception of anorexia and bulimia: a systematic review.

    PubMed

    Espíndola, Cybele Ribeiro; Blay, Sérgio Luís

    2009-08-01

    A systematic literature review published between 1990 and 2006 using a qualitative approach was conducted to explore family members' perception of anorexia and bulimia nervosa patients. Articles were critically reviewed and a meta-synthesis analysis was carried out based on a meta-ethnographic method to analyze and summarize data. Of a total of 3,415 studies, nine met the study inclusion and exclusion criteria. Reciprocal translation was used for data interpretation allowing to identifying two concepts: disease awareness and disease impacts. Feelings of impotence were often described in family reorganization. The study results point to distortions in the concept