Development of a researcher codebook for use in evaluating social networking site profiles.

PubMed

Moreno, Megan A; Egan, Katie G; Brockman, Libby

2011-07-01

Social networking sites (SNSs) are immensely popular and allow for the display of personal information, including references to health behaviors. Evaluating displayed content on an SNS for research purposes requires a systematic approach and a precise data collection instrument. The purpose of this article is to describe one approach to the development of a research codebook so that others may develop and test their own codebooks for use in SNS research. Our SNS research codebook began on the basis of health behavior theory and clinical criteria. Key elements in the codebook developmental process included an iterative team approach and an emphasis on confidentiality. Codebook successes include consistently high inter-rater reliability. Challenges include time investment in coder training and SNS server changes. We hope that this article will provide detailed information about one systematic approach to codebook development so that other researchers may use this structure to develop and test their own codebooks for use in SNS research. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Challenges in systematic reviews: synthesis of topics related to the delivery, organization, and financing of health care.

PubMed

Bravata, Dena M; McDonald, Kathryn M; Shojania, Kaveh G; Sundaram, Vandana; Owens, Douglas K

2005-06-21

Some important health policy topics, such as those related to the delivery, organization, and financing of health care, present substantial challenges to established methods for evidence synthesis. For example, such reviews may ask: What is the effect of for-profit versus not-for-profit delivery of care on patient outcomes? Or, which strategies are the most effective for promoting preventive care? This paper describes innovative methods for synthesizing evidence related to the delivery, organization, and financing of health care. We found 13 systematic reviews on these topics that described novel methodologic approaches. Several of these syntheses used 3 approaches: conceptual frameworks to inform problem formulation, systematic searches that included nontraditional literature sources, and hybrid synthesis methods that included simulations to address key gaps in the literature. As the primary literature on these topics expands, so will opportunities to develop additional novel methods for performing high-quality comprehensive syntheses.

How have systematic priority setting approaches influenced policy making? A synthesis of the current literature.

PubMed

Kapiriri, Lydia; Razavi, Donya

2017-09-01

There is a growing body of literature on systematic approaches to healthcare priority setting from various countries and different levels of decision making. This paper synthesizes the current literature in order to assess the extent to which program budgeting and marginal analysis (PBMA), burden of disease & cost-effectiveness analysis (BOD/CEA), multi-criteria decision analysis (MCDA), and accountability for reasonableness (A4R), are reported to have been institutionalized and influenced policy making and practice. We searched for English language publications on health care priority setting approaches (2000-2017). Our sources of literature included PubMed and Ovid databases (including Embase, Global Health, Medline, PsycINFO, EconLit). Of the four approaches PBMA and A4R were commonly applied in high income countries while BOD/CEA was exclusively applied in low income countries. PBMA and BOD/CEA were most commonly reported to have influenced policy making. The explanations for limited adoption of an approach were related to its complexity, poor policy maker understanding and resource requirements. While systematic approaches have the potential to improve healthcare priority setting; most have not been adopted in routine policy making. The identified barriers call for sustained knowledge exchange between researchers and policy-makers and development of practical guidelines to ensure that these frameworks are more accessible, applicable and sustainable in informing policy making. Copyright © 2017 Elsevier B.V. All rights reserved.

Environmental Study Plan for the Trinity River Basin, Texas

DTIC Science & Technology

1972-01-01

with the requirements of NEPA, as specified In Sec. 102. These requirements Include the utilization of "a systematic, interdisciplinary approach which...and making updated completion projections is therefore included (Appendix F). B. Basic approach of the proposed study. The proposed study is divided...different from the customary approach utilized by many research specialists. Some of these differences are discussed below. I. The study is not intended

Stuttering Treatment Research 1970-2005: I. Systematic Review Incorporating Trial Quality Assessment of Behavioral, Cognitive, and Related Approaches

ERIC Educational Resources Information Center

Bothe, Anne K.; Davidow, Jason H.; Bramlett, Robin E.; Ingham, Roger J.

2006-01-01

Purpose: To complete a systematic review, with trial quality assessment, of published research about behavioral, cognitive, and related treatments for developmental stuttering. Goals included the identification of treatment recommendations and research needs based on the available high-quality evidence about stuttering treatment for preschoolers,…

Behavior Therapy of Impotence

ERIC Educational Resources Information Center

Dengrove, Edward

1971-01-01

Behavior therapy approaches to the treatment of male sexual impotence, specifically premature ejaculation and erective impotence, are discussed. Included in the behavioral therapies are systematic desensitization, active graded therapy, assertive techniques, sexual responses, operant approaches and others. Often marriage counseling is also…

Compliance monitoring in business processes: Functionalities, application, and tool-support.

PubMed

Ly, Linh Thao; Maggi, Fabrizio Maria; Montali, Marco; Rinderle-Ma, Stefanie; van der Aalst, Wil M P

2015-12-01

In recent years, monitoring the compliance of business processes with relevant regulations, constraints, and rules during runtime has evolved as major concern in literature and practice. Monitoring not only refers to continuously observing possible compliance violations, but also includes the ability to provide fine-grained feedback and to predict possible compliance violations in the future. The body of literature on business process compliance is large and approaches specifically addressing process monitoring are hard to identify. Moreover, proper means for the systematic comparison of these approaches are missing. Hence, it is unclear which approaches are suitable for particular scenarios. The goal of this paper is to define a framework for Compliance Monitoring Functionalities (CMF) that enables the systematic comparison of existing and new approaches for monitoring compliance rules over business processes during runtime. To define the scope of the framework, at first, related areas are identified and discussed. The CMFs are harvested based on a systematic literature review and five selected case studies. The appropriateness of the selection of CMFs is demonstrated in two ways: (a) a systematic comparison with pattern-based compliance approaches and (b) a classification of existing compliance monitoring approaches using the CMFs. Moreover, the application of the CMFs is showcased using three existing tools that are applied to two realistic data sets. Overall, the CMF framework provides powerful means to position existing and future compliance monitoring approaches.

Compliance monitoring in business processes: Functionalities, application, and tool-support

PubMed Central

Ly, Linh Thao; Maggi, Fabrizio Maria; Montali, Marco; Rinderle-Ma, Stefanie; van der Aalst, Wil M.P.

2015-01-01

In recent years, monitoring the compliance of business processes with relevant regulations, constraints, and rules during runtime has evolved as major concern in literature and practice. Monitoring not only refers to continuously observing possible compliance violations, but also includes the ability to provide fine-grained feedback and to predict possible compliance violations in the future. The body of literature on business process compliance is large and approaches specifically addressing process monitoring are hard to identify. Moreover, proper means for the systematic comparison of these approaches are missing. Hence, it is unclear which approaches are suitable for particular scenarios. The goal of this paper is to define a framework for Compliance Monitoring Functionalities (CMF) that enables the systematic comparison of existing and new approaches for monitoring compliance rules over business processes during runtime. To define the scope of the framework, at first, related areas are identified and discussed. The CMFs are harvested based on a systematic literature review and five selected case studies. The appropriateness of the selection of CMFs is demonstrated in two ways: (a) a systematic comparison with pattern-based compliance approaches and (b) a classification of existing compliance monitoring approaches using the CMFs. Moreover, the application of the CMFs is showcased using three existing tools that are applied to two realistic data sets. Overall, the CMF framework provides powerful means to position existing and future compliance monitoring approaches. PMID:26635430

Systematic review of systematic reviews for the management of urinary incontinence and promotion of continence using conservative behavioural approaches in older people in care homes.

PubMed

Roe, Brenda; Flanagan, Lisa; Maden, Michelle

2015-07-01

To synthesize evidence from systematic reviews on the management of urinary incontinence and promotion of continence using conservative/behavioural approaches in older people in care homes to inform clinical practice, guidelines and research. Incontinence is highly prevalent in older people in care home populations. Systematic review of systematic reviews with narrative synthesis. Electronic searches of published systematic reviews in English using MEDLINE and CINAHL with no date restrictions up to September 2013. Searches supplemented by hand searching and electronic searching of Cochrane Library and PROSPERO. PRISMA statement was followed, as were established methods for systematic review of systematic reviews. Five systematic reviews of high quality were included, three specific to intervention studies and two reviewed descriptive studies. Urinary incontinence was the primary outcome in three reviews with factors associated with the management of urinary incontinence the primary outcome for the other reviews. Toileting programmes, in particular prompted voiding, with use of incontinence pads are the main conservative behavioural approach for the management of incontinence and promotion of continence in this population with evidence of effectiveness in the short term. Evidence from associated factors; exercise, mobility, comorbidities, hydration, skin care, staff perspectives, policies and older people's experiences and preference are limited. The majority of evidence of effectiveness are from studies from one country which may or may not be transferable to other care home populations. Future international studies are warranted of complex combined interventions using mixed methods to provide evidence of effectiveness, context of implementation and economic evaluation. © 2015 John Wiley & Sons Ltd.

Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.

PubMed

Guise, Jeanne-Marie; Chang, Christine; Viswanathan, Meera; Glick, Susan; Treadwell, Jonathan; Umscheid, Craig A; Whitlock, Evelyn; Fu, Rongwei; Berliner, Elise; Paynter, Robin; Anderson, Johanna; Motu'apuaka, Pua; Trikalinos, Tom

2014-11-01

The purpose of this Agency for Healthcare Research and Quality Evidence-based Practice Center methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. We performed a literature scan and conducted semistructured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions (CMCIs) or organizational leaders who implement CMCIs in health care. Challenges identified include lack of consistent terminology for such interventions (eg, complex, multicomponent, multidimensional, multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from holistic to individual component analytic approaches; and incomplete and inconsistent reporting of elements critical to understanding the success and impact of multicomponent interventions, such as methods used for implementation the context in which interventions are implemented. We provide a framework for the spectrum of conceptual and analytic approaches to synthesizing studies of multicomponent interventions and an initial list of critical reporting elements for such studies. This information is intended to help systematic reviewers understand the options and tradeoffs available for such reviews. Copyright © 2014 Elsevier Inc. All rights reserved.

A Primer on Systematic Reviews and Meta-Analyses.

PubMed

Nguyen, Nghia H; Singh, Siddharth

2018-05-01

With the rapid growth of biomedical literature, there is increasing need to make meaningful inferences from a comprehensive and complex body of evidence. Systematic reviews with or without meta-analyses offer an objective and summative approach to synthesize knowledge and critically appraise evidence to inform clinical practice. Systematic reviews also help identify key knowledge gaps for future investigation. In this review, the authors provide a step-by-step approach to conducting a systematic review. These include: (1) formulating a focused and clinically-relevant question; (2) designing a detailed review protocol with explicit inclusion and exclusion criteria; (3) performing a systematic literature search of multiple databases and unpublished data, in consultation with a medical librarian, to identify relevant studies; (4) meticulous data abstraction by at least two sets of investigators independently; (5) assessing risk of bias in individual studies; (6) quantitative synthesis with meta-analysis; and (7) critically and transparently ascertaining quality of evidence. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

PubMed

Costa, Anderson Adriano Leal Freitas da; Vasconcellos, Igor Martins; Pacheco, Rafael Leite; Bella, Zsuzsanna Ilona Katalin de Jármy Di; Riera, Rachel

2018-01-01

Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP). A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy). The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality) for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

Successful management of Barth syndrome: a systematic review highlighting the importance of a flexible and multidisciplinary approach.

PubMed

Reynolds, Stacey

2015-01-01

This review describes and summarizes the available evidence related to the treatment and management of Barth syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify articles published between December 2004 and January 2015. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach was used to guide the article selection and evaluation process. Of the 128 articles screened, 28 articles matched the systematic review inclusion criteria. The results of this review indicate the need for a flexible and multidisciplinary approach to manage the symptoms most commonly associated with Barth syndrome. It is recommended that a comprehensive care team should include individuals with Barth syndrome, their family members and caregivers, as well as medical, rehabilitative, nutritional, psychological, and educational professionals. The evidence for specific treatments, therapies, and techniques for individuals with Barth syndrome is currently lacking in both quality and quantity.

Triage for action: Systematic assessment and dissemination of construction health and safety research.

PubMed

Baker, Robin; Chang, Charlotte; Bunting, Jessica; Betit, Eileen

2015-08-01

Research translation too often relies on passive methods that fail to reach those who can impact the workplace. The need for better research to practice (r2p) approaches is especially pressing in construction, where a disproportionate number of workers suffer serious injury illness. A triage process was designed and used to systematically review completed research, assess r2p readiness, establish priorities, and launch dissemination follow-up efforts. A mixed quantitative and qualitative approach was used. The process proved effective in ensuring that significant findings and evidence-based solutions are disseminated actively. Key factors emerged in the selection of follow-up priorities, including availability of partners able to reach end users, windows of opportunity, and cross-cutting approaches that can benefit multiple dissemination efforts. Use of a systematic triage process may have an important role to play in building r2p capacity in construction safety and health. © 2015 Wiley Periodicals, Inc.

Integrated Approaches to Occupational Health and Safety: A Systematic Review.

PubMed

Cooklin, A; Joss, N; Husser, E; Oldenburg, B

2017-09-01

The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

Ankle arthrodesis: A systematic approach and review of the literature

PubMed Central

Yasui, Youichi; Hannon, Charles P; Seow, Dexter; Kennedy, John G

2016-01-01

Ankle arthrodesis is a common treatment used for patients with end-stage ankle arthritis (ESAA). The surgical goal of ankle arthrodesis is to obtain bony union between the tibia and talus with adequate alignment [slight valgus (0°-5°)], neutral dorsiflexion, and slight external rotation positions) in order to provide a pain-free plantigrade foot for weightbearing activities. There are many variations in operative technique including deferring approaches (open or arthroscopic) and differing fixation methods (internal or external fixation). Each technique has its advantage and disadvantages. Success of ankle arthrodesis can be dependent on several factors, including patient selection, surgeons’ skills, patient comorbidities, operative care, etc. However, from our experience, the majority of ESAA patients obtain successful clinical outcomes. This review aims to outline the indications and goals of arthrodesis for treatment of ESAA and discuss both open and arthroscopic ankle arthrodesis. A systematic step by step operative technique guide is presented for both the arthroscopic and open approaches including a postoperative protocol. We review the current evidence supporting each approach. The review finishes with a report of the most recent evidence of outcomes after both approaches and concerns regarding the development of hindfoot arthritis. PMID:27900266

Strategies for Effective Learning.

ERIC Educational Resources Information Center

Frierson, Henry T., Jr.

Suggestions are offered for applying learning techniques for a variety of learning situations. The approaches are applicable to learning medical school content as well as other advanced educational content. Ways to control external distractors are suggested, including a systematic approach to completing large tasks, such as writing a research…

Technical Training: A Systematic Approach.

ERIC Educational Resources Information Center

Gammuto, John J.

1980-01-01

To employ scarce personnel and money to best advantage, company management must diagnose critical training needs and assign them priorities. A systems approach is recommended, which gives focus to training design while accommodating most organization training goals. Included are suggestions for system design, facility management, and cost…

Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: an illustrated guide

PubMed Central

2013-01-01

Background Healthcare delivery is largely accomplished in and through conversations between people, and healthcare quality and effectiveness depend enormously upon the communication practices employed within these conversations. An important body of evidence about these practices has been generated by conversation analysis and related discourse analytic approaches, but there has been very little systematic reviewing of this evidence. Methods We developed an approach to reviewing evidence from conversation analytic and related discursive research through the following procedures: • reviewing existing systematic review methods and our own prior experience of applying these • clarifying distinctive features of conversation analytic and related discursive work which must be taken into account when reviewing • holding discussions within a review advisory team that included members with expertise in healthcare research, conversation analytic research, and systematic reviewing • attempting and then refining procedures through conducting an actual review which examined evidence about how people talk about difficult future issues including illness progression and dying Results We produced a step-by-step guide which we describe here in terms of eight stages, and which we illustrate from our ‘Review of Future Talk’. The guide incorporates both established procedures for systematic reviewing, and new techniques designed for working with conversation analytic evidence. Conclusions The guide is designed to inform systematic reviews of conversation analytic and related discursive evidence on specific domains and topics. Whilst we designed it for reviews that aim at informing healthcare practice and policy, it is flexible and could be used for reviews with other aims, for instance those aiming to underpin research programmes and projects. We advocate systematically reviewing conversation analytic and related discursive findings using this approach in order to translate them into a form that is credible and useful to healthcare practitioners, educators and policy-makers. PMID:23721181

Stakeholder involvement in systematic reviews: a protocol for a systematic review of methods, outcomes and effects.

PubMed

Pollock, Alex; Campbell, Pauline; Struthers, Caroline; Synnot, Anneliese; Nunn, Jack; Hill, Sophie; Goodare, Heather; Watts, Chris; Morley, Richard

2017-01-01

Researchers are expected to actively involve stakeholders (including patients, the public, health professionals, and others) in their research. Although researchers increasingly recognise that this is good practice, there is limited practical guidance about how to involve stakeholders. Systematic reviews are a research method in which international literature is brought together, using carefully designed and rigorous methods to answer a specified question about healthcare. We want to investigate how researchers have involved stakeholders in systematic reviews, and how involvement has potentially affected the quality and impact of reviews. We plan to bring this information together by searching and reviewing the literature for reports of stakeholder involvement in systematic reviews. This paper describes in detail the methods that we plan to use to do this. After carrying out comprehensive searches for literature, we will: 1. Provide an overview of identified reports, describing key information such as types of stakeholders involved, and how. 2. Pick out reports of involvement which include detailed descriptions of how researchers involved people in a systematic review and summarise the methods they used. We will consider who was involved, how people were recruited, and how the involvement was organised and managed. 3. Bring together any reports which have explored the effect, or impact, of involving stakeholders in a systematic review. We will assess the quality of these reports, and summarise their findings. Once completed, our review will be used to produce training resources aimed at helping researchers to improve ways of involving stakeholders in systematic reviews. Background There is an expectation for stakeholders (including patients, the public, health professionals, and others) to be involved in research. Researchers are increasingly recognising that it is good practice to involve stakeholders in systematic reviews. There is currently a lack of evidence about (A) how to do this and (B) the effects, or impact, of such involvement. We aim to create a map of the evidence relating to stakeholder involvement in systematic reviews, and use this evidence to address the two points above. Methods We will complete a mixed-method synthesis of the evidence, first completing a scoping review to create a broad map of evidence relating to stakeholder involvement in systematic reviews, and secondly completing two contingent syntheses. We will use a stepwise approach to searching; the initial step will include comprehensive searches of electronic databases, including CENTRAL, AMED, Embase, Medline, Cinahl and other databases, supplemented with pre-defined hand-searching and contacting authors. Two reviewers will undertake each review task (i.e., screening, data extraction) using standard systematic review processes. For the scoping review, we will include any paper, regardless of publication status or study design, which investigates, reports or discusses involvement in a systematic review. Included papers will be summarised within structured tables. Criteria for judging the focus and comprehensiveness of the description of methods of involvement will be applied, informing which papers are included within the two contingent syntheses. Synthesis A will detail the methods that have been used to involve stakeholders in systematic reviews. Papers from the scoping review that are judged to provide an adequate description of methods or approaches will be included. Details of the methods of involvement will be extracted from included papers using pre-defined headings, presented in tables and described narratively. Synthesis B will include studies that explore the effect of stakeholder involvement on the quality, relevance or impact of a systematic review, as identified from the scoping review. Study quality will be appraised, data extracted and synthesised within tables. Discussion This review should help researchers select, improve and evaluate methods of involving stakeholders in systematic reviews. Review findings will contribute to Cochrane training resources.

Reduction of Family Violence in Aboriginal Communities: A Systematic Review of Interventions and Approaches1

PubMed Central

Shea, Beverley; Nahwegahbow, Amy; Andersson, Neil

2010-01-01

Many efforts to reduce family violence are documented in the published literature. We conducted a systematic review of interventions intended to prevent family violence in Aboriginal communities. We retrieved studies published up to October 2009; 506 papers included one systematic review, two randomized controlled trials, and fourteen nonrandomized studies or reviews. Two reviews discussed interventions relevant to primary prevention (reducing the risk factors for family violence), including parenting, role modelling, and active participation. More studies addressed secondary prevention (where risk factors exist, reducing outbreaks of violence) such as restriction on the trading hours for take away alcohol and home visiting programs for high risk families. Examples of tertiary prevention (preventing recurrence) include traditional healing circles and group counselling. Most studies contributed a low level of evidence. PMID:21052554

Treatment of Selective Mutism: A Best-Evidence Synthesis.

ERIC Educational Resources Information Center

Stone, Beth Pionek; Kratochwill, Thomas R.; Sladezcek, Ingrid; Serlin, Ronald C.

2002-01-01

Presents systematic analysis of the major treatment approaches used for selective mutism. Based on nonparametric statistical tests of effect sizes, major findings include the following: treatment of selective mutism is more effective than no treatment; behaviorally oriented treatment approaches are more effective than no treatment; and no…

An overview of SAE ARP 1587: Aircraft gas turbine engine monitoring system guide

NASA Technical Reports Server (NTRS)

Murphy, J. A.

1981-01-01

A systematic approach to developing an engine monitoring system (EMS) is outlined. An extensive shopping list of EMS capabilities and benefits are included. A team approach to developing an EMS is emphasized with a description of the responsibilities of each team member.

Conceptualising paediatric health disparities: a metanarrative systematic review and unified conceptual framework.

PubMed

Ridgeway, Jennifer L; Wang, Zhen; Finney Rutten, Lila J; van Ryn, Michelle; Griffin, Joan M; Murad, M Hassan; Asiedu, Gladys B; Egginton, Jason S; Beebe, Timothy J

2017-08-04

There exists a paucity of work in the development and testing of theoretical models specific to childhood health disparities even though they have been linked to the prevalence of adult health disparities including high rates of chronic disease. We conducted a systematic review and thematic analysis of existing models of health disparities specific to children to inform development of a unified conceptual framework. We systematically reviewed articles reporting theoretical or explanatory models of disparities on a range of outcomes related to child health. We searched Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus (database inception to 9 July 2015). A metanarrative approach guided the analysis process. A total of 48 studies presenting 48 models were included. This systematic review found multiple models but no consensus on one approach. However, we did discover a fair amount of overlap, such that the 48 models reviewed converged into the unified conceptual framework. The majority of models included factors in three domains: individual characteristics and behaviours (88%), healthcare providers and systems (63%), and environment/community (56%), . Only 38% of models included factors in the health and public policies domain. A disease-agnostic unified conceptual framework may inform integration of existing knowledge of child health disparities and guide future research. This multilevel framework can focus attention among clinical, basic and social science research on the relationships between policy, social factors, health systems and the physical environment that impact children's health outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A systematic approach for evaluating and scoring human data.

PubMed

Money, Chris D; Tomenson, John A; Penman, Michael G; Boogaard, Peter J; Jeffrey Lewis, R

2013-07-01

An approach is described for how the quality of human data can be systematically assessed and categorised. The approach mirrors the animal data quality considerations set out by Klimisch et al., in order that human data quality can be addressed in a complementary manner and to help facilitate transparent (and repeatable) weight of evidence comparisons. Definitions are proposed for the quality and adequacy of data. Quality is differentiated into four categories. A description of how the scheme can be used for evaluating data reliability, especially for use when contributing entries to the IUCLID database, is shown. A discussion of how the criteria might also be used when determining overall data relevance is included. The approach is intended to help harmonise human data evaluation processes worldwide. Copyright © 2013 Elsevier Inc. All rights reserved.

A systematic, multimodality approach to emergency elbow imaging.

PubMed

Singer, Adam D; Hanna, Tarek; Jose, Jean; Datir, Abhijit

2016-01-01

The elbow is a complex synovial hinge joint that is frequently involved in both athletic and nonathletic injuries. A thorough understanding of the normal anatomy and various injury patterns is essential when utilizing diagnostic imaging to identify damaged structures and to assist in surgical planning. In this review, the elbow anatomy will be scrutinized in a systematic approach. This will be followed by a comprehensive presentation of elbow injuries that are commonly seen in the emergency department accompanied by multimodality imaging findings. A short discussion regarding pitfalls in elbow imaging is also included. Copyright © 2015 Elsevier Inc. All rights reserved.

Science-based regulatory and policy considerations in nutrition.

PubMed

Schneeman, Barbara

2015-05-01

Scientific evidence is necessary for the development of effective and enforceable regulations and government policy. To use scientific information appropriately, a systematic approach is needed for review and evaluation of the evidence. Federal agencies in the United States have developed useful approaches for such a review and evaluation to develop nutrition labeling, including health claims, and for updating of the Dietary Guidelines for Americans. The WHO is using a systematic evaluation process to update its recommendations on diet and health. The results of such reviews also highlight research needs to address relevant gaps in our knowledge. © 2015 American Society for Nutrition.

Minors and euthanasia: a systematic review of argument-based ethics literature.

PubMed

Cuman, Giulia; Gastmans, Chris

2017-07-01

Euthanasia was first legalised in the Netherlands in 2002, followed by similar legislation in Belgium the same year. Since the beginning, however, only the Netherlands included the possibility for minors older than 12 years to request euthanasia. In 2014, the Belgian Act legalising euthanasia was amended to include requests by minors who possess the capacity of discernment. This amendment sparked great debate, and raised difficult ethical questions about when and how a minor can be deemed competent. We conducted a systematic review of argument-based literature on euthanasia in minors. The search process followed PRISMA guidelines. Thirteen publications were included. The four-principle approach of medical ethics was used to organise the ethical arguments underlying this debate. The justification for allowing euthanasia in minors is buttressed mostly by the principles of beneficence and respect for autonomy. Somewhat paradoxically, both principles are also used in the literature to argue against the extension of legislation to minors. Opponents of euthanasia generally rely on the principle of non-maleficence. The present analysis reveals that the debate surrounding euthanasia in minors is at an early stage. In order to allow a more in-depth ethical discussion, we suggest enriching the four-principle approach by including a care-ethics approach. What is Known: • The Netherlands and Belgium are the only two countries in the world with euthanasia legislation making it possible for minors to receive euthanasia. • This legislation provoked great debate globally, with ethical arguments for and against this legislation. What is New: • A systematic description of the ethical concepts and arguments grounding the debate on euthanasia in minors, as reported in the argument-based ethics literature. • A need has been identified to enrich the debate with a care-ethics approach to avoid oversimplifying the ethical decision-making process.

Peer Tutoring Systems: Applications in Classroom and Specialized Environments

ERIC Educational Resources Information Center

Heron, Timothy E.; Villareal, Donna M.; Yao, Ma; Christianson, Rebecca J.; Heron, Kathleen M.

2006-01-01

Peer-mediated approaches have been used for years to improve the academic behaviors of students, especially those with disabilities. The most systematized and well researched of the peer-mediated approaches relates to peer tutoring systems, which include specific elements of training, implementation, and evaluation. The purpose of this article is…

A Systematic Review of Assessment Tools Measuring Interprofessional Education Outcomes Relevant to Pharmacy Education.

PubMed

Shrader, Sarah; Farland, Michelle Z; Danielson, Jennifer; Sicat, Brigitte; Umland, Elena M

2017-08-01

Objective. To identify and describe the available quantitative tools that assess interprofessional education (IPE) relevant to pharmacy education. Methods. A systematic approach was used to identify quantitative IPE assessment tools relevant to pharmacy education. The search strategy included the National Center for Interprofessional Practice and Education Resource Exchange (Nexus) website, a systematic search of the literature, and a manual search of journals deemed likely to include relevant tools. Results. The search identified a total of 44 tools from the Nexus website, 158 abstracts from the systematic literature search, and 570 abstracts from the manual search. A total of 36 assessment tools met the criteria to be included in the summary, and their application to IPE relevant to pharmacy education was discussed. Conclusion. Each of the tools has advantages and disadvantages. No single comprehensive tool exists to fulfill assessment needs. However, numerous tools are available that can be mapped to IPE-related accreditation standards for pharmacy education.

The World Starts With Me: using intervention mapping for the systematic adaptation and transfer of school-based sexuality education from Uganda to Indonesia.

PubMed

Leerlooijer, Joanne N; Ruiter, Robert A C; Reinders, Jo; Darwisyah, Wati; Kok, Gerjo; Bartholomew, L Kay

2011-06-01

Evidence-based health promotion programmes, including HIV/AIDS prevention and sexuality education programmes, are often transferred to other cultures, priority groups and implementation settings. Challenges in this process include the identification of retaining core elements that relate to the programme's effectiveness while making changes that enhances acceptance in the new context and for the new priority group. This paper describes the use of a systematic approach to programme adaptation using a case study as an example. Intervention Mapping, a protocol for the development of evidence-based behaviour change interventions, was used to adapt the comprehensive school-based sexuality education programme 'The World Starts With Me'. The programme was developed for a priority population in Uganda and adapted to a programme for Indonesian secondary school students. The approach helped to systematically address the complexity and challenges of programme adaptation and to find a balance between preservation of essential programme elements (i.e. logic models) that may be crucial to the programme's effectiveness, including key objectives and theoretical behaviour change methods, and the adaptation of the programme to be acceptable to the new priority group and the programme implementers.

Prevalence of scabies and impetigo worldwide: a systematic review.

PubMed

Romani, Lucia; Steer, Andrew C; Whitfeld, Margot J; Kaldor, John M

2015-08-01

Scabies is a skin disease that, through secondary bacterial skin infection (impetigo), can lead to serious complications such as septicaemia, renal disease, and rheumatic heart disease. Yet the worldwide prevalence of scabies is uncertain. We undertook a systematic review, searching several databases and the grey literature, for population-based studies that reported on the prevalence of scabies and impetigo in a community setting. All included studies were assessed for quality. 2409 articles were identified and 48 studies were included. Data were available for all regions except North America. The prevalence of scabies ranged from 0·2% to 71·4%. All regions except for Europe and the Middle East included populations with a prevalence greater than 10%. Overall, scabies prevalence was highest in the Pacific and Latin American regions, and was substantially higher in children than in adolescents and adults. Impetigo was common, particularly in children, with the highest prevalence in Australian Aboriginal communities (49·0%). Comprehensive scabies control strategies are urgently needed, such as a community-based mass drug administration approach, along with a more systematic approach to the monitoring of disease burden. Copyright © 2015 Elsevier Ltd. All rights reserved.

School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews.

PubMed

Shackleton, Nichola; Jamal, Farah; Viner, Russell M; Dickson, Kelly; Patton, George; Bonell, Christopher

2016-04-01

Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches. We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively. We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective. There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A systematic policy approach to changing the food system and physical activity environments to prevent obesity.

PubMed

Sacks, Gary; Swinburn, Boyd A; Lawrence, Mark A

2008-06-05

As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be systematically identified by considering policy opportunities for each level of governance (local, state, national, international and organisational) in each sector of the food system (primary production, food processing, distribution, marketing, retail, catering and food service) and each sector that influences physical activity environments (infrastructure and planning, education, employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of governance and all relevant sectors. In the Australian context, potential regulatory policy intervention areas are widespread throughout the food system, e.g., land-use zoning (primary production within local government), food safety (food processing within state government), food labelling (retail within national government). Policy areas for influencing physical activity are predominantly local and state government responsibilities including, for example, walking and cycling environments (infrastructure and planning sector) and physical activity education in schools (education sector). The analysis structure presented in this article provides a tool to systematically identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of developing and implementing a comprehensive obesity prevention strategy. It also serves to highlight the need for a coordinated approach to policy development and implementation across all levels of government in order to ensure complementary policy action.

A systematic review and critical appraisal of qualitative metasynthetic practice in public health to develop a taxonomy of operations of reciprocal translation.

PubMed

Melendez-Torres, G J; Grant, Sean; Bonell, Chris

2015-12-01

Reciprocal translation, the understanding of one study's findings in terms of another's, is the foundation of most qualitative metasynthetic methods. In light of the proliferation of metasynthesis methods, the current review sought to create a taxonomy of operations of reciprocal translation using recently published qualitative metasyntheses. On 19 August 2013, MEDLINE, Embase and PsycINFO were searched. Included articles were full reports of metasyntheses of qualitative studies published in 2012 in English-language peer-reviewed journals. Two reviewers, working independently, screened records, assessed full texts for inclusion and extracted data on methods from each included metasynthesis. Systematic review methods used were summarised, and metasynthetic methods were inductively analysed to develop the taxonomy. Of 61 included metasyntheses, 21 (34%) reported fully replicable search strategies and 51 (84%) critically appraised included studies. Based on methods in these metasyntheses, we developed a taxonomy of reciprocal translation with four overlapping categories: visual representation; key paper integration; data reduction and thematic extraction; and line-by-line coding. This systematic review presents an update on methods and reporting currently used in qualitative metasynthesis. It also goes beyond the proliferation of approaches to offer a parsimonious approach to understanding how reciprocal translations are accomplished across metasynthetis methods. Copyright © 2015 John Wiley & Sons, Ltd.

A Systematic Approach to Error Free Telemetry

DTIC Science & Technology

2017-06-28

A SYSTEMATIC APPROACH TO ERROR FREE TELEMETRY 412TW-TIM-17-03 DISTRIBUTION A: Approved for public release. Distribution is...Systematic Approach to Error-Free Telemetry) was submitted by the Commander, 412th Test Wing, Edwards AFB, California 93524. Prepared by...Technical Information Memorandum 3. DATES COVERED (From - Through) February 2016 4. TITLE AND SUBTITLE A Systematic Approach to Error-Free

Surgical management of a suspicious adnexal mass: a systematic review.

PubMed

Covens, Allan L; Dodge, Jason E; Lacchetti, Christina; Elit, Laurie M; Le, Tien; Devries-Aboud, Michaela; Fung-Kee-Fung, Michael

2012-07-01

To systematically review the existing literature in order to determine the optimal recommended protocols for the surgical management of adnexal masses suspicious for apparent early stage malignancy. A review of all systematic reviews and guidelines published between 1999 and 2009 was conducted as a first step. After the identification of two systematic reviews on the topic, searches of MEDLINE for studies published since 2004 were also conducted to update and supplement the evidentiary base. The updated literature search identified 31 studies that met the inclusion criteria. A bivariate random effects analysis of 15 frozen section diagnosis studies yielded an overall sensitivity of 89.2% (95% CI, 86.3 to 91.5%) and specificity of 97.9% (95% CI, 96.6 to 98.7%). The surgical evidence suggests that systematic lymphadenectomy and proper surgical staging improve survival. Conservative fertility-preserving surgical approaches are an acceptable option in women with low malignant potential tumours. The accuracy and the adequacy of surgical staging by laparotomy or laparoscopic approaches appear to be comparable, with neither approach conferring a survival advantage. Intraoperative tumour rupture was indeed reported to occur more frequently in patients undergoing laparoscopy versus laparotomy in two retrospective cohort studies. The best available evidence was collected and included in this rigorous systematic review. The abundant evidentiary base provided the context and direction for the surgical management of adnexal masses suspicious for apparent early stage malignancy. Copyright © 2012 Elsevier Inc. All rights reserved.

Chronic pain and opioid misuse: a review of reviews.

PubMed

Voon, Pauline; Karamouzian, Mohammad; Kerr, Thomas

2017-08-15

The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse. A systematic database search was conducted to identify systematic reviews published between 2000 and 2016. Eligible studies were systematic reviews related to chronic non-cancer pain and PO or other substance misuse. Evidence from the included reviews was synthesized according to epidemiology and clinical management themes. Of 1908 identified articles, 18 systematic reviews were eligible for final inclusion. Two meta-analyses estimated the prevalence of chronic non-cancer pain in individuals using POs non-medically to be approximately 48% to 60%, which is substantially higher than the prevalence of chronic non-cancer pain in general population samples (11% to 19%). Five systematic reviews estimated the rates of PO or other opioid use in chronic pain populations with substantial variation in results (0.05% to 81%), likely due to widely varying definitions of dependence, substance use disorder, misuse, addiction, and abuse. Several clinical assessment and treatment approaches were identified, including: standardized assessment instruments; urine drug testing; medication counts; prescription drug monitoring programs; blood level monitoring; treatment agreements; opioid selection; dosing and dispensing strategies; and opioid agonist treatment. However, the reviews commonly noted serious limitations, inconsistencies, and imprecision of studies, and a lack of evidence on effectiveness or clinical utility for the majority of these strategies. Overall, current systematic reviews have found a lack of high-quality evidence or consistent findings on the prevalence, risk factors, and optimal clinical assessment and treatment approaches related to concurrent chronic pain and substance misuse. Given the role of systematic reviews in guiding evidence-based medicine and health policy, there is an urgent need for high-quality primary research to guide future systematic reviews to address the escalating epidemic of harms related to chronic pain and substance misuse.

Addressing continuous data measured with different instruments for participants excluded from trial analysis: a guide for systematic reviewers.

PubMed

Ebrahim, Shanil; Johnston, Bradley C; Akl, Elie A; Mustafa, Reem A; Sun, Xin; Walter, Stephen D; Heels-Ansdell, Diane; Alonso-Coello, Pablo; Guyatt, Gordon H

2014-05-01

We previously developed an approach to address the impact of missing participant data in meta-analyses of continuous variables in trials that used the same measurement instrument. We extend this approach to meta-analyses including trials that use different instruments to measure the same construct. We reviewed the available literature, conducted an iterative consultative process, and developed an approach involving a complete-case analysis complemented by sensitivity analyses that apply a series of increasingly stringent assumptions about results in patients with missing continuous outcome data. Our approach involves choosing the reference measurement instrument; converting scores from different instruments to the units of the reference instrument; developing four successively more stringent imputation strategies for addressing missing participant data; calculating a pooled mean difference for the complete-case analysis and imputation strategies; calculating the proportion of patients who experienced an important treatment effect; and judging the impact of the imputation strategies on the confidence in the estimate of effect. We applied our approach to an example systematic review of respiratory rehabilitation for chronic obstructive pulmonary disease. Our extended approach provides quantitative guidance for addressing missing participant data in systematic reviews of trials using different instruments to measure the same construct. Copyright © 2014 Elsevier Inc. All rights reserved.

Implementation of Systematic Review Tools in IRIS | Science ...

EPA Pesticide Factsheets

Currently, the number of chemicals present in the environment exceeds the ability of public health scientists to efficiently screen the available data in order to produce well-informed human health risk assessments in a timely manner. For this reason, the US EPA’s Integrated Risk Information System (IRIS) program has started implementing new software tools into the hazard characterization workflow. These automated tools aid in multiple phases of the systematic review process including scoping and problem formulation, literature search, and identification and screening of available published studies. The increased availability of these tools lays the foundation for automating or semi-automating multiple phases of the systematic review process. Some of these software tools include modules to facilitate a structured approach to study quality evaluation of human and animal data, although approaches are generally lacking for assessing complex mechanistic information, in particular “omics”-based evidence tools are starting to become available to evaluate these types of studies. We will highlight how new software programs, online tools, and approaches for assessing study quality can be better integrated to allow for a more efficient and transparent workflow of the risk assessment process as well as identify tool gaps that would benefit future risk assessments. Disclaimer: The views expressed here are those of the authors and do not necessarily represent the view

SILVAH: managers and scientists working together to improve research and management

Treesearch

Susan L Stout; Patrick H. Brose

2014-01-01

SILVAH is a systematic approach to silvicultural prescription development based on inventory and analysis of stand data for Allegheny hardwood, northern hardwood, and mixed oak forests. SILVAH includes annual training sessions and decision support software, and it ensures a consistent, complete, and objective approach to prescriptions. SILVAH has created a community of...

Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions

PubMed Central

McCall, Marcy C.; Ward, Alison; Roberts, Nia W.; Heneghan, Carl

2013-01-01

Objectives. Overview the quality, direction, and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult populations. Methods. We searched for systematic reviews in 10 online databases, bibliographic references, and hand-searches in yoga-related journals. Included reviews satisfy Oxman criteria and specify yoga as a primary intervention in one or more randomized controlled trials for treatment in adults. The AMSTAR tool and GRADE approach evaluated the methodological quality of reviews and quality of evidence. Results. We identified 2202 titles, of which 41 full-text articles were assessed for eligibility and 26 systematic reviews satisfied inclusion criteria. Thirteen systematic reviews include quantitative data and six papers include meta-analysis. The quality of evidence is generally low. Sixteen different types of health conditions are included. Eleven reviews show tendency towards positive effects of yoga intervention, 15 reviews report unclear results, and no, reviews report adverse effects of yoga. Yoga appears most effective for reducing symptoms in anxiety, depression, and pain. Conclusion. Although the quality of systematic reviews is high, the quality of supporting evidence is low. Significant heterogeneity and variability in reporting interventions by type of yoga, settings, and population characteristics limit the generalizability of results. PMID:23762174

Systematic searching for theory to inform systematic reviews: is it feasible? Is it desirable?

PubMed

Booth, Andrew; Carroll, Christopher

2015-09-01

In recognising the potential value of theory in understanding how interventions work comes a challenge - how to make identification of theory less haphazard? To explore the feasibility of systematic identification of theory. We searched PubMed for published reviews (1998-2012) that had explicitly sought to identify theory. Systematic searching may be characterised by a structured question, methodological filters and an itemised search procedure. We constructed a template (BeHEMoTh - Behaviour of interest; Health context; Exclusions; Models or Theories) for use when systematically identifying theory. The authors tested the template within two systematic reviews. Of 34 systematic reviews, only 12 reviews (35%) reported a method for identifying theory. Nineteen did not specify how they identified studies containing theory. Data were unavailable for three reviews. Candidate terms include concept(s)/conceptual, framework(s), model(s), and theory/theories/theoretical. Information professionals must overcome inadequate reporting and the use of theory out of context. The review team faces an additional concern in lack of 'theory fidelity'. Based on experience with two systematic reviews, the BeHEMoTh template and procedure offers a feasible and useful approach for identification of theory. Applications include realist synthesis, framework synthesis or review of complex interventions. The procedure requires rigorous evaluation. © 2015 Health Libraries Group.

Periapical implant lesion: A systematic review

PubMed Central

Blaya-Tárraga, Juan-Antonio; Cervera-Ballester, Juan; Peñarrocha-Oltra, David; Peñarrocha-Diago, Miguel

2017-01-01

Background The aim of this study was to systematically review the evidence for periapical implant lesion, which makes a patient more susceptible to the periapical lesion, frequency, symptoms, signs (including radiological findings) and possible treatment options. Material and Methods A systematic literature review and analysis of publications included in PubMed, Embase and Cochrane; articles published until March 2016; with a populations, exposures and outcomes (PEO) search strategy was performed, focused on the issue: “In patients with periapical lesion to the implant during the osseointegration, what symptoms, signs, and changes in complementary examination manifested, for according to that stage, be intervened with the appropriate approach?”. The set criteria for inclusion were peer-reviewed articles. Results From a total of 212 papers identified, 36 studies were included in this systematic review, with 15461 implants evaluated and 183 periapical implant lesions. Which 8 papers included more than 5 cases and 28 included equal or less than 5 cases. Analysis of the papers revealed that periapical implant lesion is classified according to evolution stages into acute (non-suppurated and suppurated) and subacute (or suppurated-fistulized). In the acute stage and in the subacute if there is no loss of implant stability, the correct treatment approach is implant periapical surgery. In the subacute stage associated with implant mobility the implant must be removed. Conclusions Evidence on the subject is very limited, there are few studies with small sample, without homogeneity of criteria for diagnosing the disease and without design of scientific evidence. Currently etiology lacks consensus. The early diagnosis of periapical implant periapical lesions during the osseointegration phase and early treatment, will lead to a higher survival rate of implants treated, hence preventing the need for implant extraction. Key words:Apical peri-implantitis, retrograde peri-implantitis, inflammatory peri-implantitis lesion. PMID:29053646

eHealth Intervention for Problematic Internet Use (PIU).

PubMed

Lam, Lawrence T; Lam, Mary K

2016-12-01

Excessive use of the Internet is considered a problematic behaviour by clinicians and researchers. Cognitive behaviour therapy (CBT) has been advocated for a long time as a treatment approach and has been extended to include family therapy in the recent years. As eTherapy (eHealth) has become an important component in the treatment of many mental health problems, it is prudent to explore the current status of the eHealth approach as an intervention option for this problem. This systematic review aims to examine the current development of online intervention programmes for this particular condition. The PRISMA guidelines for systematic reviews and meta-analysis were employed to conduct the search for literature following a systematic and structured approach. Of the 182 articles screened, three satisfied the selection criteria. Information was extracted and analysed systematically for each study and tabulated. All these studies were pilot studies with small sample sizes. Two of these articles aimed to explore the therapeutic efficacy of newly developed online intervention programmes for Internet addiction (IA) and online gaming addiction. The third article described the design and development of an App for smartphone addiction. The results obtained from this review have provided insight into the on-going development of eHealth interventions as well as the health informatics approaches in offering a possible and practical solution to tackle this growing problem.

A meta-analysis but not a systematic review: an evaluation of the Global BMI Mortality Collaboration.

PubMed

Flegal, Katherine M; Ioannidis, John P A

2017-08-01

Meta-analyses of individual participant data (MIPDs) offer many advantages and are considered the highest level of evidence. However, MIPDs can be seriously compromised when they are not solidly founded upon a systematic review. These data-intensive collaborative projects may be led by experts who already have deep knowledge of the literature in the field and of the results of published studies and how these results vary based on different analytical approaches. If investigators tailor the searches, eligibility criteria, and analysis plan of the MIPD, they run the risk of reaching foregone conclusions. We exemplify this potential bias in a MIPD on the association of body mass index with mortality conducted by a collaboration of outstanding and extremely knowledgeable investigators. Contrary to a previous meta-analysis of group data that used a systematic review approach, the MIPD did not seem to use a formal search: it considered 239 studies, of which the senior author was previously aware of at least 238, and it violated its own listed eligibility criteria to include those studies and exclude other studies. It also preferred an analysis plan that was also known to give a specific direction of effects in already published results of most of the included evidence. MIPDs where results of constituent studies are already largely known need safeguards to their validity. These may include careful systematic searches, adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data guidelines, and exploration of the robustness of results with different analyses. They should also avoid selective emphasis on foregone conclusions based on previously known results with specific analytical choices. Copyright © 2017 Elsevier Inc. All rights reserved.

Paraquat and Parkinson's disease: a systematic review protocol according to the OHAT approach for hazard identification.

PubMed

Vaccari, Carolina; El Dib, Regina; de Camargo, João Lauro V

2017-05-15

Parkinson's disease (PD) is a progressive neurodegenerative condition that has genetic susceptibility, aging, and exposure to certain chemicals as risk factors. In recent decades, epidemiological and experimental studies have investigated the role of pesticides in the development of PD, in particular that of the herbicide paraquat. Here, we, therefore, aim to systematically review the association between paraquat exposure and PD. Observational studies (cohort, case-control, and cross-sectional) eligible for this systematic review will enroll any participant who was occupationally and/or environmentally exposed to paraquat. Experimental studies, including in vivo and in vitro assays designed to assess neurotoxicological endpoints or mechanisms of paraquat neurotoxicity, will also be eligible. Outcomes of interest include the following: PD diagnosis; neurobehavioral, biochemical, and/or morphological alterations; and cellular, biochemical, and/or molecular pathways to oxidative stress. Using terms to include all forms of paraquat combined with PD, the following electronic databases will be searched: PubMed, EMBASE, LILACS, Toxnet, and Web of Science, without restrictions as to language, year, or status of publication. A team of reviewers will independently select potential titles and abstracts, extract data, assess risk of bias, and determine the overall quality of evidence for each outcome using the Office of Health Assessment and Translation (OHAT) approach for systematic reviews and evidence integration. Dichotomous data will be summarized as odds ratios, and continuous data will be given as mean differences, both with their respective 95% confidence intervals. This is the first time that the OHAT systematic review protocol will be applied to investigate a possible causal association between exposure to paraquat and PD. Results from this study could serve as basis for regulatory agencies to define paraquat levels of concern, supporting its risk assessment process. PROSPERO CRD42016050861.

A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.

PubMed

Viswanathan, Meera; Carey, Timothy S; Belinson, Suzanne E; Berliner, Elise; Chang, Stephanie M; Graham, Elaine; Guise, Jeanne-Marie; Ip, Stanley; Maglione, Margaret A; McCrory, Douglas C; McPheeters, Melissa; Newberry, Sydne J; Sista, Priyanka; White, C Michael

2014-11-01

Groups such as the Institute of Medicine emphasize the importance of attention to financial conflicts of interest. Little guidance exists, however, on managing the risk of bias for systematic reviews from nonfinancial conflicts of interest. We sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. Workgroup members built on existing guidance from international and domestic institutions on managing conflicts of interest. We then developed practical guidance in the form of an instrument for each potential source of conflict. We modified the Institute of Medicine's definition of conflict of interest to arrive at a definition specific to nonfinancial conflicts. We propose questions for funders and systematic review principal investigators to evaluate the risk of nonfinancial conflicts of interest. Once risks have been identified, options for managing conflicts include disclosure followed by no change in the systematic review team or activities, inclusion on the team along with other members with differing viewpoints to ensure diverse perspectives, exclusion from certain activities, and exclusion from the project entirely. The feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated. Copyright © 2014 Elsevier Inc. All rights reserved.

