Sample records for methodological limitations including

  1. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations.

    PubMed

    Munthe-Kaas, Heather; Bohren, Meghan A; Glenton, Claire; Lewin, Simon; Noyes, Jane; Tunçalp, Özge; Booth, Andrew; Garside, Ruth; Colvin, Christopher J; Wainwright, Megan; Rashidian, Arash; Flottorp, Signe; Carlsen, Benedicte

    2018-01-25

    The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's methodological limitations component. We developed the methodological limitations component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual methodological limitations component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define methodological limitations as the extent to which there are concerns about the design or conduct of the primary studies that contributed evidence to an individual review finding. In this paper, we describe the methodological limitations component and its rationale and offer guidance on how to assess methodological limitations of a review finding as part of the CERQual approach. This guidance outlines the information required to assess methodological limitations component, the steps that need to be taken to assess methodological limitations of data contributing to a review finding and examples of methodological limitation assessments. This paper provides guidance for review authors and others on undertaking an assessment of methodological limitations in the context of the CERQual approach. More work is needed to determine which criteria critical appraisal tools should include when assessing methodological limitations. We currently recommend that whichever tool is used, review authors provide a transparent description of their assessments of methodological limitations in a review finding. We expect the CERQual approach and its individual components to develop further as our experiences with the practical implementation of the approach increase.

  2. 76 FR 23825 - Study Methodologies for Diagnostics in the Postmarket Setting; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... community on issues related to the studies and methodological approaches examining diagnostics in the... discuss a large number of methodological concerns at the workshop, including, but not limited to the...

  3. Social Competence in Late Elementary School: Relationships to Parenting and Neighborhood Context

    ERIC Educational Resources Information Center

    Caughy, Margaret O'Brien; Franzini, Luisa; Windle, Michael; Dittus, Patricia; Cuccaro, Paula; Elliott, Marc N.; Schuster, Mark A.

    2012-01-01

    Despite evidence that neighborhoods confer both risk and resilience for youth development, the existing neighborhood research has a number of methodological limitations including lack of diversity in neighborhoods sampled and neighborhood characteristics assessed. The purpose of this study was to address these methodological limitations of…

  4. Methodology to Estimate the Quantity, Composition, and ...

    EPA Pesticide Factsheets

    This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estimates have been limited to building-related CDD, a goal in the development of this methodology was to use data originating from CDD facilities and contractors to better capture the current picture of total CDD management, including materials from roads, bridges and infrastructure. This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estimates have been limited to building-related CDD, a goal in the development of this methodology was to use data originating from CDD facilities and contractors to better capture the current picture of total CDD management, including materials from roads, bridges and infrastructure.

  5. Documentation of indigenous Pacific agroforestry systems: a review of methodologies

    Treesearch

    Bill Raynor

    1993-01-01

    Recent interest in indigenous agroforestry has led to a need for documentation of these systems. However, previous work is very limited, and few methodologies are well-known or widely accepted. This paper outlines various methodologies (including sampling methods, data to be collected, and considerations in analysis) for documenting structure and productivity of...

  6. [Methodological limitations and recommendations in publications on migrant population health in Spain].

    PubMed

    Monge, Susana; Ronda, Elena; Pons-Vigués, Mariona; Vives Cases, Carmen; Malmusi, Davide; Gil-González, Diana

    2015-01-01

    Our objective was to describe the methodological limitations and recommendations identified by authors of original articles on immigration and health in Spain. A literature review was conducted of original articles published in Spanish or English between 1998 and 2012 combining keywords on immigration and health. A total of 311 articles were included; of these, 176 (56.6%) mentioned limitations, and 15 (4.8%) made recommendations. The most frequently mentioned limitations included the following: reduced sample sizes; internal validity and sample representativeness issues, with under- or overrepresentation of specific groups; problems of validity of the collected information and missing data mostly related to measurement tools; and absence of key variables for adjustment or stratification. Based on these results, a series of recommendations are proposed to minimise common limitations and advance the quality of scientific production on immigration and health in our setting. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. Evaluation Methods Sourcebook.

    ERIC Educational Resources Information Center

    Love, Arnold J., Ed.

    The chapters commissioned for this book describe key aspects of evaluation methodology as they are practiced in a Canadian context, providing representative illustrations of recent developments in evaluation methodology as it is currently applied. The following chapters are included: (1) "Program Evaluation with Limited Fiscal and Human…

  8. Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations.

    PubMed

    Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

    2016-09-13

    Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention.

  9. Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations

    PubMed Central

    Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

    2016-01-01

    Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention. PMID:27649218

  10. Anti-tobacco mass media and socially disadvantaged groups: a systematic and methodological review.

    PubMed

    Guillaumier, Ashleigh; Bonevski, Billie; Paul, Chris

    2012-07-01

    Only a limited amount of research has been conducted to explore whether there are socioeconomic status differences in responses to mass media. However, the methodological quality of this evidence has not been assessed, limiting confidence in conclusions that can be drawn regarding study outcomes. A systematic review of the effectiveness of anti-tobacco mass media campaigns with socially disadvantaged groups was conducted, and the methodological quality of included studies was assessed. Medline, The Cochrane Library, PsycInfo, Embase and Web of Science were searched using MeSH and keywords for quantitative studies conducted in Western countries prior to March 2012. A methodological quality assessment and narrative analysis of included studies was undertaken. Seventeen relevant studies (reported in 18 papers) were identified; however, weak study designs and selection bias were common characteristics, limiting strong conclusions about effectiveness. Using predominantly non-cessation related outcome measures reviewed papers indicated mixed results for mass media tobacco control campaign effectiveness among various social groups. Most studies assessed mass media impact on low socioeconomic status groups rather than highly socially disadvantaged groups. Methodological rigour of evaluations in this field must be improved to aid understanding regarding the effectiveness of mass media campaigns in driving cessation among disadvantaged groups. The results of this review indicate a gap in methodologically rigorous research into the effectiveness of mass media campaigns among socially disadvantaged groups, particularly the highly disadvantaged. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  11. On the Evolving Nature of Exposure Therapy

    ERIC Educational Resources Information Center

    Schare, Mitchell L.; Wyatt, Kristin P.

    2013-01-01

    Four articles examining methodological applications of exposure therapy and its limited dissemination were briefly reviewed. Methodological articles included those by Abramowitz et al., Gryczkowski et al., and Weiner and McKay, which addressed couple treatment of obsessive-compulsive disorder (OCD), modification of evidence-based anxiety…

  12. Development of a Practical Methodology for Elastic-Plastic and Fully Plastic Fatigue Crack Growth

    NASA Technical Reports Server (NTRS)

    McClung, R. C.; Chell, G. G.; Lee, Y. -D.; Russell, D. A.; Orient, G. E.

    1999-01-01

    A practical engineering methodology has been developed to analyze and predict fatigue crack growth rates under elastic-plastic and fully plastic conditions. The methodology employs the closure-corrected effective range of the J-integral, delta J(sub eff) as the governing parameter. The methodology contains original and literature J and delta J solutions for specific geometries, along with general methods for estimating J for other geometries and other loading conditions, including combined mechanical loading and combined primary and secondary loading. The methodology also contains specific practical algorithms that translate a J solution into a prediction of fatigue crack growth rate or life, including methods for determining crack opening levels, crack instability conditions, and material properties. A critical core subset of the J solutions and the practical algorithms has been implemented into independent elastic-plastic NASGRO modules. All components of the entire methodology, including the NASGRO modules, have been verified through analysis and experiment, and limits of applicability have been identified.

  13. Development of a Practical Methodology for Elastic-Plastic and Fully Plastic Fatigue Crack Growth

    NASA Technical Reports Server (NTRS)

    McClung, R. C.; Chell, G. G.; Lee, Y.-D.; Russell, D. A.; Orient, G. E.

    1999-01-01

    A practical engineering methodology has been developed to analyze and predict fatigue crack growth rates under elastic-plastic and fully plastic conditions. The methodology employs the closure-corrected effective range of the J-integral, (Delta)J(sub eff), as the governing parameter. The methodology contains original and literature J and (Delta)J solutions for specific geometries, along with general methods for estimating J for other geometries and other loading conditions, including combined mechanical loading and combined primary and secondary loading. The methodology also contains specific practical algorithms that translate a J solution into a prediction of fatigue crack growth rate or life, including methods for determining crack opening levels, crack instability conditions, and material properties. A critical core subset of the J solutions and the practical algorithms has been implemented into independent elastic-plastic NASGRO modules. All components of the entire methodology, including the NASGRO modules, have been verified through analysis and experiment, and limits of applicability have been identified.

  14. Roadmap for Navy Family Research.

    DTIC Science & Technology

    1980-08-01

    of methodological limitations, including: small, often non -representative or narrowly defined samples; inadequate statistical controls, inadequate...1-1 1.2 Overview of the Research Roadmap ..................... 1-2 2. Methodology ...the Office of Naval Research by the Westinghouse Public Applied Systems Division, and is designed to provide the Navy with a systematic framework for

  15. Considering consumer choice in the economic evaluation of mandatory health programmes: a review.

    PubMed

    Parkinson, Bonny; Goodall, Stephen

    2011-08-01

    Governments are increasing their focus on mandatory public health programmes following positive economic evaluations of their impact. This review aims to examine whether loss of consumer choice should be included in economic evaluations of mandatory health programmes (MHP). A systematic literature review was conducted to identify economic evaluations of MHP, whether they discuss the impact on consumer choice and any methodological limitations. Overall 39 economic evaluations were identified, of which 10 discussed the loss of consumer choice and 6 attempted to place a value on the loss of consumer choice. Methodological limitations included: measuring the marginal cost of compliance, unavailability of price elasticity estimates, the impact of income effects, double counting health impacts, biased willingness-to-pay responses, and "protest" responses. Overall it was found that the inclusion of the loss of consumer choice rarely impacted on the final outcome of the study. The impact of MHP on the loss of consumer choice has largely been ignored in economic evaluations. Its importance remains uncertain due to its infrequent inclusion and significant methodological limitations. Further research regarding which methodology is best for valuing the loss of consumer choice and whether it is important to the final implementation decision is warranted. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. A Test Method for Monitoring Modulus Changes during Durability Tests on Building Joint Sealants

    Treesearch

    Christopher C. White; Donald L. Hunston; Kar Tean Tan; Gregory T. Schueneman

    2012-01-01

    The durability of building joint sealants is generally assessed using a descriptive methodology involving visual inspection of exposed specimens for defects. It is widely known that this methodology has inherent limitations, including that the results are qualitative. A new test method is proposed that provides more fundamental and quantitative information about...

  17. Updating the limit efficiency of silicon solar cells

    NASA Technical Reports Server (NTRS)

    Wolf, M.

    1979-01-01

    Evaluation of the limit efficiency based on the simplest, most basic mathematical method that is appropriate for the conditions imposed by the cell model is discussed. The methodology, the solar cell structure, and the selection of the material parameters used in the evaluation are described. The results are discussed including a set of design goals derived from the limit efficiency.

  18. Assessing the impact of modeling limits on intelligent systems

    NASA Technical Reports Server (NTRS)

    Rouse, William B.; Hammer, John M.

    1990-01-01

    The knowledge bases underlying intelligent systems are validated. A general conceptual framework is provided for considering the roles in intelligent systems of models of physical, behavioral, and operational phenomena. A methodology is described for identifying limits in particular intelligent systems, and the use of the methodology is illustrated via an experimental evaluation of the pilot-vehicle interface within the Pilot's Associate. The requirements and functionality are outlined for a computer based knowledge engineering environment which would embody the approach advocated and illustrated in earlier discussions. Issues considered include the specific benefits of this functionality, the potential breadth of applicability, and technical feasibility.

  19. An Overview of Meta-Analyses of Danhong Injection for Unstable Angina.

    PubMed

    Zhang, Xiaoxia; Wang, Hui; Chang, Yanxu; Wang, Yuefei; Lei, Xiang; Fu, Shufei; Zhang, Junhua

    2015-01-01

    Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA). Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

  20. An Overview of Meta-Analyses of Danhong Injection for Unstable Angina

    PubMed Central

    Zhang, Xiaoxia; Chang, Yanxu; Wang, Yuefei; Lei, Xiang; Fu, Shufei; Zhang, Junhua

    2015-01-01

    Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA). Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved. PMID:26539221

  1. A methodology for the assessment of manned flight simulator fidelity

    NASA Technical Reports Server (NTRS)

    Hess, Ronald A.; Malsbury, Terry N.

    1989-01-01

    A relatively simple analytical methodology for assessing the fidelity of manned flight simulators for specific vehicles and tasks is offered. The methodology is based upon an application of a structural model of the human pilot, including motion cue effects. In particular, predicted pilot/vehicle dynamic characteristics are obtained with and without simulator limitations. A procedure for selecting model parameters can be implemented, given a probable pilot control strategy. In analyzing a pair of piloting tasks for which flight and simulation data are available, the methodology correctly predicted the existence of simulator fidelity problems. The methodology permitted the analytical evaluation of a change in simulator characteristics and indicated that a major source of the fidelity problems was a visual time delay in the simulation.

  2. Relevance and Retrieval Evaluation: Perspectives from Medicine.

    ERIC Educational Resources Information Center

    Hersh, William

    1994-01-01

    Discusses topical relevance and situational relevance, which takes into account the impact of the retrieval system on the user, in the context of medicine. Topics addressed include scientific validity; limitations of current evaluation methodology, including recall and precision; and a framework for future retrieval research based on an…

  3. Use of methodological tools for assessing the quality of studies in periodontology and implant dentistry: a systematic review.

    PubMed

    Faggion, Clovis M; Huda, Fahd; Wasiak, Jason

    2014-06-01

    To evaluate the methodological approaches used to assess the quality of studies included in systematic reviews (SRs) in periodontology and implant dentistry. Two electronic databases (PubMed and Cochrane Database of Systematic Reviews) were searched independently to identify SRs examining interventions published through 2 September 2013. The reference lists of included SRs and records of 10 specialty dental journals were searched manually. Methodological approaches were assessed using seven criteria based on the Cochrane Handbook for Systematic Reviews of Interventions. Temporal trends in methodological quality were also explored. Of the 159 SRs with meta-analyses included in the analysis, 44 (28%) reported the use of domain-based tools, 15 (9%) reported the use of checklists and 7 (4%) reported the use of scales. Forty-two (26%) SRs reported use of more than one tool. Criteria were met heterogeneously; authors of 15 (9%) publications incorporated the quality of evidence of primary studies into SRs, whereas 69% of SRs reported methodological approaches in the Materials/Methods section. Reporting of four criteria was significantly better in recent (2010-2013) than in previous publications. The analysis identified several methodological limitations of approaches used to assess evidence in studies included in SRs in periodontology and implant dentistry. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. A Systematic Scoping Review of Yoga Intervention Components and Study Quality

    PubMed Central

    Elwy, A. Rani; Groessl, Erik J.; Eisen, Susan V.; Riley, Kristen; Maiya, Meghan; Lee, Jennifer P.; Sarkin, Andrew; Park, Crystal L.

    2014-01-01

    Context The scientific study of yoga requires rigorous methodology. This review aimed to systematically assess all studies of yoga interventions to: (1) determine yoga intervention characteristics; (2) examine methodologic quality of the subset of RCTs; and (3) explore how well these interventions are reported. Evidence acquisition Searches were conducted through April 2012 in PubMed, PsycInfo, Ageline, and Ovid’s Alternative and Complementary Medicine database using the text term yoga, and through handsearching five journals. Original studies were included if the intervention: (1) consisted of at least one yoga session with some type of health assessment; (2) targeted adults age ≥18 years; (3) was published in an English language peer–reviewed journal; and (4) was available for review. Evidence synthesis Of 3,062 studies identified, 465 studies in 30 countries were included. Analyses were conducted through 2013. Most interventions took place in India (n=228) or the U.S. (n=124), with intensity ranging from a single yoga session up to two sessions per day. Intervention lengths ranged from one session to 2 years. Asanas (poses) were mentioned as yoga components in 369 (79%) interventions, but were either minimally or not at all described in 200 (54%) of these. Most interventions (74%, n=336) did not include home practice. Of the included studies, 151 were RCTs. RCT quality was rated as poor. Conclusions This review highlights the inadequate reporting and methodologic limitations of current yoga intervention research, which limits study interpretation and comparability. Recommendations for future methodology and reporting are discussed. PMID:24996759

  5. Conceptual, Methodological, and Ethical Problems in Communicating Uncertainty in Clinical Evidence

    PubMed Central

    Han, Paul K. J.

    2014-01-01

    The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”— second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making. PMID:23132891

  6. The efficacy of hypnosis as an intervention for labor and delivery pain: a comprehensive methodological review.

    PubMed

    Landolt, Alison S; Milling, Leonard S

    2011-08-01

    This paper presents a comprehensive methodological review of research on the efficacy of hypnosis for reducing labor and delivery pain. To be included, studies were required to use a between-subjects or mixed model design in which hypnosis was compared with a control condition or alternative intervention in reducing labor pain. An exhaustive search of the PsycINFO and PubMed databases produced 13 studies satisfying these criteria. Hetero-hypnosis and self-hypnosis were consistently shown to be more effective than standard medical care, supportive counseling, and childbirth education classes in reducing pain. Other benefits included better infant Apgar scores and shorter Stage 1 labor. Common methodological limitations of the literature include a failure to use random assignment, to specify the demographic characteristics of samples, and to use a treatment manual. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. The use of coupled atmospheric and hydrological models for water-resources management in headwater basins

    USGS Publications Warehouse

    Leavesley, G.; Hay, L.

    1998-01-01

    Coupled atmospheric and hydrological models provide an opportunity for the improved management of water resources in headwater basins. Issues currently limiting full implementation of coupled-model methodologies include (a) the degree of uncertainty in the accuracy of precipitation and other meteorological variables simulated by atmospheric models, and (b) the problem of discordant scales between atmospheric and bydrological models. Alternative methodologies being developed to address these issues are reviewed.

  8. Ecological and methodological drivers of species' distribution and phenology responses to climate change.

    PubMed

    Brown, Christopher J; O'Connor, Mary I; Poloczanska, Elvira S; Schoeman, David S; Buckley, Lauren B; Burrows, Michael T; Duarte, Carlos M; Halpern, Benjamin S; Pandolfi, John M; Parmesan, Camille; Richardson, Anthony J

    2016-04-01

    Climate change is shifting species' distribution and phenology. Ecological traits, such as mobility or reproductive mode, explain variation in observed rates of shift for some taxa. However, estimates of relationships between traits and climate responses could be influenced by how responses are measured. We compiled a global data set of 651 published marine species' responses to climate change, from 47 papers on distribution shifts and 32 papers on phenology change. We assessed the relative importance of two classes of predictors of the rate of change, ecological traits of the responding taxa and methodological approaches for quantifying biological responses. Methodological differences explained 22% of the variation in range shifts, more than the 7.8% of the variation explained by ecological traits. For phenology change, methodological approaches accounted for 4% of the variation in measurements, whereas 8% of the variation was explained by ecological traits. Our ability to predict responses from traits was hindered by poor representation of species from the tropics, where temperature isotherms are moving most rapidly. Thus, the mean rate of distribution change may be underestimated by this and other global syntheses. Our analyses indicate that methodological approaches should be explicitly considered when designing, analysing and comparing results among studies. To improve climate impact studies, we recommend that (1) reanalyses of existing time series state how the existing data sets may limit the inferences about possible climate responses; (2) qualitative comparisons of species' responses across different studies be limited to studies with similar methodological approaches; (3) meta-analyses of climate responses include methodological attributes as covariates; and (4) that new time series be designed to include the detection of early warnings of change or ecologically relevant change. Greater consideration of methodological attributes will improve the accuracy of analyses that seek to quantify the role of climate change in species' distribution and phenology changes. © 2015 John Wiley & Sons Ltd.

  9. LIFE CYCLE IMPACT ASSESSMENT SOPHISTICATION

    EPA Science Inventory

    An international workshop was held in Brussels on 11/29-30/1998, to discuss LCIA Sophistication. LCA experts from North America, Europs, and Asia attended. Critical reviews of associated factors, including current limitations of available assessment methodologies, and comparison...

  10. Statistical core design methodology using the VIPRE thermal-hydraulics code

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

    Lloyd, M.W.; Feltus, M.A.

    1994-12-31

    This Penn State Statistical Core Design Methodology (PSSCDM) is unique because it not only includes the EPRI correlation/test data standard deviation but also the computational uncertainty for the VIPRE code model and the new composite box design correlation. The resultant PSSCDM equation mimics the EPRI DNBR correlation results well, with an uncertainty of 0.0389. The combined uncertainty yields a new DNBR limit of 1.18 that will provide more plant operational flexibility. This methodology and its associated correlation and uniqe coefficients are for a very particular VIPRE model; thus, the correlation will be specifically linked with the lumped channel and subchannelmore » layout. The results of this research and methodology, however, can be applied to plant-specific VIPRE models.« less

  11. Health economic evaluation: important principles and methodology.

    PubMed

    Rudmik, Luke; Drummond, Michael

    2013-06-01

    To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Visual methodologies and participatory action research: Performing women's community-based health promotion in post-Katrina New Orleans.

    PubMed

    Lykes, M Brinton; Scheib, Holly

    2016-01-01

    Recovery from disaster and displacement involves multiple challenges including accompanying survivors, documenting effects, and rethreading community. This paper demonstrates how African-American and Latina community health promoters and white university-based researchers engaged visual methodologies and participatory action research (photoPAR) as resources in cross-community praxis in the wake of Hurricane Katrina and the flooding of New Orleans. Visual techniques, including but not limited to photonarratives, facilitated the health promoters': (1) care for themselves and each other as survivors of and responders to the post-disaster context; (2) critical interrogation of New Orleans' entrenched pre- and post-Katrina structural racism as contributing to the racialised effects of and responses to Katrina; and (3) meaning-making and performances of women's community-based, cross-community health promotion within this post-disaster context. This feminist antiracist participatory action research project demonstrates how visual methodologies contributed to the co-researchers' cross-community self- and other caring, critical bifocality, and collaborative construction of a contextually and culturally responsive model for women's community-based health promotion post 'unnatural disaster'. Selected limitations as well as the potential for future cross-community antiracist feminist photoPAR in post-disaster contexts are discussed.

  13. 76 FR 67418 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Extension of Time Limit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... to 300 days if it determines that the case is extraordinarily complicated. See also 19 CFR 351.214(i... review involves extraordinarily complicated methodological issues, including Thong Thuan's multiple...

  14. 76 FR 9752 - Certain Steel Nails From the People's Republic of China: Extension of Time Limit for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... extend that 180-day period to 300 days if it determines that the case is extraordinarily complicated. See... that this new shipper review involves extraordinarily complicated methodological issues, including...

  15. 76 FR 73594 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Extension of Time Limit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... Department may extend that 180-day period to 300 days if it determines that the case is extraordinarily... determines that this new shipper review involves extraordinarily complicated methodological issues, including...

  16. Assessing medical professionalism: A systematic review of instruments and their measurement properties.

    PubMed

    Li, Honghe; Ding, Ning; Zhang, Yuanyuan; Liu, Yang; Wen, Deliang

    2017-01-01

    Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments' measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations. A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990-2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument's usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee's criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments. After screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar's instrument for nursing students, Nurse Practitioners' Roles and Competencies Scale, and Perceived Faculty Competency Inventory. Although instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing instruments and to longitudinal studies.

  17. Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review.

    PubMed

    Yang, Min; Jiang, Li; Wang, Qing; Chen, Hao; Xu, Guihua

    2017-01-01

    Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown. To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis. Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach. Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from "very low" to "low," mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes. TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice.

  18. Online interviewing with interpreters in humanitarian contexts

    PubMed Central

    Chiumento, Anna; Rahman, Atif; Frith, Lucy

    2018-01-01

    ABSTRACT Purpose: Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Method: Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. Results: A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Conclusions: Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing. PMID:29532739

  19. Online interviewing with interpreters in humanitarian contexts.

    PubMed

    Chiumento, Anna; Machin, Laura; Rahman, Atif; Frith, Lucy

    2018-12-01

    Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Reflections from a case study of a multi-site research project conducted in post-conflict countries are presented.  Synchronous online cross-language qualitative interviews were conducted in one country.  Although only a small proportion of interviews were conducted online (six out of 35), it remains important to critically consider the impact upon data produced in this way. A range of practical and methodological considerations are discussed, illustrated with examples.  Results suggest that whilst online interviewing has methodological and ethical potential and versatility, there are inherent practical challenges in settings with poor internet and electricity infrastructure.  Notable methodological limitations include barriers to building rapport due to partial visual and non-visual cues, and difficulties interpreting pauses or silences. Drawing upon experiences in this case study, strategies for managing the practical and methodological limitations of online interviewing are suggested, alongside recommendations for supporting future research practice.  These are intended to act as a springboard for further reflection, and operate alongside other conceptual frameworks for online interviewing.

  20. 12 CFR 1002.2 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... security for the credit or collateral). The creditor shall exercise reasonable diligence in obtaining such... creditor utilizing the system (including, but not limited to, minimizing bad debt losses and operating... statistical principles and methodology and adjusted as necessary to maintain predictive ability. (2) A...

  1. Cross-cultural adaptation and measurement properties of generic and cancer-related patient-reported outcome measures (PROMs) for use with cancer patients in Brazil: a systematic review.

    PubMed

    Albach, Carlos Augusto; Wagland, Richard; Hunt, Katherine J

    2018-04-01

    This systematic review (1) identifies the current generic and cancer-related patient-reported outcome measures (PROMs) that have been cross-culturally adapted to Brazilian Portuguese and applied to cancer patients and (2) critically evaluates their cross-cultural adaptation (CCA) and measurement properties. Seven databases were searched for articles regarding the translation and evaluation of measurement properties of generic and cancer-related PROMs cross-culturally adapted to Brazilian Portuguese that are applied in adult (≥18 years old) cancer patients. The methodological quality of included studies was assessed using the COSMIN checklist. The bibliographic search retrieved 1674 hits, of which seven studies analysing eight instruments were included in this review. Data on the interpretability of scores were poorly reported. Overall, the quality of the CCA process was inconsistent throughout the studies. None of the included studies performed a cross-cultural validation. The evidence concerning the quality of measurement properties is limited by poor or fair methodological quality. Moreover, limited information regarding measurement properties was provided within the included papers. This review aids the selection process of Brazilian Portuguese PROMs for use in cancer patients. After acknowledging the methodological caveats and strengths of each tool, our opinion is that for quality of life and symptoms assessment the adapted FACT-G version and the ESAS could be recommended, respectively. Future research should rely on the already accepted standards of CCA and validation studies.

  2. A Proposal for Six Sigma Integration for Large-Scale Production of Penicillin G and Subsequent Conversion to 6-APA.

    PubMed

    Nandi, Anirban; Pan, Sharadwata; Potumarthi, Ravichandra; Danquah, Michael K; Sarethy, Indira P

    2014-01-01

    Six Sigma methodology has been successfully applied to daily operations by several leading global private firms including GE and Motorola, to leverage their net profits. Comparatively, limited studies have been conducted to find out whether this highly successful methodology can be applied to research and development (R&D). In the current study, we have reviewed and proposed a process for a probable integration of Six Sigma methodology to large-scale production of Penicillin G and its subsequent conversion to 6-aminopenicillanic acid (6-APA). It is anticipated that the important aspects of quality control and quality assurance will highly benefit from the integration of Six Sigma methodology in mass production of Penicillin G and/or its conversion to 6-APA.

  3. A Proposal for Six Sigma Integration for Large-Scale Production of Penicillin G and Subsequent Conversion to 6-APA

    PubMed Central

    Nandi, Anirban; Danquah, Michael K.

    2014-01-01

    Six Sigma methodology has been successfully applied to daily operations by several leading global private firms including GE and Motorola, to leverage their net profits. Comparatively, limited studies have been conducted to find out whether this highly successful methodology can be applied to research and development (R&D). In the current study, we have reviewed and proposed a process for a probable integration of Six Sigma methodology to large-scale production of Penicillin G and its subsequent conversion to 6-aminopenicillanic acid (6-APA). It is anticipated that the important aspects of quality control and quality assurance will highly benefit from the integration of Six Sigma methodology in mass production of Penicillin G and/or its conversion to 6-APA. PMID:25057428

  4. Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review.

    PubMed

    Bassuk, Ellen L; Hanson, Justine; Greene, R Neil; Richard, Molly; Laudet, Alexandre

    2016-04-01

    This systematic review identifies, appraises, and summarizes the evidence on the effectiveness of peer-delivered recovery support services for people in recovery from alcohol and drug addiction. Nine studies met criteria for inclusion in the review. They were assessed for quality and outcomes including substance use and recovery-related factors. Despite significant methodological limitations found in the included studies, the body of evidence suggests salutary effects on participants. Current limitations and recommendations for future research are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Passenger rail vehicle safety assessment methodology. Volume I, Summary of safe performance limits.

    DOT National Transportation Integrated Search

    2000-04-01

    This report presents a methodology based on computer simulation that asseses the safe dyamic performance limits of commuter passenger vehicles. The methodology consists of determining the critical design parameters and characteristic properties of bo...

  6. Online Public Access Catalog User Studies: A Review of Research Methodologies, March 1986-November 1989.

    ERIC Educational Resources Information Center

    Seymour, Sharon

    1991-01-01

    Review of research methodologies used in studies of online public access catalog (OPAC) users finds that a variety of research methodologies--e.g., surveys, transaction log analysis, interviews--have been used with varying degrees of expertise. It is concluded that poor research methodology resulting from limited training and resources limits the…

  7. A call to improve sampling methodology and reporting in young novice driver research.

    PubMed

    Scott-Parker, B; Senserrick, T

    2017-02-01

    Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. At the cross-roads of participatory research and biomarker discovery in autism: the need for empirical data.

    PubMed

    Yusuf, Afiqah; Elsabbagh, Mayada

    2015-12-15

    Identifying biomarkers for autism can improve outcomes for those affected by autism. Engaging the diverse stakeholders in the research process using community-based participatory research (CBPR) can accelerate biomarker discovery into clinical applications. However, there are limited examples of stakeholder involvement in autism research, possibly due to conceptual and practical concerns. We evaluate the applicability of CBPR principles to biomarker discovery in autism and critically review empirical studies adopting these principles. Using a scoping review methodology, we identified and evaluated seven studies using CBPR principles in biomarker discovery. The limited number of studies in biomarker discovery adopting CBPR principles coupled with their methodological limitations suggests that such applications are feasible but challenging. These studies illustrate three CBPR themes: community assessment, setting global priorities, and collaboration in research design. We propose that further research using participatory principles would be useful in accelerating the pace of discovery and the development of clinically meaningful biomarkers. For this goal to be successful we advocate for increased attention to previously identified conceptual and methodological challenges to participatory approaches in health research, including improving scientific rigor and developing long-term partnerships among stakeholders.

  9. 12 CFR 202.2 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... creditor shall exercise reasonable diligence in obtaining such information. (g) Business credit refers to... system (including, but not limited to, minimizing bad debt losses and operating expenses in accordance... principles and methodology and adjusted as necessary to maintain predictive ability. (2) A creditor may use...

  10. Use of Computer Simulation for the Analysis of Railroad Operations in the St. Louis Terminal Area

    DOT National Transportation Integrated Search

    1977-11-01

    This report discusses the computer simulation methodology, its uses and limitations, and its applicability to the analysis of alternative railroad terminal restructuring plans. Included is a detailed discussion of the AAR Simulation System, an overvi...

  11. An engineering methodology for implementing and testing VLSI (Very Large Scale Integrated) circuits

    NASA Astrophysics Data System (ADS)

    Corliss, Walter F., II

    1989-03-01

    The engineering methodology for producing a fully tested VLSI chip from a design layout is presented. A 16-bit correlator, NPS CORN88, that was previously designed, was used as a vehicle to demonstrate this methodology. The study of the design and simulation tools, MAGIC and MOSSIM II, was the focus of the design and validation process. The design was then implemented and the chip was fabricated by MOSIS. This fabricated chip was then used to develop a testing methodology for using the digital test facilities at NPS. NPS CORN88 was the first full custom VLSI chip, designed at NPS, to be tested with the NPS digital analysis system, Tektronix DAS 9100 series tester. The capabilities and limitations of these test facilities are examined. NPS CORN88 test results are included to demonstrate the capabilities of the digital test system. A translator, MOS2DAS, was developed to convert the MOSSIM II simulation program to the input files required by the DAS 9100 device verification software, 91DVS. Finally, a tutorial for using the digital test facilities, including the DAS 9100 and associated support equipments, is included as an appendix.

  12. The application of theories of the policy process to obesity prevention: a systematic review and meta-synthesis.

    PubMed

    Clarke, Brydie; Swinburn, Boyd; Sacks, Gary

    2016-10-13

    Theories of the policy process are recommended as tools to help explain both policy stasis and change. A systematic review of the application of such theoretical frameworks within the field of obesity prevention policy was conducted. A meta-synthesis was also undertaken to identify the key influences on policy decision-making. The review identified 17 studies of obesity prevention policy underpinned by political science theories. The majority of included studies were conducted in the United States (US), with significant heterogeneity in terms of policy level (e.g., national, state) studied, areas of focus, and methodologies used. Many of the included studies were methodologically limited, in regard to rigour and trustworthiness. Prominent themes identified included the role of groups and networks, political institutions, and political system characteristics, issue framing, the use of evidence, personal values and beliefs, prevailing political ideology, and timing. The limited application of political science theories indicates a need for future theoretically based research into the complexity of policy-making and multiple influences on obesity prevention policy processes.

  13. Swallowing outcomes following Intensity Modulated Radiation Therapy (IMRT) for head & neck cancer - a systematic review.

    PubMed

    Roe, Justin W G; Carding, Paul N; Dwivedi, Raghav C; Kazi, Rehan A; Rhys-Evans, Peter H; Harrington, Kevin J; Nutting, Christopher M

    2010-10-01

    A systematic review to establish what evidence is available for swallowing outcomes following IMRT for head and neck cancer. Online electronic databases were searched to identify papers published in English from January 1998 to December 2009. Papers were independently appraised by two reviewers for methodological quality, method of swallowing evaluation and categorized according to the World Health Organisation's International Classification of Health Functions. The impact of radiation dose to dysphagia aspiration risk structures (DARS) was also evaluated. Sixteen papers met the inclusion criteria. The literature suggests that limiting the radiation dose to certain structures may result in favourable swallowing outcomes. Methodological limitations included variable assessment methods and outcome measures and heterogeneity of patients. There are only limited prospective data, especially where pre-treatment measures have been taken and compared to serial post-treatment assessment. Few studies have investigated the impact of IMRT on swallow function and the impact on everyday life. Initial studies have reported potential benefits but are limited in terms of study design and outcome data. Further well designed, prospective, longitudinal swallowing studies including multidimensional evaluation methods are required to enable a more comprehensive understanding of dysphagia complications and inform pre-treatment counselling and rehabilitation planning. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. System engineering toolbox for design-oriented engineers

    NASA Technical Reports Server (NTRS)

    Goldberg, B. E.; Everhart, K.; Stevens, R.; Babbitt, N., III; Clemens, P.; Stout, L.

    1994-01-01

    This system engineering toolbox is designed to provide tools and methodologies to the design-oriented systems engineer. A tool is defined as a set of procedures to accomplish a specific function. A methodology is defined as a collection of tools, rules, and postulates to accomplish a purpose. For each concept addressed in the toolbox, the following information is provided: (1) description, (2) application, (3) procedures, (4) examples, if practical, (5) advantages, (6) limitations, and (7) bibliography and/or references. The scope of the document includes concept development tools, system safety and reliability tools, design-related analytical tools, graphical data interpretation tools, a brief description of common statistical tools and methodologies, so-called total quality management tools, and trend analysis tools. Both relationship to project phase and primary functional usage of the tools are also delineated. The toolbox also includes a case study for illustrative purposes. Fifty-five tools are delineated in the text.

  15. Economic Studies in Motor Neurone Disease: A Systematic Methodological Review.

    PubMed

    Moore, Alan; Young, Carolyn A; Hughes, Dyfrig A

    2017-04-01

    Motor neurone disease (MND) is a devastating condition which greatly diminishes patients' quality of life and limits life expectancy. Health technology appraisals of future interventions in MND need robust data on costs and utilities. Existing economic evaluations have been noted to be limited and fraught with challenges. The aim of this study was to identify and critique methodological aspects of all published economic evaluations, cost studies, and utility studies in MND. We systematically reviewed all relevant published studies in English from 1946 until January 2016, searching the databases of Medline, EMBASE, Econlit, NHS Economic Evaluation Database (NHS EED) and the Health Economics Evaluation Database (HEED). Key data were extracted and synthesised narratively. A total of 1830 articles were identified, of which 15 economic evaluations, 23 cost and 3 utility studies were included. Most economic studies focused on riluzole (n = 9). Six studies modelled the progressive decline in motor function using a Markov design but did not include mutually exclusive health states. Cost estimates for a number of evaluations were based on expert opinion and were hampered by high variability and location-specific characteristics. Few cost studies reported disease-stage-specific costs (n = 3) or fully captured indirect costs. Utilities in three studies of MND patients used the EuroQol EQ-5D questionnaire or standard gamble, but included potentially unrepresentative cohorts and did not consider any health impacts on caregivers. Economic evaluations in MND suffer from significant methodological issues such as a lack of data, uncertainty with the disease course and use of inappropriate modelling framework. Limitations may be addressed through the collection of detailed and representative data from large cohorts of patients.

  16. A critical methodological review of discourse and conversation analysis studies of family therapy.

    PubMed

    Tseliou, Eleftheria

    2013-12-01

    Discourse (DA) and conversation (CA) analysis, two qualitative research methods, have been recently suggested as potentially promising for the study of family therapy due to common epistemological adherences and their potential for an in situ study of therapeutic dialog. However, to date, there is no systematic methodological review of the few existing DA and CA studies of family therapy. This study aims at addressing this lack by critically reviewing published DA and CA studies of family therapy on methodological grounds. Twenty-eight articles in total are reviewed in relation to certain methodological axes identified in the relevant literature. These include choice of method, framing of research question(s), data/sampling, type of analysis, epistemological perspective, content/type of knowledge claims, and attendance to criteria for good quality practice. It is argued that the reviewed studies show "glimpses" of the methods' potential for family therapy research despite the identification of certain "shortcomings" regarding their methodological rigor. These include unclearly framed research questions and the predominance of case study designs. They also include inconsistencies between choice of method, stated or unstated epistemological orientations and knowledge claims, and limited attendance to criteria for good quality practice. In conclusion, it is argued that DA and CA can add to the existing quantitative and qualitative methods for family therapy research. They can both offer unique ways for a detailed study of the actual therapeutic dialog, provided that future attempts strive for a methodologically rigorous practice and against their uncritical deployment. © FPI, Inc.

  17. Mechanical modulation method for ultrasensitive phase measurements in photonics biosensing.

    PubMed

    Patskovsky, S; Maisonneuve, M; Meunier, M; Kabashin, A V

    2008-12-22

    A novel polarimetry methodology for phase-sensitive measurements in single reflection geometry is proposed for applications in optical transduction-based biological sensing. The methodology uses altering step-like chopper-based mechanical phase modulation for orthogonal s- and p- polarizations of light reflected from the sensing interface and the extraction of phase information at different harmonics of the modulation. We show that even under a relatively simple experimental arrangement, the methodology provides the resolution of phase measurements as low as 0.007 deg. We also examine the proposed approach using Total Internal Reflection (TIR) and Surface Plasmon Resonance (SPR) geometries. For TIR geometry, the response appears to be strongly dependent on the prism material with the best values for high refractive index Si. The detection limit for Si-based TIR is estimated as 10(-5) in terms Refractive Index Units (RIU) change. SPR geometry offers much stronger phase response due to a much sharper phase characteristics. With the detection limit of 3.2*10(-7) RIU, the proposed methodology provides one of best sensitivities for phase-sensitive SPR devices. Advantages of the proposed method include high sensitivity, simplicity of experimental setup and noise immunity as a result of a high stability modulation.

  18. Assessing medical professionalism: A systematic review of instruments and their measurement properties

    PubMed Central

    Li, Honghe; Liu, Yang; Wen, Deliang

    2017-01-01

    Background Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments’ measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations. Methods A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990–2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument’s usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee’s criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments. Results After screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar’s instrument for nursing students, Nurse Practitioners’ Roles and Competencies Scale, and Perceived Faculty Competency Inventory. Conclusion Although instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing instruments and to longitudinal studies. PMID:28498838

  19. Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review

    PubMed Central

    Wang, Qing; Chen, Hao

    2017-01-01

    Background Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown. Objective To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis. Methods Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach. Results Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from “very low” to “low,” mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes. Conclusions TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice. PMID:29267324

  20. Yoga in the schools: a systematic review of the literature.

    PubMed

    Serwacki, Michelle L; Cook-Cottone, Catherine

    2012-01-01

    The objective of this research was to examine the evidence for delivering yoga-based interventions in schools. An electronic literature search was conducted to identify peer-reviewed, published studies in which yoga and a meditative component (breathing practices or meditation) were taught to youths in a school setting. Pilot studies, single cohort, quasi-experimental, and randomized clinical trials were considered. quality was evaluated and summarized. Twelve published studies were identified. Samples for which yoga was implemented as an intervention included youths with autism, intellectual disability, learning disability, and emotional disturbance, as well as typically developing youths. Although effects of participating in school-based yoga programs appeared to be beneficial for the most part, methodological limitations, including lack of randomization, small samples, limited detail regarding the intervention, and statistical ambiguities curtailed the ability to provide definitive conclusions or recommendations. Findings speak to the need for greater methodological rigor and an increased understanding of the mechanisms of success for school-based yoga interventions.

  1. Epidemiology, methodological and reporting characteristics of systematic reviews of nursing interventions published in China.

    PubMed

    Shi, Chunhu; Zhu, Lin; Wang, Xue; Qin, Chunxia; Xu, Qi; Tian, Jinhui

    2014-12-01

    The importance of systematic reviews (SRs) of nursing interventions' impact on practice makes their methodological quality and reporting characteristics especially important as it directly influence their utility for clinicians, patients and policy makers.The study aims to assess the methodological quality and reporting characteristics of SRs of nursing interventions in Chinese nursing journals. Three Chinese databases were searched for SRs of nursing interventions from inception to October 2011. The assessment of multiple systematic reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statements were used to assess methodological quality and reporting characteristics. Seventy-four SRs were included. The proportion of SRs complying with AMSTAR checklist items ranged from 0% to 82.4%. No SRs reported an 'a priori' design or conflict of interest. Only four items were found to be reported in more than 50% of the SRs: a list of included and excluded studies, the scientific quality of included studies, the appropriate use of methods to combine findings, and formulating conclusions appropriately. The majority of SRs of nursing interventions in China had major methodological and reporting flaws that limited their value to guide decisions. Chinese authors and journals should adopt and keep up with the AMSTAR and PRISMA statements to improve the quality of SRs in this field. © 2014 Wiley Publishing Asia Pty Ltd.

  2. [Quantity versus quality: a review on current methodological dispute in health services research].

    PubMed

    Sikorski, Claudia; Glaesmer, Heide; Bramesfeld, Anke

    2010-10-01

    The aim of this study was to determine the percentage of qualitative and quantitative research papers on health services research in two German journals. All publications of the two journals were viewed. Only empirical research papers were included. It was then assessed whether they dealt with health services research and what methodology was used to collect and analyse data. About half of all published empirical papers dealt with health services research. Of those, slightly over 20 % used qualitative methods at least partially. Ordered by topic, qualitative data collection and analysis is especially common in the fields of phenomenology, treatment determinants and treatment outcome. Sole qualitative methodology is still used rather seldom in health services research. Attempts to include quantitative as well as qualitative approaches are limited to sequential design, lowering the independent value of both approaches. The concept of triangulation yields the possibility to overcome paradigm based dichotomies. However, the choice of methodology ought to be based primarily on the research question. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Social cognition interventions for people with schizophrenia: a systematic review focussing on methodological quality and intervention modality.

    PubMed

    Grant, Nina; Lawrence, Megan; Preti, Antonio; Wykes, Til; Cella, Matteo

    2017-08-01

    People with a diagnosis of schizophrenia have significant social and functional difficulties. Social cognition was found to influences these outcomes and in recent years interventions targeting this domain were developed. This paper reviews the existing literature on social cognition interventions for people with a diagnosis of schizophrenia focussing on: i) comparing focussed (i.e. targeting only one social cognitive domain) and global interventions and ii) studies methodological quality. Systematic search was conducted on PubMed and PsycInfo. Studies were included if they were randomised control trials, participants had a diagnosis of schizophrenia or schizoaffective disorder, and the intervention targeted at least one out of four social cognition domains (i.e. theory of mind, affect recognition, social perception and attribution bias). All papers were assessed for methodological quality. Information on the intervention, control condition, study methodology and the main findings from each study were extracted and critically summarised. Data from 32 studies fulfilled the inclusion criteria, considering a total of 1440 participants. Taking part in social cognition interventions produced significant improvements in theory of mind and affect recognition compared to both passive and active control conditions. Results were less clear for social perception and attributional bias. Focussed and global interventions had similar results on outcomes. Overall study methodological quality was modest. There was very limited evidence showing that social cognitive intervention result in functional outcome improvement. The evidence considered suggests that social cognition interventions may be a valuable approach for people with a diagnosis of schizophrenia. However, evidence quality is limited by measure heterogeneity, modest study methodology and short follow-up periods. The findings point to a number of recommendations for future research, including measurement standardisation, appropriately powered studies and investigation of the impact of social cognition improvements on functioning problems. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Modern Instrumental Methods in Forensic Toxicology*

    PubMed Central

    Smith, Michael L.; Vorce, Shawn P.; Holler, Justin M.; Shimomura, Eric; Magluilo, Joe; Jacobs, Aaron J.; Huestis, Marilyn A.

    2009-01-01

    This article reviews modern analytical instrumentation in forensic toxicology for identification and quantification of drugs and toxins in biological fluids and tissues. A brief description of the theory and inherent strengths and limitations of each methodology is included. The focus is on new technologies that address current analytical limitations. A goal of this review is to encourage innovations to improve our technological capabilities and to encourage use of these analytical techniques in forensic toxicology practice. PMID:17579968

  5. ESTIMATING SOLAR RADIATION EXPOSURE IN WETLANDS USING RADIATION MODELS, FIELD DATA, AND GEOGRAPHIC INFORMATION SYSTEMS

    EPA Science Inventory

    This seminar will describe development of methods for the estimation of solar radiation doses in wetlands. The methodology presents a novel approach to incorporating aspects of solar radiation dosimetry that have historically received limited attention. These include effects of a...

  6. Public Education Finances. 2004

    ERIC Educational Resources Information Center

    US Census Bureau, 2006

    2006-01-01

    This report contains financial statistics relating to public elementary-secondary education. It includes national and state financial aggregates and display data for each public school system with an enrollment of 10,000 or more. This introductory text describes the scope, concepts, sources, survey methodology, and limitations of the data. It also…

  7. Measurement properties of tools measuring mental health knowledge: a systematic review.

    PubMed

    Wei, Yifeng; McGrath, Patrick J; Hayden, Jill; Kutcher, Stan

    2016-08-23

    Mental health literacy has received great attention recently to improve mental health knowledge, decrease stigma and enhance help-seeking behaviors. We conducted a systematic review to critically appraise the qualities of studies evaluating the measurement properties of mental health knowledge tools and the quality of included measurement properties. We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library, and ERIC for studies addressing psychometrics of mental health knowledge tools and published in English. We applied the COSMIN checklist to assess the methodological quality of each study as "excellent", "good", "fair", or "indeterminate". We ranked the level of evidence of the overall quality of each measurement property across studies as "strong", "moderate", "limited", "conflicting", or "unknown". We identified 16 mental health knowledge tools in 17 studies, addressing reliability, validity, responsiveness or measurement errors. The methodological quality of included studies ranged from "poor" to "excellent" including 6 studies addressing the content validity, internal consistency or structural validity demonstrating "excellent" quality. We found strong evidence of the content validity or internal consistency of 6 tools; moderate evidence of the internal consistency, the content validity or the reliability of 8 tools; and limited evidence of the reliability, the structural validity, the criterion validity, or the construct validity of 12 tools. Both the methodological qualities of included studies and the overall evidence of measurement properties are mixed. Based on the current evidence, we recommend that researchers consider using tools with measurement properties of strong or moderate evidence that also reached the threshold for positive ratings according to COSMIN checklist.

  8. Outcomes associated with virtual reality in psychological interventions: where are we now?

    PubMed

    Turner, Wesley A; Casey, Leanne M

    2014-12-01

    The impending commercial release of affordable VR systems is likely to accelerate both the opportunity and demand for VR applications that specifically target psychological conditions. The aim of this study was to conduct a meta-analysis of outcomes associated with VR psychological interventions and to examine the methodological rigour used in these interventions. Literature search was conducted via Ovid, ProQuest Psychology Journals and ScienceDirect (Psychology) databases. Interventions were required to: be published between 1980 to 2014; use a randomised controlled trial design; be published in a scholarly journal; focused primarily on psychological/behavioural intervention; include validated measures; include reported means and standard deviations of outcome measures; and include one group with clinical/subclinical disorders, syndromes or distressing behaviours. Thirty eligible studies were identified. Random effects meta-analysis found an overall moderate effect size for VR interventions. Individual meta-analyses found an overall large effect size against non-intervention wait-lists and an overall moderate effect size against active interventions. No correlation was found between treatment outcomes and methodological rigour. Limitations may include limited study numbers, the use of a single coder, a need for more in-depth analyses of variation in form VR intervention, and omission of presence as a moderating factor. The current review supports VR interventions as efficacious, promising forms of psychological treatment. Use of reporting guidelines such as the CONSORT and CONSORT-EHEALTH statements should promote greater emphasis on methodological rigour, providing a firm foundation for the further development of clinical VR applications. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Effectiveness of physical therapy interventions for children with cerebral palsy: A systematic review

    PubMed Central

    Anttila, Heidi; Autti-Rämö, Ilona; Suoranta, Jutta; Mäkelä, Marjukka; Malmivaara, Antti

    2008-01-01

    Background To assess the effectiveness of physical therapy (PT) interventions on functioning in children with cerebral palsy (CP). Methods A search was made in Medline, Cinahl, PEDro and the Cochrane library for the period 1990 to February 2007. Only randomized controlled trials (RCTs) on PT interventions in children with diagnosed CP were included. Two reviewers independently assessed the methodological quality and extracted the data. The outcomes measured in the trials were classified using the International Classification of Functioning, Disability and Health (ICF). Results Twenty-two trials were identified. Eight intervention categories were distinguished. Four trials were of high methodological quality. Moderate evidence of effectiveness was established for two intervention categories: effectiveness of upper extremity treatments on attained goals and active supination, and of prehensile hand treatment and neurodevelopmental therapy (NDT) or NDT twice a week on developmental status, and of constraint-induced therapy on amount and quality of hand use. Moderate evidence of ineffectiveness was found of strength training on walking speed and stride length. Conflicting evidence was found for strength training on gross motor function. For the other intervention categories the evidence was limited due to low methodological quality and the statistically insignificant results of the studies. Conclusion Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most PT interventions is available through RCTs. Moderate evidence was found for some effectiveness of upper extremity training. Well-designed trials are needed especially for focused PT interventions. PMID:18435840

  10. Global Health: Pediatric Neurology.

    PubMed

    Bearden, David R; Ciccone, Ornella; Patel, Archana A

    2018-04-01

    Neurologic disorders contribute significantly to both morbidity and mortality among children in resource-limited settings, but there are a few succinct studies summarizing the epidemiology of neurologic disorders in these settings. A review of available literature was performed to identify data on the prevalence, etiology, outcomes, and treatment of neurologic disorders in children in resource-limited settings. The burden of neurologic disorders in children is high in resource-limited settings. Barriers to optimal care include lack of trained personnel, limited access to diagnostic technology, and limited availability of drugs used to treat common conditions. Several solutions have been suggested to deal with these challenges including increased collaborations to train neurologists willing to practice in resource-limited settings and increased training of physician extenders or community health workers. Further studies are necessary to improve our understanding of the epidemiology of neurologic disorders in resource-limited settings. Future epidemiologic studies should incorporate multiple countries in resource-limited settings and utilize standardized definitions and methodologies to enable comparison across regions. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. 40 CFR Appendix B to Part 72 - Methodology for Conversion of Emissions Limits

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Methodology for Conversion of... Conversion of Emissions Limits For the purposes of the Acid Rain Program, all emissions limits must be... conditions. Generic conversions for these limits are based on the assumed average energy contents listed in...

  12. 40 CFR Appendix B to Part 72 - Methodology for Conversion of Emissions Limits

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Methodology for Conversion of... Conversion of Emissions Limits For the purposes of the Acid Rain Program, all emissions limits must be... conditions. Generic conversions for these limits are based on the assumed average energy contents listed in...

  13. Establishing equivalence: methodological progress in group-matching design and analysis.

    PubMed

    Kover, Sara T; Atwoo, Amy K

    2013-01-01

    This methodological review draws attention to the challenges faced by intellectual and developmental disabilities researchers in the appropriate design and analysis of group comparison studies. We provide a brief overview of matching methodologies in the field, emphasizing group-matching designs used in behavioral research on cognition and language in neurodevelopmental disorders, including autism spectrum disorder, Fragile X syndrome, Down syndrome, and Williams syndrome. The limitations of relying on p values to establish group equivalence are discussed in the context of other existing methods: equivalence tests, propensity scores, and regression-based analyses. Our primary recommendation for advancing research on intellectual and developmental disabilities is the use of descriptive indices of adequate group matching: effect sizes (i.e., standardized mean differences) and variance ratios.

  14. Establishing Equivalence: Methodological Progress in Group-Matching Design and Analysis

    PubMed Central

    Kover, Sara T.; Atwood, Amy K.

    2017-01-01

    This methodological review draws attention to the challenges faced by intellectual and developmental disabilities researchers in the appropriate design and analysis of group comparison studies. We provide a brief overview of matching methodologies in the field, emphasizing group-matching designs utilized in behavioral research on cognition and language in neurodevelopmental disorders, including autism spectrum disorder, fragile X syndrome, Down syndrome, and Williams syndrome. The limitations of relying on p-values to establish group equivalence are discussed in the context of other existing methods: equivalence tests, propensity scores, and regression-based analyses. Our primary recommendation for advancing research on intellectual and developmental disabilities is the use of descriptive indices of adequate group matching: effect sizes (i.e., standardized mean differences) and variance ratios. PMID:23301899

  15. A normative price for energy from an electricity generation system: An Owner-dependent Methodology for Energy Generation (system) Assessment (OMEGA). Volume 1: Summary

    NASA Technical Reports Server (NTRS)

    Chamberlain, R. G.; Mcmaster, K. M.

    1981-01-01

    The utility owned solar electric system methodology is generalized and updated. The net present value of the system is determined by consideration of all financial benefits and costs (including a specified return on investment). Life cycle costs, life cycle revenues, and residual system values are obtained. Break even values of system parameters are estimated by setting the net present value to zero. While the model was designed for photovoltaic generators with a possible thermal energy byproduct, it applicability is not limited to such systems. The resulting owner-dependent methodology for energy generation system assessment consists of a few equations that can be evaluated without the aid of a high-speed computer.

  16. Is there an "abortion trauma syndrome"? Critiquing the evidence.

    PubMed

    Robinson, Gail Erlick; Stotland, Nada L; Russo, Nancy Felipe; Lang, Joan A; Occhiogrosso, Mallay

    2009-01-01

    The objective of this review is to identify and illustrate methodological issues in studies used to support claims that induced abortion results in an "abortion trauma syndrome" or a psychiatric disorder. After identifying key methodological issues to consider when evaluating such research, we illustrate these issues by critically examining recent empirical studies that are widely cited in legislative and judicial testimony in support of the existence of adverse psychiatric sequelae of induced abortion. Recent studies that have been used to assert a causal connection between abortion and subsequent mental disorders are marked by methodological problems that include, but not limited to: poor sample and comparison group selection; inadequate conceptualization and control of relevant variables; poor quality and lack of clinical significance of outcome measures; inappropriateness of statistical analyses; and errors of interpretation, including misattribution of causal effects. By way of contrast, we review some recent major studies that avoid these methodological errors. The most consistent predictor of mental disorders after abortion remains preexisting disorders, which, in turn, are strongly associated with exposure to sexual abuse and intimate violence. Educating researchers, clinicians, and policymakers how to appropriately assess the methodological quality of research about abortion outcomes is crucial. Further, methodologically sound research is needed to evaluate not only psychological outcomes of abortion, but also the impact of existing legislation and the effects of social attitudes and behaviors on women who have abortions.

  17. Use of virtual reality systems as proprioception method in cerebral palsy: clinical practice guideline.

    PubMed

    Monge Pereira, E; Molina Rueda, F; Alguacil Diego, I M; Cano de la Cuerda, R; de Mauro, A; Miangolarra Page, J C

    2014-01-01

    The limitations in performing functional activities in children and adolescents with cerebral palsy are important. The use of virtual reality systems is a new treatment approach that reinforces task-oriented motor learning. The purpose of this guide is to study the impact of the use of virtual reality systems in the improvement and acquisition of functional skills, and to evaluate the scientific evidence to determine the strength of recommendation of such interventions. All available full-text articles, regardless of their methodology, were included. The following data bases were consulted: PubMed (Medline), PEDro, EMBASE (OVID-Elsevier), Cochrane Library, Medline (OVID), CINAHL, ISI Web Knowledge. An assessment was made of methodological quality, the level of scientific evidence, and the strength of recommendations using the tools: Critical Review Form - Quantitative Studies and the Guidelines for Critical Review Form - Quantitative Studies and U.S. Preventive Services Task Force. Finally, we included 13 articles and 97 participants were recruited. We obtained significant improvements in outcome measures that assessed postural control and balance, upper limb function, the selective joint control, and gait. The guide has some limitations: the limited number of patients enrolled, clinical diversity and age range, as well as the methodological quality of existing trials. Virtual reality is a promising tool in the treatment of children with cerebral palsy. There is strong scientific evidence of an acceptable recommendation for the use of virtual reality systems in the treatment of cerebral palsy. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  18. The Society for Implementation Research Collaboration Instrument Review Project: a methodology to promote rigorous evaluation.

    PubMed

    Lewis, Cara C; Stanick, Cameo F; Martinez, Ruben G; Weiner, Bryan J; Kim, Mimi; Barwick, Melanie; Comtois, Katherine A

    2015-01-08

    Identification of psychometrically strong instruments for the field of implementation science is a high priority underscored in a recent National Institutes of Health working meeting (October 2013). Existing instrument reviews are limited in scope, methods, and findings. The Society for Implementation Research Collaboration Instrument Review Project's objectives address these limitations by identifying and applying a unique methodology to conduct a systematic and comprehensive review of quantitative instruments assessing constructs delineated in two of the field's most widely used frameworks, adopt a systematic search process (using standard search strings), and engage an international team of experts to assess the full range of psychometric criteria (reliability, construct and criterion validity). Although this work focuses on implementation of psychosocial interventions in mental health and health-care settings, the methodology and results will likely be useful across a broad spectrum of settings. This effort has culminated in a centralized online open-access repository of instruments depicting graphical head-to-head comparisons of their psychometric properties. This article describes the methodology and preliminary outcomes. The seven stages of the review, synthesis, and evaluation methodology include (1) setting the scope for the review, (2) identifying frameworks to organize and complete the review, (3) generating a search protocol for the literature review of constructs, (4) literature review of specific instruments, (5) development of an evidence-based assessment rating criteria, (6) data extraction and rating instrument quality by a task force of implementation experts to inform knowledge synthesis, and (7) the creation of a website repository. To date, this multi-faceted and collaborative search and synthesis methodology has identified over 420 instruments related to 34 constructs (total 48 including subconstructs) that are relevant to implementation science. Despite numerous constructs having greater than 20 available instruments, which implies saturation, preliminary results suggest that few instruments stem from gold standard development procedures. We anticipate identifying few high-quality, psychometrically sound instruments once our evidence-based assessment rating criteria have been applied. The results of this methodology may enhance the rigor of implementation science evaluations by systematically facilitating access to psychometrically validated instruments and identifying where further instrument development is needed.

  19. Energy Service Companies as a Component of a Comprehensive University Sustainability Strategy

    ERIC Educational Resources Information Center

    Pearce, Joshua M.; Miller, Laura L.

    2006-01-01

    Purpose: This paper aims to quantify and critically analyze the best practices of a comprehensive environmental stewardship strategy (ESS), which included a guaranteed energy savings program (GESP) that utilized an energy service company (ESCO). Design/methodology/approach: The environmental and economic benefits and limitations of an approach…

  20. Cross-Curricular Skills Development in Final-Year Dissertation by Active and Collaborative Methodologies

    ERIC Educational Resources Information Center

    Etaio, Iñaki; Churruca, Itziar; Rada, Diego; Miranda, Jonatan; Saracibar, Amaia; Sarrionandia, Fernando; Lasa, Arrate; Simón, Edurne; Labayen, Idoia; Martinez, Olaia

    2018-01-01

    European Frame for Higher Education has led universities to adapt their teaching schemes. Degrees must train students in competences including specific and cross-curricular skills. Nevertheless, there are important limitations to follow skill improvement through the consecutive academic years. Final-year dissertation (FYD) offers the opportunity…

  1. 42 CFR 52.7 - Use of funds; changes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR RESEARCH PROJECTS... project shall be limited to changes in methodology, approach or other aspects of the project to expedite achievement of the project's research objectives, including changes that grow out of the approved project and...

  2. Characteristic Interviews, Different Strategies: Methodological Challenges in Qualitative Interviewing among Respondents with Mild Intellectual Disabilities

    ERIC Educational Resources Information Center

    Sigstad, Hanne Marie Høybråten

    2014-01-01

    Conducting qualitative research interviews among individuals with intellectual disabilities, including cognitive limitations and difficulties in communication, presents particular research challenges. One question is whether the difficulties that informants encounter affect interviews to such an extent that the validity of the results is weakened.…

  3. Multi-Method Assessment of Feeding Problems among Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Sharp, William G.; Jaquess, David L.; Lukens, Colleen T.

    2013-01-01

    Estimates suggest that atypical eating is pervasive among children with autism spectrum disorders (ASD); however, much remains unknown regarding the nature and prevalence of feeding problems in this population due to methodological limitations, including lack of adequate assessment methods and empirical evaluation of existing measures. In the…

  4. Testing Alternative Explanations for the Associations between Parenting and Adolescent Suicidal Problems

    ERIC Educational Resources Information Center

    Boeninger, Daria K.; Masyn, Katherine E.; Conger, Rand D.

    2013-01-01

    Although studies have established associations between parenting characteristics and adolescent suicidality, the strength of the evidence for these links remains unclear, largely because of methodological limitations, including lack of accounting for possible child effects on parenting. This study addresses these issues by using autoregressive…

  5. Timing and Methodology of Application of Azoxystrobin to Control Rhizoctonia Solani in Sugarbeet

    USDA-ARS?s Scientific Manuscript database

    Rhizoctonia solani AG 2-2 is the causal agent of Rhizoctonia root and crown rot of sugar beet (Beta vulgaris) in North Dakota and Minnesota. This disease is a major limiting factor to sugar beet production. Management strategies currently include using partially resistant cultivars and fungicides. ...

  6. 40 CFR Appendix B to Part 72 - Methodology for Conversion of Emissions Limits

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Methodology for Conversion of Emissions Limits B Appendix B to Part 72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Pt. 72, App. B Appendix B to Part 72—Methodology for...

  7. 40 CFR Appendix A to Part 72 - Methodology for Annualization of Emissions Limits

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Methodology for Annualization of Emissions Limits A Appendix A to Part 72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Pt. 72, App. A Appendix A to Part 72—Methodology for...

  8. 40 CFR Appendix A to Part 72 - Methodology for Annualization of Emissions Limits

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Methodology for Annualization of Emissions Limits A Appendix A to Part 72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Pt. 72, App. A Appendix A to Part 72—Methodology for...

  9. 40 CFR Appendix B to Part 72 - Methodology for Conversion of Emissions Limits

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Methodology for Conversion of Emissions Limits B Appendix B to Part 72 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PERMITS REGULATION Pt. 72, App. B Appendix B to Part 72—Methodology for...

  10. Traditional Chinese medicine injection for angina pectoris: an overview of systematic reviews.

    PubMed

    Luo, Jing; Shang, Qinghua; Han, Mei; Chen, Keji; Xu, Hao

    2014-01-01

    Traditional Chinese medicine (TCM) injection is widely used to treat angina pectoris in China. This overview aims to systematically summarize the general characteristics of systematic reviews (SRs) on TCM injection in treating angina, and assess the methodological and reporting quality of these reviews. We searched PubMed, Embase, the Cochrane Library and four Chinese databases from inception until March 2013. Data were extracted according to a preset form. The AMSTAR and PRISMA checklists were used to explore the methodological quality and reporting characteristics of included reviews, respectively. All data analyses were descriptive. 46 SRs involving over 57,463 participants with angina reviewing 23 kinds of TCM injections were included. The main outcomes evaluated in the reviews were symptoms (43/46, 93.5%), surrogate outcomes (42/46, 91.3%) and adverse events (41/46, 87.0%). Few reviews evaluated endpoints (7/46, 15.2%) and quality of life (1/46, 2.2%). One third of the reviews (16/46, 34.8%) drew definitely positive conclusions while the others (30/46, 65.2%) suggested potential benefits mainly in symptoms, electrocardiogram and adverse events. With many serious flaws such as lack of a protocol and inappropriate data synthesis, the overall methodological and reporting quality of the reviews was limited. While many SRs of TCM injection on the treatment of angina suggested potential benefits or definitely positive effects, stakeholders should not accept the findings of these reviews uncritically due to the limited methodological and reporting quality. Future SRs should be appropriately conducted and reported according to international standards such as AMSTAR and PRISMA, rather than published in large numbers.

  11. Satellite Vulnerability to Space Debris- An Improved 3D Risk Assessment Methodology

    NASA Astrophysics Data System (ADS)

    Grassi, Lilith; Destefanis, Roberto; Tiboldo, Francesca; Donath, Therese; Winterboer, Arne; Evand, Leanne; Janovsky, Rolf; Kempf, Scott; Rudolph, Martin; Schafer, Frank; Gelhaus, Johannes

    2013-08-01

    The work described in the present paper, performed as a part of the PÇ-ROTECT project, presents an enhanced method to evaluate satellite vulnerability to micrometeoroids and orbital debris (MMOD), using the ESABASE2/Debris tool (developed under ESA contract). Starting from the estimation of induced failures on spacecraft (S/C) components and from the computation of lethal impacts (with an energy leading to the loss of the satellite), and considering the equipment redundancies and interactions between components, the debris-induced S/C functional impairment is assessed. The developed methodology, illustrated through its application to a case study satellite, includes the capability to estimate the number of failures on internal components, overcoming the limitations of current tools which do not allow propagating the debris cloud inside the S/C. The ballistic limit of internal equipment behind a sandwich panel structure is evaluated through the implementation of the Schäfer Ryan Lambert (SRL) Ballistic Limit Equation (BLE).

  12. Longevity and optimal health: working toward an integrative methodology.

    PubMed

    Oz, Mehmet; Tallent, Jeremy

    2009-08-01

    Efforts to foster a research dialogue between traditions as seemingly divergent as Western biomedicine and Indo-Tibetan medical and self-regulatory practice require a carefully conceived set of methodological guidelines. To approach a useful methodology, some specific structural differences between traditions must be negotiated, for example the Indo-Tibetan emphasis on holism in medicine and ethics, which appears to run contrary to Western trends toward specialization in both clinical and research contexts. Certain pitfalls must be avoided as well, including the tendency to appropriate elements of either tradition in a reductionistic manner. However, research methods offering creative solutions to these problems are now emerging, successfully engendering quantitative insight without subsuming one tradition within the terms of the other. Only through continued, creative work exploring both the potentials and limitations of this dialogue can collaborative research insight be attained, and an appropriate and useful set of methodological principles be approached.

  13. Measuring individual differences in responses to date-rape vignettes using latent variable models.

    PubMed

    Tuliao, Antover P; Hoffman, Lesa; McChargue, Dennis E

    2017-01-01

    Vignette methodology can be a flexible and powerful way to examine individual differences in response to dangerous real-life scenarios. However, most studies underutilize the usefulness of such methodology by analyzing only one outcome, which limits the ability to track event-related changes (e.g., vacillation in risk perception). The current study was designed to illustrate the dynamic influence of risk perception on exit point from a date-rape vignette. Our primary goal was to provide an illustrative example of how to use latent variable models for vignette methodology, including latent growth curve modeling with piecewise slopes, as well as latent variable measurement models. Through the combination of a step-by-step exposition in this text and corresponding model syntax available electronically, we detail an alternative statistical "blueprint" to enhance future violence research efforts using vignette methodology. Aggr. Behav. 43:60-73, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Methodological decisions and the evaluation of possible effects of different family structures on children: The new family structures survey (NFSS).

    PubMed

    Schumm, Walter R

    2012-11-01

    Every social science researcher must make a number of methodological decisions when planning and implementing research projects. Each such decision carries with it both advantages and limitations. The decisions faced and made by Regnerus (2012) are discussed here in the wider context of social science literature regarding same-sex parenting. Even though the apparent outcomes of Regnerus's study were unpopular, the methodological decisions he made in the design and implementation of the New Family Structures Survey were not uncommon among social scientists, including many progressive, gay and lesbian scholars. These decisions and the research they produced deserve considerable and continued discussion, but criticisms of the underlying ethics and professionalism are misplaced because nearly every methodological decision that was made has ample precedents in research published by many other credible and distinguished scholars. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Response Time Analysis and Test of Protection System Instrument Channels for APR1400 and OPR1000

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

    Lee, Chang Jae; Han, Seung; Yun, Jae Hee

    2015-07-01

    Safety limits are required to maintain the integrity of physical barriers designed to prevent the uncontrolled release of radioactive materials in nuclear power plants. The safety analysis establishes two critical constraints that include an analytical limit in terms of a measured or calculated variable, and a specific time after the analytical limit is reached to begin protective action. Keeping with the nuclear regulations and industry standards, satisfying these two requirements will ensure that the safety limit will not be exceeded during the design basis event, either an anticipated operational occurrence or a postulated accident. Various studies on the setpoint determinationmore » methodology for the safety-related instrumentation have been actively performed to ensure that the requirement of the analytical limit is satisfied. In particular, the protection setpoint methodology for the advanced power reactor 1400 (APP1400) and the optimized power reactor 1000 (OPR1000) has been recently developed to cover both the design basis event and the beyond design basis event. The developed setpoint methodology has also been quantitatively validated using specific computer programs and setpoint calculations. However, the safety of nuclear power plants cannot be fully guaranteed by satisfying the requirement of the analytical limit. In spite of the response time verification requirements of nuclear regulations and industry standards, it is hard to find the studies on the systematically integrated methodology regarding the response time evaluation. In cases of APR1400 and OPR1000, the response time analysis for the plant protection system is partially included in the setpoint calculation and the response time test is separately performed via the specific plant procedure. The test technique has a drawback which is the difficulty to demonstrate completeness of timing test. The analysis technique has also a demerit of resulting in extreme times that not actually possible. Thus, the establishment of the systematic response time evaluation methodology is needed to justify the conformance to the response time requirement used in the safety analysis. This paper proposes the response time evaluation methodology for APR1400 and OPR1000 using the combined analysis and test technique to confirm that the plant protection system can meet the analytical response time assumed in the safety analysis. In addition, the results of the quantitative evaluation performed for APR1400 and OPR1000 are presented in this paper. The proposed response time analysis technique consists of defining the response time requirement, determining the critical signal path for the trip parameter, allocating individual response time to each component on the signal path, and analyzing the total response time for the trip parameter, and demonstrates that the total analyzed response time does not exceed the response time requirement. The proposed response time test technique is composed of defining the response time requirement, determining the critical signal path for the trip parameter, determining the test method for each component on the signal path, performing the response time test, and demonstrates that the total test result does not exceed the response time requirement. The total response time should be tested in a single test that covers from the sensor to the final actuation device on the instrument channel. When the total channel is not tested in a single test, separate tests on groups of components or single components including the total instrument channel shall be combined to verify the total channel response. For APR1400 and OPR1000, the ramp test technique is used for the pressure and differential pressure transmitters and the step function testing technique is applied to the signal processing equipment and final actuation device. As a result, it can be demonstrated that the response time requirement is satisfied by the combined analysis and test technique. Therefore, the proposed methodology in this paper plays a crucial role in guaranteeing the safety of the nuclear power plants systematically satisfying one of two critical requirements from the safety analysis. (authors)« less

  16. Plasma rich in growth factors had limited effect on early bone formation in extraction sockets: Response to "Anitua, E., Alkhraisat, M.H. & Orive, G. (2013) Letter to the Editor: Rigorous methodology is the school of coherent conclusions in science. European Journal of Oral Implantology 6: 9-11.".

    PubMed

    Farina, Roberto; Bressan, Eriberto; Taut, Andrei; Cucchi, Alessandro; Trombelli, Leonardo

    2014-10-01

    To address the criticisms raised by Anitua et al. (European Journal of Oral Implantology, 6, 2013, 9-11) to the article "Plasma Rich in Growth Factors (PRGF) in Human Post-Extraction Sockets: an Histological and Histomorphometric Study.", recently published by Farina and colleagues (Clinical Oral Implants Research 2012; doi: 10.1111/clr.12033). All the methodological aspects criticized in the letter by Anitua et al. were thoroughly reconsidered and discussed in a structured short communication. When indicated, pertinent, additional material was included to reinforce our considerations. As most clinical studies in implant dentistry, including previous studies evaluating the efficacy/effectiveness of PRGF, the study by Farina et al. has some limitations. However, it is currently the only published controlled trial using quantitative parameters related to PRGF-induced early bone formation. Despite all limitations, the results of the study by Farina et al., which were based on different quantitative parameters (micro-CT scan, immunohistochemical markers of wound healing and bone deposition), indicated a limited effect of PRGF on early bone formation in extraction sockets. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

    PubMed Central

    Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

    2015-01-01

    Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety. PMID:26246841

  18. A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome.

    PubMed

    Lauche, Romy; Cramer, Holger; Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

    2015-01-01

    Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

  19. Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

    PubMed Central

    Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

    2014-01-01

    Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

  20. Exploring the Benefits of Respite Services to Family Caregivers: Methodological Issues and Current Findings

    PubMed Central

    Zarit, Steven H.; Liu, Yin; Bangerter, Lauren R.; Rovine, Michael J.

    2017-01-01

    Objectives There is growing emphasis on empirical validation of the efficacy of community-based services for older people and their families, but research on services such as respite care faces methodological challenges that have limited the growth of outcome studies. We identify problems associated with the usual research approaches for studying respite care, with the goal of stimulating use of novel and more appropriate research designs that can lead to improved studies of community-based services. Method Using the concept of research validity, we evaluate the methodological approaches in the current literature on respite services, including adult day services, in-home respite and overnight respite. Results Although randomized control trials (RCTs) are possible in community settings, validity is compromised by practical limitations of randomization and other problems. Quasi-experimental and interrupted time series designs offer comparable validity to RCTs and can be implemented effectively in community settings. Conclusion An emphasis on RCTs by funders and researchers is not supported by scientific evidence. Alternative designs can lead to development of a valid body of research on community services such as respite. PMID:26729467

  1. Exploring the benefits of respite services to family caregivers: methodological issues and current findings.

    PubMed

    Zarit, Steven H; Bangerter, Lauren R; Liu, Yin; Rovine, Michael J

    2017-03-01

    There is growing emphasis on empirical validation of the efficacy of community-based services for older people and their families, but research on services such as respite care faces methodological challenges that have limited the growth of outcome studies. We identify problems associated with the usual research approaches for studying respite care, with the goal of stimulating use of novel and more appropriate research designs that can lead to improved studies of community-based services. Using the concept of research validity, we evaluate the methodological approaches in the current literature on respite services, including adult day services, in-home respite and overnight respite. Although randomized control trials (RCTs) are possible in community settings, validity is compromised by practical limitations of randomization and other problems. Quasi-experimental and interrupted time series designs offer comparable validity to RCTs and can be implemented effectively in community settings. An emphasis on RCTs by funders and researchers is not supported by scientific evidence. Alternative designs can lead to development of a valid body of research on community services such as respite.

  2. Culturally competent social work research: methodological considerations for research with language minorities.

    PubMed

    Casado, Banghwa Lee; Negi, Nalini Junko; Hong, Michin

    2012-01-01

    Despite the growing number of language minorities, foreign-born individuals with limited English proficiency, this population has been largely left out of social work research, often due to methodological challenges involved in conducting research with this population. Whereas the professional standard calls for cultural competence, a discussion of how to implement strategies for culturally competent research with language minorities is regrettably limited in the social work literature. This article is, to the authors' knowledge, one of the first within the field of social work to tie together unique methodological issues that may arise throughout the research conceptualization, development, and implementation process with this population. Strategies for how to overcome such issues are provided by adapting and expanding on a conceptual framework by Meleis. The incorporation of such research practices with language minorities has the potential to enhance trust and, thus, improve the recruitment and retention of this hard-to-reach population. More important, studies that aim to include such culturally responsive criteria may produce results that have improved validity and, thus, contribute to the advancement of knowledge regarding this population.

  3. Psychosocial functioning and risk factors among siblings of children with cancer: An updated systematic review.

    PubMed

    Long, Kristin A; Lehmann, Vicky; Gerhardt, Cynthia A; Carpenter, Aubrey L; Marsland, Anna L; Alderfer, Melissa A

    2018-06-01

    Siblings' psychosocial adjustment to childhood cancer is poorly understood. This systematic review summarizes findings and limitations of the sibling literature since 2008, provides clinical recommendations, and offers future research directions. MEDLINE/Pubmed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched for articles related to siblings, psychosocial functioning, and pediatric cancer. After systematic screening, studies meeting inclusion criteria were rated for scientific merit, and findings were extracted and synthesized. In total, 102 studies were included (63 quantitative, 35 qualitative, 4 mixed-methods). Methodological limitations are common. Mean levels of anxiety, depression, and general adjustment are similar across siblings and comparisons, but symptoms of cancer-related posttraumatic stress are prevalent. School-aged siblings display poorer academic functioning and more absenteeism but similar peer relationships as peers. Quality of life findings are mixed. Adult siblings engage in higher levels of risky health behaviors and may have poorer health outcomes than comparisons. Risk factors for poor sibling adjustment include lower social support, poorer family functioning, lower income, non-White race, and shorter time since diagnosis, but findings are inconsistent. Qualitative themes include siblings' maturity, compassion, and autonomy, but also strong negative emotions, uncertainty, family disruptions, limited parental support, school problems, altered friendships, and unmet needs. Despite methodological limitations, research indicates a strong need for sibling support. Clinical recommendations include identifying at-risk siblings and developing interventions to facilitate family communication and increase siblings' social support, cancer-related knowledge, and treatment involvement. Future longitudinal studies focusing on mechanisms and moderators of siblings' adjustment would inform timing and targets of psychosocial care. Copyright © 2018 John Wiley & Sons, Ltd.

  4. CPR methodology with new steady-state criterion and more accurate statistical treatment of channel bow

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

    Baumgartner, S.; Bieli, R.; Bergmann, U. C.

    2012-07-01

    An overview is given of existing CPR design criteria and the methods used in BWR reload analysis to evaluate the impact of channel bow on CPR margins. Potential weaknesses in today's methodologies are discussed. Westinghouse in collaboration with KKL and Axpo - operator and owner of the Leibstadt NPP - has developed an optimized CPR methodology based on a new criterion to protect against dryout during normal operation and with a more rigorous treatment of channel bow. The new steady-state criterion is expressed in terms of an upper limit of 0.01 for the dryout failure probability per year. This ismore » considered a meaningful and appropriate criterion that can be directly related to the probabilistic criteria set-up for the analyses of Anticipated Operation Occurrences (AOOs) and accidents. In the Monte Carlo approach a statistical modeling of channel bow and an accurate evaluation of CPR response functions allow the associated CPR penalties to be included directly in the plant SLMCPR and OLMCPR in a best-estimate manner. In this way, the treatment of channel bow is equivalent to all other uncertainties affecting CPR. Emphasis is put on quantifying the statistical distribution of channel bow throughout the core using measurement data. The optimized CPR methodology has been implemented in the Westinghouse Monte Carlo code, McSLAP. The methodology improves the quality of dryout safety assessments by supplying more valuable information and better control of conservatisms in establishing operational limits for CPR. The methodology is demonstrated with application examples from the introduction at KKL. (authors)« less

  5. Systematic Review of Integrative Health Care Research: Randomized Control Trials, Clinical Controlled Trials, and Meta-Analysis

    PubMed Central

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

    2011-01-01

    A systematic review was conducted to assess the level of evidence for integrative health care research. We searched PubMed, Allied and Complementary Medicine (AMED), BIOSIS Previews, EMBASE, the entire Cochrane Library, MANTIS, Social SciSearch, SciSearch Cited Ref Sci, PsychInfo, CINAHL, and NCCAM grantee publications listings, from database inception to May 2009, as well as searches of the “gray literature.” Available studies published in English language were included. Three independent reviewers rated each article and assessed the methodological quality of studies using the Scottish Intercollegiate Guidelines Network (SIGN 50). Our search yielded 11,891 total citations but 6 clinical studies, including 4 randomized, met our inclusion criteria. There are no available systematic reviews/meta-analyses published that met our inclusion criteria. The methodological quality of the included studies was assessed independently using quality checklists of the SIGN 50. Only a small number of RCTs and CCTs with a limited number of patients and lack of adequate control groups assessing integrative health care research are available. These studies provide limited evidence of effective integrative health care on some modalities. However, integrative health care regimen appears to be generally safe. PMID:20953383

  6. Methodological quality and descriptive characteristics of prosthodontic-related systematic reviews.

    PubMed

    Aziz, T; Compton, S; Nassar, U; Matthews, D; Ansari, K; Flores-Mir, C

    2013-04-01

    Ideally, healthcare systematic reviews (SRs) should be beneficial to practicing professionals in making evidence-based clinical decisions. However, the conclusions drawn from SRs are directly related to the quality of the SR and of the included studies. The aim was to investigate the methodological quality and key descriptive characteristics of SRs published in prosthodontics. Methodological quality was analysed using the Assessment of Multiple Reviews (AMSTAR) tool. Several electronic resources (MEDLINE, EMBASE, Web of Science and American Dental Association's Evidence-based Dentistry website) were searched. In total 106 SRs were located. Key descriptive characteristics and methodological quality features were gathered and assessed, and descriptive and inferential statistical testing performed. Most SRs in this sample originated from the European continent followed by North America. Two to five authors conducted most SRs; the majority was affiliated with academic institutions and had prior experience publishing SRs. The majority of SRs were published in specialty dentistry journals, with implant or implant-related topics, the primary topics of interest for most. According to AMSTAR, most quality aspects were adequately fulfilled by less than half of the reviews. Publication bias and grey literature searches were the most poorly adhered components. Overall, the methodological quality of the prosthodontic-related systematic was deemed limited. Future recommendations would include authors to have prior training in conducting SRs and for journals to include a universal checklist that should be adhered to address all key characteristics of an unbiased SR process. © 2013 Blackwell Publishing Ltd.

  7. The impact of community-based arts and health interventions on cognition in people with dementia: a systematic literature review.

    PubMed

    Young, Rhea; Camic, Paul M; Tischler, Victoria

    2016-01-01

    Dementia is a progressive condition, affecting increasing numbers of people, characterised by cognitive decline. The current systematic review aimed to evaluate research pertaining to the impact of arts and health interventions on cognition in people with dementia. A literature search was conducted utilising PsychInfo, Cochrane Reviews, Web of Science, Medline and British Humanities Index databases. Seventeen studies were included in the review, including those related to literary, performing and visual arts. The review highlighted this as an emerging area of research with the literature consisting largely of small-scale studies with methodological limitations including lack of control groups and often poorly defined samples. All the studies suggested, however, that arts-based activities had a positive impact on cognitive processes, in particular on attention, stimulation of memories, enhanced communication and engagement with creative activities. The existent literature suggests that arts activities are helpful interventions within dementia care. A consensus has yet to emerge, however, about the direction for future research including the challenge of measurement and the importance of methodological flexibility. It is suggested that further research address some of these limitations by examining whether the impact of interventions vary depending on cognitive ability and to continue to assess how arts interventions can be of use across the stages of dementia.

  8. School-Based Sleep Education Programs for Short Sleep Duration in Adolescents: A Systematic Review and Meta-Analysis.

    PubMed

    Chung, Ka-Fai; Chan, Man-Sum; Lam, Ying-Yin; Lai, Cindy Sin-Yee; Yeung, Wing-Fai

    2017-06-01

    Insufficient sleep among students is a major school health problem. School-based sleep education programs tailored to reach large number of students may be one of the solutions. A systematic review and meta-analysis was conducted to summarize the programs' effectiveness and current status. Electronic databases were searched up until May 2015. Randomized controlled trials of school-based sleep intervention among 10- to 19-year-old students with outcome on total sleep duration were included. Methodological quality of the studies was assessed using the Cochrane's risk of bias assessment. Seven studies were included, involving 1876 students receiving sleep education programs and 2483 attending classes-as-usual. Four weekly 50-minute sleep education classes were most commonly provided. Methodological quality was only moderate, with a high or an uncertain risk of bias in several domains. Compared to classes-as-usual, sleep education programs produced significantly longer weekday and weekend total sleep time and better mood among students at immediate post-treatment, but the improvements were not maintained at follow-up. Limited by the small number of studies and methodological limitations, the preliminary data showed that school-based sleep education programs produced short-term benefits. Future studies should explore integrating sleep education with delayed school start time or other more effective approaches. © 2017, American School Health Association.

  9. Analytical and simulator study of advanced transport

    NASA Technical Reports Server (NTRS)

    Levison, W. H.; Rickard, W. W.

    1982-01-01

    An analytic methodology, based on the optimal-control pilot model, was demonstrated for assessing longitidunal-axis handling qualities of transport aircraft in final approach. Calibration of the methodology is largely in terms of closed-loop performance requirements, rather than specific vehicle response characteristics, and is based on a combination of published criteria, pilot preferences, physical limitations, and engineering judgment. Six longitudinal-axis approach configurations were studied covering a range of handling qualities problems, including the presence of flexible aircraft modes. The analytical procedure was used to obtain predictions of Cooper-Harper ratings, a solar quadratic performance index, and rms excursions of important system variables.

  10. Game-based interventions and their impact on dementia: a narrative review.

    PubMed

    Zheng, Jiaying; Chen, Xueping; Yu, Ping

    2017-12-01

    The aim of this review was to examine the efficacy of game-based interventions for people with dementia. Seven studies that met the inclusion criteria were found in four databases. Their interventions and key findings were analysed and synthesised. Game-based interventions for people with dementia are showing promise for improving cognition, coordination and behavioural and psychological symptoms. The generalisability of the findings is limited by weak methodology and small sample size. Game-based interventions can improve cognition, coordination and behavioural and psychological symptoms for people with dementia. Future research should include methodological improvement and practice guideline development.

  11. Methodology for estimating helicopter performance and weights using limited data

    NASA Technical Reports Server (NTRS)

    Baserga, Claudio; Ingalls, Charles; Lee, Henry; Peyran, Richard

    1990-01-01

    Methodology is developed and described for estimating the flight performance and weights of a helicopter for which limited data are available. The methodology is based on assumptions which couple knowledge of the technology of the helicopter under study with detailed data from well documented helicopters thought to be of similar technology. The approach, analysis assumptions, technology modeling, and the use of reference helicopter data are discussed. Application of the methodology is illustrated with an investigation of the Agusta A129 Mangusta.

  12. Examining Factors Influencing Attrition at a Small, Private, Selective Liberal Arts College

    ERIC Educational Resources Information Center

    Gansemer-Topf, Ann M.; Zhang, Yi; Beatty, Cameron C.; Paja, Scott

    2014-01-01

    Despite a diverse body of literature on college student retention, studies focusing on small, private, selective liberal arts colleges are limited. This study utilized a mixed methodology beginning with logistic regression analyses and followed with a qualitative inquiry that included interviews with students who had not persisted. While variables…

  13. 75 FR 81667 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses Involving No...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ...-Filing system does not support unlisted software, and the NRC Meta System Help Desk will not be able to... Setpoint Methodology for LSSS [Limiting Safety System Setting] Functions,'' which included the instrument... System Instrumentation,'' Function 3, Condensate Storage Tank Level--Low. The supporting TS Bases will...

  14. Using Photovoice to Initiate Improvement in a PETE Program

    ERIC Educational Resources Information Center

    Walker, Ashley; Langdon, Jody L.; Colquitt, Gavin; McCollum, Starla

    2017-01-01

    There is limited research that includes democratic practices to evaluate the PETE program in its ability to prepare preservice teachers (PTs). In other areas such as community health, methodologies have been used to provide a voice to individuals living the experience. The purpose of this study was to examine PTs' perceptions of a teacher…

  15. 78 FR 332 - Self-Regulatory Organizations; ICE Clear Europe Limited; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-03

    ..., the SPAN Arrays published by ICE Clear Europe include the Volatility Risk Credit Rate (the Offset Rate... Rule Change Related to SPAN Margin Methodology Enhancements to Inter-Contract Credits and Average..., the Proposed Rule Change In addition to providing clearing services for credit default swaps, ICE...

  16. Public and Private School Costs. A Local Analysis, 1994.

    ERIC Educational Resources Information Center

    Public Policy Forum, Inc., Milwaukee, WI.

    This document presents findings of a study that identified key factors of cost-per-pupil differences between public and private school spending among selected Milwaukee area public and private schools. The analysis was limited to cost factors only, specifically, to per-pupil spending. Methodology included a review of the school budgets of 7 public…

  17. A Gender Wellbeing Composite Indicator: The Best-Worst Global Evaluation Approach

    ERIC Educational Resources Information Center

    Dominguez-Serrano, Monica; Blancas, Francisco Javier

    2011-01-01

    In this paper we present a new global evaluation methodology for constructing composite indicators. Given the limitations in the construction of wellbeing indicators that include a gender perspective, this paper proposes separate measures for men and women, using new linear programming models to improve the traditional Data Envelopment Analysis…

  18. Research design in end-of-life research: state of science.

    PubMed

    George, Linda K

    2002-10-01

    The volume of research on end-of-life care, death, and dying has exploded during the past decade. This article reviews the conceptual and methodological adequacy of end-of-life research to date, focusing on limitations of research to date and ways of improving future research. A systematic search was conducted to identify the base of end-of-life research. Approximately 400 empirical articles were identified and are the basis of this review. Although much has been learned from research to date, limitations in the knowledge base are substantial. The most fundamental problems identified are conceptual and include failure to define dying; neglect of the distinctions among quality of life, quality of death, and quality of end-of-life care. Methodologically, the single greatest problem is the lack of longitudinal studies that cover more than the time period immediately before death. Gaps in the research base include insufficient attention to psychological and spiritual issues, the prevalence of psychiatric disorder and the effectiveness of the treatment of such disorders among dying persons, provider and health system variables, social and cultural diversity, and the effects of comorbidity on trajectories of dying.

  19. Narrative synthesis of equine-assisted psychotherapy literature: Current knowledge and future research directions.

    PubMed

    Lee, Ping-Tzu; Dakin, Emily; McLure, Merinda

    2016-05-01

    Equine-assisted psychotherapy (EAP) is an innovative emerging approach to mental health treatment. This narrative synthesis explores the current state of knowledge and areas for future research in EAP. Specifically reviewed are qualitative and quantitative empirical studies, including both articles published in peer-reviewed journals and research presented in theses and dissertations. We selected 24 studies for final inclusion in this study, dating between 2005 and 2013, and including the first EAP empirical research completed in 2005. Four of these studies are peer-reviewed journal articles, while 20 are master's theses or doctoral dissertations. The reviewed qualitative research provides initial evidence for the value of EAP for enhancing adolescents' communication and relationship skills. The reviewed experimental and quasi-experimental research provides initial evidence for the value of EAP for enhancing children's and adolescents' emotional, social and behavioural functioning. Yet, conclusions about the effectiveness of EAP must still be considered preliminary due to various methodological limitations in the reviewed research. The narrative review describes these methodological limitations and concludes with recommendations for future research. © 2015 John Wiley & Sons Ltd.

  20. Advanced statistical analysis of Raman spectroscopic data for the identification of body fluid traces: semen and blood mixtures.

    PubMed

    Sikirzhytski, Vitali; Sikirzhytskaya, Aliaksandra; Lednev, Igor K

    2012-10-10

    Conventional confirmatory biochemical tests used in the forensic analysis of body fluid traces found at a crime scene are destructive and not universal. Recently, we reported on the application of near-infrared (NIR) Raman microspectroscopy for non-destructive confirmatory identification of pure blood, saliva, semen, vaginal fluid and sweat. Here we expand the method to include dry mixtures of semen and blood. A classification algorithm was developed for differentiating pure body fluids and their mixtures. The classification methodology is based on an effective combination of Support Vector Machine (SVM) regression (data selection) and SVM Discriminant Analysis of preprocessed experimental Raman spectra collected using an automatic mapping of the sample. This extensive cross-validation of the obtained results demonstrated that the detection limit of the minor contributor is as low as a few percent. The developed methodology can be further expanded to any binary mixture of complex solutions, including but not limited to mixtures of other body fluids. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Mind-body Therapies for Menopausal Symptoms: A Systematic Review

    PubMed Central

    Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek

    2010-01-01

    Objective To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. Methods To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Results Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Conclusions Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. PMID:20167444

  2. A review of economic evaluations of behavior change interventions: setting an agenda for research methods and practice.

    PubMed

    Alayli-Goebbels, Adrienne F G; Evers, Silvia M A A; Alexeeva, Daria; Ament, André J H A; de Vries, Nanne K; Tilly, Jan C; Severens, Johan L

    2014-06-01

    The objective of this study was to review methodological quality of economic evaluations of lifestyle behavior change interventions (LBCIs) and to examine how they address methodological challenges for public health economic evaluation identified in the literature. Pubmed and the NHS economic evaluation database were searched for published studies in six key areas for behavior change: smoking, physical activity, dietary behavior, (illegal) drug use, alcohol use and sexual behavior. From included studies (n = 142), we extracted data on general study characteristics, characteristics of the LBCIs, methodological quality and handling of methodological challenges. Economic evaluation evidence for LBCIs showed a number of weaknesses: methods, study design and characteristics of evaluated interventions were not well reported; methodological quality showed several shortcomings and progress with addressing methodological challenges remained limited. Based on the findings of this review we propose an agenda for improving future evidence to support decision-making. Recommendations for practice include improving reporting of essential study details and increasing adherence with good practice standards. Recommendations for research methods focus on mapping out complex causal pathways for modeling, developing measures to capture broader domains of wellbeing and community outcomes, testing methods for considering equity, identifying relevant non-health sector costs and advancing methods for evidence synthesis. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Agile methodology selection criteria: IT start-up case study

    NASA Astrophysics Data System (ADS)

    Micic, Lj

    2017-05-01

    Project management in modern IT companies is often based on agile methodologies which have several advantages compared to traditional methodologies such is waterfall. Having in mind that clients sometimes change project during development it is crucial for an IT company to choose carefully which methodology is going to implement and is it going to be mostly based on one or is it going got be combination of several. There are several modern and often used methodologies but among those Scrum, Kanban and XP programming are usually the most common. Sometimes companies use mostly tools and procedures from one but quite often they use some of the combination of those methodologies. Having in mind that those methodologies are just a framework they allow companies to adapt it for their specific projects as well as for other limitations. These methodologies are in limited usage Bosnia but more and more IT companies are starting to use agile methodologies because it is practice and common not just for their clients abroad but also starting to be the only option in order to deliver quality product on time. However it is always challenging which methodology or combination of several companies should implement and how to connect it to its own project, organizational framework and HR management. This paper presents one case study based on local IT start up and delivers solution based on theoretical framework and practical limitations that case company has.

  4. Study protocol for a scoping review on rehabilitation scoping reviews.

    PubMed

    Colquhoun, Heather L; Jesus, Tiago S; O'Brien, Kelly K; Tricco, Andrea C; Chui, Adora; Zarin, Wasifa; Lillie, Erin; Hitzig, Sander L; Straus, Sharon

    2017-09-01

    Scoping reviews are increasingly popular in rehabilitation. However, significant variability in scoping review conduct and reporting currently exists, limiting potential for the methodology to advance rehabilitation research, practice and policy. Our aim is to conduct a scoping review of rehabilitation scoping reviews in order to examine the current volume, yearly distribution, proportion, scope and methodological practices involved in the conduct of scoping reviews in rehabilitation. Key areas of methodological improvement will be described. Methods and analysis: We will undertake the review using the Arksey and O'Malley scoping review methodology. Our search will involve two phases. The first will combine a previously conducted scoping review of scoping reviews (not distinct to rehabilitation, with data current to July 2014) together with a rehabilitation keyword search in PubMed. Articles found in the first phase search will undergo a full text review. The second phase will include an update of the previously conducted scoping review of scoping reviews (July 2014 to current). This update will include the search of nine electronic databases, followed by title and abstract screening as well as a full text review. All screening and extraction will be performed independently by two authors. Articles will be included if they are scoping reviews within the field of rehabilitation. A consultation exercise with key targets will inform plans to improve rehabilitation scoping reviews. Ethics and dissemination: Ethics will be required for the consultation phase of our scoping review. Dissemination will include peer-reviewed publication and conferences in rehabilitation-specific contexts.

  5. Integrating teamwork, clinician occupational well-being and patient safety - development of a conceptual framework based on a systematic review.

    PubMed

    Welp, Annalena; Manser, Tanja

    2016-07-19

    There is growing evidence that teamwork in hospitals is related to both patient outcomes and clinician occupational well-being. Furthermore, clinician well-being is associated with patient safety. Despite considerable research activity, few studies include all three concepts, and their interrelations have not yet been investigated systematically. To advance our understanding of these potentially complex interrelations we propose an integrative framework taking into account current evidence and research gaps identified in a systematic review. We conducted a literature search in six major databases (Medline, PsycArticles, PsycInfo, Psyndex, ScienceDirect, and Web of Knowledge). Inclusion criteria were: peer reviewed papers published between January 2000 and June 2015 investigating a statistical relationship between at least two of the three concepts; teamwork, patient safety, and clinician occupational well-being in hospital settings, including practicing nurses and physicians. We assessed methodological quality using a standardized rating system and qualitatively appraised and extracted relevant data, such as instruments, analyses and outcomes. The 98 studies included in this review were highly diverse regarding quality, methodology and outcomes. We found support for the existence of independent associations between teamwork, clinician occupational well-being and patient safety. However, we identified several conceptual and methodological limitations. The main barrier to advancing our understanding of the causal relationships between teamwork, clinician well-being and patient safety is the lack of an integrative, theory-based, and methodologically thorough approach investigating the three concepts simultaneously and longitudinally. Based on psychological theory and our findings, we developed an integrative framework that addresses these limitations and proposes mechanisms by which these concepts might be linked. Knowledge about the mechanisms underlying the relationships between these concepts helps to identify avenues for future research, aimed at benefiting clinicians and patients by using the synergies between teamwork, clinician occupational well-being and patient safety.

  6. A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries.

    PubMed

    Liu, Liang Qin; Moody, Julie; Traynor, Michael; Dyson, Sue; Gall, Angela

    2014-11-01

    Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCIs). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. To critically appraise and synthesize the research evidence on ES for PU prevention and treatment in SCI. Review was limited to peer-reviewed studies published in English from 1970 to July 2013. Studies included randomized controlled trials (RCTs), non-RCTs, prospective cohort studies, case series, case control, and case report studies. Target population included adults with SCI. Interventions of any type of ES were accepted. Any outcome measuring effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments. Twenty-seven studies were included, 9 of 27 studies were RCTs. Six RCTs were therapeutic trials. ES enhanced PU healing in all 11 therapeutic studies. Two types of ES modalities were identified in therapeutic studies (surface electrodes, anal probe), four types of modalities in preventive studies (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular ES implant). The methodological quality of the studies was poor, in particular for prevention studies. A significant effect of ES on enhancement of PU healing is shown in limited Grade I evidence. The great variability in ES parameters, stimulating locations, and outcome measure leads to an inability to advocate any one standard approach for PU therapy or prevention. Future research is suggested to improve the design of ES devices, standardize ES parameters, and conduct more rigorous trials.

  7. A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries

    PubMed Central

    Liu, Liang Qin; Moody, Julie; Traynor, Michael; Dyson, Sue; Gall, Angela

    2014-01-01

    Context Electrical stimulation (ES) can confer benefit to pressure ulcer (PU) prevention and treatment in spinal cord injuries (SCIs). However, clinical guidelines regarding the use of ES for PU management in SCI remain limited. Objectives To critically appraise and synthesize the research evidence on ES for PU prevention and treatment in SCI. Method Review was limited to peer-reviewed studies published in English from 1970 to July 2013. Studies included randomized controlled trials (RCTs), non-RCTs, prospective cohort studies, case series, case control, and case report studies. Target population included adults with SCI. Interventions of any type of ES were accepted. Any outcome measuring effectiveness of PU prevention and treatment was included. Methodological quality was evaluated using established instruments. Results Twenty-seven studies were included, 9 of 27 studies were RCTs. Six RCTs were therapeutic trials. ES enhanced PU healing in all 11 therapeutic studies. Two types of ES modalities were identified in therapeutic studies (surface electrodes, anal probe), four types of modalities in preventive studies (surface electrodes, ES shorts, sacral anterior nerve root implant, neuromuscular ES implant). Conclusion The methodological quality of the studies was poor, in particular for prevention studies. A significant effect of ES on enhancement of PU healing is shown in limited Grade I evidence. The great variability in ES parameters, stimulating locations, and outcome measure leads to an inability to advocate any one standard approach for PU therapy or prevention. Future research is suggested to improve the design of ES devices, standardize ES parameters, and conduct more rigorous trials. PMID:24969965

  8. The factor structure of posttraumatic stress disorder: a literature update, critique of methodology, and agenda for future research.

    PubMed

    Elhai, Jon D; Palmieri, Patrick A

    2011-08-01

    We present an update of recent literature (since 2007) exploring the factor structure of posttraumatic stress disorder (PTSD) symptom measures. Research supporting a four-factor emotional numbing model and a four-factor dysphoria model is presented, with these models fitting better than all other models examined. Variables accounting for factor structure differences are reviewed, including PTSD query instructions, type of PTSD measure, extent of trauma exposure, ethnicity, and timing of administration. Methodological and statistical limitations with recent studies are presented. Finally, a research agenda and recommendations are offered to push this research area forward, including suggestions to validate PTSD’s factors against external measures of psychopathology, test moderators of factor structure, and examine heterogeneity of symptom presentations based on factor structure examination.

  9. Psychoanalysis and homosexuality: do we need a new theory?

    PubMed

    Auchincloss, E L; Vaughan, S C

    2001-01-01

    No need exists, it is argued, for a new psychoanalytic theory of homosexuality. Certainly psychoanalysis should not be expected to generate such a theory using its own methodology alone. The preoccupation with producing such a theory avoids more important questions about psychoanalytic theory building raised by an examination of the long relationship between psychoanalysis and homosexuality. These questions concern the problems related to using psychoanalytic methodology (1) to construct categories (including the categories normal and abnormal), (2) to construct causal theory (the problems include the limitations of psychoanalytic developmental theory and a long-standing confusion between psychoanalytic developmental theory, psychoanalytic genetic reconstruction, and psychodynamics), and (3) to identify "bedrock." Finally, the question is addressed of what might be needed that is new in the psychoanalytic approach to homosexuality.

  10. Review of methodological challenges in comparing the effectiveness of neoadjuvant chemotherapy versus primary debulking surgery for advanced ovarian cancer in the United States.

    PubMed

    Cole, Ashley L; Austin, Anna E; Hickson, Ryan P; Dixon, Matthew S; Barber, Emma L

    2018-05-11

    Randomized trials outside the U.S. have found non-inferior survival for neoadjuvant chemotherapy (NACT) versus primary debulking surgery (PDS) for advanced ovarian cancer (AOC). However, these trials reported lower overall survival and lower rates of optimal debulking than U.S. studies, leading to questions about generalizability to U.S. practice, where aggressive debulking is more common. Consequently, comparative effectiveness in the U.S. remains controversial. We reviewed U.S. comparative effectiveness studies of NACT versus PDS for AOC. Here we describe methodological challenges, compare results to trials outside the U.S., and make suggestions for future research. We identified U.S. studies published in 2010 or later that evaluated the comparative effectiveness of NACT versus PDS on survival in AOC through a PubMed search. Two independent reviewers abstracted data from eligible articles. Nine of 230 articles were eligible for review. Methodological challenges included unmeasured confounders, heterogeneous treatment effects, treatment variations over time, and inconsistent measurement of treatment and survival. Whereas some limitations were unavoidable, several limitations noted across studies were avoidable, including conditioning on mediating factors and immortal time introduced by measuring survival beginning from diagnosis. Without trials in the U.S., non-randomized studies are an important source of evidence for the ideal treatment for AOC. However, several methodological challenges exist when assessing the comparative effectiveness of NACT versus PDS in a non-randomized setting. Future observational studies must ensure that treatment is consistent throughout the study period and that treatment groups are comparable. Rapidly-evolving oncology data networks may allow for identification of treatment intent and other important confounders. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Oral Chinese proprietary medicine for angina pectoris: an overview of systematic reviews/meta-analyses.

    PubMed

    Luo, Jing; Xu, Hao; Yang, Guoyan; Qiu, Yu; Liu, Jianping; Chen, Keji

    2014-08-01

    Oral Chinese proprietary medicine (CPM) is commonly used to treat angina pectoris, and many relevant systematic reviews/meta-analyses are available. However, these reviews have not been systematically summarized and evaluated. We conducted an overview of these reviews, and explored their methodological and reporting quality to inform both practice and further research. We included systematic reviews/meta-analyses on oral CPM in treating angina until March 2013 by searching PubMed, Embase, the Cochrane Library and four Chinese databases. We extracted data according to a pre-designed form, and assessed the methodological and reporting characteristics of the reviews in terms of AMSTAR and PRISMA respectively. Most of the data analyses were descriptive. 36 systematic reviews/meta-analyses involving over 82,105 participants with angina reviewing 13 kinds of oral CPM were included. The main outcomes assessed in the reviews were surrogate outcomes (34/36, 94.4%), adverse events (31/36, 86.1%), and symptoms (30/36, 83.3%). Six reviews (6/36, 16.7%) drew definitely positive conclusions, while the others suggested potential benefits in the symptoms, electrocardiogram, and adverse events. The overall methodological and reporting quality of the reviews was limited, with many serious flaws such as the lack of review protocol and incomprehensive literature searches. Though many systematic reviews/meta-analyses on oral CPM for angina suggested potential benefits or definitely positive effects, stakeholders should interpret the findings of these reviews with caution, considering the overall limited methodological and reporting quality. We recommend further studies should be appropriately conducted and systematic reviews reported according to PRISMA standard. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Assessing the impact of healthcare research: A systematic review of methodological frameworks.

    PubMed

    Cruz Rivera, Samantha; Kyte, Derek G; Aiyegbusi, Olalekan Lee; Keeley, Thomas J; Calvert, Melanie J

    2017-08-01

    Increasingly, researchers need to demonstrate the impact of their research to their sponsors, funders, and fellow academics. However, the most appropriate way of measuring the impact of healthcare research is subject to debate. We aimed to identify the existing methodological frameworks used to measure healthcare research impact and to summarise the common themes and metrics in an impact matrix. Two independent investigators systematically searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica Database (EMBASE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL+), the Health Management Information Consortium, and the Journal of Research Evaluation from inception until May 2017 for publications that presented a methodological framework for research impact. We then summarised the common concepts and themes across methodological frameworks and identified the metrics used to evaluate differing forms of impact. Twenty-four unique methodological frameworks were identified, addressing 5 broad categories of impact: (1) 'primary research-related impact', (2) 'influence on policy making', (3) 'health and health systems impact', (4) 'health-related and societal impact', and (5) 'broader economic impact'. These categories were subdivided into 16 common impact subgroups. Authors of the included publications proposed 80 different metrics aimed at measuring impact in these areas. The main limitation of the study was the potential exclusion of relevant articles, as a consequence of the poor indexing of the databases searched. The measurement of research impact is an essential exercise to help direct the allocation of limited research resources, to maximise research benefit, and to help minimise research waste. This review provides a collective summary of existing methodological frameworks for research impact, which funders may use to inform the measurement of research impact and researchers may use to inform study design decisions aimed at maximising the short-, medium-, and long-term impact of their research.

  13. Life Cycle Assessment and Carbon Footprint in the Wine Supply-Chain

    NASA Astrophysics Data System (ADS)

    Pattara, Claudio; Raggi, Andrea; Cichelli, Angelo

    2012-06-01

    Global warming represents one of the most critical internationally perceived environmental issues. The growing, and increasingly global, wine sector is one of the industries which is under increasing pressure to adopt approaches for environmental assessment and reporting of product-related greenhouse gas emissions. The International Organization for Vine and Wine has recently recognized the need to develop a standard and objective methodology and a related tool for calculating carbon footprint (CF). This study applied this tool to a wine previously analyzed using the life cycle assessment (LCA) methodology. The objective was to test the tool as regards both its potential and possible limitations, and thus to assess its suitability as a standard tool. Despite the tool's user-friendliness, a number of limitations were noted including the lack of accurate baseline data, a partial system boundary and the impossibility of dealing with the multi-functionality issue. When the CF and LCA results are compared in absolute terms, large discrepancies become obvious due to a number of different assumptions, as well as the modeling framework adopted. Nonetheless, in relative terms the results seem to be quite consistent. However, a critical limitation of the CF methodology was its focus on a single issue, which can lead to burden shifting. In conclusion, the study confirmed the need for both further improvement and adaptation to additional contexts and further studies to validate the use of this tool in different companies.

  14. Life cycle assessment and carbon footprint in the wine supply-chain.

    PubMed

    Pattara, Claudio; Raggi, Andrea; Cichelli, Angelo

    2012-06-01

    Global warming represents one of the most critical internationally perceived environmental issues. The growing, and increasingly global, wine sector is one of the industries which is under increasing pressure to adopt approaches for environmental assessment and reporting of product-related greenhouse gas emissions. The International Organization for Vine and Wine has recently recognized the need to develop a standard and objective methodology and a related tool for calculating carbon footprint (CF). This study applied this tool to a wine previously analyzed using the life cycle assessment (LCA) methodology. The objective was to test the tool as regards both its potential and possible limitations, and thus to assess its suitability as a standard tool. Despite the tool's user-friendliness, a number of limitations were noted including the lack of accurate baseline data, a partial system boundary and the impossibility of dealing with the multi-functionality issue. When the CF and LCA results are compared in absolute terms, large discrepancies become obvious due to a number of different assumptions, as well as the modeling framework adopted. Nonetheless, in relative terms the results seem to be quite consistent. However, a critical limitation of the CF methodology was its focus on a single issue, which can lead to burden shifting. In conclusion, the study confirmed the need for both further improvement and adaptation to additional contexts and further studies to validate the use of this tool in different companies.

  15. A Comparative Analysis of Disaster Risk, Vulnerability and Resilience Composite Indicators.

    PubMed

    Beccari, Benjamin

    2016-03-14

    In the past decade significant attention has been given to the development of tools that attempt to measure the vulnerability, risk or resilience of communities to disasters. Particular attention has been given to the development of composite indices to quantify these concepts mirroring their deployment in other fields such as sustainable development. Whilst some authors have published reviews of disaster vulnerability, risk and resilience composite indicator methodologies, these have been of a limited nature. This paper seeks to dramatically expand these efforts by analysing 106 composite indicator methodologies to understand the breadth and depth of practice. An extensive search of the academic and grey literature was undertaken for composite indicator and scorecard methodologies that addressed multiple/all hazards; included social and economic aspects of risk, vulnerability or resilience; were sub-national in scope; explained the method and variables used; focussed on the present-day; and, had been tested or implemented. Information on the index construction, geographic areas of application, variables used and other relevant data was collected and analysed. Substantial variety in construction practices of composite indicators of risk, vulnerability and resilience were found. Five key approaches were identified in the literature, with the use of hierarchical or deductive indices being the most common. Typically variables were chosen by experts, came from existing statistical datasets and were combined by simple addition with equal weights. A minimum of 2 variables and a maximum of 235 were used, although approximately two thirds of methodologies used less than 40 variables. The 106 methodologies used 2298 unique variables, the most frequently used being common statistical variables such as population density and unemployment rate. Classification of variables found that on average 34% of the variables used in each methodology related to the social environment, 25% to the disaster environment, 20% to the economic environment, 13% to the built environment, 6% to the natural environment and 3% were other indices. However variables specifically measuring action to mitigate or prepare for disasters only comprised 12%, on average, of the total number of variables in each index. Only 19% of methodologies employed any sensitivity or uncertainty analysis and in only a single case was this comprehensive. A number of potential limitations of the present state of practice and how these might impact on decision makers are discussed. In particular the limited deployment of sensitivity and uncertainty analysis and the low use of direct measures of disaster risk, vulnerability and resilience could significantly limit the quality and reliability of existing methodologies. Recommendations for improvements to indicator development and use are made, as well as suggested future research directions to enhance the theoretical and empirical knowledge base for composite indicator development.

  16. A Comparative Analysis of Disaster Risk, Vulnerability and Resilience Composite Indicators

    PubMed Central

    Beccari, Benjamin

    2016-01-01

    Introduction: In the past decade significant attention has been given to the development of tools that attempt to measure the vulnerability, risk or resilience of communities to disasters. Particular attention has been given to the development of composite indices to quantify these concepts mirroring their deployment in other fields such as sustainable development. Whilst some authors have published reviews of disaster vulnerability, risk and resilience composite indicator methodologies, these have been of a limited nature. This paper seeks to dramatically expand these efforts by analysing 106 composite indicator methodologies to understand the breadth and depth of practice. Methods: An extensive search of the academic and grey literature was undertaken for composite indicator and scorecard methodologies that addressed multiple/all hazards; included social and economic aspects of risk, vulnerability or resilience; were sub-national in scope; explained the method and variables used; focussed on the present-day; and, had been tested or implemented. Information on the index construction, geographic areas of application, variables used and other relevant data was collected and analysed. Results: Substantial variety in construction practices of composite indicators of risk, vulnerability and resilience were found. Five key approaches were identified in the literature, with the use of hierarchical or deductive indices being the most common. Typically variables were chosen by experts, came from existing statistical datasets and were combined by simple addition with equal weights. A minimum of 2 variables and a maximum of 235 were used, although approximately two thirds of methodologies used less than 40 variables. The 106 methodologies used 2298 unique variables, the most frequently used being common statistical variables such as population density and unemployment rate. Classification of variables found that on average 34% of the variables used in each methodology related to the social environment, 25% to the disaster environment, 20% to the economic environment, 13% to the built environment, 6% to the natural environment and 3% were other indices. However variables specifically measuring action to mitigate or prepare for disasters only comprised 12%, on average, of the total number of variables in each index. Only 19% of methodologies employed any sensitivity or uncertainty analysis and in only a single case was this comprehensive. Discussion: A number of potential limitations of the present state of practice and how these might impact on decision makers are discussed. In particular the limited deployment of sensitivity and uncertainty analysis and the low use of direct measures of disaster risk, vulnerability and resilience could significantly limit the quality and reliability of existing methodologies. Recommendations for improvements to indicator development and use are made, as well as suggested future research directions to enhance the theoretical and empirical knowledge base for composite indicator development. PMID:27066298

  17. Comparative quantification of health risks: Conceptual framework and methodological issues

    PubMed Central

    Murray, Christopher JL; Ezzati, Majid; Lopez, Alan D; Rodgers, Anthony; Vander Hoorn, Stephen

    2003-01-01

    Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed "stream" of exposure, including consideration of discounting; and the sources of uncertainty. PMID:12780936

  18. Uncertainty factors in screening ecological risk assessments

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

    Duke, L.D.; Taggart, M.

    2000-06-01

    The hazard quotient (HQ) method is commonly used in screening ecological risk assessments (ERAs) to estimate risk to wildlife at contaminated sites. Many ERAs use uncertainty factors (UFs) in the HQ calculation to incorporate uncertainty associated with predicting wildlife responses to contaminant exposure using laboratory toxicity data. The overall objective was to evaluate the current UF methodology as applied to screening ERAs in California, USA. Specific objectives included characterizing current UF methodology, evaluating the degree of conservatism in UFs as applied, and identifying limitations to the current approach. Twenty-four of 29 evaluated ERAs used the HQ approach: 23 of thesemore » used UFs in the HQ calculation. All 24 made interspecies extrapolations, and 21 compensated for its uncertainty, most using allometric adjustments and some using RFs. Most also incorporated uncertainty for same-species extrapolations. Twenty-one ERAs used UFs extrapolating from lowest observed adverse effect level (LOAEL) to no observed adverse effect level (NOAEL), and 18 used UFs extrapolating from subchronic to chronic exposure. Values and application of all UF types were inconsistent. Maximum cumulative UFs ranged from 10 to 3,000. Results suggest UF methodology is widely used but inconsistently applied and is not uniformly conservative relative to UFs recommended in regulatory guidelines and academic literature. The method is limited by lack of consensus among scientists, regulators, and practitioners about magnitudes, types, and conceptual underpinnings of the UF methodology.« less

  19. A neural network based methodology to predict site-specific spectral acceleration values

    NASA Astrophysics Data System (ADS)

    Kamatchi, P.; Rajasankar, J.; Ramana, G. V.; Nagpal, A. K.

    2010-12-01

    A general neural network based methodology that has the potential to replace the computationally-intensive site-specific seismic analysis of structures is proposed in this paper. The basic framework of the methodology consists of a feed forward back propagation neural network algorithm with one hidden layer to represent the seismic potential of a region and soil amplification effects. The methodology is implemented and verified with parameters corresponding to Delhi city in India. For this purpose, strong ground motions are generated at bedrock level for a chosen site in Delhi due to earthquakes considered to originate from the central seismic gap of the Himalayan belt using necessary geological as well as geotechnical data. Surface level ground motions and corresponding site-specific response spectra are obtained by using a one-dimensional equivalent linear wave propagation model. Spectral acceleration values are considered as a target parameter to verify the performance of the methodology. Numerical studies carried out to validate the proposed methodology show that the errors in predicted spectral acceleration values are within acceptable limits for design purposes. The methodology is general in the sense that it can be applied to other seismically vulnerable regions and also can be updated by including more parameters depending on the state-of-the-art in the subject.

  20. Kumaravadivelu's Framework as a Basis for Improving English Language Teaching in Saudi Arabia: Opportunities and Challenges

    ERIC Educational Resources Information Center

    Ahmad, Afnan Masaoud

    2014-01-01

    This paper discusses the issues with EFL teaching in Saudi Arabia, including the reliance on traditional teaching methodologies and banning use of first languages in classrooms. As a result, these traditional teaching practices produce less proficient learners who have limited knowledge about proper linguistic use. In order to overcome these…

  1. Can Improvisation Be "Taught"?: A Call for Free Improvisation in Our Schools

    ERIC Educational Resources Information Center

    Hickey, Maud

    2009-01-01

    The purpose of this article is to present the idea that the music education profession's current drive to include improvisation in school music is limited in its approach, and that "teaching" improvisation, in the traditional sense, is not possible. These beliefs are based on an examination of current methodologies and texts in light of the…

  2. 75 FR 32362 - Fresh Garlic From the People's Republic of China: Extension of Time Limit for the Preliminary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... that tolled the deadlines for all Import Administration cases by seven calendar days due to the Federal...-day period to 300 days if it determines that the case is extraordinarily complicated. See 19 CFR 351... shipper reviews involve extraordinarily complicated methodological issues, including the examination of...

  3. A Design Science Research Methodology for Developing a Computer-Aided Assessment Approach Using Method Marking Concept

    ERIC Educational Resources Information Center

    Genemo, Hussein; Miah, Shah Jahan; McAndrew, Alasdair

    2016-01-01

    Assessment has been defined as an authentic method that plays an important role in evaluating students' learning attitude in acquiring lifelong knowledge. Traditional methods of assessment including the Computer-Aided Assessment (CAA) for mathematics show limited ability to assess students' full work unless multi-step questions are sub-divided…

  4. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication.

    PubMed

    Moorhead, S Anne; Hazlett, Diane E; Harrison, Laura; Carroll, Jennifer K; Irwin, Anthea; Hoving, Ciska

    2013-04-23

    There is currently a lack of information about the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals from primary research. To review the current published literature to identify the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals, and identify current gaps in the literature to provide recommendations for future health communication research. This paper is a review using a systematic approach. A systematic search of the literature was conducted using nine electronic databases and manual searches to locate peer-reviewed studies published between January 2002 and February 2012. The search identified 98 original research studies that included the uses, benefits, and/or limitations of social media for health communication among the general public, patients, and health professionals. The methodological quality of the studies assessed using the Downs and Black instrument was low; this was mainly due to the fact that the vast majority of the studies in this review included limited methodologies and was mainly exploratory and descriptive in nature. Seven main uses of social media for health communication were identified, including focusing on increasing interactions with others, and facilitating, sharing, and obtaining health messages. The six key overarching benefits were identified as (1) increased interactions with others, (2) more available, shared, and tailored information, (3) increased accessibility and widening access to health information, (4) peer/social/emotional support, (5) public health surveillance, and (6) potential to influence health policy. Twelve limitations were identified, primarily consisting of quality concerns and lack of reliability, confidentiality, and privacy. Social media brings a new dimension to health care as it offers a medium to be used by the public, patients, and health professionals to communicate about health issues with the possibility of potentially improving health outcomes. Social media is a powerful tool, which offers collaboration between users and is a social interaction mechanism for a range of individuals. Although there are several benefits to the use of social media for health communication, the information exchanged needs to be monitored for quality and reliability, and the users' confidentiality and privacy need to be maintained. Eight gaps in the literature and key recommendations for future health communication research were provided. Examples of these recommendations include the need to determine the relative effectiveness of different types of social media for health communication using randomized control trials and to explore potential mechanisms for monitoring and enhancing the quality and reliability of health communication using social media. Further robust and comprehensive evaluation and review, using a range of methodologies, are required to establish whether social media improves health communication practice both in the short and long terms.

  5. Methodological issues in the study of violence against women

    PubMed Central

    Ruiz‐Pérez, Isabel; Plazaola‐Castaño, Juncal; Vives‐Cases, Carmen

    2007-01-01

    The objective of this paper is to review the methodological issues that arise when studying violence against women as a public health problem, focusing on intimate partner violence (IPV), since this is the form of violence that has the greatest consequences at a social and political level. The paper focuses first on the problems of defining what is meant by IPV. Secondly, the paper describes the difficulties in assessing the magnitude of the problem. Obtaining reliable data on this type of violence is a complex task, because of the methodological issues derived from the very nature of the phenomenon, such as the private, intimate context in which this violence often takes place, which means the problem cannot be directly observed. Finally, the paper examines the limitations and bias in research on violence, including the lack of consensus with regard to measuring events that may or may not represent a risk factor for violence against women or the methodological problem related to the type of sampling used in both aetiological and prevalence studies. PMID:18000113

  6. A systematic methodology for selecting decontamination strategies following a biocontamination event.

    PubMed

    Krauter, Paula; Edwards, Donna; Yang, Lynn; Tucker, Mark

    2011-09-01

    Decontamination and recovery of a facility or outdoor area after a wide-area biological incident involving a highly persistent agent (eg, Bacillus anthracis spores) is a complex process that requires extensive information and significant resources, which are likely to be limited, particularly if multiple facilities or areas are affected. This article proposes a systematic methodology for evaluating information to select the decontamination or alternative treatments that optimize use of resources if decontamination is required for the facility or area. The methodology covers a wide range of approaches, including volumetric and surface decontamination, monitored natural attenuation, and seal and abandon strategies. A proposed trade-off analysis can help decision makers understand the relative appropriateness, efficacy, and labor, skill, and cost requirements of the various decontamination methods for the particular facility or area needing treatment--whether alone or as part of a larger decontamination effort. Because the state of decontamination knowledge and technology continues to evolve rapidly, the methodology presented here is designed to accommodate new strategies and materials and changing information.

  7. A deviation based assessment methodology for multiple machine health patterns classification and fault detection

    NASA Astrophysics Data System (ADS)

    Jia, Xiaodong; Jin, Chao; Buzza, Matt; Di, Yuan; Siegel, David; Lee, Jay

    2018-01-01

    Successful applications of Diffusion Map (DM) in machine failure detection and diagnosis have been reported in several recent studies. DM provides an efficient way to visualize the high-dimensional, complex and nonlinear machine data, and thus suggests more knowledge about the machine under monitoring. In this paper, a DM based methodology named as DM-EVD is proposed for machine degradation assessment, abnormality detection and diagnosis in an online fashion. Several limitations and challenges of using DM for machine health monitoring have been analyzed and addressed. Based on the proposed DM-EVD, a deviation based methodology is then proposed to include more dimension reduction methods. In this work, the incorporation of Laplacian Eigen-map and Principal Component Analysis (PCA) are explored, and the latter algorithm is named as PCA-Dev and is validated in the case study. To show the successful application of the proposed methodology, case studies from diverse fields are presented and investigated in this work. Improved results are reported by benchmarking with other machine learning algorithms.

  8. Groundwater vulnerability to climate change: A review of the assessment methodology.

    PubMed

    Aslam, Rana Ammar; Shrestha, Sangam; Pandey, Vishnu Prasad

    2018-01-15

    Impacts of climate change on water resources, especially groundwater, can no longer be hidden. These impacts are further exacerbated under the integrated influence of climate variability, climate change and anthropogenic activities. The degree of impact varies according to geographical location and other factors leading systems and regions towards different levels of vulnerability. In the recent past, several attempts have been made in various regions across the globe to quantify the impacts and consequences of climate and non-climate factors in terms of vulnerability to groundwater resources. Firstly, this paper provides a structured review of the available literature, aiming to critically analyse and highlight the limitations and knowledge gaps involved in vulnerability (of groundwater to climate change) assessment methodologies. The effects of indicator choice and the importance of including composite indicators are then emphasised. A new integrated approach for the assessment of groundwater vulnerability to climate change is proposed to successfully address those limitations. This review concludes that the choice of indicator has a significant role in defining the reliability of computed results. The effect of an individual indicator is also apparent but the consideration of a combination (variety) of indicators may give more realistic results. Therefore, in future, depending upon the local conditions and scale of the study, indicators from various groups should be chosen. Furthermore, there are various assumptions involved in previous methodologies, which limit their scope by introducing uncertainty in the calculated results. These limitations can be overcome by implementing the proposed approach. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [Application of root cause analysis in healthcare].

    PubMed

    Hsu, Tsung-Fu

    2007-12-01

    The main purpose of this study was to explore various aspects of root cause analysis (RCA), including its definition, rationale concept, main objective, implementation procedures, most common analysis methodology (fault tree analysis, FTA), and advantages and methodologic limitations in regard to healthcare. Several adverse events that occurred at a certain hospital were also analyzed by the author using FTA as part of this study. RCA is a process employed to identify basic and contributing causal factors underlying performance variations associated with adverse events. The rationale concept of RCA offers a systemic approach to improving patient safety that does not assign blame or liability to individuals. The four-step process involved in conducting an RCA includes: RCA preparation, proximate cause identification, root cause identification, and recommendation generation and implementation. FTA is a logical, structured process that can help identify potential causes of system failure before actual failures occur. Some advantages and significant methodologic limitations of RCA were discussed. Finally, we emphasized that errors stem principally from faults attributable to system design, practice guidelines, work conditions, and other human factors, which induce health professionals to make negligence or mistakes with regard to healthcare. We must explore the root causes of medical errors to eliminate potential RCA system failure factors. Also, a systemic approach is needed to resolve medical errors and move beyond a current culture centered on assigning fault to individuals. In constructing a real environment of patient-centered safety healthcare, we can help encourage clients to accept state-of-the-art healthcare services.

  10. Grounded theory as a method for research in speech and language therapy.

    PubMed

    Skeat, J; Perry, A

    2008-01-01

    The use of qualitative methodologies in speech and language therapy has grown over the past two decades, and there is now a body of literature, both generally describing qualitative research, and detailing its applicability to health practice(s). However, there has been only limited profession-specific discussion of qualitative methodologies and their potential application to speech and language therapy. To describe the methodology of grounded theory, and to explain how it might usefully be applied to areas of speech and language research where theoretical frameworks or models are lacking. Grounded theory as a methodology for inductive theory-building from qualitative data is explained and discussed. Some differences between 'modes' of grounded theory are clarified and areas of controversy within the literature are highlighted. The past application of grounded theory to speech and language therapy, and its potential for informing research and clinical practice, are examined. This paper provides an in-depth critique of a qualitative research methodology, including an overview of the main difference between two major 'modes'. The article supports the application of a theory-building approach in the profession, which is sometimes complex to learn and apply, but worthwhile in its results. Grounded theory as a methodology has much to offer speech and language therapists and researchers. Although the majority of research and discussion around this methodology has rested within sociology and nursing, grounded theory can be applied by researchers in any field, including speech and language therapists. The benefit of the grounded theory method to researchers and practitioners lies in its application to social processes and human interactions. The resulting theory may support further research in the speech and language therapy profession.

  11. Fracture mechanics approach to estimate rail wear limits

    DOT National Transportation Integrated Search

    2009-10-01

    This paper describes a systematic methodology to estimate allowable limits for rail head wear in terms of vertical head-height loss, gage-face side wear, and/or the combination of the two. This methodology is based on the principles of engineering fr...

  12. Automatic Reacquisition of Satellite Positions by Detecting Their Expected Streaks in Astronomical Images

    NASA Astrophysics Data System (ADS)

    Levesque, M.

    Artificial satellites, and particularly space junk, drift continuously from their known orbits. In the surveillance-of-space context, they must be observed frequently to ensure that the corresponding orbital parameter database entries are up-to-date. Autonomous ground-based optical systems are periodically tasked to observe these objects, calculate the difference between their predicted and real positions and update object orbital parameters. The real satellite positions are provided by the detection of the satellite streaks in the astronomical images specifically acquired for this purpose. This paper presents the image processing techniques used to detect and extract the satellite positions. The methodology includes several processing steps including: image background estimation and removal, star detection and removal, an iterative matched filter for streak detection, and finally false alarm rejection algorithms. This detection methodology is able to detect very faint objects. Simulated data were used to evaluate the methodology's performance and determine the sensitivity limits where the algorithm can perform detection without false alarm, which is essential to avoid corruption of the orbital parameter database.

  13. ICP-MS/MS-Based Ionomics: A Validated Methodology to Investigate the Biological Variability of the Human Ionome.

    PubMed

    Konz, Tobias; Migliavacca, Eugenia; Dayon, Loïc; Bowman, Gene; Oikonomidi, Aikaterini; Popp, Julius; Rezzi, Serge

    2017-05-05

    We here describe the development, validation and application of a quantitative methodology for the simultaneous determination of 29 elements in human serum using state-of-the-art inductively coupled plasma triple quadrupole mass spectrometry (ICP-MS/MS). This new methodology offers high-throughput elemental profiling using simple dilution of minimal quantity of serum samples. We report the outcomes of the validation procedure including limits of detection/quantification, linearity of calibration curves, precision, recovery and measurement uncertainty. ICP-MS/MS-based ionomics was used to analyze human serum of 120 older adults. Following a metabolomic data mining approach, the generated ionome profiles were subjected to principal component analysis revealing gender and age-specific differences. The ionome of female individuals was marked by higher levels of calcium, phosphorus, copper and copper to zinc ratio, while iron concentration was lower with respect to male subjects. Age was associated with lower concentrations of zinc. These findings were complemented with additional readouts to interpret micronutrient status including ceruloplasmin, ferritin and inorganic phosphate. Our data supports a gender-specific compartmentalization of the ionome that may reflect different bone remodelling in female individuals. Our ICP-MS/MS methodology enriches the panel of validated "Omics" approaches to study molecular relationships between the exposome and the ionome in relation with nutrition and health.

  14. Authentic leadership in healthcare: a scoping review.

    PubMed

    Malila, Niina; Lunkka, Nina; Suhonen, Marjo

    2018-02-05

    Purpose The purpose of this paper is to review peer-reviewed original research articles on authentic leadership (AL) in health care to identify potential research gaps and present recommendations for future research. The objectives are to examine and map evidence of the main characteristics, research themes and methodologies in the studies. AL is a leader's non-authoritarian, ethical and transparent behaviour pattern. Design/methodology/approach A scoping review with thematic analysis was conducted. A three-step search strategy was used with database and manual searches. The included studies were composed of English language peer-reviewed original research articles referring to both AL and health care. Findings In total, 29 studies were included. The studies favoured Canadian nurses in acute care hospitals. AL was understood as its original definition. The review identified four research themes: well-being at work, patient care quality, work environment and AL promotion. Quantitative research methodology with the authentic leadership questionnaire and cross-sectional design were prevalent. Research limitations/implications Future research needs more variation in research themes, study populations, settings, organisations, work sectors, geographical origins and theory perspectives. Different research methodologies, such as qualitative and mixed methods research and longitudinal designs, should be used more. Originality/value This is presumably the first literature review to map the research on AL in health care.

  15. Measurement properties of instruments that assess participation in young people with autism spectrum disorder: a systematic review.

    PubMed

    Lami, Francesca; Egberts, Kristine; Ure, Alexandra; Conroy, Rowena; Williams, Katrina

    2018-03-01

    To systematically review the measurement properties of instruments assessing participation in young people with autism spectrum disorder (ASD). A search was performed in MEDLINE, PsycINFO, and PubMed combining three constructs ('ASD', 'test of participation', 'measurement properties'). Results were restricted to articles including people aged 6 to 29 years. The 2539 identified articles were independently screened by two reviewers. For the included articles, data were extracted using standard forms and their risk of bias was assessed. Nine studies (8 cross-sectional) met the inclusion criteria, providing information on seven different instruments. The total sample included 634 participants, with sex available for 600 (males=494; females=106) and age available for 570, with mean age for these participants 140.58 months (SD=9.11; range=36-624). Included instruments were the school function assessment, vocational index, children's assessment of participation and enjoyment/preferences for activities of children, experience sampling method, Pediatric Evaluation of Disability Inventory, Computer Adaptive Test, adolescent and young adult activity card sort, and Patient-Reported Outcomes Measurement Information System parent-proxy peer relationships. Seven studies assessed reliability and validity; good properties were reported for half of the instruments considered. Most studies (n=6) had high risk of bias. Overall the quality of the evidence for each tool was limited. Validation of these instruments, or others that comprehensively assess participation, is needed. Future studies should follow recommended methodological standards. Seven instruments have been used to assess participation in young people with autism. One instrument, with excellent measurement properties in one study, does not comprehensively assess participation. Studies of three instruments that incorporate a more comprehensive assessment of participation have methodological limitations. Overall, limited evidence exists regarding measurement properties of participation assessments for young people with autism. © 2017 Mac Keith Press.

  16. The Prevalence of Oropharyngeal Dysphagia in Adults Presenting with Temporomandibular Disorders Associated with Rheumatoid Arthritis: A Systematic Review and Meta-analysis.

    PubMed

    Gilheaney, Órla; Zgaga, Lina; Harpur, Isolde; Sheaf, Greg; Kiefer, Liss; Béchet, Sibylle; Walshe, Margaret

    2017-10-01

    Temporomandibular disorders (TMDs) are the most frequent non-dental orofacial pain disorders and may be associated with rheumatoid arthritis (RA), resulting in oropharyngeal dysphagia (OD). However, clinicians' understanding of involvement with OD caused by RA-related TMDs is limited and the methodological quality of research in this field has been criticised. Therefore, the aim of this study was to systematically review the prevalence of oral preparatory and oral stage signs and symptoms of OD in adults presenting with TMDs associated with RA. A systematic review of the literature was completed. The following electronic databases were searched from inception to February 2016, with no date/language restriction: EMBASE, PubMed, CINAHL, Web of Science, Elsevier Scopus, Science Direct, AMED, The Cochrane Database of Systematic Reviews, and ProQuest Dissertations and Theses A & I. Grey literature and reference lists of the included studies were also searched. Studies reporting the frequency of OD in adults presenting with TMD and RA were included. Study eligibility and quality were assessed by three independent reviewers. Methodological quality was assessed using the Down's and Black tool. The search yielded 19 eligible studies. Typical difficulties experienced by RA patients included impaired swallowing (24.63%), impaired masticatory ability (30.69%), masticatory pain (35.58%), and masticatory fatigue (21.26%). No eligible studies reported figures relating to the prevalence of weight loss. Eligible studies were deemed on average to be of moderate quality. Study limitations included the small number of studies which met the inclusion criteria and the limited amount of studies utilising objective assessments. Valid and reliable prospective research is urgently required to address the assessment and treatment of swallowing difficulties in RA as TMJ involvement may produce signs and symptoms of OD.