The methodological quality of systematic reviews published in high-impact nursing journals: a review of the literature.

PubMed

Pölkki, Tarja; Kanste, Outi; Kääriäinen, Maria; Elo, Satu; Kyngäs, Helvi

2014-02-01

To analyse systematic review articles published in the top 10 nursing journals to determine the quality of the methods employed within them. Systematic review is defined as a scientific research method that synthesises high-quality scientific knowledge on a given topic. The number of such reviews in nursing science has increased dramatically during recent years, but their methodological quality has not previously been assessed. A review of the literature using a narrative approach. Ranked impact factor scores for nursing journals were obtained from the Journal Citation Report database of the Institute of Scientific Information (ISI Web of Knowledge). All issues from the years 2009 and 2010 of the top 10 ranked journals were included. CINAHL and MEDLINE databases were searched to locate studies using the search terms 'systematic review' and 'systematic literature review'. A total of 39 eligible studies were identified. Their methodological quality was evaluated through the specific criteria of quality assessment, description of synthesis and strengths and weaknesses reported in the included studies. Most of the eligible systematic reviews included several different designs or types of quantitative study. The majority included a quality assessment, and a total of 17 different criteria were identified. The method of synthesis was mentioned in about half of the reviews, the most common being narrative synthesis. The weaknesses of reviews were discussed, while strengths were rarely highlighted. The methodological quality of the systematic reviews examined varied considerably, although they were all published in nursing journals with a high-impact factor. Despite the fact that systematic reviews are considered the most robust source of research evidence, they vary in methodological quality. This point is important to consider in clinical practice when applying the results to patient care. © 2013 Blackwell Publishing Ltd.

A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information.

PubMed

Mialon, M; Swinburn, B; Sacks, G

2015-07-01

Unhealthy diets represent one of the major risk factors for non-communicable diseases. There is currently a risk that the political influence of the food industry results in public health policies that do not adequately balance public and commercial interests. This paper aims to develop a framework for categorizing the corporate political activity of the food industry with respect to public health and proposes an approach to systematically identify and monitor it. The proposed framework includes six strategies used by the food industry to influence public health policies and outcomes: information and messaging; financial incentive; constituency building; legal; policy substitution; opposition fragmentation and destabilization. The corporate political activity of the food industry could be identified and monitored through publicly available data sourced from the industry itself, governments, the media and other sources. Steps for country-level monitoring include identification of key food industry actors and related sources of information, followed by systematic data collection and analysis of relevant documents, using the proposed framework as a basis for classification of results. The proposed monitoring approach should be pilot tested in different countries as part of efforts to increase the transparency and accountability of the food industry. This approach has the potential to help redress any imbalance of interests and thereby contribute to the prevention and control of non-communicable diseases. © 2015 World Obesity.

Are probiotics effective in preventing urinary tract infection?

PubMed

Canales, Juan; Rada, Gabriel

2018-04-04

Urinary tract infection is the most common bacterial infection and recurrences are common. Probiotics have been proposed as an alternative to decrease this risk. However, it is not clear if they are really effective. To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We identified six systematic reviews including nine studies overall, of which seven were randomized trials. We concluded it is not clear whether probiotics decrease the risk of symptomatic urinary tract infection, because the certainty of the evidence is very low.

What is the effectiveness of systemic corticosteroids in children with croup?

PubMed

Muñoz-Osores, Elizabeth; Arenas, Deidyland

2017-06-06

Systemic corticosteroids constitute standard treatment in children with acute obstructive laryngitis (croup). However, there is some uncertainty in relation with the magnitude of the benefits and risks associated with their use. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified six systematic reviews including 25 randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reananalysed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded the use of systemic corticosteroids increases the number of patients with clinical improvement at 12 hours and reduces the risk of readmission.

Long-distance effects in B→ K^*ℓ ℓ from analyticity

NASA Astrophysics Data System (ADS)

Bobeth, Christoph; Chrzaszcz, Marcin; van Dyk, Danny; Virto, Javier

2018-06-01

We discuss a novel approach to systematically determine the dominant long-distance contribution to B→ K^*ℓ ℓ decays in the kinematic region where the dilepton invariant mass is below the open charm threshold. This approach provides the most consistent and reliable determination to date and can be used to compute Standard Model predictions for all observables of interest, including the kinematic region where the dilepton invariant mass lies between the J/ψ and the ψ (2S) resonances. We illustrate the power of our results by performing a New Physics fit to the Wilson coefficient C_9. This approach is systematically improvable from theoretical and experimental sides, and applies to other decay modes of the type B→ Vℓ ℓ , B→ Pℓ ℓ and B→ Vγ.

Human interest meets biodiversity hotspots: A new systematic approach for urban ecosystem conservation.

PubMed

Kasada, Minoru; Matsuba, Misako; Miyashita, Tadashi

2017-01-01

Creating a win-win relationship between biodiversity and human well-being is one of the major current challenges for environmental policy. One way to approach this challenge is to identify sites with both high biodiversity and high human interest in urban areas. Here, we propose a new systematic approach to identify such sites by using land prices and biodiversity indexes for butterflies and birds from a nationwide perspective. As a result, we found sites that are valuable to humans and to other organisms, including national red-list species, and they are located in sites with cultural heritages and near seaside. By referencing the habitat features and landscape characteristics of these sites, we can establish high quality environments that provide a benefit to both humans and biodiversity in urban landscapes.

Routine development of objectively derived search strategies.

PubMed

Hausner, Elke; Waffenschmidt, Siw; Kaiser, Thomas; Simon, Michael

2012-02-29

Over the past few years, information retrieval has become more and more professionalized, and information specialists are considered full members of a research team conducting systematic reviews. Research groups preparing systematic reviews and clinical practice guidelines have been the driving force in the development of search strategies, but open questions remain regarding the transparency of the development process and the available resources. An empirically guided approach to the development of a search strategy provides a way to increase transparency and efficiency. Our aim in this paper is to describe the empirically guided development process for search strategies as applied by the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, or "IQWiG"). This strategy consists of the following steps: generation of a test set, as well as the development, validation and standardized documentation of the search strategy. We illustrate our approach by means of an example, that is, a search for literature on brachytherapy in patients with prostate cancer. For this purpose, a test set was generated, including a total of 38 references from 3 systematic reviews. The development set for the generation of the strategy included 25 references. After application of textual analytic procedures, a strategy was developed that included all references in the development set. To test the search strategy on an independent set of references, the remaining 13 references in the test set (the validation set) were used. The validation set was also completely identified. Our conclusion is that an objectively derived approach similar to that used in search filter development is a feasible way to develop and validate reliable search strategies. Besides creating high-quality strategies, the widespread application of this approach will result in a substantial increase in the transparency of the development process of search strategies.

Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data: the PRISMA-IPD Statement.

PubMed

Stewart, Lesley A; Clarke, Mike; Rovers, Maroeska; Riley, Richard D; Simmonds, Mark; Stewart, Gavin; Tierney, Jayne F

2015-04-28

Systematic reviews and meta-analyses of individual participant data (IPD) aim to collect, check, and reanalyze individual-level data from all studies addressing a particular research question and are therefore considered a gold standard approach to evidence synthesis. They are likely to be used with increasing frequency as current initiatives to share clinical trial data gain momentum and may be particularly important in reviewing controversial therapeutic areas. To develop PRISMA-IPD as a stand-alone extension to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement, tailored to the specific requirements of reporting systematic reviews and meta-analyses of IPD. Although developed primarily for reviews of randomized trials, many items will apply in other contexts, including reviews of diagnosis and prognosis. Development of PRISMA-IPD followed the EQUATOR Network framework guidance and used the existing standard PRISMA Statement as a starting point to draft additional relevant material. A web-based survey informed discussion at an international workshop that included researchers, clinicians, methodologists experienced in conducting systematic reviews and meta-analyses of IPD, and journal editors. The statement was drafted and iterative refinements were made by the project, advisory, and development groups. The PRISMA-IPD Development Group reached agreement on the PRISMA-IPD checklist and flow diagram by consensus. Compared with standard PRISMA, the PRISMA-IPD checklist includes 3 new items that address (1) methods of checking the integrity of the IPD (such as pattern of randomization, data consistency, baseline imbalance, and missing data), (2) reporting any important issues that emerge, and (3) exploring variation (such as whether certain types of individual benefit more from the intervention than others). A further additional item was created by reorganization of standard PRISMA items relating to interpreting results. Wording was modified in 23 items to reflect the IPD approach. PRISMA-IPD provides guidelines for reporting systematic reviews and meta-analyses of IPD.

Revisiting a Cognitive Framework for Test Design: Applications for a Computerized Perceptual Speed Test.

ERIC Educational Resources Information Center

Alderton, David L.

This paper highlights the need for a systematic, content aware, and theoretically-based approach to test design. The cognitive components approach is endorsed, and is applied to the development of a computerized perceptual speed test. Psychometric literature is reviewed and shows that: every major multi-factor theory includes a clerical/perceptual…

Semi-automating the manual literature search for systematic reviews increases efficiency.

PubMed

Chapman, Andrea L; Morgan, Laura C; Gartlehner, Gerald

2010-03-01

To minimise retrieval bias, manual literature searches are a key part of the search process of any systematic review. Considering the need to have accurate information, valid results of the manual literature search are essential to ensure scientific standards; likewise efficient approaches that minimise the amount of personnel time required to conduct a manual literature search are of great interest. The objective of this project was to determine the validity and efficiency of a new manual search method that utilises the scopus database. We used the traditional manual search approach as the gold standard to determine the validity and efficiency of the proposed scopus method. Outcome measures included completeness of article detection and personnel time involved. Using both methods independently, we compared the results based on accuracy of the results, validity and time spent conducting the search, efficiency. Regarding accuracy, the scopus method identified the same studies as the traditional approach indicating its validity. In terms of efficiency, using scopus led to a time saving of 62.5% compared with the traditional approach (3 h versus 8 h). The scopus method can significantly improve the efficiency of manual searches and thus of systematic reviews.

Phase shifts in I = 2 ππ-scattering from two lattice approaches

NASA Astrophysics Data System (ADS)

Kurth, T.; Ishii, N.; Doi, T.; Aoki, S.; Hatsuda, T.

2013-12-01

We present a lattice QCD study of the phase shift of I = 2 ππ scattering on the basis of two different approaches: the standard finite volume approach by Lüscher and the recently introduced HAL QCD potential method. Quenched QCD simulations are performed on lattices with extents N s = 16 , 24 , 32 , 48 and N t = 128 as well as lattice spacing a ~ 0 .115 fm and a pion mass of m π ~ 940 MeV. The phase shift and the scattering length are calculated in these two methods. In the potential method, the error is dominated by the systematic uncertainty associated with the violation of rotational symmetry due to finite lattice spacing. In Lüscher's approach, such systematic uncertainty is difficult to be evaluated and thus is not included in this work. A systematic uncertainty attributed to the quenched approximation, however, is not evaluated in both methods. In case of the potential method, the phase shift can be calculated for arbitrary energies below the inelastic threshold. The energy dependence of the phase shift is also obtained from Lüscher's method using different volumes and/or nonrest-frame extension of it. The results are found to agree well with the potential method.

Are concurrent systematic cores needed at the time of targeted biopsy in patients with prior negative prostate biopsies?

PubMed

Albisinni, S; Aoun, F; Noel, A; El Rassy, E; Lemort, M; Paesmans, M; van Velthoven, R; Roumeguère, T; Peltier, A

2018-01-01

MRI-guided targeted biopsies are advised in patients who have undergone an initial series of negative systematic biopsies, in whom prostate cancer (PCa) suspicion remains elevated. The aim of the study was to evaluate whether, in men with prior negative prostate biopsies, systematic cores are also warranted at the time of an MRI-targeted repeat biopsy. We enrolled patients with prior negative biopsy undergoing real time MRI/TRUS fusion guided prostate biopsy at our institute between 2014 and 2016. Patients with at least one index lesion on multiparametric MRI were included. All eligible patients underwent both systematic random biopsies (12-14 cores) and targeted biopsies (2-4 cores). The study included 74 men with a median age of 65 years, PSA level of 9.27ng/mL, and prostatic volume of 45ml. The overall PCa detection rate and the clinically significant cancer detection rate were 56.7% and 39.2%, respectively. Targeted cores demonstrated similar clinically significant PCa detection rate compared to systematic cores (33.8% vs. 28.4%, P=0.38) with significantly less tissue sampling. Indeed, a combination approach was significantly superior to a targeted-only in overall PCa detection (+16.7% overall detection rate, P=0.007). Although differences in clinically significant PCa detection were statistically non-significant (P=0.13), a combination approach did allow detecting 7 extra clinically significant PCas (+13.8%). In patients with elevated PSA and prior negative biopsies, concurrent systematic sampling may be needed at the time of targeted biopsy in order to maximize PCa detection rate. Larger studies are needed to validate our findings. 4. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Cochrane systematic reviews are useful to map research gaps for decreasing maternal mortality.

PubMed

Chapman, Evelina; Reveiz, Ludovic; Chambliss, Amy; Sangalang, Stephanie; Bonfill, Xavier

2013-01-01

To use an "evidence-mapping" approach to assess the usefulness of Cochrane reviews in identifying research gaps in the maternal health. The article describes the general mapping, prioritizing, reconciling, and updating approach: (1) identifying gaps in the maternal health research using published systematic reviews and formulating research questions, (2) prioritizing questions using Delphi method, (3) reconciling identified research priorities with the existing literature (i.e., searching of ongoing trials in trials registries), (4) updating the process. A comprehensive search of Cochrane systematic reviews published or updated from January 2006 to March 2011 was performed. We evaluated the "Implications for Research" section to identify gaps in the research. Our search strategy identified 695 references; 178 systematic reviews identifying at least one research gap were used. We formulated 319 research questions, which were classified into 11 different categories based on the direct and indirect causes of maternal mortality: postpartum hemorrhage, abortion, hypertensive disorders, infection/sepsis, caesarean section, diabetes, pregnancy prevention, preterm labor, other direct causes, indirect causes, and health policies and systems. Most research questions concerned the effectiveness of clinical interventions, including drugs (42.6%), nonpharmacologic interventions (16.3%), and health system (14.7%). It is possible to identify gaps in the maternal health research by using this approach. Copyright © 2013 Elsevier Inc. All rights reserved.

Considering methodological options for reviews of theory: illustrated by a review of theories linking income and health.

PubMed

Campbell, Mhairi; Egan, Matt; Lorenc, Theo; Bond, Lyndal; Popham, Frank; Fenton, Candida; Benzeval, Michaela

2014-10-13

Review of theory is an area of growing methodological advancement. Theoretical reviews are particularly useful where the literature is complex, multi-discipline, or contested. It has been suggested that adopting methods from systematic reviews may help address these challenges. However, the methodological approaches to reviews of theory, including the degree to which systematic review methods can be incorporated, have received little discussion in the literature. We recently employed systematic review methods in a review of theories about the causal relationship between income and health. This article discusses some of the methodological issues we considered in developing the review and offers lessons learnt from our experiences. It examines the stages of a systematic review in relation to how they could be adapted for a review of theory. The issues arising and the approaches taken in the review of theories in income and health are considered, drawing on the approaches of other reviews of theory. Different approaches to searching were required, including electronic and manual searches, and electronic citation tracking to follow the development of theories. Determining inclusion criteria was an iterative process to ensure that inclusion criteria were specific enough to make the review practical and focused, but not so narrow that key literature was excluded. Involving subject specialists was valuable in the literature searches to ensure principal papers were identified and during the inductive approaches used in synthesis of theories to provide detailed understanding of how theories related to another. Reviews of theory are likely to involve iterations and inductive processes throughout, and some of the concepts and techniques that have been developed for qualitative evidence synthesis can be usefully translated to theoretical reviews of this kind. It may be useful at the outset of a review of theory to consider whether the key aim of the review is to scope out theories relating to a particular issue; to conduct in-depth analysis of key theoretical works with the aim of developing new, overarching theories and interpretations; or to combine both these processes in the review. This can help decide the most appropriate methodological approach to take at particular stages of the review.

Systematic Review of the Literature on Pain in Patients with Polytrauma Including Traumatic Brain Injury

PubMed Central

Dobscha, Steven K.; Clark, Michael E.; Morasco, Benjamin J.; Freeman, Michele; Campbell, Rose; Helfand, Mark

2010-01-01

Objective To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design Systematic review. Methods We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated. PMID:19818031

Quality of reporting of outcomes in phase III studies of pulmonary tuberculosis: a systematic review.

PubMed

Bonnett, Laura Jayne; Ken-Dror, Gie; Davies, Geraint Rhys

2018-02-21

Despite more than 60 years of clinical trials, tuberculosis (TB) still causes a high global burden of mortality and morbidity. Treatment currently requires multiple drugs in combination, taken over a prolonged period. New drugs are needed to shorten treatment duration, prevent resistance and reduce adverse events. However, to improve on current methodology in drug development, a more complete understanding of the existing clinical evidence base is required. A systematic review was undertaken to summarise outcomes reported in phase III trials of patients with newly diagnosed pulmonary TB. A systematic search of databases (PubMed, MEDLINE, EMBASE, CENTRAL and LILACs) was conducted on 30 November 2017 to retrieve relevant peer-reviewed articles. Reference lists of included studies were also searched. This systematic review considered all reported outcomes. Of 248 included studies, 229 considered "on-treatment" outcomes whilst 148 reported "off-treatment" outcomes. There was wide variation and ambiguity in the definition of reported outcomes, including their relationship to treatment and in the time points evaluated. Additional challenges were observed regarding the analysis approach taken (per protocol versus intention to treat) and the varying durations of "intensive" and "continuation" phases of treatment. Bacteriological outcomes were most frequently reported but radiological and clinical data were often included as an implicit or explicit component of the overall definition of outcome. Terminology used to define long-term outcomes in phase III trials is inconsistent, reflecting evolving differences in protocols and practices. For successful future cumulative meta-analysis, the findings of this review suggest that greater availability of individual patient data and the development of a core outcome set would be desirable. In the meantime, we propose a simple and logical approach which should facilitate combination of key evidence and inform improvements in the methodology of TB drug development and clinical trials.

Molecular Phylogenetics and Systematics of the Bivalve Family Ostreidae Based on rRNA Sequence-Structure Models and Multilocus Species Tree

PubMed Central

Salvi, Daniele; Macali, Armando; Mariottini, Paolo

2014-01-01

The bivalve family Ostreidae has a worldwide distribution and includes species of high economic importance. Phylogenetics and systematic of oysters based on morphology have proved difficult because of their high phenotypic plasticity. In this study we explore the phylogenetic information of the DNA sequence and secondary structure of the nuclear, fast-evolving, ITS2 rRNA and the mitochondrial 16S rRNA genes from the Ostreidae and we implemented a multi-locus framework based on four loci for oyster phylogenetics and systematics. Sequence-structure rRNA models aid sequence alignment and improved accuracy and nodal support of phylogenetic trees. In agreement with previous molecular studies, our phylogenetic results indicate that none of the currently recognized subfamilies, Crassostreinae, Ostreinae, and Lophinae, is monophyletic. Single gene trees based on Maximum likelihood (ML) and Bayesian (BA) methods and on sequence-structure ML were congruent with multilocus trees based on a concatenated (ML and BA) and coalescent based (BA) approaches and consistently supported three main clades: (i) Crassostrea, (ii) Saccostrea, and (iii) an Ostreinae-Lophinae lineage. Therefore, the subfamily Crassotreinae (including Crassostrea), Saccostreinae subfam. nov. (including Saccostrea and tentatively Striostrea) and Ostreinae (including Ostreinae and Lophinae taxa) are recognized. Based on phylogenetic and biogeographical evidence the Asian species of Crassostrea from the Pacific Ocean are assigned to Magallana gen. nov., whereas an integrative taxonomic revision is required for the genera Ostrea and Dendostrea. This study pointed out the suitability of the ITS2 marker for DNA barcoding of oyster and the relevance of using sequence-structure rRNA models and features of the ITS2 folding in molecular phylogenetics and taxonomy. The multilocus approach allowed inferring a robust phylogeny of Ostreidae providing a broad molecular perspective on their systematics. PMID:25250663

Molecular phylogenetics and systematics of the bivalve family Ostreidae based on rRNA sequence-structure models and multilocus species tree.

PubMed

Salvi, Daniele; Macali, Armando; Mariottini, Paolo

2014-01-01

The bivalve family Ostreidae has a worldwide distribution and includes species of high economic importance. Phylogenetics and systematic of oysters based on morphology have proved difficult because of their high phenotypic plasticity. In this study we explore the phylogenetic information of the DNA sequence and secondary structure of the nuclear, fast-evolving, ITS2 rRNA and the mitochondrial 16S rRNA genes from the Ostreidae and we implemented a multi-locus framework based on four loci for oyster phylogenetics and systematics. Sequence-structure rRNA models aid sequence alignment and improved accuracy and nodal support of phylogenetic trees. In agreement with previous molecular studies, our phylogenetic results indicate that none of the currently recognized subfamilies, Crassostreinae, Ostreinae, and Lophinae, is monophyletic. Single gene trees based on Maximum likelihood (ML) and Bayesian (BA) methods and on sequence-structure ML were congruent with multilocus trees based on a concatenated (ML and BA) and coalescent based (BA) approaches and consistently supported three main clades: (i) Crassostrea, (ii) Saccostrea, and (iii) an Ostreinae-Lophinae lineage. Therefore, the subfamily Crassostreinae (including Crassostrea), Saccostreinae subfam. nov. (including Saccostrea and tentatively Striostrea) and Ostreinae (including Ostreinae and Lophinae taxa) are recognized [corrected]. Based on phylogenetic and biogeographical evidence the Asian species of Crassostrea from the Pacific Ocean are assigned to Magallana gen. nov., whereas an integrative taxonomic revision is required for the genera Ostrea and Dendostrea. This study pointed out the suitability of the ITS2 marker for DNA barcoding of oyster and the relevance of using sequence-structure rRNA models and features of the ITS2 folding in molecular phylogenetics and taxonomy. The multilocus approach allowed inferring a robust phylogeny of Ostreidae providing a broad molecular perspective on their systematics.

Making the Most of What We Already Know: A Three-Stage Approach to Systematic Reviewing.

PubMed

Rebelo Da Silva, Natalie; Zaranyika, Hazel; Langer, Laurenz; Randall, Nicola; Muchiri, Evans; Stewart, Ruth

2016-09-06

Conducting a systematic review in social policy is a resource-intensive process in terms of time and funds. It is thus important to understand the scope of the evidence base of a topic area prior to conducting a synthesis of primary research in order to maximize these resources. One approach to conserving resources is to map out the available evidence prior to undertaking a traditional synthesis. A few examples of this approach exist in the form of gap maps, overviews of reviews, and systematic maps supported by social policy and systematic review agencies alike. Despite this growing call for alternative approaches to systematic reviews, it is still common for systematic review teams to embark on a traditional in-depth review only. This article describes a three-stage approach to systematic reviewing that was applied to a systematic review focusing in interventions for smallholder farmers in Africa. We argue that this approach proved useful in helping us to understand the evidence base. By applying preliminary steps as part of a three-stage approach, we were able to maximize the resources needed to conduct a traditional systematic review on a more focused research question. This enabled us to identify and fill real knowledge gaps, build on work that had already been done, and avoid wasting resources on areas of work that would have no useful outcome. It also facilitated meaningful engagement between the review team and our key policy stakeholders. © The Author(s) 2016.

Systematic Approach to Identifying Deeply Buried Archeological Deposits

DOT National Transportation Integrated Search

2018-02-01

Traditional methods used to discover archeological sites include pedestrian surface surveys and relatively shallow hand-dug shovel or soil core testing. While these methods are appropriate for locating surface and near-surface sites on ridges, hillto...

A systematic approach for introducing innovative product design in courses with engineering and nonengineering students.

PubMed

Patterson, P E

2007-01-01

In our new global economy, biomedical product development teams need to be even more innovative in an environment constrained by fewer resources with less time from concept to market. Teams are often comprised of individuals spread around the world. To simulate this setting, we revised an existing course to incorporate teams of on-campus and distance students, with each team including both engineers and other specialties. Through interactive lectures and projects, we presented a systematic approach to innovation that should be useful to engineers and non-engineers alike. Students found the course challenging and exciting, displaying an improved ability to work in distributed teams and in developing innovative design solutions.

Changing physician behavior: what works?

PubMed

Mostofian, Fargoi; Ruban, Cynthiya; Simunovic, Nicole; Bhandari, Mohit

2015-01-01

There are various interventions for guideline implementation in clinical practice, but the effects of these interventions are generally unclear. We conducted a systematic review to identify effective methods of implementing clinical research findings and clinical guidelines to change physician practice patterns, in surgical and general practice. Systematic review of reviews. We searched electronic databases (MEDLINE, EMBASE, and PubMed) for systematic reviews published in English that evaluated the effectiveness of different implementation methods. Two reviewers independently assessed eligibility for inclusion and methodological quality, and extracted relevant data. Fourteen reviews covering a wide range of interventions were identified. The intervention methods used include: audit and feedback, computerized decision support systems, continuing medical education, financial incentives, local opinion leaders, marketing, passive dissemination of information, patient-mediated interventions, reminders, and multifaceted interventions. Active approaches, such as academic detailing, led to greater effects than traditional passive approaches. According to the findings of 3 reviews, 71% of studies included in these reviews showed positive change in physician behavior when exposed to active educational methods and multifaceted interventions. Active forms of continuing medical education and multifaceted interventions were found to be the most effective methods for implementing guidelines into general practice. Additionally, active approaches to changing physician performance were shown to improve practice to a greater extent than traditional passive methods. Further primary research is necessary to evaluate the effectiveness of these methods in a surgical setting.

MUSiC—An Automated Scan for Deviations between Data and Monte Carlo Simulation

NASA Astrophysics Data System (ADS)

Meyer, Arnd

2010-02-01

A model independent analysis approach is presented, systematically scanning the data for deviations from the standard model Monte Carlo expectation. Such an analysis can contribute to the understanding of the CMS detector and the tuning of event generators. The approach is sensitive to a variety of models of new physics, including those not yet thought of.

MUSiC - An Automated Scan for Deviations between Data and Monte Carlo Simulation

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

Meyer, Arnd

2010-02-10

A model independent analysis approach is presented, systematically scanning the data for deviations from the standard model Monte Carlo expectation. Such an analysis can contribute to the understanding of the CMS detector and the tuning of event generators. The approach is sensitive to a variety of models of new physics, including those not yet thought of.

Are cannabinoids an alternative for cachexia-anorexia syndrome in patients with advanced cancer?

PubMed

Cabeza, Claudia; Corsi, Oscar; Pérez-Cruz, Pedro

2017-12-29

Cachexia and anorexia are among the most frequent symptoms in patients with cancer. Cannabinoids have been used in patients with advanced cancer; however, their role is still controversial. To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, and generated a summary of findings table using the GRADE approach. We identified ten systematic reviews including three studies overall, of which two were randomized trials. We concluded it is not clear whether cannabinoids have any positive effect on increasing weight because the certainty of the evidence is very low. They might not have any effect on appetite, and are probably associated to frequent adverse effects.

Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches.

PubMed

Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves

2015-01-01

After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

Human interest meets biodiversity hotspots: A new systematic approach for urban ecosystem conservation

PubMed Central

Kasada, Minoru; Matsuba, Misako; Miyashita, Tadashi

2017-01-01

Creating a win-win relationship between biodiversity and human well-being is one of the major current challenges for environmental policy. One way to approach this challenge is to identify sites with both high biodiversity and high human interest in urban areas. Here, we propose a new systematic approach to identify such sites by using land prices and biodiversity indexes for butterflies and birds from a nationwide perspective. As a result, we found sites that are valuable to humans and to other organisms, including national red-list species, and they are located in sites with cultural heritages and near seaside. By referencing the habitat features and landscape characteristics of these sites, we can establish high quality environments that provide a benefit to both humans and biodiversity in urban landscapes. PMID:28235020

What Are the Effects of Teaching Evidence-Based Health Care (EBHC)? Overview of Systematic Reviews

PubMed Central

Young, Taryn; Rohwer, Anke; Volmink, Jimmy; Clarke, Mike

2014-01-01

Background An evidence-based approach to health care is recognized internationally as a key competency for healthcare practitioners. This overview systematically evaluated and organized evidence from systematic reviews on teaching evidence-based health care (EBHC). Methods/Findings We searched for systematic reviews evaluating interventions for teaching EBHC to health professionals compared to no intervention or different strategies. Outcomes covered EBHC knowledge, skills, attitudes, practices and health outcomes. Comprehensive searches were conducted in April 2013. Two reviewers independently selected eligible reviews, extracted data and evaluated methodological quality. We included 16 systematic reviews, published between 1993 and 2013. There was considerable overlap across reviews. We found that 171 source studies included in the reviews related to 81 separate studies, of which 37 are in more than one review. Studies used various methodologies to evaluate educational interventions of varying content, format and duration in undergraduates, interns, residents and practicing health professionals. The evidence in the reviews showed that multifaceted, clinically integrated interventions, with assessment, led to improvements in knowledge, skills and attitudes. Interventions improved critical appraisal skills and integration of results into decisions, and improved knowledge, skills, attitudes and behaviour amongst practicing health professionals. Considering single interventions, EBHC knowledge and attitude were similar for lecture-based versus online teaching. Journal clubs appeared to increase clinical epidemiology and biostatistics knowledge and reading behavior, but not appraisal skills. EBHC courses improved appraisal skills and knowledge. Amongst practicing health professionals, interactive online courses with guided critical appraisal showed significant increase in knowledge and appraisal skills. A short workshop using problem-based approaches, compared to no intervention, increased knowledge but not appraisal skills. Conclusions EBHC teaching and learning strategies should focus on implementing multifaceted, clinically integrated approaches with assessment. Future rigorous research should evaluate minimum components for multifaceted interventions, assessment of medium to long-term outcomes, and implementation of these interventions. PMID:24489771

Patients' decision making in total knee arthroplasty: a systematic review of qualitative research.

PubMed

Barlow, T; Griffin, D; Barlow, D; Realpe, A

2015-10-01

A patient-centred approach, usually achieved through shared decision making, has the potential to help improve decision making around knee arthroplasty surgery. However, such an approach requires an understanding of the factors involved in patient decision making. This review's objective is to systematically examine the qualitative literature surrounding patients' decision making in knee arthroplasty. A systematic literature review using Medline and Embase was conducted to identify qualitative studies that examined patients' decision making around knee arthroplasty. An aggregated account of what is known about patients' decision making in knee arthroplasties is provided. Seven studies with 234 participants in interviews or focus groups are included. Ten themes are replicated across studies, namely: expectations of surgery; coping mechanisms; relationship with clinician; fear; pain; function; psychological implications; social network; previous experience of surgery; and conflict in opinions. This review is helpful in not only directing future research to areas that are not understood, or require confirmation, but also in highlighting areas that future interventions could address. These include those aimed at delivering information, which are likely to affect the satisfaction rate, demand, and use of knee arthroplasties. Cite this article: Bone Joint Res 2015;4;163-169. ©2015 Griffin.

Reuse at the Software Productivity Consortium

NASA Technical Reports Server (NTRS)

Weiss, David M.

1989-01-01

The Software Productivity Consortium is sponsored by 14 aerospace companies as a developer of software engineering methods and tools. Software reuse and prototyping are currently the major emphasis areas. The Methodology and Measurement Project in the Software Technology Exploration Division has developed some concepts for reuse which they intend to develop into a synthesis process. They have identified two approaches to software reuse: opportunistic and systematic. The assumptions underlying the systematic approach, phrased as hypotheses, are the following: the redevelopment hypothesis, i.e., software developers solve the same problems repeatedly; the oracle hypothesis, i.e., developers are able to predict variations from one redevelopment to others; and the organizational hypothesis, i.e., software must be organized according to behavior and structure to take advantage of the predictions that the developers make. The conceptual basis for reuse includes: program families, information hiding, abstract interfaces, uses and information hiding hierarchies, and process structure. The primary reusable software characteristics are black-box descriptions, structural descriptions, and composition and decomposition based on program families. Automated support can be provided for systematic reuse, and the Consortium is developing a prototype reuse library and guidebook. The software synthesis process that the Consortium is aiming toward includes modeling, refinement, prototyping, reuse, assessment, and new construction.

Complementary and alternative medicine for treatment of irritable bowel syndrome.

PubMed

Shen, Yi-Hao A; Nahas, Richard

2009-02-01

To review the evidence supporting selected complementary and alternative medicine approaches used in the treatment of irritable bowel syndrome (IBS). MEDLINE (from January 1966), EMBASE (from January 1980), and the Cochrane Database of Systematic Reviews were searched until March 2008, combining the terms irritable bowel syndrome or irritable colon with complementary therapies, alternative medicine, acupuncture, fiber, peppermint oil, herbal, traditional, yoga, massage, meditation, mind, relaxation, probiotic, hypnotherapy, psychotherapy, cognitive therapy, or behavior therapy. Results were screened to include only clinical trials, systematic reviews, and meta-analyses. Level I evidence was available for most interventions. Soluble fibre improves constipation and global IBS symptoms. Peppermint oil alleviates IBS symptoms, including abdominal pain. Probiotic trials show overall benefit for IBS but there is little evidence supporting the use of any specific strain. Hypnotherapy and cognitive-behavioural therapy are also effective therapeutic options for appropriate patients. Certain herbal formulas are supported by limited evidence, but safety is a potential concern. All interventions are supported by systematic reviews or meta-analyses. Several complementary and alternative therapies can be recommended as part of an evidence-based approach to the treatment of IBS; these might provide patients with satisfactory relief and improve the therapeutic alliance.

An overview of systematic reviews on the public health consequences of social isolation and loneliness.

PubMed

Leigh-Hunt, N; Bagguley, D; Bash, K; Turner, V; Turnbull, S; Valtorta, N; Caan, W

2017-11-01

Social isolation and loneliness have been associated with ill health and are common in the developed world. A clear understanding of their implications for morbidity and mortality is needed to gauge the extent of the associated public health challenge and the potential benefit of intervention. A systematic review of systematic reviews (systematic overview) was undertaken to determine the wider consequences of social isolation and loneliness, identify any differences between the two, determine differences from findings of non-systematic reviews and to clarify the direction of causality. Eight databases were searched from 1950 to 2016 for English language reviews covering social isolation and loneliness but not solely social support. Suitability for inclusion was determined by two or more reviewers, the methodological quality of included systematic reviews assessed using the a measurement tool to assess systematic reviews (AMSTAR) checklist and the quality of evidence within these reviews using the grading of recommendations, assessment, development and evaluations (GRADE) approach. Non-systematic reviews were sought for a comparison of findings but not included in the primary narrative synthesis. Forty systematic reviews of mainly observational studies were identified, largely from the developed world. Meta-analyses have identified a significant association between social isolation and loneliness with increased all-cause mortality and social isolation with cardiovascular disease. Narrative systematic reviews suggest associations with poorer mental health outcomes, with less strong evidence for behavioural and other physical health outcomes. No reviews were identified for wider socio-economic or developmental outcomes. This systematic overview highlights that there is consistent evidence linking social isolation and loneliness to worse cardiovascular and mental health outcomes. The role of social isolation and loneliness in other conditions and their socio-economic consequences is less clear. More research is needed on associations with cancer, health behaviours, and the impact across the life course and wider socio-economic consequences. Policy makers and health and local government commissioners should consider social isolation and loneliness as important upstream factors impacting on morbidity and mortality due to their effects on cardiovascular and mental health. Prevention strategies should therefore be developed across the public and voluntary sectors, using an asset-based approach. Copyright © 2017 The Royal Society for Public Health. All rights reserved.

Performing Systematic Literature Reviews with Novices: An Iterative Approach

ERIC Educational Resources Information Center

Lavallée, Mathieu; Robillard, Pierre-N.; Mirsalari, Reza

2014-01-01

Reviewers performing systematic literature reviews require understanding of the review process and of the knowledge domain. This paper presents an iterative approach for conducting systematic literature reviews that addresses the problems faced by reviewers who are novices in one or both levels of understanding. This approach is derived from…

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

NONE

Training programs at DOE facilities should prepare personnel to safely and efficiently operate and maintain the facilities in accordance with DOE requirements. This guide presents good practices for a systematic approach to on-the-job training (OJT) and OJT programs and should be used in conjunction with DOE Training Program Handbook: A Systematic Approach to Training, and with the DOE Handbook entitled Alternative Systematic Approaches to Training to develop performance-based OJT programs. DOE contractors may also use this guide to modify existing OJT programs that do not meet the systematic approach to training (SAT) objectives.

Developing an Environmental Currency Relevant to People

EPA Science Inventory

EPA (and others worldwide) wanted to more fully include environmental attributes in decision making but there was no systematic approach that defined and organized the environment to identify and potentially quantify those environmental attributes that humans required, valued, or...

A Big Empty Space

ERIC Educational Resources Information Center

Blake, Anthony; Francis, David

1973-01-01

Approaches to developing management ability include systematic techniques, mental enlargement, self-analysis, and job-related counseling. A method is proposed to integrate them into a responsive program involving depth understanding, vision of the future, specialization commitment to change, and self-monitoring control. (MS)

Systematic approach to characterisation of NORM in Thailand.

PubMed

Chanyotha, S; Kranrod, C; Pengvanich, P

2015-11-01

The aim of this article is to provide information on the systematic approach that has been developed for the measurement of natural radiation exposure and the characterisation of naturally occurring radioactive materials (NORM) in terms of occurrence and distribution in various industrial processes, including the produced waste from the mineral industries in Thailand. The approach can be adapted for various types of study areas. The importance of collaboration among research institutions is discussed. Some developments include 25 documents; the redesign of the field equipment, such as the gamma survey meter, for convenient access to conduct measurement in various study areas; the method to collect and analyse radon gas from a natural gas pipeline and the manganese dioxide fibre to adsorb radium on-site for laboratory analysis. The NORM project in Thailand has been carried out for more than 10 y to support the development of NORM regulation in Thailand. In the previous studies as well as current, international standards for action levels have been adopted for safety purpose. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Bayesian approach to transforming public gene expression repositories into disease diagnosis databases.

PubMed

Huang, Haiyan; Liu, Chun-Chi; Zhou, Xianghong Jasmine

2010-04-13

The rapid accumulation of gene expression data has offered unprecedented opportunities to study human diseases. The National Center for Biotechnology Information Gene Expression Omnibus is currently the largest database that systematically documents the genome-wide molecular basis of diseases. However, thus far, this resource has been far from fully utilized. This paper describes the first study to transform public gene expression repositories into an automated disease diagnosis database. Particularly, we have developed a systematic framework, including a two-stage Bayesian learning approach, to achieve the diagnosis of one or multiple diseases for a query expression profile along a hierarchical disease taxonomy. Our approach, including standardizing cross-platform gene expression data and heterogeneous disease annotations, allows analyzing both sources of information in a unified probabilistic system. A high level of overall diagnostic accuracy was shown by cross validation. It was also demonstrated that the power of our method can increase significantly with the continued growth of public gene expression repositories. Finally, we showed how our disease diagnosis system can be used to characterize complex phenotypes and to construct a disease-drug connectivity map.

Integrating molecular and morphological approaches for characterizing parasite cryptic species: implications for parasitology.

PubMed

Nadler, Steven A; DE León, Gerardo Pérez-Ponce

2011-11-01

Herein we review theoretical and methodological considerations important for finding and delimiting cryptic species of parasites (species that are difficult to recognize using traditional systematic methods). Applications of molecular data in empirical investigations of cryptic species are discussed from an historical perspective, and we evaluate advantages and disadvantages of approaches that have been used to date. Developments concerning the theory and practice of species delimitation are emphasized because theory is critical to interpretation of data. The advantages and disadvantages of different molecular methodologies, including the number and kind of loci, are discussed relative to tree-based approaches for detecting and delimiting cryptic species. We conclude by discussing some implications that cryptic species have for research programmes in parasitology, emphasizing that careful attention to the theory and operational practices involved in finding, delimiting, and describing new species (including cryptic species) is essential, not only for fully characterizing parasite biodiversity and broader aspects of comparative biology such as systematics, evolution, ecology and biogeography, but to applied research efforts that strive to improve development and understanding of epidemiology, diagnostics, control and potential eradication of parasitic diseases.

Patient centred care for the medical treatment of lower urinary tract symptoms in patients with benign prostatic obstruction: a key point to improve patients' care - a systematic review.

PubMed

De Nunzio, Cosimo; Presicce, Fabrizio; Lombardo, Riccardo; Trucchi, Alberto; Bellangino, Mariangela; Tubaro, Andrea; Moja, Egidio

2018-06-26

Even though evidence based medicine, guidelines and algorithms still represent the pillars of the management of chronic diseases (i.e: hypertension, diabetes mellitus), a patient centred approach has been recently proposed as a successful strategy, in particular to improve drug adherence. Aim of the present review is to evaluate the unmet needs in LUTS/BPH management and the possible impact of a patient centered approach in this setting. A National Center for Biotechnology Information (NCBI) PubMed search for relevant articles published from January 2000 until December 2016 was performed by combining the following MESH terms: patients centred medicine, patient centered care, person centered care, patient centered outcomes, value based care, shared decision making, male, Lower Urinary Tract Symptoms, Benign Prostatic Hyperplasia, treatment. We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). All studies reporting on patient centred approach, shared decision making and evidence-based medicine were included in the review. All original article, reviews, letters, congress abstracts, and editorials comments were included in the review. Studies reporting single case reports, experimental studies on animal models and studies not in English were not included in the review. Overall 751 abstracts were reviewed, out of them 87 full texts were analysed resulting in 36 papers included. The evidence summarised in this systematic review confirmed how a patient centred visit may improve patient's adherence to medication. Although a patient centred model has been rarely used in urology, management of Low Urinary Tract Symptoms (LUTS) and Benign Prostatic Obstruction (BPO) may represent the perfect ground to experiment and improve this approach. Notwithstanding all the innovations in LUTS/BPO medical treatment, the real life picture is far from ideal. Recent evidence shows a dramatical low drug adherence and satisfaction to medical treatment in LUTS/BPH patients. A patient centred approach may improve drug adherence and some unmet needs in this area, potentially reducing complications and costs. However further well designed studies are needed to confirm this data.

Scientific Evaluation and Review of Claims in Health Care (SEaRCH): A Streamlined, Systematic, Phased Approach for Determining "What Works" in Healthcare.

PubMed

Jonas, Wayne B; Crawford, Cindy; Hilton, Lara; Elfenbaum, Pamela

2017-01-01

Answering the question of "what works" in healthcare can be complex and requires the careful design and sequential application of systematic methodologies. Over the last decade, the Samueli Institute has, along with multiple partners, developed a streamlined, systematic, phased approach to this process called the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™). The SEaRCH process provides an approach for rigorously, efficiently, and transparently making evidence-based decisions about healthcare claims in research and practice with minimal bias. SEaRCH uses three methods combined in a coordinated fashion to help determine what works in healthcare. The first, the Claims Assessment Profile (CAP), seeks to clarify the healthcare claim and question, and its ability to be evaluated in the context of its delivery. The second method, the Rapid Evidence Assessment of the Literature (REAL © ), is a streamlined, systematic review process conducted to determine the quantity, quality, and strength of evidence and risk/benefit for the treatment. The third method involves the structured use of expert panels (EPs). There are several types of EPs, depending on the purpose and need. Together, these three methods-CAP, REAL, and EP-can be integrated into a strategic approach to help answer the question "what works in healthcare?" and what it means in a comprehensive way. SEaRCH is a systematic, rigorous approach for evaluating healthcare claims of therapies, practices, programs, or products in an efficient and stepwise fashion. It provides an iterative, protocol-driven process that is customized to the intervention, consumer, and context. Multiple communities, including those involved in health service and policy, can benefit from this organized framework, assuring that evidence-based principles determine which healthcare practices with the greatest promise are used for improving the public's health and wellness.

Elements of integrated care approaches for older people: a review of reviews.

PubMed

Briggs, Andrew M; Valentijn, Pim P; Thiyagarajan, Jotheeswaran A; Araujo de Carvalho, Islene

2018-04-07

The World Health Organization (WHO) recently proposed an Integrated Care for Older People approach to guide health systems and services in better supporting functional ability of older people. A knowledge gap remains in the key elements of integrated care approaches used in health and social care delivery systems for older populations. The objective of this review was to identify and describe the key elements of integrated care models for elderly people reported in the literature. Review of reviews using a systematic search method. A systematic search was performed in MEDLINE and the Cochrane database in June 2017. Reviews of interventions aimed at care integration at the clinical (micro), organisational/service (meso) or health system (macro) levels for people aged ≥60 years were included. Non-Cochrane reviews published before 2015 were excluded. Reviews were assessed for quality using the Assessment of Multiple Systematic Reviews (AMSTAR) 1 tool. Fifteen reviews (11 systematic reviews, of which six were Cochrane reviews) were included, representing 219 primary studies. Three reviews (20%) included only randomised controlled trials (RCT), while 10 reviews (65%) included both RCTs and non-RCTs. The region where the largest number of primary studies originated was North America (n=89, 47.6%), followed by Europe (n=60, 32.1%) and Oceania (n=31, 16.6%). Eleven (73%) reviews focused on clinical 'micro' and organisational 'meso' care integration strategies. The most commonly reported elements of integrated care models were multidisciplinary teams, comprehensive assessment and case management. Nurses, physiotherapists, general practitioners and social workers were the most commonly reported service providers. Methodological quality was variable (AMSTAR scores: 1-11). Seven (47%) reviews were scored as high quality (AMSTAR score ≥8). Evidence of elements of integrated care for older people focuses particularly on micro clinical care integration processes, while there is a relative lack of information regarding the meso organisational and macro system-level care integration strategies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Guide for preparing active solar heating systems operation and maintenance manuals

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

Not Available

1991-01-01

This book presents a systematic and standardized approach to the preparation of operation and maintenance manuals for active solar heating systems. Provides an industry consensus of the best operating and maintenance procedures for large commercial-scale solar service water and space heating systems. A sample O M manual is included. 3-ring binder included.

Distance Learning.

ERIC Educational Resources Information Center

Orey, Michael; Koenecke, Lynne; Snider, Richard C.; Perkins, Ross A.; Holmes, Glen A.; Lockee, Barbara B.; Moller, Leslie A.; Harvey, Douglas; Downs, Margaret; Godshalk, Veronica M.

2003-01-01

Contains four articles covering trends and issues on distance learning including: the experience of two learners learning via the Internet; a systematic approach to determining the scalability of a distance education program; identifying factors that affect learning community development and performance in asynchronous distance education; and…

Time to Talk: 5 Things to Know about Complementary Health Approaches for Quitting Smoking

MedlinePlus

... results on other mind and body practices, including acupuncture and hypnosis, show little evidence of benefit. A ... or no treatment. A 2011 systematic review of acupuncture studies found no consistent evidence that acupuncture is ...

Developing and refining the methods for a 'one-stop shop' for research evidence about health systems.

PubMed

Lavis, John N; Wilson, Michael G; Moat, Kaelan A; Hammill, Amanda C; Boyko, Jennifer A; Grimshaw, Jeremy M; Flottorp, Signe

2015-02-25

Policymakers, stakeholders and researchers have not been able to find research evidence about health systems using an easily understood taxonomy of topics, know when they have conducted a comprehensive search of the many types of research evidence relevant to them, or rapidly identify decision-relevant information in their search results. To address these gaps, we developed an approach to building a 'one-stop shop' for research evidence about health systems. We developed a taxonomy of health system topics and iteratively refined it by drawing on existing categorization schemes and by using it to categorize progressively larger bundles of research evidence. We identified systematic reviews, systematic review protocols, and review-derived products through searches of Medline, hand searches of several databases indexing systematic reviews, hand searches of journals, and continuous scanning of listservs and websites. We developed an approach to providing 'added value' to existing content (e.g., coding systematic reviews according to the countries in which included studies were conducted) and to expanding the types of evidence eligible for inclusion (e.g., economic evaluations and health system descriptions). Lastly, we developed an approach to continuously updating the online one-stop shop in seven supported languages. The taxonomy is organized by governance, financial, and delivery arrangements and by implementation strategies. The 'one-stop shop', called Health Systems Evidence, contains a comprehensive inventory of evidence briefs, overviews of systematic reviews, systematic reviews, systematic review protocols, registered systematic review titles, economic evaluations and costing studies, health reform descriptions and health system descriptions, and many types of added-value coding. It is continuously updated and new content is regularly translated into Arabic, Chinese, English, French, Portuguese, Russian, and Spanish. Policymakers and stakeholders can now easily access and use a wide variety of types of research evidence about health systems to inform decision-making and advocacy. Researchers and research funding agencies can use Health Systems Evidence to identify gaps in the current stock of research evidence and domains that could benefit from primary research, systematic reviews, and review overviews.