  17. Drospirenone-containing oral contraceptive pills and the risk of venous thromboembolism: a systematic review of observational studies.

    PubMed

    Larivée, N; Suissa, S; Khosrow-Khavar, F; Tagalakis, V; Filion, K B

    2017-09-01

    The effects of fourth-generation drospirenone-containing combined oral contraceptives (COCs) on the risk of venous thromboembolism (VTE) are controversial. To assess the methodological strengths and limitations of the evidence on the VTE risk of these COCs. We searched CINAHL, the Cochrane Library, EMBASE, HealthStar, Medline, and the Science Citation Index. Studies were included if they were cohort and case-control studies, reported a venous thrombotic outcome, had a comparator group, reported an effect measure of the association of interest, and were published in English or French. We assessed study quality using the ROBINS-I tool and assessed the presence of four common sources of bias: prevalent user bias, inappropriate choice of comparator, VTE misclassification, and confounding. Our systematic review included 17 studies. The relative risks of VTE associated with drospirenone- versus second-generation levonorgestrel-containing COCs ranged from 1.0 to 3.3. Based on ROBINS-I, three studies had a moderate risk, ten had a serious risk, and four had a critical risk. Nine studies included prevalent users, four included inappropriate comparators, four had VTE misclassification, and five did not account for two or more important confounding factors. The three highest quality studies had relative risks ranging from 1.0 to 1.57. As a result of the methodological limitations of the individual studies, the VTE risk of drospirenone-containing COCs remains unknown. The highest quality studies suggest there are no or slightly increased harmful effects, but their confidence limits do not rule out an almost doubling of the risk. Systematic review of drospirenone: best studies show no or slightly increased VTE risk (versus levonorgestrel). © 2017 Royal College of Obstetricians and Gynaecologists.

  18. 76 FR 9233 - Children's Health Insurance Program (CHIP); Allotment Methodology and States' Fiscal Years 2009...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... capita health care growth factor for a fiscal year is equal to 1 plus the percentage increase in the... Health Care Growth (PCHCG) Factor for FY 2010, determined as 1 plus the percentage increase in the Per... CHIP that are subject to the 10-percent limit on non-primary expenditures (including other child health...

  19. Moving from Sustainable Management to Sustainable Governance of Natural Resources: The Role of Social Learning Processes in Rural India, Bolivia and Mali

    ERIC Educational Resources Information Center

    Rist, Stephan; Chidambaranathan, Mani; Escobar, Cesar; Wiesmann, Urs; Zimmermann, Anne

    2007-01-01

    The present paper discusses a conceptual, methodological and practical framework within which the limitations of the conventional notion of natural resource management (NRM) can be overcome. NRM is understood as the application of scientific ecological knowledge to resource management. By including a consideration of the normative imperatives that…

  20. Valuation of Drug Abuse: A Review of Current Methodologies and Implications for Policy Making

    ERIC Educational Resources Information Center

    Schori, Maayan

    2011-01-01

    This article reviews the use of several valuation methods as they relate to drug abuse and places them within the context of U.S. policy. First, cost-of-illness (COI) studies are reviewed and their limitations discussed. Second, three additional economic methods of valuing drug abuse are reviewed, including cost-effectiveness analysis (CEA),…

  1. A survey of fault diagnosis technology

    NASA Technical Reports Server (NTRS)

    Riedesel, Joel

    1989-01-01

    Existing techniques and methodologies for fault diagnosis are surveyed. The techniques run the gamut from theoretical artificial intelligence work to conventional software engineering applications. They are shown to define a spectrum of implementation alternatives where tradeoffs determine their position on the spectrum. Various tradeoffs include execution time limitations and memory requirements of the algorithms as well as their effectiveness in addressing the fault diagnosis problem.

  2. Interventions to improve patient understanding of cancer clinical trial participation: a systematic review.

    PubMed

    Kao, C Y; Aranda, S; Krishnasamy, M; Hamilton, B

    2017-03-01

    Patient misunderstanding of cancer clinical trial participation is identified as a critical issue and researchers have developed and tested a variety of interventions to improve patient understanding. This systematic review identified nine papers published between 2000 and 2013, to evaluate the effects of interventions to improve patient understanding of cancer clinical trial participation. Types of interventions included audio-visual information, revised written information and a communication training workshop. Interventions were conducted alone or in combination with other forms of information provision. The nine papers, all with methodological limitations, reported mixed effects on a small range of outcomes regarding improved patient understanding of cancer clinical trial participation. The methodological limitations included: (1) the intervention development process was poorly described; (2) only a small element of the communication process was addressed; (3) studies lacked evidence regarding what information is essential and critical to enable informed consent; (4) studies lacked reliable and valid outcome measures to show that patients are sufficiently informed to provide consent; and (5) the intervention development process lacked a theoretical framework. Future research needs to consider these factors when developing interventions to improve communication and patient understanding during the informed consent process. © 2016 John Wiley & Sons Ltd.

  3. Effect of Medicinal Herbs on Primary Dysmenorrhoea- a Systematic Review

    PubMed Central

    Mirabi, Parvaneh; Alamolhoda, Seideh Hanieh; Esmaeilzadeh, Seddigheh; Mojab, Faraz

    2014-01-01

    Conventional treatment for primary dysmenorrhoea has a failure rate of 20% to 25% and may be contraindicated or not tolerated by some women. Herbal medicine may be a suitable alternative. To determine the efficacy and safety of Iranian herbal medicine for primary dysmenorrhea when compared with placebo, no treatment, and other treatment. Electronic searches of the Cochrane Menstrual Disorders and Dysmenorrhoea Group Register of controlled trials, Scopus, Google Scholar, Medline, Pubmed were performed to identify relevant randomized controlled trials (RCTs). The study abstraction and quality assessment of all studies were undertaken following the detailed descriptions of these categories as described in the JADAD Criteria for Systematic Reviews of Interventions. 25 RCTs involving a total of women were included in the review. The review found promising evidence in the form of RCTs for the use of herbal medicine in the treatment of primary dysmenorrhoea compared with pharmacological treatment. However, the results were limited by methodological flaws. Further rigorous no penetrating placebo-controlled RCTs are warranted. The review found promising evidence supporting the use of herbal medicine for primary dysmenorrhoea; however, results are limited by the poor methodological quality of the included trials. PMID:25276177

  4. Twelfth International Symposium on Methodologies for Intelligent Systems (ISMIS󈧄) Held in Charlotte, North Carolina on October 11-14, 2000

    DTIC Science & Technology

    2000-10-14

    without any knowledge of the problem area. Therefore, Darwinian-type evolutionary computation has found a very wide range of applications, including many ...the author examined many biomedical studies that included literature searches. The Science Citation Index (SCL) Abstracts of these studies...yield many records that are non-relevant to the main technical themes of the study. In summary, these types of simple limited queries can result in two

  5. Optimizing Clinical Trial Enrollment Methods Through "Goal Programming"

    PubMed Central

    Davis, J.M.; Sandgren, A.J.; Manley, A.R.; Daleo, M.A.; Smith, S.S.

    2014-01-01

    Introduction Clinical trials often fail to reach desired goals due to poor recruitment outcomes, including low participant turnout, high recruitment cost, or poor representation of minorities. At present, there is limited literature available to guide recruitment methodology. This study, conducted by researchers at the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI), provides an example of how iterative analysis of recruitment data may be used to optimize recruitment outcomes during ongoing recruitment. Study methodology UW-CTRI’s research team provided a description of methods used to recruit smokers in two randomized trials (n = 196 and n = 175). The trials targeted low socioeconomic status (SES) smokers and involved time-intensive smoking cessation interventions. Primary recruitment goals were to meet required sample size and provide representative diversity while working with limited funds and limited time. Recruitment data was analyzed repeatedly throughout each study to optimize recruitment outcomes. Results Estimates of recruitment outcomes based on prior studies on smoking cessation suggested that researchers would be able to recruit 240 low SES smokers within 30 months at a cost of $72,000. With employment of methods described herein, researchers were able to recruit 374 low SES smokers over 30 months at a cost of $36,260. Discussion Each human subjects study presents unique recruitment challenges with time and cost of recruitment dependent on the sample population and study methodology. Nonetheless, researchers may be able to improve recruitment outcomes though iterative analysis of recruitment data and optimization of recruitment methods throughout the recruitment period. PMID:25642125

  6. Issues surrounding the health economic evaluation of genomic technologies

    PubMed Central

    Buchanan, James; Wordsworth, Sarah; Schuh, Anna

    2014-01-01

    Aim Genomic interventions could enable improved disease stratification and individually tailored therapies. However, they have had a limited impact on clinical practice to date due to a lack of evidence, particularly economic evidence. This is partly because health economists are yet to reach consensus on whether existing methods are sufficient to evaluate genomic technologies. As different approaches may produce conflicting adoption decisions, clarification is urgently required. This article summarizes the methodological issues associated with conducting economic evaluations of genomic interventions. Materials & methods A structured literature review was conducted to identify references that considered the methodological challenges faced when conducting economic evaluations of genomic interventions. Results Methodological challenges related to the analytical approach included the choice of comparator, perspective and timeframe. Challenges in costing centered around the need to collect a broad range of costs, frequently, in a data-limited environment. Measuring outcomes is problematic as standard measures have limited applicability, however, alternative metrics (e.g., personal utility) are underdeveloped and alternative approaches (e.g., cost–benefit analysis) underused. Effectiveness data quality is weak and challenging to incorporate into standard economic analyses, while little is known about patient and clinician behavior in this context. Comprehensive value of information analyses are likely to be helpful. Conclusion Economic evaluations of genomic technologies present a particular challenge for health economists. New methods may be required to resolve these issues, but the evidence to justify alternative approaches is yet to be produced. This should be the focus of future work in this field. PMID:24236483

  7. Quantification of pelvic floor muscle strength in female urinary incontinence: A systematic review and comparison of contemporary methodologies.

    PubMed

    Deegan, Emily G; Stothers, Lynn; Kavanagh, Alex; Macnab, Andrew J

    2018-01-01

    There remains no gold standard for quantification of voluntary pelvic floor muscle (PFM) strength, despite international guidelines that recommend PFM assessment in females with urinary incontinence (UI). Methods currently reported for quantification of skeletal muscle strength across disciplines are systematically reviewed and their relevance for clinical and academic use related to the pelvic floor are described. A systematic review via Medline, PubMed, CINHAL, and the Cochrane database using key terms for pelvic floor anatomy and function were cross referenced with skeletal muscle strength quantification from 1946 to 2016. Full text peer-reviewed articles in English having female subjects with incontinence were identified. Each study was analyzed for use of controls, type of methodology as direct or indirect measures, benefits, and limitations of the technique. A total of 1586 articles were identified of which 50 met the inclusion criteria. Nine methodologies of determining PFM strength were described including: digital palpation, perineometer, dynamometry, EMG, vaginal cones, ultrasonography, magnetic resonance imaging, urine stream interruption test, and the Colpexin pull test. Thirty-two percent lacked a control group. Technical refinements in both direct and indirect instrumentation for PFM strength measurement are allowing for sensitivity. However, the most common methods of quantification remain digital palpation and perineometry; techniques that pose limitations and yield subjective or indirect measures of muscular strength. Dynamometry has potential as an accurate and sensitive tool, but is limited by inability to assess PFM strength during dynamic movements. © 2017 Wiley Periodicals, Inc.

  8. Methodology for Determining Limit Torques for Threaded Fasteners

    NASA Technical Reports Server (NTRS)

    Hissam, Andy

    2011-01-01

    In aerospace design, where minimizing weight is always a priority, achieving the full capacity from fasteners is essential. To do so, the initial bolt preload must be maximized. The benefits of high preload are well documented and include improved fatigue resistance, a stiffer joint, and resistance to loosening. But many factors like elastic interactions and embedment tend to lower the initial preload placed on the bolt. These factors provide additional motivation to maximize the initial preload. But, to maximize bolt preload, you must determine what torque to apply. Determining this torque is greatly complicated by the large preload scatter generally seen with torque control. This paper presents a detailed methodology for generating limit torques for threaded fasteners. This methodology accounts for the large scatter in preload found with torque control, and therefore, addresses the statistical nature of the problem. It also addresses prevailing torque, a feature common in aerospace fasteners. Although prevailing torque provides a desired locking feature, it can also increase preload scatter. In addition, it can limit the amount of preload that can be generated due to the torsion it creates in the bolt. This paper discusses the complications of prevailing torque and how best to handle it. A wide range of torque-tension bolt testing was conducted in support of this research. The results from this research will benefit the design engineer as well as analyst involved in the design of bolted joints, leading to better, more optimized structural designs.

  9. Contributions of mobile technologies to addiction research.

    PubMed

    Swendsen, Joel

    2016-06-01

    Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more accurate assessment of temporal relationships among variables, as well as the reduction in both contextual constraints and discipline-specific methodological isolation. The present article presents a conceptual review of these advances while using illustrations of research applications that are capable of overcoming specific methodological barriers. Finally, a brief review of both the benefits and risks of mobile technology use for the treatment of patients will be addressed.

  10. [Evaluation of the methods for the determination of nitrites in baby foods according Mexican legislation].

    PubMed

    Morales Guerrero, Josefina C; García Zepeda, Rodrigo A; Flores Ruvalcaba, Edgar; Martínez Michel, Lorelei

    2012-09-01

    We evaluated the two methods accepted by the Mexican norm for the determination of nitritesin infant meat-based food with vegetables. We determined the content of nitrites in the infant food, raw materials as well as products from the intermediate stages of production. A reagent blank and a reference sample were included at each analytical run. In addition, we determined the sensitivity, recovery percentage and accuracy of each methodology. Infant food results indicated an important difference in the nitrite content determined under each methodology, due to the persistent presence of turbidity in the extracts. Different treatments were proposed to eliminate the turbidity, but these only managed to reduce it. The turbidity was attributed to carbohydrates which disclosed concentration exhibit a wide dispersion and were below the quantifiable limit under both methodologies; therefore it is not recommended to apply these techniques with food suspected to contain traces of nitrites.

  11. Contributions of mobile technologies to addiction research

    PubMed Central

    Swendsen, Joel

    2016-01-01

    Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more accurate assessment of temporal relationships among variables, as well as the reduction in both contextual constraints and discipline-specific methodological isolation. The present article presents a conceptual review of these advances while using illustrations of research applications that are capable of overcoming specific methodological barriers. Finally, a brief review of both the benefits and risks of mobile technology use for the treatment of patients will be addressed. PMID:27489461

  12. Respondent Techniques for Reduction of Emotions Limiting School Adjustment: A Quantitative Review and Methodological Critique.

    ERIC Educational Resources Information Center

    Misra, Anjali; Schloss, Patrick J.

    1989-01-01

    The critical analysis of 23 studies using respondent techniques for the reduction of excessive emotional reactions in school children focuses on research design, dependent variables, independent variables, component analysis, and demonstrations of generalization and maintenance. Results indicate widespread methodological flaws that limit the…

  13. Design for performance enhancement in feedback control systems with multiple saturating nonlinearities. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Kapasouris, Petros

    1988-01-01

    A systematic control design methodology is introduced for multi-input/multi-output systems with multiple saturations. The methodology can be applied to stable and unstable open loop plants with magnitude and/or rate control saturations and to systems in which state limitations are desired. This new methodology is a substantial improvement over previous heuristic single-input/single-output approaches. The idea is to introduce a supervisor loop so that when the references and/or disturbances are sufficiently small, the control system operates linearly as designed. For signals large enough to cause saturations, the control law is modified in such a way to ensure stability and to preserve, to the extent possible, the behavior of the linear control design. Key benefits of this methodology are: the modified compensator never produces saturating control signals, integrators and/or slow dynamics in the compensator never windup, the directional properties of the controls are maintained, and the closed loop system has certain guaranteed stability properties. The advantages of the new design methodology are illustrated by numerous simulations, including the multivariable longitudinal control of modified models of the F-8 (stable) and F-16 (unstable) aircraft.

  14. Global Carbon Project: the Global Carbon Budget 2015 (V.1.0., issued Nov. 2015 and V.1.1, issued Dec. 2015)

    DOE Data Explorer

    Le Quere, C. [University of East Anglia, Norwich UK; Moriarty, R. [University of East Anglia, Norwich UK; Andrew, R. M. [Univ. of Oslo (Norway); Canadell, J. G. [Commonwealth Scientific and Industrial Research Organization (CSIRO) Oceans and Atmosphere, Canberra ACT (Australia); Sitch, S. [University of Exeter, Exter UK; Boden, T. A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States) Carbon Dioxide Information Analysis Center (CDIAC); al., et

    2015-01-01

    Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe data sets and a methodology to quantify all major components of the global carbon budget, including their uncertainties, based on the combination of a range of data, algorithms, statistics, and model estimates and their interpretation by a broad scientific community. We discuss changes compared to previous estimates as well as consistency within and among components, alongside methodology and data limitations.

  15. Methodologies for Optimum Capital Expenditure Decisions for New Medical Technology

    PubMed Central

    Landau, Thomas P.; Ledley, Robert S.

    1980-01-01

    This study deals with the development of a theory and an analytical model to support decisions regarding capital expenditures for complex new medical technology. Formal methodologies and quantitative techniques developed by applied mathematicians and management scientists can be used by health planners to develop cost-effective plans for the utilization of medical technology on a community or region-wide basis. In order to maximize the usefulness of the model, it was developed and tested against multiple technologies. The types of technologies studied include capital and labor-intensive technologies, technologies whose utilization rates vary with hospital occupancy rate, technologies whose use can be scheduled, and limited-use and large-use technologies.

  16. Can we predict the outcome for people with patellofemoral pain? A systematic review on prognostic factors and treatment effect modifiers.

    PubMed

    Matthews, M; Rathleff, M S; Claus, A; McPoil, T; Nee, R; Crossley, K; Vicenzino, B

    2017-12-01

    Patellofemoral pain (PFP) is a multifactorial and often persistent knee condition. One strategy to enhance patient outcomes is using clinically assessable patient characteristics to predict the outcome and match a specific treatment to an individual. A systematic review was conducted to determine which baseline patient characteristics were (1) associated with patient outcome (prognosis); or (2) modified patient outcome from a specific treatment (treatment effect modifiers). 6 electronic databases were searched (July 2016) for studies evaluating the association between those with PFP, their characteristics and outcome. All studies were appraised using the Epidemiological Appraisal Instrument. Studies that aimed to identify treatment effect modifiers underwent a checklist for methodological quality. The 24 included studies evaluated 180 participant characteristics. 12 studies investigated prognosis, and 12 studies investigated potential treatment effect modifiers. Important methodological limitations were identified. Some prognostic studies used a retrospective design. Studies aiming to identify treatment effect modifiers often analysed too many variables for the limiting sample size and typically failed to use a control or comparator treatment group. 16 factors were reported to be associated with a poor outcome, with longer duration of symptoms the most reported (>4 months). Preliminary evidence suggests increased midfoot mobility may predict those who have a successful outcome to foot orthoses. Current evidence can identify those with increased risk of a poor outcome, but methodological limitations make it difficult to predict the outcome after one specific treatment compared with another. Adequately designed randomised trials are needed to identify treatment effect modifiers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Critical Protection Item classification for a waste processing facility at Savannah River Site

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

    Ades, M.J.; Garrett, R.J.

    1993-10-01

    This paper describes the methodology for Critical Protection Item (CPI) classification and its application to the Structures, Systems and Components (SSC) of a waste processing facility at the Savannah River Site (SRS). The WSRC methodology for CPI classification includes the evaluation of the radiological and non-radiological consequences resulting from postulated accidents at the waste processing facility and comparison of these consequences with allowable limits. The types of accidents considered include explosions and fire in the facility and postulated accidents due to natural phenomena, including earthquakes, tornadoes, and high velocity straight winds. The radiological analysis results indicate that CPIs are notmore » required at the waste processing facility to mitigate the consequences of radiological release. The non-radiological analysis, however, shows that the Waste Storage Tank (WST) and the dike spill containment structures around the formic acid tanks in the cold chemical feed area and waste treatment area of the facility should be identified as CPIs. Accident mitigation options are provided and discussed.« less

  18. Ecologic Momentary Assessment: Perspectives on Applications and Opportunities in Research and Practice Regarding Nutrition Behaviors.

    PubMed

    Hand, Rosa K; Perzynski, Adam T

    2016-09-01

    Retrospective self-reported data have limitations, making it important to evaluate alternative forms of measurement for nutrition behaviors. Ecological momentary assessment (EMA) attempts to overcome the challenges of recalled data with real-time data collection in a subject's natural environment, often leveraging technology. This perspective piece 1) introduces the concepts and terminology of EMA, 2) provides an overview of the methodological and analytical considerations, 3) gives examples of past research using EMA, and 4) suggests new opportunities (including combining assessment and intervention) and limitations (including the need for technology) for the application of EMA to research and practice regarding nutrition behaviors. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  19. An Approach for Preoperative Planning and Performance of MR-guided Interventions Demonstrated With a Manual Manipulator in a 1.5T MRI Scanner

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

    Seimenis, Ioannis; Tsekos, Nikolaos V.; Keroglou, Christoforos

    2012-04-15

    Purpose: The aim of this work was to develop and test a general methodology for the planning and performance of robot-assisted, MR-guided interventions. This methodology also includes the employment of software tools with appropriately tailored routines to effectively exploit the capabilities of MRI and address the relevant spatial limitations. Methods: The described methodology consists of: (1) patient-customized feasibility study that focuses on the geometric limitations imposed by the gantry, the robotic hardware, and interventional tools, as well as the patient; (2) stereotactic preoperative planning for initial positioning of the manipulator and alignment of its end-effector with a selected target; andmore » (3) real-time, intraoperative tool tracking and monitoring of the actual intervention execution. Testing was performed inside a standard 1.5T MRI scanner in which the MR-compatible manipulator is deployed to provide the required access. Results: A volunteer imaging study demonstrates the application of the feasibility stage. A phantom study on needle targeting is also presented, demonstrating the applicability and effectiveness of the proposed preoperative and intraoperative stages of the methodology. For this purpose, a manually actuated, MR-compatible robotic manipulation system was used to accurately acquire a prescribed target through alternative approaching paths. Conclusions: The methodology presented and experimentally examined allows the effective performance of MR-guided interventions. It is suitable for, but not restricted to, needle-targeting applications assisted by a robotic manipulation system, which can be deployed inside a cylindrical scanner to provide the required access to the patient facilitating real-time guidance and monitoring.« less

  20. Methodologic limitations of prescription opioid safety research and recommendations for improving the evidence base.

    PubMed

    Ranapurwala, Shabbar I; Naumann, Rebecca B; Austin, Anna E; Dasgupta, Nabarun; Marshall, Stephen W

    2018-06-03

    The ongoing opioid epidemic has claimed more than a quarter million Americans' lives over the past 15 years. The epidemic began with an escalation of prescription opioid deaths and has now evolved to include secondary waves of illicit heroin and fentanyl deaths, while the deaths due to prescription opioid overdoses are still increasing. In response, the Centers for Disease Control and Prevention (CDC) moved to limit opioid prescribing with the release of opioid prescribing guidelines for chronic noncancer pain in March 2016. The guidelines represent a logical and timely federal response to this growing crisis. However, CDC acknowledged that the evidence base linking opioid prescribing to opioid use disorders and overdose was grades 3 and 4. Motivated by the need to strengthen the evidence base, this review details limitations of the opioid safety studies cited in the CDC guidelines with a focus on methodological limitations related to internal and external validity. Internal validity concerns were related to poor confounding control, variable misclassification, selection bias, competing risks, and potential competing interventions. External validity concerns arose from the use of limited source populations, historical data (in a fast-changing epidemic), and issues with handling of cancer and acute pain patients' data. We provide a nonexhaustive list of 7 recommendations to address these limitations in future opioid safety studies. Strengthening the opioid safety evidence base will aid any future revisions of the CDC guidelines and enhance their prevention impact. Copyright © 2018 John Wiley & Sons, Ltd.

  1. Low-Radiation Cellular Inductive Powering of Rodent Wireless Brain Interfaces: Methodology and Design Guide.

    PubMed

    Soltani, Nima; Aliroteh, Miaad S; Salam, M Tariqus; Perez Velazquez, Jose Luis; Genov, Roman

    2016-08-01

    This paper presents a general methodology of inductive power delivery in wireless chronic rodent electrophysiology applications. The focus is on such systems design considerations under the following key constraints: maximum power delivery under the allowable specific absorption rate (SAR), low cost and spatial scalability. The methodology includes inductive coil design considerations within a low-frequency ferrite-core-free power transfer link which includes a scalable coil-array power transmitter floor and a single-coil implanted or worn power receiver. A specific design example is presented that includes the concept of low-SAR cellular single-transmitter-coil powering through dynamic tracking of a magnet-less receiver spatial location. The transmitter coil instantaneous supply current is monitored using a small number of low-cost electronic components. A drop in its value indicates the proximity of the receiver due to the reflected impedance of the latter. Only the transmitter coil nearest to the receiver is activated. Operating at the low frequency of 1.5 MHz, the inductive powering floor delivers a maximum of 15.9 W below the IEEE C95 SAR limit, which is over three times greater than that in other recently reported designs. The power transfer efficiency of 39% and 13% at the nominal and maximum distances of 8 cm and 11 cm, respectively, is maintained.

  2. Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies.

    PubMed

    Leong, H M; Carter, Mark; Stephenson, Jennifer

    2015-12-01

    Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Measuring allostatic load in the workforce: a systematic review

    PubMed Central

    MAUSS, Daniel; LI, Jian; SCHMIDT, Burkhard; ANGERER, Peter; JARCZOK, Marc N.

    2014-01-01

    The Allostatic Load Index (ALI) has been used to establish associations between stress and health-related outcomes. This review summarizes the measurement and methodological challenges of allostatic load in occupational settings. Databases of Medline, PubPsych, and Cochrane were searched to systematically explore studies measuring ALI in working adults following the PRISMA statement. Study characteristics, biomarkers and methods were tabulated. Methodological quality was evaluated using a standardized checklist. Sixteen articles (2003–2013) met the inclusion criteria, with a total of 39 (range 6–17) different variables used to calculate ALI. Substantial heterogeneity was observed in the number and type of biomarkers used, the analytic techniques applied and study quality. Particularly, primary mediators were not regularly included in ALI calculation. Consensus on methods to measure ALI in working populations is limited. Research should include longitudinal studies using multi-systemic variables to measure employees at risk for biological wear and tear. PMID:25224337

  4. 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.

  5. A systematic review of training programs for parents of children with autism spectrum disorders: single subject contributions.

    PubMed

    Patterson, Stephanie Y; Smith, Veronica; Mirenda, Pat

    2012-09-01

    The purpose of this systematic review was to examine research utilizing single subject research designs (SSRD) to explore the effectiveness of interventions designed to increase parents' ability to support communication and social development in children with autism spectrum disorders (ASDs). Included studies were systematically assessed for methodological quality (Logan et al., 2008; Smith et al., 2007) and intervention effects. Data examining participant characteristics, study methodology, outcomes, and analysis were systematically extracted. Eleven SSRD parent-training intervention studies examining 44 participants with ASD were included. Overall, the studies were of moderate quality and reported increases in parent skills and child language and communication outcomes. The results supported by improvement rate difference (IRD) analysis indicated several interventions demonstrated positive effects for both parent and child outcomes. However, limited generalization and follow-up data suggested only one intervention demonstrated parents' accurate and ongoing intervention implementation beyond training.

  6. A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews.

    PubMed

    Jin, Ying-Hui; Wang, Guo-Hao; Sun, Yi-Rong; Li, Qi; Zhao, Chen; Li, Ge; Si, Jin-Hua; Li, Yan; Lu, Cui; Shang, Hong-Cai

    2016-11-14

    To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines-for example, in enemas, foot massage and compressing the umbilicus. A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency. There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical appraisal of systematic reviews/meta-analyses of TCMN interventions is particularly important to provide sound guidance for TCMN. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Balancing benefit and risk of medicines: a systematic review and classification of available methodologies.

    PubMed

    Mt-Isa, Shahrul; Hallgreen, Christine E; Wang, Nan; Callréus, Torbjörn; Genov, Georgy; Hirsch, Ian; Hobbiger, Stephen F; Hockley, Kimberley S; Luciani, Davide; Phillips, Lawrence D; Quartey, George; Sarac, Sinan B; Stoeckert, Isabelle; Tzoulaki, Ioanna; Micaleff, Alain; Ashby, Deborah

    2014-07-01

    The need for formal and structured approaches for benefit-risk assessment of medicines is increasing, as is the complexity of the scientific questions addressed before making decisions on the benefit-risk balance of medicines. We systematically collected, appraised and classified available benefit-risk methodologies to facilitate and inform their future use. A systematic review of publications identified benefit-risk assessment methodologies. Methodologies were appraised on their fundamental principles, features, graphical representations, assessability and accessibility. We created a taxonomy of methodologies to facilitate understanding and choice. We identified 49 methodologies, critically appraised and classified them into four categories: frameworks, metrics, estimation techniques and utility survey techniques. Eight frameworks describe qualitative steps in benefit-risk assessment and eight quantify benefit-risk balance. Nine metric indices include threshold indices to measure either benefit or risk; health indices measure quality-of-life over time; and trade-off indices integrate benefits and risks. Six estimation techniques support benefit-risk modelling and evidence synthesis. Four utility survey techniques elicit robust value preferences from relevant stakeholders to the benefit-risk decisions. Methodologies to help benefit-risk assessments of medicines are diverse and each is associated with different limitations and strengths. There is not a 'one-size-fits-all' method, and a combination of methods may be needed for each benefit-risk assessment. The taxonomy introduced herein may guide choice of adequate methodologies. Finally, we recommend 13 of 49 methodologies for further appraisal for use in the real-life benefit-risk assessment of medicines. Copyright © 2014 John Wiley & Sons, Ltd.

  8. A Framework for Model-Based Diagnostics and Prognostics of Switched-Mode Power Supplies

    DTIC Science & Technology

    2014-10-02

    system. Some highlights of the work are included but not only limited to the following aspects: first, the methodology is based on electronic ... electronic health management, with the goal of expanding the realm of electronic diagnostics and prognostics. 1. INTRODUCTION Electronic systems such...as electronic controls, onboard computers, communications, navigation and radar perform many critical functions in onboard military and commercial

  9. Identifying Barriers, Perceptions and Motivations Related to Healthy Eating and Physical Activity among 6th to 8th Grade, Rural, Limited-Resource Adolescents

    ERIC Educational Resources Information Center

    Kumar, Janavi; Adhikari, Koushik; Li, Yijing; Lindshield, Erika; Muturi, Nancy; Kidd, Tandalayo

    2016-01-01

    Purpose: The purpose of this paper is to enable community members to discuss their perceptions of eating habits and physical activity in relation to sixth, seventh, and eighth graders, and reveal facilitators and barriers to healthy eating behavior and physical activity engagement. Design/methodology/approach: Nine focus groups, which included six…

  10. Computer-Based Cognitive Training for Executive Functions after Stroke: A Systematic Review

    PubMed Central

    van de Ven, Renate M.; Murre, Jaap M. J.; Veltman, Dick J.; Schmand, Ben A.

    2016-01-01

    Background: Stroke commonly results in cognitive impairments in working memory, attention, and executive function, which may be restored with appropriate training programs. Our aim was to systematically review the evidence for computer-based cognitive training of executive dysfunctions. Methods: Studies were included if they concerned adults who had suffered stroke or other types of acquired brain injury, if the intervention was computer training of executive functions, and if the outcome was related to executive functioning. We searched in MEDLINE, PsycINFO, Web of Science, and The Cochrane Library. Study quality was evaluated based on the CONSORT Statement. Treatment effect was evaluated based on differences compared to pre-treatment and/or to a control group. Results: Twenty studies were included. Two were randomized controlled trials that used an active control group. The other studies included multiple baselines, a passive control group, or were uncontrolled. Improvements were observed in tasks similar to the training (near transfer) and in tasks dissimilar to the training (far transfer). However, these effects were not larger in trained than in active control groups. Two studies evaluated neural effects and found changes in both functional and structural connectivity. Most studies suffered from methodological limitations (e.g., lack of an active control group and no adjustment for multiple testing) hampering differentiation of training effects from spontaneous recovery, retest effects, and placebo effects. Conclusions: The positive findings of most studies, including neural changes, warrant continuation of research in this field, but only if its methodological limitations are addressed. PMID:27148007

  11. An efficient direct solver for rarefied gas flows with arbitrary statistics

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

    Diaz, Manuel A., E-mail: f99543083@ntu.edu.tw; Yang, Jaw-Yen, E-mail: yangjy@iam.ntu.edu.tw; Center of Advanced Study in Theoretical Science, National Taiwan University, Taipei 10167, Taiwan

    2016-01-15

    A new numerical methodology associated with a unified treatment is presented to solve the Boltzmann–BGK equation of gas dynamics for the classical and quantum gases described by the Bose–Einstein and Fermi–Dirac statistics. Utilizing a class of globally-stiffly-accurate implicit–explicit Runge–Kutta scheme for the temporal evolution, associated with the discrete ordinate method for the quadratures in the momentum space and the weighted essentially non-oscillatory method for the spatial discretization, the proposed scheme is asymptotic-preserving and imposes no non-linear solver or requires the knowledge of fugacity and temperature to capture the flow structures in the hydrodynamic (Euler) limit. The proposed treatment overcomes themore » limitations found in the work by Yang and Muljadi (2011) [33] due to the non-linear nature of quantum relations, and can be applied in studying the dynamics of a gas with internal degrees of freedom with correct values of the ratio of specific heat for the flow regimes for all Knudsen numbers and energy wave lengths. The present methodology is numerically validated with the unified treatment by the one-dimensional shock tube problem and the two-dimensional Riemann problems for gases of arbitrary statistics. Descriptions of ideal quantum gases including rotational degrees of freedom have been successfully achieved under the proposed methodology.« less

  12. Application of a new methodology for coastal multi-hazard-assessment & management on the state of Karnataka, India.

    PubMed

    Rosendahl Appelquist, Lars; Balstrøm, Thomas

    2015-04-01

    This paper presents the application of a new methodology for coastal multi-hazard assessment & management under a changing global climate on the state of Karnataka, India. The recently published methodology termed the Coastal Hazard Wheel (CHW) is designed for local, regional and national hazard screening in areas with limited data availability, and covers the hazards of ecosystem disruption, gradual inundation, salt water intrusion, erosion and flooding. The application makes use of published geophysical data and remote sensing information and is showcasing how the CHW framework can be applied at a scale relevant for regional planning purposes. It uses a GIS approach to develop regional and sub-regional hazard maps as well as to produce relevant hazard risk data, and includes a discussion of uncertainties, limitations and management perspectives. The hazard assessment shows that 61 percent of Karnataka's coastline has a high or very high inherent hazard of erosion, making erosion the most prevalent coastal hazard. The hazards of flooding and salt water intrusion are also relatively widespread as 39 percent of Karnataka's coastline has a high or very high inherent hazard for both of these hazard types. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. From concepts, theory, and evidence of heterogeneity of treatment effects to methodological approaches: a primer.

    PubMed

    Willke, Richard J; Zheng, Zhiyuan; Subedi, Prasun; Althin, Rikard; Mullins, C Daniel

    2012-12-13

    Implicit in the growing interest in patient-centered outcomes research is a growing need for better evidence regarding how responses to a given intervention or treatment may vary across patients, referred to as heterogeneity of treatment effect (HTE). A variety of methods are available for exploring HTE, each associated with unique strengths and limitations. This paper reviews a selected set of methodological approaches to understanding HTE, focusing largely but not exclusively on their uses with randomized trial data. It is oriented for the "intermediate" outcomes researcher, who may already be familiar with some methods, but would value a systematic overview of both more and less familiar methods with attention to when and why they may be used. Drawing from the biomedical, statistical, epidemiological and econometrics literature, we describe the steps involved in choosing an HTE approach, focusing on whether the intent of the analysis is for exploratory, initial testing, or confirmatory testing purposes. We also map HTE methodological approaches to data considerations as well as the strengths and limitations of each approach. Methods reviewed include formal subgroup analysis, meta-analysis and meta-regression, various types of predictive risk modeling including classification and regression tree analysis, series of n-of-1 trials, latent growth and growth mixture models, quantile regression, and selected non-parametric methods. In addition to an overview of each HTE method, examples and references are provided for further reading.By guiding the selection of the methods and analysis, this review is meant to better enable outcomes researchers to understand and explore aspects of HTE in the context of patient-centered outcomes research.

  14. Yogurt for treating antibiotic-associated diarrhea: Systematic review and meta-analysis.

    PubMed

    Patro-Golab, Bernadeta; Shamir, Raanan; Szajewska, Hania

    2015-06-01

    Antibiotic-associated diarrhea (AAD) is a common complication in individuals treated with antibiotics. The aim of this review was to systematically evaluate the efficacy of yogurt consumption for the prevention of AAD. In this systematic review, a number of databases including MEDLINE, EMBASE, and the Cochrane Library, with no language restrictions, were searched up to September 2014 for randomized controlled trials (RCTs) evaluating the effect of yogurt consumption in adults and children who were receiving antibiotics. The risk for bias was assessed using the Cochrane risk of bias tool. Two RCTs, both low in methodological quality, were included. Compared with no intervention, yogurt consumption reduced the risk for diarrhea in the fixed effect model (two RCTs, n = 314, relative risk [RR], 0.56; 95% confidence interval [CI], 0.31-1.00). Significant heterogeneity between the trials was detected (I(2) = 67%). The significant reduction in the risk for diarrhea was lost in the random effects model (RR, 0.45; 95% CI, 0.11-1.75). Given the simple nature of the intervention, the scarcity of data is noteworthy. No consistent effect of yogurt consumption for preventing AAD was shown. However, the data are limited and the included trials had methodological limitations. Results from large, rigorously designed RCTs are needed to assess the effect of yogurt consumption on AAD prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. The effects of group supervision of nurses: a systematic literature review.

    PubMed

    Francke, Anneke L; de Graaff, Fuusje M

    2012-09-01

    To gain insight into the existing scientific evidence on the effects of group supervision for nurses. A systematic literature study of original research publications. Searches were performed in February 2010 in PubMed, CINAHL, Cochrane Library, Embase, ERIC, the NIVEL catalogue, and PsycINFO. No limitations were applied regarding date of publication, language or country. Original research publications were eligible for review when they described group supervision programmes directed at nurses; used a control group or a pre-test post-test design; and gave information about the effects of group supervision on nurse or patient outcomes. The two review authors independently assessed studies for inclusion. The methodological quality of included studies was also independently assessed by the review authors, using a check list developed by Van Tulder et al. in collaboration with the Dutch Cochrane Centre. Data related to the original publications were extracted by one review author and checked by a second review author. No statistical pooling of outcomes was performed, because there was large heterogeneity of outcomes. A total of 1087 potentially relevant references were found. After screening of the references, eight studies with a control group and nine with a pre-test post-test design were included. Most of the 17 studies included have serious methodological limitations, but four Swedish publications in the field of dementia care had high methodological quality and all point to positive effects on nurses' attitudes and skills and/or nurse-patient interactions. However, in interpreting these positive results, it must be taken into account that these four high-quality publications concern sub-studies of one 'sliced' research project using the same study sample. Moreover, these four publications combined a group supervision intervention with the introduction of individual care planning, which also hampers conclusions about the effectiveness of group supervision alone. Although there are rather a lot of indications that group supervision of nurses is effective, evidence on the effects is still scarce. Further methodologically sound research is needed. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    PubMed

    Gorgon, Edward James R; Lazaro, Rolando T

    2016-01-01

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

  17. State of the evidence: Cannabinoids and cancer pain-A systematic review.

    PubMed

    Tateo, Sydney

    2017-02-01

    Cannabinoids are widely used to alleviate intractable symptoms such as pain, nausea, and muscle spasticity. The purpose of this review was to ascertain the current state of the science regarding use of cannabinoids for cancer pain. Four electronic databases were searched for randomized control trials of cannabinoids and cancer pain. Studies included examined the analgesic effects of cannabinoids for cancer pain. Methodological quality was assessed using the Jadad scale. Eight randomized control trials met the inclusion criteria for review. Most trials found analgesic effects from cannabinoids when compared to placebo, although not all associations reached statistical significance. The analgesic effects of cannabinoids were also limited by dose-dependent side effects. Side effects most commonly reported were changes in cognition, sedation, and dizziness. There is evidence that cannabinoids are effective adjuvants for cancer pain not completely relieved by opioid therapy, but there is a dearth of high-quality studies to support a stronger conclusion. Cannabinoids appear to be safe in low and medium doses. Methodological limitations of the trials limited the ability to make sound conclusions. Further research is warranted before efficacy, safety, and utility of cannabinoids for cancer pain can be determined. ©2016 American Association of Nurse Practitioners.

  18. A New Dimension of Health Care: Systematic Review of the Uses, Benefits, and Limitations of Social Media for Health Communication

    PubMed Central

    Hazlett, Diane E; Harrison, Laura; Carroll, Jennifer K; Irwin, Anthea; Hoving, Ciska

    2013-01-01

    Background There is currently a lack of information about the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals from primary research. Objective To review the current published literature to identify the uses, benefits, and limitations of social media for health communication among the general public, patients, and health professionals, and identify current gaps in the literature to provide recommendations for future health communication research. Methods This paper is a review using a systematic approach. A systematic search of the literature was conducted using nine electronic databases and manual searches to locate peer-reviewed studies published between January 2002 and February 2012. Results The search identified 98 original research studies that included the uses, benefits, and/or limitations of social media for health communication among the general public, patients, and health professionals. The methodological quality of the studies assessed using the Downs and Black instrument was low; this was mainly due to the fact that the vast majority of the studies in this review included limited methodologies and was mainly exploratory and descriptive in nature. Seven main uses of social media for health communication were identified, including focusing on increasing interactions with others, and facilitating, sharing, and obtaining health messages. The six key overarching benefits were identified as (1) increased interactions with others, (2) more available, shared, and tailored information, (3) increased accessibility and widening access to health information, (4) peer/social/emotional support, (5) public health surveillance, and (6) potential to influence health policy. Twelve limitations were identified, primarily consisting of quality concerns and lack of reliability, confidentiality, and privacy. Conclusions Social media brings a new dimension to health care as it offers a medium to be used by the public, patients, and health professionals to communicate about health issues with the possibility of potentially improving health outcomes. Social media is a powerful tool, which offers collaboration between users and is a social interaction mechanism for a range of individuals. Although there are several benefits to the use of social media for health communication, the information exchanged needs to be monitored for quality and reliability, and the users’ confidentiality and privacy need to be maintained. Eight gaps in the literature and key recommendations for future health communication research were provided. Examples of these recommendations include the need to determine the relative effectiveness of different types of social media for health communication using randomized control trials and to explore potential mechanisms for monitoring and enhancing the quality and reliability of health communication using social media. Further robust and comprehensive evaluation and review, using a range of methodologies, are required to establish whether social media improves health communication practice both in the short and long terms. PMID:23615206

  19. Deciphering the complex: methodological overview of statistical models to derive OMICS-based biomarkers.

    PubMed

    Chadeau-Hyam, Marc; Campanella, Gianluca; Jombart, Thibaut; Bottolo, Leonardo; Portengen, Lutzen; Vineis, Paolo; Liquet, Benoit; Vermeulen, Roel C H

    2013-08-01

    Recent technological advances in molecular biology have given rise to numerous large-scale datasets whose analysis imposes serious methodological challenges mainly relating to the size and complex structure of the data. Considerable experience in analyzing such data has been gained over the past decade, mainly in genetics, from the Genome-Wide Association Study era, and more recently in transcriptomics and metabolomics. Building upon the corresponding literature, we provide here a nontechnical overview of well-established methods used to analyze OMICS data within three main types of regression-based approaches: univariate models including multiple testing correction strategies, dimension reduction techniques, and variable selection models. Our methodological description focuses on methods for which ready-to-use implementations are available. We describe the main underlying assumptions, the main features, and advantages and limitations of each of the models. This descriptive summary constitutes a useful tool for driving methodological choices while analyzing OMICS data, especially in environmental epidemiology, where the emergence of the exposome concept clearly calls for unified methods to analyze marginally and jointly complex exposure and OMICS datasets. Copyright © 2013 Wiley Periodicals, Inc.

  20. Search and selection methodology of systematic reviews in orthodontics (2000-2004).

    PubMed

    Flores-Mir, Carlos; Major, Michael P; Major, Paul W

    2006-08-01

    More systematic reviews related to orthodontic topics are published each year, although little has been done to evaluate their search and selection methodologies. Systematic reviews related to orthodontics published between January 1, 2000, and December 31, 2004, were searched for their use of multiple electronic databases and secondary searches. The search and selection methods of identified systematic reviews were evaluated against the Cochrane Handbook's guidelines. Sixteen orthodontic systematic reviews were identified in this period. The percentage of reviews documenting and using each criterion of article searching has changed over the last 5 years, with no recognizable directional trend. On average, most systematic reviews documented their electronic search terms (88%) and inclusion-exclusion criteria (100%), and used secondary searching (75%). Many still failed to search more than MEDLINE (56%), failed to document the database names and search dates (37%), failed to document the search strategy (62%), did not use several reviewers for selecting studies (75%), and did not include all languages (81%). The methodology of systematic reviews in orthodontics is still limited, with key methodological components frequently absent or not appropriately described.

  1. Assessing the impact of healthcare research: A systematic review of methodological frameworks

    PubMed Central

    Keeley, Thomas J.; Calvert, Melanie J.

    2017-01-01

    Background Increasingly, researchers need to demonstrate the impact of their research to their sponsors, funders, and fellow academics. However, the most appropriate way of measuring the impact of healthcare research is subject to debate. We aimed to identify the existing methodological frameworks used to measure healthcare research impact and to summarise the common themes and metrics in an impact matrix. Methods and findings Two independent investigators systematically searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica Database (EMBASE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL+), the Health Management Information Consortium, and the Journal of Research Evaluation from inception until May 2017 for publications that presented a methodological framework for research impact. We then summarised the common concepts and themes across methodological frameworks and identified the metrics used to evaluate differing forms of impact. Twenty-four unique methodological frameworks were identified, addressing 5 broad categories of impact: (1) ‘primary research-related impact’, (2) ‘influence on policy making’, (3) ‘health and health systems impact’, (4) ‘health-related and societal impact’, and (5) ‘broader economic impact’. These categories were subdivided into 16 common impact subgroups. Authors of the included publications proposed 80 different metrics aimed at measuring impact in these areas. The main limitation of the study was the potential exclusion of relevant articles, as a consequence of the poor indexing of the databases searched. Conclusions The measurement of research impact is an essential exercise to help direct the allocation of limited research resources, to maximise research benefit, and to help minimise research waste. This review provides a collective summary of existing methodological frameworks for research impact, which funders may use to inform the measurement of research impact and researchers may use to inform study design decisions aimed at maximising the short-, medium-, and long-term impact of their research. PMID:28792957

  2. System data communication structures for active-control transport aircraft, volume 1

    NASA Technical Reports Server (NTRS)

    Hopkins, A. L.; Martin, J. H.; Brock, L. D.; Jansson, D. G.; Serben, S.; Smith, T. B.; Hanley, L. D.

    1981-01-01

    Candidate data communication techniques are identified, including dedicated links, local buses, broadcast buses, multiplex buses, and mesh networks. The design methodology for mesh networks is then discussed, including network topology and node architecture. Several concepts of power distribution are reviewed, including current limiting and mesh networks for power. The technology issues of packaging, transmission media, and lightning are addressed, and, finally, the analysis tools developed to aid in the communication design process are described. There are special tools to analyze the reliability and connectivity of networks and more general reliability analysis tools for all types of systems.

  3. Systematic review of the methodological quality of controlled trials evaluating Chinese herbal medicine in patients with rheumatoid arthritis

    PubMed Central

    Pan, Xin; Lopez-Olivo, Maria A; Song, Juhee; Pratt, Gregory; Suarez-Almazor, Maria E

    2017-01-01

    Objectives We appraised the methodological and reporting quality of randomised controlled clinical trials (RCTs) evaluating the efficacy and safety of Chinese herbal medicine (CHM) in patients with rheumatoid arthritis (RA). Design For this systematic review, electronic databases were searched from inception until June 2015. The search was limited to humans and non-case report studies, but was not limited by language, year of publication or type of publication. Two independent reviewers selected RCTs, evaluating CHM in RA (herbals and decoctions). Descriptive statistics were used to report on risk of bias and their adherence to reporting standards. Multivariable logistic regression analysis was performed to determine study characteristics associated with high or unclear risk of bias. Results Out of 2342 unique citations, we selected 119 RCTs including 18 919 patients: 10 108 patients received CHM alone and 6550 received one of 11 treatment combinations. A high risk of bias was observed across all domains: 21% had a high risk for selection bias (11% from sequence generation and 30% from allocation concealment), 85% for performance bias, 89% for detection bias, 4% for attrition bias and 40% for reporting bias. In multivariable analysis, fewer authors were associated with selection bias (allocation concealment), performance bias and attrition bias, and earlier year of publication and funding source not reported or disclosed were associated with selection bias (sequence generation). Studies published in non-English language were associated with reporting bias. Poor adherence to recommended reporting standards (<60% of the studies not providing sufficient information) was observed in 11 of the 23 sections evaluated. Limitations Study quality and data extraction were performed by one reviewer and cross-checked by a second reviewer. Translation to English was performed by one reviewer in 85% of the included studies. Conclusions Studies evaluating CHM often fail to meet expected methodological criteria, and high-quality evidence is lacking. PMID:28249848

  4. Demonstration of a Safety Analysis on a Complex System

    NASA Technical Reports Server (NTRS)

    Leveson, Nancy; Alfaro, Liliana; Alvarado, Christine; Brown, Molly; Hunt, Earl B.; Jaffe, Matt; Joslyn, Susan; Pinnell, Denise; Reese, Jon; Samarziya, Jeffrey; hide

    1997-01-01

    For the past 17 years, Professor Leveson and her graduate students have been developing a theoretical foundation for safety in complex systems and building a methodology upon that foundation. The methodology includes special management structures and procedures, system hazard analyses, software hazard analysis, requirements modeling and analysis for completeness and safety, special software design techniques including the design of human-machine interaction, verification, operational feedback, and change analysis. The Safeware methodology is based on system safety techniques that are extended to deal with software and human error. Automation is used to enhance our ability to cope with complex systems. Identification, classification, and evaluation of hazards is done using modeling and analysis. To be effective, the models and analysis tools must consider the hardware, software, and human components in these systems. They also need to include a variety of analysis techniques and orthogonal approaches: There exists no single safety analysis or evaluation technique that can handle all aspects of complex systems. Applying only one or two may make us feel satisfied, but will produce limited results. We report here on a demonstration, performed as part of a contract with NASA Langley Research Center, of the Safeware methodology on the Center-TRACON Automation System (CTAS) portion of the air traffic control (ATC) system and procedures currently employed at the Dallas/Fort Worth (DFW) TRACON (Terminal Radar Approach CONtrol). CTAS is an automated system to assist controllers in handling arrival traffic in the DFW area. Safety is a system property, not a component property, so our safety analysis considers the entire system and not simply the automated components. Because safety analysis of a complex system is an interdisciplinary effort, our team included system engineers, software engineers, human factors experts, and cognitive psychologists.

  5. 78 FR 5810 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ... AHRQ Quality Indicators (QIs), their technical specifications, and associated methodological issues.... The time- limited workgroup is more restricted to specific clinical or methodological issues, while..., data enhancements, and methodological advances. The standing workgroup may potentially provide guidance...

  6. 78 FR 22883 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... Quality Indicators (QIs), their technical specifications, and associated methodological issues. The...-limited workgroup is more restricted to specific clinical or methodological issues, while the standing... enhancements, and methodological advances. The standing workgroup may potentially provide guidance for the...

  7. Methodological Considerations in Social Cost Studies of Addictive Substances: A Systematic Literature Review.

    PubMed

    Verhaeghe, Nick; Lievens, Delfine; Annemans, Lieven; Vander Laenen, Freya; Putman, Koen

    2016-01-01

    Alcohol, tobacco, illicit drugs, and psychoactive pharmaceuticals' use is associated with a higher likelihood of developing several diseases and injuries and, as a consequence, considerable health-care expenditures. There is yet a lack of consistent methodologies to estimate the economic impact of addictive substances to society. The aim was to assess the methodological approaches applied in social cost studies estimating the economic impact of alcohol, tobacco, illicit drugs, and psychoactive pharmaceuticals. A systematic literature review through the electronic databases, Medline (PubMed) and Web of Science, was performed. Studies in English published from 1997 examining the social costs of the addictive substances alcohol, tobacco, illicit drugs, and psychoactive pharmaceuticals were eligible for inclusion. Twelve social cost studies met the inclusion criteria. In all studies, the direct and indirect costs were measured, but the intangible costs were seldom taken into account. A wide variety in cost items included across studies was observed. Sensitivity analyses to address the uncertainty around certain cost estimates were conducted in eight studies considered in the review. Differences in cost items included in cost-of-illness studies limit the comparison across studies. It is clear that it is difficult to deal with all consequences of substance use in cost-of-illness studies. Future social cost studies should be based on sound methodological principles in order to result in more reliable cost estimates of the economic burden of substance use.

  8. Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations of AAPM Task Group No. 218.

    PubMed

    Miften, Moyed; Olch, Arthur; Mihailidis, Dimitris; Moran, Jean; Pawlicki, Todd; Molineu, Andrea; Li, Harold; Wijesooriya, Krishni; Shi, Jie; Xia, Ping; Papanikolaou, Nikos; Low, Daniel A

    2018-04-01

    Patient-specific IMRT QA measurements are important components of processes designed to identify discrepancies between calculated and delivered radiation doses. Discrepancy tolerance limits are neither well defined nor consistently applied across centers. The AAPM TG-218 report provides a comprehensive review aimed at improving the understanding and consistency of these processes as well as recommendations for methodologies and tolerance limits in patient-specific IMRT QA. The performance of the dose difference/distance-to-agreement (DTA) and γ dose distribution comparison metrics are investigated. Measurement methods are reviewed and followed by a discussion of the pros and cons of each. Methodologies for absolute dose verification are discussed and new IMRT QA verification tools are presented. Literature on the expected or achievable agreement between measurements and calculations for different types of planning and delivery systems are reviewed and analyzed. Tests of vendor implementations of the γ verification algorithm employing benchmark cases are presented. Operational shortcomings that can reduce the γ tool accuracy and subsequent effectiveness for IMRT QA are described. Practical considerations including spatial resolution, normalization, dose threshold, and data interpretation are discussed. Published data on IMRT QA and the clinical experience of the group members are used to develop guidelines and recommendations on tolerance and action limits for IMRT QA. Steps to check failed IMRT QA plans are outlined. Recommendations on delivery methods, data interpretation, dose normalization, the use of γ analysis routines and choice of tolerance limits for IMRT QA are made with focus on detecting differences between calculated and measured doses via the use of robust analysis methods and an in-depth understanding of IMRT verification metrics. The recommendations are intended to improve the IMRT QA process and establish consistent, and comparable IMRT QA criteria among institutions. © 2018 American Association of Physicists in Medicine.

  9. A systematic review on the affordability of a healthful diet for families in the United States.

    PubMed

    Horning, Melissa L; Fulkerson, Jayne A

    2015-01-01

    As obesity rates remain alarmingly high, the importance of healthful diets is emphasized; however, affordability of such diets is disputed. Market basket surveys (MBSs) investigate the affordability of diets for families that meet minimum daily dietary requirements using actual food prices from grocery stores. This review paper describes the methods of MBSs, summarizes methodology, price and affordability findings, limitations, and suggests related policy and practice implications. This is a systematic review of 16 MBSs performed in the United States from 1985 to 2012. A comprehensive multidisciplinary database search strategy was used to identify articles meeting inclusion criteria. Results indicated MBS methodology varied across studies and price data indicated healthful diets for families are likely unaffordable when purchased from small- to medium-sized stores and may be unaffordable in larger stores when compared to the Thrifty Food Plan. Using a social ecological approach, public health nurses and all public health professionals are prime advocates for increased affordability of healthful foods. This study includes policy advocacy, particularly in support of Supplemental Nutrition Assistance Program benefits for low-income families. Future research implications are provided, including methodological recommendations for consistency and quality of forthcoming MBS research. © 2014 Wiley Periodicals, Inc.

  10. Argumentation in elementary science education: addressing methodological issues and conceptual understanding

    NASA Astrophysics Data System (ADS)

    Kaya, Ebru

    2017-11-01

    In this review essay I respond to issues raised in Mijung Kim and Wolff-Michael Roth's paper titled "Dialogical argumentation in elementary science classrooms", which presents a study dealing with dialogical argumentation in early elementary school classrooms. Since there is very limited research on lower primary school students' argumentation in school science, their paper makes a contribution to research on children's argumentation skills. In this response, I focus on two main issues to extend the discussion in Kim and Roth's paper: (a) methodological issues including conducting a quantitative study on children's argumentation levels and focusing on children's written argumentation in addition to their dialogical argumentation, and (b) investigating children's conceptual understanding along with their argumentation levels. Kim and Roth emphasize the difficulty in determining the level of children's argumentation through the Toulmin's Argument Pattern and lack of high level arguments by children due to their difficulties in writing texts. Regarding these methodological issues, I suggest designing quantitative research on coding children's argument levels because such research could potentially provide important findings on children's argumentation. Furthermore, I discuss alternative written products including posters, figures, or pictures generated by children in order to trace children's arguments, and finally articulating argumentation and conceptual understanding of children.

  11. Methodological considerations for studying social processes.

    PubMed

    Patterson, Barbara; Morin, Karen

    2012-01-01

    To discuss the nature of and considerations in the study of social processes. Social processes include the elements of time, change and human interaction and many phenomena of interest to nurse researchers. Despite the significance of social processes for nursing practice and the labelling in many studies of phenomena as processes, there seems to be an inability to describe processes fully. The paper includes a presentation of two methodological approaches for illuminating the dynamics of social processes: participant observation and prospective time-series designs. Strengths and limitations of the two paradigmatically different approaches are offered. The method an investigator chooses should be considered selectively and appropriately according to the nature of the problem, what is known about the phenomena to be studied, and the investigator's world view and theoretical perspective. The conceptualisation of process can also influence the methodological choice. Capturing a social process in its entirety with either a qualitative or quantitative approach can be a difficult task. The focus of this paper is an initiation and expansion of the dialogue about which methods provide the best insight into social processes. This knowledge may offer opportunities for nurse researchers to design and implement interventions for individuals as they progress through life events.

  12. PACKAGING CERTIFICATION PROGRAM METHODOLOGY FOR DETERMINING DOSE RATES FOR SMALL GRAM QUANTITIES IN SHIPPING PACKAGINGS

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

    Nathan, S.; Loftin, B.; Abramczyk, G.

    The Small Gram Quantity (SGQ) concept is based on the understanding that small amounts of hazardous materials, in this case radioactive materials (RAM), are significantly less hazardous than large amounts of the same materials. This paper describes a methodology designed to estimate an SGQ for several neutron and gamma emitting isotopes that can be shipped in a package compliant with 10 CFR Part 71 external radiation level limits regulations. These regulations require packaging for the shipment of radioactive materials, under both normal and accident conditions, to perform the essential functions of material containment, subcriticality, and maintain external radiation levels withinmore » the specified limits. By placing the contents in a helium leak-tight containment vessel, and limiting the mass to ensure subcriticality, the first two essential functions are readily met. Some isotopes emit sufficiently strong photon radiation that small amounts of material can yield a large dose rate outside the package. Quantifying the dose rate for a proposed content is a challenging issue for the SGQ approach. It is essential to quantify external radiation levels from several common gamma and neutron sources that can be safely placed in a specific packaging, to ensure compliance with federal regulations. The Packaging Certification Program (PCP) Methodology for Determining Dose Rate for Small Gram Quantities in Shipping Packagings provides bounding shielding calculations that define mass limits compliant with 10 CFR 71.47 for a set of proposed SGQ isotopes. The approach is based on energy superposition with dose response calculated for a set of spectral groups for a baseline physical packaging configuration. The methodology includes using the MCNP radiation transport code to evaluate a family of neutron and photon spectral groups using the 9977 shipping package and its associated shielded containers as the base case. This results in a set of multipliers for 'dose per particle' for each spectral group. For a given isotope, the source spectrum is folded with the response for each group. The summed contribution from all isotopes determines the total dose from the RAM in the container.« less

  13. Nominating under Constraints: A Systematic Comparison of Unlimited and Limited Peer Nomination Methodologies in Elementary School

    ERIC Educational Resources Information Center

    Gommans, Rob; Cillessen, Antonius H. N.

    2015-01-01

    Children's peer relationships are frequently assessed with peer nominations. An important methodological issue is whether to collect unlimited or limited nominations. Some researchers have argued that the psychometric differences between both methods are negligible, while others have claimed that one is superior over the other. The current study…

  14. Using Reported Rates of Sexually Transmitted Diseases to Illustrate Potential Methodological Issues in the Measurement of Racial and Ethnic Disparities.

    PubMed

    Chesson, Harrell W; Patel, Chirag G; Gift, Thomas L; Bernstein, Kyle T; Aral, Sevgi O

    2017-09-01

    Racial disparities in the burden of sexually transmitted diseases (STDs) have been documented and described for decades. Similarly, methodological issues and limitations in the use of disparity measures to quantify disparities in health have also been well documented. The purpose of this study was to use historic STD surveillance data to illustrate four of the most well-known methodological issues associated with the use of disparity measures. We manually searched STD surveillance reports to find examples of racial/ethnic distributions of reported STDs that illustrate key methodological issues in the use of disparity measures. The disparity measures we calculated included the black-white rate ratio, the Index of Disparity (weighted and unweighted by subgroup population), and the Gini coefficient. The 4 examples we developed included illustrations of potential differences in relative and absolute disparity measures, potential differences in weighted and nonweighted disparity measures, the importance of the reference point when calculating disparities, and differences in disparity measures in the assessment of trends in disparities over time. For example, the gonorrhea rate increased for all minority groups (relative to whites) from 1992 to 1993, yet the Index of Disparity suggested that racial/ethnic disparities had decreased. Although imperfect, disparity measures can be useful to quantify racial/ethnic disparities in STDs, to assess trends in these disparities, and to inform interventions to reduce these disparities. Our study uses reported STD rates to illustrate potential methodological issues with these disparity measures and highlights key considerations when selecting disparity measures for quantifying disparities in STDs.

  15. Patient-reported outcome instruments that evaluate adherence behaviours in adults with asthma: A systematic review of measurement properties.

    PubMed

    Gagné, Myriam; Boulet, Louis-Philippe; Pérez, Norma; Moisan, Jocelyne

    2018-04-30

    To systematically identify the measurement properties of patient-reported outcome instruments (PROs) that evaluate adherence to inhaled maintenance medication in adults with asthma. We conducted a systematic review of six databases. Two reviewers independently included studies on the measurement properties of PROs that evaluated adherence in asthmatic participants aged ≥18 years. Based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), the reviewers (1) extracted data on internal consistency, reliability, measurement error, content validity, structural validity, hypotheses testing, cross-cultural validity, criterion validity, and responsiveness; (2) assessed the methodological quality of the included studies; (3) assessed the quality of the measurement properties (positive or negative); and (4) summarised the level of evidence (limited, moderate, or strong). We screened 6,068 records and included 15 studies (14 PROs). No studies evaluated measurement error or responsiveness. Based on methodological and measurement property quality assessments, we found limited positive evidence of: (a) internal consistency of the Adherence Questionnaire, Refined Medication Adherence Reason Scale (MAR-Scale), Medication Adherence Report Scale for Asthma (MARS-A), and Test of the Adherence to Inhalers (TAI); (b) reliability of the TAI; and (c) structural validity of the Adherence Questionnaire, MAR-Scale, MARS-A, and TAI. We also found limited negative evidence of: (d) hypotheses testing of Adherence Questionnaire; (e) reliability of the MARS-A; and (f) criterion validity of the MARS-A and TAI. Our results highlighted the need to conduct further high-quality studies that will positively evaluate the reliability, validity, and responsiveness of the available PROs. This article is protected by copyright. All rights reserved.

  16. Cochrane Systematic Reviews of Chinese Herbal Medicines: An Overview

    PubMed Central

    Hu, Jing; Zhang, Junhua; Zhao, Wei; Zhang, Yongling; Zhang, Li; Shang, Hongcai

    2011-01-01

    Objectives Our study had two objectives: a) to systematically identify all existing systematic reviews of Chinese herbal medicines (CHM) published in Cochrane Library; b) to assess the methodological quality of included reviews. Methodology/Principal Findings We performed a systematic search of the Cochrane Database of Systematic Reviews (CDSR, Issue 5, 2010) to identify all reviews of CHM. A total of fifty-eight reviews were eligible for our study. Twenty-one of the included reviews had at least one Traditional Chinese Medicine (TCM) practitioner as its co-author. 7 reviews didn't include any primary study, the remaining reviews (n = 51) included a median of 9 studies and 936 participants. 50% of reviews were last assessed as up-to-date prior to 2008. The questions addressed by 39 reviews were broad in scope, in which 9 reviews combined studies with different herbal medicines. For OQAQ, the mean of overall quality score (item 10) was 5.05 (95% CI; 4.58-5.52). All reviews assessed the methodological quality of primary studies, 16% of included primary studies used adequate sequence generation and 7% used adequate allocation concealment. Of the 51 nonempty reviews, 23 reviews were reported as being inconclusive, while 27 concluded that there might be benefit of CHM, which was limited by the poor quality or inadequate quantity of included studies. 58 reviews reported searching a median of seven electronic databases, while 10 reviews did not search any Chinese database. Conclusions Now CDSR has included large numbers of CHM reviews, our study identified some areas which could be improved, such as almost half of included reviews did not have the participation of TCM practitioners and were not up-to-date according to Cochrane criteria, some reviews pooled the results of different herbal medicines and ignored the searching of Chinese databases. PMID:22174870

  17. Satellite vulnerability to space debris - an improved 3D risk assessment methodology

    NASA Astrophysics Data System (ADS)

    Grassi, Lilith; Tiboldo, Francesca; Destefanis, Roberto; Donath, Thérèse; Winterboer, Arne; Evans, Leanne; Janovsky, Rolf; Kempf, Scott; Rudolph, Martin; Schäfer, Frank; Gelhaus, Johannes

    2014-06-01

    The work described in the present paper, performed as a part of the P2 project, presents an enhanced method to evaluate satellite vulnerability to micrometeoroids and orbital debris (MMOD), using the ESABASE2/Debris tool (developed under ESA contract). Starting from the estimation of induced failures on spacecraft (S/C) components and from the computation of lethal impacts (with an energy leading to the loss of the satellite), and considering the equipment redundancies and interactions between components, the debris-induced S/C functional impairment is assessed. The developed methodology, illustrated through its application to a case study satellite, includes the capability to estimate the number of failures on internal components, overcoming the limitations of current tools which do not allow propagating the debris cloud inside the S/C. The ballistic limit of internal equipment behind a sandwich panel structure is evaluated through the implementation of the Schäfer Ryan Lambert (SRL) Ballistic Limit Equation (BLE). The analysis conducted on the case study satellite shows the S/C vulnerability index to be in the range of about 4% over the complete mission, with a significant reduction with respect to the results typically obtained with the traditional analysis, which considers as a failure the structural penetration of the satellite structural panels. The methodology has then been applied to select design strategies (additional local shielding, relocation of components) to improve S/C protection with respect to MMOD. The results of the analyses conducted on the improved design show a reduction of the vulnerability index of about 18%.

  18. Capturing complexity in work disability research: application of system dynamics modeling methodology.

    PubMed

    Jetha, Arif; Pransky, Glenn; Hettinger, Lawrence J

    2016-01-01

    Work disability (WD) is characterized by variable and occasionally undesirable outcomes. The underlying determinants of WD outcomes include patterns of dynamic relationships among health, personal, organizational and regulatory factors that have been challenging to characterize, and inadequately represented by contemporary WD models. System dynamics modeling (SDM) methodology applies a sociotechnical systems thinking lens to view WD systems as comprising a range of influential factors linked by feedback relationships. SDM can potentially overcome limitations in contemporary WD models by uncovering causal feedback relationships, and conceptualizing dynamic system behaviors. It employs a collaborative and stakeholder-based model building methodology to create a visual depiction of the system as a whole. SDM can also enable researchers to run dynamic simulations to provide evidence of anticipated or unanticipated outcomes that could result from policy and programmatic intervention. SDM may advance rehabilitation research by providing greater insights into the structure and dynamics of WD systems while helping to understand inherent complexity. Challenges related to data availability, determining validity, and the extensive time and technical skill requirements for model building may limit SDM's use in the field and should be considered. Contemporary work disability (WD) models provide limited insight into complexity associated with WD processes. System dynamics modeling (SDM) has the potential to capture complexity through a stakeholder-based approach that generates a simulation model consisting of multiple feedback loops. SDM may enable WD researchers and practitioners to understand the structure and behavior of the WD system as a whole, and inform development of improved strategies to manage straightforward and complex WD cases.

  19. Interdisciplinary mixed methods research with structurally vulnerable populations: case studies of injection drug users in San Francisco.

    PubMed

    Lopez, Andrea M; Bourgois, Philippe; Wenger, Lynn D; Lorvick, Jennifer; Martinez, Alexis N; Kral, Alex H

    2013-03-01

    Research with injection drug users (IDUs) benefits from interdisciplinary theoretical and methodological innovation because drug use is illegal, socially sanctioned and often hidden. Despite the increasing visibility of interdisciplinary, mixed methods research projects with IDUs, qualitative components are often subordinated to quantitative approaches and page restrictions in top addiction journals limit detailed reports of complex data collection and analysis logistics, thus minimizing the fuller scientific potential of genuine mixed methods. We present the methodological logistics and conceptual approaches of four mixed-methods research projects that our interdisciplinary team conducted in San Francisco with IDUs over the past two decades. These projects include combinations of participant-observation ethnography, in-depth qualitative interviewing, epidemiological surveys, photo-documentation, and geographic mapping. We adapted Greene et al.'s framework for combining methods in a single research project through: data triangulation, methodological complementarity, methodological initiation, and methodological expansion. We argue that: (1) flexible and self-reflexive methodological procedures allowed us to seize strategic opportunities to document unexpected and sometimes contradictory findings as they emerged to generate new research questions, (2) iteratively mixing methods increased the scope, reliability, and generalizability of our data, and (3) interdisciplinary collaboration contributed to a scientific "value added" that allowed for more robust theoretical and practical findings about drug use and risk-taking. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Interdisciplinary Mixed Methods Research with Structurally Vulnerable Populations: Case Studies of Injection Drug Users in San Francisco

    PubMed Central

    Lopez, Andrea; Bourgois, Philippe; Wenger, Lynn; Lorvick, Jennifer; Martinez, Alexis; Kral, Alex H.

    2013-01-01

    Research with injection drug users (IDUs) benefits from interdisciplinary theoretical and methodological innovation because drug use is illegal, socially sanctioned and often hidden. Despite the increasing visibility of interdisciplinary, mixed methods research projects with IDUs, qualitative components are often subordinated to quantitative approaches and page restrictions in top addiction journals limit detailed reports of complex data collection and analysis logistics, thus minimizing the fuller scientific potential of genuine mixed methods. We present the methodological logistics and conceptual approaches of four mixed-methods research projects that our interdisciplinary team conducted in San Francisco with IDUs over the past two decades. These projects include combinations of participant-observation ethnography, in-depth qualitative interviewing, epidemiological surveys, photo-documentation, and geographic mapping. We adapted Greene et al.’s framework for combining methods in a single research project through: data triangulation, methodological complementarity, methodological initiation, and methodological expansion. We argue that: (1) flexible and self-reflexive methodological procedures allowed us to seize strategic opportunities to document unexpected and sometimes contradictory findings as they emerged to generate new research questions, (2) iteratively mixing methods increased the scope, reliability, and generalizability of our data, and (3) interdisciplinary collaboration contributed to a scientific “value added” that allowed for more robust theoretical and practical findings about drug use and risk-taking. PMID:23312109

  1. Analysis of correlation between pediatric asthma exacerbation and exposure to pollutant mixtures with association rule mining.

    PubMed

    Toti, Giulia; Vilalta, Ricardo; Lindner, Peggy; Lefer, Barry; Macias, Charles; Price, Daniel

    2016-11-01

    Traditional studies on effects of outdoor pollution on asthma have been criticized for questionable statistical validity and inefficacy in exploring the effects of multiple air pollutants, alone and in combination. Association rule mining (ARM), a method easily interpretable and suitable for the analysis of the effects of multiple exposures, could be of use, but the traditional interest metrics of support and confidence need to be substituted with metrics that focus on risk variations caused by different exposures. We present an ARM-based methodology that produces rules associated with relevant odds ratios and limits the number of final rules even at very low support levels (0.5%), thanks to post-pruning criteria that limit rule redundancy and control for statistical significance. The methodology has been applied to a case-crossover study to explore the effects of multiple air pollutants on risk of asthma in pediatric subjects. We identified 27 rules with interesting odds ratio among more than 10,000 having the required support. The only rule including only one chemical is exposure to ozone on the previous day of the reported asthma attack (OR=1.14). 26 combinatory rules highlight the limitations of air quality policies based on single pollutant thresholds and suggest that exposure to mixtures of chemicals is more harmful, with odds ratio as high as 1.54 (associated with the combination day0 SO 2 , day0 NO, day0 NO 2 , day1 PM). The proposed method can be used to analyze risk variations caused by single and multiple exposures. The method is reliable and requires fewer assumptions on the data than parametric approaches. Rules including more than one pollutant highlight interactions that deserve further investigation, while helping to limit the search field. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Product environmental footprint in policy and market decisions: Applicability and impact assessment.

    PubMed

    Lehmann, Annekatrin; Bach, Vanessa; Finkbeiner, Matthias

    2015-07-01

    In April 2013, the European Commission published the Product and Organisation Environmental Footprint (PEF/OEF) methodology--a life cycle-based multicriteria measure of the environmental performance of products, services, and organizations. With its approach of "comparability over flexibility," the PEF/OEF methodology aims at harmonizing existing methods, while decreasing the flexibility provided by the International Organization for Standardization (ISO) standards regarding methodological choices. Currently, a 3-y pilot phase is running, aiming at testing the methodology and developing product category and organization sector rules (PEFCR/OEFSR). Although a harmonized method is in theory a good idea, the PEF/OEF methodology presents challenges, including a risk of confusion and limitations in applicability to practice. The paper discusses the main differences between the PEF and ISO methodologies and highlights challenges regarding PEF applicability, with a focus on impact assessment. Some methodological aspects of the PEF and PEFCR Guides are found to contradict the ISO 14044 (2006) and ISO 14025 (2006). Others, such as prohibition of inventory cutoffs, are impractical. The evaluation of the impact assessment methods proposed in the PEF/OEF Guide showed that the predefined methods for water consumption, land use, and abiotic resources are not adequate because of modeling artefacts, missing inventory data, or incomplete characterization factors. However, the methods for global warming and ozone depletion perform very well. The results of this study are relevant for the PEF (and OEF) pilot phase, which aims at testing the PEF (OEF) methodology (and potentially adapting it) as well as addressing challenges and coping with them. © 2015 SETAC.

  3. Methods for determination of optic nerve blood flow.

    PubMed Central

    Glazer, L. C.

    1988-01-01

    A variety of studies have been conducted over the past two decades to determine if decreased optic nerve blood flow has a role in the etiology of glaucomatous nerve damage. Five basic methods have been employed in examining blood flow. Invasive studies, utilizing electrodes placed in the optic nerve head, represent one of the first attempts to measure blood flow. More recently, the methodologies have included axoplasmic flow analysis, microspheres, radioactive tracers such as iodoantipyrine, and laser doppler measurements. The results of these studies are inconclusive and frequently contradictory. When the studies are grouped by methodology, only the iodoantipyrine data are consistent. While each of the experimental techniques has limitations, iodoantipyrine appears to have better resolution than either invasive studies or microspheres. PMID:3284212

  4. Electron-lattice coupling after high-energy deposition in aluminum

    NASA Astrophysics Data System (ADS)

    Gorbunov, S. A.; Medvedev, N. A.; Terekhin, P. N.; Volkov, A. E.

    2015-07-01

    This paper presents an analysis of the parameters of highly-excited electron subsystem of aluminum, appearing e.g. after swift heavy ion impact or laser pulse irradiation. For elevated electron temperatures, the electron heat capacity and the screening parameter are evaluated. The electron-phonon approximation of electron-lattice coupling is compared with its precise formulation based on the dynamic structure factor (DSF) formalism. The DSF formalism takes into account collective response of a lattice to excitation including all possible limit cases of this response. In particular, it automatically provides realization of electron-phonon coupling as the low-temperature limit, while switching to the plasma-limit for high electron temperatures. Aluminum is chosen as a good model system for illustration of the presented methodology.

  5. Pregnancy outcome and ultraviolet radiation; A systematic review

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

    Megaw, Lauren, E-mail: lauren.megaw@ed.ac.uk

    Background: Season and vitamin D are indirect and direct correlates of ultraviolet (UV) radiation and are associated with pregnancy outcomes. Further to producing vitamin D, UV has positive effects on cardiovascular and immune health that may support a role for UV directly benefitting pregnancy. Objectives: To investigate the effects of UV exposure on pregnancy; specifically fetal growth, preterm birth and hypertensive complications. Methods: We conducted a systematic review of Medline, EMBASE, DoPHER, Global Health, ProQuest Public Health, AustHealth Informit, SCOPUS and Google Scholar to identify 537 citations, 8 of which are included in this review. This review was registered onmore » PROSPERO and a. narrative synthesis is presented following PRISMA guidance. Results: All studies were observational and assessed at high risk of bias. Higher first trimester UV was associated with and improved fetal growth and increased hypertension in pregnancy. Interpretation is limited by study design and quality. Meta-analysis was precluded by the variety of outcomes and methods. Discussion: The low number of studies and risk of bias limit the validity of any conclusions. Environmental health methodological issues are discussed with consideration given to design and analytical improvements to further address this reproductive environmental health question. Conclusions: The evidence for UV having benefits for pregnancy hypertension and fetal growth is limited by the methodological approaches utilized. Future epidemiological efforts should focus on improving the methods of modeling and linking widely available environmental data to reproductive health outcomes. - Highlights: • Biologically plausible pathways support an association between ultraviolet radiation (UV) and pregnancy outcomes. • This study is the first systematic review of prevailing literature on the relationship between UV and singleton pregnancy outcomes. • It focuses on both substantive findings and the methodologies that were used. • Only seven studies met the search criteria and these were methodologically heterogeneous demonstrating a paucity of evidence. • Given the plausibility of the UV pathway, more studies examining this hypothesis are needed.« less

  6. 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. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Psycho-Socio-Economic Issues Challenging Multidrug Resistant Tuberculosis Patients: A Systematic Review

    PubMed Central

    Thomas, Beena Elizabeth; Shanmugam, Poonguzhali; Malaisamy, Muniyandi; Ovung, Senthanro; Suresh, Chandra; Subbaraman, Ramnath; Adinarayanan, Srividya; Nagarajan, Karikalan

    2016-01-01

    Background Limited treatment options, long duration of treatment and associated toxicity adversely impact the physical and mental well-being of multidrug-resistant tuberculosis (MDR-TB) patients. Despite research advances in the microbiological and clinical aspects of MDR-TB, research on the psychosocial context of MDR-TB is limited and less understood. Methodology We searched the databases of PubMed, MEDLINE, Embase and Google Scholar to retrieve all published articles. The final manuscripts included in the review were those with a primary focus on psychosocial issues of MDR-TB patients. These were assessed and the information was thematically extracted on the study objective, methodology used, key findings, and their implications. Intervention studies were evaluated using components of the methodological and quality rating scale. Due to the limited number of studies and the multiple methodologies employed in the observational studies, we summarized these studies using a narrative approach, rather than conducting a formal meta-analysis. We used ‘thematic synthesis’ method for extracting qualitative evidences and systematically organised to broader descriptive themes. Results A total of 282 published articles were retrieved, of which 15 articles were chosen for full text review based on the inclusion criteria. Six were qualitative studies; one was a mixed methods study; and eight were quantitative studies. The included studies were divided into the following issues affecting MDR-TB patients: a) psychological issues b) social issues and economic issues c) psychosocial interventions. It was found that all studies have documented range of psychosocial and economic challenges experienced by MDR-TB patients. Depression, stigma, discrimination, side effects of the drugs causing psychological distress, and the financial constraints due to MDR-TB were some of the common issues reported in the studies. There were few intervention studies which addressed these psychosocial issues most of which were small pilot studies. There is dearth of large scale randomized psychosocial intervention studies that can be scaled up to strengthen management of MDR-TB patients which is crucial for the TB control programme. Conclusion This review has captured the psychosocial and economic issues challenging MDR patients. However there is urgent need for feasible, innovative psychosocial and economic intervention studies that help to equip MDR-TB patients cope with their illness, improve treatment adherence, treatment outcomes and the overall quality of life of MDR-TB patients. PMID:26807933

  8. Review of reviews on exposures to synthetic organic chemicals and children's neurodevelopment: Methodological and interpretation challenges.

    PubMed

    LaKind, Judy S; Anthony, Laura G; Goodman, Michael

    2017-01-01

    Environmental epidemiology data are becoming increasingly important in public health decision making, which commonly incorporates a systematic review of multiple studies. This review addresses two fundamental questions: What is the quality of available reviews on associations between exposure to synthetic organic chemicals and neurodevelopmental outcomes? What is the value (e.g., quality and consistency) of the underlying literature? Published reviews on associations between synthetic organic environmental chemical exposures and neurodevelopmental outcomes in children were systematically evaluated. Seventy-four relevant reviews were identified, and these were evaluated with respect to four methodological characteristics: (1) systematic inclusion/exclusion criteria and reproducible methods for search and retrieval of studies; (2) structured evaluation of underlying data quality; (3) systematic assessment of consistency across specific exposure-outcome associations; and (4) evaluation of reporting/publication bias. None of the 74 reviews fully met the criteria for all four methodological characteristics. Only four reviews met two criteria, and six reviews fulfilled only one criterion. Perhaps more importantly, the higher quality reviews were not able to meet all of the criteria owing to the shortcomings of underlying studies, which lacked comparability in terms of specific research question of interest, overall design, exposure assessment, outcome ascertainment, and analytic methods. Thus, even the most thoughtful and rigorous review may be of limited value if the underlying literature includes investigations that address different hypotheses and are beset by methodological inconsistencies and limitations. Issues identified in this review of reviews illustrate considerable challenges that are facing assessments of epidemiological evidence.

  9. Vertical microphysical profiles of convective clouds as a tool for obtaining aerosol cloud-mediated climate forcings

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

    Rosenfeld, Daniel

    Quantifying the aerosol/cloud-mediated radiative effect at a global scale requires simultaneous satellite retrievals of cloud condensation nuclei (CCN) concentrations and cloud base updraft velocities (Wb). Hitherto, the inability to do so has been a major cause of high uncertainty regarding anthropogenic aerosol/cloud-mediated radiative forcing. This can be addressed by the emerging capability of estimating CCN and Wb of boundary layer convective clouds from an operational polar orbiting weather satellite. Our methodology uses such clouds as an effective analog for CCN chambers. The cloud base supersaturation (S) is determined by Wb and the satellite-retrieved cloud base drop concentrations (Ndb), which ismore » the same as CCN(S). Developing and validating this methodology was possible thanks to the ASR/ARM measurements of CCN and vertical updraft profiles. Validation against ground-based CCN instruments at the ARM sites in Oklahoma, Manaus, and onboard a ship in the northeast Pacific showed a retrieval accuracy of ±25% to ±30% for individual satellite overpasses. The methodology is presently limited to boundary layer not raining convective clouds of at least 1 km depth that are not obscured by upper layer clouds, including semitransparent cirrus. The limitation for small solar backscattering angles of <25º restricts the satellite coverage to ~25% of the world area in a single day. This methodology will likely allow overcoming the challenge of quantifying the aerosol indirect effect and facilitate a substantial reduction of the uncertainty in anthropogenic climate forcing.« less

  10. Psychotherapy Outcome Research: Issues and Questions.

    PubMed

    Shean, Glenn

    2016-03-01

    Emphasis on identifying evidence-based therapies (EBTs) has increased markedly. Lists of EBTs are the rationale for recommendations for how psychotherapy provider training programs should be evaluated, professional competence assessed, and licensure and reimbursement policies structured. There are however methodological concerns that limit the external validity of EBTs. Among the most salient is the circularity inherent in randomized control trials (RCTs) of psychotherapy that constrains the manner in which the psychological problems are defined, psychotherapy can be practiced, and change evaluated. RCT studies favor therapies that focus of specific symptoms and can be described in a manual, administered reliably across patients, completed in relatively few sessions, and involve short-term evaluations of outcome. The epistemological assumptions of a natural science approach to psychotherapy research limit how studies are conducted and assessed in ways that that advantage symptom-focused approaches and disadvantage those approaches that seek to bring broad recovery-based changes. Research methods that are not limited to RCTs and include methodology to minimize the effects of "therapist allegiance" are necessary for valid evaluations of therapeutic approaches that seek to facilitate changes that are broader than symptom reduction. Recent proposals to adopt policies that dictate training, credentialing, and reimbursement based on lists of EBTs unduly limit how psychotherapy can be conceptualized and practiced, and are not in the best interests of the profession or of individuals seeking psychotherapy services.

  11. A methodology for stochastic analysis of share prices as Markov chains with finite states.

    PubMed

    Mettle, Felix Okoe; Quaye, Enoch Nii Boi; Laryea, Ravenhill Adjetey

    2014-01-01

    Price volatilities make stock investments risky, leaving investors in critical position when uncertain decision is made. To improve investor evaluation confidence on exchange markets, while not using time series methodology, we specify equity price change as a stochastic process assumed to possess Markov dependency with respective state transition probabilities matrices following the identified state pace (i.e. decrease, stable or increase). We established that identified states communicate, and that the chains are aperiodic and ergodic thus possessing limiting distributions. We developed a methodology for determining expected mean return time for stock price increases and also establish criteria for improving investment decision based on highest transition probabilities, lowest mean return time and highest limiting distributions. We further developed an R algorithm for running the methodology introduced. The established methodology is applied to selected equities from Ghana Stock Exchange weekly trading data.

  12. Methodological issues associated with clinical trials in epilepsy.

    PubMed

    Ferlazzo, Edoardo; Sueri, Chiara; Gasparini, Sara; Russo, Emilio; Cianci, Vittoria; Ascoli, Michele; De Sarro, Giovambattista; Aguglia, Umberto

    2017-10-01

    despite methodological advances in epilepsy clinical trials, the proportion of patients reaching seizure-freedom has not substantially changed over the years. We review the main methodological limitations of current trials, the possible strategies to overcome these limits, and the issues that need to be addressed in next future. Area covered: references were identified by PubMed search until March 2017 and unpublished literature was searched on ClinicalTrials.gov. Add-on trials mainly involve refractory epilepsy subjects, reducing overall response to the investigational drug. The inclusion of subjects with earlier disease from less developed countries has partially allowed overcoming this limitation, but has introduced more random variability of results. Monotherapy trials rise methodological, economical, and ethical concerns with different regulatory requirements in European Union and in the United States of America. Newer trial designs, such as futility trials or 'time-to-event' design, have been implemented. Moreover, both add-on and monotherapy trials results might be affected by patient's ability to recognize and record seizures, and by randomness of seizures occurrence over time. Possible strategies to achieve more reliable outcomes are detailed. Expert commentary: clinical trial methodology needs to be optimized to better address regulatory agencies requirements and to encounter both patients' and clinicians' needs.

  13. Herbal Medicine for Xerostomia in Cancer Patients: A Systematic Review of Randomized Controlled Trials.

    PubMed

    Park, Bongki; Noh, Hyeonseok; Choi, Dong-Jun

    2018-06-01

    Xerostomia (dry mouth) causes many clinical problems, including oral infections, speech difficulties, and impaired chewing and swallowing of food. Many cancer patients have complained of xerostomia induced by cancer therapy. The aim of this systematic review is to assess the efficacy of herbal medicine for the treatment of xerostomia in cancer patients. Randomized controlled trials investigating the use of herbal medicines to treat xerostomia in cancer patients were included. We searched the following 12 databases without restrictions on time or language. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Twenty-five randomized controlled trials involving 1586 patients met the inclusion criteria. A total of 24 formulas were examined in the included trials. Most of the included trials were insufficiently reported in the methodology section. Five formulas were shown to significantly improve the salivary flow rate compared to comparators. Regarding the grade of xerostomia, all formulas with the exception of a Dark Plum gargle solution with normal saline were significantly effective in reducing the severity of dry mouth. Adverse events were reported in 4 trials, and adverse effects of herbal medicine were reported in 3 trials. We found herbal medicines had potential benefits for improving salivary function and reducing the severity of dry mouth in cancer patients. However, methodological limitations and a relatively small sample size reduced the strength of the evidence. More high-quality trials reporting sufficient methodological data are warranted to enforce the strength of evidence regarding the effectiveness of herbal medicines.

  14. The Effectiveness of Manual Therapy for Relieving Pain, Stiffness, and Dysfunction in Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

    PubMed

    Xu, Qinguang; Chen, Bei; Wang, Yueyi; Wang, Xuezong; Han, Dapeng; Ding, Daofang; Zheng, Yuxin; Cao, Yuelong; Zhan, Hongsheng; Zhou, Yao

    2017-05-01

    Knee osteoarthritis (KOA) is the most common form of arthritis, leading to pain disability in seniors and increased health care utilization. Manual therapy is one widely used physical treatment for KOA. To evaluate the effectiveness and adverse events (AEs) of manual therapy compared to other treatments for relieving pain, stiffness, and physical dysfunction in patients with KOA. A systematic review and meta-analysis of manual therapy for KOA. We searched PubMed, EMBASE, the Cochrane Library, and Chinese databases for relevant randomized controlled trials (RCTs) of manual therapy for patients with KOA from the inception to October 2015 without language restrictions. RCTs compared manual therapy to the placebo or other interventional control with an appropriate description of randomization. Two reviewers independently conducted the search results identification, data extraction, and methodological quality assessment. The methodological quality was assessed by PEDro scale. Pooled data was expressed as standard mean difference (SMD), with 95% confident intervals (CIs) in a random effects model. The meta-analysis of manual therapy for KOA on pain, stiffness, and physical function were conducted. Fourteen studies involving 841 KOA participants compared to other treatments were included. The methodological quality of most included RCTs was poor. The mean PEDro scale score was 6.6. The meta-analyses results showed that manual therapy had statistically significant effects on relieving pain (standardized mean difference, SMD = -0.61, 95% CI -0.95 to -0.28, P = 76%), stiffness (SMD = -0.58, 95% CI -0.95 to -0.21, P = 81%), improving physical function (SMD = -0.49, 95% CI -0.76 to -0.22, P = 65%), and total score (SMD = -0.56, 95% CI -0.78 to -0.35, P = 50%). But in the subgroups, manual therapy did not show significant improvements on stiffness and physical function when treatment duration was less than 4 weeks. And the long-term information for manual therapy was insufficient. The limitations of this systematic review include the paucity of literature and inevitable heterogeneity between included studies. The preliminary evidence from our study suggests that manual therapy might be effective and safe for improving pain, stiffness, and physical function in KOA patients and could be treated as complementary and alternative options. However, the evidence may be limited by potential bias and poor methodological quality of included studies. High-quality RCTs with long-term follow-up are warranted to confirm our findings.Key words: Knee osteoarthritis, manual therapy, systematic review.

  15. What are the Limitations of Enzymes in Synthetic Organic Chemistry?

    PubMed

    Reetz, Manfred T

    2016-12-01

    Enzymes have been used in organic chemistry and biotechnology for 100 years, but their widespread application has been prevented by a number of limitations, including the often-observed limited thermostability, narrow substrate scope, and low or wrong stereo- and/or regioselectivity. Directed evolution provides a means to address and generally solve these problems, especially since recent methodology development has made this protein engineering method faster, more efficient, and more reliable than in the past. This Darwinian approach to asymmetric catalysis has led to a number of industrial applications. Metabolic-pathway engineering, mutasynthesis, and fermentation are likewise enzyme-based techniques that enrich chemistry. This account outlines the scope, and particularly, the limitations, of biocatalysis. The complementary nature of enzymes and man-made catalysts is emphasized. © 2016 The Chemical Society of Japan & Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Consistent assignment of nursing staff to residents in nursing homes: a critical review of conceptual and methodological issues.

    PubMed

    Roberts, Tonya; Nolet, Kimberly; Bowers, Barbara

    2015-06-01

    Consistent assignment of nursing staff to residents is promoted by a number of national organizations as a strategy for improving nursing home quality and is included in pay for performance schedules in several states. However, research has shown inconsistent effects of consistent assignment on quality outcomes. In order to advance the state of the science of research on consistent assignment and inform current practice and policy, a literature review was conducted to critique conceptual and methodological understandings of consistent assignment. Twenty original research reports of consistent assignment in nursing homes were found through a variety of search strategies. Consistent assignment was conceptualized and operationalized in multiple ways with little overlap from study to study. There was a lack of established methods to measure consistent assignment. Methodological limitations included a lack of control and statistical analyses of group differences in experimental-level studies, small sample sizes, lack of attention to confounds in multicomponent interventions, and outcomes that were not theoretically linked. Future research should focus on developing a conceptual understanding of consistent assignment focused on definition, measurement, and links to outcomes. To inform current policies, testing consistent assignment should include attention to contexts within and levels at which it is most effective. Published by Oxford University Press on behalf of the Gerontological Society of America 2013.

  17. An approach to the parametric design of ion thrusters

    NASA Technical Reports Server (NTRS)

    Wilbur, Paul J.; Beattie, John R.; Hyman, Jay, Jr.

    1988-01-01

    A methodology that can be used to determine which of several physical constraints can limit ion thruster power and thrust, under various design and operating conditions, is presented. The methodology is exercised to demonstrate typical limitations imposed by grid system span-to-gap ratio, intragrid electric field, discharge chamber power per unit beam area, screen grid lifetime, and accelerator grid lifetime constraints. Limitations on power and thrust for a thruster defined by typical discharge chamber and grid system parameters when it is operated at maximum thrust-to-power are discussed. It is pointed out that other operational objectives such as optimization of payload fraction or mission duration can be substituted for the thrust-to-power objective and that the methodology can be used as a tool for mission analysis.

  18. The biomechanical differences between barefoot and shod distance running: a systematic review and preliminary meta-analysis.

    PubMed

    Hall, Jonathan P L; Barton, Christian; Jones, Paul Remy; Morrissey, Dylan

    2013-12-01

    Distance running continues to experience increased participation in the Western world, although it is associated with high injury rates. Barefoot running has been increasingly proposed as a means to prevent overuse injury due to various biomechanical differences, including reduced joint loading rates and altered kinematics and muscle activity patterns compared to shod running. The aim of this review was to systematically evaluate biomechanical differences between running barefoot and shod, including the quality of available evidence, in order to provide guidance on the phenomenon of barefoot running to the running and sports medicine communities. A comprehensive search of MEDLINE, Web of Knowledge and EMBASE from inception to January 2013 was performed. Trials evaluating injury-free recreational or competitive adults who participate in long-distance running (≥5 km), where a comparison of barefoot and shod running lower-limb kinetics, kinematics and/or electromyography were included. Studies examining sprinting and studies of single-subject design were excluded. Following initial searching, two reviewers identified a shortlist of relevant studies based on title and abstract, with the full text of these studies being tested against the inclusion criteria. References of included studies were examined and citation tracking was performed in Web of Knowledge. Two independent reviewers evaluated the methodological quality of each included study using a modified version of the Downs and Black quality index. Results of the quality assessment were used to identify high- and low-quality studies, data pooling was completed where possible and levels of evidence were determined based on the van Tulder criteria. Eighteen studies were identified, all of low methodological quality. Effect size (ES) calculation was possible for 12 studies. Pooled results indicate moderate evidence that barefoot running is associated with reduced peak ground reaction force (GRF), increased foot and ankle plantarflexion and increased knee flexion at ground contact compared with running in a neutral shoe. Limited evidence indicates barefoot running is associated with reduced impact GRF, reduced peak knee flexion and varus joint moments, and a higher stride frequency compared to a neutral shoe. Very limited to limited evidence also indicates power absorption at the knee is decreased while being increased at the ankle whilst barefoot running. Additionally, the effects of barefoot running on loading rate appear dependent on strike pattern adopted, with a forefoot strike pattern found to reduce loading rate, whilst a rearfoot strike pattern increases loading rate when running barefoot compared to shod. Key methodological weaknesses that must be addressed in future research were identified. Of particular note were absence of investigator blinding, infrequent intervention randomisation, small sample sizes and lack of evaluation following habituation. Two studies could not be retrieved because of publication in a non-English-language journal. Of particular note is that the validity of the body of work is compromised by the lack of evaluation after habituation, or re-training, of previously shod rearfoot-striking runners to barefoot forefoot-striking running styles. There has been a great deal of publicity for barefoot running, and many claims made about its effects and risks. Despite a large amount of biomechanical data available for meta-analysis, clear guidance for clinical practice is limited because of the low methodological quality of the associated studies. Preliminary biomechanical differences identified suggest barefoot running may be associated with positive biomechanical changes in regards to injury prevention, although this may be dependent on strike pattern adopted. Further research employing more robust methodology, which addresses weaknesses highlighted in this review, is needed to confirm current preliminary evidence. Additionally, prospective research would have higher validity were the biomechanical effects of habituating to barefoot running fully examined alongside an evaluation of prevention of repetitive use injury.

  19. From concepts, theory, and evidence of heterogeneity of treatment effects to methodological approaches: a primer

    PubMed Central

    2012-01-01

    Implicit in the growing interest in patient-centered outcomes research is a growing need for better evidence regarding how responses to a given intervention or treatment may vary across patients, referred to as heterogeneity of treatment effect (HTE). A variety of methods are available for exploring HTE, each associated with unique strengths and limitations. This paper reviews a selected set of methodological approaches to understanding HTE, focusing largely but not exclusively on their uses with randomized trial data. It is oriented for the “intermediate” outcomes researcher, who may already be familiar with some methods, but would value a systematic overview of both more and less familiar methods with attention to when and why they may be used. Drawing from the biomedical, statistical, epidemiological and econometrics literature, we describe the steps involved in choosing an HTE approach, focusing on whether the intent of the analysis is for exploratory, initial testing, or confirmatory testing purposes. We also map HTE methodological approaches to data considerations as well as the strengths and limitations of each approach. Methods reviewed include formal subgroup analysis, meta-analysis and meta-regression, various types of predictive risk modeling including classification and regression tree analysis, series of n-of-1 trials, latent growth and growth mixture models, quantile regression, and selected non-parametric methods. In addition to an overview of each HTE method, examples and references are provided for further reading. By guiding the selection of the methods and analysis, this review is meant to better enable outcomes researchers to understand and explore aspects of HTE in the context of patient-centered outcomes research. PMID:23234603

  20. Reading Out Single-Molecule Digital RNA and DNA Isothermal Amplification in Nanoliter Volumes with Unmodified Camera Phones

    PubMed Central

    2016-01-01

    Digital single-molecule technologies are expanding diagnostic capabilities, enabling the ultrasensitive quantification of targets, such as viral load in HIV and hepatitis C infections, by directly counting single molecules. Replacing fluorescent readout with a robust visual readout that can be captured by any unmodified cell phone camera will facilitate the global distribution of diagnostic tests, including in limited-resource settings where the need is greatest. This paper describes a methodology for developing a visual readout system for digital single-molecule amplification of RNA and DNA by (i) selecting colorimetric amplification-indicator dyes that are compatible with the spectral sensitivity of standard mobile phones, and (ii) identifying an optimal ratiometric image-process for a selected dye to achieve a readout that is robust to lighting conditions and camera hardware and provides unambiguous quantitative results, even for colorblind users. We also include an analysis of the limitations of this methodology, and provide a microfluidic approach that can be applied to expand dynamic range and improve reaction performance, allowing ultrasensitive, quantitative measurements at volumes as low as 5 nL. We validate this methodology using SlipChip-based digital single-molecule isothermal amplification with λDNA as a model and hepatitis C viral RNA as a clinically relevant target. The innovative combination of isothermal amplification chemistry in the presence of a judiciously chosen indicator dye and ratiometric image processing with SlipChip technology allowed the sequence-specific visual readout of single nucleic acid molecules in nanoliter volumes with an unmodified cell phone camera. When paired with devices that integrate sample preparation and nucleic acid amplification, this hardware-agnostic approach will increase the affordability and the distribution of quantitative diagnostic and environmental tests. PMID:26900709

  1. The Educational Toolbox: Kick Start Your Educational Program in Quality Improvement.

    PubMed

    Hoffman, Rebecca L; Medbery, Rachel L; Vandermeer, Thomas J; Morris, Jon B; Kelz, Rachel R

    2015-01-01

    To disseminate materials and learning from the proceedings of the Association of Program Directors 2014 Annual Meeting workshop on the integration of quality improvement (QI) education into the existing educational infrastructure. Modern surgical practice demands an understanding of QI methodology. Yet, today׳s surgeons are not formally educated in QI methodology. Therefore, it is hard to follow the historical mantra of "see one, do one, teach one" in the quality realm. Participants were given a brief introduction to QI approaches. A number of concrete examples of how to incorporate QI education into training programs were presented, followed by a small group session focused on the identification of barriers to incorporation. Participants were provided with a worksheet to help navigate the initial incorporation of QI education in 3 steps. Participants were representative of all types of training programs, with differing levels of existing QI integration. Barriers to QI education included lack of resident interest/buy-in, concerns over the availability of educational resources (i.e., limited time to devote to QI), and a limited QI knowledge among surgical educators. The 3 steps to kick starting the educational process included (1) choosing a specific method of QI education, (2) incorporation via barrier, infrastructure, and stakeholder identification, and (3) implementation and ongoing assessment. Recent changes in the delivery of surgical care along with the new accreditation system have necessitated the development of QI education programs for use in surgical education. To continue to make surgery safer and ensure optimal patient outcomes, surgical educators must teach each resident to adopt quality science methodology in a meaningful way. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Integrated Aero-Propulsion CFD Methodology for the Hyper-X Flight Experiment

    NASA Technical Reports Server (NTRS)

    Cockrell, Charles E., Jr.; Engelund, Walter C.; Bittner, Robert D.; Dilley, Arthur D.; Jentink, Tom N.; Frendi, Abdelkader

    2000-01-01

    Computational fluid dynamics (CFD) tools have been used extensively in the analysis and development of the X-43A Hyper-X Research Vehicle (HXRV). A significant element of this analysis is the prediction of integrated vehicle aero-propulsive performance, which includes an integration of aerodynamic and propulsion flow fields. This paper describes analysis tools used and the methodology for obtaining pre-flight predictions of longitudinal performance increments. The use of higher-fidelity methods to examine flow-field characteristics and scramjet flowpath component performance is also discussed. Limited comparisons with available ground test data are shown to illustrate the approach used to calibrate methods and assess solution accuracy. Inviscid calculations to evaluate lateral-directional stability characteristics are discussed. The methodology behind 3D tip-to-tail calculations is described and the impact of 3D exhaust plume expansion in the afterbody region is illustrated. Finally, future technology development needs in the area of hypersonic propulsion-airframe integration analysis are discussed.

  3. Gis-Based Accessibility Analysis of Urban Emergency Shelters: the Case of Adana City

    NASA Astrophysics Data System (ADS)

    Unal, M.; Uslu, C.

    2016-10-01

    Accessibility analysis of urban emergency shelters can help support urban disaster prevention planning. Pre-disaster emergency evacuation zoning has become a significant topic on disaster prevention and mitigation research. In this study, we assessed the level of serviceability of urban emergency shelters within maximum capacity, usability, sufficiency and a certain walking time limit by employing spatial analysis techniques of GIS-Network Analyst. The methodology included the following aspects: the distribution analysis of emergency evacuation demands, the calculation of shelter space accessibility and the optimization of evacuation destinations. This methodology was applied to Adana, a city in Turkey, which is located within the Alpine-Himalayan orogenic system, the second major earthquake belt after the Pacific-Belt. It was found that the proposed methodology could be useful in aiding to understand the spatial distribution of urban emergency shelters more accurately and establish effective future urban disaster prevention planning. Additionally, this research provided a feasible way for supporting emergency management in terms of shelter construction, pre-disaster evacuation drills and rescue operations.

  4. About the Undecidable Thing of Onthologic Truth of the Reality of the Fundamental Physics

    NASA Astrophysics Data System (ADS)

    Amaya, J. M.; Carbonell, M. V.; Martínez, E.; Flórez, M.

    2007-04-01

    In the philosophy of contemporary science, different currents from thought have been arising, each one of which, it has developed methodologies that include a set of normative rules for the evaluation that must decide the acceptance or rejection of the scientific theories already elaborated. These methodologies, rivals to each other, are: "Inductivism", "Conventionalism", "Falsacionism" and the "Theories like structures" (Kühn and Lakatos). These evaluative methodologies of the quality and validity of the scientific knowledge (or metatheories of science) associate a epistemological validation as soon as until limit or border of science forms, it presents/displays and it describes the observable world as well as the one that there is behind the appearances. Consequence of it has been the appearance of different valorative interpretations from the representation that the scientific theories give us of which reality is called, such as "Scientific realism", "Antirealism", "Conjectural realism", "Structural realism" etc that has based their theses on the problem on language, truth and reality.

  5. Methodological quality of systematic reviews on treatments for depression: a cross-sectional study.

    PubMed

    Chung, V C H; Wu, X Y; Feng, Y; Ho, R S T; Wong, S Y S; Threapleton, D

    2017-05-02

    Depression is one of the most common mental disorders and identifying effective treatment strategies is crucial for the control of depression. Well-conducted systematic reviews (SRs) and meta-analyses can provide the best evidence for supporting treatment decision-making. Nevertheless, the trustworthiness of conclusions can be limited by lack of methodological rigour. This study aims to assess the methodological quality of a representative sample of SRs on depression treatments. A cross-sectional study on the bibliographical and methodological characteristics of SRs published on depression treatments trials was conducted. Two electronic databases (the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects) were searched for potential SRs. SRs with at least one meta-analysis on the effects of depression treatments were considered eligible. The methodological quality of included SRs was assessed using the validated AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool. The associations between bibliographical characteristics and scoring on AMSTAR items were analysed using logistic regression analysis. A total of 358 SRs were included and appraised. Over half of included SRs (n = 195) focused on non-pharmacological treatments and harms were reported in 45.5% (n = 163) of all studies. Studies varied in methods and reporting practices: only 112 (31.3%) took the risk of bias among primary studies into account when formulating conclusions; 245 (68.4%) did not fully declare conflict of interests; 93 (26.0%) reported an 'a priori' design and 104 (29.1%) provided lists of both included and excluded studies. Results from regression analyses showed: more recent publications were more likely to report 'a priori' designs [adjusted odds ratio (AOR) 1.31, 95% confidence interval (CI) 1.09-1.57], to describe study characteristics fully (AOR 1.16, 95% CI 1.06-1.28), and to assess presence of publication bias (AOR 1.13, 95% CI 1.06-1.19), but were less likely to list both included and excluded studies (AOR 0.86, 95% CI 0.81-0.92). SRs published in journals with higher impact factor (AOR 1.14, 95% CI 1.04-1.25), completed by more review authors (AOR 1.12, 95% CI 1.01-1.24) and SRs on non-pharmacological treatments (AOR 1.62, 95% CI 1.01-2.59) were associated with better performance in publication bias assessment. The methodological quality of included SRs is disappointing. Future SRs should strive to improve rigour by considering of risk of bias when formulating conclusions, reporting conflict of interests and authors should explicitly describe harms. SR authors should also use appropriate methods to combine the results, prevent language and publication biases, and ensure timely updates.

  6. Methodological Review of Intimate Partner Violence Prevention Research

    ERIC Educational Resources Information Center

    Murray, Christine E.; Graybeal, Jennifer

    2007-01-01

    The authors present a methodological review of empirical program evaluation research in the area of intimate partner violence prevention. The authors adapted and utilized criterion-based rating forms to standardize the evaluation of the methodological strengths and weaknesses of each study. The findings indicate that the limited amount of…

  7. Qualitative Approaches to Mixed Methods Practice

    ERIC Educational Resources Information Center

    Hesse-Biber, Sharlene

    2010-01-01

    This article discusses how methodological practices can shape and limit how mixed methods is practiced and makes visible the current methodological assumptions embedded in mixed methods practice that can shut down a range of social inquiry. The article argues that there is a "methodological orthodoxy" in how mixed methods is practiced…

  8. JEDI Methodology | Jobs and Economic Development Impact Models | NREL

    Science.gov Websites

    Methodology JEDI Methodology The intent of the Jobs and Economic Development Impact (JEDI) models costs) to demonstrate the employment and economic impacts that will likely result during the estimate of overall economic impacts from specific scenarios. Please see Limitations of JEDI Models for

  9. Conducting Research with LGB People of Color: Methodological Challenges and Strategies

    ERIC Educational Resources Information Center

    DeBlaere, Cirleen; Brewster, Melanie E.; Sarkees, Anthony; Moradi, Bonnie

    2010-01-01

    Methodological barriers have been highlighted as a primary reason for the limited research with lesbian, gay, and bisexual (LGB) people of color. Thus, strategies for anticipating and addressing potential methodological barriers are needed. To address this need, this article discusses potential challenges associated with conducting research with…

  10. Investigating the Effectiveness of Special Education: An Analysis of Methodology.

    ERIC Educational Resources Information Center

    Tindal, Gerald

    1985-01-01

    The review examines evaluations of the efficacy of special education programs for mildly disabled children. The author suggests that serious methodological flaws make our present knowledge in this area very weak and proposes a methodology to address and overcome many of the limitations of previous research. (Author)

  11. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials.

    PubMed

    van Die, M Diana; Burger, Henry G; Teede, Helena J; Bone, Kerry M

    2013-05-01

    Vitex agnus-castus L. (chaste tree; chasteberry) is a popular herbal treatment, predominantly used for a range of female reproductive conditions in Anglo-American and European practice. The objective of this systematic review was to evaluate the evidence for the efficacy and safety of Vitex extracts from randomised, controlled trials investigating women's health.Eight databases were searched using Latin and common names for Vitex and phytotherapeutic preparations of the herb as a sole agent, together with filters for randomised, controlled trials or clinical trials. Methodological quality was assessed according to the Cochrane risk of bias and Jadad scales, as well as the proposed elaboration of CONSORT for reporting trials on herbal interventions.Thirteen randomised, controlled trials were identified and twelve are included in this review, of which eight investigated premenstrual syndrome, two premenstrual dysphoric disorder, and two latent hyperprolactinaemia. For premenstrual syndrome, seven of eight trials found Vitex extracts to be superior to placebo (5 of 6 studies), pyridoxine (1), and magnesium oxide (1). In premenstrual dysphoric disorder, one study reported Vitex to be equivalent to fluoxetine, while in the other, fluoxetine outperformed Vitex. In latent hyperprolactinaemia, one trial reported it to be superior to placebo for reducing TRH-stimulated prolactin secretion, normalising a shortened luteal phase, increasing mid-luteal progesterone and 17β-oestradiol levels, while the other found Vitex comparable to bromocriptine for reducing serum prolactin levels and ameliorating cyclic mastalgia. Adverse events with Vitex were mild and generally infrequent. The methodological quality of the included studies varied, but was generally moderate-to-high. Limitations include small sample sizes in some studies, heterogeneity of conditions being treated, and a range of reference treatments.Despite some methodological limitations, the results from randomised, controlled trials to date suggest benefits for Vitex extracts in the treatment of premenstrual syndrome, premenstrual dysphoric disorder and latent hyperprolactinaemia. Further research is recommended, and greater transparency in reporting for future trials. Georg Thieme Verlag KG Stuttgart · New York.

  12. Low Temperature Creep of a Titanium Alloy Ti-6Al-2Cb-1Ta-0.8Mo

    NASA Technical Reports Server (NTRS)

    Chu, H. P.

    1997-01-01

    This paper presents a methodology for the analysis of low temperature creep of titanium alloys in order to establish design limitations due to the effect of creep. The creep data on a titanium Ti-6Al-2Cb-1Ta-0.8Mo are used in the analysis. A creep equation is formulated to determine the allowable stresses so that creep at ambient temperatures can be kept within an acceptable limit during the service life of engineering structures or instruments. Microcreep which is important to design of precision instruments is included in the discussion also.

  13. Yoga and quality-of-life improvement in patients with breast cancer: a literature review.

    PubMed

    Levine, Alison Spatz; Balk, Judith L

    2012-01-01

    Women undergoing treatment for breast cancer often turn to complementary and alternative medicine (CAM), including yoga, for improvement of mood, quality of life (QOL), sleep, and treatment-related side effects. The extant literature was reviewed to examine the clinical effects of yoga practice on QOL for patients with breast cancer. QOL was defined as physical well-being, social functioning, emotional health, and function-al adaptation. Seven databases, including PubMed, Ovid MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Library, and Web of Science were used to search for studies of patients with breast cancer that included a yoga intervention and QOL assessment. Attention was paid to assessing study population, outcome variables, the type of yoga intervention used, and methodological strengths and limitations. Seventy-one articles were identified that fit the search criteria. Although the literature provided evidence of QOL benefits of yoga for patients with breast cancer, no specific aspect of yoga was identified as being most advantageous. Although participation in yoga programs appeared to benefit patients with breast cancer, greater methodological rigor is required to understand the mechanisms that contribute to their effectiveness.

  14. Multi-application controls: Robust nonlinear multivariable aerospace controls applications

    NASA Technical Reports Server (NTRS)

    Enns, Dale F.; Bugajski, Daniel J.; Carter, John; Antoniewicz, Bob

    1994-01-01

    This viewgraph presentation describes the general methodology used to apply Honywell's Multi-Application Control (MACH) and the specific application to the F-18 High Angle-of-Attack Research Vehicle (HARV) including piloted simulation handling qualities evaluation. The general steps include insertion of modeling data for geometry and mass properties, aerodynamics, propulsion data and assumptions, requirements and specifications, e.g. definition of control variables, handling qualities, stability margins and statements for bandwidth, control power, priorities, position and rate limits. The specific steps include choice of independent variables for least squares fits to aerodynamic and propulsion data, modifications to the management of the controls with regard to integrator windup and actuation limiting and priorities, e.g. pitch priority over roll, and command limiting to prevent departures and/or undesirable inertial coupling or inability to recover to a stable trim condition. The HARV control problem is characterized by significant nonlinearities and multivariable interactions in the low speed, high angle-of-attack, high angular rate flight regime. Systematic approaches to the control of vehicle motions modeled with coupled nonlinear equations of motion have been developed. This paper will discuss the dynamic inversion approach which explicity accounts for nonlinearities in the control design. Multiple control effectors (including aerodynamic control surfaces and thrust vectoring control) and sensors are used to control the motions of the vehicles in several degrees-of-freedom. Several maneuvers will be used to illustrate performance of MACH in the high angle-of-attack flight regime. Analytical methods for assessing the robust performance of the multivariable control system in the presence of math modeling uncertainty, disturbances, and commands have reached a high level of maturity. The structured singular value (mu) frequency response methodology is presented as a method for analyzing robust performance and the mu-synthesis method will be presented as a method for synthesizing a robust control system. The paper concludes with the author's expectations regarding future applications of robust nonlinear multivariable controls.

  15. Fracture toughness testing data. A bibliography

    NASA Technical Reports Server (NTRS)

    Carpenter, J. L., Jr.; Moya, N.; Stuhrke, W. F.

    1975-01-01

    This bibliography is comprised of approximately 800 reference citations related to the mechanics of failure in aerospace structures. Most of the references are for documents that include fracture toughness testing data and its application or documents on the availability and usefulness of fracture mechanics analysis methodology. The bibliography represents a search of the literature published in the period April 1962 through April 1974 and is largely limited to documents published in the United States.

  16. Methodological issues associated with preclinical drug development and increased placebo effects in schizophrenia clinical trials.

    PubMed

    Brown, Matt A; Bishnoi, Ram J; Dholakia, Sara; Velligan, Dawn I

    2016-01-20

    Recent failures to detect efficacy in clinical trials investigating pharmacological treatments for schizophrenia raise concerns regarding the potential contribution of methodological shortcomings to this research. This review provides an examination of two key methodological issues currently suspected of playing a role in hampering schizophrenia drug development; 1) limitations on the translational utility of preclinical development models, and 2) methodological challenges posed by increased placebo effects. Recommendations for strategies to address these methodological issues are addressed.

  17. Seeking to understand: using generic qualitative research to explore access to medicines and pharmacy services among resettled refugees.

    PubMed

    Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

    2016-06-01

    Introduction There are challenges associated with selecting a qualitative research approach. In a field abundant with terminology and theories, it may be difficult for a pharmacist to know where and how to begin a qualitative research journey. The purpose of this paper is to provide insight into generic qualitative research and to describe the journey of data collection of a novice qualitative researcher in the quest to answer her research question: 'What are the barriers to accessing medicines and pharmacy services for resettled refugees in Queensland, Australia?' Methodology Generic qualitative research draws on the strengths of one or more qualitative approaches. The aim is to draw out participants' ideas about things that are 'outside themselves'; rather than focussing on their inner feelings the research seeks to understand a phenomenon, a process, or the perspectives of participants. Sampling is designed to obtain a broad range of opinions about events and experiences and data collection includes interviews, questionnaires or surveys; thematic analysis is often used to analyse data. When to use Generic qualitative research provides an opportunity to develop research designs that fit researchers' epistemological stance and discipline, with research choices, including methodology and methods, being informed by the research question. Limitations Generic qualitative research is one of many methodologies that may be used to answer a research question and there is a paucity of literature about how to do it well. There is also debate about its validity as a qualitative methodology.

  18. Rapid evidence assessment: increasing the transparency of an emerging methodology.

    PubMed

    Varker, Tracey; Forbes, David; Dell, Lisa; Weston, Adele; Merlin, Tracy; Hodson, Stephanie; O'Donnell, Meaghan

    2015-12-01

    Within the field of evidence-based practice, policy makers, health care professionals and consumers require timely reviews to inform decisions on efficacious health care and treatments. Rapid evidence assessment (REA), also known as rapid review, has emerged in recent years as a literature review methodology that fulfils this need. It highlights what is known in a clinical area to the target audience in a relatively short time frame. This article discusses the lack of transparency and limited critical appraisal that can occur in REA, and goes on to propose general principles for conducting a REA. The approach that we describe is consistent with the principles underlying systematic review methodology, but also makes allowances for the rapid delivery of information as required while utilizing explicit and reproducible methods at each stage. Our method for conducting REA includes: developing an explicit research question in consultation with the end-users; clear definition of the components of the research question; development of a thorough and reproducible search strategy; development of explicit evidence selection criteria; and quality assessments and transparent decisions about the level of information to be obtained from each study. In addition, the REA may also include an assessment of the quality of the total body of evidence. Transparent reporting of REA methodologies will provide greater clarity to end-users about how the information is obtained and about the trade-offs that are made between speed and rigour. © 2015 John Wiley & Sons, Ltd.

  19. A methodological review of qualitative case study methodology in midwifery research.

    PubMed

    Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

    2016-10-01

    To explore the use and application of case study research in midwifery. Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. A methodological review of midwifery case study research using recognized templates, frameworks and reporting guidelines facilitated comprehensive analysis. An electronic database search using the date range January 2005-December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting. © 2016 John Wiley & Sons Ltd.

  20. The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review.

    PubMed

    Bear, Danielle E; Wandrag, Liesl; Merriweather, Judith L; Connolly, Bronwen; Hart, Nicholas; Grocott, Michael P W

    2017-08-26

    The lack of benefit from randomised controlled trials has resulted in significant controversy regarding the role of nutrition during critical illness in terms of long-term recovery and outcome. Although methodological caveats with a failure to adequately appreciate biological mechanisms may explain these disappointing results, it must be acknowledged that nutritional support during early critical illness, when considered alone, may have limited long-term functional impact.This narrative review focuses specifically on recent clinical trials and evaluates the impact of nutrition during critical illness on long-term physical and functional recovery.Specific focus on the trial design and methodological limitations has been considered in detail. Limitations include delivery of caloric and protein targets, patient heterogeneity, short duration of intervention, inappropriate clinical outcomes and a disregard for baseline nutritional status and nutritional intake in the post-ICU period.With survivorship at the forefront of critical care research, it is imperative that nutrition studies carefully consider biological mechanisms and trial design because these factors can strongly influence outcomes, in particular long-term physical and functional outcome. Failure to do so may lead to inconclusive clinical trials and consequent rejection of the potentially beneficial effects of nutrition interventions during critical illness.

  1. A Systematic Review of Risk Factors Prospectively Associated with Borderline Personality Disorder: Taking Stock and Moving Forward

    PubMed Central

    Stepp, Stephanie D.; Lazarus, Sophie A.; Byrd, Amy L.

    2016-01-01

    There is an urgent need to identify signs that harbinger onset of borderline personality disorder (BPD). Advancement in this area is required to refine developmental theories, discover etiological mechanisms, improve early detection, and achieve our ultimate goal of prevention. Though many studies have supported a wide range of factors that increase subsequent risk for BPD, this literature has yet to be critically evaluated, and there are no comprehensive reviews that examine and integrate these findings. To address this limitation, we conducted a systematic review to summarize and synthesize the current literature. Electronic databases were systematically searched for prospective, longitudinal studies that examined risk factors of subsequent BPD outcomes (features, symptoms, diagnosis) resulting in a total of 39 studies, reflecting 24 unique samples. Though increased risk for BPD was reliably attributed to multiple factors within social, family, maltreatment, and child domains, the most striking limitation of this research is its lack of disorder-specific findings Additional limitations, including notable heterogeneity in sampling methodology, symptom assessment methodology, and developmental timing of assessments, are discussed in terms of how close are we to pinpointing who is most at risk and why in an attempt to provide a roadmap for future research. PMID:27709988

  2. A systematic review of risk factors prospectively associated with borderline personality disorder: Taking stock and moving forward.

    PubMed

    Stepp, Stephanie D; Lazarus, Sophie A; Byrd, Amy L

    2016-10-01

    There is an urgent need to identify signs that harbinger onset of borderline personality disorder (BPD). Advancement in this area is required to refine developmental theories, discover etiological mechanisms, improve early detection, and achieve our ultimate goal of prevention. Though many studies have supported a wide range of factors that increase subsequent risk for BPD, this literature has yet to be critically evaluated, and there are no comprehensive reviews that examine and integrate these findings. To address this limitation, we conducted a systematic review to summarize and synthesize the current literature. Electronic databases were systematically searched for prospective, longitudinal studies that examined risk factors of subsequent BPD outcomes (features, symptoms, diagnosis), resulting in a total of 39 studies, reflecting 24 unique samples. Though increased risk for BPD was reliably attributed to multiple factors within social, family, maltreatment, and child domains, the most striking limitation of this research is its lack of disorder-specific findings. Additional limitations, including notable heterogeneity in sampling methodology, symptom assessment methodology, and developmental timing of assessments, are discussed in terms of how close we are to pinpointing who is most at risk and why in an attempt to provide a roadmap for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Niños Sanos, Familia Sana: Mexican immigrant study protocol for a multifaceted CBPR intervention to combat childhood obesity in two rural California towns

    PubMed Central

    2013-01-01

    Background Overweight and obese children are likely to develop serious health problems. Among children in the U.S., Latino children are affected disproportionally by the obesity epidemic. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a five-year, multi-faceted intervention study to decrease the rate of BMI growth in Mexican origin children in California’s Central Valley. This paper describes the methodology applied to develop and launch the study. Methods/Design Investigators use a community-based participatory research approach to develop a quasi-experimental intervention consisting of four main components including nutrition, physical activity, economic and art-community engagement. Each component’s definition, method of delivery, data collection and evaluation are described. Strategies to maintain engagement of the comparison community are reported as well. Discussion We present a study methodology for an obesity prevention intervention in communities with unique environmental conditions due to rural and isolated location, limited infrastructure capacity and limited resources. This combined with numerous cultural considerations and an unstable population with limited exposure to researcher expectations necessitates reassessment and adaptation of recruitment strategies, intervention delivery and data collection methods. Trial registration # NCT01900613. Trial registration NCT01900613. PMID:24172250

  4. Analysis of crack initiation and growth in the high level vibration test at Tadotsu

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

    Kassir, M.K.; Park, Y.J.; Hofmayer, C.H.

    1993-08-01

    The High Level Vibration Test data are used to assess the accuracy and usefulness of current engineering methodologies for predicting crack initiation and growth in a cast stainless steel pipe elbow under complex, large amplitude loading. The data were obtained by testing at room temperature a large scale modified model of one loop of a PWR primary coolant system at the Tadotsu Engineering Laboratory in Japan. Fatigue crack initiation time is reasonably predicted by applying a modified local strain approach (Coffin-Mason-Goodman equation) in conjunction with Miner`s rule of cumulative damage. Three fracture mechanics methodologies are applied to investigate the crackmore » growth behavior observed in the hot leg of the model. These are: the {Delta}K methodology (Paris law), {Delta}J concepts and a recently developed limit load stress-range criterion. The report includes a discussion on the pros and cons of the analysis involved in each of the methods, the role played by the key parameters influencing the formulation and a comparison of the results with the actual crack growth behavior observed in the vibration test program. Some conclusions and recommendations for improvement of the methodologies are also provided.« less

  5. The potential of neuroscience for health sciences education: towards convergence of evidence and resisting seductive allure.

    PubMed

    de Bruin, Anique B H

    2016-12-01

    Since emergence of the field 'Educational Neuroscience' (EN) in the late nineties of the previous century, a debate has emerged about the potential this field holds to influence teaching and learning in the classroom. By now, most agree that the original claims promising direct translations to teaching and learning were too strong. I argue here that research questions in (health professions) education require multi-methodological approaches, including neuroscience, while carefully weighing what (combination of) approaches are most suitable given a research question. Only through a multi-methodological approach will convergence of evidence emerge, which is so desperately needed for improving teaching and learning in the classroom. However, both researchers and teachers should become aware of the so-called 'seductive allure' of EN; that is, the demonstrable physical location and apparent objectivity of the measurements can be interpreted as yielding more powerful evidence and warranting stronger conclusions than, e.g., behavioral experiments, where in fact oftentimes the reverse is the case. I conclude that our tendency as researchers to commit ourselves to one methodological approach and to addressing educational research questions from a single methodological perspective is limiting progress in educational science and in translation to education.

  6. Social capital: theory, evidence, and implications for oral health.

    PubMed

    Rouxel, Patrick L; Heilmann, Anja; Aida, Jun; Tsakos, Georgios; Watt, Richard G

    2015-04-01

    In the last two decades, there has been increasing application of the concept of social capital in various fields of public health, including oral health. However, social capital is a contested concept with debates on its definition, measurement, and application. This study provides an overview of the concept of social capital, highlights the various pathways linking social capital to health, and discusses the potential implication of this concept for health policy. An extensive and diverse international literature has examined the relationship between social capital and a range of general health outcomes across the life course. A more limited but expanding literature has also demonstrated the potential influence of social capital on oral health. Much of the evidence in relation to oral health is limited by methodological shortcomings mainly related to the measurement of social capital, cross-sectional study designs, and inadequate controls for confounding factors. Further research using stronger methodological designs should explore the role of social capital in oral health and assess its potential application in the development of oral health improvement interventions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Whither cognitive bias modification research? Commentary on the special section articles.

    PubMed

    MacLeod, Colin; Koster, Ernst H W; Fox, Elaine

    2009-02-01

    This commentary reviews key theoretical, methodological, and clinical issues raised by recent research on cognitive bias modification (CBM). The authors identify the major ways in which the new work reported within this special section extends earlier CBM research. In particular, they note that it considers a wider range of participants, includes a greater diversity of symptoms measures, and targets for change a broader array of processing biases than previously has been the case. Furthermore, they point out that the present work develops and employs a more diverse arsenal of bias modification procedures, in some cases delivered across extended periods of time within naturalistic settings. They also draw attention to methodological limitations associated with the current studies, offering recommendations concerning how future CBM research might profitably build upon these exciting new directions while overcoming such limitations. Finally, they evaluate the theoretical and applied implications of the reported findings, discussing their capacity to illuminate the causal contributions made by cognitive bias to emotional vulnerability and their promise concerning the potential therapeutic value of CBM as a clinical tool.

  8. A comprehensive review on the quasi-induced exposure technique.

    PubMed

    Jiang, Xinguo; Lyles, Richard W; Guo, Runhua

    2014-04-01

    The goal is to comprehensively examine the state-of-the-art applications and methodological development of quasi-induced exposure and consequently pinpoint the future research directions in terms of implementation guidelines, limitations, and validity tests. The paper conducts a comprehensive review on approximately 45 published papers relevant to quasi-induced exposure regarding four key topics of interest: applications, responsibility assignment, validation of assumptions, and methodological development. Specific findings include that: (1) there is no systematic data screening procedure in place and how the eliminated crash data will impact the responsibility assignment is generally unknown; (2) there is a lack of necessary efforts to assess the validity of assumptions prior to its application and the validation efforts are mostly restricted to the aggregated levels due to the limited availability of exposure truth; and (3) there is a deficiency of quantitative analyses to evaluate the magnitude and directions of bias as a result of injury risks and crash avoidance ability. The paper points out the future research directions and insights in terms of the validity tests and implementation guidelines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Limits of detection and decision. Part 4

    NASA Astrophysics Data System (ADS)

    Voigtman, E.

    2008-02-01

    Probability density functions (PDFs) have been derived for a number of commonly used limit of detection definitions, including several variants of the Relative Standard Deviation of the Background-Background Equivalent Concentration (RSDB-BEC) method, for a simple linear chemical measurement system (CMS) having homoscedastic, Gaussian measurement noise and using ordinary least squares (OLS) processing. All of these detection limit definitions serve as both decision and detection limits, thereby implicitly resulting in 50% rates of Type 2 errors. It has been demonstrated that these are closely related to Currie decision limits, if the coverage factor, k, is properly defined, and that all of the PDFs are scaled reciprocals of noncentral t variates. All of the detection limits have well-defined upper and lower limits, thereby resulting in finite moments and confidence limits, and the problem of estimating the noncentrality parameter has been addressed. As in Parts 1-3, extensive Monte Carlo simulations were performed and all the simulation results were found to be in excellent agreement with the derived theoretical expressions. Specific recommendations for harmonization of detection limit methodology have also been made.

  10. Efficacy and safety of Suanzaoren decoction for primary insomnia: a systematic review of randomized controlled trials

    PubMed Central

    2013-01-01

    Background Insomnia is a widespread human health problem, but there currently are the limitations of conventional therapies available. Suanzaoren decoction (SZRD) is a well known classic Chinese herbal prescription for insomnia and has been treating people’s insomnia for more than thousand years. The objective of this study was to evaluate the efficacy and safety of SZRD for insomnia. Methods A systematic literature search was performed for 6 databases up to July of 2012 to identify randomized control trials (RCTs) involving SZRD for insomniac patients. The methodological quality of RCTs was assessed independently using the Cochrane Handbook for Systematic Reviews of Interventions. Results Twelve RCTs with total of 1376 adult participants were identified. The methodological quality of all included trials are no more than 3/8 score. Majority of the RCTs concluded that SZRD was more significantly effective than benzodiazepines for treating insomnia. Despite these positive outcomes, there were many methodological shortcomings in the studies reviewed, including insufficient information about randomization generation and absence of allocation concealment, lack of blinding and no placebo control, absence of intention-to-treat analysis and lack of follow-ups, selective publishing and reporting, and small number of sample sizes. A number of clinical heterogeneity such as diagnosis, intervention, control, and outcome measures were also reviewed. Only 3 trials reported adverse events, whereas the other 9 trials did not provide the safety information. Conclusions Despite the apparent reported positive findings, there is insufficient evidence to support efficacy of SZRD for insomnia due to the poor methodological quality and the small number of trials of the included studies. SZRD seems generally safe, but is insufficient evidence to make conclusions on the safety because fewer studies reported the adverse events. Further large sample-size and well-designed RCTs are needed. PMID:23336848

  11. Cost-of-illness studies for bipolar disorder: systematic review of international studies.

    PubMed

    Jin, Huajie; McCrone, Paul

    2015-04-01

    Bipolar disorder (BD) may result in a greater burden than all forms of cancer, Alzheimer's disease and epilepsy. Cost-of-illness (COI) studies provide useful information on the economic burden that BD imposes on a society. Furthermore, COI studies are pivotal sources of evidence used in economic evaluations. This study aims to give a general overview of COI studies for BD and to discuss methodological issues that might potentially influence results. This study also aims to provide recommendations to improve practice in this area, based on the review. A search was performed to identify COI studies of BD. The following electronic databases were searched: MEDLINE, EMBASE, PsycInfo, Cochrane Database of Systematic Reviews, HMIC and openSIGLE. The primary outcome of this review was the annual cost per BD patient. A narrative assessment of key methodological issues was also included. Based on these findings, recommendations for good practice were drafted. Fifty-four studies were included in this review. Because of the widespread methodological heterogeneity among included studies, no attempt has been made to pool results of different studies. Potential areas for methodological improvement were identified. These were: description of the disease and population, the approach to deal with comorbidities, reporting the rationale and impact for choosing different cost perspectives, and ways in which uncertainty is addressed. This review showed that numerous COI studies have been conducted for BD since 1995. However, these studies employed varying methods, which limit the comparability of findings. The recommendations provided by this review can be used by those conducting COI studies and those critiquing them, to increase the credibility and reporting of study results.

  12. Life cycle costing of food waste: A review of methodological approaches.

    PubMed

    De Menna, Fabio; Dietershagen, Jana; Loubiere, Marion; Vittuari, Matteo

    2018-03-01

    Food waste (FW) is a global problem that is receiving increasing attention due to its environmental and economic impacts. Appropriate FW prevention, valorization, and management routes could mitigate or avoid these effects. Life cycle thinking and approaches, such as life cycle costing (LCC), may represent suitable tools to assess the sustainability of these routes. This study analyzes different LCC methodological aspects and approaches to evaluate FW management and valorization routes. A systematic literature review was carried out with a focus on different LCC approaches, their application to food, FW, and waste systems, as well as on specific methodological aspects. The review consisted of three phases: a collection phase, an iterative phase with experts' consultation, and a final literature classification. Journal papers and reports were retrieved from selected databases and search engines. The standardization of LCC methodologies is still in its infancy due to a lack of consensus over definitions and approaches. Research on the life cycle cost of FW is limited and generally focused on FW management, rather than prevention or valorization of specific flows. FW prevention, valorization, and management require a consistent integration of LCC and Life Cycle Assessment (LCA) to avoid tradeoffs between environmental and economic impacts. This entails a proper investigation of methodological differences between attributional and consequential modelling in LCC, especially with regard to functional unit, system boundaries, multi-functionality, included cost, and assessed impacts. Further efforts could also aim at finding the most effective and transparent categorization of costs, in particular when dealing with multiple stakeholders sustaining costs of FW. Interpretation of results from LCC of FW should take into account the effect on larger economic systems. Additional key performance indicators and analytical tools could be included in consequential approaches. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Association between component costs, study methodologies, and foodborne illness-related factors with the cost of nontyphoidal Salmonella illness.