Open Scenario Study, Phase I. Volume 1. Assessment Overview and Results

DTIC Science & Technology

2008-03-01

review of resources and requirements necessary to implement the response and improving civil military relations. Money Laudering Presents local...or money ? C. PHASE ONE APPROACH To systematically address these kinds of questions, IDA pursued a three-part approach that included reviewing the...their organizations a significant amount of time or money ? B. INTERVIEW QUESTIONS The final sponsor-approved version of the interview questions

Symposium on General Linear Model Approach to the Analysis of Experimental Data in Educational Research (Athens, Georgia, June 29-July 1, 1967). Final Report.

ERIC Educational Resources Information Center

Bashaw, W. L., Ed.; Findley, Warren G., Ed.

This volume contains the five major addresses and subsequent discussion from the Symposium on the General Linear Models Approach to the Analysis of Experimental Data in Educational Research, which was held in 1967 in Athens, Georgia. The symposium was designed to produce systematic information, including new methodology, for dissemination to the…

Diabetes education for Chinese adults with type 2 diabetes: A systematic review and meta-analysis of the effect on glycemic control.

PubMed

Choi, Tammie S T; Davidson, Zoe E; Walker, Karen Z; Lee, Jia Hwa; Palermo, Claire

2016-06-01

The purpose of this study is to systematically review evidence in English and Chinese publications to determine the size of glycemic effect of different diabetes education approaches for Chinese patients. CINAHL Plus, Embase, Ovid Medline, Scopus and the China National Knowledge Infrastructure database were searched. Studies were included if they were randomised controlled trials with a detailed description of education approach, with more than 50 Chinese-adult participants, reporting actual glycemic outcome and with at least 3-month follow-up. Data was systematically extracted and cross-checked by the authors. Methodological quality was assessed. Fifty-three studies, including five English and 48 Chinese publications, were included. The overall weighted mean difference (WMD) in glycated haemoglobin (HbA1c) was -1.19% (-13mmol/mol). Ongoing regular education was most-commonly employed, with a reported WMD of -2.02% (-22mmol/mol). Glycemic control was further enhanced in studies using information reinforcement strategies. Diabetes education in any format generates glycemic improvement for Chinese patients, but is particularly effective when an ongoing regular education is employed. Innovative strategies aligned with cultural concepts, such as employing patient examination to reinforce diabetes management knowledge and/or involving family in patient care deserve further trial to determine whether they enhance glycemic control in this group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of different dietary approaches on glycemic control and cardiovascular risk factors in patients with type 2 diabetes: a protocol for a systematic review and network meta-analysis.

PubMed

Schwingshackl, Lukas; Chaimani, Anna; Hoffmann, Georg; Schwedhelm, Carolina; Boeing, Heiner

2017-03-20

Dietary advice is one of the cornerstones in the management of type 2 diabetes mellitus. The American Diabetes Association recommended a hypocaloric diet for overweight or obese adults with type 2 diabetes in order to induce weight loss. However, there is limited evidence on the optimal approaches to control hyperglycemia in type 2 diabetes patients. The aim of the present study is to assess the comparative efficacy of different dietary approaches on glycemic control and blood lipids in patients with type 2 diabetes mellitus in a systematic review including a standard pairwise and network meta-analysis of randomized trials. We will conduct searches in Cochrane Central Register of Controlled Trials (CENTRAL) on the Cochrane Library, PubMed (from 1966), and Google Scholar. Citations, abstracts, and relevant papers will be screened for eligibility by two reviewers independently. Randomized controlled trials (with a control group or randomized trials with at least two intervention groups) will be included if they meet the following criteria: (1) include type 2 diabetes mellitus, (2) include patients aged ≥18 years, (3) include dietary intervention (different type of diets: e.g., Mediterranean dietary pattern, low-carbohydrate diet, low-fat diet, vegetarian diet, high protein diet); either hypo, iso-caloric, or ad libitum diets, (4) minimum intervention period of 12 weeks. For each outcome measure of interest, random effects pairwise and network meta-analyses will be performed in order to determine the pooled relative effect of each intervention relative to every other intervention in terms of the post-intervention values (or mean differences between the changes from baseline value scores). Subgroup analyses are planned for study length, sample size, age, and sex. This systematic review will synthesize the available evidence on the comparative efficacy of different dietary approaches in the management of glycosylated hemoglobin (primary outcome), fasting glucose, and cardiovascular risk factors in type 2 diabetes mellitus patients. The results of the present network meta-analysis will influence evidence-based treatment decisions since it will be fundamental for based recommendations in the management of type 2 diabetes. PROSPERO 42016047464.

A systematic grounded approach to the development of complex interventions: the Australian WorkHealth Program--arthritis as a case study.

PubMed

Reavley, Nicola; Livingston, Jenni; Buchbinder, Rachelle; Bennell, Kim; Stecki, Chris; Osborne, Richard Harry

2010-02-01

Despite demands for evidence-based research and practice, little attention has been given to systematic approaches to the development of complex interventions to tackle workplace health problems. This paper outlines an approach to the initial stages of a workplace program development which integrates health promotion and disease management. The approach commences with systematic and genuine processes of obtaining information from key stakeholders with broad experience of these interventions. This information is constructed into a program framework in which practice-based and research-informed elements are both valued. We used this approach to develop a workplace education program to reduce the onset and impact of a common chronic disease - osteoarthritis. To gain information systematically at a national level, a structured concept mapping workshop with 47 participants from across Australia was undertaken. Participants were selected to maximise the whole-of-workplace perspective and included health education providers, academics, clinicians and policymakers. Participants generated statements in response to a seeding statement: Thinking as broadly as possible, what changes in education and support should occur in the workplace to help in the prevention and management of arthritis? Participants grouped the resulting statements into conceptually coherent groups and a computer program was used to generate a 'cluster map' along with a list of statements sorted according to cluster membership. In combination with research-based evidence, the concept map informed the development of a program logic model incorporating the program's guiding principles, possible service providers, services, training modes, program elements and the causal processes by which participants might benefit. The program logic model components were further validated through research findings from diverse fields, including health education, coaching, organisational learning, workplace interventions, workforce development and osteoarthritis disability prevention. In summary, wide and genuine consultation, concept mapping, and evidence-based program logic development were integrated to develop a whole-of-system complex intervention in which potential effectiveness and assimilation into the workplace for which optimised. Copyright 2009 Elsevier Ltd. All rights reserved.

Risk factors for depression in community-treated epilepsy: systematic review.

PubMed

Lacey, Cameron J; Salzberg, Michael R; D'Souza, Wendyl J

2015-02-01

Depression is one of the most common psychiatric comorbidities in epilepsy; however, the factors contributing to this association remain unclear. There is a growing consensus that methodological limitations, particularly selection bias, affect many of the original studies. A systematic review focussed on community-based studies offers an alternative approach for the identification of the risk factors for depression. Searches were performed in MEDLINE (Ovid), 2000 to 31 December 2013, EMBASE, and Google Scholar to identify studies examining risk factors for depression in epilepsy. Community-based studies of adults with epilepsy that reported at least one risk factor for depression were included. The search identified 17 studies that met selection criteria, representing a combined total of 12,212 people with epilepsy with a mean sample size of 718. The most consistent risk factors for depression were sociodemographic factors, despite the fact that most studies focus on epilepsy-related factors. Most studies lacked a systematic conceptual approach to investigating depression, and few risk factors were consistently well studied. Future community-based studies require a detailed systematic approach to improve the ability to detect risk factors for depression in epilepsy. Psychological factors were rarely studied in community-based samples with epilepsy, although the consistent association with depression in the few studies that did suggests this warrants further examination. Copyright © 2014 Elsevier Inc. All rights reserved.

Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers’ perceptions

PubMed Central

Wallace, John; Nwosu, Bosah; Clarke, Mike

2012-01-01

Objective To review the barriers to the uptake of research evidence from systematic reviews by decision makers. Search strategy We searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Reference lists of primary studies and related reviews were also consulted. Selection criteria Studies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. All study designs, settings and decision makers were included. One investigator screened titles to identify candidate articles then two reviewers independently assessed the quality and the relevance of retrieved reports. Data extraction Two reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Using a pre-established taxonomy, the barriers were organised into a framework according to their effect on knowledge, attitudes or behaviour. Results Of 1726 articles initially identified, we selected 27 unique published studies describing at least one barrier to the uptake of evidence from systematic reviews. These studies included a total of 25 surveys and 2 qualitative studies. Overall, the majority of participants (n=10 218) were physicians (64%). The most commonly investigated barriers were lack of use (14/25), lack of awareness (12/25), lack of access (11/25), lack of familiarity (7/25), lack of usefulness (7/25), lack of motivation (4/25) and external barriers (5/25). Conclusions This systematic review reveals that strategies to improve the uptake of evidence from reviews and meta-analyses will need to overcome a wide variety of obstacles. Our review describes the reasons why knowledge users, especially physicians, do not call on systematic reviews. This study can inform future approaches to enhancing systematic review uptake and also suggests potential avenues for future investigation. PMID:22942232

Are diuretics effective for Ménière`s disease?

PubMed

Rosenbaum, Andrés; Winter, Matías

2018-03-28

Ménière`s disease is an inner ear disorder characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Diuretics have been widely used for the treatment of attacks, but there is controversy about their effectiveness. To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We identified three systematic reviews including nineteen studies overall, of which four were randomized trials. We concluded it is not clear whether diuretics lead to a symptomatic improvement of vertigo or an objective decrease in hearing loss in patients with Ménière`s disease, because the certainty of the evidence is very low.

Topical vs. systemic treatments for acute otitis media.

PubMed

Thornton, Kathy; Parrish, Francie; Swords, Christine

2011-01-01

Acute otitis media (AOM) is a common condition in children that is often treated with systemic antibiotic therapy; however, research suggests that non-complicated AOM will resolve spontaneously using only eardrops. To determine best practice for the use of systematic antibiotics compared to topical treatment of AOM, a systematic review of evidence was conducted. Cochrane, Medline, CINAHL, and other databases were searched. Inclusion criteria were studies published from 1995-2010 that included children with AOM and were randomized controlled trials (RCTs). Five systematic reviews and five RCTs were included in the review. Current evidence recommends using topical and other alternative approaches for treating non-complicated AOM in children 2 years of age or older; however, many practitioners are not currently following these recommendations for various reasons. Additional research to address these reasons may help determine how to improve practitioner adherence to best practice evidence and guidelines to help reduce the unnecessary use of systemic antibiotics.

Nutritional Intervention as a Preventive Approach for Cognitive-Related Outcomes in Cognitively Healthy Older Adults: A Systematic Review.

PubMed

Solfrizzi, Vincenzo; Agosti, Pasquale; Lozupone, Madia; Custodero, Carlo; Schilardi, Andrea; Valiani, Vincenzo; Sardone, Rodolfo; Dibello, Vittorio; Di Lena, Luca; Lamanna, Angela; Stallone, Roberta; Bellomo, Antonello; Greco, Antonio; Daniele, Antonio; Seripa, Davide; Sabbà, Carlo; Logroscino, Giancarlo; Panza, Francesco

2018-05-26

The link diet-cognitive function/dementia has been largely investigated in observational studies; however, there was a lack of evidence from randomized clinical trials (RCTs) on the prevention of late-life cognitive disorders though dietary intervention in cognitively healthy older adults. In the present article, we systematically reviewed RCTs published in the last four years (2014-2017) exploring nutritional intervention efficacy in preventing the onset of late-life cognitive disorders and dementia in cognitively healthy subjects aged 60 years and older using different levels of investigation (i.e., dietary pattern changes/medical food/nutraceutical supplementation/multidomain approach and dietary macro- and micronutrient approaches) as well as possible underlying mechanisms of nutritional prevention. From the 35 included RCTs, there was moderate evidence that intervention through dietary pattern changes, medical food/nutraceutical supplementation, and multidomain approach improved specific cognitive domains or cognitive-related blood biomarkers. There was high evidence that protein supplementation improved specific cognitive domains or functional status in prefrail older adults without effect.

Definitions, Foundations and Associations of Physical Literacy: A Systematic Review.

PubMed

Edwards, Lowri C; Bryant, Anna S; Keegan, Richard J; Morgan, Kevin; Jones, Anwen M

2017-01-01

The concept of physical literacy has stimulated increased research attention in recent years-being deployed in physical education, sport participation, and the promotion of physical activity. Independent research groups currently operationalize the construct differently. The purpose of this systematic review was to conduct a systematic review of the physical literacy construct, as reflected in contemporary research literature. Five databases were searched using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for systematic reviews. Inclusion criteria were English language, peer reviewed, published by March 2016, and seeking to conceptualize physical literacy. Articles that met these criteria were analyzed in relation to three core areas: properties/attributes, philosophical foundations and theoretical associations with other constructs. A total of 50 published articles met the inclusion criteria and were analyzed qualitatively using inductive thematic analysis. The thematic analysis addressed the three core areas. Under definitions, core attributes that define physical literacy were identified, as well as areas of conflict between different approaches currently being adopted. One relatively clear philosophical approach was prominent in approximately half of the papers, based on a monist/holistic ontology and phenomenological epistemology. Finally, the analysis identified a number of theoretical associations, including health, physical activity and academic performance. Current literature contains different representations of the physical literacy construct. The costs and benefits of adopting an exclusive approach versus pluralism are considered. Recommendations for both researchers and practitioners focus on identifying and clearly articulating the definitions, philosophical assumptions and expected outcomes prior to evaluating the effectiveness of this emerging concept.

A systematic checklist approach to immunosuppression risk management: An audit of practice at two clinical neuroimmunology centers.

PubMed

Mori, Amelia M; Agarwal, Smriti; Lee, Monique W M; Rafferty, Martina; Hardy, Todd A; Coles, Alasdair; Reddel, Stephen W; Riminton, D Sean

2017-11-15

There is no consensus approach to safety screening for immune intervention in clinical neuroimmunology. An immunosuppression risk evaluation checklist was used as an audit tool to assess real-world immunosuppression risk management and formulate recommendations for quality improvements in patient safety. Ninety-nine patients from two centres with 27 non-MS diagnoses were included. An average of 1.9 comorbidities with the potential to adversely impact morbidity and mortality associated with immunosuppression were identified. Diabetes and smoking were the most common, however a range of rarer but potentially life-threatening co-morbid disorders in the context of immunosuppression were identified. Inadequate documentation of risk mitigation tasks was common at 40.1% of total tasks across both cohorts. A routine, systematic immunosuppression checklist approach should be considered to improve immunosuppression risk management in clinical neuroimmunology practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Making literature reviews more reliable through application of lessons from systematic reviews.

PubMed

Haddaway, N R; Woodcock, P; Macura, B; Collins, A

2015-12-01

Review articles can provide valuable summaries of the ever-increasing volume of primary research in conservation biology. Where findings may influence important resource-allocation decisions in policy or practice, there is a need for a high degree of reliability when reviewing evidence. However, traditional literature reviews are susceptible to a number of biases during the identification, selection, and synthesis of included studies (e.g., publication bias, selection bias, and vote counting). Systematic reviews, pioneered in medicine and translated into conservation in 2006, address these issues through a strict methodology that aims to maximize transparency, objectivity, and repeatability. Systematic reviews will always be the gold standard for reliable synthesis of evidence. However, traditional literature reviews remain popular and will continue to be valuable where systematic reviews are not feasible. Where traditional reviews are used, lessons can be taken from systematic reviews and applied to traditional reviews in order to increase their reliability. Certain key aspects of systematic review methods that can be used in a context-specific manner in traditional reviews include focusing on mitigating bias; increasing transparency, consistency, and objectivity, and critically appraising the evidence and avoiding vote counting. In situations where conducting a full systematic review is not feasible, the proposed approach to reviewing evidence in a more systematic way can substantially improve the reliability of review findings, providing a time- and resource-efficient means of maximizing the value of traditional reviews. These methods are aimed particularly at those conducting literature reviews where systematic review is not feasible, for example, for graduate students, single reviewers, or small organizations. © 2015 Society for Conservation Biology.

Using high-throughput literature mining to support read-across predictions of toxicity (SOT)

EPA Science Inventory

Building scientific confidence in the development and evaluation of read-across remains an ongoing challenge. Approaches include establishing systematic frameworks to identify sources of uncertainty and ways to address them. One source of uncertainty is related to characterizing ...

High-throughput literature mining to support read-across predictions of toxicity (ASCCT meeting)

EPA Science Inventory

Building scientific confidence in the development and evaluation of read-across remains an ongoing challenge. Approaches include establishing systematic frameworks to identify sources of uncertainty and ways to address them. One source of uncertainty is related to characterizing ...

Life course approach in social epidemiology: an overview, application and future implications.

PubMed

Cable, Noriko

2014-01-01

The application of the life course approach to social epidemiology has helped epidemiologists theoretically examine social gradients in population health. Longitudinal data with rich contextual information collected repeatedly and advanced statistical approaches have made this challenging task easier. This review paper provides an overview of the life course approach in epidemiology, its research application, and future challenges. In summary, a systematic approach to methods, including theoretically guided measurement of socioeconomic position, would assist researchers in gathering evidence for reducing social gradients in health, and collaboration across individual disciplines will make this task achievable.

Induction chemotherapy vs post-operative adjuvant therapy for malignant pleural mesothelioma.

PubMed

Marulli, Giuseppe; Faccioli, Eleonora; Bellini, Alice; Mammana, Marco; Rea, Federico

2017-08-01

Malignant pleural mesothelioma (MPM) is an aggressive neoplasia. Multidisciplinary treatments, including the association of induction and/or adjuvant therapeutic regimens with surgery, have been reported to give encouraging results. Current therapeutic options are not well standardized yet, especially regarding the best association between surgery and medical treatments. The present review aims to assess safety, efficacy and outcomes of different therapies for MPM. Areas covered: This article focuses on the multimodality treatment of mesothelioma. A systematic review was performed by using electronic databases to identify studies that considered induction and adjuvant approaches in MPM therapy in a multidisciplinary setting, including surgery. Endpoints included overall survival, disease free survival, disease recurrence, and complications. Expert commentary: This systematic review offers a comprehensive view of current multidisciplinary therapeutic strategies for MPM, suggesting that multimodality therapy offers acceptable outcomes with better results reported for trimodality approaches. Individualization of care for each patient is fundamental in choosing the most appropriate treatment. The growing complexity of treatment protocols mandates that MPM patients be referred to specialized Centers, in which every component of the interdisciplinary team can provide the necessary expertise and quality of care.

Machinery health prognostics: A systematic review from data acquisition to RUL prediction

NASA Astrophysics Data System (ADS)

Lei, Yaguo; Li, Naipeng; Guo, Liang; Li, Ningbo; Yan, Tao; Lin, Jing

2018-05-01

Machinery prognostics is one of the major tasks in condition based maintenance (CBM), which aims to predict the remaining useful life (RUL) of machinery based on condition information. A machinery prognostic program generally consists of four technical processes, i.e., data acquisition, health indicator (HI) construction, health stage (HS) division, and RUL prediction. Over recent years, a significant amount of research work has been undertaken in each of the four processes. And much literature has made an excellent overview on the last process, i.e., RUL prediction. However, there has not been a systematic review that covers the four technical processes comprehensively. To fill this gap, this paper provides a review on machinery prognostics following its whole program, i.e., from data acquisition to RUL prediction. First, in data acquisition, several prognostic datasets widely used in academic literature are introduced systematically. Then, commonly used HI construction approaches and metrics are discussed. After that, the HS division process is summarized by introducing its major tasks and existing approaches. Afterwards, the advancements of RUL prediction are reviewed including the popular approaches and metrics. Finally, the paper provides discussions on current situation, upcoming challenges as well as possible future trends for researchers in this field.

Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers.

PubMed

Raheb, Ghoncheh; Khaleghi, Esmat; Moghanibashi-Mansourieh, Amir; Farhoudian, Ali; Teymouri, Robab

2016-01-01

This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. A covariance analysis test and independent and dependent t -test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients' self-understanding and self-recognition, and enhancing social functioning.

Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers

PubMed Central

Raheb, Ghoncheh; Khaleghi, Esmat; Moghanibashi-Mansourieh, Amir; Farhoudian, Ali; Teymouri, Robab

2016-01-01

Purpose This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. Patients and methods This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. Results A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. Conclusion Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients’ self-understanding and self-recognition, and enhancing social functioning. PMID:27895520

Liaison psychiatry and bariatric surgery: double standards. What are the possibilities for the systematization of the pre-operative psychiatric assessment in Belgium?

PubMed

Jacques, Denis; Reynaert, Christine; Zdanowicz, Nicolas

2016-09-01

In the context of health care in Belgium, the psychological or psychiatric opinion of a multidisciplinary team is required in the assessment of bariatric surgery candidates. In clinical practice, a wide variety of liaison psychiatry assessment methods exist. On the basis of a post-operative psychiatric comorbidity case report and a literature review on "liaison psychiatry and bariatric surgery" we aim to identify opportunities for the systematization of bariatric pre-surgery psychiatric evaluation. The bariatric pre-surgery evaluation must be rigorous and founded on evidence-based medicine. On this basis, specific psychiatric criteria may be defined and researched in assessments. The issue remains for psychiatric comorbidities that develop after surgery and for which a preventive framework should be sustained in the liaison psychiatry approach. The aim of the research is to support an improved systematization of the psychological assessments of pre-operative bariatric surgery candidates. We believe that systematic evaluation tools should be defined for the identification of possible absolute or relative contra-indications and that a preventive approach to post-operative psychiatric disorders should be included in this assessment.

Systematic and statistical uncertainties in simulated r-process abundances due to uncertain nuclear masses

DOE PAGES

Surman, Rebecca; Mumpower, Matthew; McLaughlin, Gail

2017-02-27

Unknown nuclear masses are a major source of nuclear physics uncertainty for r-process nucleosynthesis calculations. Here we examine the systematic and statistical uncertainties that arise in r-process abundance predictions due to uncertainties in the masses of nuclear species on the neutron-rich side of stability. There is a long history of examining systematic uncertainties by the application of a variety of different mass models to r-process calculations. Here we expand upon such efforts by examining six DFT mass models, where we capture the full impact of each mass model by updating the other nuclear properties — including neutron capture rates, β-decaymore » lifetimes, and β-delayed neutron emission probabilities — that depend on the masses. Unlike systematic effects, statistical uncertainties in the r-process pattern have just begun to be explored. Here we apply a global Monte Carlo approach, starting from the latest FRDM masses and considering random mass variations within the FRDM rms error. Here, we find in each approach that uncertain nuclear masses produce dramatic uncertainties in calculated r-process yields, which can be reduced in upcoming experimental campaigns.« less

Systematic and statistical uncertainties in simulated r-process abundances due to uncertain nuclear masses

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

Surman, Rebecca; Mumpower, Matthew; McLaughlin, Gail

Unknown nuclear masses are a major source of nuclear physics uncertainty for r-process nucleosynthesis calculations. Here we examine the systematic and statistical uncertainties that arise in r-process abundance predictions due to uncertainties in the masses of nuclear species on the neutron-rich side of stability. There is a long history of examining systematic uncertainties by the application of a variety of different mass models to r-process calculations. Here we expand upon such efforts by examining six DFT mass models, where we capture the full impact of each mass model by updating the other nuclear properties — including neutron capture rates, β-decaymore » lifetimes, and β-delayed neutron emission probabilities — that depend on the masses. Unlike systematic effects, statistical uncertainties in the r-process pattern have just begun to be explored. Here we apply a global Monte Carlo approach, starting from the latest FRDM masses and considering random mass variations within the FRDM rms error. Here, we find in each approach that uncertain nuclear masses produce dramatic uncertainties in calculated r-process yields, which can be reduced in upcoming experimental campaigns.« less

Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment.

PubMed

McCallum, Lindsay C; Ollson, Christopher A; Stefanovic, Ingrid L

2016-01-01

The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

Influenza forecasting in human populations: a scoping review.

PubMed

Chretien, Jean-Paul; George, Dylan; Shaman, Jeffrey; Chitale, Rohit A; McKenzie, F Ellis

2014-01-01

Forecasts of influenza activity in human populations could help guide key preparedness tasks. We conducted a scoping review to characterize these methodological approaches and identify research gaps. Adapting the PRISMA methodology for systematic reviews, we searched PubMed, CINAHL, Project Euclid, and Cochrane Database of Systematic Reviews for publications in English since January 1, 2000 using the terms "influenza AND (forecast* OR predict*)", excluding studies that did not validate forecasts against independent data or incorporate influenza-related surveillance data from the season or pandemic for which the forecasts were applied. We included 35 publications describing population-based (N = 27), medical facility-based (N = 4), and regional or global pandemic spread (N = 4) forecasts. They included areas of North America (N = 15), Europe (N = 14), and/or Asia-Pacific region (N = 4), or had global scope (N = 3). Forecasting models were statistical (N = 18) or epidemiological (N = 17). Five studies used data assimilation methods to update forecasts with new surveillance data. Models used virological (N = 14), syndromic (N = 13), meteorological (N = 6), internet search query (N = 4), and/or other surveillance data as inputs. Forecasting outcomes and validation metrics varied widely. Two studies compared distinct modeling approaches using common data, 2 assessed model calibration, and 1 systematically incorporated expert input. Of the 17 studies using epidemiological models, 8 included sensitivity analysis. This review suggests need for use of good practices in influenza forecasting (e.g., sensitivity analysis); direct comparisons of diverse approaches; assessment of model calibration; integration of subjective expert input; operational research in pilot, real-world applications; and improved mutual understanding among modelers and public health officials.

Influenza Forecasting in Human Populations: A Scoping Review

PubMed Central

Chretien, Jean-Paul; George, Dylan; Shaman, Jeffrey; Chitale, Rohit A.; McKenzie, F. Ellis

2014-01-01

Forecasts of influenza activity in human populations could help guide key preparedness tasks. We conducted a scoping review to characterize these methodological approaches and identify research gaps. Adapting the PRISMA methodology for systematic reviews, we searched PubMed, CINAHL, Project Euclid, and Cochrane Database of Systematic Reviews for publications in English since January 1, 2000 using the terms “influenza AND (forecast* OR predict*)”, excluding studies that did not validate forecasts against independent data or incorporate influenza-related surveillance data from the season or pandemic for which the forecasts were applied. We included 35 publications describing population-based (N = 27), medical facility-based (N = 4), and regional or global pandemic spread (N = 4) forecasts. They included areas of North America (N = 15), Europe (N = 14), and/or Asia-Pacific region (N = 4), or had global scope (N = 3). Forecasting models were statistical (N = 18) or epidemiological (N = 17). Five studies used data assimilation methods to update forecasts with new surveillance data. Models used virological (N = 14), syndromic (N = 13), meteorological (N = 6), internet search query (N = 4), and/or other surveillance data as inputs. Forecasting outcomes and validation metrics varied widely. Two studies compared distinct modeling approaches using common data, 2 assessed model calibration, and 1 systematically incorporated expert input. Of the 17 studies using epidemiological models, 8 included sensitivity analysis. This review suggests need for use of good practices in influenza forecasting (e.g., sensitivity analysis); direct comparisons of diverse approaches; assessment of model calibration; integration of subjective expert input; operational research in pilot, real-world applications; and improved mutual understanding among modelers and public health officials. PMID:24714027

IMPLICIT DUAL CONTROL BASED ON PARTICLE FILTERING AND FORWARD DYNAMIC PROGRAMMING.

PubMed

Bayard, David S; Schumitzky, Alan

2010-03-01

This paper develops a sampling-based approach to implicit dual control. Implicit dual control methods synthesize stochastic control policies by systematically approximating the stochastic dynamic programming equations of Bellman, in contrast to explicit dual control methods that artificially induce probing into the control law by modifying the cost function to include a term that rewards learning. The proposed implicit dual control approach is novel in that it combines a particle filter with a policy-iteration method for forward dynamic programming. The integration of the two methods provides a complete sampling-based approach to the problem. Implementation of the approach is simplified by making use of a specific architecture denoted as an H-block. Practical suggestions are given for reducing computational loads within the H-block for real-time applications. As an example, the method is applied to the control of a stochastic pendulum model having unknown mass, length, initial position and velocity, and unknown sign of its dc gain. Simulation results indicate that active controllers based on the described method can systematically improve closed-loop performance with respect to other more common stochastic control approaches.

Development of a structured observational method for the systematic assessment of school food-choice architecture.

PubMed

Ozturk, Orgul D; McInnes, Melayne M; Blake, Christine E; Frongillo, Edward A; Jones, Sonya J

2016-01-01

The objective of this study is to develop a structured observational method for the systematic assessment of the food-choice architecture that can be used to identify key points for behavioral economic intervention intended to improve the health quality of children's diets. We use an ethnographic approach with observations at twelve elementary schools to construct our survey instrument. Elements of the structured observational method include decision environment, salience, accessibility/convenience, defaults/verbal prompts, number of choices, serving ware/method/packaging, and social/physical eating environment. Our survey reveals important "nudgeable" components of the elementary school food-choice architecture, including precommitment and default options on the lunch line.

Using humor in systematic desensitization to reduce fear.

PubMed

Ventis, W L; Higbee, G; Murdock, S A

2001-04-01

Effectiveness of systematic desensitization for fear reduction, using humorous hierarchy scenes without relaxation, was tested. Participants were 40 students highly fearful of spiders. Using a 24-item behavioral approach test with an American tarantula, participants were matched on fear level and randomly assigned to 1 of 3 treatment groups: (a) systematic desensitization, (b) humor desensitization, and (c) untreated controls. Each participant was seen for 6 sessions, including pretest and posttest. Analyses of covariance of posttest scores revealed that the 2 treatment groups showed greater reduction in fear than the controls on 3 measures but did not differ from each other. Therefore, humor in systematic desensitization reduced fear as effectively as more traditional desensitization. This finding may have therapeutic applications; however, it may also be applicable in advertising to desensitize fear of a dangerous product, such as cigarettes.

The economic burden of physical inactivity: a systematic review and critical appraisal.

PubMed

Ding, Ding; Kolbe-Alexander, Tracy; Nguyen, Binh; Katzmarzyk, Peter T; Pratt, Michael; Lawson, Kenny D

2017-10-01

To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies. Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705). Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts. Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English. Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations. Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Psychotherapeutic Treatment for Anorexia Nervosa: A Systematic Review and Network Meta-Analysis

PubMed Central

Zeeck, Almut; Herpertz-Dahlmann, Beate; Friederich, Hans-Christoph; Brockmeyer, Timo; Resmark, Gaby; Hagenah, Ulrich; Ehrlich, Stefan; Cuntz, Ulrich; Zipfel, Stephan; Hartmann, Armin

2018-01-01

Background: The aim of the study was a systematic review of studies evaluating psychotherapeutic treatment approaches in anorexia nervosa and to compare their efficacy. Weight gain was chosen as the primary outcome criterion. We also aimed to compare treatment effects according to service level (inpatient vs. outpatient) and age group (adolescents vs. adults). Methods:The data bases PubMed, Cochrane Library, Web of Science, Cinahl, and PsychInfo were used for a systematic literature search (until Feb 2017). Search terms were adapted for data base, combining versions of the search terms anorexia, treat*/therap* and controlled trial. Studies were selected using pre-defined in- and exclusion criteria. Data were extracted by two independent coders using piloted forms. Network-meta-analyses were conducted on all RCTs. For a comparison of service levels and age groups, standard mean change (SMC) statistics were used and naturalistic, non-randomized studies included. Results: Eighteen RCTs (trials on adults: 622 participants; trials on adolescents: 625 participants) were included in the network meta-analysis. SMC analyses were conducted with 38 studies (1,164 participants). While family-based approaches dominate interventions for adolescents, individual psychotherapy dominates in adults. There was no superiority of a specific approach. Weight gains were more rapid in adolescents and inpatient treatment. Conclusions: Several specialized psychotherapeutic interventions have been developed and can be recommended for AN. However, adult and adolescent patients should be distinguished, as groups differ in terms of treatment approaches considered suitable as well as treatment response. Future trials should replicate previous findings and be multi-center trials with large sample sizes to allow for subgroup analyses. Patient assessment should include variables that can be considered relevant moderators of treatment outcome. It is desirable to explore adaptive treatment strategies for subgroups of patients with AN. Identifying and addressing maintaining factors in AN remains a major challenge. PMID:29765338

Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews.

PubMed

Finfgeld-Connett, Deborah; Johnson, E Diane

2013-01-01

To report literature search strategies for the purpose of conducting knowledge-building and theory-generating qualitative systematic reviews. Qualitative systematic reviews lie on a continuum from knowledge-building and theory-generating to aggregating and summarizing. Different types of literature searches are needed to optimally support these dissimilar reviews. Articles published between 1989-Autumn 2011. These documents were identified using a hermeneutic approach and multiple literature search strategies. Redundancy is not the sole measure of validity when conducting knowledge-building and theory-generating systematic reviews. When conducting these types of reviews, literature searches should be consistent with the goal of fully explicating concepts and the interrelationships among them. To accomplish this objective, a 'berry picking' approach is recommended along with strategies for overcoming barriers to finding qualitative research reports. To enhance integrity of knowledge-building and theory-generating systematic reviews, reviewers are urged to make literature search processes as transparent as possible, despite their complexity. This includes fully explaining and rationalizing what databases were used and how they were searched. It also means describing how literature tracking was conducted and grey literature was searched. In the end, the decision to cease searching also needs to be fully explained and rationalized. Predetermined linear search strategies are unlikely to generate search results that are adequate for purposes of conducting knowledge-building and theory-generating qualitative systematic reviews. Instead, it is recommended that iterative search strategies take shape as reviews evolve. © 2012 Blackwell Publishing Ltd.

Up on the Roof: A Systematic Approach to Roof Maintenance.

ERIC Educational Resources Information Center

Burd, William

1979-01-01

A systematic roof maintenance program is characterized by carefully prepared long- and short-range plans. An essential feature of a systematic approach to roof maintenance is the stress on preventive measures rather than the patching of leaks. (Author)

Considering methodological options for reviews of theory: illustrated by a review of theories linking income and health

PubMed Central

2014-01-01

Background Review of theory is an area of growing methodological advancement. Theoretical reviews are particularly useful where the literature is complex, multi-discipline, or contested. It has been suggested that adopting methods from systematic reviews may help address these challenges. However, the methodological approaches to reviews of theory, including the degree to which systematic review methods can be incorporated, have received little discussion in the literature. We recently employed systematic review methods in a review of theories about the causal relationship between income and health. Methods This article discusses some of the methodological issues we considered in developing the review and offers lessons learnt from our experiences. It examines the stages of a systematic review in relation to how they could be adapted for a review of theory. The issues arising and the approaches taken in the review of theories in income and health are considered, drawing on the approaches of other reviews of theory. Results Different approaches to searching were required, including electronic and manual searches, and electronic citation tracking to follow the development of theories. Determining inclusion criteria was an iterative process to ensure that inclusion criteria were specific enough to make the review practical and focused, but not so narrow that key literature was excluded. Involving subject specialists was valuable in the literature searches to ensure principal papers were identified and during the inductive approaches used in synthesis of theories to provide detailed understanding of how theories related to another. Reviews of theory are likely to involve iterations and inductive processes throughout, and some of the concepts and techniques that have been developed for qualitative evidence synthesis can be usefully translated to theoretical reviews of this kind. Conclusions It may be useful at the outset of a review of theory to consider whether the key aim of the review is to scope out theories relating to a particular issue; to conduct in-depth analysis of key theoretical works with the aim of developing new, overarching theories and interpretations; or to combine both these processes in the review. This can help decide the most appropriate methodological approach to take at particular stages of the review. PMID:25312937

An Investigation of the Effects on Students' Attitudes, Beliefs, and Abilities in Problem Solving and Mathematics after One Year of a Systematic Approach to the Learning of Problem Solving.

ERIC Educational Resources Information Center

Higgins, Karen M.

This study investigated the effects of Oregon's Lane County "Problem Solving in Mathematics" (PSM) materials on middle-school students' attitudes, beliefs, and abilities in problem solving and mathematics. The instructional approach advocated in PSM includes: the direct teaching of five problem-solving skills, weekly challenge problems,…

Insect Phylogenomics: Exploring the Source of Incongruence Using New Transcriptomic Data

PubMed Central

Simon, Sabrina; Narechania, Apurva; DeSalle, Rob; Hadrys, Heike

2012-01-01

The evolution of the diverse insect lineages is one of the most fascinating issues in evolutionary biology. Despite extensive research in this area, the resolution of insect phylogeny especially of interordinal relationships has turned out to be still a great challenge. One of the challenges for insect systematics is the radiation of the polyneopteran lineages with several contradictory and/or unresolved relationships. Here, we provide the first transcriptomic data for three enigmatic polyneopteran orders (Dermaptera, Plecoptera, and Zoraptera) to clarify one of the most debated issues among higher insect systematics. We applied different approaches to generate 3 data sets comprising 78 species and 1,579 clusters of orthologous genes. Using these three matrices, we explored several key mechanistic problems of phylogenetic reconstruction including missing data, matrix selection, gene and taxa number/choice, and the biological function of the genes. Based on the first phylogenomic approach including these three ambiguous polyneopteran orders, we provide here conclusive support for monophyletic Polyneoptera, contesting the hypothesis of Zoraptera + Paraneoptera and Plecoptera + remaining Neoptera. In addition, we employ various approaches to evaluate data quality and highlight problematic nodes within the Insect Tree that still exist despite our phylogenomic approach. We further show how the support for these nodes or alternative hypotheses might depend on the taxon- and/or gene-sampling. PMID:23175716

A general framework for analysing diversity in science, technology and society.

PubMed

Stirling, Andy

2007-08-22

This paper addresses the scope for more integrated general analysis of diversity in science, technology and society. It proposes a framework recognizing three necessary but individually insufficient properties of diversity. Based on 10 quality criteria, it suggests a general quantitative non-parametric diversity heuristic. This allows the systematic exploration of diversity under different perspectives, including divergent conceptions of relevant attributes and contrasting weightings on different diversity properties. It is shown how this heuristic may be used to explore different possible trade-offs between diversity and other aspects of interest, including portfolio interactions. The resulting approach offers a way to be more systematic and transparent in the treatment of scientific and technological diversity in a range of fields, including conservation management, research governance, energy policy and sustainable innovation.

Effects of computerized cognitive training on neuroimaging outcomes in older adults: a systematic review.

PubMed

Ten Brinke, Lisanne F; Davis, Jennifer C; Barha, Cindy K; Liu-Ambrose, Teresa

2017-07-10

Worldwide, the population is aging and the number of individuals diagnosed with dementia is rising rapidly. Currently, there are no effective pharmaceutical cures. Hence, identifying lifestyle approaches that may prevent, delay, or treat cognitive impairment and dementia in older adults is becoming increasingly important. Computerized Cognitive Training (CCT) is a promising strategy to combat cognitive decline. Yet, the underlying mechanisms of the effect of CCT on cognition remain poorly understood. Hence, the primary objective of this systematic review was to examine peer-reviewed literature ascertaining the effect of CCT on both structural and functional neuroimaging measures among older adults to gain insight into the underlying mechanisms by which CCT may benefit cognitive function. In accordance with PRISMA guidelines, we used the following databases: MEDLINE, EMBASE, and CINAHL. Two independent reviewers abstracted data using pre-defined terms. These included: main study characteristics such as the type of training (i.e., single- versus multi-domain), participant demographics (age ≥ 50 years; no psychiatric conditions), and the inclusion of neuroimaging outcomes. The Physiotherapy Evidence Database (PEDro) scale was used to assess quality of all studies included in this systematic review. Nine studies were included in this systematic review, with four studies including multiple MRI sequences. Results of this systematic review are mixed: CCT was found to increase and decrease both brain structure and function in older adults. In addition, depending on region of interest, both increases and decreases in structure and function were associated with behavioural performance. Of all studies included in this systematic review, results from the highest quality studies, which were two randomized controlled trials, demonstrated that multi-domain CCT could lead to increases in hippocampal functional connectivity. Further high quality studies that include an active control, a sample size calculation, and an appropriate training dosage, are needed to confirm these findings and their relation to cognition.

Identification of key characteristics of male reproductive toxicants as an approach for screening and sorting mechanistic evidence.

EPA Science Inventory

The application of systematic review practices in human health assessment includes integration of multi-disciplinary evidence from epidemiological, experimental, and mechanistic studies. Although mode of action analysis relies on the evaluation of mechanistic and toxicological ou...

Laboratory services series: a programmed maintenance system

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

Tuxbury, D.C.; Srite, B.E.

1980-01-01

The diverse facilities, operations and equipment at a major national research and development laboratory require a systematic, analytical approach to operating equipment maintenance. A computer-scheduled preventive maintenance program is described including program development, equipment identification, maintenance and inspection instructions, scheduling, personnel, and equipment history.

49 CFR 633.25 - Contents of a project management plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; (e) A change order procedure which includes a documented, systematic approach to the handling of... covering the project management organization, appropriate consultants, property acquisition, utility... 49 Transportation 7 2011-10-01 2011-10-01 false Contents of a project management plan. 633.25...

Teaching Culturally Relevant Science.

ERIC Educational Resources Information Center

Marinez, Diana; Ortiz de Montellano, Bernard

For teachers concerned about the underrepresentation of Hispanics and Native Americans in science fields, this paper provides resource materials and instructional approaches. First, the role of ethnocentrism in determining what is included in science courses is discussed; the non-Western impact of science has been systematically ignored, it is…

Improving Endowment Management. AGB Special Report.

ERIC Educational Resources Information Center

Association of Governing Boards of Universities and Colleges, 1985

1985-01-01

Endowment practices at 23 institutions during 1978-1983 were studied to provide recommendations on endowment fund management for colleges and universities. Although most of the participating colleges were privately supported, two state-supported universities were included. Twelve of the institutions used a systematic approach to improving…

The SPARK Tool to prioritise questions for systematic reviews in health policy and systems research: development and initial validation.

PubMed

Akl, Elie A; Fadlallah, Racha; Ghandour, Lilian; Kdouh, Ola; Langlois, Etienne; Lavis, John N; Schünemann, Holger; El-Jardali, Fadi

2017-09-04

Groups or institutions funding or conducting systematic reviews in health policy and systems research (HPSR) should prioritise topics according to the needs of policymakers and stakeholders. The aim of this study was to develop and validate a tool to prioritise questions for systematic reviews in HPSR. We developed the tool following a four-step approach consisting of (1) the definition of the purpose and scope of tool, (2) item generation and reduction, (3) testing for content and face validity, (4) and pilot testing of the tool. The research team involved international experts in HPSR, systematic review methodology and tool development, led by the Center for Systematic Reviews on Health Policy and Systems Research (SPARK). We followed an inclusive approach in determining the final selection of items to allow customisation to the user's needs. The purpose of the SPARK tool was to prioritise questions in HPSR in order to address them in systematic reviews. In the item generation and reduction phase, an extensive literature search yielded 40 relevant articles, which were reviewed by the research team to create a preliminary list of 19 candidate items for inclusion in the tool. As part of testing for content and face validity, input from international experts led to the refining, changing, merging and addition of new items, and to organisation of the tool into two modules. Following pilot testing, we finalised the tool, with 22 items organised in two modules - the first module including 13 items to be rated by policymakers and stakeholders, and the second including 9 items to be rated by systematic review teams. Users can customise the tool to their needs, by omitting items that may not be applicable to their settings. We also developed a user manual that provides guidance on how to use the SPARK tool, along with signaling questions. We have developed and conducted initial validation of the SPARK tool to prioritise questions for systematic reviews in HPSR, along with a user manual. By aligning systematic review production to policy priorities, the tool will help support evidence-informed policymaking and reduce research waste. We invite others to contribute with additional real-life implementation of the tool.

Do systematic reviews on pediatric topics need special methodological considerations?

PubMed

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

2017-03-06

Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health. In this paper, we identify methodological challenges specific to the design, conduct and reporting of pediatric systematic reviews, and propose a process to address these challenges. One fundamental decision at the outset of a systematic review is whether to focus on a pediatric population only, or to include both adult and pediatric populations. Both from the policy and patient care point of view, the appropriateness of interventions and comparators administered to pre-defined pediatric age subgroup is critical. Decisions need to be based on the biological plausibility of differences in treatment effects across the developmental trajectory in children. Synthesis of evidence from different trials is often impaired by the use of outcomes and measurement instruments that differ between trials and are neither relevant nor validated in the pediatric population. Other issues specific to pediatric systematic reviews include lack of pediatric-sensitive search strategies and inconsistent choices of pediatric age subgroups in meta-analyses. In addition to these methodological issues generic to all pediatric systematic reviews, special considerations are required for reviews of health care interventions' safety and efficacy in neonatology, global health, comparative effectiveness interventions and individual participant data meta-analyses. To date, there is no standard approach available to overcome this problem. We propose to develop a consensus-based checklist of essential items which researchers should consider when they are planning (PRISMA-PC-Protocol for Children) or reporting (PRISMA-C-reporting for Children) a pediatric systematic review. Available guidelines including PRISMA do not cover the complexity associated with the conduct and reporting of systematic reviews in the pediatric population; they require additional and modified standards for reporting items. Such guidance will facilitate the translation of knowledge from the literature to bedside care and policy, thereby enhancing delivery of care and improving child health outcomes.

Synthesizing evidence on complex interventions: how meta-analytical, qualitative, and mixed-method approaches can contribute.

PubMed

Petticrew, Mark; Rehfuess, Eva; Noyes, Jane; Higgins, Julian P T; Mayhew, Alain; Pantoja, Tomas; Shemilt, Ian; Sowden, Amanda

2013-11-01

Although there is increasing interest in the evaluation of complex interventions, there is little guidance on how evidence from complex interventions may be reviewed and synthesized, and the relevance of the plethora of evidence synthesis methods to complexity is unclear. This article aims to explore how different meta-analytical approaches can be used to examine aspects of complexity; describe the contribution of various narrative, tabular, and graphical approaches to synthesis; and give an overview of the potential choice of selected qualitative and mixed-method evidence synthesis approaches. The methodological discussions presented here build on a 2-day workshop held in Montebello, Canada, in January 2012, involving methodological experts from the Campbell and Cochrane Collaborations and from other international review centers (Anderson L, Petticrew M, Chandler J, et al. systematic reviews of complex interventions. In press). These systematic review methodologists discussed the broad range of existing methods and considered the relevance of these methods to reviews of complex interventions. The evidence from primary studies of complex interventions may be qualitative or quantitative. There is a wide range of methodological options for reviewing and presenting this evidence. Specific contributions of statistical approaches include the use of meta-analysis, meta-regression, and Bayesian methods, whereas narrative summary approaches provide valuable precursors or alternatives to these. Qualitative and mixed-method approaches include thematic synthesis, framework synthesis, and realist synthesis. A suitable combination of these approaches allows synthesis of evidence for understanding complex interventions. Reviewers need to consider which aspects of complex interventions should be a focus of their review and what types of quantitative and/or qualitative studies they will be including, and this will inform their choice of review methods. These may range from standard meta-analysis through to more complex mixed-method synthesis and synthesis approaches that incorporate theory and/or user's perspectives. Copyright © 2013 Elsevier Inc. All rights reserved.

Gastric-tube versus whole-stomach esophagectomy for esophageal cancer: A systematic review and meta-analysis.

PubMed

Zhang, Wenxiong; Yu, Dongliang; Peng, Jinhua; Xu, Jianjun; Wei, Yiping

2017-01-01

To conduct a systematic review and meta-analysis of studies comparing the gastric-tube vs. whole-stomach for esophageal cancer in order to determine the optimal surgical technique of esophagectomy. A comprehensive literature search was performed using PubMed, EMBASE, ScienceDirect, Ovid MEDLINE, Cochrane Library, Web of Science, Google Scholar, and Scopus. Clinical trials that compared the gastric-tube versus whole-stomach for esophageal cancer were selected. The clinical endpoints included anastomotic leakage, anastomotic stenosis, reflux esophagitis, pneumonia, delayed gastric emptying, and thoracic stomach syndrome. A total of 6 articles (1571 patients) were included. Compared to the whole-stomach approach, the gastric-tube approach was associated with a lower incidence of reflux esophagitis (95% confidence interval [CI]: 0.16 to 0.81, p = 0.01) and thoracic stomach syndrome (95% CI: 0.17 to 0.55, p < 0.0001). The rates of anastomotic leakage, anastomotic stenosis, pneumonia, and delayed gastric emptying did not significantly differ between the two groups. The gastric-tube esophagectomy is superior to the whole-stomach approach, as it is associated with a lower incidence of postoperative reflux esophagitis and thoracic stomach syndrome. Our findings must be validated in large-scale randomized controlled trials.