    PubMed

    McLinden, Taylor; Sargeant, Jan M; Thomas, M Kate; Papadopoulos, Andrew; Fazil, Aamir

    2014-09-01

    Nontyphoidal Salmonella spp. are one of the most common causes of bacterial foodborne illness. Variability in cost inventories and study methodologies limits the possibility of meaningfully interpreting and comparing cost-of-illness (COI) estimates, reducing their usefulness. However, little is known about the relative effect these factors have on a cost-of-illness estimate. This is important for comparing existing estimates and when designing new cost-of-illness studies. Cost-of-illness estimates, identified through a scoping review, were used to investigate the association between descriptive, component cost, methodological, and foodborne illness-related factors such as chronic sequelae and under-reporting with the cost of nontyphoidal Salmonella spp. illness. The standardized cost of nontyphoidal Salmonella spp. illness from 30 estimates reported in 29 studies ranged from $0.01568 to $41.22 United States dollars (USD)/person/year (2012). The mean cost of nontyphoidal Salmonella spp. illness was $10.37 USD/person/year (2012). The following factors were found to be significant in multiple linear regression (p≤0.05): the number of direct component cost categories included in an estimate (0-4, particularly long-term care costs) and chronic sequelae costs (inclusion/exclusion), which had positive associations with the cost of nontyphoidal Salmonella spp. illness. Factors related to study methodology were not significant. Our findings indicated that study methodology may not be as influential as other factors, such as the number of direct component cost categories included in an estimate and costs incurred due to chronic sequelae. Therefore, these may be the most important factors to consider when designing, interpreting, and comparing cost of foodborne illness studies.

  14. Sensory re-education after nerve injury of the upper limb: a systematic review.

    PubMed

    Oud, Tanja; Beelen, Anita; Eijffinger, Elianne; Nollet, Frans

    2007-06-01

    To systematically review the available evidence for the effectiveness of sensory re-education to improve the sensibility of the hand in patients with a peripheral nerve injury of the upper limb. Studies were identified by an electronic search in the databases MEDLINE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), and the database of the Dutch National Institute of Allied Health Professions (Doconline) and by screening the reference lists of relevant articles. Two reviewers selected studies that met the following inclusion criteria: all designs except case reports, adults with impaired sensibility of the hand due to a peripheral nerve injury of the upper limb, and sensibility and functional sensibility as outcome measures. The methodological quality of the included studies was independently assessed by two reviewers. A best-evidence synthesis was performed, based on design, methodological quality and significant findings on outcome measures. Seven studies, with sample sizes ranging from 11 to 49, were included in the systematic review and appraised for content. Five of these studies were of poor methodological quality. One uncontrolled study (N = 1 3 ) was considered to be of sufficient methodological quality, and one randomized controlled trial (N = 49) was of high methodological quality. Best-evidence synthesis showed that there is limited evidence for the effectiveness of sensory re-education, provided by a statistically significant improvement in sensibility found in one high-quality randomized controlled trial. There is a need for further well-defined clinical trials to assess the effectiveness of sensory re-education of patients with impaired sensibility of the hand due to a peripheral nerve injury.

  15. Methodological Limitations of the Application of Expert Systems Methodology in Reading.

    ERIC Educational Resources Information Center

    Willson, Victor L.

    Methodological deficiencies inherent in expert-novice reading research make it impossible to draw inferences about curriculum change. First, comparisons of intact groups are often used as a basis for making causal inferences about how observed characteristics affect behaviors. While comparing different groups is not by itself a useless activity,…

  16. Is lavender an anxiolytic drug? A systematic review of randomised clinical trials.

    PubMed

    Perry, R; Terry, R; Watson, L K; Ernst, E

    2012-06-15

    Lavender (Lavandula angustifolia) is often recommended for stress/anxiety relief and believed to possess anxiolytic effects. To critically evaluate the efficacy/effectiveness of lavender for the reduction of stress/anxiety. Seven electronic databases were searched to identify all relevant studies. All methods of lavender administration were included. Data extraction and the assessment of the methodological quality of all included trials were conducted by two independent reviewers. Fifteen RCTs met the inclusion criteria. Two trials scored 4 points on the 5-point Jadad scale, the remaining 13 scored two or less. Results from seven trials appeared to favour lavender over controls for at least one relevant outcome. Methodological issues limit the extent to which any conclusions can be drawn regarding the efficacy/effectiveness of lavender. The best evidence suggests that oral lavender supplements may have some therapeutic effects. However, further independent replications are needed before firm conclusions can be drawn. Copyright © 2012 Elsevier GmbH. All rights reserved.

  17. Hypnosis for procedure-related pain and distress in pediatric cancer patients: a systematic review of effectiveness and methodology related to hypnosis interventions.

    PubMed

    Richardson, Janet; Smith, Joanna E; McCall, Gillian; Pilkington, Karen

    2006-01-01

    The aim of this study was to systematically review and critically appraise the evidence on the effectiveness of hypnosis for procedure-related pain and distress in pediatric cancer patients. A comprehensive search of major biomedical and specialist complementary and alternative medicine databases was conducted. Citations were included from the databases' inception to March 2005. Efforts were made to identify unpublished and ongoing research. Controlled trials were appraised using predefined criteria. Clinical commentaries were obtained for each study. Seven randomized controlled clinical trials and one controlled clinical trial were found. Studies report positive results, including statistically significant reductions in pain and anxiety/distress, but a number of methodological limitations were identified. Systematic searching and appraisal has demonstrated that hypnosis has potential as a clinically valuable intervention for procedure-related pain and distress in pediatric cancer patients. Further research into the effectiveness and acceptability of hypnosis for pediatric cancer patients is recommended.

  18. Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions.

    PubMed

    Pollock, Michelle; Fernandes, Ricardo M; Hartling, Lisa

    2017-03-23

    Overviews of reviews (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. It is recommended that authors assess and report the methodological quality of SRs in overviews-for example, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Currently, there is variation in whether and how overview authors assess and report SR quality, and limited guidance is available. Our objectives were to: examine methodological considerations involved in using AMSTAR to assess the quality of Cochrane and non-Cochrane SRs in overviews of healthcare interventions; identify challenges (and develop potential decision rules) when using AMSTAR in overviews; and examine the potential impact of considering methodological quality when making inclusion decisions in overviews. We selected seven overviews of healthcare interventions and included all SRs meeting each overview's inclusion criteria. For each SR, two reviewers independently conducted AMSTAR assessments with consensus and discussed challenges encountered. We also examined the correlation between AMSTAR assessments and SR results/conclusions. Ninety-five SRs were included (30 Cochrane, 65 non-Cochrane). Mean AMSTAR assessments (9.6/11 vs. 5.5/11; p < 0.001) and inter-rater reliability (AC1 statistic: 0.84 vs. 0.69; "almost perfect" vs. "substantial" using the Landis & Koch criteria) were higher for Cochrane compared to non-Cochrane SRs. Four challenges were identified when applying AMSTAR in overviews: the scope of the SRs and overviews often differed; SRs examining similar topics sometimes made different methodological decisions; reporting of non-Cochrane SRs was sometimes poor; and some non-Cochrane SRs included other SRs as well as primary studies. Decision rules were developed to address each challenge. We found no evidence that AMSTAR assessments were correlated with SR results/conclusions. Results indicate that the AMSTAR tool can be used successfully in overviews that include Cochrane and non-Cochrane SRs, though decision rules may be useful to circumvent common challenges. Findings support existing recommendations that quality assessments of SRs in overviews be conducted independently, in duplicate, with a process for consensus. Results also suggest that using methodological quality to guide inclusion decisions (e.g., to exclude poorly conducted and reported SRs) may not introduce bias into the overview process.

  19. The effectiveness of mindfulness-based interventions for supporting people with intellectual disabilities: a narrative review.

    PubMed

    Harper, Sarah K; Webb, Thomas L; Rayner, Kelly

    2013-05-01

    A number of studies have used mindfulness-based interventions to influence the behavior of people with intellectual disabilities, to improve their quality of life, and to reduce challenging behavior. The present review critically evaluates 18 studies and assesses the clinical and academic impact of their findings. Strengths identified included replicable methodological approaches, use of multiple baseline designs, strong construct and criterion validity, and consideration of the mechanisms by which mindfulness influences behavior change. Limitations included a lack of randomized controlled trials, inclusion of qualitative data without structured analysis, limited use of statistical analyses, and problems with sampling leading to difficulties generalizing findings. There was also a paucity of research investigating the impact of "Dialectical Behavior Therapy" and "Acceptance and Commitment Therapy" and the role of mindfulness within these approaches. Further research is warranted in this regard.

  20. 78 FR 60715 - Sedaxane; Pesticide Tolerances

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-02

    ... 28-day dermal study did not show systemic toxicity at the limit dose of 1,000 milligrams/kilogram/day... Enforcement Methodology Adequate enforcement methodology is available to enforce the tolerance expression. A...

  1. Main methods of trajectory synthesis for scenarios of space missions with gravity assist maneuvers in the system of Jupiter and with landing on one of its satellites

    NASA Astrophysics Data System (ADS)

    Golubev, Yu. F.; Tuchin, A. G.; Grushevskii, A. V.; Koryanov, V. V.; Tuchin, D. A.; Morskoy, I. M.; Simonov, A. V.; Dobrovolskii, V. S.

    2016-12-01

    The development of a methodology for designing trajectories of spacecraft intended for the contact and remote studies of Jupiter and its natural satellites is considered. This methodology should take into account a number of specific features. Firstly, in order to maintain the propellant consumption at an acceptable level, the flight profile, ensuring the injection of the spacecraft into orbit around the Jovian moon, should include a large number of gravity assist maneuvers both in the interplanetary phase of the Earth-to-Jupiter flight and during the flight in the system of the giant planet. Secondly, the presence of Jupiter's powerful radiation belts also imposes fairly strict limitations on the trajectory parameters.

  2. Assessment of Methodological Quality of Economic Evaluations in Belgian Drug Reimbursement Applications

    PubMed Central

    Simoens, Steven

    2013-01-01

    Objectives This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. Materials and Methods For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Results Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Conclusions Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation. PMID:24386474

  3. Assessment of methodological quality of economic evaluations in belgian drug reimbursement applications.

    PubMed

    Simoens, Steven

    2013-01-01

    This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation.

  4. Reducing hospital-acquired pressure ulcers using bundle methodology in pediatric and neonatal patients receiving extracorporeal membrane oxygenation therapy: An integrative review and call to action.

    PubMed

    Courtwright, Suzanne E; Mastro, Kari A; Preuster, Christa; Dardashti, Navid; McGill, Sandra; Madelon, Myrlene; Johnson, Donna

    2017-10-01

    This review focuses on identifying (1) evidence of the effectiveness of care bundle methodology to reduce hospital-acquired pressure ulcers (HAPUs) in pediatric and neonatal patients receiving extracorporeal membrane oxygenation (ECMO) therapy and (2) barriers to implementing HAPU care bundles in this at-risk population. An integrative review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search of the scientific literature was performed. Studies included were published between January 2011 and February 2016. A total of seven articles met inclusion criteria. Data were extracted from each published article and analyzed to identify common themes, specifically bundle methodology and barriers to implementing HAPU bundles, in this population. There is limited research on effectiveness of care bundle methodology in reducing HAPUs in children, and no research specific to its effectiveness in pediatric or neonatal ECMO patients. No research was identified studying barriers to implementation of HAPU care bundles in this population. Nurses are well poised to test innovative strategies to prevent HAPUs. Nurses should consider implementing and testing bundle methodology to reduce HAPU in this at-risk population, and conduct research to identify any barriers to implementing this strategy. There is literature to support the use of nurses as unit-based skin care champions to facilitate teamwork and reliable use of the bundle, both critical components to the success of bundle methodology. © 2017 Wiley Periodicals, Inc.

  5. The case for multimodal analysis of atypical interaction: questions, answers and gaze in play involving a child with autism.

    PubMed

    Muskett, Tom; Body, Richard

    2013-01-01

    Conversation analysis (CA) continues to accrue interest within clinical linguistics as a methodology that can enable elucidation of structural and sequential orderliness in interactions involving participants who produce ostensibly disordered communication behaviours. However, it can be challenging to apply CA to re-examine clinical phenomena that have initially been defined in terms of linguistics, as a logical starting point for analysis may be to focus primarily on the organisation of language ("talk") in such interactions. In this article, we argue that CA's methodological power can only be fully exploited in this research context when a multimodal analytic orientation is adopted, where due consideration is given to participants' co-ordinated use of multiple semiotic resources including, but not limited to, talk (e.g., gaze, embodied action, object use and so forth). To evidence this argument, a two-layered analysis of unusual question-answer sequences in a play episode involving a child with autism is presented. It is thereby demonstrated that only when the scope of enquiry is broadened to include gaze and other embodied action can an account be generated of orderliness within these sequences. This finding has important implications for CA's application as a research methodology within clinical linguistics.

  6. A framework for measurement and harmonization of pediatric multiple sclerosis etiologic research studies: The Pediatric MS Tool-Kit.

    PubMed

    Magalhaes, Sandra; Banwell, Brenda; Bar-Or, Amit; Fortier, Isabel; Hanwell, Heather E; Lim, Ming; Matt, Georg E; Neuteboom, Rinze F; O'Riordan, David L; Schneider, Paul K; Pugliatti, Maura; Shatenstein, Bryna; Tansey, Catherine M; Wassmer, Evangeline; Wolfson, Christina

    2018-06-01

    While studying the etiology of multiple sclerosis (MS) in children has several methodological advantages over studying etiology in adults, studies are limited by small sample sizes. Using a rigorous methodological process, we developed the Pediatric MS Tool-Kit, a measurement framework that includes a minimal set of core variables to assess etiological risk factors. We solicited input from the International Pediatric MS Study Group to select three risk factors: environmental tobacco smoke (ETS) exposure, sun exposure, and vitamin D intake. To develop the Tool-Kit, we used a Delphi study involving a working group of epidemiologists, neurologists, and content experts from North America and Europe. The Tool-Kit includes six core variables to measure ETS, six to measure sun exposure, and six to measure vitamin D intake. The Tool-Kit can be accessed online ( www.maelstrom-research.org/mica/network/tool-kit ). The goals of the Tool-Kit are to enhance exposure measurement in newly designed pediatric MS studies and comparability of results across studies, and in the longer term to facilitate harmonization of studies, a methodological approach that can be used to circumvent issues of small sample sizes. We believe the Tool-Kit will prove to be a valuable resource to guide pediatric MS researchers in developing study-specific questionnaire.

  7. Tracking of childhood overweight into adulthood: a systematic review of the literature.

    PubMed

    Singh, A S; Mulder, C; Twisk, J W R; van Mechelen, W; Chinapaw, M J M

    2008-09-01

    Overweight and obesity in youth are important public health concerns and are of particular interest because of possible long-term associations with adult weight status and morbidity. The aim of this study was to systematically review the literature and update evidence concerning persistence of childhood overweight. A computerized bibliographical search--restricted to studies with a prospective or retrospective longitudinal design--was conducted. Two authors independently extracted data and assessed the methodological quality of the included studies in four dimensions (i) study population and participation rate; (ii) study attrition; (iii) data collection and (iv) data analysis. Conclusions were based on a rating system of three levels of evidence. A total of 25 publications were selected for inclusion in this review. According to a methodological quality assessment, 13 studies were considered to be of high quality. The majority of these high-quality studies were published after 2001, indicating that recently published data, in particular, provide us with reliable information. All included studies consistently report an increased risk of overweight and obese youth becoming overweight adults, suggesting that the likelihood of persistence of overweight into adulthood is moderate for overweight and obese youth. However, predictive values varied considerably. Limiting aspects with respect to generalizability and methodological issues are discussed.

  8. Modeling and Simulation Behavior Validation Methodology and Extension Model Validation for the Individual Soldier

    DTIC Science & Technology

    2015-03-01

    domains. Major model functions include: • Ground combat: Light and heavy forces. • Air mobile forces. • Future forces. • Fixed-wing and rotary-wing...Constraints: • Study must be completed no later than 31 December 2014. • Entity behavior limited to select COMBATXXI Mobility , Unmanned Aerial System...and SQL backend , as well as any open application programming interface API. • Allows data transparency and data driven navigation through the model

  9. A methodology for calculating transport emissions in cities with limited traffic data: Case study of diesel particulates and black carbon emissions in Murmansk.

    PubMed

    Kholod, N; Evans, M; Gusev, E; Yu, S; Malyshev, V; Tretyakova, S; Barinov, A

    2016-03-15

    This paper presents a methodology for calculating exhaust emissions from on-road transport in cities with low-quality traffic data and outdated vehicle registries. The methodology consists of data collection approaches and emission calculation methods. For data collection, the paper suggests using video survey and parking lot survey methods developed for the International Vehicular Emissions model. Additional sources of information include data from the largest transportation companies, vehicle inspection stations, and official vehicle registries. The paper suggests using the European Computer Programme to Calculate Emissions from Road Transport (COPERT) 4 model to calculate emissions, especially in countries that implemented European emissions standards. If available, the local emission factors should be used instead of the default COPERT emission factors. The paper also suggests additional steps in the methodology to calculate emissions only from diesel vehicles. We applied this methodology to calculate black carbon emissions from diesel on-road vehicles in Murmansk, Russia. The results from Murmansk show that diesel vehicles emitted 11.7 tons of black carbon in 2014. The main factors determining the level of emissions are the structure of the vehicle fleet and the level of vehicle emission controls. Vehicles without controls emit about 55% of black carbon emissions. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. A theoretical and experimental investigation of propeller performance methodologies

    NASA Technical Reports Server (NTRS)

    Korkan, K. D.; Gregorek, G. M.; Mikkelson, D. C.

    1980-01-01

    This paper briefly covers aspects related to propeller performance by means of a review of propeller methodologies; presentation of wind tunnel propeller performance data taken in the NASA Lewis Research Center 10 x 10 wind tunnel; discussion of the predominent limitations of existing propeller performance methodologies; and a brief review of airfoil developments appropriate for propeller applications.

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

    PubMed

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

    2018-03-01

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

  12. Permanent catheters for recurrent ascites-a critical and systematic review of study methodology.

    PubMed

    Christensen, Lars; Wildgaard, Lorna; Wildgaard, Kim

    2016-06-01

    Management of refractory ascites traditionally includes medical treatment with diuretics or intermittent paracentesis. Patients with recurrent ascites may benefit from the use of permanent intra-abdominal catheters with more frequent drainage without hospitalization. The objective was to systematically asses the methodology of factors and endpoints reported in studies investigating permanent catheters for recurrent ascites treatment. Using a systematic search strategy, we critically assessed the methodology when treating refractory ascites using a permanent catheter. Studies critically assessed included both retro- and prospective studies. A total of 715 unique articles were found via PubMed, The Cochrane Library and Embase. Twenty-nine studies (tunnelled catheter = 12, peritoneal ports = 6 and peritoneovenous shunts = 11) with three distinct types of permanent catheters fulfilled the inclusion criteria. Only three studies reported technical success less than 100 %. Data on complications and treatment were not available in all papers; peritonitis (48 %), cellulitis (41 %), prophylactic antibiotics (48 %) and complications to catheter insertion were difficult to distinguish from advanced co-morbidity of patients. Thirteen studies (45 %) reported some type of evaluating patient experience or functional outcome, but only three studies used validated reproducible scales when assessing outcomes. Fifteen of the 29 studies included 30 patients or less. Knowledge is limited because complications and outcomes are poorly defined. The expected increase in catheter treatment of refractory ascites necessitates comparative studies, using validated patient-related outcomes, and the reporting of unambiguous complications. A proposal of variables to include in future studies is presented.

  13. What guidance is available for researchers conducting overviews of reviews of healthcare interventions? A scoping review and qualitative metasummary.

    PubMed

    Pollock, Michelle; Fernandes, Ricardo M; Becker, Lorne A; Featherstone, Robin; Hartling, Lisa

    2016-11-14

    Overviews of reviews (overviews) compile data from multiple systematic reviews to provide a single synthesis of relevant evidence for decision-making. Despite their increasing popularity, there is limited methodological guidance available for researchers wishing to conduct overviews. The objective of this scoping review is to identify and collate all published and unpublished documents containing guidance for conducting overviews examining the efficacy, effectiveness, and/or safety of healthcare interventions. Our aims were to provide a map of existing guidance documents; identify similarities, differences, and gaps in the guidance contained within these documents; and identify common challenges involved in conducting overviews. We conducted an iterative and extensive search to ensure breadth and comprehensiveness of coverage. The search involved reference tracking, database and web searches (MEDLINE, EMBASE, DARE, Scopus, Cochrane Methods Studies Database, Google Scholar), handsearching of websites and conference proceedings, and contacting overview producers. Relevant guidance statements and challenges encountered were extracted, edited, grouped, abstracted, and presented using a qualitative metasummary approach. We identified 52 guidance documents produced by 19 research groups. Relatively consistent guidance was available for the first stages of the overview process (deciding when and why to conduct an overview, specifying the scope, and searching for and including systematic reviews). In contrast, there was limited or conflicting guidance for the latter stages of the overview process (quality assessment of systematic reviews and their primary studies, collecting and analyzing data, and assessing quality of evidence), and many of the challenges identified were also related to these stages. An additional, overarching challenge identified was that overviews are limited by the methods, reporting, and coverage of their included systematic reviews. This compilation of methodological guidance for conducting overviews of healthcare interventions will facilitate the production of future overviews and can help authors address key challenges they are likely to encounter. The results of this project have been used to identify areas where future methodological research is required to generate empirical evidence for overview methods. Additionally, these results have been used to update the chapter on overviews in the next edition of the Cochrane Handbook for Systematic Reviews of Interventions.

  14. Systematic review of the methodological quality of controlled trials evaluating Chinese herbal medicine in patients with rheumatoid arthritis.

    PubMed

    Pan, Xin; Lopez-Olivo, Maria A; Song, Juhee; Pratt, Gregory; Suarez-Almazor, Maria E

    2017-03-01

    We appraised the methodological and reporting quality of randomised controlled clinical trials (RCTs) evaluating the efficacy and safety of Chinese herbal medicine (CHM) in patients with rheumatoid arthritis (RA). For this systematic review, electronic databases were searched from inception until June 2015. The search was limited to humans and non-case report studies, but was not limited by language, year of publication or type of publication. Two independent reviewers selected RCTs, evaluating CHM in RA (herbals and decoctions). Descriptive statistics were used to report on risk of bias and their adherence to reporting standards. Multivariable logistic regression analysis was performed to determine study characteristics associated with high or unclear risk of bias. Out of 2342 unique citations, we selected 119 RCTs including 18 919 patients: 10 108 patients received CHM alone and 6550 received one of 11 treatment combinations. A high risk of bias was observed across all domains: 21% had a high risk for selection bias (11% from sequence generation and 30% from allocation concealment), 85% for performance bias, 89% for detection bias, 4% for attrition bias and 40% for reporting bias. In multivariable analysis, fewer authors were associated with selection bias (allocation concealment), performance bias and attrition bias, and earlier year of publication and funding source not reported or disclosed were associated with selection bias (sequence generation). Studies published in non-English language were associated with reporting bias. Poor adherence to recommended reporting standards (<60% of the studies not providing sufficient information) was observed in 11 of the 23 sections evaluated. Study quality and data extraction were performed by one reviewer and cross-checked by a second reviewer. Translation to English was performed by one reviewer in 85% of the included studies. Studies evaluating CHM often fail to meet expected methodological criteria, and high-quality evidence is lacking. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Are research papers reporting results from nutrigenetics clinical research a potential source of biohype?

    PubMed

    Stenne, R; Hurlimann, T; Godard, Béatrice

    2012-01-01

    Nutrigenetics is a promising field, but the achievability of expected benefits is challenged by the methodological limitations that are associated with clinical research in that field. The mere existence of these limitations suggests that promises about potential outcomes may be premature. Thus, benefits claimed in scientific journal articles in which these limitations are not acknowledged might stimulate biohype. This article aims to examine whether nutrigenetics clinical research articles are a potential source of biohype. Of the 173 articles identified, 16 contained claims in which clinical applications were extrapolated from study results. The methodological limitations being incompletely acknowledged, these articles could potentially be a source of biohype.

  16. A Systematic Review of Economic Evaluation Methodologies Between Resource-Limited and Resource-Rich Countries: A Case of Rotavirus Vaccines.

    PubMed

    Thiboonboon, Kittiphong; Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Rattanavipapong, Waranya; Teerawattananon, Yot

    2016-12-01

    For more than three decades, the number and influence of economic evaluations of healthcare interventions have been increasing and gaining attention from a policy level. However, concerns about the credibility of these studies exist, particularly in studies from low- and middle- income countries (LMICs). This analysis was performed to explore economic evaluations conducted in LMICs in terms of methodological variations, quality of reporting and evidence used for the analyses. These results were compared with those studies conducted in high-income countries (HICs). Rotavirus vaccine was selected as a case study, as it is one of the interventions that many studies in both settings have explored. The search to identify individual studies on rotavirus vaccines was performed in March 2014 using MEDLINE and the National Health Service Economic Evaluation Database. Only full economic evaluations, comparing cost and outcomes of at least two alternatives, were included for review. Selected criteria were applied to assess methodological variation, quality of reporting and quality of evidence used. Eighty-five studies were included, consisting of 45 studies in HICs and 40 studies in LMICs. Seventy-five percent of the studies in LMICs were published by researchers from HICs. Compared with studies in HICs, the LMIC studies showed less methodological variety. In terms of the quality of reporting, LMICs had a high adherence to technical criteria, but HICs ultimately proved to be better. The same trend applied for the quality of evidence used. Although the quality of economic evaluations in LMICs was not as high as those from HICs, it is of an acceptable level given several limitations that exist in these settings. However, the results of this study may not reflect the fact that LMICs have developed a better research capacity in the domain of health economics, given that most of the studies were in theory led by researchers from HICs. Putting more effort into fostering the development of both research infrastructure and capacity building as well as encouraging local engagement in LMICs is thus necessary.

  17. Dementia ascertainment using existing data in UK longitudinal and cohort studies: a systematic review of methodology.

    PubMed

    Sibbett, Ruth A; Russ, Tom C; Deary, Ian J; Starr, John M

    2017-07-03

    Studies investigating the risk factors for or causation of dementia must consider subjects prior to disease onset. To overcome the limitations of prospective studies and self-reported recall of information, the use of existing data is key. This review provides a narrative account of dementia ascertainment methods using sources of existing data. The literature search was performed using: MEDLINE, EMBASE, PsychInfo and Web of Science. Included articles reported a UK-based study of dementia in which cases were ascertained using existing data. Existing data included that which was routinely collected and that which was collected for previous research. After removing duplicates, abstracts were screened and the remaining articles were included for full-text review. A quality tool was used to evaluate the description of the ascertainment methodology. Of the 3545 abstracts screened, 360 articles were selected for full-text review. 47 articles were included for final consideration. Data sources for ascertainment included: death records, national datasets, research databases and hospital records among others. 36 articles used existing data alone for ascertainment, of which 27 used only a single data source. The most frequently used source was a research database. Quality scores ranged from 7/16 to 16/16. Quality scores were better for articles with dementia ascertainment as an outcome. Some papers performed validation studies of dementia ascertainment and most indicated that observed rates of dementia were lower than expected. We identified a lack of consistency in dementia ascertainment methodology using existing data. With no data source identified as a "gold-standard", we suggest the use of multiple sources. Where possible, studies should access records with evidence to confirm the diagnosis. Studies should also calculate the dementia ascertainment rate for the population being studied to enable a comparison with an expected rate.

  18. Chinese herbal medicine for cancer-related fatigue: a systematic review of randomized clinical trials.

    PubMed

    Su, Chun-Xiang; Wang, Li-Qiong; Grant, Suzanne J; Liu, Jian-Ping

    2014-06-01

    To assess the effectiveness and safety of Chinese herbal medicine for the treatment of cancer-related fatigue. We systematically searched seven electronic databases and two trial registries for randomized clinical trials of Chinese herbal medicine for cancer-related fatigue. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool. Data were synthesized using RevMan 5.2 software. A total of 10 trials involving 751 participants with cancer-related fatigue were identified and the methodological quality of the included trials was generally poor. Chinese herbal medicine used alone or in combination with chemotherapy or supportive care showed significant relief in cancer-related fatigue compared to placebo, chemotherapy or supportive care based on single trials. Chinese herbal medicine plus chemotherapy or supportive care was superior to chemotherapy or supportive care in improving quality of life. Data from one trial demonstrated Chinese herbal medicine exerted a greater beneficial effect on relieving anxiety but no difference in alleviating depression. Seven trials reported adverse events and no severe adverse effects were found in Chinese herbal medicine groups. The findings from limited number of trials suggest that Chinese herbal medicine seems to be effective and safe in the treatment of cancer-related fatigue. However, the current evidence is insufficient to draw a confirmative conclusion due to the poor methodological quality of included trials. Thus, conducting rigorously designed trials on potential Chinese herbal medicine is warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Effect of oral healthcare education on knowledge, attitude and skills of care home nurses: a systematic literature review.

    PubMed

    de Lugt-Lustig, Kersti H M E; Vanobbergen, Jacques N O; van der Putten, Gert-Jan; De Visschere, Luc M J; Schols, Jos M G A; de Baat, Cees

    2014-02-01

    To systematically review the literature on the effect of providing oral healthcare education to care home nurses on their oral healthcare knowledge and attitude and their oral hygiene care skills. A literature search was obtained for relevant articles on oral healthcare education of nurses in care homes, using five electronic retrieval systems and databases. The search was limited to human studies, articles published in English and articles published during the period January 1990 to December 2011. The methodological quality of an article was assessed on the basis of criteria published by the Cochrane Collaboration. For articles not meeting all methodological quality criteria, relevance criteria were used to determine how much scientific evidence could be assigned to the study findings. In accordance with the methodological quality criteria, two randomized controlled trials were included. Additionally, four studies were included after determining the scientific evidence of the study findings. The studies included revealed some scientific evidence and indications that an oral healthcare education programme for care home nurses may improve the nurses' oral healthcare knowledge and attitude. Any effect of oral healthcare education to care home nurses' oral hygiene care skills could not be determined. Oral healthcare education may have a positive effect on care home nurses' oral healthcare knowledge and attitude and on care home residents' oral hygiene, whereas any effect on care home nurses' oral hygiene care skills could not be found. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Thiopeptide Antibiotics: Retrospective and Recent Advances

    PubMed Central

    Just-Baringo, Xavier; Albericio, Fernando; Álvarez, Mercedes

    2014-01-01

    Thiopeptides, or thiazolyl peptides, are a relatively new family of antibiotics that already counts with more than one hundred different entities. Although they are mainly isolated from soil bacteria, during the last decade, new members have been isolated from marine samples. Far from being limited to their innate antibacterial activity, thiopeptides have been found to possess a wide range of biological properties, including anticancer, antiplasmodial, immunosuppressive, etc. In spite of their ribosomal origin, these highly posttranslationally processed peptides have posed a fascinating synthetic challenge, prompting the development of various methodologies and strategies. Regardless of their limited solubility, intensive investigations are bringing thiopeptide derivatives closer to the clinic, where they are likely to show their veritable therapeutic potential. PMID:24445304

  1. Exercising away the blues: can it help multiple sclerosis-related depression?

    PubMed

    Feinstein, Anthony; Rector, Neil; Motl, Robert

    2013-12-01

    The present review focuses on exercise as a treatment for depression in multiple sclerosis. While exercise has emerged as a potentially useful treatment in the general psychiatry-depression literature, the findings from a small number of multiple sclerosis-related treatment trials are equivocal. Methodological limitations, including the absence of depression as a primary endpoint, characterize all the studies completed to date. Given that limitations in study design can be rectified, it is time to put exercise to the test once more. Depressed multiple sclerosis patients and those involved in their care are looking for guidance here because the prevailing zeitgeist promotes the benefits of exercise to mood. But first, some clarity is needed.

  2. BORDERLINE RESECTABLE PANCREATIC CANCER: Need for Standardization and Methods for Optimal Clinical Trial Design

    PubMed Central

    Katz, Matthew HG; Marsh, Robert; Herman, Joseph M.; Shi, Qian; Collison, Eric; Venook, Alan; Kindler, Hedy; Alberts, Steven; Philip, Philip; Lowy, Andrew M.; Pisters, Peter; Posner, Mitchell; Berlin, Jordan; Ahmad, Syed A.

    2017-01-01

    Methodological limitations of prior studies have prevented progress in the treatment of patients with borderline resectable pancreatic adenocarcinoma. Shortcomings have included the absence of staging and treatment standards and pre-existing biases with regard to the use of neoadjuvant therapy and the role of vascular resection at pancreatectomy. In this manuscript, we will review limitations of studies of borderline resectable PDAC reported to date, highlight important controversies related to this disease stage, emphasize the research infrastructure necessary for its future study, and present a recently-approved Intergroup pilot study (Alliance A0201101) that will provide a foundation upon which subsequent well-designed clinical trials can be performed. PMID:23435609

  3. Data mining for signals in spontaneous reporting databases: proceed with caution.

    PubMed

    Stephenson, Wendy P; Hauben, Manfred

    2007-04-01

    To provide commentary and points of caution to consider before incorporating data mining as a routine component of any Pharmacovigilance program, and to stimulate further research aimed at better defining the predictive value of these new tools as well as their incremental value as an adjunct to traditional methods of post-marketing surveillance. Commentary includes review of current data mining methodologies employed and their limitations, caveats to consider in the use of spontaneous reporting databases and caution against over-confidence in the results of data mining. Future research should focus on more clearly delineating the limitations of the various quantitative approaches as well as the incremental value that they bring to traditional methods of pharmacovigilance.

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

    PubMed

    Merzel, Cheryl; D'Afflitti, Joanna

    2003-04-01

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

  5. Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review

    PubMed Central

    van Mourik, Maaike S M; van Duijn, Pleun Joppe; Moons, Karel G M; Bonten, Marc J M; Lee, Grace M

    2015-01-01

    Objective Measuring the incidence of healthcare-associated infections (HAI) is of increasing importance in current healthcare delivery systems. Administrative data algorithms, including (combinations of) diagnosis codes, are commonly used to determine the occurrence of HAI, either to support within-hospital surveillance programmes or as free-standing quality indicators. We conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. Methods Systematic search of Medline, Embase, CINAHL and Cochrane for relevant studies (1995–2013). Methodological quality assessment was performed using QUADAS-2 criteria; diagnostic accuracy estimates were stratified by HAI type and key study characteristics. Results 57 studies were included, the majority aiming to detect surgical site or bloodstream infections. Study designs were very diverse regarding the specification of their administrative data algorithm (code selections, follow-up) and definitions of HAI presence. One-third of studies had important methodological limitations including differential or incomplete HAI ascertainment or lack of blinding of assessors. Observed sensitivity and positive predictive values of administrative data algorithms for HAI detection were very heterogeneous and generally modest at best, both for within-hospital algorithms and for formal quality indicators; accuracy was particularly poor for the identification of device-associated HAI such as central line associated bloodstream infections. The large heterogeneity in study designs across the included studies precluded formal calculation of summary diagnostic accuracy estimates in most instances. Conclusions Administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended. If hospitals and policymakers choose to rely on administrative data for HAI surveillance, continued improvements to existing algorithms and their robust validation are imperative. PMID:26316651

  6. A methodology for testing fault-tolerant software

    NASA Technical Reports Server (NTRS)

    Andrews, D. M.; Mahmood, A.; Mccluskey, E. J.

    1985-01-01

    A methodology for testing fault tolerant software is presented. There are problems associated with testing fault tolerant software because many errors are masked or corrected by voters, limiter, or automatic channel synchronization. This methodology illustrates how the same strategies used for testing fault tolerant hardware can be applied to testing fault tolerant software. For example, one strategy used in testing fault tolerant hardware is to disable the redundancy during testing. A similar testing strategy is proposed for software, namely, to move the major emphasis on testing earlier in the development cycle (before the redundancy is in place) thus reducing the possibility that undetected errors will be masked when limiters and voters are added.

  7. OPUS: Optimal Projection for Uncertain Systems. Volume 1

    DTIC Science & Technology

    1991-09-01

    unifiedI control- design methodology that directly addresses these technology issues. 1 In particular, optimal projection theory addresses the need for...effects, and limited identification accuracy in a 1-g environment. The principal contribution of OPUS is a unified design methodology that...characterizing solutions to constrained control- design problems. Transforming OPUS into a practi- cal design methodology requires the development of

  8. Using Constructivist Case Study Methodology to Understand Community Development Processes: Proposed Methodological Questions to Guide the Research Process

    ERIC Educational Resources Information Center

    Lauckner, Heidi; Paterson, Margo; Krupa, Terry

    2012-01-01

    Often, research projects are presented as final products with the methodologies cleanly outlined and little attention paid to the decision-making processes that led to the chosen approach. Limited attention paid to these decision-making processes perpetuates a sense of mystery about qualitative approaches, particularly for new researchers who will…

  9. Alternative Methods of Base Level Demand Forecasting for Economic Order Quantity Items,

    DTIC Science & Technology

    1975-12-01

    Note .. . . . . . . . . . . . . . . . . . . . . . . . 21 AdaptivC Single Exponential Smooti-ing ........ 21 Choosing the Smoothiing Constant... methodology used in the study, an analysis of results, .And a detailed summary. Chapter I. Methodology , contains a description o the data, a...Chapter IV. Detailed Summary, presents a detailed summary of the findings, lists the limitations inherent in the 7’" research methodology , and

  10. Thermoregulatory responses in exercising rats: methodological aspects and relevance to human physiology.

    PubMed

    Wanner, Samuel Penna; Prímola-Gomes, Thales Nicolau; Pires, Washington; Guimarães, Juliana Bohnen; Hudson, Alexandre Sérvulo Ribeiro; Kunstetter, Ana Cançado; Fonseca, Cletiana Gonçalves; Drummond, Lucas Rios; Damasceno, William Coutinho; Teixeira-Coelho, Francisco

    2015-01-01

    Rats are used worldwide in experiments that aim to investigate the physiological responses induced by a physical exercise session. Changes in body temperature regulation, which may affect both the performance and the health of exercising rats, are evident among these physiological responses. Despite the universal use of rats in biomedical research involving exercise, investigators often overlook important methodological issues that hamper the accurate measurement of clear thermoregulatory responses. Moreover, much debate exists regarding whether the outcome of rat experiments can be extrapolated to human physiology, including thermal physiology. Herein, we described the impact of different exercise intensities, durations and protocols and environmental conditions on running-induced thermoregulatory changes. We focused on treadmill running because this type of exercise allows for precise control of the exercise intensity and the measurement of autonomic thermoeffectors associated with heat production and loss. Some methodological issues regarding rat experiments, such as the sites for body temperature measurements and the time of day at which experiments are performed, were also discussed. In addition, we analyzed the influence of a high body surface area-to-mass ratio and limited evaporative cooling on the exercise-induced thermoregulatory responses of running rats and then compared these responses in rats to those observed in humans. Collectively, the data presented in this review represent a reference source for investigators interested in studying exercise thermoregulation in rats. In addition, the present data indicate that the thermoregulatory responses of exercising rats can be extrapolated, with some important limitations, to human thermal physiology.

  11. U.S. DOE NETL methodology for estimating the prospective CO 2 storage resource of shales at the national and regional scale

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

    Levine, Jonathan S.; Fukai, Isis; Soeder, Daniel J.

    While the majority of shale formations will serve as reservoir seals for stored anthropogenic carbon dioxide (CO2), hydrocarbon-bearing shale formations may be potential geologic sinks after depletion through primary production. Here in this paper we present the United States-Department of Energy-National Energy Technology Laboratory (US-DOE-NETL) methodology for screening-level assessment of prospective CO 2 storage resources in shale using a volumetric equation. Volumetric resource estimates are produced from the bulk volume, porosity, and sorptivity of the shale and storage efficiency factors based on formation-scale properties and petrophysical limitations on fluid transport. Prospective shale formations require: (1) prior hydrocarbon production using horizontalmore » drilling and stimulation via staged, high-volume hydraulic fracturing, (2) depths sufficient to maintain CO 2 in a supercritical state, generally >800 m, and (3) an overlying seal. The US-DOE-NETL methodology accounts for storage of CO 2 in shale as a free fluid phase within fractures and matrix pores and as an sorbed phase on organic matter and clays. Uncertainties include but are not limited to poorly-constrained geologic variability in formation thickness, porosity, existing fluid content, organic richness, and mineralogy. Knowledge of how these parameters may be linked to depositional environments, facies, and diagenetic history of the shale will improve the understanding of pore-to-reservoir scale behavior, and provide improved estimates of prospective CO 2 storage.« less

  12. U.S. DOE NETL methodology for estimating the prospective CO 2 storage resource of shales at the national and regional scale

    DOE PAGES

    Levine, Jonathan S.; Fukai, Isis; Soeder, Daniel J.; ...

    2016-05-31

    While the majority of shale formations will serve as reservoir seals for stored anthropogenic carbon dioxide (CO2), hydrocarbon-bearing shale formations may be potential geologic sinks after depletion through primary production. Here in this paper we present the United States-Department of Energy-National Energy Technology Laboratory (US-DOE-NETL) methodology for screening-level assessment of prospective CO 2 storage resources in shale using a volumetric equation. Volumetric resource estimates are produced from the bulk volume, porosity, and sorptivity of the shale and storage efficiency factors based on formation-scale properties and petrophysical limitations on fluid transport. Prospective shale formations require: (1) prior hydrocarbon production using horizontalmore » drilling and stimulation via staged, high-volume hydraulic fracturing, (2) depths sufficient to maintain CO 2 in a supercritical state, generally >800 m, and (3) an overlying seal. The US-DOE-NETL methodology accounts for storage of CO 2 in shale as a free fluid phase within fractures and matrix pores and as an sorbed phase on organic matter and clays. Uncertainties include but are not limited to poorly-constrained geologic variability in formation thickness, porosity, existing fluid content, organic richness, and mineralogy. Knowledge of how these parameters may be linked to depositional environments, facies, and diagenetic history of the shale will improve the understanding of pore-to-reservoir scale behavior, and provide improved estimates of prospective CO 2 storage.« less

  13. Thermoregulatory responses in exercising rats: methodological aspects and relevance to human physiology

    PubMed Central

    Wanner, Samuel Penna; Prímola-Gomes, Thales Nicolau; Pires, Washington; Guimarães, Juliana Bohnen; Hudson, Alexandre Sérvulo Ribeiro; Kunstetter, Ana Cançado; Fonseca, Cletiana Gonçalves; Drummond, Lucas Rios; Damasceno, William Coutinho; Teixeira-Coelho, Francisco

    2015-01-01

    Rats are used worldwide in experiments that aim to investigate the physiological responses induced by a physical exercise session. Changes in body temperature regulation, which may affect both the performance and the health of exercising rats, are evident among these physiological responses. Despite the universal use of rats in biomedical research involving exercise, investigators often overlook important methodological issues that hamper the accurate measurement of clear thermoregulatory responses. Moreover, much debate exists regarding whether the outcome of rat experiments can be extrapolated to human physiology, including thermal physiology. Herein, we described the impact of different exercise intensities, durations and protocols and environmental conditions on running-induced thermoregulatory changes. We focused on treadmill running because this type of exercise allows for precise control of the exercise intensity and the measurement of autonomic thermoeffectors associated with heat production and loss. Some methodological issues regarding rat experiments, such as the sites for body temperature measurements and the time of day at which experiments are performed, were also discussed. In addition, we analyzed the influence of a high body surface area-to-mass ratio and limited evaporative cooling on the exercise-induced thermoregulatory responses of running rats and then compared these responses in rats to those observed in humans. Collectively, the data presented in this review represent a reference source for investigators interested in studying exercise thermoregulation in rats. In addition, the present data indicate that the thermoregulatory responses of exercising rats can be extrapolated, with some important limitations, to human thermal physiology. PMID:27227066

  14. Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

    PubMed Central

    Lober, Robert M.; Doan, Adam T.; Matsumoto, Craig I.; Kenning, Tyler J.; Evans, James J.

    2016-01-01

    Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory evoked potentials. Methodological considerations as well as benefits and limitations are discussed. The authors argue that, while individual modalities have their limitations, multimodality neuromonitoring provides a real-time, comprehensive assessment of nervous system function and allows for safer, more aggressive management of skull base tumors via the endonasal route. PMID:27293965

  15. How Methodologic Differences Affect Results of Economic Analyses: A Systematic Review of Interferon Gamma Release Assays for the Diagnosis of LTBI

    PubMed Central

    Oxlade, Olivia; Pinto, Marcia; Trajman, Anete; Menzies, Dick

    2013-01-01

    Introduction Cost effectiveness analyses (CEA) can provide useful information on how to invest limited funds, however they are less useful if different analysis of the same intervention provide unclear or contradictory results. The objective of our study was to conduct a systematic review of methodologic aspects of CEA that evaluate Interferon Gamma Release Assays (IGRA) for the detection of Latent Tuberculosis Infection (LTBI), in order to understand how differences affect study results. Methods A systematic review of studies was conducted with particular focus on study quality and the variability in inputs used in models used to assess cost-effectiveness. A common decision analysis model of the IGRA versus Tuberculin Skin Test (TST) screening strategy was developed and used to quantify the impact on predicted results of observed differences of model inputs taken from the studies identified. Results Thirteen studies were ultimately included in the review. Several specific methodologic issues were identified across studies, including how study inputs were selected, inconsistencies in the costing approach, the utility of the QALY (Quality Adjusted Life Year) as the effectiveness outcome, and how authors choose to present and interpret study results. When the IGRA versus TST test strategies were compared using our common decision analysis model predicted effectiveness largely overlapped. Implications Many methodologic issues that contribute to inconsistent results and reduced study quality were identified in studies that assessed the cost-effectiveness of the IGRA test. More specific and relevant guidelines are needed in order to help authors standardize modelling approaches, inputs, assumptions and how results are presented and interpreted. PMID:23505412

  16. Methodological and ethical issues related to qualitative telephone interviews on sensitive topics.

    PubMed

    Mealer, Meredith; Jones Rn, Jacqueline

    2014-03-01

    To explore the methodological and ethical issues of conducting qualitative telephone interviews about personal or professional trauma with critical care nurses. The most common method for conducting interviews is face-to-face. However, there is evidence to support telephone interviewing on a variety of sensitive topics including post-traumatic stress disorder (PTSD). Qualitative telephone interviews can limit emotional distress because of the comfort experienced through virtual communication. Critical care nurses are at increased risk of developing PTSD due to the cumulative exposure to work-related stress in the intensive care unit. We explored the methodological and ethical issues of conducting qualitative telephone interviews, drawing on our experiences communicating with a group of critical care nurses. Qualitative research interviews with 27 critical care nurses. Fourteen of the nurses met the diagnostic criteria for PTSD; 13 did not and had scores consistent with high levels of resilience. This is a methodology paper on the authors' experiences of interviewing critical care nurses on sensitive topics via the telephone. The authors found that establishing rapport and connections with the participants and the therapeutic use of non-verbal communication were essential, and fostered trust and compassion. The ethical issues of this mode of communication include protecting the privacy and confidentiality associated with the disclosure of sensitive information, and minimising the risk of psychological harm to the researcher and participants. Qualitative telephone interviews are a valuable method of collecting information on sensitive topics. This paper explores a method of interviewing in the workplace. It will help inform interventions to promote healthy adaptation following trauma exposure in the intensive care unit.

  17. Methodology for the Absolute Configuration Determination of Epoxythymols Using the Constituents of Ageratina glabrata.

    PubMed

    Arreaga-González, Héctor M; Pardo-Novoa, Julio C; Del Río, Rosa E; Rodríguez-García, Gabriela; Torres-Valencia, J Martín; Manríquez-Torres, J Jesús; Cerda-García-Rojas, Carlos M; Joseph-Nathan, Pedro; Gómez-Hurtado, Mario A

    2018-01-26

    A methodology to determine the enantiomeric excess and the absolute configuration (AC) of natural epoxythymols was developed and tested using five constituents of Ageratina glabrata. The methodology is based on enantiomeric purity determination employing 1,1'-bi-2-naphthol (BINOL) as a chiral solvating agent combined with vibrational circular dichroism (VCD) measurements and calculations. The conformational searching included an extensive Monte Carlo protocol that considered the rotational barriers to cover the whole conformational spaces. (+)-(8S)-10-Benzoyloxy-6-hydroxy-8,9-epoxythymol isobutyrate (1), (+)-(8S)-10-acetoxy-6-methoxy-8,9-epoxythymol isobutyrate (4), and (+)-(8S)-10-benzoyloxy-6-methoxy-8,9-epoxythymol isobutyrate (5) were isolated as enantiomerically pure constituents, while 10-isobutyryloxy-8,9-epoxythymol isobutyrate (2) was obtained as a 75:25 (8S)/(8R) scalemic mixture. In the case of 10-benzoyloxy-8,9-epoxythymol isobutyrate (3), the BINOL methodology revealed a 56:44 scalemic mixture and the VCD measurement was beyond the limit of sensitivity since the enantiomeric excess is only 12%. The racemization process of epoxythymol derivatives was studied using compound 1 and allowed the clarification of some stereochemical aspects of epoxythymol derivatives since their ACs have been scarcely analyzed and a particular behavior in their specific rotations was detected. In more than 30 oxygenated thymol derivatives, including some epoxythymols, the reported specific rotation values fluctuate from -1.6 to +1.4 passing through zero, suggesting the presence of scalemic and close to racemic mixtures, since enantiomerically pure natural constituents showed positive or negative specific rotations greater than 10 units.

  18. Systematic reviews and meta-analyses on treatment of asthma: critical evaluation

    PubMed Central

    Jadad, Alejandro R; Moher, Michael; Browman, George P; Booker, Lynda; Sigouin, Christopher; Fuentes, Mario; Stevens, Robert

    2000-01-01

    Objective To evaluate the clinical, methodological, and reporting aspects of systematic reviews and meta-analyses on the treatment of asthma and to compare those published by the Cochrane Collaboration with those published in paper based journals. Design Analysis of studies identified from Medline, CINAHL, HealthSTAR, EMBASE, Cochrane Library, personal collections, and reference lists. Studies Articles describing a systematic review or a meta-analysis of the treatment of asthma that were published as a full report, in any language or format, in a peer reviewed journal or the Cochrane Library. Main outcome measures General characteristics of studies reviewed and methodological characteristics (sources of articles; language restrictions; format, design, and publication status of studies included; type of data synthesis; and methodological quality). Results 50 systematic reviews and meta-analyses were included. More than half were published in the past two years. Twelve reviews were published in the Cochrane Library and 38 were published in 22 peer reviewed journals. Forced expiratory volume in one second was the most frequently used outcome, but few reviews evaluated the effect of treatment on costs or patient preferences. Forty reviews were judged to have serious or extensive flaws. All six reviews associated with industry were in this group. Seven of the 10 most rigorous reviews were published in the Cochrane Library. Conclusions Most reviews published in peer reviewed journals or funded by industry have serious methodological flaws that limit their value to guide decisions. Cochrane reviews are more rigorous and better reported than those published in peer reviewed journals. PMID:10688558

  19. A Scoping Review of Social Media Use in Social Work Practice.

    PubMed

    Chan, Chitat

    2016-01-01

    The trend of using social media in social work is increasing, but research which systematically reviews and evaluates their uses in actual practice is limited. This article reviews the social work literature to identify the uses, benefits, and limitations of social media in social work practice, and identifies current gaps in the literature to provide recommendations for future social work research. Articles in 64 social work journals published between 2000 and 2014 were screened and analyzed. The included articles (n = 20) were analyzed with particular reference to their level of evidence and ways of social media use. The methodological quality of the studies in this review was low, and this was consistent with the findings of recent systematic reviews of social media use in medical healthcare. The findings initially suggested that social media can potentially contribute to various social work processes, including: service user engagement, need assessment, intervention, and program evaluation. Limitations include lack of quality control, reliability, confidentiality, and privacy. In social work, the dominant research concern in social media is more about professional ethics than their application in intervention. Implications for research and practice are discussed.

  20. Shuttle TPS thermal performance and analysis methodology

    NASA Technical Reports Server (NTRS)

    Neuenschwander, W. E.; Mcbride, D. U.; Armour, G. A.

    1983-01-01

    Thermal performance of the thermal protection system was approximately as predicted. The only extensive anomalies were filler bar scorching and over-predictions in the high Delta p gap heating regions of the orbiter. A technique to predict filler bar scorching has been developed that can aid in defining a solution. Improvement in high Delta p gap heating methodology is still under study. Minor anomalies were also examined for improvements in modeling techniques and prediction capabilities. These include improved definition of low Delta p gap heating, an analytical model for inner mode line convection heat transfer, better modeling of structure, and inclusion of sneak heating. The limited number of problems related to penetration items that presented themselves during orbital flight tests were resolved expeditiously, and designs were changed and proved successful within the time frame of that program.

  1. Determination of tocopherols and sitosterols in seeds and nuts by QuEChERS-liquid chromatography.

    PubMed

    Delgado-Zamarreño, M Milagros; Fernández-Prieto, Cristina; Bustamante-Rangel, Myriam; Pérez-Martín, Lara

    2016-02-01

    In the present work a simple, reliable and affordable sample treatment method for the simultaneous analysis of tocopherols and free phytosterols in nuts was developed. Analyte extraction was carried out using the QuEChERS methodology and analyte separation and detection were accomplished using HPLC-DAD. The use of this methodology for the extraction of natural occurring substances provides advantages such as speed, simplicity and ease of use. The parameters evaluated for the validation of the method developed included the linearity of the calibration plots, the detection and quantification limits, repeatability, reproducibility and recovery. The proposed method was successfully applied to the analysis of tocopherols and free phytosterols in samples of almonds, cashew nuts, hazelnuts, peanuts, tiger nuts, sun flower seeds and pistachios. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Fabrication of Compact Superconducting Lowpass Filters for Ultrasensitive Detectors

    NASA Technical Reports Server (NTRS)

    Brown, Ari; Chervenak, James; Chuss, David; Mikula, Vilem; Ray, Christopher; Rostem, Karwan; U-Yen, Kongpop; Wassell, Edward; Wollack, Edward

    2012-01-01

    It is extremely important for current and future far-infrared and sub-millimeter ultrasensitive detectors, which include transition edge sensors (TES) and microwave kinetic inductance detectors, to be adequately filtered from stray electromagnetic radiation in order to achieve their optimal performance. One means of filtering stray radiation is to block leakage associated with electrical connections in the detector environment. Here we discuss a fabrication methodology for realizing non-dissipative planar filters imbedded in the wall of the detector enclosure to limit wave propagation modes up to far-infrared frequencies. Our methodology consists of fabricating a boxed stripline transmission line, in which a superconducting (Nb, Mo, or Al) transmission line is encased in a silicon dioxide dielectric insulator coated with a metallic shell. We report on achieved attenuation and return loss and find that it replicates the simulated data to a high degree.

  3. Substance use and risky sexual behavior for exposure to HIV: Issues in methodology, interpretation, and prevention

    PubMed Central

    Leigh, Barbara C.; Stall, Ron

    2008-01-01

    Recent reports have suggested that the use of alcohol or drugs is related to sexual behavior that is high-risk for HIV infection. If substance use leads to unsafe sexual activity, understanding the dynamics of this relationship can contribute to research, preventive and education efforts to contain the spread of AIDS. In this paper, we review research on the relationship between substance use and high-risk sexual behavior. We then consider the inherent limitations of the research designs used to study this relationship, outline some methodological concerns including measurement and sampling issues, and comment on causal interpretations of correlational research findings. We end with a consideration of potential avenues for avenues for future research and a discussion of implications of these findings for current AIDS prevention policies. PMID:8256876

  4. Measurements of Gluconeogenesis and Glycogenolysis: A Methodological Review

    PubMed Central

    Chung, Stephanie T.; Chacko, Shaji K.; Sunehag, Agneta L.

    2015-01-01

    Gluconeogenesis is a complex metabolic process that involves multiple enzymatic steps regulated by myriad factors, including substrate concentrations, the redox state, activation and inhibition of specific enzyme steps, and hormonal modulation. At present, the most widely accepted technique to determine gluconeogenesis is by measuring the incorporation of deuterium from the body water pool into newly formed glucose. However, several techniques using radioactive and stable-labeled isotopes have been used to quantitate the contribution and regulation of gluconeogenesis in humans. Each method has its advantages, methodological assumptions, and set of propagated errors. In this review, we examine the strengths and weaknesses of the most commonly used stable isotopes methods to measure gluconeogenesis in vivo. We discuss the advantages and limitations of each method and summarize the applicability of these measurements in understanding normal and pathophysiological conditions. PMID:26604176

  5. Estimating the hydraulic parameters of a confined aquifer based on the response of groundwater levels to seismic Rayleigh waves

    NASA Astrophysics Data System (ADS)

    Sun, Xiaolong; Xiang, Yang; Shi, Zheming

    2018-05-01

    Groundwater flow models implemented to manage regional water resources require aquifer hydraulic parameters. Traditional methods for obtaining these parameters include laboratory experiments, field tests and model inversions, and each are potentially hindered by their unique limitations. Here, we propose a methodology for estimating hydraulic conductivity and storage coefficients using the spectral characteristics of the coseismic groundwater-level oscillations and seismic Rayleigh waves. The results from Well X10 are consistent with the variations and spectral characteristics of the water-level oscillations and seismic waves and present an estimated hydraulic conductivity of approximately 1 × 10-3 m s-1 and storativity of 15 × 10-6. The proposed methodology for estimating hydraulic parameters in confined aquifers is a practical and novel approach for groundwater management and seismic precursor anomaly analyses.

  6. Alzheimer's disease and diet: a systematic review.

    PubMed

    Yusufov, Miryam; Weyandt, Lisa L; Piryatinsky, Irene

    2017-02-01

    Purpose/Aim: Approximately 44 million people worldwide have Alzheimer's disease (AD). Numerous claims have been made regarding the influence of diet on AD development. The aims of this systematic review were to summarize the evidence considering diet as a protective or risk factor for AD, identify methodological challenges and limitations, and provide future research directions. Medline, PsycINFO and PsycARTICLES were searched for articles that examined the relationship between diet and AD. On the basis of the inclusion and exclusion criteria, 64 studies were included, generating a total of 141 dietary patterns or "models". All studies were published between 1997 and 2015, with a total of 132 491 participants. Twelve studies examined the relationship between a Mediterranean (MeDi) diet and AD development, 10 of which revealed a significant association. Findings were inconsistent with respect to sample size, AD diagnosis and food measures. Further, the majority of studies (81.3%) included samples with mean baseline ages that were at risk for AD based on age (>65 years), ranging from 52.0 to 85.4 years. The range of follow-up periods was 1.5-32.0 years. The mean age of the samples poses a limitation in determining the influence of diet on AD; given that AD has a long prodromal phase prior to the manifestation of symptoms and decline. Further studies are necessary to determine whether diet is a risk or protective factor for AD, foster translation of research into clinical practice and elucidate dietary recommendations. Despite the methodological limitations, the finding that 50 of the 64 reviewed studies revealed an association between diet and AD incidence offers promising implications for diet as a modifiable risk factor for AD.

  7. Indocyanine green videoangiography methodological variations: review.

    PubMed

    Simal-Julián, Juan A; Miranda-Lloret, Pablo; Evangelista-Zamora, Rocio; Sanromán-Álvarez, Pablo; Pérez de San Román, Laila; Pérez-Borredá, Pedro; Beltrán-Giner, Andrés; Botella-Asunción, Carlos

    2015-01-01

    Indocyanine green videoangiography (ICGVA) procedures have become widespread within the spectrum of microsurgical techniques for neurovascular pathologies. We have conducted a review to identify and assess the impact of all of the methodological variations of conventional ICGVA applied in the field of neurovascular pathology that have been published to date in the English literature. A total of 18 studies were included in this review, identifying four primary methodological variants compared to conventional ICGVA: techniques based on the transient occlusion, intra-arterial ICG administration via catheters, use of endoscope system with a filter to collect florescence of ICG, and quantitative fluorescence analysis. These variants offer some possibilities for resolving the limitations of the conventional technique (first, the vascular structure to be analyzed must be exposed and second, vascular filling with ICG follows an additive pattern) and allow qualitatively superior information to be obtained during surgery. Advantages and disadvantages of each procedure are discussed. More case studies with a greater number of patients are needed to compare the different procedures with their gold standard, in order to establish these results consistently.

  8. The use of repetitive transcranial magnetic stimulation for modulating craving and addictive behaviours: a critical literature review of efficacy, technical and methodological considerations.

    PubMed

    Grall-Bronnec, M; Sauvaget, A

    2014-11-01

    Repetitive transcranial magnetic stimulation (rTMS) is a potential therapeutic intervention for the treatment of addiction. This critical review aims to summarise the recent developments with respect to the efficacy of rTMS for all types of addiction and related disorders (including eating disorders), and concentrates on the associated methodological and technical issues. The bibliographic search consisted of a computerised screening of the Medline and ScienceDirect databases up to December 2013. Criteria for inclusion were the target problem was an addiction, a related disorder, or craving; the intervention was performed using rTMS; and the study was a clinical trial. Of the potential 638 articles, 18 met the criteria for inclusion. Most of these (11 of the 18) supported the efficacy of rTMS, especially in the short term. In most cases, the main assessment criterion was the measurement of craving using a Visual Analogue Scale. The results are discussed with respect to the study limitations and, in particular, the many methodological and technical discrepancies that were identified. Key recommendations are provided.

  9. Stochastic output error vibration-based damage detection and assessment in structures under earthquake excitation

    NASA Astrophysics Data System (ADS)

    Sakellariou, J. S.; Fassois, S. D.

    2006-11-01

    A stochastic output error (OE) vibration-based methodology for damage detection and assessment (localization and quantification) in structures under earthquake excitation is introduced. The methodology is intended for assessing the state of a structure following potential damage occurrence by exploiting vibration signal measurements produced by low-level earthquake excitations. It is based upon (a) stochastic OE model identification, (b) statistical hypothesis testing procedures for damage detection, and (c) a geometric method (GM) for damage assessment. The methodology's advantages include the effective use of the non-stationary and limited duration earthquake excitation, the handling of stochastic uncertainties, the tackling of the damage localization and quantification subproblems, the use of "small" size, simple and partial (in both the spatial and frequency bandwidth senses) identified OE-type models, and the use of a minimal number of measured vibration signals. Its feasibility and effectiveness are assessed via Monte Carlo experiments employing a simple simulation model of a 6 storey building. It is demonstrated that damage levels of 5% and 20% reduction in a storey's stiffness characteristics may be properly detected and assessed using noise-corrupted vibration signals.

  10. Systematic review of studies on measurement properties of instruments for adults published in the American Journal of Occupational Therapy, 2009-2013.

    PubMed

    Yuen, Hon K; Austin, Sarah L

    2014-01-01

    We describe the methodological quality of recent studies on instrument development and testing published in the American Journal of Occupational Therapy (AJOT). We conducted a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist to appraise 48 articles on measurement properties of assessments for adults published in AJOT between 2009 and 2013. Most studies had adequate methodological quality in design and statistical analysis. Common methodological limitations included that methods used to examine internal consistency were not consistently linked to the theoretical constructs underpinning assessments; participants in some test-retest reliability studies were not stable during the interim period; and in several studies of reliability and convergent validity, sample sizes were inadequate. AJOT's dissemination of psychometric research evidence has made important contributions to moving the profession toward the American Occupational Therapy Association's Centennial Vision. This study's results provide a benchmark by which to evaluate future accomplishments. Copyright © 2014 by the American Occupational Therapy Association, Inc.

  11. Integrated payload and mission planning, phase 3. Volume 1: Integrated payload and mission planning process evaluation

    NASA Technical Reports Server (NTRS)

    Sapp, T. P.; Davin, D. E.

    1977-01-01

    The integrated payload and mission planning process for STS payloads was defined, and discrete tasks which evaluate performance and support initial implementation of this process were conducted. The scope of activity was limited to NASA and NASA-related payload missions only. The integrated payload and mission planning process was defined in detail, including all related interfaces and scheduling requirements. Related to the payload mission planning process, a methodology for assessing early Spacelab mission manager assignment schedules was defined.

  12. Rater methodology for stroboscopy: a systematic review.

    PubMed

    Bonilha, Heather Shaw; Focht, Kendrea L; Martin-Harris, Bonnie

    2015-01-01

    Laryngeal endoscopy with stroboscopy (LES) remains the clinical gold standard for assessing vocal fold function. LES is used to evaluate the efficacy of voice treatments in research studies and clinical practice. LES as a voice treatment outcome tool is only as good as the clinician interpreting the recordings. Research using LES as a treatment outcome measure should be evaluated based on rater methodology and reliability. The purpose of this literature review was to evaluate the rater-related methodology from studies that use stroboscopic findings as voice treatment outcome measures. Systematic literature review. Computerized journal databases were searched for relevant articles using terms: stroboscopy and treatment. Eligible articles were categorized and evaluated for the use of rater-related methodology, reporting of number of raters, types of raters, blinding, and rater reliability. Of the 738 articles reviewed, 80 articles met inclusion criteria. More than one-third of the studies included in the review did not report the number of raters who participated in the study. Eleven studies reported results of rater reliability analysis with only two studies reporting good inter- and intrarater reliability. The comparability and use of results from treatment studies that use LES are limited by a lack of rigor in rater methodology and variable, mostly poor, inter- and intrarater reliability. To improve our ability to evaluate and use the findings from voice treatment studies that use LES features as outcome measures, greater consistency of reporting rater methodology characteristics across studies and improved rater reliability is needed. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  13. Reliability-Based Stability Analysis of Rock Slopes Using Numerical Analysis and Response Surface Method

    NASA Astrophysics Data System (ADS)

    Dadashzadeh, N.; Duzgun, H. S. B.; Yesiloglu-Gultekin, N.

    2017-08-01

    While advanced numerical techniques in slope stability analysis are successfully used in deterministic studies, they have so far found limited use in probabilistic analyses due to their high computation cost. The first-order reliability method (FORM) is one of the most efficient probabilistic techniques to perform probabilistic stability analysis by considering the associated uncertainties in the analysis parameters. However, it is not possible to directly use FORM in numerical slope stability evaluations as it requires definition of a limit state performance function. In this study, an integrated methodology for probabilistic numerical modeling of rock slope stability is proposed. The methodology is based on response surface method, where FORM is used to develop an explicit performance function from the results of numerical simulations. The implementation of the proposed methodology is performed by considering a large potential rock wedge in Sumela Monastery, Turkey. The accuracy of the developed performance function to truly represent the limit state surface is evaluated by monitoring the slope behavior. The calculated probability of failure is compared with Monte Carlo simulation (MCS) method. The proposed methodology is found to be 72% more efficient than MCS, while the accuracy is decreased with an error of 24%.

  14. A systematic methodology for the robust quantification of energy efficiency at wastewater treatment plants featuring Data Envelopment Analysis.

    PubMed

    Longo, S; Hospido, A; Lema, J M; Mauricio-Iglesias, M

    2018-05-10

    This article examines the potential benefits of using Data Envelopment Analysis (DEA) for conducting energy-efficiency assessment of wastewater treatment plants (WWTPs). WWTPs are characteristically heterogeneous (in size, technology, climate, function …) which limits the correct application of DEA. This paper proposes and describes the Robust Energy Efficiency DEA (REED) in its various stages, a systematic state-of-the-art methodology aimed at including exogenous variables in nonparametric frontier models and especially designed for WWTP operation. In particular, the methodology systematizes the modelling process by presenting an integrated framework for selecting the correct variables and appropriate models, possibly tackling the effect of exogenous factors. As a result, the application of REED improves the quality of the efficiency estimates and hence the significance of benchmarking. For the reader's convenience, this article is presented as a step-by-step guideline to guide the user in the determination of WWTPs energy efficiency from beginning to end. The application and benefits of the developed methodology are demonstrated by a case study related to the comparison of the energy efficiency of a set of 399 WWTPs operating in different countries and under heterogeneous environmental conditions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Costing of physical activity programmes in primary prevention: a review of the literature

    PubMed Central

    2011-01-01

    This literature review aims to analyse the costing methodology in economic analyses of primary preventive physical activity programmes. It demonstrates the usability of a recently published theoretical framework in practice, and may serve as a guide for future economic evaluation studies and for decision making. A comprehensive literature search was conducted to identify all relevant studies published before December 2009. All studies were analysed regarding their key economic findings and their costing methodology. In summary, 18 international economic analyses of primary preventive physical activity programmes were identified. Many of these studies conclude that the investigated intervention provides good value for money compared with alternatives (no intervention, usual care or different programme) or is even cost-saving. Although most studies did provide a description of the cost of the intervention programme, methodological details were often not displayed, and savings resulting from the health effects of the intervention were not always included sufficiently. This review shows the different costing methodologies used in the current health economic literature and compares them with a theoretical framework. The high variability regarding the costs assessment and the lack of transparency concerning the methods limits the comparability of the results, which points out the need for a handy minimal dataset of cost assessment. PMID:22827967

  16. The EURO-URHIS 2 project in Ho Chi Min City: contextual adequacy in cross-cultural research.

    PubMed

    Steels, Stephanie Linawati

    2016-03-01

    The European Urban Health Indicators System Project Part 2 (EURO-URHIS 2) is a cross-national study that was implemented in Europe. It consists of four data collection tools that were specifically developed to collect health data at an urban level. This paper reviews some of the methodological constraints in adapting the EURO-URHIS 2 study in Ho Chi Minh City, Vietnam. No attempt to extend the original study beyond Europe has been reported before. Cultural, political, economic and social differences create specific obstacles as well as challenges. This paper sets out how these challenges were addressed, examining key aspects of the methodology, including study design, translation of the questionnaire and data collection. It was found that the EURO-URHIS 2 adult data collection tool methodology could not be replicated in Vietnam. A lack of basic infrastructure and population registers led to significant changes being made to the sampling and survey administration. It was recommended that the Expanded Programme on Immunization (EPI) was used as the replacement method. Despite the limitations in using the EPI method, the overall strengths and benefits were found to address methodological issues and the resource poor setting. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Report on an Assessment of the Application of EPP Results from the Strain Limit Evaluation Procedure to the Prediction of Cyclic Life Based on the SMT Methodology

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

    Jetter, R. I.; Messner, M. C.; Sham, T. -L.

    The goal of the proposed integrated Elastic Perfectly-Plastic (EPP) and Simplified Model Test (SMT) methodology is to incorporate an SMT data based approach for creep-fatigue damage evaluation into the EPP methodology to avoid the separate evaluation of creep and fatigue damage and eliminate the requirement for stress classification in current methods; thus greatly simplifying evaluation of elevated temperature cyclic service. This methodology should minimize over-conservatism while properly accounting for localized defects and stress risers. To support the implementation of the proposed methodology and to verify the applicability of the code rules, analytical studies and evaluation of thermomechanical test results continuedmore » in FY17. This report presents the results of those studies. An EPP strain limits methodology assessment was based on recent two-bar thermal ratcheting test results on 316H stainless steel in the temperature range of 405 to 7050C. Strain range predictions from the EPP evaluation of the two-bar tests were also evaluated and compared with the experimental results. The role of sustained primary loading on cyclic life was assessed using the results of pressurized SMT data from tests on Alloy 617 at 9500C. A viscoplastic material model was used in an analytic simulation of two-bar tests to compare with EPP strain limits assessments using isochronous stress strain curves that are consistent with the viscoplastic material model. A finite element model of a prior 304H stainless steel Oak Ridge National Laboratory (ORNL) nozzle-to-sphere test was developed and used for an EPP strain limits and creep-fatigue code case damage evaluations. A theoretical treatment of a recurring issue with convergence criteria for plastic shakedown illustrated the role of computer machine precision in EPP calculations.« less

  18. Methodological challenges for the evaluation of clinical effectiveness in the context of accelerated regulatory approval: an overview.

    PubMed

    Woolacott, Nerys; Corbett, Mark; Jones-Diette, Julie; Hodgson, Robert

    2017-10-01

    Regulatory authorities are approving innovative therapies with limited evidence. Although this level of data is sufficient for the regulator to establish an acceptable risk-benefit balance, it is problematic for downstream health technology assessment, where assessment of cost-effectiveness requires reliable estimates of effectiveness relative to existing clinical practice. Some key issues associated with a limited evidence base include using data, from nonrandomized studies, from small single-arm trials, or from single-center trials; and using surrogate end points. We examined these methodological challenges through a pragmatic review of the available literature. Methods to adjust nonrandomized studies for confounding are imperfect. The relative treatment effect generated from single-arm trials is uncertain and may be optimistic. Single-center trial results may not be generalizable. Surrogate end points, on average, overestimate treatment effects. Current methods for analyzing such data are limited, and effectiveness claims based on these suboptimal forms of evidence are likely to be subject to significant uncertainty. Assessments of cost-effectiveness, based on the modeling of such data, are likely to be subject to considerable uncertainty. This uncertainty must not be underestimated by decision makers: methods for its quantification are required and schemes to protect payers from the cost of uncertainty should be implemented. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  19. Seizures and Epilepsy in Alzheimer’s Disease

    PubMed Central

    Friedman, Daniel; Honig, Lawrence S.; Scarmeas, Nikolaos

    2013-01-01

    Introduction Many studies have shown that patients with Alzheimer’s disease (AD) are at increased risk for developing seizures and epilepsy. However, reported prevalence and incidence of seizures and relationship of seizures to disease measures such as severity, outcome and progression vary widely between studies. Methods Literature review of the available clinical and epidemiological data on the topic of seizures in patients with AD. We review seizure rates and types, risk factors for seizures, electroencephalogram (EEG)studies, and treatment responses. Finally, we consider limitations and methodological issues. Results There is considerable variability in the reported prevalence and incidence of seizures in patients with AD - with reported lifetime prevalence rates of 1.5 - 64%. More recent, prospective, and larger studies in general report lower rates. Some, but not all, studies have noted increased seizure risk with increasing dementia severity or with younger age of AD onset. Generalized convulsive seizures are the most commonly reported type, but often historical information is the only basis used to determine seizure type and the manifestation of seizures may be difficult to distinguish from other behaviors common in demented patients. EEG has infrequently been performed and reported. Data on treatment of seizures in AD are extremely limited. Similarly, the relationship between seizures and cognitive impairment in AD is unclear. Conclusions The literature on seizures and epilepsy in AD, including diagnosis, risk factors, and response to treatment suffers from methodological limitations and gaps. PMID:22070283

  20. The effectiveness and cost-effectiveness of diversion and aftercare programmes for offenders using class A drugs: a systematic review and economic evaluation.

    PubMed

    Hayhurst, Karen P; Leitner, Maria; Davies, Linda; Flentje, Rachel; Millar, Tim; Jones, Andrew; King, Carlene; Donmall, Michael; Farrell, Michael; Fazel, Seena; Harris, Rochelle; Hickman, Matthew; Lennox, Charlotte; Mayet, Soraya; Senior, Jane; Shaw, Jennifer

    2015-01-01

    The societal costs of problematic class A drug use in England and Wales exceed £15B; drug-related crime accounts for almost 90% of costs. Diversion plus treatment and/or aftercare programmes may reduce drug-related crime and costs. To assess the effectiveness and cost-effectiveness of diversion and aftercare for class A drug-using offenders, compared with no diversion. Adult class A drug-using offenders diverted to treatment or an aftercare programme for their drug use. Programmes to identify and divert problematic drug users to treatment (voluntary, court mandated or monitored services) at any point within the criminal justice system (CJS). Aftercare follows diversion and treatment, excluding care following prison or non-diversionary drug treatment. Thirty-three electronic databases and government online resources were searched for studies published between January 1985 and January 2012, including MEDLINE, PsycINFO and ISI Web of Science. Bibliographies of identified studies were screened. The UK Drug Data Warehouse, the UK Drug Treatment Outcomes Research Study and published statistics and reports provided data for the economic evaluation. Included studies evaluated diversion in adult class A drug-using offenders, in contact with the CJS. The main outcomes were drug use and offending behaviour, and these were pooled using meta-analysis. The economic review included full economic evaluations for adult opiate and/or crack, or powder, cocaine users. An economic decision analytic model, estimated incremental costs per unit of outcome gained by diversion and aftercare, over a 12-month time horizon. The perspectives included the CJS, NHS, social care providers and offenders. Probabilistic sensitivity analysis and one-way sensitivity analysis explored variance in parameter estimates, longer time horizons and structural uncertainty. Sixteen studies met the effectiveness review inclusion criteria, characterised by poor methodological quality, with modest sample sizes, high attrition rates, retrospective data collection, limited follow-up, no random allocation and publication bias. Most study samples comprised US methamphetamine users. Limited meta-analysis was possible, indicating a potential small impact of diversion interventions on reducing drug use [odds ratio (OR) 1.68, 95% confidence interval (CI) 1.12 to 2.53 for reduced primary drug use, and OR 2.60, 95% CI 1.70 to 3.98 for reduced use of other drugs]. The cost-effectiveness review did not identify any relevant studies. The economic evaluation indicated high uncertainty because of variance in data estimates and limitations in the model design. The primary analysis was unclear whether or not diversion was cost-effective. The sensitivity analyses indicated some scenarios where diversion may be cost-effective. Nearly all participants (99.6%) in the effectiveness review were American (Californian) methamphetamine users, limiting transfer of conclusions to the UK. Data and methodological limitations mean it is unclear whether or not diversion is effective or cost-effective. High-quality evidence for the effectiveness and cost-effectiveness of diversion schemes is sparse and does not relate to the UK. Importantly this research identified a range of methodological limitations in existing evidence. These highlight the need for research to conceptualise, define and develop models of diversion programmes and identify a core outcome set. A programme of feasibility, pilot and definitive trials, combined with process evaluation and qualitative research is recommended to assess the effectiveness and cost-effectiveness of diversionary interventions in class A drug-using offenders. The National Institute for Health Research Health Technology Assessment programme.

  1. Pathophysiology of hypertension in obese children: a systematic review.

    PubMed

    Wirix, A J G; Kaspers, P J; Nauta, J; Chinapaw, M J M; Kist-van Holthe, J E

    2015-10-01

    Hypertension is increasingly common in overweight and obese children. The mechanisms behind the development of hypertension in obesity are complex, and evidence is limited. In order to effectively treat obese children for hypertension, it is important to have a deeper understanding of the pathophysiology of hypertension in obese children. The present review summarizes the main factors associated with hypertension in obese children and discusses their potential role in its pathophysiology. Systematic searches were conducted in PubMed and EMBASE for articles published up to October 2014. In total, 60 relevant studies were included. The methodological quality of the included studies ranged from weak to strong. Several factors important in the development of hypertension in obese children have been suggested, including endocrine determinants, such as corticosteroids and adipokines, sympathetic nervous system activity, disturbed sodium homeostasis, as well as oxidative stress, inflammation and endothelial dysfunction. Understanding the pathophysiology of hypertension in overweight and obese children is important and could have implications for its screening and treatment. Based on solely cross-sectional observational studies, it is impossible to infer causality. Longitudinal studies of high methodological quality are needed to gain more insight into the complex mechanisms behind the development of hypertension in obese children. © 2015 World Obesity.

  2. Mechanical system reliability for long life space systems

    NASA Technical Reports Server (NTRS)

    Kowal, Michael T.

    1994-01-01

    The creation of a compendium of mechanical limit states was undertaken in order to provide a reference base for the application of first-order reliability methods to mechanical systems in the context of the development of a system level design methodology. The compendium was conceived as a reference source specific to the problem of developing the noted design methodology, and not an exhaustive or exclusive compilation of mechanical limit states. The compendium is not intended to be a handbook of mechanical limit states for general use. The compendium provides a diverse set of limit-state relationships for use in demonstrating the application of probabilistic reliability methods to mechanical systems. The compendium is to be used in the reliability analysis of moderately complex mechanical systems.

  3. Propulsion system performance resulting from an integrated flight/propulsion control design

    NASA Technical Reports Server (NTRS)

    Mattern, Duane; Garg, Sanjay

    1992-01-01

    Propulsion-system-specific results are presented from the application of the integrated methodology for propulsion and airframe control (IMPAC) design approach to integrated flight/propulsion control design for a 'short takeoff and vertical landing' (STOVL) aircraft in transition flight. The IMPAC method is briefly discussed and the propulsion system specifications for the integrated control design are examined. The structure of a linear engine controller that results from partitioning a linear centralized controller is discussed. The details of a nonlinear propulsion control system are presented, including a scheme to protect the engine operational limits: the fan surge margin and the acceleration/deceleration schedule that limits the fuel flow. Also, a simple but effective multivariable integrator windup protection scheme is examined. Nonlinear closed-loop simulation results are presented for two typical pilot commands for transition flight: acceleration while maintaining flightpath angle and a change in flightpath angle while maintaining airspeed. The simulation nonlinearities include the airframe/engine coupling, the actuator and sensor dynamics and limits, the protection scheme for the engine operational limits, and the integrator windup protection. Satisfactory performance of the total airframe plus engine system for transition flight, as defined by the specifications, was maintained during the limit operation of the closed-loop engine subsystem.

  4. Introducing a methodology for estimating duration of surgery in health services research.

    PubMed

    Redelmeier, Donald A; Thiruchelvam, Deva; Daneman, Nick

    2008-09-01

    The duration of surgery is an indicator for the quality, risks, and efficiency of surgical procedures. We introduce a new methodology for assessing the duration of surgery based on anesthesiology billing records, along with reviewing its fundamental logic and limitations. The validity of the methodology was assessed through a population-based cohort of patients (n=480,986) undergoing elective operations in 246 Ontario hospitals with 1,084 anesthesiologists between April 1, 1992 and March 31, 2002 (10 years). The weaknesses of the methodology relate to missing data, self-serving exaggerations by providers, imprecisions from clinical diversity, upper limits due to accounting regulations, fluctuations from updates over the years, national differences in reimbursement schedules, and the general failings of claims base analyses. The strengths of the methodology are in providing data that match clinical experiences, correspond to chart review, are consistent over time, can detect differences where differences would be anticipated, and might have implications for examining patient outcomes after long surgical times. We suggest that an understanding and application of large studies of surgical duration may help scientists explore selected questions concerning postoperative complications.

  5. Home and health in the third age - methodological background and descriptive findings.

    PubMed

    Kylén, Maya; Ekström, Henrik; Haak, Maria; Elmståhl, Sölve; Iwarsson, Susanne

    2014-07-11

    The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. The study sample included 371 people aged 67-70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens.

  6. Home and Health in the Third Age — Methodological Background and Descriptive Findings

    PubMed Central

    Kylén, Maya; Ekström, Henrik; Haak, Maria; Elmståhl, Sölve; Iwarsson, Susanne

    2014-01-01

    Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67–70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens. PMID:25019267

  7. 2010 CEOS Field Reflectance Intercomparisons Lessons Learned

    NASA Technical Reports Server (NTRS)

    Thome, Kurtis; Fox, Nigel

    2011-01-01

    This paper summarizes lessons learned from the 2009 and 2010 joint field campaigns to Tuz Golu, Turkey. Emphasis is placed on the 2010 campaign related to understanding the equipment and measurement protocols, processing schemes, and traceability to SI quantities. Participants in both 2009 and 2010 used an array of measurement approaches to determine surface reflectance. One lesson learned is that even with all of the differences in collection between groups, the differences in reflectance are currently dominated by instrumental artifacts including knowledge of the white reference. Processing methodology plays a limited role once the bi-directional reflectance of the white reference is used rather than a hemispheric-directional value. The lack of a basic set of measurement protocols, or best practices, limits a group s ability to ensure SI traceability and the development of proper error budgets. Finally, rigorous attention to sampling methodology and its impact on instrument behavior is needed. The results of the 2009 and 2010 joint campaigns clearly demonstrate both the need and utility of such campaigns and such comparisons must continue in the future to ensure a coherent set of data that can span multiple sensor types and multiple decades.

  8. Mixed-methods research in pharmacy practice: basics and beyond (part 1).

    PubMed

    Hadi, Muhammad Abdul; Alldred, David Phillip; Closs, S José; Briggs, Michelle

    2013-10-01

    This is the first of two papers which explore the use of mixed-methods research in pharmacy practice. In an era of evidence-based medicine and policy, high-quality research evidence is essential for the development of effective pharmacist-led services. Over the past decade, the use of mixed-methods research has become increasingly common in healthcare, although to date its use has been relatively limited in pharmacy practice research. In this article, the basic concepts of mixed-methods research including its definition, typologies and advantages in relation to pharmacy practice research are discussed. Mixed-methods research brings together qualitative and quantitative methodologies within a single study to answer or understand a research problem. There are a number of mixed-methods designs available, but the selection of an appropriate design must always be dictated by the research question. Importantly, mixed-methods research should not be seen as a 'tool' to collect qualitative and quantitative data, rather there should be some degree of 'integration' between the two data sets. If conducted appropriately, mixed-methods research has the potential to generate quality research evidence by combining strengths and overcoming the respective limitations of qualitative and quantitative methodologies. © 2012 Royal Pharmaceutical Society.

  9. Advancing the use of minirhizotrons in wetlands

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

    Iversen, Colleen M; Murphy, Meaghan T.; Allen, Michael F.

    Background: Wetlands store a substantial amount of carbon (C) in deep soil organic matter deposits, and play an important role in global fluxes of carbon dioxide and methane. Fine roots (i.e., ephemeral roots that are active in water and nutrient uptake) are recognized as important components of biogeochemical cycles in nutrient-limited wetland ecosystems. However, quantification of fine-root dynamics in wetlands has generally been limited to destructive approaches, possibly because of methodological difficulties associated with the unique environmental, soil, and plant community characteristics of these systems. Non-destructive minirhizotron technology has rarely been used in wetland ecosystems. Scope: Our goal was tomore » develop a consensus on, and a methodological framework for, the appropriate installation and use of minirhizotron technology in wetland ecosystems. Here, we discuss a number of potential solutions for the challenges associated with the deployment of minirhizotron technology in wetlands, including minirhizotron installation and anchorage, capture and analysis of minirhizotron images, and upscaling of minirhizotron data for analysis of biogeochemical pools and parameterization of land surface models. Conclusions: The appropriate use of minirhizotron technology to examine relatively understudied fine-root dynamics in wetlands will advance our knowledge of ecosystem C and nutrient cycling in these globally important ecosystems.« less

  10. A Systematic Review of Experimental and Clinical Acupuncture in Chemotherapy-Induced Peripheral Neuropathy

    PubMed Central

    Franconi, Giovanna; Schröder, Sven; Marchetti, Paolo; Robinson, Nicola

    2013-01-01

    Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect that can be very disabling and can limit or delay the dose of chemotherapy that can be administered. Acupuncture may be effective for treating peripheral neuropathy. The aim of this study was to review the available literature on the use of acupuncture for CIPN. The systematic literature search was performed using MEDLINE, Google Scholar, Cochrane Database, CINHAL, and ISI Proceedings. Hand searching was conducted, and consensus was reached on all extracted data. Only papers in the English language were included, irrespective of study design. From 3989 retrieved papers, 8 relevant papers were identified. One was an experimental study which showed that electroacupuncture suppressed CIPN pain in rats. In addition, there were 7 very heterogeneous clinical studies, 1 controlled randomised study using auricular acupuncture, 2 randomized controlled studies using somatic acupuncture, and 3 case series/case reports which suggested a positive effect of acupuncture in CIPN. Conclusions. Only one controlled randomised study demonstrated that acupuncture may be beneficial for CIPN. All the clinical studies reviewed had important methodological limitations. Further studies with robust methodology are needed to demonstrate the role of acupuncture for treating CIPN resulting from cancer treatment. PMID:23983788

  11. Satellite retrieval of cloud condensation nuclei concentrations by using clouds as CCN chambers

    PubMed Central

    Rosenfeld, Daniel; Zheng, Youtong; Hashimshoni, Eyal; Pöhlker, Mira L.; Jefferson, Anne; Pöhlker, Christopher; Yu, Xing; Zhu, Yannian; Liu, Guihua; Yue, Zhiguo; Fischman, Baruch; Li, Zhanqing; Giguzin, David; Goren, Tom; Artaxo, Paulo; Pöschl, Ulrich

    2016-01-01

    Quantifying the aerosol/cloud-mediated radiative effect at a global scale requires simultaneous satellite retrievals of cloud condensation nuclei (CCN) concentrations and cloud base updraft velocities (Wb). Hitherto, the inability to do so has been a major cause of high uncertainty regarding anthropogenic aerosol/cloud-mediated radiative forcing. This can be addressed by the emerging capability of estimating CCN and Wb of boundary layer convective clouds from an operational polar orbiting weather satellite. Our methodology uses such clouds as an effective analog for CCN chambers. The cloud base supersaturation (S) is determined by Wb and the satellite-retrieved cloud base drop concentrations (Ndb), which is the same as CCN(S). Validation against ground-based CCN instruments at Oklahoma, at Manaus, and onboard a ship in the northeast Pacific showed a retrieval accuracy of ±25% to ±30% for individual satellite overpasses. The methodology is presently limited to boundary layer not raining convective clouds of at least 1 km depth that are not obscured by upper layer clouds, including semitransparent cirrus. The limitation for small solar backscattering angles of <25° restricts the satellite coverage to ∼25% of the world area in a single day. PMID:26944081

  12. Satellite retrieval of cloud condensation nuclei concentrations by using clouds as CCN chambers.

    PubMed

    Rosenfeld, Daniel; Zheng, Youtong; Hashimshoni, Eyal; Pöhlker, Mira L; Jefferson, Anne; Pöhlker, Christopher; Yu, Xing; Zhu, Yannian; Liu, Guihua; Yue, Zhiguo; Fischman, Baruch; Li, Zhanqing; Giguzin, David; Goren, Tom; Artaxo, Paulo; Barbosa, Henrique M J; Pöschl, Ulrich; Andreae, Meinrat O

    2016-05-24

    Quantifying the aerosol/cloud-mediated radiative effect at a global scale requires simultaneous satellite retrievals of cloud condensation nuclei (CCN) concentrations and cloud base updraft velocities (Wb). Hitherto, the inability to do so has been a major cause of high uncertainty regarding anthropogenic aerosol/cloud-mediated radiative forcing. This can be addressed by the emerging capability of estimating CCN and Wb of boundary layer convective clouds from an operational polar orbiting weather satellite. Our methodology uses such clouds as an effective analog for CCN chambers. The cloud base supersaturation (S) is determined by Wb and the satellite-retrieved cloud base drop concentrations (Ndb), which is the same as CCN(S). Validation against ground-based CCN instruments at Oklahoma, at Manaus, and onboard a ship in the northeast Pacific showed a retrieval accuracy of ±25% to ±30% for individual satellite overpasses. The methodology is presently limited to boundary layer not raining convective clouds of at least 1 km depth that are not obscured by upper layer clouds, including semitransparent cirrus. The limitation for small solar backscattering angles of <25° restricts the satellite coverage to ∼25% of the world area in a single day.

  13. Incorporating Measurement Error from Modeled Air Pollution Exposures into Epidemiological Analyses.

    PubMed

    Samoli, Evangelia; Butland, Barbara K

    2017-12-01

    Outdoor air pollution exposures used in epidemiological studies are commonly predicted from spatiotemporal models incorporating limited measurements, temporal factors, geographic information system variables, and/or satellite data. Measurement error in these exposure estimates leads to imprecise estimation of health effects and their standard errors. We reviewed methods for measurement error correction that have been applied in epidemiological studies that use model-derived air pollution data. We identified seven cohort studies and one panel study that have employed measurement error correction methods. These methods included regression calibration, risk set regression calibration, regression calibration with instrumental variables, the simulation extrapolation approach (SIMEX), and methods under the non-parametric or parameter bootstrap. Corrections resulted in small increases in the absolute magnitude of the health effect estimate and its standard error under most scenarios. Limited application of measurement error correction methods in air pollution studies may be attributed to the absence of exposure validation data and the methodological complexity of the proposed methods. Future epidemiological studies should consider in their design phase the requirements for the measurement error correction method to be later applied, while methodological advances are needed under the multi-pollutants setting.

  14. A methodology for determining rural public transportation needs in Virginia.

    DOT National Transportation Integrated Search

    1974-01-01

    The need for rural public transportation is coming into focus, although-Its magnitude is unknown because of limited data. This study was initiated to develop an efficient and economical methodology for determining the transportation needs of the rura...

  15. Passenger rail vehicle safety assessment methodology. Volume II, Detailed analyses and simulation results.

    DOT National Transportation Integrated Search

    2000-04-01

    This report presents detailed analytic tools and results on dynamic response which are used to develop the safe dynamic performance limits of commuter passenger vehicles. The methodology consists of determining the critical parameters and characteris...

  16. Particle Count Limits Recommendation for Aviation Fuel

    DTIC Science & Technology

    2015-10-05

    Particle Counter Methodology • Particle counts are taken utilizing calibration methodologies and standardized cleanliness code ratings – ISO 11171 – ISO...Limits Receipt Vehicle Fuel Tank Fuel Injector Aviation Fuel DEF (AUST) 5695B 18/16/13 Parker 18/16/13 14/10/7 Pamas / Parker / Particle Solutions 19/17...12 U.S. DOD 19/17/14/13* Diesel Fuel World Wide Fuel Charter 5th 18/16/13 DEF (AUST) 5695B 18/16/13 Caterpillar 18/16/13 Detroit Diesel 18/16/13 MTU

  17. Testing for genetically modified organisms (GMOs): Past, present and future perspectives.

    PubMed

    Holst-Jensen, Arne

    2009-01-01

    This paper presents an overview of GMO testing methodologies and how these have evolved and may evolve in the next decade. Challenges and limitations for the application of the test methods as well as to the interpretation of results produced with the methods are highlighted and discussed, bearing in mind the various interests and competences of the involved stakeholders. To better understand the suitability and limitations of detection methodologies the evolution of transformation processes for creation of GMOs is briefly reviewed.

  18. Constraints on sea to air emissions from methane clathrates in the vicinity of Svalbard

    NASA Astrophysics Data System (ADS)

    Pisso, Ignacio; Vadakkepuliyambatta, Sunil; Platt, Stephen Matthew; Eckhardt, Sabine; Allen, Grant; Pitt, Joseph; Silyakova, Anna; Hermansen, Ove; Schmidbauer, Norbert; Mienert, Jurgen; Myhre, Cathrine Lund; Stohl, Andreas

    2016-04-01

    Methane stored in the seabed in the form of clathrates has the potential to be released into the atmosphere due to ongoing ocean warming. The Methane Emissions from Arctic Ocean to Atmosphere (MOCA, http://moca.nilu.no/) proje sct conducted measurement campaigns in the vicinity of Svalbard during the summers of 2014 and 2015 in collaboration with the Centre for Arctic Gas Hydrate, Environment and Climate (CAGE, https://cage.uit.no/) and the MAMM (https://arcticmethane.wordpress.com) project . The extensive set of measurements includes air (BAe 146) and ship (RV Helmer Hansen) borne methane concentrations, complemented with the nearby monitoring site at Zeppelin mountain. In order to assess the atmospheric impact of emissions from seabed methane hydrates, we characterised the local and long range atmospheric transport during the aircraft campaign and different scenarios for the emission sources. We present a range of upper bounds for the CH4 emissions during the campaign period as well as the methodologies used to obtain them. The methodologies include a box model, Lagrangian transport and elementary inverse modelling. We emphasise the analysis of the aircraft data. We discuss in detail the different methodologies used for determining the upper flux bounds as well as its uncertainties and limitations. The additional information provided by the ship and station observations will be briefly mentioned.

  19. The added value of thorough economic evaluation of telemedicine networks.

    PubMed

    Le Goff-Pronost, Myriam; Sicotte, Claude

    2010-02-01

    This paper proposes a thorough framework for the economic evaluation of telemedicine networks. A standard cost analysis methodology was used as the initial base, similar to the evaluation method currently being applied to telemedicine, and to which we suggest adding subsequent stages that enhance the scope and sophistication of the analytical methodology. We completed the methodology with a longitudinal and stakeholder analysis, followed by the calculation of a break-even threshold, a calculation of the economic outcome based on net present value (NPV), an estimate of the social gain through external effects, and an assessment of the probability of social benefits. In order to illustrate the advantages, constraints and limitations of the proposed framework, we tested it in a paediatric cardiology tele-expertise network. The results demonstrate that the project threshold was not reached after the 4 years of the study. Also, the calculation of the project's NPV remained negative. However, the additional analytical steps of the proposed framework allowed us to highlight alternatives that can make this service economically viable. These included: use over an extended period of time, extending the network to other telemedicine specialties, or including it in the services offered by other community hospitals. In sum, the results presented here demonstrate the usefulness of an economic evaluation framework as a way of offering decision makers the tools they need to make comprehensive evaluations of telemedicine networks.

  20. Nuclear Forensics: A Methodology Applicable to Nuclear Security and to Non-Proliferation

    NASA Astrophysics Data System (ADS)

    Mayer, K.; Wallenius, M.; Lützenkirchen, K.; Galy, J.; Varga, Z.; Erdmann, N.; Buda, R.; Kratz, J.-V.; Trautmann, N.; Fifield, K.

    2011-09-01

    Nuclear Security aims at the prevention and detection of and response to, theft, sabotage, unauthorized access, illegal transfer or other malicious acts involving nuclear material. Nuclear Forensics is a key element of nuclear security. Nuclear Forensics is defined as a methodology that aims at re-establishing the history of nuclear material of unknown origin. It is based on indicators that arise from known relationships between material characteristics and process history. Thus, nuclear forensics analysis includes the characterization of the material and correlation with production history. To this end, we can make use of parameters such as the isotopic composition of the nuclear material and accompanying elements, chemical impurities, macroscopic appearance and microstructure of the material. In the present paper, we discuss the opportunities for attribution of nuclear material offered by nuclear forensics as well as its limitations. Particular attention will be given to the role of nuclear reactions. Such reactions include the radioactive decay of the nuclear material, but also reactions with neutrons. When uranium (of natural composition) is exposed to neutrons, plutonium is formed, as well as 236U. We will illustrate the methodology using the example of a piece of uranium metal that dates back to the German nuclear program in the 1940's. A combination of different analytical techniques and model calculations enables a nuclear forensics interpretation, thus correlating the material characteristics with the production history.

  1. Documenting legal status: a systematic review of measurement of undocumented status in health research.

    PubMed

    Young, Maria-Elena De Trinidad; Madrigal, Daniel S

    2017-01-01

    Undocumented status is rarely measured in health research, yet it influences the lives and well-being of immigrants. The growing body of research on undocumented status and health shows the need to assess the measurement of this legal status. We discuss the definition of undocumented status, conduct a systematic review of the methodological approaches currently taken to measure undocumented status of immigrants in the USA, and discuss recommendations for advancement of measurement methods. We conducted a systematic review of 61 studies indexed in PubMed, conducted in the USA, and published from 2004 to 2014. We categorized each of the studies' data source and type, measurement type, and information for classifying undocumented participants. Studies used self-reported or proxy measures of legal status. Information to classify undocumented participants included self-reported status, possession of a Social Security number, possession of health insurance or institutional resources, concern about deportation, and participant characteristics. Findings show it is feasible to collect self-reported measures of undocumented status. We recommend that researchers collect self-reported measures of undocumented status whenever possible and limit the use of proxy measures. Validated and standardized measures are needed for within and across country measurement. Authors should provide methodological information about measurement in publications. Finally, individuals who are undocumented should be included in the development of these methodologies. This systematic review is not registered.

  2. [Pharmacological Treatment of Apathy in Parkinson's Disease: a Systematic Review of the Literature].

    PubMed

    Holguín Lew, Jorge Carlos; Caamaño Jaraba, Jessica; Gómez Alzate, Alejandra; Hidalgo López, Catalina; Marino Mondragón, Daniel Felipe; Restrepo Moreno, Sebastián; Rico Abella, Liz Evelin

    2017-10-01

    Apathy, defined as a deficit for initiating and maintaining action, is a symptom affecting patients with diverse psychiatric and neuropsychiatric diseases, including dementia, sequelae of traumatic brain injury, schizophrenia, depression, and Parkinson's disease (PD). Apathy negatively affects function and quality of life of PD patients, and it is an important cause of caregiver's distress. The pharmacological treatment of apathy in PD is the focus of this systematic review. A comprehensive search and systematic selection was performed in different databases of original research papers on the treatment of apathy in PD. The results were then consolidated, and a critical analysis was made of the research papers. The results are then discussed according to the methodological standards for systematic reviews of the literature. A total of 11 studies were included. Although some studies showed efficacy, all of them had important methodological limitations that hampered the interpretation of results. The results of the examined studies cannot be considered as evidence for guiding clinical decisions. So far, no evidence-based recommendations can be offered for the treatment of apathy in PD. More studies with better methodological quality are needed. It is a potentially fruitful area for research and one badly needed by both PD patients and their caregivers. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

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

    Grabaskas, David; Brunett, Acacia J.; Passerini, Stefano

    GE Hitachi Nuclear Energy (GEH) and Argonne National Laboratory (Argonne) participated in a two year collaboration to modernize and update the probabilistic risk assessment (PRA) for the PRISM sodium fast reactor. At a high level, the primary outcome of the project was the development of a next-generation PRA that is intended to enable risk-informed prioritization of safety- and reliability-focused research and development. A central Argonne task during this project was a reliability assessment of passive safety systems, which included the Reactor Vessel Auxiliary Cooling System (RVACS) and the inherent reactivity feedbacks of the metal fuel core. Both systems were examinedmore » utilizing a methodology derived from the Reliability Method for Passive Safety Functions (RMPS), with an emphasis on developing success criteria based on mechanistic system modeling while also maintaining consistency with the Fuel Damage Categories (FDCs) of the mechanistic source term assessment. This paper provides an overview of the reliability analyses of both systems, including highlights of the FMEAs, the construction of best-estimate models, uncertain parameter screening and propagation, and the quantification of system failure probability. In particular, special focus is given to the methodologies to perform the analysis of uncertainty propagation and the determination of the likelihood of violating FDC limits. Additionally, important lessons learned are also reviewed, such as optimal sampling methodologies for the discovery of low likelihood failure events and strategies for the combined treatment of aleatory and epistemic uncertainties.« less

  4. Systematic review of the use of online questionnaires of older adults.

    PubMed

    Remillard, Meegan L; Mazor, Kathleen M; Cutrona, Sarah L; Gurwitz, Jerry H; Tjia, Jennifer

    2014-04-01

    To describe methodological approaches to population targeting and sampling and to summarize limitations of Internet-based questionnaires in older adults. Systematic literature review. Studies using online questionnaires in older adult populations. English-language articles using search terms for geriatric, age 65 and over, Internet survey, online survey, Internet questionnaire, and online questionnaire in PubMed and EBSCO host between 1984 and July 2012. Inclusion criteria were study population mean age 65 and older and use of an online questionnaire for research. Review of 336 abstracts yielded 14 articles for full review by two investigators; 11 articles met inclusion criteria. Articles were extracted for study design and setting, participant characteristics, recruitment strategy, country, and study limitations. Eleven articles were published after 2001. Studies had populations with a mean age of 65 to 78, included descriptive and analytical designs, and were conducted in the United States, Australia, and Japan. Recruiting methods varied widely from paper fliers and personal e-mails to use of consumer marketing panels. Investigator-reported study limitations included the use of small convenience samples and limited generalizability. Online questionnaires are a feasible method of surveying older adults in some geographic regions and for some subsets of older adults, but limited Internet access constrains recruiting methods and often limits study generalizability. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  5. Quantifying construction and demolition waste: An analytical review

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

    Wu, Zezhou; Yu, Ann T.W., E-mail: bsannyu@polyu.edu.hk; Shen, Liyin

    2014-09-15

    Highlights: • Prevailing C and D waste quantification methodologies are identified and compared. • One specific methodology cannot fulfill all waste quantification scenarios. • A relevance tree for appropriate quantification methodology selection is proposed. • More attentions should be paid to civil and infrastructural works. • Classified information is suggested for making an effective waste management plan. - Abstract: Quantifying construction and demolition (C and D) waste generation is regarded as a prerequisite for the implementation of successful waste management. In literature, various methods have been employed to quantify the C and D waste generation at both regional and projectmore » levels. However, an integrated review that systemically describes and analyses all the existing methods has yet to be conducted. To bridge this research gap, an analytical review is conducted. Fifty-seven papers are retrieved based on a set of rigorous procedures. The characteristics of the selected papers are classified according to the following criteria - waste generation activity, estimation level and quantification methodology. Six categories of existing C and D waste quantification methodologies are identified, including site visit method, waste generation rate method, lifetime analysis method, classification system accumulation method, variables modelling method and other particular methods. A critical comparison of the identified methods is given according to their characteristics and implementation constraints. Moreover, a decision tree is proposed for aiding the selection of the most appropriate quantification method in different scenarios. Based on the analytical review, limitations of previous studies and recommendations of potential future research directions are further suggested.« less

  6. The effect of interventions aiming to optimise the prescription of antibiotics in dental care—A systematic review

    PubMed Central

    Böhmer, Femke

    2017-01-01

    Background Abundant evidence in dentistry suggests that antibiotics are prescribed despite the existence of guidelines aiming to reduce the development of antibiotic resistance. This review investigated (1) which type of interventions aiming to optimise prescription of antibiotics exist in dentistry, (2) the effect of these interventions and (3) the specific strengths and limitations of the studies reporting on these interventions. Method Literature search was based on Medline, Embase, Global Health, Cochrane CENTRAL, ClinicalTrials.gov and Current Controlled Trials. Studies with one of the two primary outcomes were included: (1) The number of antibiotics prescribed and/or (2) the accuracy of the prescription, commonly measured as a percentage of adherence to local clinical guidelines. Results Nine studies met these inclusion criteria. Five studies reported on the prescription of antibiotics in primary dental care and four studies focused on outpatient dental care. Interventions used in primary dental care included a combination of audit, feedback, education, local consensus, dissemination of guidelines and/or academic detailing. Trials in the outpatient setting made use of expert panel discussions, educational feedback on previous acts of prescribing, the dissemination of guidelines and the establishment of internal guidelines. All studies successfully reduced the number of antibiotics prescribed and/or increased the accuracy of the prescription. However, most studies were confounded by a high risk of selection bias, selective outcome reporting and high variance across study groups. In particular, information relating to study design and methodology was insufficient. Only three studies related the prescriptions to the number of patients treated with antibiotics. Conclusions This systematic review was able to offer conclusions which took the limitations of the investigated studies into account. Unfortunately, few studies could be included and many of these studies were confounded by a low quality of scientific reporting and lack of information regarding study methodology. High-quality research with objective and standardised outcome reporting, longer periods of follow-up, rigorous methodology and adequate standard of study reporting is urgently needed. PMID:29136646

  7. Evaluation of grid generation technologies from an applied perspective

    NASA Technical Reports Server (NTRS)

    Hufford, Gary S.; Harrand, Vincent J.; Patel, Bhavin C.; Mitchell, Curtis R.

    1995-01-01

    An analysis of the grid generation process from the point of view of an applied CFD engineer is given. Issues addressed include geometric modeling, structured grid generation, unstructured grid generation, hybrid grid generation and use of virtual parts libraries in large parametric analysis projects. The analysis is geared towards comparing the effective turn around time for specific grid generation and CFD projects. The conclusion was made that a single grid generation methodology is not universally suited for all CFD applications due to both limitations in grid generation and flow solver technology. A new geometric modeling and grid generation tool, CFD-GEOM, is introduced to effectively integrate the geometric modeling process to the various grid generation methodologies including structured, unstructured, and hybrid procedures. The full integration of the geometric modeling and grid generation allows implementation of extremely efficient updating procedures, a necessary requirement for large parametric analysis projects. The concept of using virtual parts libraries in conjunction with hybrid grids for large parametric analysis projects is also introduced to improve the efficiency of the applied CFD engineer.

  8. Prevalence and risk factors associated with musculoskeletal complaints among users of mobile handheld devices: A systematic review.

    PubMed

    Xie, Yanfei; Szeto, Grace; Dai, Jie

    2017-03-01

    This systematic review aimed at evaluating the prevalence and risk factors for musculoskeletal complaints associated with mobile handheld device use. Pubmed, Medline, Web of Science, CINAHL and Embase were searched. The methodological quality of included studies was assessed. Strength of evidence for risk factors was determined based on study designs, methodological quality and consistency of results. Five high-quality, eight acceptable-quality and two low-quality peer-reviewed articles were included. This review demonstrates that the prevalence of musculoskeletal complaints among mobile device users ranges from 1.0% to 67.8% and neck complaints have the highest prevalence rates ranging from 17.3% to 67.8%. This study also finds some evidence for neck flexion, frequency of phone calls, texting and gaming in relation to musculoskeletal complaints among mobile device users. Inconclusive evidence is shown for other risk factors such as duration of use and human-device interaction techniques due to inconsistent results or a limited number of studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Alternative approximation concepts for space frame synthesis

    NASA Technical Reports Server (NTRS)

    Lust, R. V.; Schmit, L. A.

    1985-01-01

    A structural synthesis methodology for the minimum mass design of 3-dimensionall frame-truss structures under multiple static loading conditions and subject to limits on displacements, rotations, stresses, local buckling, and element cross-sectional dimensions is presented. A variety of approximation concept options are employed to yield near optimum designs after no more than 10 structural analyses. Available options include: (A) formulation of the nonlinear mathematcal programming problem in either reciprocal section property (RSP) or cross-sectional dimension (CSD) space; (B) two alternative approximate problem structures in each design space; and (C) three distinct assumptions about element end-force variations. Fixed element, design element linking, and temporary constraint deletion features are also included. The solution of each approximate problem, in either its primal or dual form, is obtained using CONMIN, a feasible directions program. The frame-truss synthesis methodology is implemented in the COMPASS computer program and is used to solve a variety of problems. These problems were chosen so that, in addition to exercising the various approximation concepts options, the results could be compared with previously published work.

  10. Rating methodological quality: toward improved assessment and investigation.

    PubMed

    Moyer, Anne; Finney, John W

    2005-01-01

    Assessing methodological quality is considered essential in deciding what investigations to include in research syntheses and in detecting potential sources of bias in meta-analytic results. Quality assessment is also useful in characterizing the strengths and limitations of the research in an area of study. Although numerous instruments to measure research quality have been developed, they have lacked empirically-supported components. In addition, different summary quality scales have yielded different findings when they were used to weight treatment effect estimates for the same body of research. Suggestions for developing improved quality instruments include: distinguishing distinct domains of quality, such as internal validity, external validity, the completeness of the study report, and adherence to ethical practices; focusing on individual aspects, rather than domains of quality; and focusing on empirically-verified criteria. Other ways to facilitate the constructive use of quality assessment are to improve and standardize the reporting of research investigations, so that the quality of studies can be more equitably and thoroughly compared, and to identify optimal methods for incorporating study quality ratings into meta-analyses.

  11. Mechanistic modelling of the inhibitory effect of pH on microbial growth.

    PubMed

    Akkermans, Simen; Van Impe, Jan F

    2018-06-01

    Modelling and simulation of microbial dynamics as a function of processing, transportation and storage conditions is a useful tool to improve microbial food safety and quality. The goal of this research is to improve an existing methodology for building mechanistic predictive models based on the environmental conditions. The effect of environmental conditions on microbial dynamics is often described by combining the separate effects in a multiplicative way (gamma concept). This idea was extended further in this work by including the effects of the lag and stationary growth phases on microbial growth rate as independent gamma factors. A mechanistic description of the stationary phase as a function of pH was included, based on a novel class of models that consider product inhibition. Experimental results on Escherichia coli growth dynamics indicated that also the parameters of the product inhibition equations can be modelled with the gamma approach. This work has extended a modelling methodology, resulting in predictive models that are (i) mechanistically inspired, (ii) easily identifiable with a limited work load and (iii) easily extended to additional environmental conditions. Copyright © 2017. Published by Elsevier Ltd.

  12. The IMI PROTECT project: purpose, organizational structure, and procedures.

    PubMed

    Reynolds, Robert F; Kurz, Xavier; de Groot, Mark C H; Schlienger, Raymond G; Grimaldi-Bensouda, Lamiae; Tcherny-Lessenot, Stephanie; Klungel, Olaf H

    2016-03-01

    The Pharmacoepidemiological Research on Outcomes of Therapeutics by a European ConsorTium (PROTECT) initiative was a collaborative European project that sought to address limitations of current methods in the field of pharmacoepidemiology and pharmacovigilance. Initiated in 2009 and ending in 2015, PROTECT was part of the Innovative Medicines Initiative, a joint undertaking by the European Union and pharmaceutical industry. Thirty-five partners including academics, regulators, small and medium enterprises, and European Federation of Pharmaceuticals Industries and Associations companies contributed to PROTECT. Two work packages within PROTECT implemented research examining the extent to which differences in the study design, methodology, and choice of data source can contribute to producing discrepant results from observational studies on drug safety. To evaluate the effect of these differences, the project applied different designs and analytic methodology for six drug-adverse event pairs across several electronic healthcare databases and registries. This papers introduces the organizational structure and procedures of PROTECT, including how drug-adverse event and data sources were selected, study design and analyses documents were developed, and results managed centrally. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Aeroelastic analysis for propellers - mathematical formulations and program user's manual

    NASA Technical Reports Server (NTRS)

    Bielawa, R. L.; Johnson, S. A.; Chi, R. M.; Gangwani, S. T.

    1983-01-01

    Mathematical development is presented for a specialized propeller dedicated version of the G400 rotor aeroelastic analysis. The G400PROP analysis simulates aeroelastic characteristics particular to propellers such as structural sweep, aerodynamic sweep and high subsonic unsteady airloads (both stalled and unstalled). Formulations are presented for these expanded propeller related methodologies. Results of limited application of the analysis to realistic blade configurations and operating conditions which include stable and unstable stall flutter test conditions are given. Sections included for enhanced program user efficiency and expanded utilization include descriptions of: (1) the structuring of the G400PROP FORTRAN coding; (2) the required input data; and (3) the output results. General information to facilitate operation and improve efficiency is also provided.

  14. Non-invasive neuroimaging using near-infrared light

    NASA Technical Reports Server (NTRS)

    Strangman, Gary; Boas, David A.; Sutton, Jeffrey P.

    2002-01-01

    This article reviews diffuse optical brain imaging, a technique that employs near-infrared light to non-invasively probe the brain for changes in parameters relating to brain function. We describe the general methodology, including types of measurements and instrumentation (including the tradeoffs inherent in the various instrument components), and the basic theory required to interpret the recorded data. A brief review of diffuse optical applications is included, with an emphasis on research that has been done with psychiatric populations. Finally, we discuss some practical issues and limitations that are relevant when conducting diffuse optical experiments. We find that, while diffuse optics can provide substantial advantages to the psychiatric researcher relative to the alternative brain imaging methods, the method remains substantially underutilized in this field.

  15. A portable circulating tumor cell capture microdevice

    NASA Astrophysics Data System (ADS)

    Datar, Ram H.

    2009-03-01

    Sensitive detection of earliest metastatic spread of tumors in a minimally invasive and user-friendly manner will revolutionize the clinical management of cancer patients. The current methodologies for circulating tumor cell (CTC) capture and identification have significant limitations including time, cost, limited capture efficiency and lack of standardization. We have developed and optimized a novel parylene membrane filter-based portable microdevice for size-based isolation of CTC from human peripheral blood. Following characterization with a model system to study the recovery rate and enrichment factor, a comparison of the microdevice with the commercially available system using blood from cancer patients demonstrated superior recovery rate and the promise of clinical utility of the microdevice. The development of the microdevice and its potential clinical applicability will be discussed.

  16. A review of ecologic studies of lung cancer and indoor radon.

    PubMed

    Stidley, C A; Samet, J M

    1993-09-01

    Although radon exposure is an established cause of lung cancer among underground miners, the lung cancer risk to the general population from indoor radon remains controversial. This controversy stems in part from the contradictory results of published studies of indoor radon and lung cancer, including 15 ecologic studies, seven of which found a positive association, six no association, and two a negative association. To address the misunderstanding of the indoor radon risk that has resulted from these ecologic studies, the authors discuss the general methodologic problems and limitations of ecologic studies, and the particular limitations of these 15 studies. The authors conclude that the shortcomings of the ecologic studies render them uninformative on the lung cancer risk associated with indoor radon.

  17. Limited receptive area neural classifier for recognition of swallowing sounds using continuous wavelet transform.

    PubMed

    Makeyev, Oleksandr; Sazonov, Edward; Schuckers, Stephanie; Lopez-Meyer, Paulo; Melanson, Ed; Neuman, Michael

    2007-01-01

    In this paper we propose a sound recognition technique based on the limited receptive area (LIRA) neural classifier and continuous wavelet transform (CWT). LIRA neural classifier was developed as a multipurpose image recognition system. Previous tests of LIRA demonstrated good results in different image recognition tasks including: handwritten digit recognition, face recognition, metal surface texture recognition, and micro work piece shape recognition. We propose a sound recognition technique where scalograms of sound instances serve as inputs of the LIRA neural classifier. The methodology was tested in recognition of swallowing sounds. Swallowing sound recognition may be employed in systems for automated swallowing assessment and diagnosis of swallowing disorders. The experimental results suggest high efficiency and reliability of the proposed approach.

  18. [The evaluation of pharmacological drugs, medical devices, and non-pharmacological or public health interventions: Experimental design limitations. Moving towards new methods?

    PubMed

    Villeval, M; Carayol, M; Lamy, S; Lepage, B; Lang, T

    2016-12-01

    In the field of health, evidence-based medicine and associated methods like randomised controlled trials (RCTs) have become widely used. RCT has become the gold standard for evaluating causal links between interventions and health results. Originating in pharmacology, this method has been progressively expanded to medical devices, non-pharmacological individual interventions, as well as collective public health interventions. Its use in these domains has led to the formulation of several limits, and it has been called into question as an undisputed gold standard. Some of those limits (e.g. confounding biases and external validity) are common to these four different domains, while others are more specific. This paper describes the different limits, as well as several research avenues. Some are methodological reflections aiming at adapting RCT to the complexity of the tested interventions, and at overcoming some of its limits. Others are alternative methods. The objective is not to remove RCT from the range of evaluation methodologies, but to resituate it within this range. The aim is to encourage choosing between different methods according to the features and the level of the intervention to evaluate, thereby calling for methodological pluralism. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. The Schistosomiasis Clinical Trials Landscape: A Systematic Review of Antischistosomal Treatment Efficacy Studies and a Case for Sharing Individual Participant-Level Data (IPD)

    PubMed Central

    Vaillant, Michel; Lang, Trudie A.; Guérin, Philippe J.; Olliaro, Piero L.

    2016-01-01

    Background Schistosomiasis control mainly relies on preventive chemotherapy with praziquantel (PZQ) distributed through mass drug administration. With a target of 260 million treatments yearly, reliably assessing and monitoring efficacy is all-important. Recommendations for treatment and control of schistosomiasis are supported by systematic reviews and meta-analyses of aggregated data, which however also point to limitations due to heterogeneity in trial design, analyses and reporting. Some such limitations could be corrected through access to individual participant-level data (IPD), which facilitates standardised analyses. Methodology A systematic literature review was conducted to identify antischistosomal drug efficacy studies performed since 2000; including electronic searches of the Cochrane Infectious Diseases Group specialised register and the Cochrane Library, PubMed, CENTRAL and Embase; complemented with a manual search for articles listed in past reviews. Antischistosomal treatment studies with assessment of outcome within 60 days post-treatment were eligible. Meta-data, i.e. study-level characteristics (Schistosoma species, number of patients, drug administered, country, etc.) and efficacy parameters were extracted from published documents to evaluate the scope of an individual-level data sharing platform. Principal findings Out of 914 documents screened, 90 studies from 26 countries were included, enrolling 20,517 participants infected with Schistosoma spp. and treated with different PZQ regimens or other drugs. Methodologies varied in terms of diagnostic approaches (number of samples and test repeats), time of outcome assessment, and outcome measure (cure rate or egg reduction rate, as an arithmetic or geometric mean), making direct comparison of published data difficult. Conclusions This review describes the landscape of schistosomiasis clinical research. The volume of data and the methodological and reporting heterogeneity identified all indicate that there is scope for an individual participant-level database, to allow for standardised analyses. PMID:27347678

  20. Systems science and systems thinking for public health: a systematic review of the field.

    PubMed

    Carey, Gemma; Malbon, Eleanor; Carey, Nicole; Joyce, Andrew; Crammond, Brad; Carey, Alan

    2015-12-30

    This paper reports on findings from a systematic review designed to investigate the state of systems science research in public health. The objectives were to: (1) explore how systems methodologies are being applied within public health and (2) identify fruitful areas of activity. A systematic review was conducted from existing literature that draws on or uses systems science (in its various forms) and relates to key public health areas of action and concern, including tobacco, alcohol, obesity and the social determinants of health. 117 articles were included in the review. An inductive qualitative content analysis was used for data extraction. The following were systematically extracted from the articles: approach, methodology, transparency, strengths and weaknesses. These were then organised according to theme (ie, commonalities between studies within each category), in order to provide an overview of the state of the field as a whole. The assessment of data quality was intrinsic to the goals of the review itself, and therefore, was carried out as part of the analysis. 4 categories of research were identified from the review, ranging from editorial and commentary pieces to complex system dynamic modelling. Our analysis of each of these categories of research highlighted areas of potential for systems science to strengthen public health efforts, while also revealing a number of limitations in the dynamic systems modelling being carried out in public health. There is a great deal of interest in how the application of systems concepts and approach might aid public health. Our analysis suggests that soft systems modelling techniques are likely to be the most useful addition to public health, and align well with current debate around knowledge transfer and policy. However, the full range of systems methodologies is yet to be engaged with by public health researchers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Retinal image registration for eye movement estimation.

    PubMed

    Kolar, Radim; Tornow, Ralf P; Odstrcilik, Jan

    2015-01-01

    This paper describes a novel methodology for eye fixation measurement using a unique videoophthalmoscope setup and advanced image registration approach. The representation of the eye movements via Poincare plot is also introduced. The properties, limitations and perspective of this methodology are finally discussed.

  2. A systematic review of the evidence base for telehospice.

    PubMed

    Oliver, Debra Parker; Demiris, George; Wittenberg-Lyles, Elaine; Washington, Karla; Day, Tami; Novak, Hannah

    2012-01-01

    Abstract The use of telehealth technologies to overcome the geographic distances in the delivery of hospice care has been termed telehospice. Although telehospice research has been conducted over the last 10 years, little is known about the comprehensive findings within the field. The purpose of this systematic article was to focus on available research and answer the question, What is the state of the evidence related to telehospice services? The article was limited to studies that had been published in the English language and indexed between January 1, 2000 and March 23, 2010. Indexed databases included PubMed and PsycINFO and contained specified key words. Only research published in peer review journals and reporting empirical data, rather than opinion or editorials, were included. A two-part scoring framework was modified and applied to assess the methodological rigor and pertinence of each study. Scoring criteria allowed the evaluation of both quantitative and qualitative methodologies. Twenty-six studies were identified with the search strategy. Although limited in number and in strength, studies have evaluated the use of a variety of technologies, attitudes toward use by providers and consumers, clinical outcomes, barriers, readiness, and cost. A small evidence base for telehospice has emerged over the last 10 years. Although the evidence is of medium strength, its pertinence is strong. The evidence base could be strengthened with randomized trials and additional clinical-outcome-focused research in larger randomized samples and in qualitative studies with better-described samples.

  3. Do psychosocial interventions improve rehabilitation outcomes after anterior cruciate ligament reconstruction? A systematic review.

    PubMed

    Coronado, Rogelio A; Bird, Mackenzie L; Van Hoy, Erin E; Huston, Laura J; Spindler, Kurt P; Archer, Kristin R

    2018-03-01

    To examine the role of psychosocial interventions in improving patient-reported clinical outcomes, including return to sport/activity, and intermediary psychosocial factors after anterior cruciate ligament reconstruction. MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science were searched from each database's inception to March 2017 for published studies in patients after anterior cruciate ligament reconstruction. Studies were included if they reported on the effects of a postoperative psychosocial intervention on a patient-reported clinical measure of disability, function, pain, quality of life, return to sport/activity, or intermediary psychosocial factor. Data were extracted using a standardized form and summary effects from each article were compiled. The methodological quality of randomized trials was assessed using the Physiotherapy Evidence Database Scale and scores greater than 5/10 were considered high quality. A total of 893 articles were identified from the literature search. Of these, four randomized trials ( N = 210) met inclusion criteria. The four articles examined guided imagery and relaxation, coping modeling, and visual imagery as postoperative psychosocial interventions. Methodological quality scores of the studies ranged from 5 to 9. There were inconsistent findings for the additive benefit of psychosocial interventions for improving postoperative function, pain, or self-efficacy and limited evidence for improving postoperative quality of life, anxiety, or fear of reinjury. No study examined the effects of psychosocial interventions on return to sport/activity. Overall, there is limited evidence on the efficacy of postoperative psychosocial interventions for improving functional recovery after anterior cruciate ligament reconstruction.

  4. Overcoming the Challenges of Unstructured Data in Multisite, Electronic Medical Record-based Abstraction.

    PubMed

    Polnaszek, Brock; Gilmore-Bykovskyi, Andrea; Hovanes, Melissa; Roiland, Rachel; Ferguson, Patrick; Brown, Roger; Kind, Amy J H

    2016-10-01

    Unstructured data encountered during retrospective electronic medical record (EMR) abstraction has routinely been identified as challenging to reliably abstract, as these data are often recorded as free text, without limitations to format or structure. There is increased interest in reliably abstracting this type of data given its prominent role in care coordination and communication, yet limited methodological guidance exists. As standard abstraction approaches resulted in substandard data reliability for unstructured data elements collected as part of a multisite, retrospective EMR study of hospital discharge communication quality, our goal was to develop, apply and examine the utility of a phase-based approach to reliably abstract unstructured data. This approach is examined using the specific example of discharge communication for warfarin management. We adopted a "fit-for-use" framework to guide the development and evaluation of abstraction methods using a 4-step, phase-based approach including (1) team building; (2) identification of challenges; (3) adaptation of abstraction methods; and (4) systematic data quality monitoring. Unstructured data elements were the focus of this study, including elements communicating steps in warfarin management (eg, warfarin initiation) and medical follow-up (eg, timeframe for follow-up). After implementation of the phase-based approach, interrater reliability for all unstructured data elements demonstrated κ's of ≥0.89-an average increase of +0.25 for each unstructured data element. As compared with standard abstraction methodologies, this phase-based approach was more time intensive, but did markedly increase abstraction reliability for unstructured data elements within multisite EMR documentation.

  5. The Effects of Breakfast and Breakfast Composition on Cognition in Adults123

    PubMed Central

    Spitznagel, Mary Beth

    2016-01-01

    Extensive literature has addressed the acute cognitive effects of breaking a fast. Recent reviews in this line of work have synthesized available research on the cognitive consequences of fasting compared with nutrient intake and the cognitive effects of macronutrient consumption. These largely have been inconclusive, possibly in part because of selection criteria limiting the scope of studies covered. The purpose of the current review is to integrate the results of the literature examining the cognitive effects of breakfast and breakfast composition in adults with the use of a flexible definition of breakfast, specifically, any caloric intake after a fasting period of ≥8 h. This review includes 38 studies that examine the acute cognitive impact of breakfast and 16 studies that examine the effects of breakfast composition. Results suggest that healthy adults show a small but robust advantage for memory (particularly delayed recall) from consuming breakfast. Largely equivocal results emerge for attention and motor and executive function; there were no effects from breakfast on language. Regarding breakfast composition, a smaller number of studies and widely disparate methodology addressing this question preclude definitive conclusions about the effects of cognition. A subset of this literature examines these questions in the context of glucoregulation; the findings emphasize the importance of considering differences in glucoregulation in research designs, even among healthy cohorts. The limitations of this literature include methodologic differences, such as the use of different tests to measure cognitive constructs, as well as the effects of timing in test administration. PMID:27184286

  6. Literature Review of Research on Chronic Pain and Yoga in Military Populations

    PubMed Central

    Miller, Shari; Gaylord, Susan; Buben, Alex; Brintz, Carrie; Rae Olmsted, Kristine; Asefnia, Nakisa; Bartoszek, Michael

    2017-01-01

    Background: Although yoga is increasingly being provided to active duty soldiers and veterans, studies with military populations are limited and effects on chronic pain are largely unknown. We reviewed the existing body of literature and provide recommendations for future research. Methods: We conducted a literature review of electronic databases (PubMed, PsychINFO, Web of Science, Science Citation Index Expanded, Social Sciences Citation Index, Conference Proceedings Citation Index—Science, and Conference Proceedings Citation Index—Social Science & Humanities). The studies were reviewed for characteristics such as mean age of participants, sample size, yoga type, and study design. Only peer-reviewed studies were included in the review. Results: The search yielded only six studies that examined pain as an outcome of yoga for military populations. With one exception, studies were with veteran populations. Only one study was conducted with Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) veterans. One study was a randomized controlled trial (RCT). Four of the five studies remaining used pre/post design, while the last study used a post-only design. Conclusions: Studies on the use of yoga to treat chronic pain in military populations are in their infancy. Methodological weaknesses include small sample sizes, a lack of studies with key groups (active duty, OEF/IEF veterans), and use of single group uncontrolled designs (pre/post; post only) for all but one study. Future research is needed to address these methodological limitations and build on this small body of literature. PMID:28930278

  7. Integrated Response Time Evaluation Methodology for the Nuclear Safety Instrumentation System

    NASA Astrophysics Data System (ADS)

    Lee, Chang Jae; Yun, Jae Hee

    2017-06-01

    Safety analysis for a nuclear power plant establishes not only an analytical limit (AL) in terms of a measured or calculated variable but also an analytical response time (ART) required to complete protective action after the AL is reached. If the two constraints are met, the safety limit selected to maintain the integrity of physical barriers used for preventing uncontrolled radioactivity release will not be exceeded during anticipated operational occurrences and postulated accidents. Setpoint determination methodologies have actively been developed to ensure that the protective action is initiated before the process conditions reach the AL. However, regarding the ART for a nuclear safety instrumentation system, an integrated evaluation methodology considering the whole design process has not been systematically studied. In order to assure the safety of nuclear power plants, this paper proposes a systematic and integrated response time evaluation methodology that covers safety analyses, system designs, response time analyses, and response time tests. This methodology is applied to safety instrumentation systems for the advanced power reactor 1400 and the optimized power reactor 1000 nuclear power plants in South Korea. The quantitative evaluation results are provided herein. The evaluation results using the proposed methodology demonstrate that the nuclear safety instrumentation systems fully satisfy corresponding requirements of the ART.

  8. Educational games in geriatric medicine education: a systematic review

    PubMed Central

    2010-01-01

    Objective To systematically review the medical literature to assess the effect of geriatric educational games on the satisfaction, knowledge, beliefs, attitudes and behaviors of health care professionals. Methods We conducted a systematic review following the Cochrane Collaboration methodology including an electronic search of 10 electronic databases. We included randomized controlled trials (RCT) and controlled clinical trials (CCT) and excluded single arm studies. Population of interests included members (practitioners or students) of the health care professions. Outcomes of interests were participants' satisfaction, knowledge, beliefs, attitude, and behaviors. Results We included 8 studies evaluating 5 geriatric role playing games, all conducted in United States. All studies suffered from one or more methodological limitations but the overall quality of evidence was acceptable. None of the studies assessed the effects of the games on beliefs or behaviors. None of the 8 studies reported a statistically significant difference between the 2 groups in terms of change in attitude. One study assessed the impact on knowledge and found non-statistically significant difference between the 2 groups. Two studies found levels of satisfaction among participants to be high. We did not conduct a planned meta-analysis because the included studies either reported no statistical data or reported different summary statistics. Conclusion The available evidence does not support the use of role playing interventions in geriatric medical education with the aim of improving the attitudes towards the elderly. PMID:20416055

  9. Differences in regional grey matter volumes in currently ill patients with anorexia nervosa.

    PubMed

    Phillipou, Andrea; Rossell, Susan Lee; Gurvich, Caroline; Castle, David Jonathan; Abel, Larry Allen; Nibbs, Richard Grant; Hughes, Matthew Edward

    2018-01-01

    Neurobiological findings in anorexia nervosa (AN) are inconsistent, including differences in regional grey matter volumes. Methodological limitations often contribute to the inconsistencies reported. The aim of this study was to improve on these methodologies by utilising voxel-based morphometry (VBM) analysis with the use of diffeomorphic anatomic registration through an exponentiated lie algebra algorithm (DARTEL), in a relatively large group of individuals with AN. Twenty-six individuals with AN and 27 healthy controls underwent a T1-weighted magnetic resonance imaging (MRI) scan. AN participants were found to have reduced grey matter volumes in a number of areas including regions of the basal ganglia (including the ventral striatum), and parietal and temporal cortices. Body mass index (BMI) and global scores on the Eating Disorder Examination Questionnaire (EDE-Q) were also found to correlate with grey matter volumes in a region of the brainstem (including the substantia nigra and ventral tegmental area) in AN, and predicted 56% of the variance in grey matter volumes in this area. The brain regions associated with grey matter reductions in AN are consistent with regions responsible for cognitive deficits associated with the illness including anhedonia, deficits in affect perception and saccadic eye movement abnormalities. Overall, the findings suggest reduced grey matter volumes in AN that are associated with eating disorder symptomatology. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  10. Interventions to Improve Parental Communication About Sex: A Systematic Review

    PubMed Central

    Holland, Cynthia L.; Bost, James

    2011-01-01

    CONTEXT: The relative effectiveness of interventions to improve parental communication with adolescents about sex is not known. OBJECTIVE: To compare the effectiveness and methodologic quality of interventions for improving parental communication with adolescents about sex. METHODS: We searched 6 databases: OVID/Medline, PsychInfo, ERIC, Cochrane Review, Communication and Mass Media, and the Cumulative Index to Nursing and Allied Health Literature. We included studies published between 1980 and July 2010 in peer-reviewed English-language journals that targeted US parents of adolescents aged 11 to 18 years, used an experimental or quasi-experimental design, included a control group, and had a pretest/posttest design. We abstracted data on multiple communication outcomes defined by the integrative conceptual model (communication frequency, content, skills, intentions, self-efficacy, perceived environmental barriers/facilitators, perceived social norms, attitudes, outcome expectations, knowledge, and beliefs). Methodologic quality was assessed using the 11-item methodologic quality score. RESULTS: Twelve studies met inclusion criteria. Compared with controls, parents who participated in these interventions experienced improvements in multiple communication domains including the frequency, quality, intentions, comfort, and self-efficacy for communicating. We noted no effects on parental attitudes toward communicating or the outcomes they expected to occur as a result of communicating. Four studies were of high quality, 7 were of medium quality, and 1 was of lower quality. CONCLUSIONS: Our review was limited by the lack of standardized measures for assessing parental communication. Still, interventions for improving parent-adolescent sex communication are well designed and have some targeted effects. Wider dissemination could augment efforts by schools, clinicians, and health educators. PMID:21321027

  11. Interventions to improve parental communication about sex: a systematic review.

    PubMed

    Akers, Aletha Y; Holland, Cynthia L; Bost, James

    2011-03-01

    The relative effectiveness of interventions to improve parental communication with adolescents about sex is not known. To compare the effectiveness and methodologic quality of interventions for improving parental communication with adolescents about sex. We searched 6 databases: OVID/Medline, PsychInfo, ERIC, Cochrane Review, Communication and Mass Media, and the Cumulative Index to Nursing and Allied Health Literature. We included studies published between 1980 and July 2010 in peer-reviewed English-language journals that targeted US parents of adolescents aged 11 to 18 years, used an experimental or quasi-experimental design, included a control group, and had a pretest/posttest design. We abstracted data on multiple communication outcomes defined by the integrative conceptual model (communication frequency, content, skills, intentions, self-efficacy, perceived environmental barriers/facilitators, perceived social norms, attitudes, outcome expectations, knowledge, and beliefs). Methodologic quality was assessed using the 11-item methodologic quality score. Twelve studies met inclusion criteria. Compared with controls, parents who participated in these interventions experienced improvements in multiple communication domains including the frequency, quality, intentions, comfort, and self-efficacy for communicating. We noted no effects on parental attitudes toward communicating or the outcomes they expected to occur as a result of communicating. Four studies were of high quality, 7 were of medium quality, and 1 was of lower quality. Our review was limited by the lack of standardized measures for assessing parental communication. Still, interventions for improving parent-adolescent sex communication are well designed and have some targeted effects. Wider dissemination could augment efforts by schools, clinicians, and health educators.