A systematic meta-review of evaluations of youth violence prevention programs: Common and divergent findings from 25 years of meta-analyses and systematic reviews☆

PubMed Central

Matjasko, Jennifer L.; Vivolo-Kantor, Alana M.; Massetti, Greta M.; Holland, Kristin M.; Holt, Melissa K.; Cruz, Jason Dela

2018-01-01

Violence among youth is a pervasive public health problem. In order to make progress in reducing the burden of injury and mortality that result from youth violence, it is imperative to identify evidence-based programs and strategies that have a significant impact on violence. There have been many rigorous evaluations of youth violence prevention programs. However, the literature is large, and it is difficult to draw conclusions about what works across evaluations from different disciplines, contexts, and types of programs. The current study reviews the meta-analyses and systematic reviews published prior to 2009 that synthesize evaluations of youth violence prevention programs. This meta-review reports the findings from 37 meta-analyses and 15 systematic reviews; the included reviews were coded on measures of the social ecology, prevention approach, program type, and study design. A majority of the meta-analyses and systematic reviews were found to demonstrate moderate program effects. Meta-analyses yielded marginally smaller effect sizes compared to systematic reviews, and those that included programs targeting family factors showed marginally larger effects than those that did not. In addition, there are a wide range of individual/family, program, and study moderators of program effect sizes. Implications of these findings and suggestions for future research are discussed. PMID:29503594

Multidisciplinary approaches to managing osteoarthritis in multiple joint sites: a systematic review.

PubMed

Finney, Andrew; Healey, Emma; Jordan, Joanne L; Ryan, Sarah; Dziedzic, Krysia S

2016-07-08

The National Institute for Health and Care Excellence's Osteoarthritis (OA) guidelines recommended that future research should consider the benefits of combination therapies in people with OA across multiple joint sites. However, the clinical effectiveness of such approaches to OA management is unknown. This systematic review therefore aimed to identify the clinical and cost effectiveness of multidisciplinary approaches targeting multiple joint sites for OA in primary care. A systematic review of randomised controlled trials. Computerised bibliographic databases were searched (MEDLINE, EMBASE, CINAHL, PsychINFO, BNI, HBE, HMIC, AMED, Web of Science and Cochrane). Studies were included if they met the following criteria; a randomised controlled trial (RCT), a primary care population with OA across at least two different peripheral joint sites (multiple joint sites), and interventions undertaken by at least two different health disciplines (multidisciplinary). The Cochrane 'Risk of Bias' tool and PEDro were used for quality assessment of eligible studies. Clinical and cost effectiveness was determined by extracting and examining self-reported outcomes for pain, function, quality of life (QoL) and health care utilisation. The date range for the search was from database inception until August 2015. The search identified 1148 individual titles of which four were included in the review. A narrative review was conducted due to the heterogeneity of the included trials. Each of the four trials used either educational or exercise interventions facilitated by a range of different health disciplines. Moderate clinical benefits on pain, function and QoL were reported across the studies. The beneficial effects of exercise generally decreased over time within all studies. Two studies were able to show a reduction in healthcare utilisation due to a reduction in visits to a physiotherapist or a reduction in x-rays and orthopaedic referrals. The intervention that showed the most promise used educational interventions delivered by GPs with reinforcement by practice nurses. There are currently very few studies that target multidisciplinary approaches suitable for OA across multiple joint sites, in primary care. A more consistent approach to outcome measurement in future studies of this nature should be considered to allow for better comparison.

Minimally invasive approach for adrenal lesions: Systematic review of laparoscopic versus retroperitoneoscopic adrenalectomy and assessment of risk factors for complications.

PubMed

Conzo, G; Tartaglia, E; Gambardella, C; Esposito, D; Sciascia, V; Mauriello, C; Nunziata, A; Siciliano, G; Izzo, G; Cavallo, F; Thomas, G; Musella, M; Santini, L

2016-04-01

In the last decades, minimally invasive transperitoneal laparoscopic adrenalectomy has become the standard of care for surgical resection of the adrenal gland tumors. Recently, however, adrenalectomy by a mininvasive retroperitoneal approach has reached increasingly popularity as alternative technique. Short hospitalization, lower postoperative pain and decrease of complications and a better cosmetic resolution are the main advantages of these innovative techniques. In order to determine the better surgical management of adrenal neoplasms, the Authors analyzed and compared the feasibility and the postoperative complications of minimally invasive adrenalectomy approaches. A systematic research of the English literature, including major meta-analysis articles, clinical randomized trials, retrospective studies and systematic reviews was performed, comparing laparoscopic transperitoneal adrenalectomy versus retroperitoneoscopic adrenalectomy. Many studies support that posterior retroperitoneal adrenalectomy is superior or at least comparable to laparoscopic transperitoneal adrenalectomy in operation time, pain score, blood loss, hospitalization, complications rates and return to normal activity. However, laparoscopic transperitoneal adrenalectomy is up to now a safe and standardized procedure with a shorter learning curve and a similar low morbidity rate, even for tumors larger than 6 cm. Nevertheless, further studies are needed to objectively evaluate these techniques, excluding selection bias and bias related to differences in surgeons' experiences with this approaches. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

A systematic approach for the development of a kindergarten-based intervention for the prevention of obesity in preschool age children: the ToyBox-study.

PubMed

Manios, Y; Grammatikaki, E; Androutsos, O; Chinapaw, M J M; Gibson, E L; Buijs, G; Iotova, V; Socha, P; Annemans, L; Wildgruber, A; Mouratidou, T; Yngve, A; Duvinage, K; de Bourdeaudhuij, I

2012-03-01

The increasing childhood obesity epidemic calls for appropriate measures and effective policies to be applied early in life. Large-scale socioecological frameworks providing a holistic multifactorial and cost-effective approach necessary to support obesity prevention initiatives in this age are however currently missing. To address this missing link, ToyBox-study aims to build and evaluate a cost-effective kindergarten-based, family-involved intervention scheme to prevent obesity in early childhood, which could potentially be expanded on a pan-European scale. A multidisciplinary team of researchers from 10 countries have joined forces and will work to realize this according to a systematic stepwise approach that combines the use of the PRECEDE-PROCEED model and intervention mapping protocol. ToyBox-study will conduct systematic and narrative reviews, secondary data analyses, focus group research and societal assessment to design, implement and evaluate outcome, impact, process and cost effectiveness of the intervention. This is the first time that such a holistic approach has been used on a pan-European scale to promote healthy weight and healthy energy balance-related behaviours for the prevention of early childhood obesity. The results of ToyBox-study will be disseminated among key stakeholders including researchers, policy makers, practitioners and the general population. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

A New Methodology for Systematic Exploitation of Technology Databases.

ERIC Educational Resources Information Center

Bedecarrax, Chantal; Huot, Charles

1994-01-01

Presents the theoretical aspects of a data analysis methodology that can help transform sequential raw data from a database into useful information, using the statistical analysis of patents as an example. Topics discussed include relational analysis and a technology watch approach. (Contains 17 references.) (LRW)

ACT Aspire™. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2017

2017-01-01

The "ACT Aspire"™ system provides a longitudinal, systematic approach for assessing and monitoring students' preparation for high school studies and readiness for college and career. "ACT Aspire"™ includes assessments for students from grade 3 through early high school in five subject areas: English, mathematics, reading,…

U. S. VETERINARY IMMUNE REAGENTS NETWORK: PROGRESS WITH POULTRY IMMUNE REAGENTS

USDA-ARS?s Scientific Manuscript database

This poster will present a progress report on the CSREES-funded NRI grant to support a broad community approach to systematically address the immunological reagent gap for the US veterinary immunology research community including for the following groups: ruminants (concentrating on cattle but inclu...

Waste in Place Elementary Curriculum Guide.

ERIC Educational Resources Information Center

Keep America Beautiful, Inc., Stamford, CT.

This curriculum guide is a behavioral-based, systematic approach to changing attitudes and practices related to waste handling. Activities included are on litter prevention, waste reduction, reuse, recycling, composting, waste-to-energy, and landfill. These activities are used to assist students in making informed decisions about waste disposal…

Piaget's Theory: A Psychological Critique.

ERIC Educational Resources Information Center

Brown, Geoffrey; Desforges, Charles

The authors offer a detailed and systematic critique of Piaget's theory of cognitive development, examining it in relation to other theories of development. Chapter 1 points out some of the problems in building and evaluating scientific theories and considers contrasting approaches to cognitive development (including those which focus on…

Methods for detecting, quantifying, and adjusting for dissemination bias in meta-analysis are described.

PubMed

Mueller, Katharina Felicitas; Meerpohl, Joerg J; Briel, Matthias; Antes, Gerd; von Elm, Erik; Lang, Britta; Motschall, Edith; Schwarzer, Guido; Bassler, Dirk

2016-12-01

To systematically review methodological articles which focus on nonpublication of studies and to describe methods of detecting and/or quantifying and/or adjusting for dissemination in meta-analyses. To evaluate whether the methods have been applied to an empirical data set for which one can be reasonably confident that all studies conducted have been included. We systematically searched Medline, the Cochrane Library, and Web of Science, for methodological articles that describe at least one method of detecting and/or quantifying and/or adjusting for dissemination bias in meta-analyses. The literature search retrieved 2,224 records, of which we finally included 150 full-text articles. A great variety of methods to detect, quantify, or adjust for dissemination bias were described. Methods included graphical methods mainly based on funnel plot approaches, statistical methods, such as regression tests, selection models, sensitivity analyses, and a great number of more recent statistical approaches. Only few methods have been validated in empirical evaluations using unpublished studies obtained from regulators (Food and Drug Administration, European Medicines Agency). We present an overview of existing methods to detect, quantify, or adjust for dissemination bias. It remains difficult to advise which method should be used as they are all limited and their validity has rarely been assessed. Therefore, a thorough literature search remains crucial in systematic reviews, and further steps to increase the availability of all research results need to be taken. Copyright © 2016 Elsevier Inc. All rights reserved.

Can cognitive behavioural therapy based strategies be integrated into physiotherapy for the prevention of chronic low back pain? A systematic review.

PubMed

Brunner, Emanuel; De Herdt, Amber; Minguet, Philippe; Baldew, Se-Sergio; Probst, Michel

2013-01-01

The primary purpose was to detect randomized controlled trials investigating cognitive behaviour therapy-based (CBT) treatments applied in acute/sub-acute low back pain (LBP). The secondary purpose was to analyse the methodological properties of the included studies, and to identify theory-based treatment strategies that are applicable for physiotherapists. A systematic literature search was conducted using four databases. Risk of bias of included studies was assessed and the methodological properties summarized. In addition, content and treatment theory of detected CBT-based strategies were systematically analysed and classified into three distinctive concepts of CBT: operant, cognitive and respondent treatment. Finally, applicability of treatment strategies in physiotherapy practice was discussed. Eight studies were included in the present systematic review. Half of the studies suffered from high risk of bias, and study characteristics varied in all domains of methodology, particularly in terms of treatment design and outcome measures. Graded activity, an operant treatment approach based on principles of operant conditioning, was identified as a CBT-based strategy with traceable theoretical justification that can be applied by physiotherapists. Operant conditioning can be integrated in ambulant physiotherapy practice and is a promising CBT-based strategy for the prevention of chronic LBP.

Applying probabilistic temporal and multisite data quality control methods to a public health mortality registry in Spain: a systematic approach to quality control of repositories.

PubMed

Sáez, Carlos; Zurriaga, Oscar; Pérez-Panadés, Jordi; Melchor, Inma; Robles, Montserrat; García-Gómez, Juan M

2016-11-01

To assess the variability in data distributions among data sources and over time through a case study of a large multisite repository as a systematic approach to data quality (DQ). Novel probabilistic DQ control methods based on information theory and geometry are applied to the Public Health Mortality Registry of the Region of Valencia, Spain, with 512 143 entries from 2000 to 2012, disaggregated into 24 health departments. The methods provide DQ metrics and exploratory visualizations for (1) assessing the variability among multiple sources and (2) monitoring and exploring changes with time. The methods are suited to big data and multitype, multivariate, and multimodal data. The repository was partitioned into 2 probabilistically separated temporal subgroups following a change in the Spanish National Death Certificate in 2009. Punctual temporal anomalies were noticed due to a punctual increment in the missing data, along with outlying and clustered health departments due to differences in populations or in practices. Changes in protocols, differences in populations, biased practices, or other systematic DQ problems affected data variability. Even if semantic and integration aspects are addressed in data sharing infrastructures, probabilistic variability may still be present. Solutions include fixing or excluding data and analyzing different sites or time periods separately. A systematic approach to assessing temporal and multisite variability is proposed. Multisite and temporal variability in data distributions affects DQ, hindering data reuse, and an assessment of such variability should be a part of systematic DQ procedures. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Inter-clinician and intra-clinician reliability of force application during joint mobilization: a systematic review.

PubMed

Gorgos, Kara S; Wasylyk, Nicole T; Van Lunen, Bonnie L; Hoch, Matthew C

2014-04-01

Joint mobilizations are commonly used by clinicians to decrease pain and restore joint arthrokinematics following musculoskeletal injury. The force applied during a joint mobilization treatment is subjective to the individual clinician but may have an effect on patient outcomes. The purpose of this systematic review was to critically appraise and synthesize the studies which examined the reliability of clinicians' force application during joint mobilization. A systematic search of PubMed and EBSCO Host databases from inception to March 1, 2013 was conducted to identify studies assessing the reliability of force application during joint mobilizations. Two reviewers utilized the Quality Appraisal of Reliability Studies (QAREL) assessment tool to determine the quality of included studies. The relative reliability of the included studies was examined through intraclass correlation coefficients (ICC) to synthesize study findings. All results were collated qualitatively with a level of evidence approach. A total of seven studies met the eligibility and were included. Five studies were included that assessed inter-clinician reliability, and six studies were included that assessed intra-clinician reliability. The overall level of evidence for inter-clinician reliability was strong for poor-to-moderate reliability (ICC = -0.04 to 0.70). The overall level of evidence for intra-clinician reliability was strong for good reliability (ICC = 0.75-0.99). This systematic review indicates there is variability in force application between clinicians but individual clinicians apply forces consistently. The results of this systematic review suggest innovative instructional methods are needed to improve consistency and validate the forces applied during of joint mobilization treatments. This is particularly evident for improving the consistency of force application across clinicians. Copyright © 2014 Elsevier Ltd. All rights reserved.

What methods are used to apply positive deviance within healthcare organisations? A systematic review

PubMed Central

Baxter, Ruth; Taylor, Natalie; Kellar, Ian; Lawton, Rebecca

2016-01-01

Background The positive deviance approach focuses on those who demonstrate exceptional performance, despite facing the same constraints as others. ‘Positive deviants’ are identified and hypotheses about how they succeed are generated. These hypotheses are tested and then disseminated within the wider community. The positive deviance approach is being increasingly applied within healthcare organisations, although limited guidance exists and different methods, of varying quality, are used. This paper systematically reviews healthcare applications of the positive deviance approach to explore how positive deviance is defined, the quality of existing applications and the methods used within them, including the extent to which staff and patients are involved. Methods Peer-reviewed articles, published prior to September 2014, reporting empirical research on the use of the positive deviance approach within healthcare, were identified from seven electronic databases. A previously defined four-stage process for positive deviance in healthcare was used as the basis for data extraction. Quality assessments were conducted using a validated tool, and a narrative synthesis approach was followed. Results 37 of 818 articles met the inclusion criteria. The positive deviance approach was most frequently applied within North America, in secondary care, and to address healthcare-associated infections. Research predominantly identified positive deviants and generated hypotheses about how they succeeded. The approach and processes followed were poorly defined. Research quality was low, articles lacked detail and comparison groups were rarely included. Applications of positive deviance typically lacked staff and/or patient involvement, and the methods used often required extensive resources. Conclusion Further research is required to develop high quality yet practical methods which involve staff and patients in all stages of the positive deviance approach. The efficacy and efficiency of positive deviance must be assessed and compared with other quality improvement approaches. PROSPERO registration number CRD42014009365. PMID:26590198

Structured approaches to promote patient and family engagement in treatment in acute care hospital settings: protocol for a systematic scoping review.

PubMed

Goodridge, Donna; Henry, Chrysanthus; Watson, Erin; McDonald, Meghan; New, Lucia; Harrison, Elizabeth L; Scharf, Murray; Penz, Erika; Campbell, Steve; Rotter, Thomas

2018-02-26

While effective engagement of patients and families in treatment is increasingly viewed as a priority for many healthcare systems, much remains to be learned about the nature and outcomes of approaches that seek to accomplish this goal in the acute care hospital setting. Wide variability in the implementation of practices designed to promote patient and family engagement in hospitals has been noted. Approaches aimed at promoting patient and family engagement in treatment share the over-arching goal of changing behaviors of patients, families, and healthcare providers and possibly administrators. Behavior change techniques (BCTs) can be a key element of patient and family engagement approaches. This scoping review will contribute to the development of an evidence base detailing that the BCTs have potential to be effective in patient and family engagement interventions. The specific objectives of this review are to (a) identify and classify approaches used in acute care hospitals to engage patient and families in treatment according to the behavior change technique taxonomy; and (b) evaluate and synthesize the outcomes for these approaches for patients and families, healthcare providers, and health administrators/funders. This systematic scoping review will allow us to determine the extent, range, and nature of research activity related to initiatives designed to promote patient and family engagement in care. A comprehensive electronic literature search will be conducted in MEDLINE, EMBASE, and CINAHL. Studies will be included if they report on outcomes of a structured or systematic approach to the promotion of adult inpatient and family engagement in treatment in acute care settings. Studies will be selected in a two-stage screening process (title and abstract; full text) and quality will be assessed using the mixed methods assessment tool. Data extraction will include narrative descriptions of the intervention and classification of the behavior change techniques employed. This review aims to identify and classify the specific behavior change techniques underpinning patient and family engagement interventions used in acute care hospital settings. By identifying the "active ingredients" in these interventions, our findings will be transferable to a wide range of acute care hospital contexts and populations.

A Bayesian Approach to Systematic Error Correction in Kepler Photometric Time Series

NASA Astrophysics Data System (ADS)

Jenkins, Jon Michael; VanCleve, J.; Twicken, J. D.; Smith, J. C.; Kepler Science Team

2011-01-01

In order for the Kepler mission to achieve its required 20 ppm photometric precision for 6.5 hr observations of 12th magnitude stars, the Presearch Data Conditioning (PDC) software component of the Kepler Science Processing Pipeline must reduce systematic errors in flux time series to the limit of stochastic noise for errors with time-scales less than three days, without smoothing or over-fitting away the transits that Kepler seeks. The current version of PDC co-trends against ancillary engineering data and Pipeline generated data using essentially a least squares (LS) approach. This approach is successful for quiet stars when all sources of systematic error have been identified. If the stars are intrinsically variable or some sources of systematic error are unknown, LS will nonetheless attempt to explain all of a given time series, not just the part the model can explain well. Negative consequences can include loss of astrophysically interesting signal, and injection of high-frequency noise into the result. As a remedy, we present a Bayesian Maximum A Posteriori (MAP) approach, in which a subset of intrinsically quiet and highly-correlated stars is used to establish the probability density function (PDF) of robust fit parameters in a diagonalized basis. The PDFs then determine a "reasonable” range for the fit parameters for all stars, and brake the runaway fitting that can distort signals and inject noise. We present a closed-form solution for Gaussian PDFs, and show examples using publically available Quarter 1 Kepler data. A companion poster (Van Cleve et al.) shows applications and discusses current work in more detail. Kepler was selected as the 10th mission of the Discovery Program. Funding for this mission is provided by NASA, Science Mission Directorate.

The difficulties of systematic reviews.

PubMed

Westgate, Martin J; Lindenmayer, David B

2017-10-01

The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. We drew on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora-including nonrandom selection of review topics, small-world properties of semantic networks, and spatiotemporal variation in word meaning-greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for narrative reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review and highlights 2 useful directions for future research. First, in cases where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods-such as natural language processing or the construction of research thesauri and ontologies-that provide tools for mapping and resolving that complexity. These tools could help individual researchers classify research material in a more robust manner and provide valuable guidance for future researchers on that topic. Second, a linguistic perspective highlights that scientific writing is a rich resource worthy of detailed study, an observation that can sometimes be lost during the search for data during systematic review or meta-analysis. For example, mapping semantic networks can reveal redundancy and complementarity among scientific concepts, leading to new insights and research questions. Consequently, wider adoption of linguistic approaches may facilitate improved rigor and richness in research synthesis. © 2017 Society for Conservation Biology.

Development and use of a content search strategy for retrieving studies on patients' views and preferences.

PubMed

Selva, Anna; Solà, Ivan; Zhang, Yuan; Pardo-Hernandez, Hector; Haynes, R Brian; Martínez García, Laura; Navarro, Tamara; Schünemann, Holger; Alonso-Coello, Pablo

2017-08-30

Identifying scientific literature addressing patients' views and preferences is complex due to the wide range of studies that can be informative and the poor indexing of this evidence. Given the lack of guidance we developed a search strategy to retrieve this type of evidence. We assembled an initial list of terms from several sources, including the revision of the terms and indexing of topic-related studies and, methods research literature, and other relevant projects and systematic reviews. We used the relative recall approach, evaluating the capacity of the designed search strategy for retrieving studies included in relevant systematic reviews for the topic. We implemented in practice the final version of the search strategy for conducting systematic reviews and guidelines, and calculated search's precision and the number of references needed to read (NNR). We assembled an initial version of the search strategy, which had a relative recall of 87.4% (yield of 132/out of 151 studies). We then added some additional terms from the studies not initially identified, and re-tested this improved version against the studies included in a new set of systematic reviews, reaching a relative recall of 85.8% (151/out of 176 studies, 95% CI 79.9 to 90.2). This final version of the strategy includes two sets of terms related with two domains: "Patient Preferences and Decision Making" and "Health State Utilities Values". When we used the search strategy for the development of systematic reviews and clinical guidelines we obtained low precision values (ranging from 2% to 5%), and the NNR from 20 to 50. This search strategy fills an important research gap in this field. It will help systematic reviewers, clinical guideline developers, and policy-makers to retrieve published research on patients' views and preferences. In turn, this will facilitate the inclusion of this critical aspect when formulating heath care decisions, including recommendations.

Developing core economic outcome sets for asthma studies: a protocol for a systematic review.

PubMed

Hounsome, Natalia; Fitzsimmons, Deborah; Phillips, Ceri; Patel, Anita

2017-08-11

Core outcome sets are standardised lists of outcomes, which should be measured and reported in all clinical studies of a specific condition. This study aims to develop core outcome sets for economic evaluations in asthma studies. Economic outcomes include items such as costs, resource use or quality-adjusted life years. The starting point in developing core outcome sets will be conducting a systematic literature review to establish a preliminary list of reporting items to be considered for inclusion in the core outcome set. We will conduct literature searches of peer-reviewed studies published from January 1990 to January 2017. These will include any comparative or observational studies (including economic models) and systematic reviews reporting economic outcomes. All identified economic outcomes will be tabulated together with the major study characteristics, such as population, study design, the nature and intensity of the intervention, mode of data collection and instrument(s) used to derive an outcome. We will undertake a 'realist synthesis review' to analyse the identified economic outcomes. The outcomes will be summarised in the context of evaluation perspectives, types of economic evaluation and methodological approaches. Parallel to undertaking a systematic review, we will conduct semistructured interviews with stakeholders (including people with personal experience of asthma, health professionals, researchers and decision makers) in order to explore additional outcomes which have not been considered, or used, in published studies. The list of outcomes generated from the systematic review and interviews with stakeholders will form the basis of a Delphi survey to refine the identified outcomes into a core outcome set. The review will not involve access to individual-level data. Findings from our systematic review will be communicated to a broad range of stakeholders including clinical guideline developers, research funders, trial registries, ethics committees and other regulators. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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.

Measuring the impact of medicines regulatory interventions – Systematic review and methodological considerations

PubMed Central

Morales, Daniel R.; Pacurariu, Alexandra; Kurz, Xavier

2017-01-01

Aims Evaluating the public health impact of regulatory interventions is important but there is currently no common methodological approach to guide this evaluation. This systematic review provides a descriptive overview of the analytical methods for impact research. Methods We searched MEDLINE and EMBASE for articles with an empirical analysis evaluating the impact of European Union or non‐European Union regulatory actions to safeguard public health published until March 2017. References from systematic reviews and articles from other known sources were added. Regulatory interventions, data sources, outcomes of interest, methodology and key findings were extracted. Results From 1246 screened articles, 229 were eligible for full‐text review and 153 articles in English language were included in the descriptive analysis. Over a third of articles studied analgesics and antidepressants. Interventions most frequently evaluated are regulatory safety communications (28.8%), black box warnings (23.5%) and direct healthcare professional communications (10.5%); 55% of studies measured changes in drug utilization patterns, 27% evaluated health outcomes, and 18% targeted knowledge, behaviour or changes in clinical practice. Unintended consequences like switching therapies or spill‐over effects were rarely evaluated. Two‐thirds used before–after time series and 15.7% before–after cross‐sectional study designs. Various analytical approaches were applied including interrupted time series regression (31.4%), simple descriptive analysis (28.8%) and descriptive analysis with significance tests (23.5%). Conclusion Whilst impact evaluation of pharmacovigilance and product‐specific regulatory interventions is increasing, the marked heterogeneity in study conduct and reporting highlights the need for scientific guidance to ensure robust methodologies are applied and systematic dissemination of results occurs. PMID:29105853

Utility of a Systematic Approach to Teaching Photographic Nasal Analysis to Otolaryngology Residents.

PubMed

Robitschek, Jon; Dresner, Harley; Hilger, Peter

2017-12-01

Photographic nasal analysis constitutes a critical step along the path toward accurate diagnosis and precise surgical planning in rhinoplasty. The learned process by which one assesses photographs, analyzes relevant anatomical landmarks, and generates a global view of the nasal aesthetic is less widely described. To discern the common pitfalls in performing photographic nasal analysis and to quantify the utility of a systematic approach model in teaching photographic nasal analysis to otolaryngology residents. This prospective observational study included 20 participants from a university-based otolaryngology residency program. The control and intervention groups underwent baseline graded assessment of 3 patients. The intervention group received instruction on a systematic approach model for nasal analysis, and both groups underwent postintervention testing at 10 weeks. Data were collected from October 1, 2015, through June 1, 2016. A 10-minute, 11-slide presentation provided instruction on a systematic approach to nasal analysis to the intervention group. Graded photographic nasal analysis using a binary 18-point system. The 20 otolaryngology residents (15 men and 5 women; age range, 24-34 years) were adept at mentioning dorsal deviation and dorsal profile with focused descriptions of tip angle and contour. Areas commonly omitted by residents included verification of the Frankfort plane, position of the lower lateral crura, radix position, and ratio of the ala to tip lobule. The intervention group demonstrated immediate improvement after instruction on the teaching model, with the mean (SD) postintervention test score doubling compared with their baseline performance (7.5 [2.7] vs 10.3 [2.5]; P < .001). At 10 weeks after the intervention, the mean comparative improvement in overall graded nasal analysis was 17% (95% CI, 10%-23%; P < .001). Otolaryngology residents demonstrated proficiency at incorporating nasal deviation, tip angle, and dorsal profile contour into their nasal analysis. They often omitted verification of the Frankfort plane, position of lower lateral crura, radix depth, and ala-to-tip lobule ratio. Findings with this novel 10-minute teaching model should be validated at other teaching institutions, and the instruction model should be further enhanced to teach more sophisticated analysis to residents as they proceed through training. NA.

Analysis of Arterial Blood Gas Report in Chronic Kidney Diseases - Comparison between Bedside and Multistep Systematic Method.

PubMed

Ghatak, Ishita; Dhat, Vaishali; Tilak, Mona A; Roy, Indranath

2016-08-01

Acid Base Disorders (ABDs) are commonly encountered in critically ill Chronic Kidney Disease (CKD) patients. Timely and correct analysis of Arterial Blood Gases (ABG) is critical for the diagnosis, treatment and prediction of outcome of the patients. The aim was to explore type and prevalence of ABDs in 31 critically ill CKD patients from a tertiary care hospital in Maharashtra, to compare two methods of analysis- bedside and systematic approaches and to clinically correlate the nature of ABDs in these patients. The initial ABG reports of 31 consecutive CKD patients were analysed by two methods. Medica Easy stat analyser was the equipment for analysis with Principle of potentiometry and ion selective electrode for pH and pCO2 and amperometry for pO2. Serum albumin was also measured by Bromocresol green dye binding method using liquixx albumin kit in Erba XL 300 autoanalyser. Chi-square test was used for statistical analysis using Epi Info version 3.5.4 and SPSS 14.0 softwares. The systematic method showed a significantly higher prevalence of mixed disorders (50%) compared to bedside method (12.9%). Most prevalent disorder by bedside method was metabolic acidosis in 15 cases (48.39%). By the systematic method, 3 reports were invalid. As a single category, most prevalent type was both simple respiratory alkalosis and mixed metabolic acidosis with respiratory alkalosis- 6 of 31 cases in each type (19.36% each). As a whole, metabolic acidosis (including both High Anion Gap Metabolic Acidosis or HAGMA and Non Anion Gap Metabolic Acidosis or NAGMA with 4 in each type) was most prevalent- 8 of 31(25.8%). Systematic approach was more effective in diagnosing mixed acid base disorders. By systematic method the findings of analysis in most cases could be correlated with the clinical condition and provisional diagnosis. Thus interpretation of ABDs by using stepwise approach could be useful to the clinicians in early diagnosis and management of the patients.

MicroRNAs associated with exercise and diet: a systematic review.

PubMed

Flowers, Elena; Won, Gloria Y; Fukuoka, Yoshimi

2015-01-01

MicroRNAs are posttranscriptional regulators of gene expression. MicroRNAs reflect individual biologic adaptation to exposures in the environment. As such, measurement of circulating microRNAs presents an opportunity to evaluate biologic changes associated with behavioral interventions (i.e., exercise, diet) for weight loss. The aim of this study was to perform a systematic review of the literature to summarize what is known about circulating microRNAs associated with exercise, diet, and weight loss. We performed a systematic review of three scientific databases. We included studies reporting on circulating microRNAs associated with exercise, diet, and weight loss in humans. Of 1,219 studies identified in our comprehensive database search, 14 were selected for inclusion. Twelve reported on microRNAs associated with exercise, and two reported on microRNAs associated with diet and weight loss. The majority of studies used a quasiexperimental, cross-sectional design. There were numerous differences in the type and intensity of exercise and dietary interventions, the biologic source of microRNAs, and the methodological approaches used quantitate microRNAs. Data from several studies support an association between circulating microRNAs and exercise. The evidence for an association between circulating microRNAs and diet is weaker because of a small number of studies. Additional research is needed to validate previous observations using methodologically rigorous approaches to microRNA quantitation to determine the specific circulating microRNA signatures associated with behavioral approaches to weight loss. Future directions include longitudinal studies to determine if circulating microRNAs are predictive of response to behavioral interventions. Copyright © 2015 the American Physiological Society.

HELP for behaviours that challenge in adults with intellectual and developmental disabilities

PubMed Central

Green, Laurie; McNeil, Karen; Korossy, Marika; Boyd, Kerry; Grier, Elizabeth; Ketchell, MacKenzie; Loh, Alvin; Lunsky, Yona; McMillan, Shirley; Sawyer, Amanda; Thakur, Anupam; Bradley, Elspeth

2018-01-01

Abstract Objective To provide primary care physicians with an understanding of the causes of behaviours that challenge (BTC) in adults with intellectual and developmental disabilities (IDD), as presented in the 2018 Canadian consensus guidelines for primary care of adults with IDD; to offer a systematic approach to the assessment and treatment of such behaviours; and to link to tools to support these assessments. Sources of information This review elaborates upon guidelines 26 to 29 in the mental health section of the 2018 Canadian consensus guidelines. Several of the authors participated in the development of these guidelines, which were based on literature searches and interdisciplinary input. Main message Most adults with IDD are followed by primary care providers but they comprise a small proportion of primary care practices. Unique ways of communicating needs, diagnostic queries, and BTC are common in this population. This complexity can lead to missed diagnoses and inappropriate antipsychotic medication use with attendant risks. This article presents a systematic approach, HELP, to the assessment and treatment of factors of Health, Environment, Lived experience, and Psychiatric conditions that can lead to BTC and includes tools to support these assessments. Conclusion A structured approach to the assessment and treatment of BTC in adults with IDD helps family physicians provide guideline-directed, individualized care to this population. This includes a systematic evaluation using the HELP framework that takes place over multiple visits. A team of health professionals might be needed for optimal care, but these resources are not routinely available across Canada. PMID:29650741

Survival analysis using primary care electronic health record data: A systematic review of the literature.

PubMed

Hodgkins, Adam Jose; Bonney, Andrew; Mullan, Judy; Mayne, Darren John; Barnett, Stephen

2018-01-01

An emerging body of research involves observational studies in which survival analysis is applied to data obtained from primary care electronic health records (EHRs). This systematic review of these studies examined the utility of using this approach. An electronic literature search of the Scopus, PubMed, Web of Science, CINAHL, and Cochrane databases was conducted. Search terms and exclusion criteria were chosen to select studies where survival analysis was applied to the data extracted wholly from EHRs used in primary care medical practice. A total of 46 studies that met the inclusion criteria for the systematic review were examined. All were published within the past decade (2005-2014) with a majority ( n = 26, 57%) being published between 2012 and 2014. Even though citation rates varied from nil to 628, over half ( n = 27, 59%) of the studies were cited 10 times or more. The median number of subjects was 18,042 with five studies including over 1,000,000 patients. Of the included studies, 35 (76%) were published in specialty journals and 11 (24%) in general medical journals. The many conditions studied largely corresponded well with conditions important to general practice. Survival analysis applied to primary care electronic medical data is a research approach that has been frequently used in recent times. The utility of this approach was demonstrated by the ability to produce research with large numbers of subjects, across a wide range of conditions and with the potential of a high impact. Importantly, primary care data were thus available to inform primary care practice.

Classroom Crisis Intervention through Contracting: A Moral Development Model.

ERIC Educational Resources Information Center

Smaby, Marlowe H.; Tamminen, Armas W.

1981-01-01

A counselor can arbitrate problem situations using a systematic approach to classroom intervention which includes meetings with the teacher and students. This crisis intervention model based on moral development can be more effective than reliance on guidance activities disconnected from the actual classroom settings where the problems arise.…

The Immigrant and Hispanic Paradoxes: A Systematic Review of Their Predictions and Effects

ERIC Educational Resources Information Center

Teruya, Stacey A.; Bazargan-Hejazi, Shahrzad

2013-01-01

A survey of the literature indicates that reported advantages of the Immigrant and Hispanic Paradox are inconsistent and equivocal. The "healthy migrant hypothesis" also suggests that current research approaches consider only "healthy" groups. Other methodological concerns include the simple underreporting of deaths, and that…

TECHNICAL FACT SHEET: A Systematic Evaluation of Dissolved Metals Loss during Water Sample Filtration

EPA Science Inventory

This research study examined how water quality collection and filtration approaches, including commonly used capsule and disc syringe filters, may cause losses in the amounts of soluble lead and copper found in a sample. A variety of commercially available filter materials with a...

Management Development Study.

ERIC Educational Resources Information Center

Department of Transportation, Washington, DC.

This document reports on a management development study within the Department of Transportation (DOT). The aim of the study was to develop a systematic approach to management development for military and civilian personnel. A variety of methods was used to gather data including having DOT staff members gather the information to be passed on to the…

Dyslexia and the Individual.

ERIC Educational Resources Information Center

Meredith, Patrick

The main objective of this book is to explain the thinking that is involved in working out a systematic scheme of the variables related to dyslexia. The contents of the book include "Origins of the Approach,""Some Principles of Instruction"; "Verbal Behavior"; "Our Ideas about Language"; "Left and Right"; "The Biology of the Book"; "Exploring…

Methods for Instructional Diagnosis with Limited Available Resources.

ERIC Educational Resources Information Center

Gillmore, Gerald M.; Clark, D. Joseph

College teaching should be approached with the same careful delineation of problems and systematic attempts to find solutions which characterize research. Specific methods for the diagnosis of instructional problems include audio-video taping, use of teaching assistants, colleague assistance, classroom tests, student projects in and out of class,…

Successful Examples of Instructional Technology in Higher Education.

ERIC Educational Resources Information Center

Hortin, John A.

College programs considered to be successful in their use of instructional technology are described. The definition of instructional technology used to judge the media programs is as follows: a systematic approach to improve learning through media management, educational program development, and learning resources. Programs include the following:…

Family Engagement within Schoolwide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Garbacz, S. Andrew; McIntosh, Kent; Eagle, John W.; Dowd-Eagle, Shannon E.; Hirano, Kara A.; Ruppert, Traci

2016-01-01

Parent educational involvement is an important avenue for enhancing student outcomes. Schools seek myriad ways to include families; however, the parent involvement practices used by schools lack coordination and are disconnected from existing school approaches. School wide Positive Behavioral Interventions and Supports (PBIS) is a systematic and…

Family Planning Vouchers in Low and Middle Income Countries: A Systematic Review

PubMed Central

Bellows, Ben; Bulaya, Carol; Inambwae, Sophie; Lissner, Craig L.; Ali, Moazzam; Bajracharya, Ashish

2016-01-01

Family planning (FP) vouchers have targeted subsidies to disadvantaged populations for quality reproductive health services since the 1960s. To summarize the effect of FP voucher programs in low‐ and middle‐income countries, a systematic review was conducted, screening studies from 33 databases through three phases: keyword search, title and abstract review, and full text review. Sixteen articles were selected including randomized control trials, controlled before‐and‐after, interrupted time series analyses, cohort, and before‐and‐after studies. Twenty‐three study outcomes were clustered around contraceptive uptake, with study outcomes including fertility in the early studies and equity and discontinuation in more recent publications. Research gaps include measures of FP quality, unintended outcomes, clients’ qualitative experiences, FP voucher integration with health systems, and issues related to scale‐up of the voucher approach. PMID:27859338

Training and learning robotic surgery, time for a more structured approach: a systematic review.

PubMed

Schreuder, H W R; Wolswijk, R; Zweemer, R P; Schijven, M P; Verheijen, R H M

2012-01-01

Robotic assisted laparoscopic surgery is growing rapidly and there is an increasing need for a structured approach to train future robotic surgeons. To review the literature on training and learning strategies for robotic assisted laparoscopic surgery. A systematic search of MEDLINE, EMBASE, the Cochrane Library and the Journal of Robotic Surgery was performed. We included articles concerning training, learning, education and teaching of robotic assisted laparoscopic surgery in any specialism. Two authors independently selected articles to be included. We categorised the included articles into: training modalities, learning curve, training future surgeons, curriculum design and implementation. We included 114 full text articles. Training modalities such as didactic training, skills training (dry lab, virtual reality, animal or cadaver models), case observation, bedside assisting, proctoring and the mentoring console can be used for training in robotic assisted laparoscopic surgery. Several training programmes in general and specific programmes designed for residents, fellows and surgeons are described in the literature. We provide guidelines for development of a structured training programme. Robotic surgical training consists of system training and procedural training. System training should be formally organised and should be competence based, instead of time based. Virtual reality training will play an import role in the near future. Procedural training should be organised in a stepwise approach with objective assessment of each step. This review aims to facilitate and improve the implementation of structured robotic surgical training programmes. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

The consequences of sickness presenteeism on health and wellbeing over time: A systematic review.

PubMed

Skagen, Kristian; Collins, Alison M

2016-07-01

The association between sickness presenteeism, defined as going to work despite illness, and different health outcomes is increasingly being recognized as a significant and relevant area of research. However, the long term effects on future employee health are less well understood, and to date there has been no review of the empirical evidence. The aim of this systematic review was to present a summary of the sickness presenteeism evidence so far in relation to health and wellbeing over time. Eight databases were searched for longitudinal studies that investigated the consequences of workplace sickness presenteeism, had a baseline and at least one follow-up point, and included at least one specific measure of sickness presenteeism. Of the 453 papers identified, 12 studies met the eligibility criteria and were included in the review. We adopted a thematic approach to the analysis because of the heterogeneous nature of the sickness presenteeism research. The majority of studies found that sickness presenteeism at baseline is a risk factor for future sickness absence and decreased self-rated health. However, our findings highlight that a consensus has not yet been reached in terms of physical and mental health. This is because the longitudinal studies included in this review adopt a wide variety of approaches including the definition of sickness presenteeism, recall periods, measures used and different statistical approaches which is problematic if this research area is to advance. Future research directions are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Presentation approaches for enhancing interpretability of patient-reported outcomes (PROs) in meta-analysis: a protocol for a systematic survey of Cochrane reviews.

PubMed

Devji, Tahira; Johnston, Bradley C; Patrick, Donald L; Bhandari, Mohit; Thabane, Lehana; Guyatt, Gordon H

2017-09-27

Meta-analyses of clinical trials often provide sufficient information for decision-makers to evaluate whether chance can explain apparent differences between interventions. Interpretation of the magnitude and importance of treatment effects beyond statistical significance can, however, be challenging, particularly for patient-reported outcomes (PROs) measured using questionnaires with which clinicians have limited familiarity. The objectives of our study are to systematically evaluate Cochrane systematic review authors' approaches to calculation, reporting and interpretation of pooled estimates of patient-reported outcome measures (PROMs) in meta-analyses. We will conduct a methodological survey of a random sample of Cochrane systematic reviews published from 1 January 2015 to 1 April 2017 that report at least one statistically significant pooled result for at least one PRO in the abstract. Author pairs will independently review all titles, abstracts and full texts identified by the literature search, and they will extract data using a standardised data extraction form. We will extract the following: year of publication, number of included trials, number of included participants, clinical area, type of intervention(s) and control(s), type of meta-analysis and use of the Grading of Recommendations, Assessment, Development and Evaluation approach to rate the quality of evidence, as well as information regarding the characteristics of PROMs, calculation and presentation of PROM effect estimates and interpretation of PROM effect estimates. We will document and summarise the methods used for the analysis, reporting and interpretation of each summary effect measure. We will summarise categorical variables with frequencies and percentages and continuous outcomes as means and/or medians and associated measures of dispersion. Ethics approval for this study is not required. We will disseminate the results of this review in peer-reviewed publications and conference presentations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition

PubMed Central

O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C

2016-01-01

Background Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. Objective The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Methods Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. Results The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Conclusions Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible. PMID:27489143

Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition.

PubMed

O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C; Moynihan, Paula

2016-08-03

Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible.

Reducing the volume, exposure and negative impacts of advertising for foods high in fat, sugar and salt to children: A systematic review of the evidence from statutory and self-regulatory actions and educational measures.

PubMed

Chambers, Stephanie A; Freeman, Ruth; Anderson, Annie S; MacGillivray, Steve

2015-06-01

To identify and review evidence on 1) the effectiveness of statutory and self-regulatory actions to reduce the volume, exposure or wider impact of advertising for foods high in fat, sugar and salt (HFSS) to children, and 2) the role of educational measures. A systematic review of three databases (Medline, CINAHL and PsycINFO) and grey literature was carried out. Relevant evidence included studies evaluating advertising bans and restrictions, advertising literacy programmes and parental communication styles. Relevant media included TV, internet, radio, magazines and newspaper advertising. No studies were excluded based on language or publication date. Forty-seven publications were included: 19 provided evidence for the results of statutory regulation, 25 for self-regulation, and six for educational approaches. Outcome measures varied in approach, quality and results. Findings suggested statutory regulation could reduce the volume of and children's exposure to advertising for foods HFSS, and had potential to impact more widely. Self-regulatory approaches showed varied results in reducing children's exposure. There was some limited support for educational measures. Consistency in measures from evaluations over time would assist the development and interpretation of the evidence base on successful actions and measures to reduce the volume, exposure and impact of advertising for foods HFSS to children. Copyright © 2015 Elsevier Inc. All rights reserved.

Performance assessment of 3D surface imaging technique for medical imaging applications

NASA Astrophysics Data System (ADS)

Li, Tuotuo; Geng, Jason; Li, Shidong

2013-03-01

Recent development in optical 3D surface imaging technologies provide better ways to digitalize the 3D surface and its motion in real-time. The non-invasive 3D surface imaging approach has great potential for many medical imaging applications, such as motion monitoring of radiotherapy, pre/post evaluation of plastic surgery and dermatology, to name a few. Various commercial 3D surface imaging systems have appeared on the market with different dimension, speed and accuracy. For clinical applications, the accuracy, reproducibility and robustness across the widely heterogeneous skin color, tone, texture, shape properties, and ambient lighting is very crucial. Till now, a systematic approach for evaluating the performance of different 3D surface imaging systems still yet exist. In this paper, we present a systematic performance assessment approach to 3D surface imaging system assessment for medical applications. We use this assessment approach to exam a new real-time surface imaging system we developed, dubbed "Neo3D Camera", for image-guided radiotherapy (IGRT). The assessments include accuracy, field of view, coverage, repeatability, speed and sensitivity to environment, texture and color.

Health Impact Assessment practice and potential for integration within Environmental Impact and Strategic Environmental Assessments in Italy.

PubMed

Linzalone, Nunzia; Assennato, Giorgio; Ballarini, Adele; Cadum, Ennio; Cirillo, Mario; Cori, Liliana; De Maio, Francesca; Musmeci, Loredana; Natali, Marinella; Rieti, Sabrina; Soggiu, Maria Eleonora; Bianchi, Fabrizio

2014-12-01

Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population's health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA andSEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health,significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection ofthe environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest.

Accounting for Multiple Births in Neonatal and Perinatal Trials: Systematic Review and Case Study

PubMed Central

Hibbs, Anna Maria; Black, Dennis; Palermo, Lisa; Cnaan, Avital; Luan, Xianqun; Truog, William E; Walsh, Michele C; Ballard, Roberta A

2010-01-01

Objectives To determine the prevalence in the neonatal literature of statistical approaches accounting for the unique clustering patterns of multiple births. To explore the sensitivity of an actual trial to several analytic approaches to multiples. Methods A systematic review of recent perinatal trials assessed the prevalence of studies accounting for clustering of multiples. The NO CLD trial served as a case study of the sensitivity of the outcome to several statistical strategies. We calculated odds ratios using non-clustered (logistic regression) and clustered (generalized estimating equations, multiple outputation) analyses. Results In the systematic review, most studies did not describe the randomization of twins and did not account for clustering. Of those studies that did, exclusion of multiples and generalized estimating equations were the most common strategies. The NO CLD study included 84 infants with a sibling enrolled in the study. Multiples were more likely than singletons to be white and were born to older mothers (p<0.01). Analyses that accounted for clustering were statistically significant; analyses assuming independence were not. Conclusions The statistical approach to multiples can influence the odds ratio and width of confidence intervals, thereby affecting the interpretation of a study outcome. A minority of perinatal studies address this issue. PMID:19969305

Accounting for multiple births in neonatal and perinatal trials: systematic review and case study.

PubMed

Hibbs, Anna Maria; Black, Dennis; Palermo, Lisa; Cnaan, Avital; Luan, Xianqun; Truog, William E; Walsh, Michele C; Ballard, Roberta A

2010-02-01

To determine the prevalence in the neonatal literature of statistical approaches accounting for the unique clustering patterns of multiple births and to explore the sensitivity of an actual trial to several analytic approaches to multiples. A systematic review of recent perinatal trials assessed the prevalence of studies accounting for clustering of multiples. The Nitric Oxide to Prevent Chronic Lung Disease (NO CLD) trial served as a case study of the sensitivity of the outcome to several statistical strategies. We calculated odds ratios using nonclustered (logistic regression) and clustered (generalized estimating equations, multiple outputation) analyses. In the systematic review, most studies did not describe the random assignment of twins and did not account for clustering. Of those studies that did, exclusion of multiples and generalized estimating equations were the most common strategies. The NO CLD study included 84 infants with a sibling enrolled in the study. Multiples were more likely than singletons to be white and were born to older mothers (P < .01). Analyses that accounted for clustering were statistically significant; analyses assuming independence were not. The statistical approach to multiples can influence the odds ratio and width of confidence intervals, thereby affecting the interpretation of a study outcome. A minority of perinatal studies address this issue. Copyright 2010 Mosby, Inc. All rights reserved.

Impact of Physical Activity Intervention Programs on Self-Efficacy in Youths: A Systematic Review

PubMed Central

Cataldo, Rosa; John, Janice; Chandran, Latha; Pati, Susmita; Shroyer, A. Laurie W.

2013-01-01

Lack of physical activity has contributed to the nation's childhood obesity crisis, but the impact of physical activity on self-efficacy as a mediator of behavior change has not been examined. This systematic review (SR) describes the published evidence related to the impact of physical activity intervention programs on self-efficacy among youths. From January 2000 to June 2011, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to identify publications from PubMed, PsychInfo, Web of Knowledge, and the Cochran Database of Systematic Reviews. The Cochrane Population, Intervention, Control, Outcome, Study Design (PICOS) approach guided this SR articles selection and evaluation process. Of the 102 publications screened, 10 original studies matched the SR inclusion criteria. The types of physical activity interventions and self-efficacy assessments for these 10 studies were diverse. Of the 10 included articles, 6 articles identified an improvement in post-self-efficacy assessments compared to baseline and 4 showed no effect. In conclusion, physical activity intervention programs may improve self-efficacy in youths. A standardized approach to classify and measure self-efficacy is required. Further research is needed to quantify the association of self-efficacy ratings after completing physical activity interventions with objective health improvements, such as weight loss. PMID:24555151

The trend in inquiry-based learning (IBL) research from many perspectives: A systematic review

NASA Astrophysics Data System (ADS)

Anuar, Nor Syuhada Binti Saiful; Sani, Siti Shamsiah Binti; Ahmad, Che Nidzam Binti Che; Damanhuri, Muhd Ibrahim Bin Muhammad; Borhan, Mohamad Termizi Bin

2017-05-01

Inquiry-based learning (IBL) is one of the teaching approaches that has been suggested by the Kementerian Pelajaran Malaysia (KPM). Although IBL has been in existence for many years, the effect of this approach in terms of teacher's verbal interaction during teaching has not been considered to any great extent. For this reason, a systematic review was conducted to observe the pattern of the existing IBL research. This systematic review of quantitative and qualitative studies published between 2006 and 2016 was undertaken by using the following databases: Taylor & Francis Online (2012-2015), Wiley Online Library (2012-2015), ScienceDirect, SpringerLink, SAGE Journals, and EBSCOHOST. Research articles from trustworthy websites were also used. The main keywords used were teacher verbal interaction, inquiry-based learning (IBL), secondary school science and classroom interaction. Eleven studies were included in this review but only two out of the eleven selected papers discussed teacher verbal interaction. Hence, more research needs to be conducted in order to observe the effect of IBL towards teacher's verbal interaction during learning sessions.

Are cannabinoids an effective treatment for chronic non-cancer pain?

PubMed

Allende-Salazar, Rubén F; Rada, Gabriel

2017-06-14

The use of cannabinoids has been proposed as an analgesic for different painful conditions, especially for chronic pain refractory to usual treatment. However, its real efficacy and safety remains controversial. We sought to determine whether cannabinoids are an effective treatment for chronic non-cancer pain. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified 37 systematic reviews including 41 studies overall, of which 32 were randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded it is not clear whether cannabinoids decrease pain in patients with chronic non-cancer pain because the certainty of available evidence is very low. On the other hand, they are associated with significant adverse effects.

A systematic review of randomized controlled trials with herbal medicine on chronic rhinosinusitis.

PubMed

Anushiravani, Majid; Bakhshaee, Mahdi; Taghipour, Ali; Naghedi-Baghdar, Hamideh; Farshchi, Masoumeh Kaboli; Hoseini, Seyed Saeed; Mehri, Mohammad Reza

2018-03-01

Chronic rhinosinusitis (CRS) is a common disease with evidence to show that its incidence and prevalence are increasing. Medicinal plants are commonly used to treat CRS. This systematic review aimed to assess the effectiveness and safety of herbal preparations for treatment of the patients with CRS. Cochran, Embase, ISI, PubMed, and Scopus databases were searched until August 1, 2016. Only randomized controlled trials were included. Four randomized controlled trials were included in this systematic review. Various medicinal plants were studied in each article. Inclusion and exclusion criteria, and outcome measures varied among different articles. The results of this trials showed that this special medicinal plants may be effective in the treatment of CRS. No serious reactions were reported during the administration of herbal remedies in the 4 studies. However, trials with a well-designed approach are needed to study the actual safety and efficacy of herbs in the treatment of CRS. Copyright © 2017 John Wiley & Sons, Ltd.

Single-Blinded Prospective Implementation of a Preoperative Imaging Checklist for Endoscopic Sinus Surgery.

PubMed

Error, Marc; Ashby, Shaelene; Orlandi, Richard R; Alt, Jeremiah A

2018-01-01

Objective To determine if the introduction of a systematic preoperative sinus computed tomography (CT) checklist improves identification of critical anatomic variations in sinus anatomy among patients undergoing endoscopic sinus surgery. Study Design Single-blinded prospective cohort study. Setting Tertiary care hospital. Subjects and Methods Otolaryngology residents were asked to identify critical surgical sinus anatomy on preoperative CT scans before and after introduction of a systematic approach to reviewing sinus CT scans. The percentage of correctly identified structures was documented and compared with a 2-sample t test. Results A total of 57 scans were reviewed: 28 preimplementation and 29 postimplementation. Implementation of the sinus CT checklist improved identification of critical sinus anatomy from 24% to 84% correct ( P < .001). All residents, junior and senior, demonstrated significant improvement in identification of sinus anatomic variants, including those not directly included in the systematic review implemented. Conclusion The implementation of a preoperative endoscopic sinus surgery radiographic checklist improves identification of critical anatomic sinus variations in a training population.

A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer.

PubMed

Ehdaie, Behfar; Assel, Melissa; Benfante, Nicole; Malhotra, Deepak; Vickers, Andrew

2017-06-01

Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment. To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS. A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3+3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix. A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars. The rate of AS acceptance by patients for management of low-risk prostate cancer. In the pilot phase, 81 of 86 patients (94%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval -0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment. A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening-related overtreatment that occurs across medicine. In this study, we evaluated the impact of teaching physicians how to better communicate the benefits and risks of prostate cancer treatments on the willingness of patients to choose active surveillance. Decisions related to cancer are often guided by emotions and biases that lead most patients to seek radical treatment; however, we demonstrated that if discussions are framed differently, these biases can be overcome and more patients will choose active surveillance. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

A Systematic Approach to Discussing Active Surveillance with Patients with Low-risk Prostate Cancer

PubMed Central

Ehdaie, Behfar; Assel, Melissa; Benfante, Nicole; Malhotra, Deepak; Vickers, Andrew

2017-01-01

Background Physicians report difficulty convincing patients with prostate cancer about the merits of active surveillance (AS); as a result, a majority of patients unnecessarily choose to undergo radical treatment. Objective To develop and evaluate a systematic approach for physicians to counsel patients with low-risk prostate cancer to increase acceptance of AS. Design, setting, and participants A systematic counseling approach was developed and piloted in one clinic. Then five surgeons participated in a 1-h training session in which they learned about the approach. A total of 1003 patients with Gleason 3 + 3 prostate cancer were included in the study. We compared AS rates for 761 patients who were counseled over a 24-mo period before the training intervention with AS rates for 242 patients who were counseled over a 12-mo period afterwards, controlling for temporal trends and case mix. Intervention A systematic approach for communicating the merits of AS using appropriate framing techniques derived from principles studied by negotiation scholars. Outcome measurements and statistical analysis The rate of AS acceptance by patients for management of low-risk prostate cancer. Results and limitations In the pilot phase, 81 of 86 patients (93%) accepted AS after counseling by the physician who developed the counseling approach. In the subsequent study, the cohort for the training intervention comprised 1003 consecutive patients, 80% of whom met the Epstein criteria for very low-risk disease. The proportion of patients who selected AS increased from 69% before the training intervention to 81% afterwards. After adjusting for time trends and case mix, the rate of AS after the intervention was 9.1% higher (95% confidence interval −0.4% to 19.4%) than expected, a relative reduction of approximately 30% in the risk of unnecessary curative treatment. Conclusions A systematic approach to counseling can be taught to physicians in a 1-h lecture. We found evidence that even this minimal intervention can decrease overtreatment. Our novel approach offers a framework to help address cancer screening–related overtreatment that occurs across medicine. Patient summary In this study, we evaluated the impact of teaching physicians how to better communicate the benefits and risks of prostate cancer treatments on the willingness of patients to choose active surveillance. Decisions related to cancer are often guided by emotions and biases that lead most patients to seek radical treatment; however, we demonstrated that if discussions are framed differently, these biases can be overcome and more patients will choose active surveillance. PMID:28129893

Optimal strategies to consider when peer reviewing a systematic review and meta-analysis.

PubMed

Moher, David

2015-11-02

Systematic reviews are popular. A recent estimate indicates that 11 new systematic reviews are published daily. Nevertheless, evidence indicates that the quality of reporting of systematic reviews is not optimal. One likely reason is that the authors' reports have received inadequate peer review. There are now many different types of systematic reviews and peer reviewing them can be enhanced by using a reporting guideline to supplement whatever template the journal editors have asked you, as a peer reviewer, to use. Additionally, keeping up with the current literature, whether as a content expert or being aware of advances in systematic review methods is likely be make for a more comprehensive and effective peer review. Providing a brief summary of what the systematic review has reported is an important first step in the peer review process (and not performed frequently enough). At its core, it provides the authors with some sense of what the peer reviewer believes was performed (Methods) and found (Results). Importantly, it also provides clarity regarding any potential problems in the methods, including statistical approaches for meta-analysis, results, and interpretation of the systematic review, for which the peer reviewer can seek explanations from the authors; these clarifications are best presented as questions to the authors.

Epidemiology characteristics, reporting characteristics, and methodological quality of systematic reviews and meta-analyses on traditional Chinese medicine nursing interventions published in Chinese journals.

PubMed

Yang, Min; Jiang, Li; Wang, Aihong; Xu, Guihua

2017-02-01

To evaluate the epidemiological characteristics, reporting characteristics, and methodological quality of systematic reviews in the traditional Chinese medicine nursing field published in Chinese journals. The number of systematic reviews in the traditional Chinese medicine nursing field has increased, but their epidemiology, quality, and reporting characteristics have not been assessed completely. We generated an overview of reviews using a narrative approach. Four Chinese databases were searched for systematic reviews from inception to December 2015. The Preferred Reporting Items of Systematic Reviews and Meta-analyses and the Assessment of Multiple Systematic Reviews checklists were adopted to evaluate reporting and methodological quality, respectively. A total of 73 eligible systematic reviews, published from 2005 to 2015, were included. The deficiencies in reporting characteristics mainly lay in the lack of structured abstract or protocol, incomplete reporting of search strategies, study selection, and risk of bias. The deficiencies in methodological quality were reflected in the lack of a priori design and conflict of interest, incomplete literature searches, and assessment of publication bias. The quality of the evaluated reviews was unsatisfactory; attention should be paid to the improvement of reporting and methodological quality in the conduct of systematic reviews. © 2016 John Wiley & Sons Australia, Ltd.

Systematic approach to developing empirical interatomic potentials for III-N semiconductors

NASA Astrophysics Data System (ADS)

Ito, Tomonori; Akiyama, Toru; Nakamura, Kohji

2016-05-01

A systematic approach to the derivation of empirical interatomic potentials is developed for III-N semiconductors with the aid of ab initio calculations. The parameter values of empirical potential based on bond order potential are determined by reproducing the cohesive energy differences among 3-fold coordinated hexagonal, 4-fold coordinated zinc blende, wurtzite, and 6-fold coordinated rocksalt structures in BN, AlN, GaN, and InN. The bond order p is successfully introduced as a function of the coordination number Z in the form of p = a exp(-bZn ) if Z ≤ 4 and p = (4/Z)α if Z ≥ 4 in empirical interatomic potential. Moreover, the energy difference between wurtzite and zinc blende structures can be successfully evaluated by considering interaction beyond the second-nearest neighbors as a function of ionicity. This approach is feasible for developing empirical interatomic potentials applicable to a system consisting of poorly coordinated atoms at surfaces and interfaces including nanostructures.

Evaluation of evidence-based literature and formulation of recommendations for the clinical preventive guidelines for immigrants and refugees in Canada

PubMed Central

Tugwell, Peter; Pottie, Kevin; Welch, Vivian; Ueffing, Erin; Chambers, Andrea; Feightner, John

2011-01-01

Background: This article describes the evidence review and guideline development method developed for the Clinical Preventive Guidelines for Immigrants and Refugees in Canada by the Canadian Collaboration for Immigrant and Refugee Health Guideline Committee. Methods: The Appraisal of Guidelines for Research and Evaluation (AGREE) best-practice framework was combined with the recently developed Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to produce evidence-based clinical guidelines for immigrants and refugees in Canada. Results: A systematic approach was designed to produce the evidence reviews and apply the GRADE approach, including building on evidence from previous systematic reviews, searching for and comparing evidence between general and specific immigrant populations, and applying the GRADE criteria for making recommendations. This method was used for priority health conditions that had been selected by practitioners caring for immigrants and refugees in Canada. Interpretation: This article outlines the 14-step method that was defined to standardize the guideline development process for each priority health condition. PMID:20573711

Evaluation of EIT system performance.

PubMed

Yasin, Mamatjan; Böhm, Stephan; Gaggero, Pascal O; Adler, Andy

2011-07-01

An electrical impedance tomography (EIT) system images internal conductivity from surface electrical stimulation and measurement. Such systems necessarily comprise multiple design choices from cables and hardware design to calibration and image reconstruction. In order to compare EIT systems and study the consequences of changes in system performance, this paper describes a systematic approach to evaluate the performance of the EIT systems. The system to be tested is connected to a saline phantom in which calibrated contrasting test objects are systematically positioned using a position controller. A set of evaluation parameters are proposed which characterize (i) data and image noise, (ii) data accuracy, (iii) detectability of single contrasts and distinguishability of multiple contrasts, and (iv) accuracy of reconstructed image (amplitude, resolution, position and ringing). Using this approach, we evaluate three different EIT systems and illustrate the use of these tools to evaluate and compare performance. In order to facilitate the use of this approach, all details of the phantom, test objects and position controller design are made publicly available including the source code of the evaluation and reporting software.

Tools for Implementing an Evidence-Based Approach in Public Health Practice

PubMed Central

Jacobs, Julie A.; Jones, Ellen; Gabella, Barbara A.; Spring, Bonnie

2012-01-01

Increasing disease rates, limited funding, and the ever-growing scientific basis for intervention demand the use of proven strategies to improve population health. Public health practitioners must be ready to implement an evidence-based approach in their work to meet health goals and sustain necessary resources. We researched easily accessible and time-efficient tools for implementing an evidence-based public health (EBPH) approach to improve population health. Several tools have been developed to meet EBPH needs, including free online resources in the following topic areas: training and planning tools, US health surveillance, policy tracking and surveillance, systematic reviews and evidence-based guidelines, economic evaluation, and gray literature. Key elements of EBPH are engaging the community in assessment and decision making; using data and information systems systematically; making decisions on the basis of the best available peer-reviewed evidence (both quantitative and qualitative); applying program-planning frameworks (often based in health-behavior theory); conducting sound evaluation; and disseminating what is learned. PMID:22721501

Research Applications of Magnetic Resonance Spectroscopy (MRS) to Investigate Psychiatric Disorders

PubMed Central

Dager, SR; Oskin, NM; Richards, TL; Posse, S

2009-01-01

Advances in magnetic resonance spectroscopy (MRS) methodology and related analytic strategies allow sophisticated testing of neurobiological models of disease pathology in psychiatric disorders. An overview of principles underlying MRS, methodological considerations and investigative approaches is presented. A review of recent research is presented that highlights innovative approaches applying MRS, in particular 1H MRS, to systematically investigate specific psychiatric disorders, including autism spectrum disorders, schizophrenia, panic disorder, major depression and bipolar disorder. PMID:19363431

Systematic cavity design approach for a multi-frequency gyrotron for DEMO and study of its RF behavior

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

Kalaria, P. C., E-mail: parth.kalaria@partner.kit.edu; Avramidis, K. A.; Franck, J.

High frequency (>230 GHz) megawatt-class gyrotrons are planned as RF sources for electron cyclotron resonance heating and current drive in DEMOnstration fusion power plants (DEMOs). In this paper, for the first time, a feasibility study of a 236 GHz DEMO gyrotron is presented by considering all relevant design goals and the possible technical limitations. A mode-selection procedure is proposed in order to satisfy the multi-frequency and frequency-step tunability requirements. An effective systematic design approach for the optimal design of a gradually tapered cavity is presented. The RF-behavior of the proposed cavity is verified rigorously, supporting 920 kW of stable output power withmore » an interaction efficiency of 36% including the considerations of realistic beam parameters.« less

An exploration of crowdsourcing citation screening for systematic reviews

PubMed Central

Mortensen, Michael L.; Adam, Gaelen P.; Trikalinos, Thomas A.; Kraska, Tim

2017-01-01

Systematic reviews are increasingly used to inform health care decisions, but are expensive to produce. We explore the use of crowdsourcing (distributing tasks to untrained workers via the web) to reduce the cost of screening citations. We used Amazon Mechanical Turk as our platform and 4 previously conducted systematic reviews as examples. For each citation, workers answered 4 or 5 questions that were equivalent to the eligibility criteria. We aggregated responses from multiple workers into an overall decision to include or exclude the citation using 1 of 9 algorithms and compared the performance of these algorithms to the corresponding decisions of trained experts. The most inclusive algorithm (designating a citation as relevant if any worker did) identified 95% to 99% of the citations that were ultimately included in the reviews while excluding 68% to 82% of irrelevant citations. Other algorithms increased the fraction of irrelevant articles excluded at some cost to the inclusion of relevant studies. Crowdworkers completed screening in 4 to 17 days, costing $460 to $2220, a cost reduction of up to 88% compared to trained experts. Crowdsourcing may represent a useful approach to reducing the cost of identifying literature for systematic reviews. PMID:28677322

Methodological quality of behavioural weight loss studies: a systematic review

PubMed Central

Lemon, S. C.; Wang, M. L.; Haughton, C. F.; Estabrook, D. P.; Frisard, C. F.; Pagoto, S. L.

2018-01-01

Summary This systematic review assessed the methodological quality of behavioural weight loss intervention studies conducted among adults and associations between quality and statistically significant weight loss outcome, strength of intervention effectiveness and sample size. Searches for trials published between January, 2009 and December, 2014 were conducted using PUBMED, MEDLINE and PSYCINFO and identified ninety studies. Methodological quality indicators included study design, anthropometric measurement approach, sample size calculations, intent-to-treat (ITT) analysis, loss to follow-up rate, missing data strategy, sampling strategy, report of treatment receipt and report of intervention fidelity (mean = 6.3). Indicators most commonly utilized included randomized design (100%), objectively measured anthropometrics (96.7%), ITT analysis (86.7%) and reporting treatment adherence (76.7%). Most studies (62.2%) had a follow-up rate >75% and reported a loss to follow-up analytic strategy or minimal missing data (69.9%). Describing intervention fidelity (34.4%) and sampling from a known population (41.1%) were least common. Methodological quality was not associated with reporting a statistically significant result, effect size or sample size. This review found the published literature of behavioural weight loss trials to be of high quality for specific indicators, including study design and measurement. Identified for improvement include utilization of more rigorous statistical approaches to loss to follow up and better fidelity reporting. PMID:27071775

Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline.

PubMed

Gordon, Catherine M; Ackerman, Kathryn E; Berga, Sarah L; Kaplan, Jay R; Mastorakos, George; Misra, Madhusmita; Murad, M Hassan; Santoro, Nanette F; Warren, Michelle P

2017-05-01

The American Society for Reproductive Medicine, the European Society of Endocrinology, and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. To formulate clinical practice guidelines for the diagnosis and treatment of functional hypothalamic amenorrhea (FHA). The participants include an Endocrine Society-appointed task force of eight experts, a methodologist, and a medical writer. This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies. One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and cosponsoring organizations reviewed and commented on preliminary drafts of this guideline. FHA is a form of chronic anovulation, not due to identifiable organic causes, but often associated with stress, weight loss, excessive exercise, or a combination thereof. Investigations should include assessment of systemic and endocrinologic etiologies, as FHA is a diagnosis of exclusion. A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support. Medical complications include, among others, bone loss and infertility, and appropriate therapies are under debate and investigation. Copyright © 2017 Endocrine Society

Systematic Functional Interrogation of Rare Cancer Variants Identifies Oncogenic Alleles | Office of Cancer Genomics

Cancer.gov

Cancer genome characterization efforts now provide an initial view of the somatic alterations in primary tumors. However, most point mutations occur at low frequency, and the function of these alleles remains undefined. We have developed a scalable systematic approach to interrogate the function of cancer-associated gene variants. We subjected 474 mutant alleles curated from 5,338 tumors to pooled in vivo tumor formation assays and gene expression profiling. We identified 12 transforming alleles, including two in genes (PIK3CB, POT1) that have not been shown to be tumorigenic.

Methodological challenges involved in compiling the Nahua pharmacopeia.

PubMed

De Vos, Paula

2017-06-01

Recent work in the history of science has questioned the Eurocentric nature of the field and sought to include a more global approach that would serve to displace center-periphery models in favor of approaches that take seriously local knowledge production. Historians of Iberian colonial science have taken up this approach, which involves reliance on indigenous knowledge traditions of the Americas. These traditions present a number of challenges to modern researchers, including availability and reliability of source material, issues of translation and identification, and lack of systematization. This essay explores the challenges that emerged in the author's attempt to compile a pre-contact Nahua pharmacopeia, the reasons for these challenges, and the ways they may - or may not - be overcome.

Outcomes of therapeutic TMD interventions on oral health related quality of life: A qualitative systematic review.

PubMed

Song, Yi Lin; Yap, Adrian U-Jin

2018-04-26

This systematic review aims to determine the impact of temporomandibular disorder (TMD) therapeutic interventions on patients' oral health related quality of life (OHRQoL) and to recommend approaches that improve QoL. A systematic search of the literature was performed between January 2007 and October 2017 to identify articles on TMD interventions and OHRQoL. Randomized controlled trials, and retrospective and prospective cohort studies that mentioned dedicated tools for measurement of OHRQoL changes in TMD patients after therapeutic interventions were included. Abstracts of studies that did not mention any form of measurement of OHRQoL in their treatment outcome were excluded. The initial screening yielded 171 articles. After evaluation of abstracts and full text articles, five articles fulfilled all selection criteria and were included. Most TMD treatment interventions seem to improve QoL to some extent, but no single treatment modality can be advocated as the sole approach to managing TMD. Psychotherapy, occlusal appliance therapy, arthrocentesis, and orthodontics/ orthognathic surgery (in subjects with severe malocclusion) appear to improve OHRQoL of TMD patients. Recommendation on the best TMD intervention for improving QoL could not be made due to the diverse TMD subtypes and non-disease specific OHRQoL instruments employed. More studies incorporating TMD-specific OHRQoL measures and targeting explicit TMD subtypes based on internationally accepted diagnostic criteria are warranted in this area of research.

Impact of Surgical Route in Influencing the Risk of Lymphatic Complications After Ovarian Cancer Staging.

PubMed

Bogani, Giorgio; Borghi, Chiara; Ditto, Antonino; Signorelli, Mauro; Martinelli, Fabio; Chiappa, Valentina; Scaffa, Cono; Perotto, Stefania; Leone Roberti Maggiore, Umberto; Montanelli, Luca; Di Donato, Violante; Infantino, Carmelo; Lorusso, Domenica; Raspagliesi, Francesco

Lymphatic complications are a common occurrence after staging surgery for early-stage ovarian cancer (eEOC). We investigated whether the introduction of minimally invasive surgery influences the risk of developing lymphoceles and lymphorrhea in patients undergoing staging for eEOC. For this purpose, data of consecutive patients affected by eEOC undergoing staging surgery between January 1980 and January 2016 were retrospectively reviewed, and a systematic review and meta-analysis was performed. This systematic review was registered in the International Prospective Register of Systematic Review. Among 341 patients included in the present study, 47 severe postoperative complications occurred (13.7%), including 40 lymphatic complications: 31 symptomatic lymphoceles (9%) and 9 cases of lymphorrhea (2.6%), respectively. Laparoscopic staging correlated with a lower risk of developing any severe lymphatic complications in comparison with open surgery (p = .02). In particular, the laparoscopic approach and para-aortic node involvement were associated with a trend toward lower lymphoceles (odds ratio, .13; 95% confidence interval, .07-2.20; p = .05) and a trend toward higher risk of lymphorrhea developing (odds ratio, 4.02; 95% confidence interval, .93-17.3; p = .06), respectively. In conclusion, the implementation of a minimally invasive approach might result in a slight reduction of lymphatic complications after eEOC staging. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews.

PubMed

Jadczak, Agathe D; Makwana, Naresh; Luscombe-Marsh, Natalie; Visvanathan, Renuka; Schultz, Timothy J

2018-03-01

This umbrella review aimed to determine the effectiveness of exercise interventions, alone or in combination with other interventions, in improving physical function in community-dwelling older people identified as pre-frail or frail. Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty. Several systematic reviews discuss the effects of exercise interventions on physical function parameters, such as strength, mobility, gait, balance and physical performance, and indicate that multi-component exercise, including resistance, aerobic, balance and flexibility training, appears to be the best way in which to improve physical function parameters in frail older people. However, there is still uncertainty as to which exercise characteristics (type, frequency, intensity, duration and combinations) are the most effective and sustainable over the long-term. Participants were adults, 60 years or over, living in the community and identified as pre-frail or frail. Quantitative systematic reviews, with or without meta-analysis that examined the effectiveness of exercise interventions of any form, duration, frequency and intensity, alone or in combination with other interventions designed to alter physical function parameters in frail older people, were considered. The quantitative outcome measures were physical function, including muscular strength, gait, balance, mobility and physical performance. An iterative search strategy for ten bibliometric databases and gray literature was developed. Critical appraisal of seven systematic reviews was conducted independently by two reviewers using a standard Joanna Briggs Institute tool. Data was extracted independently by two reviewers using a standard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach. Seven systematic reviews were included in this umbrella review, with a total of 58 relevant randomized controlled trials and 6927 participants. Five systematic reviews examined the effects of exercise only, while two systematic reviews reported on exercise in combination with a nutritional approach, including protein supplementations, as well as fruit and dairy products. The average exercise frequency was 2-3 times per week (mean 3.0 ± 1.5 times per week; range 1-7 weekly) for 10-90 minutes per session (mean of 52.0 ± 16.5 mins) and a total duration of 5-72 weeks with the majority lasting a minimum of 2.5 months (mean 22.7 ± 17.7 weeks). Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength, gait speed, balance and physical performance, including resistance, aerobic, balance and flexibility tasks. Resistance training alone also appeared to be beneficial, in particular for improving muscular strength, gait speed and physical performance. Other types of exercise were not sufficiently studied and their effectiveness is yet to be established. Interventions for pre-frail and frail older adults should include multi-component exercises, including in particular resistance training, as well as aerobic, balance and flexibility tasks. Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made.

Psychotherapeutic Applications of Mobile Phone-based Technologies: A Systematic Review of Current Research and Trends.

PubMed

Menon, Vikas; Rajan, Tess Maria; Sarkar, Siddharth

2017-01-01

There is a growing interest in using mobile phone technology to offer real-time psychological interventions and support. However, questions remain on the clinical effectiveness and feasibility of such approaches in psychiatric populations. Our aim was to systematically review the published literature on mobile phone apps and other mobile phone-based technology for psychotherapy in mental health disorders. To achieve this, electronic searches of PubMed, ScienceDirect, and Google Scholar were carried out in January 2016. Generated abstracts were systematically screened for eligibility to be included in the review. Studies employing psychotherapy in any form, being delivered through mobile-based technology and reporting core mental health outcomes in mental illness were included in the study. We also included trials in progress with published protocols reporting at least some outcome measures of such interventions. From a total of 1563 search results, 24 eligible articles were identified and reviewed. These included trials in anxiety disorders (8), substance use disorders (5), depression (4), bipolar disorders (3), schizophrenia and psychotic disorders (3), and attempted suicide (1). Of these, eight studies involved the use of smartphone apps and others involved personalized text messages, automated programs, or delivered empirically supported treatments. Trial lengths varied from 6 weeks to 1 year. Good overall retention rates indicated that the treatments were feasible and largely acceptable. Benefits were reported on core outcomes in mental health illness indicating efficacy of such approaches though sample sizes were small. To conclude, mobile phone-based psychotherapies are a feasible and acceptable treatment option for patients with mental disorders. However, there remains a paucity of data on their effectiveness in real-world settings, especially from low- and middle-income countries.

Mental health promotion and problem prevention in schools: what does the evidence say?

PubMed

Weare, Katherine; Nind, Melanie

2011-12-01

The European Union Dataprev project reviewed work on mental health in four areas, parenting, schools, the workplace and older people. The schools workpackage carried out a systematic review of reviews of work on mental health in schools from which it identified evidence-based interventions and programmes and extracted the general principles from evidence-based work. A systematic search of the literature uncovered 52 systematic reviews and meta-analyses of mental health in schools. The interventions identified by the reviews had a wide range of beneficial effects on children, families and communities and on a range of mental health, social, emotional and educational outcomes. The effect sizes associated with most interventions were generally small to moderate in statistical terms, but large in terms of real-world impacts. The effects associated with interventions were variable and their effectiveness could not always be relied on. The characteristics of more effective interventions included: teaching skills, focusing on positive mental health; balancing universal and targeted approaches; starting early with the youngest children and continuing with older ones; operating for a lengthy period of time and embedding work within a multi-modal/whole-school approach which included such features as changes to the curriculum including teaching skills and linking with academic learning, improving school ethos, teacher education, liaison with parents, parenting education, community involvement and coordinated work with outside agencies. Interventions were only effective if they were completely and accurately implemented: this applied particularly to whole-school interventions which could be ineffective if not implemented with clarity, intensity and fidelity. The implications for policy and practice around mental health in schools are discussed, including the suggestion of some rebalancing of priorities and emphases.

The Chronic Care Model and Diabetes Management in US Primary Care Settings: A Systematic Review

PubMed Central

Stellefson, Michael; Stopka, Christine

2013-01-01

Introduction The Chronic Care Model (CCM) uses a systematic approach to restructuring medical care to create partnerships between health systems and communities. The objective of this study was to describe how researchers have applied CCM in US primary care settings to provide care for people who have diabetes and to describe outcomes of CCM implementation. Methods We conducted a literature review by using the Cochrane database of systematic reviews, CINAHL, and Health Source: Nursing/Academic Edition and the following search terms: “chronic care model” (and) “diabet*.” We included articles published between January 1999 and October 2011. We summarized details on CCM application and health outcomes for 16 studies. Results The 16 studies included various study designs, including 9 randomized controlled trials, and settings, including academic-affiliated primary care practices and private practices. We found evidence that CCM approaches have been effective in managing diabetes in US primary care settings. Organizational leaders in health care systems initiated system-level reorganizations that improved the coordination of diabetes care. Disease registries and electronic medical records were used to establish patient-centered goals, monitor patient progress, and identify lapses in care. Primary care physicians (PCPs) were trained to deliver evidence-based care, and PCP office–based diabetes self-management education improved patient outcomes. Only 7 studies described strategies for addressing community resources and policies. Conclusion CCM is being used for diabetes care in US primary care settings, and positive outcomes have been reported. Future research on integration of CCM into primary care settings for diabetes management should measure diabetes process indicators, such as self-efficacy for disease management and clinical decision making. PMID:23428085

Achievements and Challenges in Computational Protein Design.

PubMed

Samish, Ilan

2017-01-01

Computational protein design (CPD), a yet evolving field, includes computer-aided engineering for partial or full de novo designs of proteins of interest. Designs are defined by a requested structure, function, or working environment. This chapter describes the birth and maturation of the field by presenting 101 CPD examples in a chronological order emphasizing achievements and pending challenges. Integrating these aspects presents the plethora of CPD approaches with the hope of providing a "CPD 101". These reflect on the broader structural bioinformatics and computational biophysics field and include: (1) integration of knowledge-based and energy-based methods, (2) hierarchical designated approach towards local, regional, and global motifs and the integration of high- and low-resolution design schemes that fit each such region, (3) systematic differential approaches towards different protein regions, (4) identification of key hot-spot residues and the relative effect of remote regions, (5) assessment of shape-complementarity, electrostatics and solvation effects, (6) integration of thermal plasticity and functional dynamics, (7) negative design, (8) systematic integration of experimental approaches, (9) objective cross-assessment of methods, and (10) successful ranking of potential designs. Future challenges also include dissemination of CPD software to the general use of life-sciences researchers and the emphasis of success within an in vivo milieu. CPD increases our understanding of protein structure and function and the relationships between the two along with the application of such know-how for the benefit of mankind. Applied aspects range from biological drugs, via healthier and tastier food products to nanotechnology and environmentally friendly enzymes replacing toxic chemicals utilized in the industry.

Got (the Right) Milk? How a Blended Quality Improvement Approach Catalyzed Change.

PubMed

Luton, Alexandra; Bondurant, Patricia G; Campbell, Amy; Conkin, Claudia; Hernandez, Jae; Hurst, Nancy

2015-10-01

The expression, storage, preparation, fortification, and feeding of breast milk are common ongoing activities in many neonatal intensive care units (NICUs) today. Errors in breast milk administration are a serious issue that should be prevented to preserve the health and well-being of NICU babies and their families. This paper describes how a program to improve processes surrounding infant feeding was developed, implemented, and evaluated. The project team used a blended quality improvement approach that included the Model for Improvement, Lean and Six Sigma methodologies, and principles of High Reliability Organizations to identify and drive short-term, medium-term, and long-term improvement strategies. Through its blended quality improvement approach, the team strengthened the entire dispensation system for both human milk and formula and outlined a clear vision and plan for further improvements as well. The NICU reduced feeding errors by 83%. Be systematic in the quality improvement approach, and apply proven methods to improving processes surrounding infant feeding. Involve expert project managers with nonclinical perspective to guide work in a systematic way and provide unbiased feedback. Create multidisciplinary, cross-departmental teams that include a vast array of stakeholders in NICU feeding processes to ensure comprehensive examination of current state, identification of potential risks, and "outside the box" potential solutions. As in the realm of pharmacy, the processes involved in preparing feedings for critically ill infants should be carried out via predictable, reliable means including robust automated verification that integrates seamlessly into existing processes. The use of systems employed in pharmacy for medication preparation should be considered in the human milk and formula preparation setting.

Balancing costs and benefits at different stages of medical innovation: a systematic review of Multi-criteria decision analysis (MCDA).

PubMed

Wahlster, Philip; Goetghebeur, Mireille; Kriza, Christine; Niederländer, Charlotte; Kolominsky-Rabas, Peter

2015-07-09

The diffusion of health technologies from translational research to reimbursement depends on several factors included the results of health economic analysis. Recent research identified several flaws in health economic concepts. Additionally, the heterogeneous viewpoints of participating stakeholders are rarely systematically addressed in current decision-making. Multi-criteria Decision Analysis (MCDA) provides an opportunity to tackle these issues. The objective of this study was to review applications of MCDA methods in decisions addressing the trade-off between costs and benefits. Using basic steps of the PRISMA guidelines, a systematic review of the healthcare literature was performed to identify original research articles from January 1990 to April 2014. Medline, PubMed, Springer Link and specific journals were searched. Using predefined categories, bibliographic records were systematically extracted regarding the type of policy applications, MCDA methodology, criteria used and their definitions. 22 studies were included in the analysis. 15 studies (68 %) used direct MCDA approaches and seven studies (32 %) used preference elicitation approaches. Four studies (19 %) focused on technologies in the early innovation process. The majority (18 studies - 81 %) examined reimbursement decisions. Decision criteria used in studies were obtained from the literature research and context-specific studies, expert opinions, and group discussions. The number of criteria ranged between three up to 15. The most frequently used criteria were health outcomes (73 %), disease impact (59 %), and implementation of the intervention (40 %). Economic criteria included cost-effectiveness criteria (14 studies, 64 %), and total costs/budget impact of an intervention (eight studies, 36 %). The process of including economic aspects is very different among studies. Some studies directly compare costs with other criteria while some include economic consideration in a second step. In early innovation processes, MCDA can provide information about stakeholder preferences as well as evidence needs in further development. However, only a minority of these studies include economic features due to the limited evidence. The most important economic criterion cost-effectiveness should not be included from a technical perspective as it is already a composite of costs and benefit. There is a significant lack of consensus in methodology employed by the various studies which highlights the need for guidance on application of MCDA at specific phases of an innovation.

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

A Systematic Review of Different Implants and Approaches for Proximal Interphalangeal Joint Arthroplasty

PubMed Central

Yamamoto, Michiro; Malay, Sunitha; Fujihara, Yuki; Zhong, Lin; Chung, Kevin C.

2016-01-01

Background Outcomes after implant arthroplasty for primary degenerative and posttraumatic osteoarthritis (OA) of proximal interphalangeal (PIP) joint were different according to the implant design and surgical approach. The purpose of this systematic review was to evaluate outcomes of various types of implant arthroplasty for PIP joint OA with emphasis on different surgical approaches. Methods The authors searched all available literature in the PubMed and EMBASE databases for articles reporting on outcomes of implant arthroplasty for PIP joint OA. Data collection included active arc of motion (AOM), extension lag, and complications. We combined the data of various types of surface replacement arthroplasty into one group to compare with silicone arthroplasty. Results A total of 849 articles were screened, yielding 40 studies for final review. The mean postoperative AOM and the mean gain in AOM of silicone implant with volar approach were 58° and 17° respectively which was greater than surface replacement implant with dorsal approach as 51° and 8°, respectively. The mean postoperative extension lag of silicone implant with volar approach and surface replacement with dorsal approach was 5° and 14° respectively. The revision rate of silicone implant with volar approach and surface replacement with dorsal approach was 6% and 18% at the mean follow-up period of 41.2 and 51 months, respectively. Conclusions Silicone implant with volar approach showed the best AOM with less extension lag and fewer complications after surgery among all the implant designs and surgical approaches. PMID:28445369

Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis.

PubMed

Martins, Wagner Rodrigues; Blasczyk, Juscelino Castro; Aparecida Furlan de Oliveira, Micaele; Lagôa Gonçalves, Karina Ferreira; Bonini-Rocha, Ana Clara; Dugailly, Pierre-Michel; de Oliveira, Ricardo Jacó

2016-02-01

Temporomandibular joint disorder (TMD) requires a complex diagnostic and therapeutic approach, which usually involves a multidisciplinary management. Among these treatments, musculoskeletal manual techniques are used to improve health and healing. To assess the effectiveness of musculoskeletal manual approach in temporomandibular joint disorder patients. A systematic review with meta-analysis. During August 2014 a systematic review of relevant databases (PubMed, The Cochrane Library, PEDro and ISI web of knowledge) was performed to identify controlled clinical trials without date restriction and restricted to the English language. Clinical outcomes were pain and range of motion focalized in temporomandibular joint. The mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) and overall effect size were calculated at every post treatment. The PEDro scale was used to demonstrate the quality of the included studies. From the 308 articles identified by the search strategy, 8 articles met the inclusion criteria. The meta-analysis showed a significant difference (p < 0.0001) and large effect on active mouth opening (SMD, 0.83; 95% CI, 0.42 to 1.25) and on pain during active mouth opening (MD, 1.69; 95% CI, 1.09 to 2.30) in favor of musculoskeletal manual techniques when compared to other conservative treatments for TMD. Musculoskeletal manual approaches are effective for treating TMD. In the short term, there is a larger effect regarding the latter when compared to other conservative treatments for TMD. Copyright © 2015 Elsevier Ltd. All rights reserved.

Endoscopic versus surgical treatment of ampullary adenomas: a systematic review and meta-analysis

PubMed Central

Mendonça, Ernesto Quaresma; Bernardo, Wanderley Marques; de Moura, Eduardo Guimarães Hourneaux; Chaves, Dalton Marques; Kondo, André; Pu, Leonardo Zorrón Cheng Tao; Baracat, Felipe Iankelevich

2016-01-01

The aim of this study is to address the outcomes of endoscopic resection compared with surgery in the treatment of ampullary adenomas. A systematic review and meta-analysis were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For this purpose, the Medline, Embase, Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were scanned. Studies included patients with ampullary adenomas and data considering endoscopic treatment compared with surgery. The entire analysis was based on a fixed-effects model. Five retrospective cohort studies were selected (466 patients). All five studies (466 patients) had complete primary resection data available and showed a difference that favored surgical treatment (risk difference [RD] = -0.24, 95% confidence interval [CI] = -0.44 to -0.04). Primary success data were identified in all five studies as well. Analysis showed that the surgical approach outperformed endoscopic treatment for this outcome (RD = -0.37, 95% CI = -0.50 to -0.24). Recurrence data were found in all studies (466 patients), with a benefit indicated for surgical treatment (RD = 0.10, 95% CI = -0.01 to 0.19). Three studies (252 patients) presented complication data, but analysis showed no difference between the approaches for this parameter (RD = -0.15, 95% CI = -0.53 to 0.23). Considering complete primary resection, primary success and recurrence outcomes, the surgical approach achieves significantly better results. Regarding complication data, this systematic review concludes that rates are not significantly different. PMID:26872081

Systematic comparison of jet energy-loss schemes in a realistic hydrodynamic medium

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

Bass, Steffen A.; Majumder, Abhijit; Gale, Charles

2009-02-15

We perform a systematic comparison of three different jet energy-loss approaches. These include the Armesto-Salgado-Wiedemann scheme based on the approach of Baier-Dokshitzer-Mueller-Peigne-Schiff and Zakharov (BDMPS-Z/ASW), the higher twist (HT) approach and a scheme based on the Arnold-Moore-Yaffe (AMY) approach. In this comparison, an identical medium evolution will be utilized for all three approaches: this entails not only the use of the same realistic three-dimensional relativistic fluid dynamics (RFD) simulation, but also the use of identical initial parton-distribution functions and final fragmentation functions. We are, thus, in a unique position to not only isolate fundamental differences between the various approaches butmore » also make rigorous calculations for different experimental measurements using state of the art components. All three approaches are reduced to versions containing only one free tunable parameter, this is then related to the well-known transport parameter q. We find that the parameters of all three calculations can be adjusted to provide a good description of inclusive data on R{sub AA} vs transverse momentum. However, we do observe slight differences in their predictions for the centrality and azimuthal angular dependence of R{sub AA} vs p{sub T}. We also note that the values of the transport coefficient q in the three approaches to describe the data differ significantly.« less

Teaching Reading for Students with Intellectual Disabilities: A Systematic Review

ERIC Educational Resources Information Center

Alnahdi, Ghaleb Hamad

2015-01-01

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

Use of programme theory to understand the differential effects of interventions across socio-economic groups in systematic reviews-a systematic methodology review.

PubMed

Maden, Michelle; Cunliffe, Alex; McMahon, Naoimh; Booth, Andrew; Carey, Gina Michelle; Paisley, Suzy; Dickson, Rumona; Gabbay, Mark

2017-12-29

Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice. A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health. Multiple databases were searched from January 2013 to May 2016. Studies were included if they were systematic reviews assessing the effectiveness of an intervention and included data on SES. Two reviewers independently screened all studies, undertook quality assessment and extracted data. A narrative approach to synthesis was adopted. A total of 37 systematic reviews were included, 10 of which were explicit in the use of terminology for 'programme theory'. Twenty-nine studies used programme theory to inform both their a priori assumptions and explain their review findings. Of these, 22 incorporated considerations of both what and how interventions do/do not work in SES groups to both predict and explain their review findings. Thirteen studies acknowledged 24 unique theoretical references to support their assumptions of what or how interventions may have different effects in SES groups. Most reviewers used supplementary evidence to support their considerations of differential effectiveness. The majority of authors outlined a programme theory in the "Introduction" and "Discussion" sections of the review to inform their assumptions or provide explanations of what or how interventions may result in differential effects within or across SES groups. About a third of reviews used programme theory to inform the review analysis and/or synthesis. Few authors used programme theory to inform their inclusion criteria, data extraction or quality assessment. Twenty-one studies tested their a priori programme theory. The use of programme theory to inform considerations of if, what and how interventions lead to differential effects on health in different SES groups in the systematic review process is not yet widely adopted, is used implicitly, is often fragmented and is not implemented in a systematic way.

Review of the Role of Faith- and Community-Based Organizations in Providing Comprehensive Sexuality Education

ERIC Educational Resources Information Center

Landry, David J.; Lindberg, Laura Duberstein; Gemmill, Alison; Boonstra, Heather; Finer, Lawrence B.

2011-01-01

This article reviews the role of faith- and community-based organizations in providing comprehensive sexuality education for adolescents in the United States. To gather information about these organizations, a broad approach was used that included a formal literature review, systematic searches through organizational Web sites, and the convening…

Involving Families and Communities in CSPAP Development Using Asset Mapping

ERIC Educational Resources Information Center

Allar, Ishonté; Elliott, Eloise; Jones, Emily; Kristjansson, Alfgeir L.; Taliaferro, Andrea; Bulger, Sean M.

2017-01-01

The purpose of this article is to provide an introduction to asset mapping as a systematic approach to facilitating increased family and community involvement in comprehensive school physical activity programs (CSPAP). It includes a brief summary of the literature related to the importance of family and community in children's physical activity…

Information Architecture for the Web: The IA Matrix Approach to Designing Children's Portals.

ERIC Educational Resources Information Center

Large, Andrew; Beheshti, Jamshid; Cole, Charles

2002-01-01

Presents a matrix that can serve as a tool for designing the information architecture of a Web portal in a logical and systematic manner. Highlights include interfaces; metaphors; navigation; interaction; information retrieval; and an example of a children's Web portal to provide access to museum information. (Author/LRW)

Institutionalisation of Internal Quality Assurance: Focusing on Institutional Work and the Significance of Disciplinary Differences

ERIC Educational Resources Information Center

Vukasovic, Martina

2014-01-01

The study suggests that institutionalisation of a comprehensive and systematic approach to internal quality assurance of higher education institutions inspired by the Bologna Process has regulative, normative and cultural-cognitive dimensions. It includes development of structures and procedures for quality assurance, as well as boosting of the…

Effective Programs for Elementary Science: A Best-Evidence Synthesis

ERIC Educational Resources Information Center

Slavin, Robert E.; Lake, Cynthia; Hanley, Pam; Thurston, Allen

2012-01-01

This article presents a systematic review of research on the achievement outcomes of all types of approaches to teaching science in elementary schools. Study inclusion criteria included use of randomized or matched control groups, a study duration of at least 4 weeks, and use of achievement measures independent of the experimental treatment. A…

Experimental Evaluations of Elementary Science Programs: A Best-Evidence Synthesis

ERIC Educational Resources Information Center

Slavin, Robert E.; Lake, Cynthia; Hanley, Pam; Thurston, Allen

2014-01-01

This article presents a systematic review of research on the achievement outcomes of all types of approaches to teaching science in elementary schools. Study inclusion criteria included use of randomized or matched control groups, a study duration of at least 4 weeks, and use of achievement measures independent of the experimental treatment. A…

A Study of Statistics through Tootsie Pops

ERIC Educational Resources Information Center

Aaberg, Shelby; Vitosh, Jason; Smith, Wendy

2016-01-01

A classic TV commercial once asked, "How many licks does it take to get to the center of a Tootsie Roll Tootsie Pop?" The narrator claims, "The world may never know" (Tootsie Roll 2012), but an Internet search returns a multitude of answers, some of which include rigorous systematic approaches by academics to address the…

The Research Landscape of School-Based Sexuality Education: Systematic Mapping of the Literature

ERIC Educational Resources Information Center

Roien, Line Anne; Graugaard, Christian; Simovska, Venka

2018-01-01

Purpose: The purpose of this paper is to map and discuss the overall characteristics of international research on school-based sexuality education, published in academic journals, with a particular focus on the framing of non-conservative approaches including sexuality education research targeting young pupils 6-12 years of age.…

Planning for Worker Re-Adjustment: A Technical Assistance Guide for States.

ERIC Educational Resources Information Center

Balfe, Kevin

This guide summarizes key principles drawn from successful programs for helping unemployed workers find new jobs and presents a systematic approach to help states plan and manage their worker readjustment efforts. The guide contains two major sections. The first section is an overview and summary that includes background on the dislocation…

Integrative Consensus: A Systematic Approach to Integrating Comprehensive Assessment Data for Young Children with Behavior Problems

ERIC Educational Resources Information Center

Shernoff, Elisa S.; Hill, Carri; Danis, Barbara; Leventhal, Bennett L.; Wakschlag, Lauren S.