  12. Sensory stimulation for persons with dementia: a review of the literature.

    PubMed

    Strøm, Benedicte S; Ytrehus, Siri; Grov, Ellen-Karine

    2016-07-01

    To provide an overview of available sensory stimulation interventions, and their effect on persons with dementia and to present theoretical and methodological characteristics of the studies included. Different sensory stimulation interventions are used for persons with dementia to increase alertness, reduce agitation and improve quality of life. However, the effect of these interventions is not clear, neither are their characteristics. A systematic search and review of the literature with description of the content and an evaluation of theoretical and methodological approaches. Systematic searches in CINAHL, PubMed (Medline), The Cochrane library and PsycINFO. Studies included have been subject to quality assessment by means of Critical Appraisal Skills Programme. Fifty-five studies were included and thirty of these documented significant effect. The effect of the sensory stimulation interventions mainly reported on negative behaviours, except from five studies assessing quality of life and well-being. The majority of the studies had methodological limitations. The different sensory stimulation interventions were organised into eight categories: music, light therapy, acupressure/reflexology, massage/aromatherapy and doll therapy/pet therapy/toy therapy, the Sonas programme and Snoezelen. More studies are needed to clarify appropriate substantial background for the specific interventions. However, most of the studies based their interventions on a theoretical foundation. Furthermore, more research is needed to measure the effect of sensory stimulation on communication as well as quality of life. In addition, studies are to focus on whether the effect depends on the stage of dementia. Nurses are to be aware of sensory stimulation as a possible intervention to improve persons' quality of life. © 2016 John Wiley & Sons Ltd.

  13. Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other muscle wasting illness: a systematic review.

    PubMed

    Wandrag, L; Brett, S J; Frost, G; Hickson, M

    2015-08-01

    Muscle wasting during critical illness impairs recovery. Dietary strategies to minimise wasting include nutritional supplements, particularly essential amino acids. We reviewed the evidence on enteral supplementation with amino acids or their metabolites in the critically ill and in muscle wasting illness with similarities to critical illness, aiming to assess whether this intervention could limit muscle wasting in vulnerable patient groups. Citation databases, including MEDLINE, Web of Knowledge, EMBASE, the meta-register of controlled trials and the Cochrane Collaboration library, were searched for articles from 1950 to 2013. Search terms included 'critical illness', 'muscle wasting', 'amino acid supplementation', 'chronic obstructive pulmonary disease', 'chronic heart failure', 'sarcopenia' and 'disuse atrophy'. Reviews, observational studies, sport nutrition, intravenous supplementation and studies in children were excluded. One hundred and eighty studies were assessed for eligibility and 158 were excluded. Twenty-two studies were graded according to standardised criteria using the GRADE methodology: four in critical care populations, and 18 from other clinically relevant areas. Methodologies, interventions and outcome measures used were highly heterogeneous and meta-analysis was not appropriate. Methodology and quality of studies were too varied to draw any firm conclusion. Dietary manipulation with leucine enriched essential amino acids (EAA), β-hydroxy-β-methylbutyrate and creatine warrant further investigation in critical care; EAA has demonstrated improvements in body composition and nutritional status in other groups with muscle wasting illness. High-quality research is required in critical care before treatment recommendations can be made. © 2014 The British Dietetic Association Ltd.

  14. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis.

    PubMed

    Ahmed Ali, Usama; Pahlplatz, Johanna M; Nealon, Wiliam H; van Goor, Harry; Gooszen, Hein G; Boermeester, Marja A

    2015-03-19

    Endoscopy and surgery are the treatment modalities of choice for patients with chronic pancreatitis and dilated pancreatic duct (obstructive chronic pancreatitis). Physicians face, without clear consensus, the choice between endoscopy or surgery for this group of patients. To assess and compare the effects and complications of surgical and endoscopic interventions in the management of pain for obstructive chronic pancreatitis. We searched the following databases in The Cochrane Library: CENTRAL (2014, Issue 2), the Cochrane Database of Systematic Reviews (2014, Issue 2), and DARE (2014, Issue 2). We also searched the following databases up to 25 March 2014: MEDLINE (from 1950), Embase (from 1980), and the Conference Proceedings Citation Index - Science (CPCI-S) (from 1990). We performed a cross-reference search. Two review authors independently performed the selection of trials. All randomised controlled trials (RCTs) of endoscopic or surgical interventions in obstructive chronic pancreatitis. We included trials comparing endoscopic versus surgical interventions as well as trials comparing either endoscopic or surgical interventions to conservative treatment (i.e. non-invasive treatment modalities). We included relevant trials irrespective of blinding, the number of participants randomised, and the language of the article. We used standard methodological procedures expected by The Cochrane Collaboration. Two authors independently extracted data from the articles. We evaluated the methodological quality of the included trials and requested additional information from study authors in the case of missing data. We identified three eligible trials. Two trials compared endoscopic intervention with surgical intervention and included a total of 111 participants: 55 in the endoscopic group and 56 in the surgical group. Compared with the endoscopic group, the surgical group had a higher proportion of participants with pain relief, both at middle/long-term follow-up (two to five years: risk ratio (RR) 1.62, 95% confidence interval (CI) 1.22 to 2.15) and long-term follow-up (≥ five years, RR 1.56, 95% CI 1.18 to 2.05). Surgical intervention resulted in improved quality of life and improved preservation of exocrine pancreatic function at middle/long-term follow-up (two to five years), but not at long-term follow-up (≥ 5 years). No differences were found in terms of major post-interventional complications or mortality, although the number of participants did not allow for this to be reliably evaluated. One trial, including 32 participants, compared surgical intervention with conservative treatment: 17 in the surgical group and 15 in the conservative group. The trial showed that surgical intervention resulted in a higher percentage of participants with pain relief and better preservation of pancreatic function. The trial had methodological limitations, and the number of participants was relatively small. For patients with obstructive chronic pancreatitis and dilated pancreatic duct, this review shows that surgery is superior to endoscopy in terms of pain relief. Morbidity and mortality seem not to differ between the two intervention modalities, but the small trials identified do not provide sufficient power to detect the small differences expected in this outcome.Regarding the comparison of surgical intervention versus conservative treatment, this review has shown that surgical intervention in an early stage of chronic pancreatitis is a promising approach in terms of pain relief and pancreatic function. Other trials need to confirm these results because of the methodological limitations and limited number of participants assessed in the present evidence.

  15. A critical appraisal of the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing interventions: a systematic review of reviews

    PubMed Central

    Jin, Ying-Hui; Wang, Guo-Hao; Sun, Yi-Rong; Li, Qi; Zhao, Chen; Li, Ge; Si, Jin-Hua; Li, Yan; Lu, Cui; Shang, Hong-Cai

    2016-01-01

    Objective To assess the methodology and quality of evidence of systematic reviews and meta-analyses of traditional Chinese medical nursing (TCMN) interventions in Chinese journals. These interventions include acupressure, massage, Tai Chi, Qi Gong, electroacupuncture and use of Chinese herbal medicines—for example, in enemas, foot massage and compressing the umbilicus. Design A systematic literature search for systematic reviews and meta-analyses of TCMN interventions was performed. Review characteristics were extracted. The methodological quality and the quality of the evidence were evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Result We included 20 systematic reviews and meta-analyses, and a total of 11 TCMN interventions were assessed in the 20 reviews. The compliance with AMSTAR checklist items ranged from 4.5 to 8 and systematic reviews/meta-analyses were, on average, of medium methodological quality. The quality of the evidence we assessed ranged from very low to moderate; no high-quality evidence was found. The top two causes for downrating confidence in effect estimates among the 31 bodies of evidence assessed were the risk of bias and inconsistency. Conclusions There is room for improvement in the methodological quality of systematic reviews/meta-analyses of TCMN interventions published in Chinese journals. Greater efforts should be devoted to ensuring a more comprehensive search strategy, clearer specification of the interventions of interest in the eligibility criteria and identification of meaningful outcomes for clinicians and patients (consumers). The overall quality of evidence among reviews remains suboptimal, which raise concerns about their roles in influencing clinical practice. Thus, the conclusions in reviews we assessed must be treated with caution and their roles in influencing clinical practice should be limited. A critical appraisal of systematic reviews/meta-analyses of TCMN interventions is particularly important to provide sound guidance for TCMN. PMID:28186925

  16. Lessons Learned From Methodological Validation Research in E-Epidemiology.

    PubMed

    Kesse-Guyot, Emmanuelle; Assmann, Karen; Andreeva, Valentina; Castetbon, Katia; Méjean, Caroline; Touvier, Mathilde; Salanave, Benoît; Deschamps, Valérie; Péneau, Sandrine; Fezeu, Léopold; Julia, Chantal; Allès, Benjamin; Galan, Pilar; Hercberg, Serge

    2016-10-18

    Traditional epidemiological research methods exhibit limitations leading to high logistics, human, and financial burden. The continued development of innovative digital tools has the potential to overcome many of the existing methodological issues. Nonetheless, Web-based studies remain relatively uncommon, partly due to persistent concerns about validity and generalizability. The objective of this viewpoint is to summarize findings from methodological studies carried out in the NutriNet-Santé study, a French Web-based cohort study. On the basis of the previous findings from the NutriNet-Santé e-cohort (>150,000 participants are currently included), we synthesized e-epidemiological knowledge on sample representativeness, advantageous recruitment strategies, and data quality. Overall, the reported findings support the usefulness of Web-based studies in overcoming common methodological deficiencies in epidemiological research, in particular with regard to data quality (eg, the concordance for body mass index [BMI] classification was 93%), reduced social desirability bias, and access to a wide range of participant profiles, including the hard-to-reach subgroups such as young (12.30% [15,118/122,912], <25 years) and old people (6.60% [8112/122,912], ≥65 years), unemployed or homemaker (12.60% [15,487/122,912]), and low educated (38.50% [47,312/122,912]) people. However, some selection bias remained (78.00% (95,871/122,912) of the participants were women, and 61.50% (75,590/122,912) had postsecondary education), which is an inherent aspect of cohort study inclusion; other specific types of bias may also have occurred. Given the rapidly growing access to the Internet across social strata, the recruitment of participants with diverse socioeconomic profiles and health risk exposures was highly feasible. Continued efforts concerning the identification of specific biases in e-cohorts and the collection of comprehensive and valid data are still needed. This summary of methodological findings from the NutriNet-Santé cohort may help researchers in the development of the next generation of high-quality Web-based epidemiological studies.

  17. The midterm effectiveness of extracorporeal shockwave therapy in the management of chronic calcific shoulder tendinitis.

    PubMed

    Lee, Soak-Yee; Cheng, Bijun; Grimmer-Somers, Karen

    2011-07-01

    This systematic review explored the midterm effectiveness of extracorporeal shockwave therapy (ESWT) in reducing pain and improving shoulder function. Calcified rotator cuff tendinitis is a common cause of chronic shoulder pain that leads to significant pain and functional limitations. ESWT is an alternative to surgery when conservative treatments such as nonsteroidal antiinflammatory drugs, steroidal injections, and physiotherapy fail to relieve symptoms. It is hypothesised that ESWT is effective in the midterm for reducing pain and improving function for patients with chronic calcific tendinitis and that a dose-response relationship exists in the treatment parameters for effectiveness. Articles were electronically searched from the Cochrane Controlled Trials Register, MEDLINE, CINAHL, PUBMED, EMBASE, SPORTSDiscus and PEDro using a comprehensive search strategy. Studies were included if they were randomized controlled trials testing the midterm effectiveness of ESWT for chronic calcific tendonitis. Methodologic quality was assessed by PEDro (total score = 10). The strength of the evidence was reported using the National Health and Medical Research Council body of evidence framework. Six of the nine included studies scored 7 or more for methodologic quality. All studies had follow-up periods of at least 6 months. Common methodologic flaws were insufficient blinding of clinicians and assessors. There was consistent evidence of midterm effectiveness of ESWT in reducing pain and improving shoulder function for patients with chronic calcified tendinitis. ESWT is a potential alternative to surgery with good mid-term effectiveness and minimal side effects. This review noted several limitations with the current body of evidence. Studies were mainly from a few European countries involving medical doctors, with a lack of diverse perspectives and effectiveness evaluation from other health professionals who might use this treatment option for patients with chronic calcific tendinitis. Further, the different outcome measures used and inadequate reporting details in the included studies did not permit a quantitative synthesis of the effectiveness of this treatment. A lack of follow up period beyond one year in the studies also precluded conclusion to be made on the longer term effectiveness of ESWT. Due to variable treatment parameters (eg dosage), this review was unable to provide clear guidance of the dose-effect of the midterm effectiveness of ESWT. Studies of better methodologic design using standardized treatment protocols and studies with longer follow-up are required. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  18. The instrumental genesis process in future primary teachers using Dynamic Geometry Software

    NASA Astrophysics Data System (ADS)

    Ruiz-López, Natalia

    2018-05-01

    This paper, which describes a study undertaken with pairs of future primary teachers using GeoGebra software to solve geometry problems, includes a brief literature review, the theoretical framework and methodology used. An analysis of the instrumental genesis process for a pair participating in the case study is also provided. This analysis addresses the techniques and types of dragging used, the obstacles to learning encountered, a description of the interaction between the pair and their interaction with the teacher, and the type of language used. Based on this analysis, possibilities and limitations of the instrumental genesis process are identified for the development of geometric competencies such as conjecture creation, property checking and problem researching. It is also suggested that the methodology used in the analysis of the problem solving process may be useful for those teachers and researchers who want to integrate Dynamic Geometry Software (DGS) in their classrooms.

  19. Performance testing of 3D point cloud software

    NASA Astrophysics Data System (ADS)

    Varela-González, M.; González-Jorge, H.; Riveiro, B.; Arias, P.

    2013-10-01

    LiDAR systems are being used widely in recent years for many applications in the engineering field: civil engineering, cultural heritage, mining, industry and environmental engineering. One of the most important limitations of this technology is the large computational requirements involved in data processing, especially for large mobile LiDAR datasets. Several software solutions for data managing are available in the market, including open source suites, however, users often unknown methodologies to verify their performance properly. In this work a methodology for LiDAR software performance testing is presented and four different suites are studied: QT Modeler, VR Mesh, AutoCAD 3D Civil and the Point Cloud Library running in software developed at the University of Vigo (SITEGI). The software based on the Point Cloud Library shows better results in the loading time of the point clouds and CPU usage. However, it is not as strong as commercial suites in working set and commit size tests.

  20. Association of Internet addiction and alexithymia - A scoping review.

    PubMed

    Mahapatra, Ananya; Sharma, Pawan

    2018-06-01

    It has been hypothesized that individuals with alexithymia who have difficulty in identifying, expressing, and communicating emotions may overuse Internet as a tool of social interaction to better regulate their emotions and to fulfill their unmet social needs. Similarly, an increasing body of evidence suggests that alexithymia may also play an essential role in the etiopathogenesis of addictive disorders. We conducted a scoping review of questionnaire-based studies of problematic Internet use/Internet addiction and alexithymia. From initial 51 studies, all of the final 12 included studies demonstrated a significant positive association between scores of alexithymia and severity of Internet addiction. However, the causal direction of the association is not clear because the interplay of numerous other variables that could affect the relation has not been studied. There are limitations in the methodology of the studies conducted. Hence, we emphasise the need for longitudinal studies with stronger methodologies. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Methodology of Clinical Trials Aimed at Assessing Interventions for Cutaneous Leishmaniasis

    PubMed Central

    Olliaro, Piero; Vaillant, Michel; Arana, Byron; Grogl, Max; Modabber, Farrokh; Magill, Alan; Lapujade, Olivier; Buffet, Pierre; Alvar, Jorge

    2013-01-01

    The current evidence-base for recommendations on the treatment of cutaneous leishmaniasis (CL) is generally weak. Systematic reviews have pointed to a general lack of standardization of methods for the conduct and analysis of clinical trials of CL, compounded with poor overall quality of several trials. For CL, there is a specific need for methodologies which can be applied generally, while allowing the flexibility needed to cover the diverse forms of the disease. This paper intends to provide clinical investigators with guidance for the design, conduct, analysis and report of clinical trials of treatments for CL, including the definition of measurable, reproducible and clinically-meaningful outcomes. Having unified criteria will help strengthen evidence, optimize investments, and enhance the capacity for high-quality trials. The limited resources available for CL have to be concentrated in clinical studies of excellence that meet international quality standards. PMID:23556016

  2. Identification of Novel "Inks" for 3D Printing Using High-Throughput Screening: Bioresorbable Photocurable Polymers for Controlled Drug Delivery.

    PubMed

    Louzao, Iria; Koch, Britta; Taresco, Vincenzo; Ruiz-Cantu, Laura; Irvine, Derek J; Roberts, Clive J; Tuck, Christopher; Alexander, Cameron; Hague, Richard; Wildman, Ricky; Alexander, Morgan R

    2018-02-28

    A robust methodology is presented to identify novel biomaterials suitable for three-dimensional (3D) printing. Currently, the application of additive manufacturing is limited by the availability of functional inks, especially in the area of biomaterials; this is the first time when this method is used to tackle this problem, allowing hundreds of formulations to be readily assessed. Several functional properties, including the release of an antidepressive drug (paroxetine), cytotoxicity, and printability, are screened for 253 new ink formulations in a high-throughput format as well as mechanical properties. The selected candidates with the desirable properties are successfully scaled up using 3D printing into a range of object architectures. A full drug release study and degradability and tensile modulus experiments are presented on a simple architecture to validating the suitability of this methodology to identify printable inks for 3D printing devices with bespoke properties.

  3. Drugs of Abuse and Addiction: An integrated approach to teaching.

    PubMed

    Miller, Lindsey N; Mercer, Susan L

    2017-05-01

    To describe the design, implementation, and student perceptions of a Drugs of Abuse and Addiction elective course utilizing an integrated teaching model. Third-year pharmacy students enrolled in the two credit hour elective. Teaching methodology included didactic lecture, journal club, simulated addiction assignment with reflection, debates, external speakers, site visit to a residential drug court program and research paper with presentation. A course objective survey was administered upon course completion. All students strongly agreed that having science- and clinical-based faculty members develop and deliver course content was beneficial. Additionally, all students agree to strongly agree that their research project helped them integrate and comprehend the science and practice surrounding drugs of abuse and addiction. Students enjoyed an integrated teaching approach and multiple teaching methodologies leading to increased engagement and enhancement of student learning. Course enrollment was beneficial for personalized learning, but limited student perspective. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. 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

  5. Traumatogenic Processes and Pathways to Mental Health Outcomes for Sexual Minorities Exposed to Bias Crime Information.

    PubMed

    Lannert, Brittany K

    2015-07-01

    Vicarious traumatization of nonvictim members of communities targeted by bias crimes has been suggested by previous qualitative studies and often dominates public discussion following bias events, but proximal and distal responses of community members have yet to be comprehensively modeled, and quantitative research on vicarious responses is scarce. This comprehensive review integrates theoretical and empirical literatures in social, clinical, and physiological psychology in the development of a model of affective, cognitive, and physiological responses of lesbian, gay, and bisexual individuals upon exposure to information about bias crimes. Extant qualitative research in vicarious response to bias crimes is reviewed in light of theoretical implications and methodological limitations. Potential pathways to mental health outcomes are outlined, including accumulative effects of anticipatory defensive responding, multiplicative effects of minority stress, and putative traumatogenic physiological and cognitive processes of threat. Methodological considerations, future research directions, and clinical implications are also discussed. © The Author(s) 2014.

  6. Exercise as Treatment for Anxiety: Systematic Review and Analysis.

    PubMed

    Stonerock, Gregory L; Hoffman, Benson M; Smith, Patrick J; Blumenthal, James A

    2015-08-01

    Exercise has been shown to reduce symptoms of anxiety, but few studies have studied exercise in individuals preselected because of their high anxiety. The objective of this study is to review and critically evaluate studies of exercise training in adults with either high levels of anxiety or an anxiety disorder. We conducted a systematic review of randomized clinical trials (RCTs) in which anxious adults were randomized to an exercise or nonexercise control condition. Data were extracted concerning anxiety outcomes and study design. Existing meta-analyses were also reviewed. 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. Exercise may be a useful treatment for anxiety, but lack of data from rigorous, methodologically sound RCTs precludes any definitive conclusions about its effectiveness.

  7. The prevalence of psychopathology in siblings of children with mental health problems: a 20-year systematic review.

    PubMed

    Ma, Nylanda; Roberts, Rachel; Winefield, Helen; Furber, Gareth

    2015-02-01

    While the importance of looking at the entire family system in the context of child and adolescent mental health is well recognised, siblings of children with mental health problems (MHPs) are often overlooked. The existing literature on the mental health of these siblings needs to be reviewed. A systematic search located publications from 1990 to 2011 in four electronic databases. Thirty-nine relevant studies reported data on the prevalence of psychopathology in siblings of target children with MHPs. Siblings of target children had higher rates of at least one type of psychopathology than comparison children. Risk of psychopathology varied across the type of MHP in the target child. Other covariates included sibling age and gender and parental psychopathology. Significant variations and limitations in methodology were found in the existing literature. Methodological guidelines for future studies are outlined. Implications for clinicians, parents, and for future research are discussed.

  8. Automated motion artifact removal for intravital microscopy, without a priori information.

    PubMed

    Lee, Sungon; Vinegoni, Claudio; Sebas, Matthew; Weissleder, Ralph

    2014-03-28

    Intravital fluorescence microscopy, through extended penetration depth and imaging resolution, provides the ability to image at cellular and subcellular resolution in live animals, presenting an opportunity for new insights into in vivo biology. Unfortunately, physiological induced motion components due to respiration and cardiac activity are major sources of image artifacts and impose severe limitations on the effective imaging resolution that can be ultimately achieved in vivo. Here we present a novel imaging methodology capable of automatically removing motion artifacts during intravital microscopy imaging of organs and orthotopic tumors. The method is universally applicable to different laser scanning modalities including confocal and multiphoton microscopy, and offers artifact free reconstructions independent of the physiological motion source and imaged organ. The methodology, which is based on raw data acquisition followed by image processing, is here demonstrated for both cardiac and respiratory motion compensation in mice heart, kidney, liver, pancreas and dorsal window chamber.

  9. Automated motion artifact removal for intravital microscopy, without a priori information

    PubMed Central

    Lee, Sungon; Vinegoni, Claudio; Sebas, Matthew; Weissleder, Ralph

    2014-01-01

    Intravital fluorescence microscopy, through extended penetration depth and imaging resolution, provides the ability to image at cellular and subcellular resolution in live animals, presenting an opportunity for new insights into in vivo biology. Unfortunately, physiological induced motion components due to respiration and cardiac activity are major sources of image artifacts and impose severe limitations on the effective imaging resolution that can be ultimately achieved in vivo. Here we present a novel imaging methodology capable of automatically removing motion artifacts during intravital microscopy imaging of organs and orthotopic tumors. The method is universally applicable to different laser scanning modalities including confocal and multiphoton microscopy, and offers artifact free reconstructions independent of the physiological motion source and imaged organ. The methodology, which is based on raw data acquisition followed by image processing, is here demonstrated for both cardiac and respiratory motion compensation in mice heart, kidney, liver, pancreas and dorsal window chamber. PMID:24676021

  10. E-Cigarettes and Smoking Cessation: A Primer for Oncology Clinicians.

    PubMed

    Zborovskaya, Yanina

    2017-02-01

    Electronic cigarettes 
(e-cigarettes) are a psychosocial phenomenon of the 21st century with serious implications to public and individual health. The significant increase of their popularity and use has raised concerns in the healthcare community regarding their potential benefits and harm, particularly their use as a smoking cessation methodology. Current knowledge is presented about e-cigarettes, including the clinical implications of their use, and associated controversies are analyzed. In addition, practice recommendations and communication guidance are provided. An integrative review was performed. The long-term effect of e-cigarettes on individual and public health is unknown. Evidence from short-term studies, although limited, shows that e-cigarette use is less harmful than smoking. However, the evidence does not support the use of e-cigarettes as a smoking cessation methodology. Such recommendation remains a judgment call for the clinician based on each individual case.

  11. Methodologic and ethical ramifications of sex and gender differences in public health research.

    PubMed

    Lawrence, Kitty; Rieder, Anita

    2007-01-01

    Experience and investigative studies have shown that inequalities still exist between the sexes as well as in how public health policies and strategies approach the needs of the sexes. Sufficient attention has not been given to gender in public health research. Gender-based differences and similarities need to be promoted, and more structured guidelines are needed to build gender into public health research models. The aim of this review was to investigate and discuss public health research and to answer several related questions on gender biases, ethics and methodologies, and the establishment of guidelines. Using the search terms public health research and gender , or ethics , gender , and public health, a literature search was conducted predominately with, but not limited to, the PubMed database. English- or German-language articles were identified that examined the current status of gender in public health research as well as any relevant ethical guidelines. A review of the current literature showed that much work has been undertaken to promote the inclusion of gender in health research. However, deficiencies in the extent of gender-oriented research have been found in a number of key areas, including ethics committees and public health research methodology. Women were found to be underrepresented in ethics committees, which lack clear guidance, particularly in the European Union, to ensure the inclusion of gender issues in public health research. Data are often not sex disaggregated, and information on gender and social circumstances are frequently lacking. Furthermore, some methodologies, such as those used in the field of occupational health, underestimate men's or women's burden of disease. Recommendations include establishing guidelines for researchers on how to incorporate gender in health research, ensuring that the composition of ethics committees is more representative of society, and recommending that data collection systems or bodies ensure that data are disaggregated by sex and include socioeconomic aspects.

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

    Dobromir Panayotov; Andrew Grief; Brad J. Merrill

    'Fusion for Energy' (F4E) develops designs and implements the European Test Blanket Systems (TBS) in ITER - Helium-Cooled Lithium-Lead (HCLL) and Helium-Cooled Pebble-Bed (HCPB). Safety demonstration is an essential element for the integration of TBS in ITER and accident analyses are one of its critical segments. A systematic approach to the accident analyses had been acquired under the F4E contract on TBS safety analyses. F4E technical requirements and AMEC and INL efforts resulted in the development of a comprehensive methodology for fusion breeding blanket accident analyses. It addresses the specificity of the breeding blankets design, materials and phenomena and atmore » the same time is consistent with the one already applied to ITER accident analyses. Methodology consists of several phases. At first the reference scenarios are selected on the base of FMEA studies. In the second place elaboration of the accident analyses specifications we use phenomena identification and ranking tables to identify the requirements to be met by the code(s) and TBS models. Thus the limitations of the codes are identified and possible solutions to be built into the models are proposed. These include among others the loose coupling of different codes or code versions in order to simulate multi-fluid flows and phenomena. The code selection and issue of the accident analyses specifications conclude this second step. Furthermore the breeding blanket and ancillary systems models are built on. In this work challenges met and solutions used in the development of both MELCOR and RELAP5 codes models of HCLL and HCPB TBSs will be shared. To continue the developed models are qualified by comparison with finite elements analyses, by code to code comparison and sensitivity studies. Finally, the qualified models are used for the execution of the accident analyses of specific scenario. When possible the methodology phases will be illustrated in the paper by limited number of tables and figures. Description of each phase and its results in detail as well the methodology applications to EU HCLL and HCPB TBSs will be published in separate papers. The developed methodology is applicable to accident analyses of other TBSs to be tested in ITER and as well to DEMO breeding blankets.« less

  13. Are validated outcome measures used in distal radial fractures truly valid?

    PubMed Central

    Nienhuis, R. W.; Bhandari, M.; Goslings, J. C.; Poolman, R. W.; Scholtes, V. A. B.

    2016-01-01

    Objectives Patient-reported outcome measures (PROMs) are often used to evaluate the outcome of treatment in patients with distal radial fractures. Which PROM to select is often based on assessment of measurement properties, such as validity and reliability. Measurement properties are assessed in clinimetric studies, and results are often reviewed without considering the methodological quality of these studies. Our aim was to systematically review the methodological quality of clinimetric studies that evaluated measurement properties of PROMs used in patients with distal radial fractures, and to make recommendations for the selection of PROMs based on the level of evidence of each individual measurement property. Methods A systematic literature search was performed in PubMed, EMbase, CINAHL and PsycINFO databases to identify relevant clinimetric studies. Two reviewers independently assessed the methodological quality of the studies on measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Level of evidence (strong / moderate / limited / lacking) for each measurement property per PROM was determined by combining the methodological quality and the results of the different clinimetric studies. Results In all, 19 out of 1508 identified unique studies were included, in which 12 PROMs were rated. The Patient-rated wrist evaluation (PRWE) and the Disabilities of Arm, Shoulder and Hand questionnaire (DASH) were evaluated on most measurement properties. The evidence for the PRWE is moderate that its reliability, validity (content and hypothesis testing), and responsiveness are good. The evidence is limited that its internal consistency and cross-cultural validity are good, and its measurement error is acceptable. There is no evidence for its structural and criterion validity. The evidence for the DASH is moderate that its responsiveness is good. The evidence is limited that its reliability and the validity on hypothesis testing are good. There is no evidence for the other measurement properties. Conclusion According to this systematic review, there is, at best, moderate evidence that the responsiveness of the PRWE and DASH are good, as are the reliability and validity of the PRWE. We recommend these PROMs in clinical studies in patients with distal radial fractures; however, more clinimetric studies of higher methodological quality are needed to adequately determine the other measurement properties. Cite this article: Dr Y. V. Kleinlugtenbelt. Are validated outcome measures used in distal radial fractures truly valid?: A critical assessment using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Bone Joint Res 2016;5:153–161. DOI: 10.1302/2046-3758.54.2000462. PMID:27132246

  14. Systematic review of the cost effectiveness of prophylactic treatments in the prevention of gastropathy in patients with rheumatoid arthritis or osteoarthritis taking non-steroidal anti-inflammatory drugs

    PubMed Central

    van Dieten, H. E M; Bos, I.; van Tulder, M. W; Lems, W.; Dijkmans, B.; Boers, M.

    2000-01-01

    A systematic review on the cost effectiveness of prophylactic treatments of non-steroidal anti-inflammatory drug (NSAID) induced gastropathy in patients with osteoarthritis or rheumatoid arthritis was conducted. Two reviewers conducted the literature search and the review. Both full and partial economic evaluations published in English, Dutch, or German were included. The criteria list published in the textbook of Drummond was used to determine the quality of the economic evaluations. The methodological quality of three randomised controlled trials (RCTs) in which the economic evaluations obtained probability estimates of NSAID induced gastropathy and adverse events was assessed by a list of internal validity criteria. The conclusions were based on a rating system consisting of four levels of evidence.
  Ten economic evaluations were included; three were based on RCTs. All evaluations studied misoprostol as prophylactic treatment: in one evaluation misoprostol was studied as a fixed component in a combination with diclofenac (Arthrotec). All economic evaluations comprised analytical studies containing a decision tree. The three trials were of high methodological quality. Nine economic evaluations were considered high quality and one economic evaluation was considered of low methodological quality. There is strong evidence (level "A") that the use of misoprostol for the prevention of NSAID induced gastropathy is cost effective, and limited evidence (level "C") that the use of Arthrotec is cost effective. Although the levels of evidence used in this review are arbitrary, it is believed that a qualitative analysis is useful: quantitative analyses in this field are hampered by the heterogeneity of economic evaluations. Existing criteria to evaluate the methodological quality of economic evaluations may need refinement for use in systematic reviews.

 PMID:11005773

  15. What are scoping studies? A review of the nursing literature.

    PubMed

    Davis, Kathy; Drey, Nick; Gould, Dinah

    2009-10-01

    Scoping studies are increasingly undertaken as distinct activities. The interpretation, methodology and expectations of scoping are highly variable. This suggests that conceptually, scoping is a poorly defined ambiguous term. The distinction between scoping as an integral preliminary process in the development of a research proposal or a formative, methodologically rigorous activity in its own right has not been extensively examined. The aim of this review is to explore the nature and status of scoping studies within the nursing literature and develop a working definition to ensure consistency in the future use of scoping as a research related activity. This paper follows an interpretative scoping review methodology. An explicit systematic search strategy included literary and web-based key word searches and advice from key researchers. Electronic sources included bibliographic and national research register databases and a general browser. The scoping studies varied widely in terms of intent, procedural and methodological rigor. An atheoretical stance was common although explicit conceptual clarification and development of a topic was limited. Four different levels of inquiry ranging from preliminary descriptive surveys to more substantive conceptual approaches were conceptualised. These levels reflected differing dimensional distinctions in which some activities constitute research whereas in others the scoping activities appear to fall outside the remit of research. Reconnaissance emerges as a common synthesising construct to explain the purpose of scoping. Scoping studies in relation to nursing are embryonic and continue to evolve. Its main strengths lie in its ability to extract the essence of a diverse body of evidence giving it meaning and significance that is both developmental and intellectually creative. As with other approaches to research and evidence synthesis a more standardized approach is required.

  16. Vulnerability or Sensitivity to the Environment? Methodological Issues, Trends, and Recommendations in Gene-Environment Interactions Research in Human Behavior.

    PubMed

    Leighton, Caroline; Botto, Alberto; Silva, Jaime R; Jiménez, Juan Pablo; Luyten, Patrick

    2017-01-01

    Research on the potential role of gene-environment interactions (GxE) in explaining vulnerability to psychopathology in humans has witnessed a shift from a diathesis-stress perspective to differential susceptibility approaches. This paper critically reviews methodological issues and trends in this body of research. Databases were screened for studies of GxE in the prediction of personality traits, behavior, and mental health disorders in humans published between January 2002 and January 2015. In total, 315 papers were included. Results showed that 34 candidate genes have been included in GxE studies. Independent of the type of environment studied (early or recent life events, positive or negative environments), about 67-83% of studies have reported significant GxE interactions, which is consistent with a social susceptibility model. The percentage of positive results does not seem to differ depending on the gene studied, although publication bias might be involved. However, the number of positive findings differs depending on the population studied (i.e., young adults vs. older adults). Methodological considerations limit the ability to draw strong conclusions, particularly as almost 90% ( n  = 283/315) of published papers are based on samples from North America and Europe, and about 70% of published studies (219/315) are based on samples that were also used in other reports. At the same time, there are clear indications of methodological improvements over time, as is shown by a significant increase in longitudinal and experimental studies as well as in improved minimum genotyping. Recommendations for future research, such as minimum quality assessment of genes and environmental factors, specifying theoretical models guiding the study, and taking into account of cultural, ethnic, and lifetime perspectives, are formulated.

  17. Systematic review of the cost effectiveness of prophylactic treatments in the prevention of gastropathy in patients with rheumatoid arthritis or osteoarthritis taking non-steroidal anti-inflammatory drugs.

    PubMed

    van Dieten, H E; Korthals-de Bos, I B; van Tulder, M W; Lems, W F; Dijkmans, B A; Boers, M

    2000-10-01

    A systematic review on the cost effectiveness of prophylactic treatments of non-steroidal anti-inflammatory drug (NSAID) induced gastropathy in patients with osteoarthritis or rheumatoid arthritis was conducted. Two reviewers conducted the literature search and the review. Both full and partial economic evaluations published in English, Dutch, or German were included. The criteria list published in the textbook of Drummond was used to determine the quality of the economic evaluations. The methodological quality of three randomised controlled trials (RCTs) in which the economic evaluations obtained probability estimates of NSAID induced gastropathy and adverse events was assessed by a list of internal validity criteria. The conclusions were based on a rating system consisting of four levels of evidence. Ten economic evaluations were included; three were based on RCTs. All evaluations studied misoprostol as prophylactic treatment: in one evaluation misoprostol was studied as a fixed component in a combination with diclofenac (Arthrotec). All economic evaluations comprised analytical studies containing a decision tree. The three trials were of high methodological quality. Nine economic evaluations were considered high quality and one economic evaluation was considered of low methodological quality. There is strong evidence (level "A") that the use of misoprostol for the prevention of NSAID induced gastropathy is cost effective, and limited evidence (level "C") that the use of Arthrotec is cost effective. Although the levels of evidence used in this review are arbitrary, it is believed that a qualitative analysis is useful: quantitative analyses in this field are hampered by the heterogeneity of economic evaluations. Existing criteria to evaluate the methodological quality of economic evaluations may need refinement for use in systematic reviews.

  18. Measurement properties of translated versions of neck-specific questionnaires: a systematic review

    PubMed Central

    2011-01-01

    Background Several disease-specific questionnaires to measure pain and disability in patients with neck pain have been translated. However, a simple translation of the original version doesn't guarantee similar measurement properties. The objective of this study is to critically appraise the quality of the translation process, cross-cultural validation and the measurement properties of translated versions of neck-specific questionnaires. Methods Bibliographic databases were searched for articles concerning the translation or evaluation of the measurement properties of a translated version of a neck-specific questionnaire. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist and criteria for measurement properties. Results The search strategy resulted in a total of 3641 unique hits, of which 27 articles, evaluating 6 different questionnaires in 15 different languages, were included in this study. Generally the methodological quality of the translation process is poor and none of the included studies performed a cross-cultural adaptation. A substantial amount of information regarding the measurement properties of translated versions of the different neck-specific questionnaires is lacking. Moreover, the evidence for the quality of measurement properties of the translated versions is mostly limited or assessed in studies of poor methodological quality. Conclusions Until results from high quality studies are available, we advise to use the Catalan, Dutch, English, Iranian, Korean, Spanish and Turkish version of the NDI, the Chinese version of the NPQ, and the Finnish, German and Italian version of the NPDS. The Greek NDI needs cross-cultural validation and there is no methodologically sound information for the Swedish NDI. For all other languages we advise to translate the original version of the NDI. PMID:21645355

  19. Measurement properties of translated versions of neck-specific questionnaires: a systematic review.

    PubMed

    Schellingerhout, Jasper M; Heymans, Martijn W; Verhagen, Arianne P; de Vet, Henrica C; Koes, Bart W; Terwee, Caroline B

    2011-06-06

    Several disease-specific questionnaires to measure pain and disability in patients with neck pain have been translated. However, a simple translation of the original version doesn't guarantee similar measurement properties. The objective of this study is to critically appraise the quality of the translation process, cross-cultural validation and the measurement properties of translated versions of neck-specific questionnaires. Bibliographic databases were searched for articles concerning the translation or evaluation of the measurement properties of a translated version of a neck-specific questionnaire. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist and criteria for measurement properties. The search strategy resulted in a total of 3641 unique hits, of which 27 articles, evaluating 6 different questionnaires in 15 different languages, were included in this study. Generally the methodological quality of the translation process is poor and none of the included studies performed a cross-cultural adaptation. A substantial amount of information regarding the measurement properties of translated versions of the different neck-specific questionnaires is lacking. Moreover, the evidence for the quality of measurement properties of the translated versions is mostly limited or assessed in studies of poor methodological quality. Until results from high quality studies are available, we advise to use the Catalan, Dutch, English, Iranian, Korean, Spanish and Turkish version of the NDI, the Chinese version of the NPQ, and the Finnish, German and Italian version of the NPDS. The Greek NDI needs cross-cultural validation and there is no methodologically sound information for the Swedish NDI. For all other languages we advise to translate the original version of the NDI.

  20. Test-treatment RCTs are susceptible to bias: a review of the methodological quality of randomized trials that evaluate diagnostic tests.

    PubMed

    Ferrante di Ruffano, Lavinia; Dinnes, Jacqueline; Sitch, Alice J; Hyde, Chris; Deeks, Jonathan J

    2017-02-24

    There is a growing recognition for the need to expand our evidence base for the clinical effectiveness of diagnostic tests. Many international bodies are calling for diagnostic randomized controlled trials to provide the most rigorous evidence of impact to patient health. Although these so-called test-treatment RCTs are very challenging to undertake due to their methodological complexity, they have not been subjected to a systematic appraisal of their methodological quality. The extent to which these trials may be producing biased results therefore remains unknown. We set out to address this issue by conducting a methodological review of published test-treatment trials to determine how often they implement adequate methods to limit bias and safeguard the validity of results. We ascertained all test-treatment RCTs published 2004-2007, indexed in CENTRAL, including RCTs which randomized patients to diagnostic tests and measured patient outcomes after treatment. Tests used for screening, monitoring or prognosis were excluded. We assessed adequacy of sequence generation, allocation concealment and intention-to-treat, appropriateness of primary analyses, blinding and reporting of power calculations, and extracted study characteristics including the primary outcome. One hundred three trials compared 105 control with 119 experimental interventions, and reported 150 primary outcomes. Randomization and allocation concealment were adequate in 57 and 37% of trials. Blinding was uncommon (patients 5%, clinicians 4%, outcome assessors 21%), as was an adequate intention-to-treat analysis (29%). Overall 101 of 103 trials (98%) were at risk of bias, as judged using standard Cochrane criteria. Test-treatment trials are particularly susceptible to attrition and inadequate primary analyses, lack of blinding and under-powering. These weaknesses pose much greater methodological and practical challenges to conducting reliable RCT evaluations of test-treatment strategies than standard treatment interventions. We suggest a cautious approach that first examines whether a test-treatment intervention can accommodate the methodological safeguards necessary to minimize bias, and highlight that test-treatment RCTs require different methods to ensure reliability than standard treatment trials. Please see the companion paper to this article: http://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-016-0286-0 .

  1. Funding source and the quality of reports of chronic wounds trials: 2004 to 2011

    PubMed Central

    2014-01-01

    Background Critical commentaries suggest that wound care randomised controlled trials (RCTs) are often poorly reported with many methodological flaws. Furthermore, interventions in chronic wounds, rather than being drugs, are often medical devices for which there are no requirements for RCTs to bring products to market. RCTs in wounds trials therefore potentially represent a form of marketing. This study presents a methodological overview of chronic wound trials published between 2004 and 2011 and investigates the influence of industry funding on methodological quality. Methods A systematic search for RCTs for the treatment of chronic wounds published in the English language between 2004 and 2011 (inclusive) in the Cochrane Wounds Group Specialised Register of Trials was carried out. Data were extracted on aspects of trial design, conduct and quality including sample size, duration of follow-up, specification of a primary outcome, use of surrogate outcomes, and risks of bias. In addition, the prevalence of industry funding was assessed and its influence on the above aspects of trial design, conduct and quality was assessed. Results A total of 167 RCTs met our inclusion criteria. We found chronic wound trials often have short durations of follow-up (median 12 weeks), small sample sizes (median 63), fail to define a primary outcome in 41% of cases, and those that do define a primary outcome, use surrogate measures of healing in 40% of cases. Only 40% of trials used appropriate methods of randomisation, 25% concealed allocation and 34% blinded outcome assessors. Of the included trials, 41% were wholly or partially funded by industry, 33% declared non-commercial funding and 26% did not report a funding source. Industry funding was not statistically significantly associated with any measure of methodological quality, though this analysis was probably underpowered. Conclusions This overview confirms concerns raised about the methodological quality of RCTs in wound care and illustrates that greater efforts must be made to follow international standards for conducting and reporting RCTs. There is currently minimal evidence of an influence of industry funding on methodological quality although analyses had limited power and funding source was not reported for a quarter of studies. PMID:24422753

  2. Funding source and the quality of reports of chronic wounds trials: 2004 to 2011.

    PubMed

    Hodgson, Robert; Allen, Richard; Broderick, Ellen; Bland, J Martin; Dumville, Jo C; Ashby, Rebecca; Bell-Syer, Sally; Foxlee, Ruth; Hall, Jill; Lamb, Karen; Madden, Mary; O'Meara, Susan; Stubbs, Nikki; Cullum, Nicky

    2014-01-14

    Critical commentaries suggest that wound care randomised controlled trials (RCTs) are often poorly reported with many methodological flaws. Furthermore, interventions in chronic wounds, rather than being drugs, are often medical devices for which there are no requirements for RCTs to bring products to market. RCTs in wounds trials therefore potentially represent a form of marketing. This study presents a methodological overview of chronic wound trials published between 2004 and 2011 and investigates the influence of industry funding on methodological quality. A systematic search for RCTs for the treatment of chronic wounds published in the English language between 2004 and 2011 (inclusive) in the Cochrane Wounds Group Specialised Register of Trials was carried out.Data were extracted on aspects of trial design, conduct and quality including sample size, duration of follow-up, specification of a primary outcome, use of surrogate outcomes, and risks of bias. In addition, the prevalence of industry funding was assessed and its influence on the above aspects of trial design, conduct and quality was assessed. A total of 167 RCTs met our inclusion criteria. We found chronic wound trials often have short durations of follow-up (median 12 weeks), small sample sizes (median 63), fail to define a primary outcome in 41% of cases, and those that do define a primary outcome, use surrogate measures of healing in 40% of cases. Only 40% of trials used appropriate methods of randomisation, 25% concealed allocation and 34% blinded outcome assessors. Of the included trials, 41% were wholly or partially funded by industry, 33% declared non-commercial funding and 26% did not report a funding source. Industry funding was not statistically significantly associated with any measure of methodological quality, though this analysis was probably underpowered. This overview confirms concerns raised about the methodological quality of RCTs in wound care and illustrates that greater efforts must be made to follow international standards for conducting and reporting RCTs. There is currently minimal evidence of an influence of industry funding on methodological quality although analyses had limited power and funding source was not reported for a quarter of studies.

  3. Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis

    PubMed Central

    Nosè, Michela; Ballette, Francesca; Bighelli, Irene; Turrini, Giulia; Purgato, Marianna; Tol, Wietse; Priebe, Stefan; Barbui, Corrado

    2017-01-01

    Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future. PMID:28151992

  4. Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis.

    PubMed

    Nosè, Michela; Ballette, Francesca; Bighelli, Irene; Turrini, Giulia; Purgato, Marianna; Tol, Wietse; Priebe, Stefan; Barbui, Corrado

    2017-01-01

    Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future.

  5. Yogurt for treating acute gastroenteritis in children: Systematic review and meta-analysis.

    PubMed

    Patro-Gołąb, Bernadeta; Shamir, Raanan; Szajewska, Hania

    2015-10-01

    In May 2014, the updated guidelines for the management of acute gastroenteritis (AGE) were published. The use of yogurt in the nutritional management of AGE was not addressed, although it is frequently used in many countries for this purpose. We aimed to systematically evaluate the efficacy of yogurt consumption for the management of AGE in children. In this systematic review, a number of databases, including MEDLINE, EMBASE, and the Cochrane Library, with no language restrictions, were searched up to July 2014 for randomized controlled trials (RCTs) evaluating the effect of yogurt consumption in children with AGE. The risk of bias was assessed using the Cochrane risk of bias tool. Four RCTs (n = 448) that were generally low in methodological quality, all performed in hospital setting, were included. Compared with placebo/no intervention, yogurt consumption had no significant effect on stool volume. The data on the effect of yogurt consumption on the duration of diarrhea and stool frequency were not consistent. The chance of treatment success (or failure) was similar in both groups. Compared with placebo, the duration of hospitalization was shorter in children who received yogurt, but the difference was of a borderline significance. Total weight gain increased for those treated with yogurt. The consumption of yogurt had a positive effect on weight gain, but no consistent effect on AGE outcomes in hospitalized children. Given the limited data and the methodological limitations of the included trials, the evidence should be viewed with caution. The effect of yogurt consumption in the ambulatory setting is unknown. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  6. Traditional Chinese medicinal herbs for the treatment of idiopathic chronic fatigue and chronic fatigue syndrome.

    PubMed

    Adams, Denise; Wu, Taixiang; Yang, Xunzhe; Tai, Shusheng; Vohra, Sunita

    2009-10-07

    Chronic fatigue is increasingly common. Conventional medical care is limited in treating chronic fatigue, leading some patients to use traditional Chinese medicine therapies, including herbal medicine. To assess the effectiveness of traditional Chinese medicine herbal products in treating idiopathic chronic fatigue and chronic fatigue syndrome. The following databases were searched for terms related to traditional Chinese medicine, chronic fatigue, and clinical trials: CCDAN Controlled Trials Register (July 2009), MEDLINE (1966-2008), EMBASE (1980-2008), AMED (1985-2008), CINAHL (1982-2008), PSYCHINFO (1985-2008), CENTRAL (Issue 2 2008), the Chalmers Research Group PedCAM Database (2004), VIP Information (1989-2008), CNKI (1976-2008), OCLC Proceedings First (1992-2008), Conference Papers Index (1982-2008), and Dissertation Abstracts (1980-2008). Reference lists of included studies and review articles were examined and experts in the field were contacted for knowledge of additional studies. Selection criteria included published or unpublished randomized controlled trials (RCTs) of participants diagnosed with idiopathic chronic fatigue or chronic fatigue syndrome comparing traditional Chinese medicinal herbs with placebo, conventional standard of care (SOC), or no treatment/wait lists. The outcome of interest was fatigue. 13 databases were searched for RCTs investigating TCM herbal products for the treatment of chronic fatigue. Over 2400 references were located. Studies were screened and assessed for inclusion criteria by two authors. No studies that met all inclusion criteria were identified. Although studies examining the use of TCM herbal products for chronic fatigue were located, methodologic limitations resulted in the exclusion of all studies. Of note, many of the studies labelled as RCTs and conducted in China did not utilize rigorous randomization procedures. Improvements in methodology in future studies is required for meaningful synthesis of data.

  7. New approaches to wipe sampling methods for antineoplastic and other hazardous drugs in healthcare settings.

    PubMed

    Connor, Thomas H; Smith, Jerome P

    2016-09-01

    At the present time, the method of choice to determine surface contamination of the workplace with antineoplastic and other hazardous drugs is surface wipe sampling and subsequent sample analysis with a variety of analytical techniques. The purpose of this article is to review current methodology for determining the level of surface contamination with hazardous drugs in healthcare settings and to discuss recent advances in this area. In addition it will provide some guidance for conducting surface wipe sampling and sample analysis for these drugs in healthcare settings. Published studies on the use of wipe sampling to measure hazardous drugs on surfaces in healthcare settings drugs were reviewed. These studies include the use of well-documented chromatographic techniques for sample analysis in addition to newly evolving technology that provides rapid analysis of specific antineoplastic. Methodology for the analysis of surface wipe samples for hazardous drugs are reviewed, including the purposes, technical factors, sampling strategy, materials required, and limitations. The use of lateral flow immunoassay (LFIA) and fluorescence covalent microbead immunosorbent assay (FCMIA) for surface wipe sample evaluation is also discussed. Current recommendations are that all healthc a re settings where antineoplastic and other hazardous drugs are handled include surface wipe sampling as part of a comprehensive hazardous drug-safe handling program. Surface wipe sampling may be used as a method to characterize potential occupational dermal exposure risk and to evaluate the effectiveness of implemented controls and the overall safety program. New technology, although currently limited in scope, may make wipe sampling for hazardous drugs more routine, less costly, and provide a shorter response time than classical analytical techniques now in use.

  8. Systematic review of health and behavioural outcomes of smoking cessation interventions in prisons.

    PubMed

    de Andrade, Dominique; Kinner, Stuart A

    2016-09-01

    We conducted a systematic review to examine the impact of smoking cessation interventions, including smoking bans, on prisoners and prison staff. We systematically searched health and criminal justice databases for relevant studies. Search strings were used to combine terms related to smoking cessation interventions with terms related to incarceration. We used forward and backward snowballing to capture additional studies. Studies were included if: they were published between 1 January 1994 and 23 May 2016; the population was incarcerated adults and/or prison staff; they had a quantitative component; they were published in English; and they reported outcomes of a smoking cessation programme/ban with regard to reported change in smoking behaviour and/or behavioural outcomes. Studies were reviewed for methodological rigour using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. Data were independently reviewed for methodological quality by 1 author and a research assistant. Cessation programmes, including free nicotine replacement therapy and/or behavioural counselling can significantly increase the likelihood of quitting in prison and increase abstinence postrelease. Indoor bans have little impact on prisoner smoking behaviour. Prisoners who experience a complete smoking ban typically resume smoking shortly after release from prison. Bans may result in adverse behavioural outcomes, but these are generally minimal and short-lived. While there is limited evidence to inform tobacco control policies in custodial settings, outcomes of this review suggest that cessation programmes/bans can be an effective mechanism to interrupt prisoner smoking behaviour when properly enforced. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Endoscopic or surgical intervention for painful obstructive chronic pancreatitis.

    PubMed

    Ahmed Ali, Usama; Pahlplatz, Johanna M; Nealon, Wiliam H; van Goor, Harry; Gooszen, Hein G; Boermeester, Marja A

    2012-01-18

    Endoscopy and surgery are the treatment modalities of choice in patients with obstructive chronic pancreatitis. Physicians face the decision between endoscopy and surgery for this group of patients, without clear consensus. To assess and compare the effectiveness and complications of surgical and endoscopic interventions in the management of pain for obstructive chronic pancreatitis. We searched The Cochrane Library, MEDLINE, EMBASE and the Conference Proceedings Citation Index; and performed a cross-reference search. Two review authors performed the selection of trials independently. All randomised controlled trials (RCTs) investigating endoscopic or surgical interventions for obstructive chronic pancreatitis. All trials were included irrespective of blinding, number of patients randomised and language of the article. Two authors independently extracted data from the articles. The methodological quality of included trials was evaluated. Authors were requested additional information in the case of missing data. We screened 2082 publications and identified three eligible trials. Two trials compared endoscopic intervention to surgical intervention. These included a total of 111 patients, 55 in the endoscopic group and 56 in the surgical group. A higher proportion of patients with pain relief was found in the surgical group compared to the endoscopic group (partial or complete pain relief: RR 1.62, 95% confidence interval (CI) 1.11 to 2.37; complete pain relief: RR 2.45, 95% CI 1.18 to 5.09). Surgical intervention resulted in improved quality of life and improved preservation of exocrine pancreatic function in one trial. The number of patients did not allow for a reliable evaluation of morbidity and mortality between the two treatment modalities. One trial compared surgical intervention to conservative treatment. It included 32 patients: 17 in the surgical group and 15 in the conservative group. The trial showed that surgical intervention resulted in a higher percentage of patients with pain relief and better preservation of pancreatic function. The trial had methodological limitations and the number of patients was relatively small. For patients with obstructive chronic pancreatitis and dilated pancreatic duct, this review showed that surgery is superior to endoscopy in terms of pain control. Morbidity and mortality seemed not to differ between the two intervention modalities, but the small trials identified do not provide sufficient power to detect the small differences expected in this outcome.Regarding the comparison of surgical intervention versus conservative treatment, this review has shown that surgical intervention in an early stage of chronic pancreatitis seems to be a promising approach in terms of pain control and pancreatic function. Confirmation of these results is needed in other trials due to the methodological limitations and limited number of patients of the present evidence.

  10. A Comparison of Temporal Dominance of Sensation (TDS) and Quantitative Descriptive Analysis (QDA™) to Identify Flavors in Strawberries.

    PubMed

    Oliver, Penelope; Cicerale, Sara; Pang, Edwin; Keast, Russell

    2018-04-01

    Temporal dominance of sensations (TDS) is a rapid descriptive method that offers a different magnitude of information to traditional descriptive analysis methodologies. This methodology considers the dynamic nature of eating, assessing sensory perception of foods as they change throughout the eating event. Limited research has applied the TDS methodology to strawberries and subsequently validated the results against Quantitative Descriptive Analysis (QDA™). The aim of this research is to compare the TDS methodology using an untrained consumer panel to the results obtained via QDA™ with a trained sensory panel. The trained panelists (n = 12, minimum 60 hr each panelist) were provided with six strawberry samples (three cultivars at two maturation levels) and applied QDA™ techniques to profile each strawberry sample. Untrained consumers (n = 103) were provided with six strawberry samples (three cultivars at two maturation levels) and required to use TDS methodology to assess the dominant sensations for each sample as they change over time. Results revealed moderately comparable product configurations produced via TDS in comparison to QDA™ (RV coefficient = 0.559), as well as similar application of the sweet attribute (correlation coefficient of 0.895 at first bite). The TDS methodology however was not in agreement with the QDA™ methodology regarding more complex flavor terms. These findings support the notion that the lack of training on the definition of terms, together with the limitations of the methodology to ignore all attributes other than those dominant, provide a different magnitude of information than the QDA™ methodology. A comparison of TDS to traditional descriptive analysis indicate that TDS provides additional information to QDA™ regarding the lingering component of eating. The QDA™ results however provide more precise detail regarding singular attributes. Therefore, the TDS methodology has an application in industry when it is important to understand the lingering profile of products. However, this methodology should not be employed as a replacement to traditional descriptive analysis methods. © 2018 Institute of Food Technologists®.

  11. Fiscal transfers based on inputs or outcomes? Lessons from the Twelfth and Thirteenth Finance Commission in India

    PubMed Central

    Iyer, Smriti; Kapur, Avani; Mahbub, Rifaiyat; Mukherjee, Anit

    2017-01-01

    Summary Background There is limited empirical evidence about the efficacy of fiscal transfers for a specific purpose, including for health which represents an important source of funds for the delivery of public services especially in large populous countries such as India. Objective To examine two distinct methodologies for allocating specific‐purpose centre‐to‐state transfers, one using an input‐based formula focused on equity and the other using an outcome‐based formula focused on performance. Materials and Methods We examine the Twelfth Finance Commission (12FC)'s use of Equalization Grants for Health (EGH) as an input‐based formula and the Thirteenth Finance Commission (13FC)'s use of Incentive Grants for Health (IGH) as an outcome‐based formula. We simulate and replicate the allocation of these two transfer methodologies and examine the consequences of these fiscal transfer mechanisms. Results The EGH placed conditions for releasing funds, but states varied in their ability to meet those conditions, and hence their allocations varied, eg, Madhya Pradesh received 100% and Odisha 67% of its expected allocation. Due to the design of the IGH formula, IGH allocations were unequally distributed and highly concentrated in 4 states (Manipur, Sikkim, Tamil Nadu, Nagaland), which received over half the national IGH allocation. Discussion The EGH had limited impact in achieving equalization, whereas the IGH rewards were concentrated in states which were already doing better. Greater transparency and accountability of centre‐to‐state allocations and specifically their methodologies are needed to ensure that allocation objectives are aligned to performance. PMID:28857284

  12. A methodology for the comparative evaluation of alternative bioseparation technologies.

    PubMed

    Tran, Richard; Zhou, Yuhong; Lacki, Karol M; Titchener-Hooker, Nigel J

    2008-01-01

    Advances in upstream technologies and growing commercial demand have led to cell culture processes of ever larger volumes and expressing at higher product titers. This has increased the burden on downstream processing. Concerns regarding the capacity limitations of packed-bed chromatography have led process engineers to begin investigating new bioseparation techniques that may be considered as "alternatives" to chromatography, and which could potentially offer higher processing capacities but at a lower cost. With the wide range of alternatives, which are currently available, each with their own strengths and inherent limitations, coupled with the time pressures associated with process development, the challenge for process engineers is to determine which technologies are most worth investigating. This article presents a methodology based on a multiattribute decision making (MADM) analysis approach, utilizing both quantitative and qualitative data, which can be used to determine the "industrial attractiveness" of bioseparation technologies, accounting for trade-offs between their strengths and weaknesses. By including packed-bed chromatography in the analysis as a reference point, it was possible to determine the alternatives, which show the most promise for use in large-scale manufacturing processes. The results of this analysis show that although the majority of alternative techniques offer certain advantages over conventional packed-bed chromatography, their attractiveness overall means that currently none of these technologies may be considered as viable alternatives to chromatography. The methodology introduced in this study may be used to gain significant quantitative insight as to the key areas in which improvements are required for each technique, and thus may be used as a tool to aid in further technological development.

  13. Mindfulness and perinatal mental health: A systematic review.

    PubMed

    Hall, Helen G; Beattie, Jill; Lau, Rosalind; East, Christine; Anne Biro, Mary

    2016-02-01

    Perinatal stress is associated with adverse maternal and infant outcomes. Mindfulness training may offer a safe and acceptable strategy to support perinatal mental health. To critically appraise and synthesise the best available evidence regarding the effectiveness of mindfulness training during pregnancy to support perinatal mental health. The search for relevant studies was conducted in six electronic databases and in the grey literature. Eligible studies were assessed for methodological quality according to standardised critical appraisal instruments. Data were extracted and recorded on a pre-designed form and then entered into Review Manager. Nine studies were included in the data synthesis. It was not appropriate to combine the study results because of the variation in methodologies and the interventions tested. Statistically significant improvements were found in small studies of women undertaking mindfulness awareness training in one study for stress (mean difference (MD) -5.28, 95% confidence intervals (CI) -10.4 to -0.42, n=22), two for depression (for example MD -5.48, 95% CI -8.96 to -2.0, n=46) and four for anxiety (for example, MD -6.50, 95% CI -10.95 to -2.05, n=32). However the findings of this review are limited by significant methodological issues within the current research studies. There is insufficient evidence from high quality research on which to base recommendations about the effectiveness of mindfulness to promote perinatal mental health. The limited positive findings support the design and conduct of adequately powered, longitudinal randomised controlled trials, with active controls. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  14. A systematic review of early prognostic factors for persistent pain following acute orthopedic trauma

    PubMed Central

    Clay, Fiona J; Watson, Wendy L; Newstead, Stuart V; McClure, Roderick J

    2012-01-01

    BACKGROUND: Acute orthopedic trauma contributes substantially to the global burden of disease. OBJECTIVES: The present systematic review aimed to summarize the current knowledge concerning prognostic factors for the presence of persistent pain, pain severity and pain-related disability following acute orthopedic trauma involving a spectrum of pathologies to working-age adults. METHODS: The Ovid MEDLINE and EMBASE databases were searched for level II prognostic studies published between January 1996 and October 2010. Studies that were longitudinal and reported results with multivariate analyses appropriate for prognostic studies were included. Studies that addressed two specific injury types that have been the subject of previous reviews, namely, injuries to the spinal column and amputations, were excluded. RESULTS: The searches yielded 992 studies; 10 studies met the inclusion criteria and were rated for methodological quality. Seventeen factors were considered in more than one cohort. There was strong evidence supporting the association of female sex, older age, high pain intensity, preinjury anxiety or depression, and fewer years of education with persistent pain outcomes. There was moderate evidence supporting the association between postinjury depression or anxiety with persistent pain, and that injury severity was not a risk factor for ongoing pain. CONCLUSION: Many individuals experience persistent pain following acute trauma. Due to the lack of studies, the use of different constructs to measure the same factor and the methodological limitations associated with many of the studies, the present review was only able to reliably identify a limited set of factors that predicted persistent pain. Recommendations for the conduct of future methodologically rigorous studies of persistent pain are provided. PMID:22518366

  15. A chemical status predictor. A methodology based on World-Wide sediment samples.

    PubMed

    Gredilla, A; Fdez-Ortiz de Vallejuelo, S; de Diego, A; Arana, G; Stoichev, T; Amigo, J M; Wasserman, J C; Botello, A V; Sarkar, S K; Schäfer, J; Moreno, C; Guardia, M de la; Madariaga, J M

    2015-09-15

    As a consequence of the limited resources of underdeveloped countries and the limited interest of the developed ones, the assessment of the chemical quality of entire water bodies around the world is a utopia in the near future. The methodology described here may serve as a first approach for the fast identification of water bodies that do not meet the good chemical status demanded by the European Water Framework Directive (WFD). It also allows estimating the natural background (or reference values of concentration) of the areas under study using a simple criterion. The starting point is the calculation the World-Wide Natural Background Levels (WWNBLs) and World-Wide Threshold Values (WWTVs), two indexes that depend on the concentration of seven elements present in sediments. These elements, As, Cd, Cr, Cu, Ni, Pb and Zn, have been selected taking into account the recommendations of the UNEP (United Nations Environment Programme) and USEPA (United States Environmental Protection Agency), that describe them as elements of concern with respect to environmental toxicity. The methodology has been exemplified in a case study that includes 134 sediment samples collected in 11 transitional water bodies from 7 different countries and 4 different continents. Six of the water bodies considered met the good chemical status demanded by the WFD. The rest of them exceeded the reference WWTVs, at least for one of the elements. The estuaries of the Nerbioi-Ibaizabal (Basque Country) and Cavado (Portugal), the sea inlet of Río San Pedro (Spain), the Sepetiba Bay (Brazil) and the Yucateco lagoon (Mexico) belong to that group. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Estimation of 2D to 3D dimensions and proportionality indices for facial examination.

    PubMed

    Martos, Rubén; Valsecchi, Andrea; Ibáñez, Oscar; Alemán, Inmaculada

    2018-06-01

    Photo-anthropometry is a metric-based facial image comparison technique where measurements of the face are taken from an image using predetermined facial landmarks. In particular, dimensions and proportionality indices (DPIs) are compared to DPIs from another facial image. Different studies concluded that photo-anthropometric facial comparison, as it is currently practiced, is unsuitable for elimination purposes. The major limitation is the need for images acquired under very restrictive, controlled conditions. To overcome this latter issue, we propose a novel methodology to estimate 3D DPIs from 2D ones. It uses computer graphic techniques to simulate thousands of facial photographs under known camera conditions and regression to derive the mathematical relationship between 2D and 3D DPIs automatically. Additionally, we present a methodology that makes use of the estimated 3D DPIs for reducing the number of potential matches of a given unknown facial photograph within a set of known candidates. The error in the estimation of the 3D DPIs can be as large as 35%, but both I and III quartiles are consistently inside the ±5% range. The methodology for filtering cases has demonstrated to be useful in the task of narrowing down the list of possible candidates for a given photograph. It is able to remove on average (validated using cross-validation technique) 57% and 24% of the negative cases, depending on the amounts of DPIs available. Limitations of the work developed together with open research lines are included within the Discussion section. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Fiscal transfers based on inputs or outcomes? Lessons from the Twelfth and Thirteenth Finance Commission in India.

    PubMed

    Fan, Victoria Y; Iyer, Smriti; Kapur, Avani; Mahbub, Rifaiyat; Mukherjee, Anit

    2018-01-01

    There is limited empirical evidence about the efficacy of fiscal transfers for a specific purpose, including for health which represents an important source of funds for the delivery of public services especially in large populous countries such as India. To examine two distinct methodologies for allocating specific-purpose centre-to-state transfers, one using an input-based formula focused on equity and the other using an outcome-based formula focused on performance. We examine the Twelfth Finance Commission (12FC)'s use of Equalization Grants for Health (EGH) as an input-based formula and the Thirteenth Finance Commission (13FC)'s use of Incentive Grants for Health (IGH) as an outcome-based formula. We simulate and replicate the allocation of these two transfer methodologies and examine the consequences of these fiscal transfer mechanisms. The EGH placed conditions for releasing funds, but states varied in their ability to meet those conditions, and hence their allocations varied, eg, Madhya Pradesh received 100% and Odisha 67% of its expected allocation. Due to the design of the IGH formula, IGH allocations were unequally distributed and highly concentrated in 4 states (Manipur, Sikkim, Tamil Nadu, Nagaland), which received over half the national IGH allocation. The EGH had limited impact in achieving equalization, whereas the IGH rewards were concentrated in states which were already doing better. Greater transparency and accountability of centre-to-state allocations and specifically their methodologies are needed to ensure that allocation objectives are aligned to performance. © 2017 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

  18. Ballast water regulations and the move toward concentration-based numeric discharge limits.

    PubMed

    Albert, Ryan J; Lishman, John M; Saxena, Juhi R

    2013-03-01

    Ballast water from shipping is a principal source for the introduction of nonindigenous species. As a result, numerous government bodies have adopted various ballast water management practices and discharge standards to slow or eliminate the future introduction and dispersal of these nonindigenous species. For researchers studying ballast water issues, understanding the regulatory framework is helpful to define the scope of research needed by policy makers to develop effective regulations. However, for most scientists, this information is difficult to obtain because it is outside the standard scientific literature and often difficult to interpret. This paper provides a brief review of the regulatory framework directed toward scientists studying ballast water and aquatic invasive species issues. We describe different approaches to ballast water management in international, U.S. federal and state, and domestic ballast water regulation. Specifically, we discuss standards established by the International Maritime Organization (IMO), the U.S. Coast Guard and U.S. Environmental Protection Agency, and individual states in the United States including California, New York, and Minnesota. Additionally, outside the United States, countries such as Australia, Canada, and New Zealand have well-established domestic ballast water regulatory regimes. Different approaches to regulation have recently resulted in variations between numeric concentration-based ballast water discharge limits, particularly in the United States, as well as reliance on use of ballast water exchange pending development and adoption of rigorous science-based discharge standards. To date, numeric concentration-based discharge limits have not generally been based upon a thorough application of risk-assessment methodologies. Regulators, making decisions based on the available information and methodologies before them, have consequently established varying standards, or not established standards at all. The review and refinement of ballast water discharge standards by regulatory agencies will benefit from activity by the scientific community to improve and develop more precise risk-assessment methodologies.