2014-01-01

Comprehensive assessments that include parents and teachers are essential when assessing young children vulnerable to emotional and behavioral problems given the multiple systems and contexts that influence and support optimal development (U. Bronfenbrenner & P. A. Morris, 2006; M. J. Guralnick, 2011). However, more data complicate clinical…

Development of Systematic Approaches for Calibration of Subsurface Transport Models Using Hard and Soft Data on System Characteristics and Behavior

DTIC Science & Technology

2011-02-02

who graduated during this period and will receive scholarships or fellowships for further studies in science, mathematics, engineering or technology...nature or are collected at discrete points or localized areas in the system. The qualitative data includes, geology , large-scale stratigraphy and

Epistemological Trends in Educational Leadership Studies in Israel: 2000-2012

ERIC Educational Resources Information Center

Eyal, Ori; Rom, Noa

2015-01-01

Purpose: The purpose of this paper is to identify the epistemological trends in the Israeli Educational Leadership (EL) scholarship between the years 2000 and 2012. Design/methodology/approach: The 51 studies included in this review were detected through a systematic search in online academic databases. Abstracts of studies identified as being…

Effectiveness of Occupational Health and Safety Training: A Systematic Review with Meta-Analysis

ERIC Educational Resources Information Center

Ricci, Federico; Chiesi, Andrea; Bisio, Carlo; Panari, Chiara; Pelosi, Annalisa

2016-01-01

Purpose: This meta-analysis aims to verify the efficacy of occupational health and safety (OHS) training in terms of knowledge, attitude and beliefs, behavior and health. Design/methodology/approach: The authors included studies published in English (2007-2014) selected from ten databases. Eligibility criteria were studies concerned with the…

Strategies for Values Inquiry: An Exploratory Case Study

ERIC Educational Resources Information Center

Renger, Ralph; Bourdeau, Beth

2004-01-01

Values inquiry refers to systematic investigation of the values relevant to a program, including understanding those outcomes most prized by stakeholders. Although much attention has been given to stakeholder involvement, the literature on value inquiries per se as an approach is limited. This paper demonstrates how several of the steps used in…

Use of Electroencephalography Brain-Computer Interface Systems as a Rehabilitative Approach for Upper Limb Function After a Stroke: A Systematic Review.

PubMed

Monge-Pereira, Esther; Ibañez-Pereda, Jaime; Alguacil-Diego, Isabel M; Serrano, Jose I; Spottorno-Rubio, María P; Molina-Rueda, Francisco

2017-09-01

Brain-computer interface (BCI) systems have been suggested as a promising tool for neurorehabilitation. However, to date, there is a lack of homogeneous findings. Furthermore, no systematic reviews have analyzed the degree of validation of these interventions for upper limb (UL) motor rehabilitation poststroke. The study aims were to compile all available studies that assess an UL intervention based on an electroencephalography (EEG) BCI system in stroke; to analyze the methodological quality of the studies retrieved; and to determine the effects of these interventions on the improvement of motor abilities. TYPE: This was a systematic review. Searches were conducted in PubMed, PEDro, Embase, Cumulative Index to Nursing and Allied Health, Web of Science, and Cochrane Central Register of Controlled Trial from inception to September 30, 2015. This systematic review compiles all available studies that assess UL intervention based on an EEG-BCI system in patients with stroke, analyzing their methodological quality using the Critical Review Form for Quantitative Studies, and determining the grade of recommendation of these interventions for improving motor abilities as established by the Oxford Centre for Evidence-based Medicine. The articles were selected according to the following criteria: studies evaluating an EEG-based BCI intervention; studies including patients with a stroke and hemiplegia, regardless of lesion origin or temporal evolution; interventions using an EEG-based BCI to restore functional abilities of the affected UL, regardless of the interface used or its combination with other therapies; and studies using validated tools to evaluate motor function. After the literature search, 13 articles were included in this review: 4 studies were randomized controlled trials; 1 study was a controlled study; 4 studies were case series studies; and 4 studies were case reports. The methodological quality of the included papers ranged from 6 to 15, and the level of evidence varied from 1b to 5. The articles included in this review involved a total of 141 stroke patients. This systematic review suggests that BCI interventions may be a promising rehabilitation approach in subjects with stroke. II. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Sleep Interventions Designed to Improve Athletic Performance and Recovery: A Systematic Review of Current Approaches.

PubMed

Bonnar, Daniel; Bartel, Kate; Kakoschke, Naomi; Lang, Christin

2018-03-01

Athletes experience various situations and conditions that can interfere with their sleep, which is crucial for optimal psychological and physiological recovery as well as subsequent performance. Conventional sleep screening and intervention approaches may not be efficacious for athletes given their lifestyle, the demands of training and travel associated with interstate/international competition. The present systematic review aimed to summarize and evaluate sleep intervention studies targeting subsequent performance and recovery in competitive athletes. Based on the findings, a secondary aim was to outline a possible sleep intervention for athletes, including recommendations for content, mode of delivery and evaluation. A systematic review was conducted based on the PRISMA guidelines in May 2016 with an update completed in September 2017. Ten studies met our inclusion criteria comprising a total of 218 participants in the age range of 18-24 years with athletes from various sports (e.g., swimming, soccer, basketball, tennis). A modified version of the quality assessment scale developed by Abernethy and Bleakley was used to evaluate the quality of the studies. The included studies implemented several sleep interventions, including sleep extension and napping, sleep hygiene, and post-exercise recovery strategies. Evidence suggests that sleep extension had the most beneficial effects on subsequent performance. Consistent with previous research, these results suggest that sleep plays an important role in some, but not all, aspects of athletes' performance and recovery. Future researchers should aim to conduct sleep interventions among different athlete populations, compare results, and further establish guidelines and intervention tools for athletes to address their specific sleep demands and disturbances.

Biomarkers of systemic lupus erythematosus identified using mass spectrometry-based proteomics: a systematic review.

PubMed

Nicolaou, Orthodoxia; Kousios, Andreas; Hadjisavvas, Andreas; Lauwerys, Bernard; Sokratous, Kleitos; Kyriacou, Kyriacos

2017-05-01

Advances in mass spectrometry technologies have created new opportunities for discovering novel protein biomarkers in systemic lupus erythematosus (SLE). We performed a systematic review of published reports on proteomic biomarkers identified in SLE patients using mass spectrometry-based proteomics and highlight their potential disease association and clinical utility. Two electronic databases, MEDLINE and EMBASE, were systematically searched up to July 2015. The methodological quality of studies included in the review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Twenty-five studies were included in the review, identifying 241 SLE candidate proteomic biomarkers related to various aspects of the disease including disease diagnosis and activity or pinpointing specific organ involvement. Furthermore, 13 of the 25 studies validated their results for a selected number of biomarkers in an independent cohort, resulting in the validation of 28 candidate biomarkers. It is noteworthy that 11 candidate biomarkers were identified in more than one study. A significant number of potential proteomic biomarkers that are related to a number of aspects of SLE have been identified using mass spectrometry proteomic approaches. However, further studies are required to assess the utility of these biomarkers in routine clinical practice. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

A systematic approach to assessing the clinical significance of genetic variants.

PubMed

Duzkale, H; Shen, J; McLaughlin, H; Alfares, A; Kelly, M A; Pugh, T J; Funke, B H; Rehm, H L; Lebo, M S

2013-11-01

Molecular genetic testing informs diagnosis, prognosis, and risk assessment for patients and their family members. Recent advances in low-cost, high-throughput DNA sequencing and computing technologies have enabled the rapid expansion of genetic test content, resulting in dramatically increased numbers of DNA variants identified per test. To address this challenge, our laboratory has developed a systematic approach to thorough and efficient assessments of variants for pathogenicity determination. We first search for existing data in publications and databases including internal, collaborative and public resources. We then perform full evidence-based assessments through statistical analyses of observations in the general population and disease cohorts, evaluation of experimental data from in vivo or in vitro studies, and computational predictions of potential impacts of each variant. Finally, we weigh all evidence to reach an overall conclusion on the potential for each variant to be disease causing. In this report, we highlight the principles of variant assessment, address the caveats and pitfalls, and provide examples to illustrate the process. By sharing our experience and providing a framework for variant assessment, including access to a freely available customizable tool, we hope to help move towards standardized and consistent approaches to variant assessment. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A New Approach for Obtaining Cosmological Constraints from Type Ia Supernovae using Approximate Bayesian Computation

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

Jennings, Elise; Wolf, Rachel; Sako, Masao

2016-11-09

Cosmological parameter estimation techniques that robustly account for systematic measurement uncertainties will be crucial for the next generation of cosmological surveys. We present a new analysis method, superABC, for obtaining cosmological constraints from Type Ia supernova (SN Ia) light curves using Approximate Bayesian Computation (ABC) without any likelihood assumptions. The ABC method works by using a forward model simulation of the data where systematic uncertainties can be simulated and marginalized over. A key feature of the method presented here is the use of two distinct metrics, the `Tripp' and `Light Curve' metrics, which allow us to compare the simulated data to the observed data set. The Tripp metric takes as input the parameters of models fit to each light curve with the SALT-II method, whereas the Light Curve metric uses the measured fluxes directly without model fitting. We apply the superABC sampler to a simulated data set ofmore » $$\\sim$$1000 SNe corresponding to the first season of the Dark Energy Survey Supernova Program. Varying $$\\Omega_m, w_0, \\alpha$$ and $$\\beta$$ and a magnitude offset parameter, with no systematics we obtain $$\\Delta(w_0) = w_0^{\\rm true} - w_0^{\\rm best \\, fit} = -0.036\\pm0.109$$ (a $$\\sim11$$% 1$$\\sigma$$ uncertainty) using the Tripp metric and $$\\Delta(w_0) = -0.055\\pm0.068$$ (a $$\\sim7$$% 1$$\\sigma$$ uncertainty) using the Light Curve metric. Including 1% calibration uncertainties in four passbands, adding 4 more parameters, we obtain $$\\Delta(w_0) = -0.062\\pm0.132$$ (a $$\\sim14$$% 1$$\\sigma$$ uncertainty) using the Tripp metric. Overall we find a $17$% increase in the uncertainty on $$w_0$$ with systematics compared to without. We contrast this with a MCMC approach where systematic effects are approximately included. We find that the MCMC method slightly underestimates the impact of calibration uncertainties for this simulated data set.« less

Chinese herbal medicine for the treatment of primary hypertension: a methodology overview of systematic reviews.

PubMed

Xinke, Zhao; Yingdong, Li; Mingxia, Feng; Kai, Liu; Kaibing, Chen; Yuqing, Lu; Shaobo, Sun; Peng, Song; Bin, Liu

2016-10-20

Chinese herbal medicine has been used to treat hypertension in China and East Asia since centuries. In this study, we conduct an overview of systematic reviews of Chinese herbal medicine in the treatment of primary hypertension to 1) summarize the conclusions of these reviews, 2) evaluate the methodological quality of these reviews, and 3) rate the confidence in the effect on each outcome. We comprehensively searched six databases to retrieve systematic reviews of Chinese herbal medicine for primary hypertension from inception to December 31, 2015. We used AMSTAR to evaluate the methodological quality of included reviews, and we classified the quality of evidence for each outcome in included reviews using the GRADE approach. A total of 12 systematic reviews with 31 outcomes were included, among which 11 systematic reviews focus on the therapeutic effect of Chinese herbal medicine combined with conventional medicine or simple Chinese herbal medicine versus simple conventional medicine. Among the 11 items of AMSTAR, the lowest quality was "providing a priori design" item, none review conformed to this item, the next was "stating the conflict of interest" item, only three reviews conformed to this item. Five reviews scored less than seven in AMSTAR, which means that the overall methodological quality was fairly poor. For GRADE, of the 31 outcomes, the quality of evidence was high in none (0 %), moderate in three (10 %), low in 19 (61 %), and very low in nine (29 %). Of the five downgrading factors, risk of bias (100 %) was the most common downgrading factor in the included reviews, followed by imprecision (42 %), inconsistency (39 %), publication bias (39 %), and indirectness (0 %). The methodological quality of systematic reviews about Chinese herbal medicine for primary hypertension is fairly poor, and the quality of evidence level is low. Physicians should be cautious when applying the interventions in these reviews for primary hypertension patients in clinical practice.

Behavior Therapy for Tourette Syndrome: A Systematic Review and Meta-analysis.

PubMed

Wile, Daryl J; Pringsheim, Tamara M

2013-08-01

When tics caused by Tourette Syndrome cause meaningful impairment for patients, a comprehensive treatment approach includes education of patients, peers, and family, treatment of comorbid behavioral disorders if present, and consideration of behavior therapy and pharmacotherapy for tics themselves. This systematic review and meta-analysis demonstrates that behavior therapies based on Habit Reversal Therapy, including the Comprehensive Behavioral Intervention for Tics are effective in reducing tic severity when compared with supportive psychotherapy. When these behavior therapies are unavailable, Exposure with Response Prevention may also be effective. Both face-to-face and telehealth delivery methods for behavior therapy improve tic severity, and broader distribution of behavior therapy through increased training or telehealth methods is encouraged. High-quality randomized trials comparing behavior therapies for tics with pharmacotherapy are needed.

Measuring the impact of medicines regulatory interventions - Systematic review and methodological considerations.

PubMed

Goedecke, Thomas; Morales, Daniel R; Pacurariu, Alexandra; Kurz, Xavier

2018-03-01

Evaluating the public health impact of regulatory interventions is important but there is currently no common methodological approach to guide this evaluation. This systematic review provides a descriptive overview of the analytical methods for impact research. We searched MEDLINE and EMBASE for articles with an empirical analysis evaluating the impact of European Union or non-European Union regulatory actions to safeguard public health published until March 2017. References from systematic reviews and articles from other known sources were added. Regulatory interventions, data sources, outcomes of interest, methodology and key findings were extracted. From 1246 screened articles, 229 were eligible for full-text review and 153 articles in English language were included in the descriptive analysis. Over a third of articles studied analgesics and antidepressants. Interventions most frequently evaluated are regulatory safety communications (28.8%), black box warnings (23.5%) and direct healthcare professional communications (10.5%); 55% of studies measured changes in drug utilization patterns, 27% evaluated health outcomes, and 18% targeted knowledge, behaviour or changes in clinical practice. Unintended consequences like switching therapies or spill-over effects were rarely evaluated. Two-thirds used before-after time series and 15.7% before-after cross-sectional study designs. Various analytical approaches were applied including interrupted time series regression (31.4%), simple descriptive analysis (28.8%) and descriptive analysis with significance tests (23.5%). Whilst impact evaluation of pharmacovigilance and product-specific regulatory interventions is increasing, the marked heterogeneity in study conduct and reporting highlights the need for scientific guidance to ensure robust methodologies are applied and systematic dissemination of results occurs. © 2017 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Barriers and enablers of kangaroo mother care practice: a systematic review.

PubMed

Seidman, Gabriel; Unnikrishnan, Shalini; Kenny, Emma; Myslinski, Scott; Cairns-Smith, Sarah; Mulligan, Brian; Engmann, Cyril

2015-01-01

Kangaroo mother care (KMC) is an evidence-based approach to reducing mortality and morbidity in preterm infants. Although KMC is a key intervention package in newborn health initiatives, there is limited systematic information available on the barriers to KMC practice that mothers and other stakeholders face while practicing KMC. This systematic review sought to identify the most frequently reported barriers to KMC practice for mothers, fathers, and health practitioners, as well as the most frequently reported enablers to practice for mothers. We searched nine electronic databases and relevant reference lists for publications reporting barriers or enablers to KMC practice. We identified 1,264 unique publications, of which 103 were included based on pre-specified criteria. Publications were scanned for all barriers / enablers. Each publication was also categorized based on its approach to identification of barriers / enablers, and more weight was assigned to publications which had systematically sought to understand factors influencing KMC practice. Four of the top five ranked barriers to KMC practice for mothers were resource-related: "Issues with the facility environment / resources," "negative impressions of staff attitudes or interactions with staff," "lack of help with KMC practice or other obligations," and "low awareness of KMC / infant health." Considering only publications from low- and middle-income countries, "pain / fatigue" was ranked higher than when considering all publications. Top enablers to practice were included "mother-infant attachment" and "support from family, friends, and other mentors." Our findings suggest that mother can understand and enjoy KMC, and it has benefits for mothers, infants, and families. However, continuous KMC may be physically and emotionally difficult, and often requires support from family members, health practitioners, or other mothers. These findings can serve as a starting point for researchers and program implementers looking to improve KMC programs.

The Navigation Guide systematic review methodology: a rigorous and transparent method for translating environmental health science into better health outcomes.

PubMed

Woodruff, Tracey J; Sutton, Patrice

2014-10-01

Synthesizing what is known about the environmental drivers of health is instrumental to taking prevention-oriented action. Methods of research synthesis commonly used in environmental health lag behind systematic review methods developed in the clinical sciences over the past 20 years. We sought to develop a proof of concept of the "Navigation Guide," a systematic and transparent method of research synthesis in environmental health. The Navigation Guide methodology builds on best practices in research synthesis in evidence-based medicine and environmental health. Key points of departure from current methods of expert-based narrative review prevalent in environmental health include a prespecified protocol, standardized and transparent documentation including expert judgment, a comprehensive search strategy, assessment of "risk of bias," and separation of the science from values and preferences. Key points of departure from evidence-based medicine include assigning a "moderate" quality rating to human observational studies and combining diverse evidence streams. The Navigation Guide methodology is a systematic and rigorous approach to research synthesis that has been developed to reduce bias and maximize transparency in the evaluation of environmental health information. Although novel aspects of the method will require further development and validation, our findings demonstrated that improved methods of research synthesis under development at the National Toxicology Program and under consideration by the U.S. Environmental Protection Agency are fully achievable. The institutionalization of robust methods of systematic and transparent review would provide a concrete mechanism for linking science to timely action to prevent harm.

Methodological problems in the use of indirect comparisons for evaluating healthcare interventions: survey of published systematic reviews.

PubMed

Song, Fujian; Loke, Yoon K; Walsh, Tanya; Glenny, Anne-Marie; Eastwood, Alison J; Altman, Douglas G

2009-04-03

To investigate basic assumptions and other methodological problems in the application of indirect comparison in systematic reviews of competing healthcare interventions. Survey of published systematic reviews. Inclusion criteria Systematic reviews published between 2000 and 2007 in which an indirect approach had been explicitly used. Identified reviews were assessed for comprehensiveness of the literature search, method for indirect comparison, and whether assumptions about similarity and consistency were explicitly mentioned. The survey included 88 review reports. In 13 reviews, indirect comparison was informal. Results from different trials were naively compared without using a common control in six reviews. Adjusted indirect comparison was usually done using classic frequentist methods (n=49) or more complex methods (n=18). The key assumption of trial similarity was explicitly mentioned in only 40 of the 88 reviews. The consistency assumption was not explicit in most cases where direct and indirect evidence were compared or combined (18/30). Evidence from head to head comparison trials was not systematically searched for or not included in nine cases. Identified methodological problems were an unclear understanding of underlying assumptions, inappropriate search and selection of relevant trials, use of inappropriate or flawed methods, lack of objective and validated methods to assess or improve trial similarity, and inadequate comparison or inappropriate combination of direct and indirect evidence. Adequate understanding of basic assumptions underlying indirect and mixed treatment comparison is crucial to resolve these methodological problems. APPENDIX 1: PubMed search strategy. APPENDIX 2: Characteristics of identified reports. APPENDIX 3: Identified studies. References of included studies.

Desired attributes of evidence assessments for evidence-based practices.

PubMed

Leff, H Stephen; Conley, Jeremy A

2006-11-01

In this paper we describe three approaches to assessing evidence for stakeholders interested in evidence-based practices: narrative reviews, systematic reviews (including meta-analyses), and registries. We then compare the approaches in terms of the degree to which they posses desired attributes of evidence assessments. Our review suggests that hybrid approaches that combined the best features of all three should be pursued to further the use of evidence-based practices, and that such hybrids are possible given the capacity of the World Wide Web. We conclude by stressing the need for empirical research on evidence assessments.

Photolithography diagnostic expert systems: a systematic approach to problem solving in a wafer fabrication facility

NASA Astrophysics Data System (ADS)

Weatherwax Scott, Caroline; Tsareff, Christopher R.

1990-06-01

One of the main goals of process engineering in the semiconductor industry is to improve wafer fabrication productivity and throughput. Engineers must work continuously toward this goal in addition to performing sustaining and development tasks. To accomplish these objectives, managers must make efficient use of engineering resources. One of the tools being used to improve efficiency is the diagnostic expert system. Expert systems are knowledge based computer programs designed to lead the user through the analysis and solution of a problem. Several photolithography diagnostic expert systems have been implemented at the Hughes Technology Center to provide a systematic approach to process problem solving. This systematic approach was achieved by documenting cause and effect analyses for a wide variety of processing problems. This knowledge was organized in the form of IF-THEN rules, a common structure for knowledge representation in expert system technology. These rules form the knowledge base of the expert system which is stored in the computer. The systems also include the problem solving methodology used by the expert when addressing a problem in his area of expertise. Operators now use the expert systems to solve many process problems without engineering assistance. The systems also facilitate the collection of appropriate data to assist engineering in solving unanticipated problems. Currently, several expert systems have been implemented to cover all aspects of the photolithography process. The systems, which have been in use for over a year, include wafer surface preparation (HMDS), photoresist coat and softbake, align and expose on a wafer stepper, and develop inspection. These systems are part of a plan to implement an expert system diagnostic environment throughout the wafer fabrication facility. In this paper, the systems' construction is described, including knowledge acquisition, rule construction, knowledge refinement, testing, and evaluation. The roles played by the process engineering expert and the knowledge engineer are discussed. The features of the systems are shown, particularly the interactive quality of the consultations and the ease of system use.

From research to evidence-informed decision making: a systematic approach

PubMed Central

Poot, Charlotte C; van der Kleij, Rianne M; Brakema, Evelyn A; Vermond, Debbie; Williams, Siân; Cragg, Liza; van den Broek, Jos M; Chavannes, Niels H

2018-01-01

Abstract Background Knowledge creation forms an integral part of the knowledge-to-action framework aimed at bridging the gap between research and evidence-informed decision making. Although principles of science communication, data visualisation and user-centred design largely impact the effectiveness of communication, their role in knowledge creation is still limited. Hence, this article aims to provide researchers a systematic approach on how knowledge creation can be put into practice. Methods A systematic two-phased approach towards knowledge creation was formulated and executed. First, during a preparation phase the purpose and audience of the knowledge were defined. Subsequently, a developmental phase facilitated how the content is ‘said’ (language) and communicated (channel). This developmental phase proceeded via two pathways: a translational cycle and design cycle, during which core translational and design components were incorporated. The entire approach was demonstrated by a case study. Results The case study demonstrated how the phases in this systematic approach can be operationalised. It furthermore illustrated how created knowledge can be delivered. Conclusion The proposed approach offers researchers a systematic, practical and easy-to-implement tool to facilitate effective knowledge creation towards decision-makers in healthcare. Through the integration of core components of knowledge creation evidence-informed decision making will ultimately be optimized. PMID:29538728

Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models.

PubMed

Lotfi, Tamara; Bou-Karroum, Lama; Darzi, Andrea; Hajjar, Rayan; El Rahyel, Ahmed; El Eid, Jamale; Itani, Mira; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; El-Jardali, Fadi; Akl, Elie

2016-08-03

Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology. Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the "Cluster Approach" (with 16 case studies), the 4Ws "Who is Where, When, doing What" mapping tool (with four case studies), the "Sphere Project" (with two case studies), the "5x5" model (with one case study), and the "model of information coordination" (with one case study). The 4Ws and the 5x5 focus on coordination of services for mental health, the remaining models do not focus on a specific health topic. The Cluster approach appears to be the most widely used. One case study was a mixed implementation of the Cluster approach and the Sphere model. We identified no model of coordination for funding of health service. This systematic review identified five proposed coordination models that have been implemented by entities funding or delivering health service in humanitarian crises. There is a need to compare the effect of these different models on outcomes such as availability of and access to health services.

Obesity and eating disorders in integrative prevention programmes for adolescents: protocol for a systematic review and meta-analysis

PubMed Central

Leme, Ana Carolina Barco; Thompson, Debbe; Lenz Dunker, Karin Louise; Nicklas, Theresa; Tucunduva Philippi, Sonia; Lopez, Tabbetha; Baranowski, Tom

2018-01-01

Introduction Obesity and eating disorders are public health problems that have lifelong financial and personal costs and common risk factors, for example, body dissatisfaction, weight teasing and disordered eating. Obesity prevention interventions might lead to the development of an eating disorder since focusing on weight may contribute to excessive concern with diet and weight. Therefore, the proposed research will assess whether integrating obesity and eating disorder prevention procedures (‘integrated approach’) do better than single approach interventions in preventing obesity among adolescents, and if integrated approaches influence weight-related outcomes. Methods and analysis Integrated obesity and eating disorder prevention interventions will be identified. Randomised controlled trials and quasi-experimental trials reporting data on adolescents ranging from 10 to 19 years of age from both sexes will be included. Outcomes of interest include body composition, unhealthy weight control behaviours and body satisfaction measurements. MEDLINE/PubMed, PsycINFO, Web of Science and SciELO will be searched. Data will be extracted independently by two reviewers using a standardised data extraction form. Trial quality will be assessed using the Cochrane Collaboration criteria. The effects of integrated versus single approach intervention studies will be compared using systematic review procedures. If an adequate number of studies report data on integrated interventions among similar populations (k>5), a meta-analysis with random effects will be conducted. Sensitivity analyses and meta-regression will be performed only if between-study heterogeneity is high (I2 ≥75%). Ethics and dissemination Ethics approval will not be required as this is a systematic review of published studies. The findings will be disseminated through conference presentations and peer-reviewed journals. PMID:29674372

Protocol for a systematic review of the use of narrative storytelling and visual-arts-based approaches as knowledge translation tools in healthcare

PubMed Central

2013-01-01

Background The arts are powerful, accessible forms of communication that have the potential to impart knowledge by attracting interest and developing meaningful connections. Knowledge translation aims to reduce the ‘evidence-practice’ gap by developing, implementing and evaluating strategies designed to enhance awareness and promote behavior change congruent with research evidence. Increasingly, innovative approaches such as narrative storytelling and other arts-based interventions are being investigated to bridge the growing gap between practice and research. This study is the first to systematically identify and synthesize current research on narrative storytelling and visual art to translate and disseminate health research. Methods A health research librarian will develop and implement search strategies designed to identify relevant evidence. Studies will be included if they are primary research employing narrative storytelling and/or visual art as a knowledge translation strategy in healthcare. Two reviewers will independently perform study selection, quality assessment, and data extraction using standard forms. Disagreements will be resolved through discussion or third party adjudication. Data will be grouped and analyzed by research design, type of knowledge translation strategy (that is, a narrative or visual-arts-based approach), and target audience. An overall synthesis across all studies will be conducted. Discussion The findings from this research project will describe the ‘state of the science’ regarding the use of narrative storytelling and visual art as knowledge translation strategies. This systematic review will provide critical information for: (1) researchers conducting knowledge translation intervention studies; (2) nursing, medicine, and allied healthcare professionals; (3) healthcare consumers, including patients and families; and (4) decision makers and knowledge users who are charged to increase use of the latest research in healthcare settings. PMID:23514237

Protocol for a systematic review of the use of narrative storytelling and visual-arts-based approaches as knowledge translation tools in healthcare.

PubMed

Scott, Shannon D; Brett-MacLean, Pamela; Archibald, Mandy; Hartling, Lisa

2013-03-20

The arts are powerful, accessible forms of communication that have the potential to impart knowledge by attracting interest and developing meaningful connections. Knowledge translation aims to reduce the 'evidence-practice' gap by developing, implementing and evaluating strategies designed to enhance awareness and promote behavior change congruent with research evidence. Increasingly, innovative approaches such as narrative storytelling and other arts-based interventions are being investigated to bridge the growing gap between practice and research. This study is the first to systematically identify and synthesize current research on narrative storytelling and visual art to translate and disseminate health research. A health research librarian will develop and implement search strategies designed to identify relevant evidence. Studies will be included if they are primary research employing narrative storytelling and/or visual art as a knowledge translation strategy in healthcare. Two reviewers will independently perform study selection, quality assessment, and data extraction using standard forms. Disagreements will be resolved through discussion or third party adjudication. Data will be grouped and analyzed by research design, type of knowledge translation strategy (that is, a narrative or visual-arts-based approach), and target audience. An overall synthesis across all studies will be conducted. The findings from this research project will describe the 'state of the science' regarding the use of narrative storytelling and visual art as knowledge translation strategies. This systematic review will provide critical information for: (1) researchers conducting knowledge translation intervention studies; (2) nursing, medicine, and allied healthcare professionals; (3) healthcare consumers, including patients and families; and (4) decision makers and knowledge users who are charged to increase use of the latest research in healthcare settings.

How to get started with a systematic review in epidemiology: an introductory guide for early career researchers.

PubMed

Denison, Hayley J; Dodds, Richard M; Ntani, Georgia; Cooper, Rachel; Cooper, Cyrus; Sayer, Avan Aihie; Baird, Janis

2013-08-07

Systematic review is a powerful research tool which aims to identify and synthesize all evidence relevant to a research question. The approach taken is much like that used in a scientific experiment, with high priority given to the transparency and reproducibility of the methods used and to handling all evidence in a consistent manner.Early career researchers may find themselves in a position where they decide to undertake a systematic review, for example it may form part or all of a PhD thesis. Those with no prior experience of systematic review may need considerable support and direction getting started with such a project. Here we set out in simple terms how to get started with a systematic review. Advice is given on matters such as developing a review protocol, searching using databases and other methods, data extraction, risk of bias assessment and data synthesis including meta-analysis. Signposts to further information and useful resources are also given. A well-conducted systematic review benefits the scientific field by providing a summary of existing evidence and highlighting unanswered questions. For the individual, undertaking a systematic review is also a great opportunity to improve skills in critical appraisal and in synthesising evidence.

Management of vesicovaginal fistulas (VVFs) in women following benign gynaecologic surgery: A systematic review and meta-analysis

PubMed Central

Bodner-Adler, Barbara; Hanzal, Engelbert; Pablik, Eleonore; Koelbl, Heinz; Bodner, Klaus

2017-01-01

Background Vesicovaginal fistulas (VVF) are the most commonly acquired fistulas of the urinary tract, but we lack a standardized algorithm for their management. Surgery is the most commonly preferred approach to treat women with primary VVF following benign gynaecologic surgery. Objective To carry out a systematic review and meta-analysis on the effectiveness of operative techniques or conservative treatment for patients with postsurgical VVF. Our secondary objective was to define the surgical time and determine the types of study designs. Methods PubMed, Old Medline, Embase and Cochrane Central Register of Controlled Trials were used as data sources. This systematic review was modelled on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, including a registration number (CRD42012002097). Results We reviewed 282 full text articles to identify 124 studies for inclusion. In all, 1379/1430 (96.4%) patients were treated surgically. Overall, the transvaginal approach was performed in the majority of patients (39%), followed by a transabdominal/transvesical route (36%), a laparoscopic/robotic approach (15%) and a combined transabdominal-transvaginal approach in 3% of cases. Success rate of conservative treatment was 92.86% (95%CI: 79.54–99.89), 97.98% in surgical cases (95% CI: 96.13–99.29) and 91.63% (95% CI: 87.68–97.03) in patients with prolonged catheter drainage followed by surgery. 79/124 studies (63.7%) provided information for the length of follow-up, but showed a poor reporting standard regarding prognosis. Complications were studied only selectively. Due to the inconsistency of these data it was impossible to analyse them collectively. Conclusions Although the literature is imprecise and inconsistent, existing studies indicate that operation, mainly through a transvaginal approach, is the most commonly preferred treatment strategy in females with postsurgical VVF. Our data showed no clear odds-on favorite regarding disease management as well as surgical approach and current evidence on the surgical management of VVF does not allow any accurate estimation of success and complication rates. Standardisation of the terminology is required so that VVF can be managed with a proper surgical treatment algorithm based on characteristics of the fistula. PMID:28225769

Accessible Home Environments for People with Functional Limitations: A Systematic Review

PubMed Central

Cho, Hea Young; MacLachlan, Malcolm; Clarke, Michael; Mannan, Hasheem

2016-01-01

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. PMID:27548194

A protocol for a systematic review to identify allergenic tree nuts and the molecules responsible for their allergenic properties.

PubMed

Javed, Bushra; Padfield, Philip; Sperrin, Matthew; Simpson, Angela; Mills, E N Clare

2017-08-01

Food regulations require that tree nuts and derived ingredients are included on food labels in order to help individuals with IgE-mediated allergies to avoid them. However, there is no consensus regarding which tree nut species should be included in this definition and specified on food labels. Allergen detection methods used for monitoring foods target allergen molecules, but it not clear which are the most relevant molecules to choose. A modified population-exposure-comparators-outcome (PECO) approach has been developed to systematically review the evidence regarding (1) which allergenic tree nuts should be included in food allergen labelling lists and (2) which are the clinically relevant allergens which should be used as analytical targets. A search strategy and criteria against which the evidence will be evaluated have been developed. The resulting evidence will be used to rank tree nuts with regards their ability to cause IgE-mediated allergies, and allergen molecules regarding their capacity to elicit an allergic reaction. The results of the systematic review will enable risk assessors and managers to identify tree nut species that should be included in food allergen labelling lists and ensure analytical methods for determination of allergens in foods are targeting appropriate molecules. Copyright © 2017. Published by Elsevier Ltd.

The Emergence of Systematic Review in Toxicology

PubMed Central

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

2016-01-01

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

Improving a Synechocystis-based photoautotrophic chassis through systematic genome mapping and validation of neutral sites

PubMed Central

Pinto, Filipe; Pacheco, Catarina C.; Oliveira, Paulo; Montagud, Arnau; Landels, Andrew; Couto, Narciso; Wright, Phillip C.; Urchueguía, Javier F.; Tamagnini, Paula

2015-01-01

The use of microorganisms as cell factories frequently requires extensive molecular manipulation. Therefore, the identification of genomic neutral sites for the stable integration of ectopic DNA is required to ensure a successful outcome. Here we describe the genome mapping and validation of five neutral sites in the chromosome of Synechocystis sp. PCC 6803, foreseeing the use of this cyanobacterium as a photoautotrophic chassis. To evaluate the neutrality of these loci, insertion/deletion mutants were produced, and to assess their functionality, a synthetic green fluorescent reporter module was introduced. The constructed integrative vectors include a BioBrick-compatible multiple cloning site insulated by transcription terminators, constituting robust cloning interfaces for synthetic biology approaches. Moreover, Synechocystis mutants (chassis) ready to receive purpose-built synthetic modules/circuits are also available. This work presents a systematic approach to map and validate chromosomal neutral sites in cyanobacteria, and that can be extended to other organisms. PMID:26490728

Cognitive remediation in anorexia nervosa and related conditions: a systematic review.

PubMed

Tchanturia, Kate; Lounes, Naima; Holttum, Sue

2014-11-01

Research evidence for cognitive remediation therapy's (CRT) effectiveness for anorexia nervosa (AN) has been gathering. This approach is also increasingly being implemented in other disorders including major depressive disorder, obsessive-compulsive disorder and autistic spectrum disorder that share commonalities with AN in neuropsychological profiles and clinical presentations. This systematic literature review identified and appraised the current evidence base to see whether evidence from related conditions could be integrated into the theoretical understanding of CRT for AN as well as future AN treatment developments and research. Overall, CRT studies in AN report promising findings, and CRT appears to be associated with improvements in set-shifting and in central coherence. Cognitive remediation approaches in other conditions also show promising evidence in associated improvements in areas of executive functioning and information processing; links are made between AN treatment and what future treatment developments could consider. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

MUSiC - A general search for deviations from monte carlo predictions in CMS

NASA Astrophysics Data System (ADS)

Biallass, Philipp A.; CMS Collaboration

2009-06-01

A model independent analysis approach in CMS is presented, systematically scanning the data for deviations from the Monte Carlo expectation. Such an analysis can contribute to the understanding of the detector and the tuning of the event generators. Furthermore, due to the minimal theoretical bias this approach is sensitive to a variety of models of new physics, including those not yet thought of. Events are classified into event classes according to their particle content (muons, electrons, photons, jets and missing transverse energy). A broad scan of various distributions is performed, identifying significant deviations from the Monte Carlo simulation. The importance of systematic uncertainties is outlined, which are taken into account rigorously within the algorithm. Possible detector effects and generator issues, as well as models involving Supersymmetry and new heavy gauge bosons are used as an input to the search algorithm.

MUSiC - A Generic Search for Deviations from Monte Carlo Predictions in CMS

NASA Astrophysics Data System (ADS)

Hof, Carsten

2009-05-01

We present a model independent analysis approach, systematically scanning the data for deviations from the Standard Model Monte Carlo expectation. Such an analysis can contribute to the understanding of the CMS detector and the tuning of the event generators. Furthermore, due to the minimal theoretical bias this approach is sensitive to a variety of models of new physics, including those not yet thought of. Events are classified into event classes according to their particle content (muons, electrons, photons, jets and missing transverse energy). A broad scan of various distributions is performed, identifying significant deviations from the Monte Carlo simulation. We outline the importance of systematic uncertainties, which are taken into account rigorously within the algorithm. Possible detector effects and generator issues, as well as models involving supersymmetry and new heavy gauge bosons have been used as an input to the search algorithm.

Do Students Develop towards More Deep Approaches to Learning during Studies? A Systematic Review on the Development of Students' Deep and Surface Approaches to Learning in Higher Education

ERIC Educational Resources Information Center

Asikainen, Henna; Gijbels, David

2017-01-01

The focus of the present paper is on the contribution of the research in the student approaches to learning tradition. Several studies in this field have started from the assumption that students' approaches to learning develop towards more deep approaches to learning in higher education. This paper reports on a systematic review of longitudinal…

Systematic Approach to Calculate the Concentration of Chemical Species in Multi-Equilibrium Problems

ERIC Educational Resources Information Center

Baeza-Baeza, Juan Jose; Garcia-Alvarez-Coque, Maria Celia

2011-01-01

A general systematic approach is proposed for the numerical calculation of multi-equilibrium problems. The approach involves several steps: (i) the establishment of balances involving the chemical species in solution (e.g., mass balances, charge balance, and stoichiometric balance for the reaction products), (ii) the selection of the unknowns (the…

Health Impact Assessment Practice and Potential for Integration within Environmental Impact and Strategic Environmental Assessments in Italy

PubMed Central

Linzalone, Nunzia; Assennato, Giorgio; Ballarini, Adele; Cadum, Ennio; Cirillo, Mario; Cori, Liliana; De Maio, Francesca; Musmeci, Loredana; Natali, Marinella; Rieti, Sabrina; Soggiu, Maria Eleonora; Bianchi, Fabrizio

2014-01-01

Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population’s health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA and SEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health, significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection of the environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest. PMID:25493391

Health literacy in type 2 diabetes patients: a systematic review of systematic reviews.

PubMed

Caruso, Rosario; Magon, Arianna; Baroni, Irene; Dellafiore, Federica; Arrigoni, Cristina; Pittella, Francesco; Ausili, Davide

2018-01-01

Aim To summarize, critically review, and interpret the evidence related to the systematic reviews on health literacy (HL) amongst type 2 diabetes mellitus (T2DM). Methods The methodology for this study consisted of a systematic review of systematic reviews, using the PRISMA statement and flowchart to select studies, and searching on PubMed, CINAHL, Scopus, and Cochrane. The search covered the period between January 2006 and June 2016. Results From the 115 identified record by the queries, only six systematic reviews were included, following a quality evaluation using AMSTAR. The included systematic reviews content was analyzed by the independent work of two authors, using a narrative synthesis approach. The findings of this study (i.e., main themes) are areas of consensus and gaps in knowledge. Areas of consensus are HL definition, HL measurement tools, and the relationship between T2DM patient knowledge (or literacy) and his/her HL. The gaps in knowledge were the assessment of the relations between HL and health outcomes and self-efficacy, the gender differences, the effectiveness of interventions to improve HL, the cost-effectiveness study of interventions to improve HL, and the understanding of the influence of organizational environment on HL. Conclusion This review provides a current state of knowledge to address clinical practice and research proposals. HL could be useful to personalize patients' follow-up and it should be routinely assessed in its three dimensions (i.e. functional, interactive and critical) to enhance patients' ability to cope with clinical recommendations. Future research should be mainly aimed to test the effectiveness of evidence-based interventions to improve HL amongst T2DM patients.

Systematization of published research graphics characterizing weakly bound molecular complexes with carbon dioxide

NASA Astrophysics Data System (ADS)

Lavrentiev, N. A.; Rodimova, O. B.; Fazliev, A. Z.; Vigasin, A. A.

2017-11-01

An approach is suggested to the formation of applied ontologies in subject domains where results are represented in graphical form. An approach to systematization of research graphics is also given which contains information on weakly bound carbon dioxide complexes. The results of systematization of research plots and images that characterize the spectral properties of the CO2 complexes are presented.

Pelvic floor muscle training in groups versus individual or home treatment of women with urinary incontinence: systematic review and meta-analysis.

PubMed

Paiva, Luciana Laureano; Ferla, Lia; Darski, Caroline; Catarino, Bruna Maciel; Ramos, José Geraldo Lopes

2017-03-01

Urinary Incontinence (UI) in women is a condition that becomes more common with age. Pelvic floor muscle training (PFMT) is recommended as a first option of treatment for women with symptoms of stress urinary incontinence (SUI), mixed urinary incontinence (MUI), and for some with symptoms of urge urinary incontinence (UUI). PFMT can be performed in groups, individually, and at home, and there is no consensus as to which of the approaches is more efficient for the conservative treatment of UI. The objective was to perform a systematic review comparing the effects of group PFMT vs individual or home training in the treatment of women with UI. Cochrane's recommendations for systematic reviews were followed. The inclusion criteria were that the studies had been carried out in adult women who suffered from UI and who underwent PFMT in a group. Ten studies that fit the criteria previously mentioned were included in this systematic review. The meta-analysis showed that there was no difference when comparing PFMT in groups vs individual PFMT. However, when comparing PFMT in groups vs PFMT at home, the group intervention was more efficient in the treatment of UI. PFMT is an efficient technique for the improvement of the symptoms of female UI. When PFMT was supervised by a physiotherapist, no significant difference was noted when comparing group with individual approaches.

Serious games for upper limb rehabilitation: a systematic review.

PubMed

Proença, João Pedro; Quaresma, Cláudia; Vieira, Pedro

2018-01-01

The aim of this research is to carry out a systematic review of the use of technological gaming platforms with serious games in the upper limb rehabilitation of patients with neuromotor disorders. Through a systematic review, the first two authors defined the inclusion criteria and extracted the data, resulting in 38 studies collected from B-On, PubMed and Medline. Ninety-two per cent of the selected articles were published since 2010. This review documents 35 different gaming platforms types. Twenty-one of the 38 articles included in this review conducted a clinical trial and of those only eight report improvements in the target population following the use of the games and platforms. This review concludes that a new paradigm is emerging in the rehabilitation field, characterized by the systematic use of technological gaming platforms with serious games in/for rehabilitation. The use of this approach seems to be beneficial. However, to facilitate the full integration of these platforms, it is necessary to conduct more research in this area, explore new approaches and carry out in-depth clinical studies into the benefits of these platforms. Implications for rehabilitation This review states that the use serious games and gaming platforms for upper limb rehabilitation are starting a new paradigm in the rehabilitation. For a full integration of this technologies in the rehabilitation field more studies are needed.

Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review.

PubMed

Hoeft, Theresa J; Fortney, John C; Patel, Vikram; Unützer, Jürgen

2018-12-01

Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low-resource areas. This review focuses on task-shifting approaches and highlights future directions for research in this area. Systematic review on task sharing of mental health care in rural areas of high-income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer-reviewed journals, and (3) outreach to experts for additional articles. We included English language articles published before August 31, 2013, on interventions sharing mental health care tasks across a team in rural settings. We excluded literature: (1) from low- and middle-income countries, (2) involving direct transfer of care to another provider, and (3) describing clinical guidelines and shared decision-making tools. The review identified approaches to task sharing focused mainly on community health workers and primary care providers. Technology was identified as a way to leverage mental health specialists to support care across settings both within primary care and out in the community. The review also highlighted how provider education, supervision, and partnerships with local communities can support task sharing. Challenges, such as confidentiality, are often not addressed in the literature. Approaches to task sharing may improve reach and effectiveness of mental health care in rural and other low-resource settings, though important questions remain. We recommend promising research directions to address these questions. © 2017 National Rural Health Association.

Systematic Braiding of Two Evidence-Based Parent Training Programs: Qualitative Results from the Pilot Phase

PubMed Central

Guastaferro, Kate; Miller, Katy; Shanley Chatham, Jenelle R.; Whitaker, Daniel J.; McGilly, Kate; Lutzker, John R.

2017-01-01

An effective approach in early intervention for children and families, including child maltreatment prevention, is home-based services. Though several evidence-based programs exist, they are often grouped together, despite having different foci. This paper describes an ongoing cluster randomized trial systematically braiding two evidence-based home-based models, SafeCare® and Parents as Teachers (PAT)®, to better meet the needs of families at-risk. We describe the methodology for braiding model implementation and curriculum, specifically focusing on how structured qualitative feedback from pilot families and providers was used to create the braided curriculum and implementation. Systematic braiding of two models at the implementation and curriculum levels is a mechanism that has the potential to meet the more comprehensive needs of families at-risk for maltreatment. PMID:27870760

Celebrating methodological challenges and changes: reflecting on the emergence and importance of the role of qualitative evidence in Cochrane reviews

PubMed Central

2013-01-01

Cochrane systematic reviews have proven to be beneficial for decision making processes, both on a practitioner and a policy level, and there are current initiatives to extend the types of evidence used by them, including qualitative research. In this article we outline the major achievements of the Cochrane Qualitative and Implementation Methods Group. Although the Group has encountered numerous challenges in dealing with the evolution of qualitative evidence synthesis, both outside and within the Cochrane Collaboration, it has successfully responded to the challenges posed in terms of incorporating qualitative evidence in systematic reviews. The Methods Group will continue to advocate for more flexible and inclusive approaches to evidence synthesis in order to meet the exciting challenges and opportunities presented by mixed methods systematic reviews and reviews of complex interventions. PMID:24135194

Heuristic Reasoning and Beliefs on Immigration: An Approach to an Intercultural Education Programme

ERIC Educational Resources Information Center

Navarro, Santiago Palacios; Lopez de Arechavaleta, Blanca Olalde

2010-01-01

People use mental shortcuts to simplify the amount of information they receive from the environment. Heuristic reasoning can be included among these mental shortcuts. In general, heuristics is useful for making fast decisions and judgements, but in certain cases, it may lead to systematic errors because some relevant aspects presented in the given…

A Review of HR Practices in Knowledge-Intensive Firms and MNEs: 2000-2006

ERIC Educational Resources Information Center

Majeed, Zahid

2009-01-01

Purpose: The aim of this paper is to show the association which exists among the wide range of knowledge management, knowledge sharing and HRM practices in the knowledge-intensive firms. Design/methodology/approach: The proposed literature review includes the systematic process of research in the following manner; after identifying the main area…

Including Students with Disabilities in Positive Behavioral Interventions and Supports: Experiences and Perspectives of Special Educators

ERIC Educational Resources Information Center

Shuster, Brooke C.; Gustafson, Jenny R.; Jenkins, Abbie B.; Lloyd, Blair P.; Carter, Erik W.; Bernstein, Caitlin F.

2017-01-01

As interest in proactive and systematic approaches to supporting positive student behavior grows, important questions remain about the ways in which special education staff and their students participate in school-wide Positive Behavioral Interventions and Supports (PBIS). We report findings from a statewide study of 849 special educators…

An approach to achieve progress in spacecraft shielding

NASA Astrophysics Data System (ADS)

Thoma, K.; Schäfer, F.; Hiermaier, S.; Schneider, E.

2004-01-01

Progress in shield design against space debris can be achieved only when a combined approach based on several tools is used. This approach depends on the combined application of advanced numerical methods, specific material models and experimental determination of input parameters for these models. Examples of experimental methods for material characterization are given, covering the range from quasi static to very high strain rates for materials like Nextel and carbon fiber-reinforced materials. Mesh free numerical methods have extraordinary capabilities in the simulation of extreme material behaviour including complete failure with phase changes, combined with shock wave phenomena and the interaction with structural components. In this paper the benefits from combining numerical methods, material modelling and detailed experimental studies for shield design are demonstrated. The following examples are given: (1) Development of a material model for Nextel and Kevlar-Epoxy to enable numerical simulation of hypervelocity impacts on complex heavy protection shields for the International Space Station. (2) The influence of projectile shape on protection performance of Whipple Shields and how experimental problems in accelerating such shapes can be overcome by systematic numerical simulation. (3) The benefits of using metallic foams in "sandwich bumper shields" for spacecraft and how to approach systematic characterization of such materials.

A systematic linear space approach to solving partially described inverse eigenvalue problems

NASA Astrophysics Data System (ADS)

Hu, Sau-Lon James; Li, Haujun

2008-06-01

Most applications of the inverse eigenvalue problem (IEP), which concerns the reconstruction of a matrix from prescribed spectral data, are associated with special classes of structured matrices. Solving the IEP requires one to satisfy both the spectral constraint and the structural constraint. If the spectral constraint consists of only one or few prescribed eigenpairs, this kind of inverse problem has been referred to as the partially described inverse eigenvalue problem (PDIEP). This paper develops an efficient, general and systematic approach to solve the PDIEP. Basically, the approach, applicable to various structured matrices, converts the PDIEP into an ordinary inverse problem that is formulated as a set of simultaneous linear equations. While solving simultaneous linear equations for model parameters, the singular value decomposition method is applied. Because of the conversion to an ordinary inverse problem, other constraints associated with the model parameters can be easily incorporated into the solution procedure. The detailed derivation and numerical examples to implement the newly developed approach to symmetric Toeplitz and quadratic pencil (including mass, damping and stiffness matrices of a linear dynamic system) PDIEPs are presented. Excellent numerical results for both kinds of problem are achieved under the situations that have either unique or infinitely many solutions.

A scoping review of rapid review methods.

PubMed

Tricco, Andrea C; Antony, Jesmin; Zarin, Wasifa; Strifler, Lisa; Ghassemi, Marco; Ivory, John; Perrier, Laure; Hutton, Brian; Moher, David; Straus, Sharon E

2015-09-16

Rapid reviews are a form of knowledge synthesis in which components of the systematic review process are simplified or omitted to produce information in a timely manner. Although numerous centers are conducting rapid reviews internationally, few studies have examined the methodological characteristics of rapid reviews. We aimed to examine articles, books, and reports that evaluated, compared, used or described rapid reviews or methods through a scoping review. MEDLINE, EMBASE, the Cochrane Library, internet websites of rapid review producers, and reference lists were searched to identify articles for inclusion. Two reviewers independently screened literature search results and abstracted data from included studies. Descriptive analysis was conducted. We included 100 articles plus one companion report that were published between 1997 and 2013. The studies were categorized as 84 application papers, seven development papers, six impact papers, and four comparison papers (one was included in two categories). The rapid reviews were conducted between 1 and 12 months, predominantly in Europe (58 %) and North America (20 %). The included studies failed to report 6 % to 73 % of the specific systematic review steps examined. Fifty unique rapid review methods were identified; 16 methods occurred more than once. Streamlined methods that were used in the 82 rapid reviews included limiting the literature search to published literature (24 %) or one database (2 %), limiting inclusion criteria by date (68 %) or language (49 %), having one person screen and another verify or screen excluded studies (6 %), having one person abstract data and another verify (23 %), not conducting risk of bias/quality appraisal (7 %) or having only one reviewer conduct the quality appraisal (7 %), and presenting results as a narrative summary (78 %). Four case studies were identified that compared the results of rapid reviews to systematic reviews. Three studies found that the conclusions between rapid reviews and systematic reviews were congruent. Numerous rapid review approaches were identified and few were used consistently in the literature. Poor quality of reporting was observed. A prospective study comparing the results from rapid reviews to those obtained through systematic reviews is warranted.

Laryngeal chondrosarcoma: A systematic review of 592 cases.

PubMed

Chin, Oliver Y; Dubal, Pariket M; Sheikh, Ahmed B; Unsal, Aykut A; Park, Richard Chan Woo; Baredes, Soly; Eloy, Jean Anderson

2017-02-01

Laryngeal chondrosarcomas are rare entities that arise from the cartilaginous structures of the larynx, including the cricoid, thyroid cartilage, epiglottis, and arytenoid cartilages. These tumors represent a minority of malignancies involving the larynx and can be mistaken for benign pathologies. The treatment has historically been surgical excision, often by total laryngectomy. This review investigates treatment modalities and patient outcomes. Systematic review using PubMed/MEDLINE and EMBASE database. The databases were used to identify articles reporting cases of chondrosarcomas occurring exclusively in the larynx. Variables analyzed included patient demographics, presenting symptoms, grade, therapeutic approach, patient outcomes, and follow-up. Five hundred and ninety-two cases were identified. The average age reported was 62.5 years. There was a 3:1 male to female ratio. The most common surgical approach was local excision in 178 cases, followed by total laryngectomy in 174 cases. Nonsurgical treatment such as radiotherapy and chemotherapy was only used in 0.8% and 0.2%, respectively. Disease-specific survival rates for 1, 5, 10, and 20 years were 97.7%, 91.4%, 81.8%, and 68.0%, respectively, with no differences when comparing 5-year survival rates for location, grade, and therapy. Laryngeal chondrosarcomas are rare with a good prognosis. Various surgical approaches exist, with no difference noted in 5-year survival outcomes. Nonsurgical approaches were rarely used for these lesions. N/A. Laryngoscope, 2016 127:430-439, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

ABERRANT RESTING-STATE BRAIN ACTIVITY IN POSTTRAUMATIC STRESS DISORDER: A META-ANALYSIS AND SYSTEMATIC REVIEW.

PubMed

Koch, Saskia B J; van Zuiden, Mirjam; Nawijn, Laura; Frijling, Jessie L; Veltman, Dick J; Olff, Miranda

2016-07-01

About 10% of trauma-exposed individuals develop PTSD. Although a growing number of studies have investigated resting-state abnormalities in PTSD, inconsistent results suggest a need for a meta-analysis and a systematic review. We conducted a systematic literature search in four online databases using keywords for PTSD, functional neuroimaging, and resting-state. In total, 23 studies matched our eligibility criteria. For the meta-analysis, we included 14 whole-brain resting-state studies, reporting data on 663 participants (298 PTSD patients and 365 controls). We used the activation likelihood estimation approach to identify concurrence of whole-brain hypo- and hyperactivations in PTSD patients during rest. Seed-based studies could not be included in the quantitative meta-analysis. Therefore, a separate qualitative systematic review was conducted on nine seed-based functional connectivity studies. The meta-analysis showed consistent hyperactivity in the ventral anterior cingulate cortex and the parahippocampus/amygdala, but hypoactivity in the (posterior) insula, cerebellar pyramis and middle frontal gyrus in PTSD patients, compared to healthy controls. Partly concordant with these findings, the systematic review on seed-based functional connectivity studies showed enhanced salience network (SN) connectivity, but decreased default mode network (DMN) connectivity in PTSD. Combined, these altered resting-state connectivity and activity patterns could represent neurobiological correlates of increased salience processing and hypervigilance (SN), at the cost of awareness of internal thoughts and autobiographical memory (DMN) in PTSD. However, several discrepancies between findings of the meta-analysis and systematic review were observed, stressing the need for future studies on resting-state abnormalities in PTSD patients. © 2016 Wiley Periodicals, Inc.

Gene networks underlying convergent and pleiotropic phenotypes in a large and systematically-phenotyped cohort with heterogeneous developmental disorders.

PubMed

Andrews, Tallulah; Meader, Stephen; Vulto-van Silfhout, Anneke; Taylor, Avigail; Steinberg, Julia; Hehir-Kwa, Jayne; Pfundt, Rolph; de Leeuw, Nicole; de Vries, Bert B A; Webber, Caleb

2015-03-01

Readily-accessible and standardised capture of genotypic variation has revolutionised our understanding of the genetic contribution to disease. Unfortunately, the corresponding systematic capture of patient phenotypic variation needed to fully interpret the impact of genetic variation has lagged far behind. Exploiting deep and systematic phenotyping of a cohort of 197 patients presenting with heterogeneous developmental disorders and whose genomes harbour de novo CNVs, we systematically applied a range of commonly-used functional genomics approaches to identify the underlying molecular perturbations and their phenotypic impact. Grouping patients into 408 non-exclusive patient-phenotype groups, we identified a functional association amongst the genes disrupted in 209 (51%) groups. We find evidence for a significant number of molecular interactions amongst the association-contributing genes, including a single highly-interconnected network disrupted in 20% of patients with intellectual disability, and show using microcephaly how these molecular networks can be used as baits to identify additional members whose genes are variant in other patients with the same phenotype. Exploiting the systematic phenotyping of this cohort, we observe phenotypic concordance amongst patients whose variant genes contribute to the same functional association but note that (i) this relationship shows significant variation across the different approaches used to infer a commonly perturbed molecular pathway, and (ii) that the phenotypic similarities detected amongst patients who share the same inferred pathway perturbation result from these patients sharing many distinct phenotypes, rather than sharing a more specific phenotype, inferring that these pathways are best characterized by their pleiotropic effects.

Optimized Beam Sculpting with Generalized Fringe-rate Filters

NASA Astrophysics Data System (ADS)

Parsons, Aaron R.; Liu, Adrian; Ali, Zaki S.; Cheng, Carina

2016-03-01

We generalize the technique of fringe-rate filtering, whereby visibilities measured by a radio interferometer are re-weighted according to their temporal variation. As the Earth rotates, radio sources traverse through an interferometer’s fringe pattern at rates that depend on their position on the sky. Capitalizing on this geometric interpretation of fringe rates, we employ time-domain convolution kernels to enact fringe-rate filters that sculpt the effective primary beam of antennas in an interferometer. As we show, beam sculpting through fringe-rate filtering can be used to optimize measurements for a variety of applications, including mapmaking, minimizing polarization leakage, suppressing instrumental systematics, and enhancing the sensitivity of power-spectrum measurements. We show that fringe-rate filtering arises naturally in minimum variance treatments of many of these problems, enabling optimal visibility-based approaches to analyses of interferometric data that avoid systematics potentially introduced by traditional approaches such as imaging. Our techniques have recently been demonstrated in Ali et al., where new upper limits were placed on the 21 {cm} power spectrum from reionization, showcasing the ability of fringe-rate filtering to successfully boost sensitivity and reduce the impact of systematics in deep observations.

Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review

PubMed Central

Debbi, Stanistreet; Elisa, Puzzolo; Nigel, Bruce; Dan, Pope; Eva, Rehfuess

2014-01-01

Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS) are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus. PMID:25123070

Self-management support in chronic illness care: a concept analysis.

PubMed

Kawi, Jennifer

2012-01-01

This article reports on the concept analysis of self-management support (SMS) to provide clarity for systematic implementation in practice. SMS is a concept in its early phase of development. It is increasingly evident in literature on chronic illness care. However, the definition has been simplified or vague leading to variable SMS programs and inconsistent outcomes. Elucidation of SMS is necessary in chronic illness care to facilitate clear understanding and implementation. Rodgers' evolutionary concept analysis method was used to examine SMS. Data sources included systematic multidisciplinary searches of multiple search engines. SMS refers to comprehensive sustaining approaches toward improving chronic illness outcomes consisting of patient-centered attributes (involving patients as partners; providing diverse, innovative educational modalities specific to patients' needs; individualizing patient care), provider attributes (possessing adequate knowledge, skills, attitudes in providing care), and organizational attributes (putting an organized system of care in place, having multidisciplinary team approach, using tangible and social support). A well-clarified SMS concept is important in theory development. The attributes offer necessary components in SMS programs for systematic implementation, evaluation, and research. There is great potential that SMS can help improve outcomes of chronic illness care.

The impact of surgical resection of the primary tumor on the development of synchronous colorectal liver metastasis: a systematic review.

PubMed

Pinson, H; Cosyns, S; Ceelen, Wim P

2018-05-22

In recent years different therapeutic strategies for synchronously liver metastasized colorectal cancer were described. Apart from the classical staged surgical approach, simultaneous and liver-first strategies are now commonly used. One theoretical drawback of the classical approach is, however, the stimulatory effect on liver metastases growth that may result from resection of the primary tumour. This systematic review, therefore, aims to investigate the current insights on the stimulatory effects of colorectal surgery on the growth of synchronous colorectal liver metastases in humans. The systematic review was conducted according to the PRISMA statement. A literature search was performed using PubMed and Embase. Articles investigating the effects of colorectal surgery on synchronous colorectal liver metastases were included. Primary endpoints were metastatic tumor volume, metabolic and proliferative activity and tumour vascularization. Four articles meeting the selection criteria were found involving 200 patients. These studies investigate the effects of resection of the primary tumour on synchronous liver metastases using histological and radiological techniques. These papers support a possible stimulatory effect of resection of the primary tumor. Some limited evidence supports the hypothesis that colorectal surgery might stimulate the growth and development of synchronous colorectal liver metastases.

Factors influencing household uptake of improved solid fuel stoves in low- and middle-income countries: a qualitative systematic review.

PubMed

Debbi, Stanistreet; Elisa, Puzzolo; Nigel, Bruce; Dan, Pope; Eva, Rehfuess

2014-08-13

Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS) are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus.

What determines the effects and costs of breast cancer screening? A protocol of a systematic review of reviews.

PubMed

Mandrik, O; Ekwunife, O I; Zielonke, N; Meheus, F; Severens, J L; Lhachimi, S K; Murillo, R

2017-06-28

Multiple reviews demonstrated high variability in effectiveness and cost-effectiveness outcomes among studies on breast cancer screening (BCS) programmes. No study to our knowledge has summarized the current evidence on determinants of effectiveness and cost-effectiveness of the most used BCS approaches or tried to explain differences in conclusions of systematic reviews on this topic. Based on published reviews, this systematic review aims to assess the degree of variability of determinants for (a) effectiveness and (b) cost-effectiveness of BCS programmes using mammography, clinical breast examination, breast self-examination, ultrasonography, or their combinations among the general population. We will perform a comprehensive systematic literature search in Cochrane, Scopus, Embase, and Medline (via Pubmed). The search will be supplemented with hand searching of references of the included reviews, with hand searching in the specialized journals, and by contacting prominent experts in the field. Additional search for grey literature will be conducted on the websites of international cancer associations and networks. Two trained research assistants will screen titles and abstracts of publications independently, with at least random 10% of all abstracts being also screened by the principal researcher. The full texts of the systematic reviews will then be screened independently by two authors, and disagreements will be solved by consensus. The included reviews will be grouped by publication year, outcomes, designs of original studies, and quality. Additionally, for reviews published since 2011, transparency in reporting will be assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for the review on determinants of effectiveness and a modified PRISMA checklist for the review on determinants for cost-effectiveness. The study will apply the Assessing the Methodological Quality of Systematic Reviews checklist to assess the methodological quality of systematic reviews. We will report the data extracted from the systematic reviews in a systematic format. Meta-meta-analysis of extracted data will be conducted when feasible. This systematic review of reviews will examine the degree of variability in the effectiveness and cost-effectiveness of BCS programmes. PROSPERO CRD42016050764 and CRD42016050765.

Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews.

PubMed

Zanaboni, Paolo; Ngangue, Patrice; Mbemba, Gisele Irène Claudine; Schopf, Thomas Roger; Bergmo, Trine Strand; Gagnon, Marie-Pierre

2018-06-07

Digital health can empower citizens to manage their health and address health care system problems including poor access, uncoordinated care and increasing costs. Digital health interventions are typically complex interventions. Therefore, evaluations present methodological challenges. The objective of this study was to provide a systematic overview of the methods used to evaluate the effects of internet-based digital health interventions for citizens. Three research questions were addressed to explore methods regarding approaches (study design), effects and indicators. We conducted a systematic review of reviews of the methods used to measure the effects of internet-based digital health interventions for citizens. The protocol was developed a priori according to Preferred Reporting Items for Systematic review and Meta-Analysis Protocols and the Cochrane Collaboration methodology for overviews of reviews. Qualitative, mixed-method, and quantitative reviews published in English or French from January 2010 to October 2016 were included. We searched for published reviews in PubMed, EMBASE, The Cochrane Database of Systematic Reviews, CINHAL and Epistemonikos. We categorized the findings based on a thematic analysis of the reviews structured around study designs, indicators, types of interventions, effects and perspectives. A total of 20 unique reviews were included. The most common digital health interventions for citizens were patient portals and patients' access to electronic health records, covered by 10/20 (50%) and 6/20 (30%) reviews, respectively. Quantitative approaches to study design included observational study (15/20 reviews, 75%), randomized controlled trial (13/20 reviews, 65%), quasi-experimental design (9/20 reviews, 45%), and pre-post studies (6/20 reviews, 30%). Qualitative studies or mixed methods were reported in 13/20 (65%) reviews. Five main categories of effects were identified: (1) health and clinical outcomes, (2) psychological and behavioral outcomes, (3) health care utilization, (4) system adoption and use, and (5) system attributes. Health and clinical outcomes were measured with both general indicators and disease-specific indicators and reported in 11/20 (55%) reviews. Patient-provider communication and patient satisfaction were the most investigated psychological and behavioral outcomes, reported in 13/20 (65%) and 12/20 (60%) reviews, respectively. Evaluation of health care utilization was included in 8/20 (40%) reviews, most of which focused on the economic effects on the health care system. Although observational studies and surveys have provided evidence of benefits and satisfaction for patients, there is still little reliable evidence from randomized controlled trials of improved health outcomes. Future evaluations of digital health interventions for citizens should focus on specific populations or chronic conditions which are more likely to achieve clinically meaningful benefits and use high-quality approaches such as randomized controlled trials. Implementation research methods should also be considered. We identified a wide range of effects and indicators, most of which focused on patients as main end users. Implications for providers and the health system should also be included in evaluations or monitoring of digital health interventions. ©Paolo Zanaboni, Patrice Ngangue, Gisele Irène Claudine Mbemba, Thomas Roger Schopf, Trine Strand Bergmo, Marie-Pierre Gagnon. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.06.2018.

Phylogenomics of Lophotrochozoa with Consideration of Systematic Error.

PubMed

Kocot, Kevin M; Struck, Torsten H; Merkel, Julia; Waits, Damien S; Todt, Christiane; Brannock, Pamela M; Weese, David A; Cannon, Johanna T; Moroz, Leonid L; Lieb, Bernhard; Halanych, Kenneth M

2017-03-01

Phylogenomic studies have improved understanding of deep metazoan phylogeny and show promise for resolving incongruences among analyses based on limited numbers of loci. One region of the animal tree that has been especially difficult to resolve, even with phylogenomic approaches, is relationships within Lophotrochozoa (the animal clade that includes molluscs, annelids, and flatworms among others). Lack of resolution in phylogenomic analyses could be due to insufficient phylogenetic signal, limitations in taxon and/or gene sampling, or systematic error. Here, we investigated why lophotrochozoan phylogeny has been such a difficult question to answer by identifying and reducing sources of systematic error. We supplemented existing data with 32 new transcriptomes spanning the diversity of Lophotrochozoa and constructed a new set of Lophotrochozoa-specific core orthologs. Of these, 638 orthologous groups (OGs) passed strict screening for paralogy using a tree-based approach. In order to reduce possible sources of systematic error, we calculated branch-length heterogeneity, evolutionary rate, percent missing data, compositional bias, and saturation for each OG and analyzed increasingly stricter subsets of only the most stringent (best) OGs for these five variables. Principal component analysis of the values for each factor examined for each OG revealed that compositional heterogeneity and average patristic distance contributed most to the variance observed along the first principal component while branch-length heterogeneity and, to a lesser extent, saturation contributed most to the variance observed along the second. Missing data did not strongly contribute to either. Additional sensitivity analyses examined effects of removing taxa with heterogeneous branch lengths, large amounts of missing data, and compositional heterogeneity. Although our analyses do not unambiguously resolve lophotrochozoan phylogeny, we advance the field by reducing the list of viable hypotheses. Moreover, our systematic approach for dissection of phylogenomic data can be applied to explore sources of incongruence and poor support in any phylogenomic data set. [Annelida; Brachiopoda; Bryozoa; Entoprocta; Mollusca; Nemertea; Phoronida; Platyzoa; Polyzoa; Spiralia; Trochozoa.]. © The Author(s) 2016. Published by Oxford University Press, on behalf of the Society of Systematic Biologists. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Protocol for a mixed studies systematic review on the implementation of the recovery approach in adult mental health services

PubMed Central

Piat, Myra; Sofouli, Eleni; Sabetti, Judith; Lambrou, Angella; Chodos, Howard; Briand, Catherine; Vachon, Brigitte; Curran, Janet

2017-01-01

Introduction Recovery is integral to mental health planning in G-8 countries including Canada. A recovery-oriented approach to care aims to promote personal empowerment, illness self-management and a life beyond services for people with serious mental illness (SMI), while reducing the financial burden associated with mental illness. Although there is a growing body of literature on recovery, no synthesis of research on the implementation of recovery into mental health services exists. Objectives The objective is to conduct a mixed studies systematic review on the operationalisation of recovery into mental health services for adults with SMI. It will inform the transformation of Canadian services to a recovery orientation, but may be applicable to other countries. Methods and analysis Seven databases including PubMed, Ovid Medline, Ovid Embase, Ovid PsycInfo, CINAHL, the Cochrane Library and Scopus will be searched for peer-reviewed empirical studies published from 1998 to December 2016. Systematic reviews and studies using quantitative, qualitative and mixed methodologies will be included. Secondary searches will be conducted in reference lists of all selected full text articles. Handsearches will also be performed in the tables of contents of three recovery-focused journals for the last 5 years. International experts in the field will be contacted for comments and advice. Data extraction will include identification and methodological synthesis of each study; definition of recovery; information on recovery implementation; facilitators and barriers and study outcomes. A quality assessment will be conducted on each study. The data will be synthesised and a stepwise thematic analysis performed. Ethics and dissemination Ethics approval is not required for this knowledge synthesis. Findings will be disseminated through knowledge translation activities including: (1) a 1-day symposium; (2) presentations in national and international conferences and to local stakeholders; (3) publications in peer-reviewed journals; (4) posts on the organisational websites. PMID:28855202

Transcaval approach for endovascular aortic interventions: A systematic review.

PubMed

Wee, Ian Jun Yan; Syn, Nicholas; Choong, Andrew M T L

2018-05-24

The caval-aortic path is a novel access route for endovascular aortic interventions in aortic interventions, particularly for patients unsuitable for traditional access routes including femoral, subclavian, transapical, and aortic. A systematic review was conducted as per the PRISMA guidelines utilizing three electronic databases: Medline, Embase, and Cochrane database. There were 10 studies identified, including 7 retrospective studies, 1 prospective cohort study, and 2 case reports. Data on 209 patients (mean age 79.5±5.1 years; 51.2% male) were abstracted including preoperative work-up, technical procedure details, and outcomes. The overall technical success rate for all procedures is 96.2%, with a 4.3% mortality rate and a mean follow up of 17.9±19.8 months. Individually in the various interventions, the technical success rate of transcaval endoleak repair and transcatheter aortic valve implantation (TAVI) was 94.4% and 97.5% respectively, with a low 30-day mortality rate of 7.6% in the TAVI intervention. There is encouraging evidence regarding the rates of mortality and complications in the transcaval approach for endovascular aortic interventions. It presents a feasible alternative for a judiciously select group of patients who are not suitable for other access routes. Copyright © 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Social marketing approaches to nutrition and physical activity interventions in early care and education centres: a systematic review.

PubMed

Luecking, C T; Hennink-Kaminski, H; Ihekweazu, C; Vaughn, A; Mazzucca, S; Ward, D S

2017-12-01

Social marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown. PubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria. The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one-third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child-level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used. This review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted. © 2017 World Obesity Federation.

Systematic review of effects of current transtibial prosthetic socket designs--Part 2: Quantitative outcomes.

PubMed

Safari, Mohammad Reza; Meier, Margrit Regula

2015-01-01

This review is an attempt to untangle the complexity of transtibial prosthetic socket fit and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. In addition, we identified knowledge gaps, thus providing direction for possible future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design and type of outcome measure used. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that included the Downs and Black risk of bias assessment checklist. This article presents the results from the systematic review of the quantitative outcomes (n = 27 articles). Trends indicate that vacuum-assisted suction sockets improve gait symmetry, volume control, and residual limb health more than other socket designs. Hydrostatic sockets seem to create less inconsistent socket fittings, reducing a problem that greatly influences outcome measures. Knowledge gaps exist in the understanding of clinically meaningful changes in socket fit and its effect on biomechanical outcomes. Further, safe and comfortable pressure thresholds under various conditions should be determined through a systematic approach.

Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold: CHEST Expert Panel Report.

PubMed

Malesker, Mark A; Callahan-Lyon, Priscilla; Ireland, Belinda; Irwin, Richard S

2017-11-01

Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment approaches are needed for CACC. We conducted a systematic review on the management of CACC to update the recommendations and suggestions of the CHEST 2006 guideline on this topic. This systematic review of randomized controlled trials (RCTs) asked the question: Is there evidence of clinically relevant treatment effects for pharmacologic or nonpharmacologic therapies in reducing the duration/severity of acute CACC? Studies of adults and pediatric patients with CACC were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on using the American College of Chest Physicians organization methodology. Six systematic reviews and four primary studies identified from updated literature searches for each of the reviews or from hand searching were included and reported data on 6,496 participants with CACC who received one or more of a variety of interventions. The studies used an assortment of descriptors and assessments to identify CACC. The evidence supporting the management of CACC is overall of low quality. This document provides treatment suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research. Copyright © 2017 American College of Chest Physicians. All rights reserved.

Herbal medicine as a promising therapeutic approach for the management of vascular dementia: A systematic literature review.

PubMed

Ghorani-Azam, Adel; Sepahi, Samaneh; Khodaverdi, Elham; Mohajeri, Seyed Ahmad

2018-05-22

Vascular dementia (VaD) generally refers to memory deficits and cognitive abnormalities that are resulted from vascular disease. In this study, we aimed to systematically review the literature wherein therapeutic effects of medicinal plants have been studied on VaD. A systematic literature search was performed in the PubMed, Scopus, Web of Science, Google Scholar, and other databases using VaD, and medicinal plants as key terms. No strict inclusion criteria were defined, and almost all clinical studies were included. A total of 524 articles were found, of which only 28 relevant articles with 3461 studied patients were included to this systematic review. The results showed that medicinal plants, particularly Sancaijiangtang and Ginkgo biloba could improve behavioral and psychological symptoms, working memory, Mini-Mental State Examination, and activities of daily living as well as neuropsychiatric features. It was also shown that the age, average progression of the disease, and the type of folk medicines effective in treating the disease are important factors in the management of VaD. The results of this review indicated that herbal therapy can be a potential candidate in the treatment of VaD; however, further studies are needed to confirm such efficiency. Copyright © 2018 John Wiley & Sons, Ltd.

Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers.

PubMed

Lawani, Moulikatou Adouni; Valéra, Béatriz; Fortier-Brochu, Émilie; Légaré, France; Carmichael, Pierre-Hugues; Côté, Luc; Voyer, Philippe; Kröger, Edeltraut; Witteman, Holly; Rodriguez, Charo; Giguere, Anik M C

2017-03-15

Decision support tools build upon comprehensive and timely syntheses of literature. Rapid reviews may allow supporting their development by omitting certain components of traditional systematic reviews. We thus aimed to describe a rapid review approach underlying the development of decision support tools, i.e., five decision boxes (DB) for shared decision-making between seniors living with dementia, their caregivers, and healthcare providers. We included studies based on PICO questions (Participant, Intervention, Comparison, Outcome) describing each of the five specific decision. We gave priority to higher quality evidence (e.g., systematic reviews). For each DB, we first identified secondary sources of literature, namely, clinical summaries, clinical practice guidelines, and systematic reviews. After an initial extraction, we searched for primary studies in academic databases and grey literature to fill gaps in evidence. We extracted study designs, sample sizes, populations, and probabilities of benefits/harms of the health options. A single reviewer conducted the literature search and study selection. The data extracted by one reviewer was verified by a second experienced reviewer. Two reviewers assessed the quality of the evidence. We converted all probabilities into absolute risks for ease of understanding. Two to five experts validated the content of each DB. We conducted descriptive statistical analyses on the review processes and resources required. The approach allowed screening of a limited number of references (range: 104 to 406/review). For each review, we included 15 to 26 studies, 2 to 10 health options, 11 to 62 health outcomes and we conducted 9 to 47 quality assessments. A team of ten reviewers with varying levels of expertise was supported at specific steps by an information specialist, a biostatistician, and a graphic designer. The time required to complete a rapid review varied from 7 to 31 weeks per review (mean ± SD, 19 ± 10 weeks). Data extraction required the most time (8 ± 6.8 weeks). The average estimated cost of a rapid review was C$11,646 (SD = C$10,914). This approach enabled the development of clinical tools more rapidly than with a traditional systematic review. Future studies should evaluate the applicability of this approach to other teams/tools.

Relationship between ABO blood group and pregnancy complications: a systematic literature analysis

PubMed Central

Franchini, Massimo; Mengoli, Carlo; Lippi, Giuseppe

2016-01-01

Given the expression of ABO blood group antigens on the surface of a wide range of human cells and tissues, the putative interplay of the ABO system in human biology outside the area of transfusion and transplantation medicine constitutes an intriguing byway of research. Thanks to evidence accumulated over more than 50 years, the involvement of the ABO system in the pathogenesis of several human diseases, including cardiovascular, infectious and neoplastic disorders, is now acknowledged. However, there is controversial information on the potential association between ABO blood type and adverse pregnancy outcomes, including pre-eclampsia and related disorders (eclampsia, HELLP syndrome and intrauterine growth restriction), venous thromboembolism, post-partum haemorrhage and gestational diabetes. To elucidate the role of ABO antigens in pregnancy-related complications, we performed a systematic review of the literature published in the past 50 years. A meta-analytical approach was also applied to the existing literature on the association between ABO status and pre-eclampsia. The results of this systematic review are presented and critically discussed, along with the possible pathogenic implications. PMID:27177402

A long PCR–based approach for DNA enrichment prior to next-generation sequencing for systematic studies1

PubMed Central

Uribe-Convers, Simon; Duke, Justin R.; Moore, Michael J.; Tank, David C.

2014-01-01

• Premise of the study: We present an alternative approach for molecular systematic studies that combines long PCR and next-generation sequencing. Our approach can be used to generate templates from any DNA source for next-generation sequencing. Here we test our approach by amplifying complete chloroplast genomes, and we present a set of 58 potentially universal primers for angiosperms to do so. Additionally, this approach is likely to be particularly useful for nuclear and mitochondrial regions. • Methods and Results: Chloroplast genomes of 30 species across angiosperms were amplified to test our approach. Amplification success varied depending on whether PCR conditions were optimized for a given taxon. To further test our approach, some amplicons were sequenced on an Illumina HiSeq 2000. • Conclusions: Although here we tested this approach by sequencing plastomes, long PCR amplicons could be generated using DNA from any genome, expanding the possibilities of this approach for molecular systematic studies. PMID:25202592

Integrative Therapies for Low Back Pain That Include Complementary and Alternative Medicine Care: A Systematic Review

PubMed Central

Rose, Kevin; Kadar, Gena E.

2014-01-01

Study Design: Systematic review of the literature. Objective: To evaluate whether an integrated approach that includes different Complementary and Alternative Medicine (CAM) therapies combined or CAM therapies combined with conventional medical care is more effective for the management of low back pain (LBP) than single modalities alone. Summary of Background Data: LBP is one of the leading causes of disability worldwide, yet its optimal management is still unresolved. Methods: The PRISMA Statement guidelines were followed. The Cochrane Back Review Group scale was used to rate the quality of the studies found. Results: Twenty-one studies were found that met the inclusion criteria. The CAM modalities used in the studies included spinal manipulative therapy, acupuncture, exercise therapy, physiotherapy, massage therapy, and a topical ointment. Twenty studies included acupuncture and/or spinal manipulative therapy. Nine high quality studies showed that integrative care was clinically effective for the management of LBP. Spinal manipulative therapy combined with exercise therapy and acupuncture combined with conventional medical care or with exercise therapy appears to be promising approaches to the management of chronic cases of LBP. Conclusions: There is support in the literature for integrated CAM and conventional medical therapy for the management of chronic LBP. Further research into the integrated management of LBP is clearly needed to provide better guidance for patients and clinicians. PMID:25568825

An Alternative Approach to the Teaching of Systematic Transition Metal Chemistry.

ERIC Educational Resources Information Center

Hathaway, Brian

1979-01-01

Presents an alternative approach to teaching Systematic Transition Metal Chemistry with the transition metal chemistry skeleton features of interest. The "skeleton" is intended as a guide to predicting the chemistry of a selected compound. (Author/SA)

Economic evaluation in chronic pain: a systematic review and de novo flexible economic model.

PubMed

Sullivan, W; Hirst, M; Beard, S; Gladwell, D; Fagnani, F; López Bastida, J; Phillips, C; Dunlop, W C N

2016-07-01

There is unmet need in patients suffering from chronic pain, yet innovation may be impeded by the difficulty of justifying economic value in a field beset by data limitations and methodological variability. A systematic review was conducted to identify and summarise the key areas of variability and limitations in modelling approaches in the economic evaluation of treatments for chronic pain. The results of the literature review were then used to support the development of a fully flexible open-source economic model structure, designed to test structural and data assumptions and act as a reference for future modelling practice. The key model design themes identified from the systematic review included: time horizon; titration and stabilisation; number of treatment lines; choice/ordering of treatment; and the impact of parameter uncertainty (given reliance on expert opinion). Exploratory analyses using the model to compare a hypothetical novel therapy versus morphine as first-line treatments showed cost-effectiveness results to be sensitive to structural and data assumptions. Assumptions about the treatment pathway and choice of time horizon were key model drivers. Our results suggest structural model design and data assumptions may have driven previous cost-effectiveness results and ultimately decisions based on economic value. We therefore conclude that it is vital that future economic models in chronic pain are designed to be fully transparent and hope our open-source code is useful in order to aspire to a common approach to modelling pain that includes robust sensitivity analyses to test structural and parameter uncertainty.

Key barriers to gout care: a systematic review and thematic synthesis of qualitative studies.

PubMed

Rai, Sharan K; Choi, Hyon K; Choi, Sally H J; Townsend, Anne F; Shojania, Kam; De Vera, Mary A

2018-04-17

Gout care remains highly suboptimal, contributing to an increased global disease burden. To understand barriers to gout care, our aim was to provide a systematic review and thematic synthesis of qualitative studies worldwide reporting provider and patient perspectives and experiences with management. We conducted a mapped search of MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Social Sciences Citation Index databases and selected qualitative studies of provider and patient perspectives on gout management. We used thematic synthesis to combine the included studies and identify key themes across studies. We included 20 studies that reported the experiences and perspectives of 480 gout patients and 120 providers spanning five different countries across three continents. We identified three predominant provider themes: knowledge gaps and management approaches; perceptions and beliefs about gout patients; and system barriers to optimal gout care (e.g. time constraints and a lack of incentives). We also identified four predominant themes among gout patients: limited gout knowledge; interactions with health-care providers; attitudes towards and experiences with taking medication; and practical barriers to long-term medication use. Our systematic review of worldwide literature consistently identified gaps in gout knowledge among providers, which is likely to contribute to patients' lack of appropriate education about the fundamental causes of and essential treatment approaches for gout. Furthermore, system barriers among providers and day-to-day challenges of taking long-term medications among patients are considerable. These factors provide key targets to improve the widespread suboptimal gout care.

The role of meta-analysis in the evaluation of the effects of early nutrition on mental and motor development in children.

PubMed

Szajewska, Hania

2011-12-01

The role of early nutrition as a cost-effective measure to ensure optimal infant growth, development, and long-term health is gaining attention. In particular, the role of supplementation with nutrients such as n-3 (omega-3) fatty acids, iron, zinc, and B vitamins, which are relevant to brain structure and function, is of interest. However, for all of these nutrients, there is a lack of clarity and no consensus regarding their role in the mental and motor development of children. Systematic reviews with or without a meta-analysis are a well-established means of reviewing existing evidence and of integrating findings from various studies, including those related to infant nutrition. In this article, I provide an overview of the basic principles of systematic review and meta-analysis of randomized controlled trials (RCTs) and summarize such evidence related to the effects of early nutrition on mental and motor development. The inclusion of only RCTs in a systematic review could be considered the major strength. Randomization is the only means to control for unknown and unmeasured differences between comparison groups as well as for those that are known and measured. However, even if only RCTs are included, reviews are not free of potential biases. An understanding of the strengths and limitations of the meta-analytic approach, which I discuss in this article, is needed by everyone involved in decision making regarding interventions assessed by this approach.

Systematic review of robotic surgery in gynecology: robotic techniques compared with laparoscopy and laparotomy.

PubMed

Gala, Rajiv B; Margulies, Rebecca; Steinberg, Adam; Murphy, Miles; Lukban, James; Jeppson, Peter; Aschkenazi, Sarit; Olivera, Cedric; South, Mary; Lowenstein, Lior; Schaffer, Joseph; Balk, Ethan M; Sung, Vivian

2014-01-01

The Society of Gynecologic Surgeons Systematic Review Group performed a systematic review of both randomized and observational studies to compare robotic vs nonrobotic surgical approaches (laparoscopic, abdominal, and vaginal) for treatment of both benign and malignant gynecologic indications to compare surgical and patient-centered outcomes, costs, and adverse events associated with the various surgical approaches. MEDLINE and the Cochrane Central Register of Controlled Trials were searched from inception to May 15, 2012, for English-language studies with terms related to robotic surgery and gynecology. Studies of any design that included at least 30 women who had undergone robotic-assisted laparoscopic gynecologic surgery were included for review. The literature yielded 1213 citations, of which 97 full-text articles were reviewed. Forty-four studies (30 comparative and 14 noncomparative) met eligibility criteria. Study data were extracted into structured electronic forms and reconciled by a second, independent reviewer. Our analysis revealed that, compared with open surgery, robotic surgery consistently confers shorter hospital stay. The proficiency plateau seems to be lower for robotic surgery than for conventional laparoscopy. Of the various gynecologic applications, there seems to be evidence that renders robotic techniques advantageous over traditional open surgery for management of endometrial cancer. However, insofar as superiority, conflicting data are obtained when comparing robotics vs laparoscopic techniques. Therefore, the specific method of minimally invasive surgery, whether conventional laparoscopy or robotic surgery, should be tailored to patient selection, surgeon ability, and equipment availability. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Effectiveness of a systematic approach to promote intersectoral collaboration in comprehensive school health promotion-a multiple-case study using quantitative and qualitative data.

PubMed

Pucher, Katharina K; Candel, Math J J M; Krumeich, Anja; Boot, Nicole M W M; De Vries, Nanne K

2015-07-05

We report on the longitudinal quantitative and qualitative data resulting from a two-year trajectory (2008-2011) based on the DIagnosis of Sustainable Collaboration (DISC) model. This trajectory aimed to support regional coordinators of comprehensive school health promotion (CSHP) in systematically developing change management and project management to establish intersectoral collaboration. Multilevel analyses of quantitative data on the determinants of collaborations according to the DISC model were done, with 90 respondents (response 57 %) at pretest and 69 respondents (52 %) at posttest. Nvivo analyses of the qualitative data collected during the trajectory included minutes of monthly/bimonthly personal/telephone interviews (N = 65) with regional coordinators, and documents they produced about their activities. Quantitative data showed major improvements in change management and project management. There were also improvements in consensus development, commitment formation, formalization of the CSHP, and alignment of policies, although organizational problems within the collaboration increased. Content analyses of qualitative data identified five main management styles, including (1) facilitating active involvement of relevant parties; (2) informing collaborating parties; (3) controlling and (4) supporting their task accomplishment; and (5) coordinating the collaborative processes. We have contributed to the fundamental understanding of the development of intersectoral collaboration by combining qualitative and quantitative data. Our results support a systematic approach to intersectoral collaboration using the DISC model. They also suggest five main management styles to improve intersectoral collaboration in the initial stage. The outcomes are useful for health professionals involved in similar ventures.

A Systematic Review of Different Implants and Approaches for Proximal Interphalangeal Joint Arthroplasty.

PubMed

Yamamoto, Michiro; Malay, Sunitha; Fujihara, Yuki; Zhong, Lin; Chung, Kevin C

2017-05-01

Outcomes after implant arthroplasty for primary degenerative and posttraumatic osteoarthritis of the proximal interphalangeal joint were different according to the implant design and surgical approach. The purpose of this systematic review was to evaluate outcomes of various types of implant arthroplasty for proximal interphalangeal joint osteoarthritis, with an emphasis on different surgical approaches. The authors searched all available literature in the PubMed and EMBASE databases for articles reporting on outcomes of implant arthroplasty for proximal interphalangeal joint osteoarthritis. Data collection included active arc of motion, extension lag, and complications. The authors combined the data of various types of surface replacement arthroplasty into one group for comparison with silicone arthroplasty. A total of 849 articles were screened, yielding 40 studies for final review. The mean postoperative arc of motion and the mean gain in arc of motion of silicone implant with the volar approach were 58 and 17 degrees, respectively, which was greater than surface replacement implant with the dorsal approach at 51 and 8 degrees, respectively. The mean postoperative extension lag of silicone implant with the volar approach and surface replacement with the dorsal approach was 5 and 14 degrees, respectively. The revision rate of silicone implant with the volar approach and surface replacement with the dorsal approach was 6 percent and 18 percent at a mean follow-up of 41.2 and 51 months, respectively. Silicone implant with the volar approach showed the best arc of motion, with less extension lag and fewer complications after surgery among all the implant designs and surgical approaches.

Ethical and methodological issues in qualitative health research involving children: A systematic review.

PubMed

Huang, Xiaoyan; O'Connor, Margaret; Ke, Li-Shan; Lee, Susan

2016-05-01

The right of children to have their voice heard has been accepted by researchers, and there are increasing numbers of qualitative health studies involving children. The ethical and methodological issues of including children in research have caused worldwide concerns, and many researchers have published articles sharing their own experiences. To systematically review and synthesise experts' opinions and experiences about ethical and methodological issues of including children in research, as well as related solution strategies. The research design was a systematic review of opinion-based evidence, based on the guidelines by Joanna Briggs Institute. A search of five computerised databases has been conducted in April 2014 and 2271 articles were found. After screening the titles, abstracts, full texts and appraising the quality, 30 articles were finally included in the review. A meta-aggregative approach was applied in the data analysis and synthesis process. Ethical approval is not needed as it is a systematic review of published literature. Six themes were identified, including evaluating potential risks and benefits, gaining access, obtaining informed consent/assent, protecting confidentiality and privacy, building rapport and collecting rich data. The similarities and differences between research involving children and that involving adults were indicated. All potential incentives should be justified when designing the study. Further studies need to research how to evaluate individual capacity of children and how to balance protecting children's right to participate and their interests in the research. Cultural differences related to researching children in different regions should also be studied. © The Author(s) 2014.

Designing Integrated Approaches to Support People with Multimorbidity: Key Messages from Systematic Reviews, Health System Leaders and Citizens.

PubMed

Wilson, Michael G; Lavis, John N; Gauvin, Francois-Pierre

2016-11-01

Living with multiple chronic conditions (multimorbidity) - and facing complex, uncoordinated and fragmented care - is part of the daily life of a growing number of Canadians. We undertook: a knowledge synthesis; a "gap analysis" of existing systematic reviews; an issue brief that synthesized the available evidence about the problem, three options for addressing it and implementation considerations; a stakeholder dialogue involving key health-system leaders; and a citizen panel. We identified several recommendations for actions that can be taken, including: developing evidence-based guidance that providers can use to help achieve goals set by patients; embracing approaches to supporting self-management; supporting greater communication and collaboration across healthcare providers as well as between healthcare providers and patients; and investing more efforts in health promotion and disease prevention. Our results point to the need for health system decision-makers to support bottom-up, person-centred approaches to developing models of care that are tailored for people with multimorbidity and support a research agenda to address the identified priorities. Copyright © 2016 Longwoods Publishing.

Acetabular fractures: anatomic and clinical considerations.

PubMed

Lawrence, David A; Menn, Kirsten; Baumgaertner, Michael; Haims, Andrew H

2013-09-01

Classifying acetabular fractures can be an intimidating topic. However, it is helpful to remember that there are only three basic types of acetabular fractures: column fractures, transverse fractures, and wall fractures. Within this framework, acetabular fractures are classified into two broad categories: elementary or associated fractures. We will review the osseous anatomy of the pelvis and provide systematic approaches for reviewing both radiographs and CT scans to effectively evaluate the acetabulum. Although acetabular fracture classification may seem intimidating, the descriptions and distinctions discussed and shown in this article hopefully make the topic simpler to understand. Approach the task by recalling that there are only three basic types of acetabular fractures: column fractures (coronally oriented on CT images), transverse fractures (sagittally oriented on CT images), and wall fractures (obliquely oriented on CT images). We have provided systematic approaches for reviewing both conventional radiographs and CT scans to effectively assess the acetabulum. The clinical implications of the different fracture patterns have also been reviewed because it is critically important to include pertinent information for our clinical colleagues to provide the most efficient and timely clinical care.

A comparison of operative outcomes between standard and robotic laparoscopic surgery for endometrial cancer: A systematic review and meta‐analysis

PubMed Central

Laios, Alex; Hacking, Matthew; Nobbenhuis, Marielle

2017-01-01

Abstract Background Evidence has been systematically assessed comparing robotic with standard laparoscopy for treatment of endometrial cancer. Methods A search of Medline, Embase and Cochrane databases was performed until 30th October 2016. Results Thirty‐six papers including 33 retrospective studies, two matched case–control studies and one randomized controlled study were used in a meta‐analysis. Information from a further seven registry/database studies were assessed descriptively. There were no differences in the duration of surgery but days stay in hospital were shorter in the robotic arm (0.46 days, 95%CI 0.26 to 0.66). A robotic approach had less blood loss (57.74 mL, 95%CI 38.29 to 77.20), less conversions to laparotomy (RR = 0.41, 95%CI 0.29 to 0.59), and less overall complications (RR = 0.82, 95%CI 0.72 to 0.93). A robotic approach had higher costs ($1746.20, 95%CI $63.37 to $3429.03). Conclusion A robotic approach has favourable clinical outcomes but is more expensive. PMID:28762635

Behavioral Interventions to Improve Asthma Outcomes for Adolescents: A Systematic Review.

PubMed

Mosnaim, Giselle S; Pappalardo, Andrea A; Resnick, Scott E; Codispoti, Christopher D; Bandi, Sindhura; Nackers, Lisa; Malik, Rabia N; Vijayaraghavan, Vimala; Lynch, Elizabeth B; Powell, Lynda H

2016-01-01

Factors at multiple ecological levels, including the child, family, home, medical care, and community, impact adolescent asthma outcomes. This systematic review characterizes behavioral interventions at the child, family, home, medical system, and community level to improve asthma management among adolescents. A systematic search of PubMed, SCOPUS, OVID, PsycINFO, CINAHL, and reference review databases was conducted from January 1, 2000, through August 10, 2014. Articles were included if the title or abstract included asthma AND intervention AND (education OR self-management OR behavioral OR technology OR trigger reduction), and the mean and/or median age of participants was between 11 and 16 years. We compared populations, intervention characteristics, study designs, outcomes, settings, and intervention levels across studies to evaluate behavioral interventions to improve asthma management for adolescents. Of 1230 articles identified and reviewed, 24 articles (21 unique studies) met inclusion criteria. Promising approaches to improving adherence to daily controller medications include objective monitoring of inhaled corticosteroid adherence with allergist and/or immunologist feedback on medication-taking behavior and school nurse directly observed therapy. Efficacy at increasing asthma self-management skills was demonstrated using group interactive learning in the school setting. This systematic review is not a meta-analysis, thus limiting its quantitative assessment of studies. Publication bias may also limit our findings. Novel strategies to objectively increase controller medication adherence for adolescents include allergist and/or immunologist feedback and school nurse directly observed therapy. Schools, the most common setting across studies in this review, provide the opportunity for group interactive learning to improve asthma knowledge and self-management skills. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Knowing 'something is not right' is beyond intuition: development of a clinical algorithm to enhance surveillance and assist nurses to organise and communicate clinical findings.