  19. Methodology for the evaluation of the Stephanie Alexander Kitchen Garden program.

    PubMed

    Gibbs, L; Staiger, P K; Townsend, M; Macfarlane, S; Gold, L; Block, K; Johnson, B; Kulas, J; Waters, E

    2013-04-01

    Community and school cooking and gardening programs have recently increased internationally. However, despite promising indications, there is limited evidence of their effectiveness. This paper presents the evaluation framework and methods negotiated and developed to meet the information needs of all stakeholders for the Stephanie Alexander Kitchen Garden (SAKG) program, a combined cooking and gardening program implemented in selectively funded primary schools across Australia. The evaluation used multiple aligned theoretical frameworks and models, including a public health ecological approach, principles of effective health promotion and models of experiential learning. The evaluation is a non-randomised comparison of six schools receiving the program (intervention) and six comparison schools (all government-funded primary schools) in urban and rural areas of Victoria, Australia. A mixed-methods approach was used, relying on qualitative measures to understand changes in school cultures and the experiential impacts on children, families, teachers, parents and volunteers, and quantitative measures at baseline and 1 year follow up to provide supporting information regarding patterns of change. The evaluation study design addressed the limitations of many existing evaluation studies of cooking or garden programs. The multistrand approach to the mixed methodology maintained the rigour of the respective methods and provided an opportunity to explore complexity in the findings. Limited sensitivity of some of the quantitative measures was identified, as well as the potential for bias in the coding of the open-ended questions. The SAKG evaluation methodology will address the need for appropriate evaluation approaches for school-based kitchen garden programs. It demonstrates the feasibility of a meaningful, comprehensive evaluation of school-based programs and also demonstrates the central role qualitative methods can have in a mixed-method evaluation. So what? This paper contributes to debate about appropriate evaluation approaches to meet the information needs of all stakeholders and will support the sharing of measures and potential comparisons between program outcomes for comparable population groups and settings.

  20. 42 CFR 495.212 - Limitation on review.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.212 Limitation on review. (a... methodology and standards for determining payment amounts and payment adjustments under the MA EHR EP... related to the fixed schedule for application of limitation on incentive payments for all qualifying MA...

  1. 42 CFR 495.212 - Limitation on review.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.212 Limitation on review. (a... methodology and standards for determining payment amounts and payment adjustments under the MA EHR EP... related to the fixed schedule for application of limitation on incentive payments for all qualifying MA...

  2. 42 CFR 495.212 - Limitation on review.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.212 Limitation on review. (a... methodology and standards for determining payment amounts and payment adjustments under the MA EHR EP... related to the fixed schedule for application of limitation on incentive payments for all qualifying MA...

  3. 42 CFR 495.212 - Limitation on review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.212 Limitation on review. (a... methodology and standards for determining payment amounts and payment adjustments under the MA EHR EP... related to the fixed schedule for application of limitation on incentive payments for all qualifying MA...

  4. 42 CFR 495.212 - Limitation on review.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.212 Limitation on review. (a... methodology and standards for determining payment amounts and payment adjustments under the MA EHR EP... related to the fixed schedule for application of limitation on incentive payments for all qualifying MA...

  5. Bayesian superresolution

    NASA Astrophysics Data System (ADS)

    Isakson, Steve Wesley

    2001-12-01

    Well-known principles of physics explain why resolution restrictions occur in images produced by optical diffraction-limited systems. The limitations involved are present in all diffraction-limited imaging systems, including acoustical and microwave. In most circumstances, however, prior knowledge about the object and the imaging system can lead to resolution improvements. In this dissertation I outline a method to incorporate prior information into the process of reconstructing images to superresolve the object beyond the above limitations. This dissertation research develops the details of this methodology. The approach can provide the most-probable global solution employing a finite number of steps in both far-field and near-field images. In addition, in order to overcome the effects of noise present in any imaging system, this technique provides a weighted image that quantifies the likelihood of various imaging solutions. By utilizing Bayesian probability, the procedure is capable of incorporating prior information about both the object and the noise to overcome the resolution limitation present in many imaging systems. Finally I will present an imaging system capable of detecting the evanescent waves missing from far-field systems, thus improving the resolution further.

  6. The Differential Effect of Attentional Condition on Subsequent Vocabulary Development

    ERIC Educational Resources Information Center

    Mohammed, Halah Abdulelah; Majid, Norazman Abdul; Abdullah, Tina

    2016-01-01

    This study addressed the potential methodological issues effect of attentional condition on subsequent vocabulary development from a different perspective, which addressed several potential methodological issues of previous research that have been based on psycholinguistic notion of second language learner as a limited capacity processor. The…

  7. Predicting Dissertation Methodology Choice among Doctoral Candidates at a Faith-Based University

    ERIC Educational Resources Information Center

    Lunde, Rebecca

    2017-01-01

    Limited research has investigated dissertation methodology choice and the factors that contribute to this choice. Quantitative research is based in mathematics and scientific positivism, and qualitative research is based in constructivism. These underlying philosophical differences posit the question if certain factors predict dissertation…

  8. Estimating shallow groundwater availability in small catchments using streamflow recession and instream flow requirements of rivers in South Africa

    NASA Astrophysics Data System (ADS)

    Ebrahim, Girma Y.; Villholth, Karen G.

    2016-10-01

    Groundwater is an important resource for multiple uses in South Africa. Hence, setting limits to its sustainable abstraction while assuring basic human needs is required. Due to prevalent data scarcity related to groundwater replenishment, which is the traditional basis for estimating groundwater availability, the present article presents a novel method for determining allocatable groundwater in quaternary (fourth-order) catchments through information on streamflow. Using established methodologies for assessing baseflow, recession flow, and instream ecological flow requirement, the methodology develops a combined stepwise methodology to determine annual available groundwater storage volume using linear reservoir theory, essentially linking low flows proportionally to upstream groundwater storages. The approach was trialled for twenty-one perennial and relatively undisturbed catchments with long-term and reliable streamflow records. Using the Desktop Reserve Model, instream flow requirements necessary to meet the present ecological state of the streams were determined, and baseflows in excess of these flows were converted into a conservative estimates of allocatable groundwater storages on an annual basis. Results show that groundwater development potential exists in fourteen of the catchments, with upper limits to allocatable groundwater volumes (including present uses) ranging from 0.02 to 3.54 × 106 m3 a-1 (0.10-11.83 mm a-1) per catchment. With a secured availability of these volume 75% of the years, variability between years is assumed to be manageable. A significant (R2 = 0.88) correlation between baseflow index and the drainage time scale for the catchments underscores the physical basis of the methodology and also enables the reduction of the procedure by one step, omitting recession flow analysis. The method serves as an important complementary tool for the assessment of the groundwater part of the Reserve and the Groundwater Resource Directed Measures in South Africa and could be adapted and applied elsewhere.

  9. Reporting and Methodology of Multivariable Analyses in Prognostic Observational Studies Published in 4 Anesthesiology Journals: A Methodological Descriptive Review.

    PubMed

    Guglielminotti, Jean; Dechartres, Agnès; Mentré, France; Montravers, Philippe; Longrois, Dan; Laouénan, Cedric

    2015-10-01

    Prognostic research studies in anesthesiology aim to identify risk factors for an outcome (explanatory studies) or calculate the risk of this outcome on the basis of patients' risk factors (predictive studies). Multivariable models express the relationship between predictors and an outcome and are used in both explanatory and predictive studies. Model development demands a strict methodology and a clear reporting to assess its reliability. In this methodological descriptive review, we critically assessed the reporting and methodology of multivariable analysis used in observational prognostic studies published in anesthesiology journals. A systematic search was conducted on Medline through Web of Knowledge, PubMed, and journal websites to identify observational prognostic studies with multivariable analysis published in Anesthesiology, Anesthesia & Analgesia, British Journal of Anaesthesia, and Anaesthesia in 2010 and 2011. Data were extracted by 2 independent readers. First, studies were analyzed with respect to reporting of outcomes, design, size, methods of analysis, model performance (discrimination and calibration), model validation, clinical usefulness, and STROBE (i.e., Strengthening the Reporting of Observational Studies in Epidemiology) checklist. A reporting rate was calculated on the basis of 21 items of the aforementioned points. Second, they were analyzed with respect to some predefined methodological points. Eighty-six studies were included: 87.2% were explanatory and 80.2% investigated a postoperative event. The reporting was fairly good, with a median reporting rate of 79% (75% in explanatory studies and 100% in predictive studies). Six items had a reporting rate <36% (i.e., the 25th percentile), with some of them not identified in the STROBE checklist: blinded evaluation of the outcome (11.9%), reason for sample size (15.1%), handling of missing data (36.0%), assessment of colinearity (17.4%), assessment of interactions (13.9%), and calibration (34.9%). When reported, a few methodological shortcomings were observed, both in explanatory and predictive studies, such as an insufficient number of events of the outcome (44.6%), exclusion of cases with missing data (93.6%), or categorization of continuous variables (65.1%.). The reporting of multivariable analysis was fairly good and could be further improved by checking reporting guidelines and EQUATOR Network website. Limiting the number of candidate variables, including cases with missing data, and not arbitrarily categorizing continuous variables should be encouraged.

  10. Space radiation risk limits and Earth-Moon-Mars environmental models

    NASA Astrophysics Data System (ADS)

    Cucinotta, Francis A.; Hu, Shaowen; Schwadron, Nathan A.; Kozarev, K.; Townsend, Lawrence W.; Kim, Myung-Hee Y.

    2010-12-01

    We review NASA's short-term and career radiation limits for astronauts and methods for their application to future exploration missions outside of low Earth orbit. Career limits are intended to restrict late occurring health effects and include a 3% risk of exposure-induced death from cancer and new limits for central nervous system and heart disease risks. Short-term dose limits are used to prevent in-flight radiation sickness or death through restriction of the doses to the blood forming organs and to prevent clinically significant cataracts or skin damage through lens and skin dose limits, respectively. Large uncertainties exist in estimating the health risks of space radiation, chiefly the understanding of the radiobiology of heavy ions and dose rate and dose protraction effects, and the limitations in human epidemiology data. To protect against these uncertainties NASA estimates the 95% confidence in the cancer risk projection intervals as part of astronaut flight readiness assessments and mission design. Accurate organ dose and particle spectra models are needed to ensure astronauts stay below radiation limits and to support the goal of narrowing the uncertainties in risk projections. Methodologies for evaluation of space environments, radiation quality, and organ doses to evaluate limits are discussed, and current projections for lunar and Mars missions are described.

  11. Big–deep–smart data in imaging for guiding materials design

    DOE PAGES

    Kalinin, Sergei V.; Sumpter, Bobby G.; Archibald, Richard K.

    2015-09-23

    Harnessing big data, deep data, and smart data from state-of-the-art imaging might accelerate the design and realization of advanced functional materials. Here we discuss new opportunities in materials design enabled by the availability of big data in imaging and data analytics approaches, including their limitations, in material systems of practical interest. We specifically focus on how these tools might help realize new discoveries in a timely manner. Such methodologies are particularly appropriate to explore in light of continued improvements in atomistic imaging, modelling and data analytics methods.

  12. The application of remote sensing techniques: Technical and methodological issues

    NASA Technical Reports Server (NTRS)

    Polcyn, F. C.; Wagner, T. W.

    1974-01-01

    Capabilities and limitations of modern imaging electromagnetic sensor systems are outlined, and the products of such systems are compared with those of the traditional aerial photographic system. Focus is given to the interface between the rapidly developing remote sensing technology and the information needs of operational agencies, and communication gaps are shown to retard early adoption of the technology by these agencies. An assessment is made of the current status of imaging remote sensors and their potential for the future. Public sources of remote sensor data and several cost comparisons are included.

  13. Linear programming computational experience with onyx

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

    Atrek, E.

    1994-12-31

    ONYX is a linear programming software package based on an efficient variation of the gradient projection method. When fully configured, it is intended for application to industrial size problems. While the computational experience is limited at the time of this abstract, the technique is found to be robust and competitive with existing methodology in terms of both accuracy and speed. An overview of the approach is presented together with a description of program capabilities, followed by a discussion of up-to-date computational experience with the program. Conclusions include advantages of the approach and envisioned future developments.

  14. In Vivo Methods for the Assessment of Topical Drug Bioavailability

    PubMed Central

    Herkenne, Christophe; Alberti, Ingo; Naik, Aarti; Kalia, Yogeshvar N.; Mathy, François-Xavier; Préat, Véronique

    2007-01-01

    This paper reviews some current methods for the in vivo assessment of local cutaneous bioavailability in humans after topical drug application. After an introduction discussing the importance of local drug bioavailability assessment and the limitations of model-based predictions, the focus turns to the relevance of experimental studies. The available techniques are then reviewed in detail, with particular emphasis on the tape stripping and microdialysis methodologies. Other less developed techniques, including the skin biopsy, suction blister, follicle removal and confocal Raman spectroscopy techniques are also described. PMID:17985216

  15. Big-deep-smart data in imaging for guiding materials design.

    PubMed

    Kalinin, Sergei V; Sumpter, Bobby G; Archibald, Richard K

    2015-10-01

    Harnessing big data, deep data, and smart data from state-of-the-art imaging might accelerate the design and realization of advanced functional materials. Here we discuss new opportunities in materials design enabled by the availability of big data in imaging and data analytics approaches, including their limitations, in material systems of practical interest. We specifically focus on how these tools might help realize new discoveries in a timely manner. Such methodologies are particularly appropriate to explore in light of continued improvements in atomistic imaging, modelling and data analytics methods.

  16. Big-deep-smart data in imaging for guiding materials design

    NASA Astrophysics Data System (ADS)

    Kalinin, Sergei V.; Sumpter, Bobby G.; Archibald, Richard K.

    2015-10-01

    Harnessing big data, deep data, and smart data from state-of-the-art imaging might accelerate the design and realization of advanced functional materials. Here we discuss new opportunities in materials design enabled by the availability of big data in imaging and data analytics approaches, including their limitations, in material systems of practical interest. We specifically focus on how these tools might help realize new discoveries in a timely manner. Such methodologies are particularly appropriate to explore in light of continued improvements in atomistic imaging, modelling and data analytics methods.

  17. Synthesis of discipline-based education research in physics

    NASA Astrophysics Data System (ADS)

    Docktor, Jennifer L.; Mestre, José P.

    2014-12-01

    This paper presents a comprehensive synthesis of physics education research at the undergraduate level. It is based on work originally commissioned by the National Academies. Six topical areas are covered: (1) conceptual understanding, (2) problem solving, (3) curriculum and instruction, (4) assessment, (5) cognitive psychology, and (6) attitudes and beliefs about teaching and learning. Each topical section includes sample research questions, theoretical frameworks, common research methodologies, a summary of key findings, strengths and limitations of the research, and areas for future study. Supplemental material proposes promising future directions in physics education research.

  18. Big–deep–smart data in imaging for guiding materials design

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

    Kalinin, Sergei V.; Sumpter, Bobby G.; Archibald, Richard K.

    Harnessing big data, deep data, and smart data from state-of-the-art imaging might accelerate the design and realization of advanced functional materials. Here we discuss new opportunities in materials design enabled by the availability of big data in imaging and data analytics approaches, including their limitations, in material systems of practical interest. We specifically focus on how these tools might help realize new discoveries in a timely manner. Such methodologies are particularly appropriate to explore in light of continued improvements in atomistic imaging, modelling and data analytics methods.

  19. A Methodological Approach for Assessing Amplified Reflection Distributed Denial of Service on the Internet of Things

    PubMed Central

    Costa Gondim, João José; de Oliveira Albuquerque, Robson; Clayton Alves Nascimento, Anderson; García Villalba, Luis Javier; Kim, Tai-Hoon

    2016-01-01

    Concerns about security on Internet of Things (IoT) cover data privacy and integrity, access control, and availability. IoT abuse in distributed denial of service attacks is a major issue, as typical IoT devices’ limited computing, communications, and power resources are prioritized in implementing functionality rather than security features. Incidents involving attacks have been reported, but without clear characterization and evaluation of threats and impacts. The main purpose of this work is to methodically assess the possible impacts of a specific class–amplified reflection distributed denial of service attacks (AR-DDoS)–against IoT. The novel approach used to empirically examine the threat represented by running the attack over a controlled environment, with IoT devices, considered the perspective of an attacker. The methodology used in tests includes that perspective, and actively prospects vulnerabilities in computer systems. This methodology defines standardized procedures for tool-independent vulnerability assessment based on strategy, and the decision flows during execution of penetration tests (pentests). After validation in different scenarios, the methodology was applied in amplified reflection distributed denial of service (AR-DDoS) attack threat assessment. Results show that, according to attack intensity, AR-DDoS saturates reflector infrastructure. Therefore, concerns about AR-DDoS are founded, but expected impact on abused IoT infrastructure and devices will be possibly as hard as on final victims. PMID:27827931

  20. A Methodological Approach for Assessing Amplified Reflection Distributed Denial of Service on the Internet of Things.

    PubMed

    Costa Gondim, João José; de Oliveira Albuquerque, Robson; Clayton Alves Nascimento, Anderson; García Villalba, Luis Javier; Kim, Tai-Hoon

    2016-11-04

    Concerns about security on Internet of Things (IoT) cover data privacy and integrity, access control, and availability. IoT abuse in distributed denial of service attacks is a major issue, as typical IoT devices' limited computing, communications, and power resources are prioritized in implementing functionality rather than security features. Incidents involving attacks have been reported, but without clear characterization and evaluation of threats and impacts. The main purpose of this work is to methodically assess the possible impacts of a specific class-amplified reflection distributed denial of service attacks (AR-DDoS)-against IoT. The novel approach used to empirically examine the threat represented by running the attack over a controlled environment, with IoT devices, considered the perspective of an attacker. The methodology used in tests includes that perspective, and actively prospects vulnerabilities in computer systems. This methodology defines standardized procedures for tool-independent vulnerability assessment based on strategy, and the decision flows during execution of penetration tests (pentests). After validation in different scenarios, the methodology was applied in amplified reflection distributed denial of service (AR-DDoS) attack threat assessment. Results show that, according to attack intensity, AR-DDoS saturates reflector infrastructure. Therefore, concerns about AR-DDoS are founded, but expected impact on abused IoT infrastructure and devices will be possibly as hard as on final victims.

  1. Human perception testing methodology for evaluating EO/IR imaging systems

    NASA Astrophysics Data System (ADS)

    Graybeal, John J.; Monfort, Samuel S.; Du Bosq, Todd W.; Familoni, Babajide O.

    2018-04-01

    The U.S. Army's RDECOM CERDEC Night Vision and Electronic Sensors Directorate (NVESD) Perception Lab is tasked with supporting the development of sensor systems for the U.S. Army by evaluating human performance of emerging technologies. Typical research questions involve detection, recognition and identification as a function of range, blur, noise, spectral band, image processing techniques, image characteristics, and human factors. NVESD's Perception Lab provides an essential bridge between the physics of the imaging systems and the performance of the human operator. In addition to quantifying sensor performance, perception test results can also be used to generate models of human performance and to drive future sensor requirements. The Perception Lab seeks to develop and employ scientifically valid and efficient perception testing procedures within the practical constraints of Army research, including rapid development timelines for critical technologies, unique guidelines for ethical testing of Army personnel, and limited resources. The purpose of this paper is to describe NVESD Perception Lab capabilities, recent methodological improvements designed to align our methodology more closely with scientific best practice, and to discuss goals for future improvements and expanded capabilities. Specifically, we discuss modifying our methodology to improve training, to account for human fatigue, to improve assessments of human performance, and to increase experimental design consultation provided by research psychologists. Ultimately, this paper outlines a template for assessing human perception and overall system performance related to EO/IR imaging systems.

  2. Effect of the solvent on the size of clay nanoparticles in solution as determined using an ultraviolet-visible (UV-Vis) spectroscopy methodology.

    PubMed

    Alin, Jonas; Rubino, Maria; Auras, Rafael

    2015-06-01

    Ultraviolet-visible (UV-Vis) spectroscopy methodology was developed and utilized for the in situ nanoscale measurement of the size of mineral clay agglomerates in various liquid suspensions. The clays studied were organomodified and unmodified montmorillonite clays (I.44p, Cloisite 93a, and PGN). The methodology was compared and validated against dynamic light scattering (DLS) analysis. The method was able to measure clay agglomerates in solvents in situations where DLS analysis was unsuccessful due to the shapes, polydispersity, and high aspect ratios of the clay particles and the complexity of the aggregates, or dispersion medium. The measured clay agglomerates in suspension were found to be in the nanometer range in the more compatible solvents, and their sizes correlated with the Hansen solubility parameter space distance between the clay modifiers and the solvents. Mass detection limits for size determination were in the range from 1 to 9 mg/L. The methodology thus provides simple, rapid, and inexpensive characterization of clays or particles in the nano- or microsize range in low concentrations in various liquid media, including complex mixtures or highly viscous fluids that are difficult to analyze with DLS. In addition, by combining UV-VIS spectroscopy with DLS it was possible to discern flocculation behavior in liquids, which otherwise could result in false size measurements by DLS alone.

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

    Kaminsky, J.; Tschanz, J.F.

    In order to adress barriers to community energy-conservation efforts, DOE has established the Comprehensive Community Energy Management (CCEM) program. The role of CCEM is to provide direction and technical support for energy-conservation efforts at the local level. The program to date has included project efforts to develop combinations and variations of community energy planning and management tools applicable to communities of diverse characteristics. This paper describes the salient features of some of the tools and relates them to the testing program soon to begin in several pilot-study communities. Two methodologies that arose within such an actual planning context are takenmore » from DOE-sponsored projects in Clarksburg, West Virginia and the proposed new capital city for Alaska. Energy management in smaller communities and/or communities with limited funding and manpower resources has received special attention. One project of this type developed in general methodology that emphasizes efficient ways for small communities to reach agreement on local energy problems and potential solutions; by this guidance, the community is led to understand where it should concentrate its efforts in subsequent management activities. Another project concerns rapid growth of either a new or an existing community that could easily outstrip the management resources available locally. This methodology strives to enable the community to seize the opportunity for energy conservation through integrating the design of its energy systems and its development pattern. The last methodology creates applicable tools for comprehensive community energy planning. (MCW)« less

  4. Team learning and innovation in nursing, a review of the literature.

    PubMed

    Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Van Rompaey, Bart; Denekens, Joke

    2012-01-01

    The capability to learn and innovate has been recognized as a key-factor for nursing teams to deliver high quality performance. Researchers suggest there is a relation between team-learning activities and changes in nursing teams throughout the implementation of novelties. A review of the literature was conducted in regard to the relation between team learning and implementation of innovations in nursing teams and to explore factors that contribute or hinder team learning. The search was limited to studies that were published in English or Dutch between 1998 and 2010. Eight studies were included in the review. The results of this review revealed that research on team learning and innovation in nursing is limited. The included studies showed moderate methodological quality and low levels of evidence. Team learning included processes to gather, process, and store information from different innovations within the nursing team and the prevalence of team-learning activities was contributed or hindered by individual and contextual factors. Further research is needed on the relation between team learning and implementation of innovations in nursing. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Psycho-Socio-Economic Issues Challenging Multidrug Resistant Tuberculosis Patients: A Systematic Review.

    PubMed

    Thomas, Beena Elizabeth; Shanmugam, Poonguzhali; Malaisamy, Muniyandi; Ovung, Senthanro; Suresh, Chandra; Subbaraman, Ramnath; Adinarayanan, Srividya; Nagarajan, Karikalan

    2016-01-01

    Limited treatment options, long duration of treatment and associated toxicity adversely impact the physical and mental well-being of multidrug-resistant tuberculosis (MDR-TB) patients. Despite research advances in the microbiological and clinical aspects of MDR-TB, research on the psychosocial context of MDR-TB is limited and less understood. We searched the databases of PubMed, MEDLINE, Embase and Google Scholar to retrieve all published articles. The final manuscripts included in the review were those with a primary focus on psychosocial issues of MDR-TB patients. These were assessed and the information was thematically extracted on the study objective, methodology used, key findings, and their implications. Intervention studies were evaluated using components of the methodological and quality rating scale. Due to the limited number of studies and the multiple methodologies employed in the observational studies, we summarized these studies using a narrative approach, rather than conducting a formal meta-analysis. We used 'thematic synthesis' method for extracting qualitative evidences and systematically organised to broader descriptive themes. A total of 282 published articles were retrieved, of which 15 articles were chosen for full text review based on the inclusion criteria. Six were qualitative studies; one was a mixed methods study; and eight were quantitative studies. The included studies were divided into the following issues affecting MDR-TB patients: a) psychological issues b) social issues and economic issues c) psychosocial interventions. It was found that all studies have documented range of psychosocial and economic challenges experienced by MDR-TB patients. Depression, stigma, discrimination, side effects of the drugs causing psychological distress, and the financial constraints due to MDR-TB were some of the common issues reported in the studies. There were few intervention studies which addressed these psychosocial issues most of which were small pilot studies. There is dearth of large scale randomized psychosocial intervention studies that can be scaled up to strengthen management of MDR-TB patients which is crucial for the TB control programme. This review has captured the psychosocial and economic issues challenging MDR patients. However there is urgent need for feasible, innovative psychosocial and economic intervention studies that help to equip MDR-TB patients cope with their illness, improve treatment adherence, treatment outcomes and the overall quality of life of MDR-TB patients.

  6. Effects-Based Operations in the Cyber Domain

    DTIC Science & Technology

    2017-05-03

    as the joint targeting methodology . The description that Batschelet gave the traditional targeting methodology included a process of, “Decide, Detect...technology, requires new planning and methodology to fight back. This paper evaluates current Department of Defense doctrine to look at ways to conduct...developing its cyber tactics, techniques, and procedures, which, includes various targeting methodologies , such as the use of effects-based

  7. Seizures and epilepsy in Alzheimer's disease.

    PubMed

    Friedman, Daniel; Honig, Lawrence S; Scarmeas, Nikolaos

    2012-04-01

    Many studies have shown that patients with Alzheimer's disease (AD) are at increased risk for developing seizures and epilepsy. However, reported prevalence and incidence of seizures and relationship of seizures to disease measures such as severity, outcome, and progression vary widely between studies. We performed a literature review of the available clinical and epidemiological data on the topic of seizures in patients with AD. We review seizure rates and types, risk factors for seizures, electroencephalogram (EEG) studies, and treatment responses. Finally, we consider limitations and methodological issues. There is considerable variability in the reported prevalence and incidence of seizures in patients with AD-with reported lifetime prevalence rates of 1.5-64%. More recent, prospective, and larger studies in general report lower rates. Some, but not all, studies have noted increased seizure risk with increasing dementia severity or with younger age of AD onset. Generalized convulsive seizures are the most commonly reported type, but often historical information is the only basis used to determine seizure type and the manifestation of seizures may be difficult to distinguish from other behaviors common in demented patients. EEG has infrequently been performed and reported. Data on treatment of seizures in AD are extremely limited. Similarly, the relationship between seizures and cognitive impairment in AD is unclear. We conclude that the literature on seizures and epilepsy in AD, including diagnosis, risk factors, and response to treatment suffers from methodological limitations and gaps. © 2011 Blackwell Publishing Ltd.

  8. Effect of pre-task music on sports or exercise performance.

    PubMed

    Smirmaul, Bruno P

    2017-01-01

    Pre-task music is a very common strategy among sports competitors. However, as opposed to in-task music, the scientific evidence to support its ergogenic effects on either sports or exercise performance is limited. This brief review critically addresses the existing literature investigating the effects of pre-task music on sports and exercise performance, focusing on the methods and results of experimental studies, and offers basic and practical recommendations. In July 2015, a comprehensive literature search was performed in Web of Science, PubMed, and Google Scholar using the following key words in combination: "pre-task music," "pre-test music," "pre-exercise music," "exercise performance," "sports performance." The literature search was further expanded by both hand searching review articles on the topic and by searching the reference lists from the articles retrieved for any relevant references. Overall, a total of 15 studies in 14 articles were included. Pre-task music research has been unsystematic, methodologically limited and infrequent. Using this review as a starting point to overcome previous methodological limitations when designing future experiments may contribute to the development of pre-task music research, which is still in its infancy. Currently, there is no sufficient evidence to support the overall ergogenic effects of pre-task music on sports or exercise performance. Nonetheless, pre-task music has showed a likely ergogenic effect on shorter and predominantly anaerobic tasks such as grip strength, Wingate test, and short-duration sports or sports-like tasks, in contrast to longer and predominantly aerobic tasks.

  9. Using Q Methodology in Quality Improvement Projects.

    PubMed

    Tiernon, Paige; Hensel, Desiree; Roy-Ehri, Leah

    Q methodology consists of a philosophical framework and procedures to identify subjective viewpoints that may not be well understood, but its use in nursing is still quite limited. We describe how Q methodology can be used in quality improvement projects to better understand local viewpoints that act as facilitators or barriers to the implementation of evidence-based practice. We describe the use of Q methodology to identify nurses' attitudes about the provision of skin-to-skin care after cesarean birth. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  10. A Double Whammy: Health Promotion Among Cancer Survivors with Pre-Existing Functional Limitations

    PubMed Central

    Volker, Deborah L.; Becker, Heather; Kang, Sook Jung; Kullberg, Vicki

    2012-01-01

    Purpose/Objectives To explore the experience of living with a cancer diagnosis within the context of a pre-existing functional disability and to identify strategies to promote health in this growing population of cancer survivors. Research Approach Qualitative descriptive Setting Four sites in the United States Participants 19 female cancer survivors with pre-existing disabling conditions Methodologic Approach Four focus groups were conducted. The audiotapes were transcribed and analyzed using content analysis techniques. Main Research Variables cancer survivor, disability, health promotion Findings Analytic categories included living with a cancer diagnosis, health promotion strategies, and wellness program development for survivors with pre-existing functional limitations. Participants described many challenges associated with managing a cancer diagnosis on top of living with a chronic disabling functional limitation. They identified strategies they used to maintain their health and topics to be included in health promotion programs tailored for this unique group of cancer survivors. Conclusions The “double whammy” of a cancer diagnosis for persons with pre-existing functional limitations requires modification of health promotion strategies and programs to promote wellness in this group of cancer survivors. Interpretation Nurses and other health care providers must attend to patients’ pre-existing conditions as well as the challenges of the physical, emotional, social, and economic sequelae of a cancer diagnosis. PMID:23269771

  11. Comparison of methodological quality of positive versus negative comparative studies published in Indian medical journals: a systematic review.

    PubMed

    Charan, Jaykaran; Chaudhari, Mayur; Jackson, Ryan; Mhaskar, Rahul; Reljic, Tea; Kumar, Ambuj

    2015-06-24

    Published negative studies should have the same rigour of methodological quality as studies with positive findings. However, the methodological quality of negative versus positive studies is not known. The objective was to assess the reported methodological quality of positive versus negative studies published in Indian medical journals. A systematic review (SR) was performed of all comparative studies published in Indian medical journals with a clinical science focus and impact factor >1 between 2011 and 2013. The methodological quality of randomised controlled trials (RCTs) was assessed using the Cochrane risk of bias tool, and the Newcastle-Ottawa scale for observational studies. The results were considered positive if the primary outcome was statistically significant and negative otherwise. When the primary outcome was not specified, we used data on the first outcome reported in the history followed by the results section. Differences in various methodological quality domains between positive versus negative studies were assessed by Fisher's exact test. Seven journals with 259 comparative studies were included in this SR. 24% (63/259) were RCTs, 24% (63/259) cohort studies, and 49% (128/259) case-control studies. 53% (137/259) of studies explicitly reported the primary outcome. Five studies did not report sufficient data to enable us to determine if results were positive or negative. Statistical significance was determined by p value in 78.3% (199/254), CI in 2.8% (7/254), both p value and CI in 11.8% (30/254), and only descriptive in 6.3% (16/254) of studies. The overall methodological quality was poor and no statistically significant differences between reporting of methodological quality were detected between studies with positive versus negative findings. There was no difference in the reported methodological quality of positive versus negative studies. However, the uneven reporting of positive versus negative studies (72% vs 28%) indicates a publication bias in Indian medical journals with an impact factor of >1. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Feminist Research Methodology Groups: Origins, Forms, Functions.

    ERIC Educational Resources Information Center

    Reinharz, Shulamit

    Feminist Research Methodology Groups (FRMGs) have developed as a specific type of women's group in which feminist academics can find supportive audiences for their work while contributing to a feminist redefinition of research methods. An analysis of two FRMGs reveals common characteristics, dynamics, and outcomes. Both were limited to small…

  13. Culturally Competent Social Work Research: Methodological Considerations for Research with Language Minorities

    ERIC Educational Resources Information Center

    Casado, Banghwa Lee; Negi, Nalini Junko; Hong, Michin

    2012-01-01

    Despite the growing number of language minorities, foreign-born individuals with limited English proficiency, this population has been largely left out of social work research, often due to methodological challenges involved in conducting research with this population. Whereas the professional standard calls for cultural competence, a discussion…

  14. ADM1-based methodology for the characterisation of the influent sludge in anaerobic reactors.

    PubMed

    Huete, E; de Gracia, M; Ayesa, E; Garcia-Heras, J L

    2006-01-01

    This paper presents a systematic methodology to characterise the influent sludge in terms of the ADM1 components from the experimental measurements traditionally used in wastewater engineering. For this purpose, a complete characterisation of the model components in their elemental mass fractions and charge has been used, making a rigorous mass balance for all the process transformations and enabling the future connection with other unit-process models. It also makes possible the application of mathematical algorithms for the optimal characterisation of several components poorly defined in the ADM1 report. Additionally, decay and disintegration have been necessarily uncoupled so that the decay proceeds directly to hydrolysis instead of producing intermediate composites. The proposed methodology has been applied to the particular experimental work of a pilot-scale CSTR treating real sewage sludge, a mixture of primary and secondary sludge. The results obtained have shown a good characterisation of the influent reflected in good model predictions. However, its limitations for an appropriate prediction of alkalinity and carbon percentages in biogas suggest the convenience of including the elemental characterisation of the process in terms of carbon in the analytical program.

  15. Sampling methods to the statistical control of the production of blood components.

    PubMed

    Pereira, Paulo; Seghatchian, Jerard; Caldeira, Beatriz; Santos, Paula; Castro, Rosa; Fernandes, Teresa; Xavier, Sandra; de Sousa, Gracinda; de Almeida E Sousa, João Paulo

    2017-12-01

    The control of blood components specifications is a requirement generalized in Europe by the European Commission Directives and in the US by the AABB standards. The use of a statistical process control methodology is recommended in the related literature, including the EDQM guideline. The control reliability is dependent of the sampling. However, a correct sampling methodology seems not to be systematically applied. Commonly, the sampling is intended to comply uniquely with the 1% specification to the produced blood components. Nevertheless, on a purely statistical viewpoint, this model could be argued not to be related to a consistent sampling technique. This could be a severe limitation to detect abnormal patterns and to assure that the production has a non-significant probability of producing nonconforming components. This article discusses what is happening in blood establishments. Three statistical methodologies are proposed: simple random sampling, sampling based on the proportion of a finite population, and sampling based on the inspection level. The empirical results demonstrate that these models are practicable in blood establishments contributing to the robustness of sampling and related statistical process control decisions for the purpose they are suggested for. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Unspoken phenomena: using the photovoice method to enrich phenomenological inquiry.

    PubMed

    Plunkett, Robyn; Leipert, Beverly D; Ray, Susan L

    2013-06-01

    Photovoice is a powerful method that is gaining momentum in nursing research. As a relatively new method in nursing science, the situatedness of photovoice within or alongside various research methodologies in a single study remains in a stage of early development. The purpose of this paper is to discuss the photovoice method as a means to elicit phenomenological data when researching the lived experience. While the foundational bases of phenomenology and photovoice differ substantially, the argument presented in this paper suggests that the photovoice method can be successfully used in phenomenological inquiry provided that significant rigour checks are pursued. This includes reflecting upon the origins and understandings of both methodology and method to promote methodological congruency. Data collection and analysis approaches that contribute to phenomenological inquiry using the photovoice method in addition to rigour and ethical considerations are discussed. The use of data generated from photovoice in phenomenological inquiry may fill a void of understanding furnished by limitations of traditional phenomenological inquiry and of spoken language and can enhance understanding of the lived experience, which may not always be best understood by words alone. © 2012 John Wiley & Sons Ltd.

  17. Bacterial Production of Site Specific 13C Labeled Phenylalanine and Methodology for High Level Incorporation into Bacterially Expressed Recombinant Proteins

    PubMed Central

    Ramaraju, Bhargavi; McFeeters, Hana; Vogler, Bernhard; McFeeters, Robert L.

    2016-01-01

    Nuclear magnetic resonance spectroscopy studies of ever larger systems have benefited from many different forms of isotope labeling, in particular, site specific isotopic labeling. Site specific 13C labeling of methyl groups has become an established means of probing systems not amenable to traditional methodology. However useful, methyl reporter sites can be limited in number and/or location. Therefore, new complementary site specific isotope labeling strategies are valuable. Aromatic amino acids make excellent probes since they are often found at important interaction interfaces and play significant structural roles. Aromatic side chains have many of the same advantages as methyl containing amino acids including distinct 13C chemical shifts and multiple magnetically equivalent 1H positions. Herein we report economical bacterial production and one-step purification of phenylalanine with 13C incorporation at the Cα, Cγ and Cε positions, resulting in two isolated 1H-13C spin systems. We also present methodology to maximize incorporation of phenylalanine into recombinantly overexpressed proteins in bacteria and demonstrate compatibility with ILV-methyl labeling. Inexpensive, site specific isotope labeled phenylalanine adds another dimension to biomolecular NMR, opening new avenues of study. PMID:28028744

  18. Is Hyperbaric Oxygen Therapy Effective for Traumatic Brain Injury? A Rapid Evidence Assessment of the Literature and Recommendations for the Field.

    PubMed

    Crawford, Cindy; Teo, Lynn; Yang, EunMee; Isbister, Caitlin; Berry, Kevin

    This systematic review examines the efficacy of hyperbaric oxygen (HBO2) for traumatic brain injury (TBI) to make evidence-based recommendations for its application and future research. A comprehensive search was conducted to identify studies through 2014. Methodological quality was assessed and synthesis and interpretation of relevant data was performed. Twelve randomized trials were included. All mild TBI studies demonstrated minimal bias and no statistically significant differences between HBO2 and sham arms. Statistically significant improvement occurred over time within both groups. Moderate-to-severe TBI studies were of mixed quality, with majority of results favoring HBO2 compared with "standard care." The placebo analysis conducted was limited by lack of details. For mild TBI, results indicate HBO2 is no better than sham treatment. Improvements within both HBO2 and sham groups cannot be ignored. For acute treatment of moderate-to-severe TBI, although methodology appears flawed across some studies, because of the complexity of brain injury, HBO2 may be beneficial as a relatively safe adjunctive therapy if feasible. Further research should be considered to resolve the controversy surrounding this field, but only if methodological flaws are avoided and bias minimized.

  19. Structural computational modeling of RNA aptamers.

    PubMed

    Xu, Xiaojun; Dickey, David D; Chen, Shi-Jie; Giangrande, Paloma H

    2016-07-01

    RNA aptamers represent an emerging class of biologics that can be easily adapted for personalized and precision medicine. Several therapeutic aptamers with desirable binding and functional properties have been developed and evaluated in preclinical studies over the past 25years. However, for the majority of these aptamers, their clinical potential has yet to be realized. A significant hurdle to the clinical adoption of this novel class of biologicals is the limited information on their secondary and tertiary structure. Knowledge of the RNA's structure would greatly facilitate and expedite the post-selection optimization steps required for translation, including truncation (to reduce costs of manufacturing), chemical modification (to enhance stability and improve safety) and chemical conjugation (to improve drug properties for combinatorial therapy). Here we describe a structural computational modeling methodology that when coupled to a standard functional assay, can be used to determine key sequence and structural motifs of an RNA aptamer. We applied this methodology to enable the truncation of an aptamer to prostate specific membrane antigen (PSMA) with great potential for targeted therapy that had failed previous truncation attempts. This methodology can be easily applied to optimize other aptamers with therapeutic potential. Copyright © 2016. Published by Elsevier Inc.

  20. The clinico-radiological paradox of cognitive function and MRI burden of white matter lesions in people with multiple sclerosis: A systematic review and meta-analysis.

    PubMed

    Mollison, Daisy; Sellar, Robin; Bastin, Mark; Mollison, Denis; Chandran, Siddharthan; Wardlaw, Joanna; Connick, Peter

    2017-01-01

    Moderate correlation exists between the imaging quantification of brain white matter lesions and cognitive performance in people with multiple sclerosis (MS). This may reflect the greater importance of other features, including subvisible pathology, or methodological limitations of the primary literature. To summarise the cognitive clinico-radiological paradox and explore the potential methodological factors that could influence the assessment of this relationship. Systematic review and meta-analysis of primary research relating cognitive function to white matter lesion burden. Fifty papers met eligibility criteria for review, and meta-analysis of overall results was possible in thirty-two (2050 participants). Aggregate correlation between cognition and T2 lesion burden was r = -0.30 (95% confidence interval: -0.34, -0.26). Wide methodological variability was seen, particularly related to key factors in the cognitive data capture and image analysis techniques. Resolving the persistent clinico-radiological paradox will likely require simultaneous evaluation of multiple components of the complex pathology using optimum measurement techniques for both cognitive and MRI feature quantification. We recommend a consensus initiative to support common standards for image analysis in MS, enabling benchmarking while also supporting ongoing innovation.

  1. a Simple Spatially Weighted Measure of Temporal Stability for Data with Limited Temporal Observations

    NASA Astrophysics Data System (ADS)

    Piburn, J.; Stewart, R.; Morton, A.

    2017-10-01

    Identifying erratic or unstable time-series is an area of interest to many fields. Recently, there have been successful developments towards this goal. These new developed methodologies however come from domains where it is typical to have several thousand or more temporal observations. This creates a challenge when attempting to apply these methodologies to time-series with much fewer temporal observations such as for socio-cultural understanding, a domain where a typical time series of interest might only consist of 20-30 annual observations. Most existing methodologies simply cannot say anything interesting with so few data points, yet researchers are still tasked to work within in the confines of the data. Recently a method for characterizing instability in a time series with limitedtemporal observations was published. This method, Attribute Stability Index (ASI), uses an approximate entropy based method tocharacterize a time series' instability. In this paper we propose an explicitly spatially weighted extension of the Attribute StabilityIndex. By including a mechanism to account for spatial autocorrelation, this work represents a novel approach for the characterizationof space-time instability. As a case study we explore national youth male unemployment across the world from 1991-2014.

  2. A Systematic Narrative Review of Effects of Community-Based Intervention on Rates of Organ Donor Registration.

    PubMed

    Golding, Sarah Elizabeth; Cropley, Mark

    2017-09-01

    The demand for organ donation is increasing worldwide. One possible way of increasing the pool of potential posthumous donors is to encourage more members of the general public to join an organ donor registry. A systematic review was conducted to investigate the effectiveness of psychological interventions designed to increase the number of individuals in the community who register as organ donors. PsycINFO and PubMed databases were searched. No date limits were set. Randomized and nonrandomized controlled trials exploring the effects of community-based interventions on organ donor registration rates were included. Methodological quality was assessed using the "Quality Assessment Tool for Quantitative Studies." Twenty-four studies met the inclusion criteria; 19 studies found a positive intervention effect on registration. Only 8 studies were assessed as having reasonable methodological robustness. A narrative synthesis was conducted. Factors influencing registration rates include providing an immediate registration opportunity and using brief interventions to challenge misconceptions and concerns about organ donation. Community-based interventions can be effective at increasing organ donor registrations among the general public. Factors that may increase effectiveness include brief interventions to address concerns and providing an immediate registration opportunity. Particular consideration should be paid to the fidelity of intervention delivery. Protocol registration number: CRD42014012975.

  3. Knowledge translation tools for parents on child health topics: a scoping review.

    PubMed

    Albrecht, Lauren; Scott, Shannon D; Hartling, Lisa

    2017-09-29

    An emerging field of knowledge translation (KT) research has begun to focus on health consumers, particularly in child health. KT tools provide health consumers with research knowledge to inform health decision-making and may foster 'effective consumers'. Thus, the purpose of this scoping review was to describe the state of the field of previously published effectiveness research on child health-related KT tools for parents/caregivers to understand the evidence-base, identify gaps, and guide future research efforts. A health research librarian developed and implemented search strategies in 8 databases. One reviewer conducted screening using pre-determined criteria. A second reviewer verified 10% of screening decisions. Data extraction was performed by one reviewer. A descriptive analysis was conducted and included patient-important outcome classification, WIDER Recommendation checklist, and methodological quality assessment. Seven thousand nine hundred fifty two independent titles and abstracts were reviewed, 2267 full-text studies were retrieved and reviewed, and 18 articles were included in the final data set. A variety of KT tools, including single- (n = 10) and multi-component tools (n = 10), were evaluated spanning acute (n = 4), chronic (n = 5) and public/population health (n = 9) child health topics. Study designs included: cross-sectional (n = 4), before-after (n = 1), controlled before-after (n = 2), cohort (n = 1), and RCTs (n = 10). The KT tools were evaluated via single primary outcome category (n = 11) and multiple primary outcome categories (n = 7). Two studies demonstrated significant positive effects on primary outcome categories; the remaining studies demonstrated mixed effects (n = 9) and no effect (n = 3). Overall, methodological quality was poor; studies lacked a priori protocols (n = 18) and sample size calculations (n = 13). Overall, intervention reporting was also poor; KT tools lacked description of theoretical underpinnings (n = 14), end-user engagement (n = 13), and preliminary research (n = 9) to inform the current effectiveness evaluation. A number of child health-related knowledge translation tools have been developed for parents/caregivers. However, numerous outcomes were used to assess impact and there is limited evidence demonstrating their effectiveness. Moreover, the methodological rigor and reporting of effectiveness studies is limited. Careful tool development involving end-users and preliminary research, including usability testing and mixed methods, prior to large-scale studies may be important to advance the science of KT for health consumers.

  4. A systematic review of methodology applied during preclinical anesthetic neurotoxicity studies: important issues and lessons relevant to the design of future clinical research.

    PubMed

    Disma, Nicola; Mondardini, Maria C; Terrando, Niccolò; Absalom, Anthony R; Bilotta, Federico

    2016-01-01

    Preclinical evidence suggests that anesthetic agents harm the developing brain thereby causing long-term neurocognitive impairments. It is not clear if these findings apply to humans, and retrospective epidemiological studies thus far have failed to show definitive evidence that anesthetic agents are harmful to the developing human brain. The aim of this systematic review was to summarize the preclinical studies published over the past decade, with a focus on methodological issues, to facilitate the comparison between different preclinical studies and inform better design of future trials. The literature search identified 941 articles related to the topic of neurotoxicity. As the primary aim of this systematic review was to compare methodologies applied in animal studies to inform future trials, we excluded a priori all articles focused on putative mechanism of neurotoxicity and the neuroprotective agents. Forty-seven preclinical studies were finally included in this review. Methods used in these studies were highly heterogeneous-animals were exposed to anesthetic agents at different developmental stages, in various doses and in various combinations with other drugs, and overall showed diverse toxicity profiles. Physiological monitoring and maintenance of physiological homeostasis was variable and the use of cognitive tests was generally limited to assessment of specific brain areas, with restricted translational relevance to humans. Comparison between studies is thus complicated by this heterogeneous methodology and the relevance of the combined body of literature to humans remains uncertain. Future preclinical studies should use better standardized methodologies to facilitate transferability of findings from preclinical into clinical science. © 2015 John Wiley & Sons Ltd.

  5. Analysis of 100 pharmaceuticals and their degradates in water samples by liquid chromatography/quadrupole time-of-flight mass spectrometry.

    PubMed

    Ferrer, Imma; Thurman, E Michael

    2012-10-12

    A straightforward methodology for the chromatographic separation and accurate mass identification of 100 pharmaceuticals including some of their degradation products was developed using liquid chromatography/quadrupole time-of-flight mass spectrometry (LC/Q-TOF-MS). A table compiling the protonated or deprotonated exact masses for all compounds, as well as the exact mass of several fragment ions obtained by MS-MS is included. Excellent chromatographic separation was achieved by using 3.5 μm particle size columns and a slow and generic 30-min gradient. Isobaric and isomeric compounds (same nominal mass and same exact mass, respectively) were distinguished by various methods, including chromatography separation, MS-MS fragmentation, and isotopic signal identification. Method reporting limits of detection ranged from 1 to 1000 ng/L, after solid-phase extraction of 100mL aqueous samples. The methodology was successfully applied to the analysis of surface water impacted by wastewater effluent by identifying many of the pharmaceuticals and metabolites included in the list. Examples are given for some of the most unusual findings in environmental samples. This paper is meant to serve as a guide for those doing analysis of pharmaceuticals in environmental samples, by providing exact mass measurements of several well known, as well as newly identified and environmentally relevant pharmaceuticals in water samples. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Effectiveness of interventions to reduce ordering of thyroid function tests: a systematic review.

    PubMed

    Zhelev, Zhivko; Abbott, Rebecca; Rogers, Morwenna; Fleming, Simon; Patterson, Anthea; Hamilton, William Trevor; Heaton, Janet; Thompson Coon, Jo; Vaidya, Bijay; Hyde, Christopher

    2016-06-03

    To evaluate the effectiveness of behaviour changing interventions targeting ordering of thyroid function tests. Systematic review. MEDLINE, EMBASE and the Cochrane Database up to May 2015. We included studies evaluating the effectiveness of behaviour change interventions aiming to reduce ordering of thyroid function tests. Randomised controlled trials (RCTs), non-randomised controlled studies and before and after studies were included. There were no language restrictions. 2 reviewers independently screened all records identified by the electronic searches and reviewed the full text of any deemed potentially relevant. Study details were extracted from the included papers and their methodological quality assessed independently using a validated tool. Disagreements were resolved through discussion and arbitration by a third reviewer. Meta-analysis was not used. 27 studies (28 papers) were included. They evaluated a range of interventions including guidelines/protocols, changes to funding policy, education, decision aids, reminders and audit/feedback; often intervention types were combined. The most common outcome measured was the rate of test ordering, but the effect on appropriateness, test ordering patterns and cost were also measured. 4 studies were RCTs. The majority of the studies were of poor or moderate methodological quality. The interventions were variable and poorly reported. Only 4 studies reported unsuccessful interventions but there was no clear pattern to link effect and intervention type or other characteristics. The results suggest that behaviour change interventions are effective particularly in reducing the volume of thyroid function tests. However, due to the poor methodological quality and reporting of the studies, the likely presence of publication bias and the questionable relevance of some interventions to current day practice, we are unable to draw strong conclusions or recommend the implementation of specific intervention types. Further research is thus justified. CRD42014006192. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Accessible Home Environments for People with Functional Limitations: A Systematic Review.

    PubMed

    Cho, Hea Young; MacLachlan, Malcolm; Clarke, Michael; Mannan, Hasheem

    2016-08-17

    The aim of this review is to evaluate the health and social effects of accessible home environments for people with functional limitations, in order to provide evidence to promote well-informed decision making for policy guideline development and choices about public health interventions. MEDLINE and nine other electronic databases were searched between December 2014 and January 2015, for articles published since 2004. All study types were included in this review. Two reviewers independently screened 12,544 record titles or titles and abstracts based on our pre-defined eligibility criteria. We identified 94 articles as potentially eligible; and assessed their full text. Included studies were critically appraised using the Mixed Method Appraisal Tool, version 2011. Fourteen studies were included in the review. We did not identify any meta-analysis or systematic review directly relevant to the question for this systematic review. A narrative approach was used to synthesise the findings of the included studies due to methodological and statistical heterogeneity. Results suggest that certain interventions to enhance the accessibility of homes can have positive health and social effects. Home environments that lack accessibility modifications appropriate to the needs of their users are likely to result in people with physical impairments becoming disabled at home.

  8. Systematic Review of the Use of Online Questionnaires among the Geriatric Population

    PubMed Central

    Remillard, Meegan L.; Mazor, Kathleen M.; Cutrona, Sarah L.; Gurwitz, Jerry H.; Tjia, Jennifer

    2014-01-01

    Background/Objectives The use of internet-based questionnaires to collect information from older adults is not well established. This systematic literature review of studies using online questionnaires in older adult populations aims to 1. describe methodologic approaches to population targeting and sampling and 2. summarize limitations of Internet-based questionnaires in geriatric populations. Design, Setting, Participants We identified English language articles using search terms for geriatric, age 65 and over, Internet survey, online survey, Internet questionnaire, and online questionnaire in PubMed and EBSCO host between 1984 and July 2012. Inclusion criteria were: study population mean age ≥65 years old and use of an online questionnaire for research. Review of 336 abstracts yielded 14 articles for full review by 2 investigators; 11 articles met inclusion criteria. Measurements Articles were extracted for study design and setting, patient characteristics, recruitment strategy, country, and study limitations. Results Eleven (11) articles were published after 2001. Studies had populations with a mean age of 65 to 78 years, included descriptive and analytical designs, and were conducted in the United States, Australia, and Japan. Recruiting methods varied widely from paper fliers and personal emails to use of consumer marketing panels. Investigator-reported study limitations included the use of small convenience samples and limited generalizability. Conclusion Online questionnaires are a feasible method of surveying older adults in some geographic regions and for some subsets of older adults, but limited Internet access constrains recruiting methods and often limits study generalizability. PMID:24635138

  9. Progress in evidence-based medicine: a quarter century on.

    PubMed

    Djulbegovic, Benjamin; Guyatt, Gordon H

    2017-07-22

    In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making. In another progress, EBM incorporated and further developed the science of producing trustworthy clinical practice guidelines pioneered by investigators in the 1980s. EBM's enduring contributions to clinical medicine include placing the practice of medicine on a solid scientific basis, the development of more sophisticated hierarchies of evidence, the recognition of the crucial role of patient values and preferences in clinical decision making, and the development of the methodology for generating trustworthy recommendations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Particle-based modeling of heterogeneous chemical kinetics including mass transfer.

    PubMed

    Sengar, A; Kuipers, J A M; van Santen, Rutger A; Padding, J T

    2017-08-01

    Connecting the macroscopic world of continuous fields to the microscopic world of discrete molecular events is important for understanding several phenomena occurring at physical boundaries of systems. An important example is heterogeneous catalysis, where reactions take place at active surfaces, but the effective reaction rates are determined by transport limitations in the bulk fluid and reaction limitations on the catalyst surface. In this work we study the macro-micro connection in a model heterogeneous catalytic reactor by means of stochastic rotation dynamics. The model is able to resolve the convective and diffusive interplay between participating species, while including adsorption, desorption, and reaction processes on the catalytic surface. Here we apply the simulation methodology to a simple straight microchannel with a catalytic strip. Dimensionless Damkohler numbers are used to comment on the spatial concentration profiles of reactants and products near the catalyst strip and in the bulk. We end the discussion with an outlook on more complicated geometries and increasingly complex reactions.

  11. Particle-based modeling of heterogeneous chemical kinetics including mass transfer

    NASA Astrophysics Data System (ADS)

    Sengar, A.; Kuipers, J. A. M.; van Santen, Rutger A.; Padding, J. T.

    2017-08-01

    Connecting the macroscopic world of continuous fields to the microscopic world of discrete molecular events is important for understanding several phenomena occurring at physical boundaries of systems. An important example is heterogeneous catalysis, where reactions take place at active surfaces, but the effective reaction rates are determined by transport limitations in the bulk fluid and reaction limitations on the catalyst surface. In this work we study the macro-micro connection in a model heterogeneous catalytic reactor by means of stochastic rotation dynamics. The model is able to resolve the convective and diffusive interplay between participating species, while including adsorption, desorption, and reaction processes on the catalytic surface. Here we apply the simulation methodology to a simple straight microchannel with a catalytic strip. Dimensionless Damkohler numbers are used to comment on the spatial concentration profiles of reactants and products near the catalyst strip and in the bulk. We end the discussion with an outlook on more complicated geometries and increasingly complex reactions.

  12. Characterization of Combustion Dynamics, Detection, and Prevention of an Unstable Combustion State Based on a Complex-Network Theory

    NASA Astrophysics Data System (ADS)

    Gotoda, Hiroshi; Kinugawa, Hikaru; Tsujimoto, Ryosuke; Domen, Shohei; Okuno, Yuta

    2017-04-01

    Complex-network theory has attracted considerable attention for nearly a decade, and it enables us to encompass our understanding of nonlinear dynamics in complex systems in a wide range of fields, including applied physics and mechanical, chemical, and electrical engineering. We conduct an experimental study using a pragmatic online detection methodology based on complex-network theory to prevent a limiting unstable state such as blowout in a confined turbulent combustion system. This study introduces a modified version of the natural visibility algorithm based on the idea of a visibility limit to serve as a pragmatic online detector. The average degree of the modified version of the natural visibility graph allows us to detect the onset of blowout, resulting in online prevention.

  13. Flutter, Postflutter, and Control of a Supersonic Wing Section

    NASA Technical Reports Server (NTRS)

    Marzocca, Piergiovanni; Librescu, Liviu; Silva, Walter A.

    2002-01-01

    A number of issues related to the flutter and postflutter of two-dimensional supersonic lifting surfaces are addressed. Among them there are the 1) investigation of the implications of the nonlinear unsteady aerodynamics and structural nonlinearities on the stable/unstable character of the limit cycle and 2) study of the implications of the incorporation of a control capability on both the flutter boundary and the postflutter behavior. To this end, a powerful methodology based on the Lyapunov first quantity is implemented. Such a treatment of the problem enables one to get a better understanding of the various factors involved in the nonlinear aeroelastic problem, including the stable and unstable limit cycle. In addition, it constitutes a first step toward a more general investigation of nonlinear aeroelastic phenomena of three-dimensional lifting surfaces.

  14. Tests for the Assessment of Sport-Specific Performance in Olympic Combat Sports: A Systematic Review With Practical Recommendations.

    PubMed

    Chaabene, Helmi; Negra, Yassine; Bouguezzi, Raja; Capranica, Laura; Franchini, Emerson; Prieske, Olaf; Hbacha, Hamdi; Granacher, Urs

    2018-01-01

    The regular monitoring of physical fitness and sport-specific performance is important in elite sports to increase the likelihood of success in competition. This study aimed to systematically review and to critically appraise the methodological quality, validation data, and feasibility of the sport-specific performance assessment in Olympic combat sports like amateur boxing, fencing, judo, karate, taekwondo, and wrestling. A systematic search was conducted in the electronic databases PubMed, Google-Scholar, and Science-Direct up to October 2017. Studies in combat sports were included that reported validation data (e.g., reliability, validity, sensitivity) of sport-specific tests. Overall, 39 studies were eligible for inclusion in this review. The majority of studies (74%) contained sample sizes <30 subjects. Nearly, 1/3 of the reviewed studies lacked a sufficient description (e.g., anthropometrics, age, expertise level) of the included participants. Seventy-two percent of studies did not sufficiently report inclusion/exclusion criteria of their participants. In 62% of the included studies, the description and/or inclusion of a familiarization session (s) was either incomplete or not existent. Sixty-percent of studies did not report any details about the stability of testing conditions. Approximately half of the studies examined reliability measures of the included sport-specific tests (intraclass correlation coefficient [ICC] = 0.43-1.00). Content validity was addressed in all included studies, criterion validity (only the concurrent aspect of it) in approximately half of the studies with correlation coefficients ranging from r = -0.41 to 0.90. Construct validity was reported in 31% of the included studies and predictive validity in only one. Test sensitivity was addressed in 13% of the included studies. The majority of studies (64%) ignored and/or provided incomplete information on test feasibility and methodological limitations of the sport-specific test. In 28% of the included studies, insufficient information or a complete lack of information was provided in the respective field of the test application. Several methodological gaps exist in studies that used sport-specific performance tests in Olympic combat sports. Additional research should adopt more rigorous validation procedures in the application and description of sport-specific performance tests in Olympic combat sports.

  15. Brain Structural Effects of Psychopharmacological Treatment in Bipolar Disorder

    PubMed Central

    McDonald, Colm

    2015-01-01

    Bipolar disorder is associated with subtle neuroanatomical deficits including lateral ventricular enlargement, grey matter deficits incorporating limbic system structures, and distributed white matter pathophysiology. Substantial heterogeneity has been identified by structural neuroimaging studies to date and differential psychotropic medication use is potentially a substantial contributor to this. This selective review of structural neuroimaging and diffusion tensor imaging studies considers evidence that lithium, mood stabilisers, antipsychotic medication and antidepressant medications are associated with neuroanatomical variation. Most studies are negative and suffer from methodological weaknesses in terms of directly assessing medication effects on neuroanatomy, since they commonly comprise posthoc assessments of medication associations with neuroimaging metrics in small heterogenous patient groups. However the studies which report positive findings tend to form a relatively consistent picture whereby lithium and antiepileptic mood stabiliser use is associated with increased regional grey matter volume, especially in limbic structures. These findings are further supported by the more methodologically robust studies which include large numbers of patients or repeated intra-individual scanning in longitudinal designs. Some similar findings of an apparently ameliorative effect of lithium on white matter microstructure are also emerging. There is less support for an effect of antipsychotic or antidepressant medication on brain structure in bipolar disorder, but these studies are further limited by methodological difficulties. In general the literature to date supports a normalising effect of lithium and mood stabilisers on brain structure in bipolar disorder, which is consistent with the neuroprotective characteristics of these medications identified by preclinical studies. PMID:26412064

  16. 1H MAS NMR (magic-angle spinning nuclear magnetic resonance) techniques for the quantitative determination of hydrogen types in solid catalysts and supports.

    PubMed

    Kennedy, Gordon J; Afeworki, Mobae; Calabro, David C; Chase, Clarence E; Smiley, Randolph J

    2004-06-01

    Distinct hydrogen species are present in important inorganic solids such as zeolites, silicoaluminophosphates (SAPOs), mesoporous materials, amorphous silicas, and aluminas. These H species include hydrogens associated with acidic sites such as Al(OH)Si, non-framework aluminum sites, silanols, and surface functionalities. Direct and quantitative methodology to identify, measure, and monitor these hydrogen species are key to monitoring catalyst activity, optimizing synthesis conditions, tracking post-synthesis structural modifications, and in the preparation of novel catalytic materials. Many workers have developed several techniques to address these issues, including 1H MAS NMR (magic-angle spinning nuclear magnetic resonance). 1H MAS NMR offers many potential advantages over other techniques, but care is needed in recognizing experimental limitations and developing sample handling and NMR methodology to obtain quantitatively reliable data. A simplified approach is described that permits vacuum dehydration of multiple samples simultaneously and directly in the MAS rotor without the need for epoxy, flame sealing, or extensive glovebox use. We have found that careful optimization of important NMR conditions, such as magnetic field homogeneity and magic angle setting are necessary to acquire quantitative, high-resolution spectra that accurately measure the concentrations of the different hydrogen species present. Details of this 1H MAS NMR methodology with representative applications to zeolites, SAPOs, M41S, and silicas as a function of synthesis conditions and post-synthesis treatments (i.e., steaming, thermal dehydroxylation, and functionalization) are presented.

  17. Brain Structural Effects of Psychopharmacological Treatment in Bipolar Disorder.

    PubMed

    McDonald, Colm

    2015-01-01

    Bipolar disorder is associated with subtle neuroanatomical deficits including lateral ventricular enlargement, grey matter deficits incorporating limbic system structures, and distributed white matter pathophysiology. Substantial heterogeneity has been identified by structural neuroimaging studies to date and differential psychotropic medication use is potentially a substantial contributor to this. This selective review of structural neuroimaging and diffusion tensor imaging studies considers evidence that lithium, mood stabilisers, antipsychotic medication and antidepressant medications are associated with neuroanatomical variation. Most studies are negative and suffer from methodological weaknesses in terms of directly assessing medication effects on neuroanatomy, since they commonly comprise posthoc assessments of medication associations with neuroimaging metrics in small heterogenous patient groups. However the studies which report positive findings tend to form a relatively consistent picture whereby lithium and antiepileptic mood stabiliser use is associated with increased regional grey matter volume, especially in limbic structures. These findings are further supported by the more methodologically robust studies which include large numbers of patients or repeated intra-individual scanning in longitudinal designs. Some similar findings of an apparently ameliorative effect of lithium on white matter microstructure are also emerging. There is less support for an effect of antipsychotic or antidepressant medication on brain structure in bipolar disorder, but these studies are further limited by methodological difficulties. In general the literature to date supports a normalising effect of lithium and mood stabilisers on brain structure in bipolar disorder, which is consistent with the neuroprotective characteristics of these medications identified by preclinical studies.

  18. Adaptation of EVIAVE methodology for monitoring and follow-up when evaluating the environmental impact of landfills

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

    Arrieta, Gabriela, E-mail: tonina1903@hotmail.com; Requena, Ignacio, E-mail: requena@decsai.ugr.es; Toro, Javier, E-mail: jjtoroca@unal.edu.co

    Treatment and final disposal of Municipal Solid Waste can have a significant role in the generation of negative environmental impacts. As a prevention strategy, such activities are subjected to the process of Environmental Impact Assessment (EIA). Still, the follow-up of Environmental Management Plans or mitigation measures is limited, for one due to a lack of methodological approaches. In searching for possibilities, the University of Granada (Spain) developed a diagnostic methodology named EVIAVE, which allows one to quantify, by means of indexes, the environmental impact of landfills in view of their location and the conditions of exploitation. EVIAVE is applicable withinmore » the legal framework of the European Union and can be adapted to the environmental and legal conditions of other countries. This study entails its adaptation in Colombia, for the follow-up and control of the EIA process for landfills. Modifications involved inclusion of the environmental elements flora and fauna, and the evaluation of the environmental descriptors in agreement with the concept of vulnerability. The application of the modified EVIAVE in Colombian landfills allowed us to identify the elements affected by the operating conditions and maintenance. It may be concluded that this methodology is viable and effective for the follow-up and environmental control of EIA processes for landfills, and to analyze the associated risks, as it takes into account related environmental threats and vulnerabilities. - Highlights: • A modified methodology is used to monitor and follow-up environmental impacts in landfills. • The improved methodology includes the Vulnerability of Flora and Fauna to evaluate environmental impact of landfills. • The methodology serves to identify and evaluate the sources of risk generated in the construction and siting of landfills. • Environmental vulnerability indicators improve effectiveness of the control and follow-up phases of landfill management. • The follow-up of environmental management plans may help diminish the implementation gap in Environmental Impact Assessment.« less

  19. Conventional and genetic talent identification in sports: will recent developments trace talent?

    PubMed

    Breitbach, Sarah; Tug, Suzan; Simon, Perikles

    2014-11-01

    The purpose of talent identification (TI) is the earliest possible selection of auspicious athletes with the goal of systematically maximizing their potential. The literature proposes excellent reviews on various facets of talent research on different scientific issues such as sports sciences or genetics. However, the approaches of conventional and genetic testing have only been discussed separately by and for the respective groups of interest. In this article, we combine the discoveries of these disciplines into a single review to provide a comprehensive overview and elucidate the prevailing limitations. Fundamental problems in TI reside in the difficulties of defining the construct ‘talent’ or groups of different performance levels that represent the target variable of testing. Conventional and genetic testing reveal a number of methodological and technical limitations, and parallels are summarised in terms of the test designs, the point in time of testing, psychological skills or traits and unknown interactions between different variables. In conclusion, many deficiencies in the current talent research have gained attention. Alternative solutions include the talent development approach, while genetic testing is re-emphasised as a tool for risk stratification in sport participation. Future research needs to clearly define the group of interest and comprehensively implement all methodological improvement suggestions.

  20. Satellite retrieval of cloud condensation nuclei concentrations by using clouds as CCN chambers

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

    Rosenfeld, Daniel; Zheng, Youtong; Hashimshoni, Eyal

    Quantifying the aerosol/cloud-mediated radiative effect at a global scale requires simultaneous satellite retrievals of cloud condensation nuclei (CCN) concentrations and cloud base updraft velocities ( Wb). Hitherto, the inability to do so has been a major cause of high uncertainty regarding anthropogenic aerosol/cloud-mediated radiative forcing. This can be addressed by the emerging capability of estimating CCN and Wb of boundary layer convective clouds from an operational polar orbiting weather satellite. In this paper, our methodology uses such clouds as an effective analog for CCN chambers. The cloud base supersaturation ( S) is determined by Wb and the satellite-retrieved cloud basemore » drop concentrations ( Ndb), which is the same as CCN(S). Validation against ground-based CCN instruments at Oklahoma, at Manaus, and onboard a ship in the northeast Pacific showed a retrieval accuracy of ±25% to ±30% for individual satellite overpasses. The methodology is presently limited to boundary layer not raining convective clouds of at least 1 km depth that are not obscured by upper layer clouds, including semitransparent cirrus. Finally, the limitation for small solar backscattering angles of <25° restricts the satellite coverage to ~25% of the world area in a single day.« less

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