PubMed

Brier, Jessica; Carolyn, Moalem; Haverly, Marsha; Januario, Mary Ellen; Padula, Cynthia; Tal, Ahuva; Triosh, Henia

2015-03-01

To develop a clinical algorithm to guide nurses' critical thinking through systematic surveillance, assessment, actions required and communication strategies. To achieve this, an international, multiphase project was initiated. Patients receive hospital care postoperatively because they require the skilled surveillance of nurses. Effective assessment of postoperative patients is essential for early detection of clinical deterioration and optimal care management. Despite the significant amount of time devoted to surveillance activities, there is lack of evidence that nurses use a consistent, systematic approach in surveillance, management and communication, potentially leading to less optimal outcomes. Several explanations for the lack of consistency have been suggested in the literature. Mixed methods approach. Retrospective chart review; semi-structured interviews conducted with expert nurses (n = 10); algorithm development. Themes developed from the semi-structured interviews, including (1) complete, systematic assessment, (2) something is not right (3) validating with others, (4) influencing factors and (5) frustration with lack of response when communicating findings were used as the basis for development of the Surveillance Algorithm for Post-Surgical Patients. The algorithm proved beneficial based on limited use in clinical settings. Further work is needed to fully test it in education and practice. The Surveillance Algorithm for Post-Surgical Patients represents the approach of expert nurses, and serves to guide less expert nurses' observations, critical thinking, actions and communication. Based on this approach, the algorithm assists nurses to develop skills promoting early detection, intervention and communication in cases of patient deterioration. © 2014 John Wiley & Sons Ltd.

Living systematic review: 1. Introduction-the why, what, when, and how.

PubMed

Elliott, Julian H; Synnot, Anneliese; Turner, Tari; Simmonds, Mark; Akl, Elie A; McDonald, Steve; Salanti, Georgia; Meerpohl, Joerg; MacLehose, Harriet; Hilton, John; Tovey, David; Shemilt, Ian; Thomas, James

2017-11-01

Systematic reviews are difficult to keep up to date, but failure to do so leads to a decay in review currency, accuracy, and utility. We are developing a novel approach to systematic review updating termed "Living systematic review" (LSR): systematic reviews that are continually updated, incorporating relevant new evidence as it becomes available. LSRs may be particularly important in fields where research evidence is emerging rapidly, current evidence is uncertain, and new research may change policy or practice decisions. We hypothesize that a continual approach to updating will achieve greater currency and validity, and increase the benefits to end users, with feasible resource requirements over time. Copyright © 2017 Elsevier Inc. All rights reserved.

Advice to Stay Active or Structured Exercise in the Management of Sciatica: A Systematic Review and Meta-analysis.

PubMed

Fernandez, Matt; Hartvigsen, Jan; Ferreira, Manuela L; Refshauge, Kathryn M; Machado, Aryane F; Lemes, Ítalo R; Maher, Chris G; Ferreira, Paulo H

2015-09-15

A systematic review and meta-analysis. To evaluate the evidence on comparative effectiveness of advice to stay active versus supervised structured exercise in the management of sciatica. Conservative management of sciatica usually includes interventions to promote physical activity in the form of advice to stay active or exercise, but there has been no systematic review directly comparing the effectiveness of these 2 approaches. Data Sources included MEDLINE, CINAHL, EMBASE, and PEDro databases. Studies were randomized controlled trials comparing advice with exercise. Two independent reviewers extracted data and assessed methodological quality using the PEDro scale. Pain and disability data were extracted for all time points and converted to a common 0 to 100 scale. Data were pooled with a random effects model for short, intermediate, and long-term follow-ups. The GRADE approach was used to summarize the strength of evidence. Five trials were included in the meta-analysis, which showed a significant, although small effect favoring exercise over advice for reducing leg pain intensity in the short term (weighted mean difference: 11.43 [95% confidence interval, 0.71-22.16]) but no difference for disability (weighted mean difference: 1.45 [95% confidence interval, -2.86 to 5.76]). Furthermore, there was no difference at intermediate and long-term follow-ups between advice and exercise for patient-relevant outcomes. There is low-quality evidence (GRADE) that exercise provides small, superior effects compared with advice to stay active on leg pain in the short term for patients experiencing sciatica. However, there is moderate-quality evidence showing no difference between advice to stay active and exercise on leg pain and disability status in people with sciatica in the long term. 1.

Approaches to answering critical CER questions.

PubMed

Kinnier, Christine V; Chung, Jeanette W; Bilimoria, Karl Y

2015-01-01

While randomized controlled trials (RCTs) are the gold standard for research, many research questions cannot be ethically and practically answered using an RCT. Comparative effectiveness research (CER) techniques are often better suited than RCTs to address the effects of an intervention under routine care conditions, an outcome otherwise known as effectiveness. CER research techniques covered in this section include: effectiveness-oriented experimental studies such as pragmatic trials and cluster randomized trials, treatment response heterogeneity, observational and database studies including adjustment techniques such as sensitivity analysis and propensity score analysis, systematic reviews and meta-analysis, decision analysis, and cost effectiveness analysis. Each section describes the technique and covers the strengths and weaknesses of the approach.

Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach.

PubMed

Aromataris, Edoardo; Fernandez, Ritin; Godfrey, Christina M; Holly, Cheryl; Khalil, Hanan; Tungpunkom, Patraporn

2015-09-01

With the increase in the number of systematic reviews available, a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of reviews of existing systematic reviews. Syntheses of existing systematic reviews are referred to by many different names, one of which is an umbrella review. An umbrella review allows the findings of reviews relevant to a review question to be compared and contrasted. An umbrella review's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence, namely other systematic reviews and meta-analyses. A methodology working group was formed by the Joanna Briggs Institute to develop methodological guidance for the conduct of an umbrella review, including diverse types of evidence, both quantitative and qualitative. The aim of this study is to describe the development and guidance for the conduct of an umbrella review. Discussion and testing of the elements of methods for the conduct of an umbrella review were held over a 6-month period by members of a methodology working group. The working group comprised six participants who corresponded via teleconference, e-mail and face-to-face meeting during this development period. In October 2013, the methodology was presented in a workshop at the Joanna Briggs Institute Convention. Workshop participants, review authors and methodologists provided further testing, critique and feedback on the proposed methodology. This study describes the methodology and methods developed for the conduct of an umbrella review that includes published systematic reviews and meta-analyses as the analytical unit of the review. Details are provided regarding the essential elements of an umbrella review, including presentation of the review question in a Population, Intervention, Comparator, Outcome format, nuances of the inclusion criteria and search strategy. A critical appraisal tool with 10 questions to help assess risk of bias in systematic reviews and meta-analyses was also developed and tested. Relevant details to extract from included reviews and how to best present the findings of both quantitative and qualitative systematic reviews in a reader friendly format are provided. Umbrella reviews provide a ready means for decision makers in healthcare to gain a clear understanding of a broad topic area. The umbrella review methodology described here is the first to consider reviews that report other than quantitative evidence derived from randomized controlled trials. The methodology includes an easy to use and informative summary of evidence table to readily provide decision makers with the available, highest level of evidence relevant to the question posed.

Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare.

PubMed

Lennox, L; Maher, L; Reed, J

2018-02-09

Improvement initiatives offer a valuable mechanism for delivering and testing innovations in healthcare settings. Many of these initiatives deliver meaningful and necessary changes to patient care and outcomes. However, many improvement initiatives fail to sustain to a point where their full benefits can be realised. This has led many researchers and healthcare practitioners to develop frameworks, models and tools to support and monitor sustainability. This work aimed to identify what approaches are available to assess and influence sustainability in healthcare and to describe the different perspectives, applications and constructs within these approaches to guide their future use. A systematic review was carried out following PRISMA guidelines to identify publications that reported approaches to support or influence sustainability in healthcare. Eligibility criteria were defined through an iterative process in which two reviewers independently assessed 20% of articles to test the objectivity of the selection criteria. Data were extracted from the identified articles, and a template analysis was undertaken to identify and assess the sustainability constructs within each reported approach. The search strategy identified 1748 publications with 227 articles retrieved in full text for full documentary analysis. In total, 62 publications identifying a sustainability approach were included in this review (32 frameworks, 16 models, 8 tools, 4 strategies, 1 checklist and 1 process). Constructs across approaches were compared and 40 individual constructs for sustainability were found. Comparison across approaches demonstrated consistent constructs were seen regardless of proposed interventions, setting or level of application with 6 constructs included in 75% of the approaches. Although similarities were found, no approaches contained the same combination of the constructs nor did any single approach capture all identified constructs. From these results, a consolidated framework for sustainability constructs in healthcare was developed. Choosing a sustainability method can pose a challenge because of the diverse approaches reported in the literature. This review provides a valuable resource to researchers, healthcare professionals and improvement practitioners by providing a summary of available sustainability approaches and their characteristics. This review was registered on the PROSPERO database: CRD42016040081 in June 2016.

Systematic Review of Model-Based Economic Evaluations of Treatments for Alzheimer's Disease.

PubMed

Hernandez, Luis; Ozen, Asli; DosSantos, Rodrigo; Getsios, Denis

2016-07-01

Numerous economic evaluations using decision-analytic models have assessed the cost effectiveness of treatments for Alzheimer's disease (AD) in the last two decades. It is important to understand the methods used in the existing models of AD and how they could impact results, as they could inform new model-based economic evaluations of treatments for AD. The aim of this systematic review was to provide a detailed description on the relevant aspects and components of existing decision-analytic models of AD, identifying areas for improvement and future development, and to conduct a quality assessment of the included studies. We performed a systematic and comprehensive review of cost-effectiveness studies of pharmacological treatments for AD published in the last decade (January 2005 to February 2015) that used decision-analytic models, also including studies considering patients with mild cognitive impairment (MCI). The background information of the included studies and specific information on the decision-analytic models, including their approach and components, assumptions, data sources, analyses, and results, were obtained from each study. A description of how the modeling approaches and assumptions differ across studies, identifying areas for improvement and future development, is provided. At the end, we present our own view of the potential future directions of decision-analytic models of AD and the challenges they might face. The included studies present a variety of different approaches, assumptions, and scope of decision-analytic models used in the economic evaluation of pharmacological treatments of AD. The major areas for improvement in future models of AD are to include domains of cognition, function, and behavior, rather than cognition alone; include a detailed description of how data used to model the natural course of disease progression were derived; state and justify the economic model selected and structural assumptions and limitations; provide a detailed (rather than high-level) description of the cost components included in the model; and report on the face-, internal-, and cross-validity of the model to strengthen the credibility and confidence in model results. The quality scores of most studies were rated as fair to good (average 87.5, range 69.5-100, in a scale of 0-100). Despite the advancements in decision-analytic models of AD, there remain several areas of improvement that are necessary to more appropriately and realistically capture the broad nature of AD and the potential benefits of treatments in future models of AD.

Third molar removal and its impact on quality of life: systematic review and meta-analysis.

PubMed

Duarte-Rodrigues, Lucas; Miranda, Ednele Fabyene Primo; Souza, Taiane Oliveira; de Paiva, Haroldo Neves; Falci, Saulo Gabriel Moreira; Galvão, Endi Lanza

2018-05-24

The purpose of this systematic review was to assess the impact of third molar removal on patient's quality of life. To address the study purpose, investigators designed and implemented a systematic review. The primary outcome variable was the quality of life after third molar extraction. An electronic search was conducted through March, 2017, on the PUBMED, Virtual Health Library (VHL), Web of Science, and OVID, to identify relevant literatures. Research studies (randomized or non-randomized clinical trials) were included that evaluated the quality of life in individuals before and after third molar extraction, using validated measures of oral health-related quality of life with quantitative approach, besides procedures performed under local anesthesia. The R software was used to measure the mean difference on the quality of life between the preoperative period and follow-up days. A total of 1141 studies were identified. Of this total, 13 articles were selected in the present systematic review, of which six studies were included in the meta-analysis. All of these 13 articles used the OHIP-14, and 4 of this 13 used OHQoLUK-16 to evaluate the quality of life. Regarding quality assessment, four of the 13 included studies in this review received a maximum score of 9 points, according to the Newcastle-Ottawa (NOS). The OHIP-14 mean score on the first postoperative day was 17.57 (95% CI 11.84-23.30, I 2  = 96%) higher than the preoperative period. On the seventh postoperative day, the quality of life assessed by OHIP-14 got worse again. This systematic review revealed that the highest negative impact on quality of life of individuals submitted to third molar surgery was observed on the first postoperative day, decreasing over the follow-up period.

The full benefits of adult pneumococcal vaccination: A systematic review.

PubMed

Cafiero-Fonseca, Elizabeth T; Stawasz, Andrew; Johnson, Sydney T; Sato, Reiko; Bloom, David E

2017-01-01

Pneumococcal disease causes substantial morbidity and mortality, including among adults. Adult pneumococcal vaccines help to prevent these burdens, but they are underused. Accounting for the full benefits of adult pneumococcal vaccination may promote more rational resource allocation decisions with respect to adult pneumococcal vaccines. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to assess the extent to which the literature has empirically captured (e.g., through measurement or modeling) the full benefits of adult pneumococcal vaccination. We systematically searched PubMed and Embase to identify studies published between January 1, 2010 and April 10, 2016 that examine adult pneumococcal vaccination. We included articles if they captured any health or economic benefit of an adult pneumococcal vaccine administered to adults age ≥ 50 or ≥ 18 in risk groups. Finally, we summarized the literature by categorizing the types of benefits captured, the perspective taken, and the strength of the evidence presented. Our protocol is number 42016038335 in the PROSPERO International prospective register of systematic reviews. We identified 5,857 papers and included 150 studies for analysis. While most capture health gains and healthcare cost savings, far fewer studies consider additional benefit categories, such as productivity gains. However, the studies with a broader approach still exhibit significant limitations; for example, many present only abstracts, while others offer no new measurements. Studies that examine the 13-valent pneumococcal conjugate vaccine focus more on broad economic benefits, but still have limitations. This review highlights the need for more robust empirical accounting of the full benefits of adult pneumococcal vaccination. Literature outside this realm indicates that these broad benefits may be substantial. Failing to investigate the full benefits may lead society to undervalue vaccines' contributions and therefore underinvest in their development and adoption.

Inclusion of quasi-experimental studies in systematic reviews of health systems research.

PubMed

Rockers, Peter C; Røttingen, John-Arne; Shemilt, Ian; Tugwell, Peter; Bärnighausen, Till

2015-04-01

Systematic reviews of health systems research commonly limit studies for evidence synthesis to randomized controlled trials. However, well-conducted quasi-experimental studies can provide strong evidence for causal inference. With this article, we aim to stimulate and inform discussions on including quasi-experiments in systematic reviews of health systems research. We define quasi-experimental studies as those that estimate causal effect sizes using exogenous variation in the exposure of interest that is not directly controlled by the researcher. We incorporate this definition into a non-hierarchical three-class taxonomy of study designs - experiments, quasi-experiments, and non-experiments. Based on a review of practice in three disciplines related to health systems research (epidemiology, economics, and political science), we discuss five commonly used study designs that fit our definition of quasi-experiments: natural experiments, instrumental variable analyses, regression discontinuity analyses, interrupted times series studies, and difference studies including controlled before-and-after designs, difference-in-difference designs and fixed effects analyses of panel data. We further review current practices regarding quasi-experimental studies in three non-health fields that utilize systematic reviews (education, development, and environment studies) to inform the design of approaches for synthesizing quasi-experimental evidence in health systems research. Ultimately, the aim of any review is practical: to provide useful information for policymakers, practitioners, and researchers. Future work should focus on building a consensus among users and producers of systematic reviews regarding the inclusion of quasi-experiments. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Indigenous Youth Peer-Led Health Promotion in Canada, New Zealand, Australia, and the United States: A Systematic Review of the Approaches, Study Designs, and Effectiveness.

PubMed

Vujcich, Daniel; Thomas, Jessica; Crawford, Katy; Ward, James

2018-01-01

Youth peer-led interventions have become a popular way of sharing health information with young people and appear well suited to Indigenous community contexts. However, no systematic reviews focusing on Indigenous youth have been published. We conducted a systematic review to understand the range and characteristics of Indigenous youth-led health promotion projects implemented and their effectiveness. A systematic search of Medline, Embase, and ProQuest Social Sciences databases was conducted, supplemented by gray literature searches. Included studies focused on interventions where young Indigenous people delivered health information to age-matched peers. Twenty-four studies were identified for inclusion, based on 20 interventions (9 Australian, 4 Canadian, and 7 from the United States of America). Only one intervention was evaluated using a randomized controlled study design. The majority of evaluations took the form of pre-post studies. Methodological limitations were identified in a majority of studies. Study outcomes included improved knowledge, attitude, and behaviors. Currently, there is limited high quality evidence for the effectiveness of peer-led health interventions with Indigenous young people, and the literature is dominated by Australian-based sexual health interventions. More systematic research investigating the effectiveness of peer-led inventions is required, specifically with Indigenous populations. To improve health outcomes for Indigenous youth, greater knowledge of the mechanisms and context under which peer-delivered health promotion is effective in comparison to other methods of health promotion is needed.

Enzymatic approaches to rare sugar production.

PubMed

Zhang, Wenli; Zhang, Tao; Jiang, Bo; Mu, Wanmeng

Rare sugars have recently attracted much attention because of their potential applications in the food, nutraceutical, and pharmaceutical industries. A systematic strategy for enzymatic production of rare sugars, named Izumoring, was developed >10years ago. The strategy consists of aldose-ketose isomerization, ketose C-3 epimerization, and monosaccharide oxidation-reduction. Recent development of the Izumoring strategy is reviewed herein, especially the genetic approaches to the improvement of rare sugar-producing enzymes and the applications of target-oriented bioconversion. In addition, novel non-Izumoring enzymatic approaches are also summarized, including enzymatic condensation, phosphorylation-dephosphorylation cascade reaction, aldose epimerization, ulosonic acid decarboxylation, and biosynthesis of rare disaccharides. Copyright © 2017 Elsevier Inc. All rights reserved.

Systematic Dissemination of Research and Development Program Improvement Efforts.

ERIC Educational Resources Information Center

Sanders, Carol S.

A systematic approach to disseminaton of vocational education research and development program improvement efforts is comprehensive, effective, and efficient. Systematic dissemination is a prerequisite link to assessing impact of research and development--for program improvement to occur, successful dissemination is crucial. A systematic approach…

The Emergence of Systematic Review in Toxicology.

PubMed

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

2016-07-01

The Evidence-based Toxicology Collaboration hosted a workshop on "The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology," on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward. We conclude with a recommendation that as various agencies and organizations adapt systematic review methods, they continue to work together to ensure that there is a harmonized process for how the basic elements of systematic review methods are applied in toxicology. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology.

Commonality and Variability Analysis for Xenon Family of Separation Virtual Machine Monitors (CVAX)

DTIC Science & Technology

2017-07-18

technical approach is a systematic application of Software Product Line Engineering (SPLE). A systematic application requires describing the family and... engineering Software family September 2016 – October 2016 OSD/OUSD/ATL/ASD(R&E)/RDOffice of Information Systems & Cyber Security RD / ASD(R&E) / AT&L...by the evolving open-source Xen hypervisor. The technical approach is a systematic application of Software Product Line Engineering (SPLE). A

A Systematic Approach to Terminal Training.

ERIC Educational Resources Information Center

Sheffield, John

1980-01-01

Describes the systematic approach used by the training department of the Canada Trust Company to develop a training program for operators of the new terminals for the online banking system to which the bank was converting, the Canadian On-Line Financial Information System (COFIS). (JD)

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/.

Forest communities and the Northwest Forest Plan: what socioeconomic monitoring can tell us.

Treesearch

Jonathan Thompson

2007-01-01

The Northwest Forest Plan (the Plan) was designed to balance protection of older forest ecosystems with mitigation of impacts on rural communities and economies. It was implemented by using an adaptive management approach that featured an interagency monitoring program. This program included socioeconomic monitoring—the systematic observation and measurement of a set...

Systems in the Foundations of Information Systems Course to Retain Students and to Support the IS 2010 Model Curricula

ERIC Educational Resources Information Center

Slauson, Gayla Jo; Carpenter, Donald; Snyder, Johnny

2011-01-01

Systems in the Foundations of Information Systems course can be used to connect with students in computer information systems programs; a systematic approach to beginning student relationship management in this course is helpful. The authors suggest that four systems be created in the Foundations Course. These theoretical systems include an…

Development of Advanced Life Prediction Tools for Elastic-Plastic Fatigue Crack Growth

NASA Technical Reports Server (NTRS)

Gregg, Wayne; McGill, Preston; Swanson, Greg; Wells, Doug; Throckmorton, D. A. (Technical Monitor)

2001-01-01

The objective of this viewgraph presentation is to develop a systematic approach to improving the fracture control process, including analytical tools, standards, guidelines, and awareness. Analytical tools specifically for elastic-plastic fracture analysis is a regime that is currently empirical for the Space Shuttle External Tank (ET) and is handled by simulated service testing of pre-cracked panels.

Bringing gender sensitivity into healthcare practice: a systematic review.

PubMed

Celik, Halime; Lagro-Janssen, Toine A L M; Widdershoven, Guy G A M; Abma, Tineke A

2011-08-01

Despite the body of literature on gender dimensions and disparities between the sexes in health, practical improvements will not be realized effectively as long as we lack an overview of the ways how to implement these ideas. This systematic review provides a content analysis of literature on the implementation of gender sensitivity in health care. Literature was identified from CINAHL, PsycINFO, Medline, EBSCO and Cochrane (1998-2008) and the reference lists of relevant articles. The quality and relevance of 752 articles were assessed and finally 11 original studies were included. Our results demonstrate that the implementation of gender sensitivity includes tailoring opportunities and barriers related to the professional, organizational and the policy level. As gender disparities are embedded in healthcare, a multiple track approach to implement gender sensitivity is needed to change gendered healthcare systems. Conventional approaches, taking into account one barrier and/or opportunity, fail to prevent gender inequality in health care. For gender-sensitive health care we need to change systems and structures, but also to enhance understanding, raise awareness and develop skills among health professionals. To bring gender sensitivity into healthcare practice, interventions should address a range of factors. Copyright © 2010. Published by Elsevier Ireland Ltd.

A systematic review of dynamics in climate risk and vulnerability assessments

NASA Astrophysics Data System (ADS)

Jurgilevich, Alexandra; Räsänen, Aleksi; Groundstroem, Fanny; Juhola, Sirkku

2017-01-01

Understanding climate risk is crucial for effective adaptation action, and a number of assessment methodologies have emerged. We argue that the dynamics of the individual components in climate risk and vulnerability assessments has received little attention. In order to highlight this, we systematically reviewed 42 sub-national climate risk and vulnerability assessments. We analysed the assessments using an analytical framework with which we evaluated (1) the conceptual approaches to vulnerability and exposure used, (2) if current or future risks were assessed, and (3) if and how changes over time (i.e. dynamics) were considered. Of the reviewed assessments, over half addressed future risks or vulnerability; and of these future-oriented studies, less than 1/3 considered both vulnerability and exposure dynamics. While the number of studies that include dynamics is growing, and while all studies included socio-economic aspects, often only biophysical dynamics was taken into account. We discuss the challenges of assessing socio-economic and spatial dynamics, particularly the poor availability of data and methods. We suggest that future-oriented studies assessing risk dynamics would benefit from larger stakeholder involvement, discussion of the assessment purpose, the use of multiple methods, inclusion of uncertainty/sensitivity analyses and pathway approaches.

Canine susceptibility to visceral leishmaniasis: A systematic review upon genetic aspects, considering breed factors and immunological concepts.

PubMed

de Vasconcelos, Tassia Cristina Bello; Furtado, Marina Carvalho; Belo, Vínicus Silva; Morgado, Fernanda Nazaré; Figueiredo, Fabiano Borges

2017-10-05

Dogs have different susceptibility degrees to leishmaniasis; however, genetic research on this theme is scarce, manly on visceral form. The aims of this systematic review were to describe and discuss the existing scientific findings on genetic susceptibility to canine leishmaniasis, as well as to show the gaps of the existing knowledge. Twelve articles were selected, including breed immunological studies, genome wide associations or other gene polymorphism or gene sequencing studies, and transcription approaches. As main results of literature, there was a suggestion of genetic clinical resistance background for Ibizan Hound dogs, and alleles associated with protection or susceptibility to visceral leishmaniasis in Boxer dogs. Genetic markers can explain phenotypic variance in both pro- and anti-inflammatory cytokines and in cellular immune responses, including antigen presentation. Many gene segments are involved in canine visceral leishmaniasis phenotype, with Natural Resistance Associated Macrophage Protein 1 (NRAMP1) as the most studied. This was related to both protection and susceptibility. In comparison with murine and human genetic approaches, lack of knowledge in dogs is notorious, with many possibilities for new studies, revealing a wide field to be assessed on canine leishmaniasis susceptibility research. Copyright © 2017 Elsevier B.V. All rights reserved.

Planning a multilevel intervention to prevent hearing loss among farmworkers and managers: a systematic approach.

PubMed

Fernandez, M E; Bartholomew, L K; Alterman, T

2009-01-01

Noise-induced hearing loss (NIHL) is the second most prevalent self-reported occupational illness or injury in the U.S., and agricultural workers experience high rates of hearing loss. This article uses Intervention Mapping (IM), a systematic approach to intervention development, to make recommendations for a program to improve hearing loss protection among farmworkers and managers. Final recommendations, based on previous work in the literature on hearing loss prevention, qualitative formative research, and theoretical considerations, include a specification of a multilevel theory- and evidence-based hearing protection program for farmworkers and farm managers. Twelve performance objectives (e.g., "monitor hearing and hearing loss with regular hearing testing") are specified and crossed with six relevant determinants (knowledge and behavioral capability; perceived exposure and susceptibility and noise annoyance; outcome expectations; barriers; social influence; skills and self-efficacy) to create a highly detailed matrix of change objectives for farmworkers and for their managers. These change objectives are then grouped into five categories: two for both farmworkers and their managers (noticing exposures, taking action) and three only for the latter (surveying and planning, implementation and evaluation, and communication). Theoretical methods and practical strategies, including program materials and activities, are then delineated.

The Navigation Guide Systematic Review Methodology: A Rigorous and Transparent Method for Translating Environmental Health Science into Better Health Outcomes

PubMed Central

Sutton, Patrice

2014-01-01

Background: Synthesizing what is known about the environmental drivers of health is instrumental to taking prevention-oriented action. Methods of research synthesis commonly used in environmental health lag behind systematic review methods developed in the clinical sciences over the past 20 years. Objectives: We sought to develop a proof of concept of the “Navigation Guide,” a systematic and transparent method of research synthesis in environmental health. Discussion: The Navigation Guide methodology builds on best practices in research synthesis in evidence-based medicine and environmental health. Key points of departure from current methods of expert-based narrative review prevalent in environmental health include a prespecified protocol, standardized and transparent documentation including expert judgment, a comprehensive search strategy, assessment of “risk of bias,” and separation of the science from values and preferences. Key points of departure from evidence-based medicine include assigning a “moderate” quality rating to human observational studies and combining diverse evidence streams. Conclusions: The Navigation Guide methodology is a systematic and rigorous approach to research synthesis that has been developed to reduce bias and maximize transparency in the evaluation of environmental health information. Although novel aspects of the method will require further development and validation, our findings demonstrated that improved methods of research synthesis under development at the National Toxicology Program and under consideration by the U.S. Environmental Protection Agency are fully achievable. The institutionalization of robust methods of systematic and transparent review would provide a concrete mechanism for linking science to timely action to prevent harm. Citation: Woodruff TJ, Sutton P. 2014. The Navigation Guide systematic review methodology: a rigorous and transparent method for translating environmental health science into better health outcomes. Environ Health Perspect 122:1007–1014; http://dx.doi.org/10.1289/ehp.1307175 PMID:24968373

Meniscus Repair in Children and Adolescents: A Systematic Review of Treatment Approaches, Meniscal Healing, and Outcomes.

PubMed

Ferrari, Márcio Balbinotti; Murphy, Colin P; Gomes, João Luiz Ellera

2018-05-23

Although the consequences of traumatic meniscus tears and the importance of meniscal repair are well-established in adults, the same cannot be said for the young population. Better evidence regarding the outcomes following traumatic meniscal tears in children would improve our understanding of this increasing pathology and help define important factors in deciding the best treatment option. A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines using the Cochrane Database of Systematic Review, Cochrane Central Register of Controlled Trials, MEDLINE Ovid, and MEDLINE PubMed databases. Inclusion criteria were as follows: studies reporting the outcomes of meniscal repair in patients 18 years old or younger, with a minimum mean follow-up of 12 months, Portuguese, Spanish, or English languages, and human studies including 10 or more patients. Our search identified 2,534 individual titles. After application of the inclusion and exclusion criteria, 8 studies were included, evaluating 287 patients with repaired meniscal tears. All eight studies were classified as level of evidence IV. The mean methodological index for nonrandomized studies score was 8.6 ± 1.4. Meniscal repair included all meniscal zones and tear patterns. Anterior cruciate ligament tear was the most common associated injury. The all-inside and inside-out techniques were predominantly reported. The majority of the patients reported good to excellent outcomes and had clinical signals of meniscal healing; meniscectomies following meniscal repair were performed in just 44 cases. In conclusion, meniscal tears in pediatrics are not uncommon. Repairs of this injury were associated with good to excellent outcomes in most patients, regardless of the injury pattern, zone, or technique. Reported complications were minimal; however, higher quality studies are needed to confirm the findings of this systematic review. This is a systematic review study with Level IV. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Systematic Review of Community Engagement in the US Environmental Protection Agency’s Extramural Research Solicitations: Implications for Research Funders

PubMed Central

Yuen, Tina; Park, Alice N.; Seifer, Sarena D.

2015-01-01

Objectives. We systematically reviewed the Environmental Protection Agency, National Center for Environmental Research’s (NCER’s) requests for applications (RFAs) and identified strategies that NCER and other funders can take to bolster community engagement. Methods. We queried NCER’s publically available online archive of funding opportunities from fiscal years 1997 to 2013. From an initial list of 211 RFAs that met our inclusion criteria, 33 discussed or incorporated elements of community engagement. We examined these RFAs along 6 dimensions and the degree of alignments between them. Results. We found changes over time in the number of RFAs that included community engagement, variations in how community engagement is defined and expected, inconsistencies between application requirements and peer review criteria, and the inclusion of mechanisms supporting community engagement in research. Conclusions. The results inform a systematic approach to developing RFAs that support community engagement in research. PMID:26469656

Inclusion of Children With Disabilities in Physical Education: A Systematic Review of Literature From 2009 to 2015.

PubMed

Wilhelmsen, Terese; Sørensen, Marit

2017-07-01

This systematic review examines research published from 2009 to 2015 on inclusion of children with disabilities in physical education according to the PRISMA guidelines. We have used a stakeholder approach as a framework for organizing and discussing the results. The searches yielded 535 studies, of which 112 were included. The systematic review outlines which stakeholder perspectives received the most attention, the main themes and findings, the methodological trends that governed the research contribution, and the country of data collection. The main findings indicated that perspectives of pre- and in-service teachers and studies of attitudes still dominate the research contributions. The strengths and limitations of the research conducted to date highlight that several other perspectives need to be discussed. Especially important is seeking information from children with disabilities themselves. Other barriers and facilitators perceived by those actively involved in the inclusion process need to be sought.

A Systematic Review of Community Engagement in the US Environmental Protection Agency's Extramural Research Solicitations: Implications for Research Funders.

PubMed

Yuen, Tina; Park, Alice N; Seifer, Sarena D; Payne-Sturges, Devon

2015-12-01

We systematically reviewed the Environmental Protection Agency, National Center for Environmental Research's (NCER's) requests for applications (RFAs) and identified strategies that NCER and other funders can take to bolster community engagement. We queried NCER's publically available online archive of funding opportunities from fiscal years 1997 to 2013. From an initial list of 211 RFAs that met our inclusion criteria, 33 discussed or incorporated elements of community engagement. We examined these RFAs along 6 dimensions and the degree of alignments between them. We found changes over time in the number of RFAs that included community engagement, variations in how community engagement is defined and expected, inconsistencies between application requirements and peer review criteria, and the inclusion of mechanisms supporting community engagement in research. The results inform a systematic approach to developing RFAs that support community engagement in research.

Systematicity and a Categorical Theory of Cognitive Architecture: Universal Construction in Context

PubMed Central

Phillips, Steven; Wilson, William H.

2016-01-01

Why does the capacity to think certain thoughts imply the capacity to think certain other, structurally related, thoughts? Despite decades of intensive debate, cognitive scientists have yet to reach a consensus on an explanation for this property of cognitive architecture—the basic processes and modes of composition that together afford cognitive capacity—called systematicity. Systematicity is generally considered to involve a capacity to represent/process common structural relations among the equivalently cognizable entities. However, the predominant theoretical approaches to the systematicity problem, i.e., classical (symbolic) and connectionist (subsymbolic), require arbitrary (ad hoc) assumptions to derive systematicity. That is, their core principles and assumptions do not provide the necessary and sufficient conditions from which systematicity follows, as required of a causal theory. Hence, these approaches fail to fully explain why systematicity is a (near) universal property of human cognition, albeit in restricted contexts. We review an alternative, category theory approach to the systematicity problem. As a mathematical theory of structure, category theory provides necessary and sufficient conditions for systematicity in the form of universal construction: each systematically related cognitive capacity is composed of a common component and a unique component. Moreover, every universal construction can be viewed as the optimal construction in the given context (category). From this view, universal constructions are derived from learning, as an optimization. The ultimate challenge, then, is to explain the determination of context. If context is a category, then a natural extension toward addressing this question is higher-order category theory, where categories themselves are the objects of construction. PMID:27524975

Systematicity and a Categorical Theory of Cognitive Architecture: Universal Construction in Context.

PubMed

Phillips, Steven; Wilson, William H

2016-01-01

Why does the capacity to think certain thoughts imply the capacity to think certain other, structurally related, thoughts? Despite decades of intensive debate, cognitive scientists have yet to reach a consensus on an explanation for this property of cognitive architecture-the basic processes and modes of composition that together afford cognitive capacity-called systematicity. Systematicity is generally considered to involve a capacity to represent/process common structural relations among the equivalently cognizable entities. However, the predominant theoretical approaches to the systematicity problem, i.e., classical (symbolic) and connectionist (subsymbolic), require arbitrary (ad hoc) assumptions to derive systematicity. That is, their core principles and assumptions do not provide the necessary and sufficient conditions from which systematicity follows, as required of a causal theory. Hence, these approaches fail to fully explain why systematicity is a (near) universal property of human cognition, albeit in restricted contexts. We review an alternative, category theory approach to the systematicity problem. As a mathematical theory of structure, category theory provides necessary and sufficient conditions for systematicity in the form of universal construction: each systematically related cognitive capacity is composed of a common component and a unique component. Moreover, every universal construction can be viewed as the optimal construction in the given context (category). From this view, universal constructions are derived from learning, as an optimization. The ultimate challenge, then, is to explain the determination of context. If context is a category, then a natural extension toward addressing this question is higher-order category theory, where categories themselves are the objects of construction.

A Systematic Approach to Programmatic Assessment

ERIC Educational Resources Information Center

Moffit, Dani M.; Mansell, Jamie L.; Russ, Anne C.

2016-01-01

Context: Accrediting bodies and universities increasingly require evidence of student learning within courses and programs. Within athletic training, programmatic assessment has been a source of angst for program directors. While there are many ways to assess educational programs, this article introduces 1 systematic approach. Objective: This…

Economic Burden of Obesity: A Systematic Literature Review

PubMed Central

Tremmel, Maximilian; Gerdtham, Ulf-G.; Nilsson, Peter M.; Saha, Sanjib

2017-01-01

Background: The rising prevalence of obesity represents an important public health issue. An assessment of its costs may be useful in providing recommendations for policy and decision makers. This systematic review aimed to assess the economic burden of obesity and to identify, measure and describe the different obesity-related diseases included in the selected studies. Methods: A systematic literature search of studies in the English language was carried out in Medline (PubMed) and Web of Science databases to select cost-of-illness studies calculating the cost of obesity in a study population aged ≥18 years with obesity, as defined by a body mass index of ≥30 kg/m², for the whole selected country. The time frame for the analysis was January 2011 to September 2016. Results: The included twenty three studies reported a substantial economic burden of obesity in both developed and developing countries. There was considerable heterogeneity in methodological approaches, target populations, study time frames, and perspectives. This prevents an informative comparison between most of the studies. Specifically, there was great variety in the included obesity-related diseases and complications among the studies. Conclusions: There is an urgent need for public health measures to prevent obesity in order to save societal resources. Moreover, international consensus is required on standardized methods to calculate the cost of obesity to improve homogeneity and comparability. This aspect should also be considered when including obesity-related diseases. PMID:28422077

Impact of computer-mediated, obesity-related nutrition education interventions for adolescents: a systematic review.

PubMed

Ajie, Whitney N; Chapman-Novakofski, Karen M

2014-06-01

The purpose of this systematic review was to evaluate recent research regarding the use of computer-based nutrition education interventions targeting adolescent overweight and obesity. Online databases were systematically searched using key words, and bibliographies of related articles were manually searched. Inclusion/exclusion criteria were applied and included studies evaluated for their ability to achieve their objectives and for quality using the Nutrition Evidence Library appraisal guidelines for research design and implementation. Of the 15 studies included, 10 were randomized controlled trials. Two studies targeted weight loss, 2 targeted weight maintenance, and 11 targeted dietary improvement with or without physical activity. At least half of in-school (60%) and nonschool interventions (80%) exhibited significantly positive effects on nutrition- or obesity-related variables. Small changes in diet, physical activity, knowledge, and self-efficacy were shown; however, few results were sustained long term. Recommendations included application of health behavior theory and computer tailoring for feedback messages. Future research should include thorough description of intervention content (messages, theory, multimedia, etc.), application of rigorous methodology, as well as consideration of covariates such as parental involvement and gender. With further research and evidentiary support, this approach to obesity-related nutrition education has the potential to be successful. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Developing a Cognitive Training Strategy for First-Episode Schizophrenia: Integrating Bottom-Up and Top-Down Approaches

PubMed Central

Nuechterlein, Keith H.; Ventura, Joseph; Subotnik, Kenneth L.; Hayata, Jacqueline N.; Medalia, Alice; Bell, Morris D.

2014-01-01

It is clear that people with schizophrenia typically have cognitive problems in multiple domains as part of their illness. The cognitive deficits are among the main contributors to limitations in their everyday functioning, including their work recovery. Cognitive remediation has been applied successfully to help people with long-term, persistent schizophrenia to improve their cognitive functioning, but it is only beginning to be applied with individuals who have recently had a first episode of psychosis. Several different approaches to cognitive training have been developed. Some approaches emphasize extensive systematic practice with lower-level cognitive processes and building toward higher-level processes (“bottom-up”), while others emphasize greater focus on high-level cognitive processes that normally integrate and organize lower-level processes (“top-down”). Each approach has advantages and disadvantages for a disorder like schizophrenia, with its multiple levels of cognitive dysfunction. In addition, approaches to cognitive remediation differ in the extent to which they systematically facilitate transfer of learning to everyday functioning. We describe in this article the cognitive training approach that was developed for a UCLA study of people with a recent first episode of schizophrenia, a group that may benefit greatly from early intervention that focuses on cognition and recovery of work functioning. This approach integrated bottom-up and top-down computerized cognitive training and incorporated an additional weekly group session to bridge between computerized training and application to everyday work and school functioning. PMID:25489275

Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review.

PubMed

Tien, T; Athem, R; Arulampalam, T

2018-05-31

Pilonidal sinus is a common disease of the natal cleft, which can lead to complications including infection and abscess formation. Various operative management options are available, but the ideal technique is still debatable. More recently minimally invasive approaches have been described. Our aim was to review the current literature on endoscopic pilonidal sinus treatment (EPSiT) and its outcomes. A systematic literature review was conducted and reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of EMBASE, MEDLINE and Cochrane Library was conducted in November 2017. Full-text studies on the use of endoscopy for the treatment of pilonidal sinus were included in the review. Initial search results returned 52 articles. Eight studies (eight case series and one randomised control trial) were included in the final qualitative synthesis. These studies demonstrated that EPSiT has good complete healing rates and low recurrence rates. There was also a high level of patient satisfaction and little time taken off work. Two studies reported modifications to the original technique. The main limitation was the lack of comparative studies. Initial studies on EPSiT have shown promising results. However, there is a need for a standardised technique and more comparative studies to validate this novel procedure.

Incorporation of habitat information in the development of indices of larval bluefin tuna (Thunnus thynnus) in the Western Mediterranean Sea (2001-2005 and 2012-2013)

NASA Astrophysics Data System (ADS)

Ingram, G. Walter; Alvarez-Berastegui, Diego; Reglero, Patricia; Balbín, Rosa; García, Alberto; Alemany, Francisco

2017-06-01

Fishery independent indices of bluefin tuna larvae in the Western Mediterranean Sea are presented utilizing ichthyoplankton survey data collected from 2001 through 2005 and 2012 through 2013. Indices were developed using larval catch rates collected using two different types of bongo sampling, by first standardizing catch rates by gear/fishing-style and then employing a delta-lognormal modeling approach. The delta-lognormal models were developed three ways: 1) a basic larval index including the following covariates: time of day, a systematic geographic area variable, month and year; 2) a standard environmental larval index including the following covariates: mean water temperature over the mixed layer depth, mean salinity over the mixed layer depth, geostrophic velocity, time of day, a systematic geographic area variable, month and year; and 3) a habitat-adjusted larval index including the following covariates: a potential habitat variable, time of day, a systematic geographic area variable, month and year. Results indicated that all three model-types had similar precision in index values. However, the habitat-adjusted larval index demonstrated a high correlation with estimates of spawning stock biomass from the previous stock assessment model, and, therefore, is recommended as a tuning index in future stock assessment models.

[Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise].

PubMed

Morgano, Gian Paolo; Davoli, Marina; Moja, Lorenzo; Amato, Laura; Ferroni, Eliana; Tirani, Marcello

2015-06-01

Guideline developers worldwide are struggling with the lack of guidance for the practical steps in the guideline enterprise. Our objective was to systematically compile a comprehensive checklist of items linked to relevant resources and tools that guideline developers would consider for development and support of implementation. Data sources included manuals of international guideline developers, literature on guidelines for guidelines with a focus on international and national guideline agencies, professional societies, and recent systematic guidance articles. We reviewed these sources in duplicate, extracted items using a sensitive approach and developed overarching topics that are relevant to guidelines. In an iterative process, we reviewed items for duplication and omissions and involved experts in guideline development for revisions. We developed a checklist with 18 topics and 146 items and a webpage to facilitate its use by guideline developers (http://cebgrade.mcmaster.ca/guidecheck.html). The topics and items included cover all stages of the guideline enterprise, from planning to formulating recommendations, to dissemination and evaluation. The final itemized guideline development checklist (GDC) includes links to training material and resources for methodology. The GDC will serve as a resource for those involved in guideline development and we will use crowdsourcing to keep the checklist up to date and enhance it.

Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series.

PubMed

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

2018-01-25

The GRADE-CERQual ('Confidence in the Evidence from Reviews of Qualitative research') approach provides guidance for assessing how much confidence to place in findings from systematic reviews of qualitative research (or qualitative evidence syntheses). The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. Confidence in the evidence from qualitative evidence syntheses is an assessment of the extent to which a review finding is a reasonable representation of the phenomenon of interest. CERQual provides a systematic and transparent framework for assessing confidence in individual review findings, based on consideration of four components: (1) methodological limitations, (2) coherence, (3) adequacy of data, and (4) relevance. A fifth component, dissemination (or publication) bias, may also be important and is being explored. As with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach for effectiveness evidence, CERQual suggests summarising evidence in succinct, transparent, and informative Summary of Qualitative Findings tables. These tables are designed to communicate the review findings and the CERQual assessment of confidence in each finding. This article is the first of a seven-part series providing guidance on how to apply the CERQual approach. In this paper, we describe the rationale and conceptual basis for CERQual, the aims of the approach, how the approach was developed, and its main components. We also outline the purpose and structure of this series and discuss the growing role for qualitative evidence in decision-making. Papers 3, 4, 5, 6, and 7 in this series discuss each CERQual component, including the rationale for including the component in the approach, how the component is conceptualised, and how it should be assessed. Paper 2 discusses how to make an overall assessment of confidence in a review finding and how to create a Summary of Qualitative Findings table. The series is intended primarily for those undertaking qualitative evidence syntheses or using their findings in decision-making processes but is also relevant to guideline development agencies, primary qualitative researchers, and implementation scientists and practitioners.

Introducing a Chair-Side Novel Approach to Reach Evidence-based Periodontal Information in the Daily Periodontal Practice

PubMed Central

Dannan, Aous

2009-01-01

Background Evidence-based healthcare is not an easier approach to patient management, but should provide both clinicians and patients with greater confidence and trust in their mutual relationship. The intellectual embrace of evidence-based methods, coupled with clinical expertise and consideration of the patients individual uniqueness and requirements, is needed for all periodontal therapists if optimum care is the goal. One important element of evidence-based decision making in periodontology is the systematic review. Systematic reviews usually provide the periodontist with the highest level of evidence which should be taken into consideration when constructing any treatment plan in the dental clinic. However, reaching systematic reviews might be a time-consuming procedure that needs further personal skills. Methods In this paper, a chair-side novel approach to facilitate the incorporation of systematic reviews into daily periodontal practice is presented. It is based on three simple tools, namely, a list of suitable periodontics-related key words, a data bank of all up-to-date published systematic reviews in periodontology, and hand-made paper sheets to match the key words with their related systematic review statements. Results and Conclusions A primary validation of this method indicated the simplicity in learning and application. Keywords Chair-side; Evidence-based medicine; Periodontology; Systematic review PMID:22461868

Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation.

PubMed

Keith, Rosalind E; Crosson, Jesse C; O'Malley, Ann S; Cromp, DeAnn; Taylor, Erin Fries

2017-02-10

Much research does not address the practical needs of stakeholders responsible for introducing health care delivery interventions into organizations working to achieve better outcomes. In this article, we present an approach to using the Consolidated Framework for Implementation Research (CFIR) to guide systematic research that supports rapid-cycle evaluation of the implementation of health care delivery interventions and produces actionable evaluation findings intended to improve implementation in a timely manner. To present our approach, we describe a formative cross-case qualitative investigation of 21 primary care practices participating in the Comprehensive Primary Care (CPC) initiative, a multi-payer supported primary care practice transformation intervention led by the Centers for Medicare and Medicaid Services. Qualitative data include observational field notes and semi-structured interviews with primary care practice leadership, clinicians, and administrative and medical support staff. We use intervention-specific codes, and CFIR constructs to reduce and organize the data to support cross-case analysis of patterns of barriers and facilitators relating to different CPC components. Using the CFIR to guide data collection, coding, analysis, and reporting of findings supported a systematic, comprehensive, and timely understanding of barriers and facilitators to practice transformation. Our approach to using the CFIR produced actionable findings for improving implementation effectiveness during this initiative and for identifying improvements to implementation strategies for future practice transformation efforts. The CFIR is a useful tool for guiding rapid-cycle evaluation of the implementation of practice transformation initiatives. Using the approach described here, we systematically identified where adjustments and refinements to the intervention could be made in the second year of the 4-year intervention. We think the approach we describe has broad application and encourage others to use the CFIR, along with intervention-specific codes, to guide the efficient and rigorous analysis of rich qualitative data. NCT02318108.

A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers

PubMed Central

Chung, Chen-Shuan; Chiang, Tsung-Hsien; Lee, Yi-Chia

2015-01-01

An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk for complicated ulcer disease, a poorer response to gastric acid suppressants, and a higher recurrence rate after treatment. Risk factors associated with this disease may include genetic predisposition, older age, chronic mesenteric ischemia, smoking, concomitant diseases, a higher American Society of Anesthesiologists score, and higher stress. Therefore, the diagnosis and management of emerging disease should systematically explore all known causes and treat underlying disease, while including regular endoscopic surveillance to confirm ulcer healing and the use of proton-pump inhibitors on a case-by-case basis. PMID:26354049

Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia.

PubMed

Morin, Mélanie; Carroll, Marie-Soleil; Bergeron, Sophie

2017-07-01

Pelvic floor muscle physical therapy is recommended in clinical guidelines for women with provoked vestibulodynia (PVD). Including isolated or combined treatment modalities, physical therapy is viewed as an effective first-line intervention, yet no systematic review concerning the effectiveness of physical therapy has been conducted. To systematically appraise the current literature on the effectiveness of physical therapy modalities for decreasing pain during intercourse and improving sexual function in women with PVD. A systematic literature search using PubMed, Scopus, CINHAL, and PEDro was conducted until October 2016. Moreover, a manual search from reference lists of included articles was performed. Ongoing trials also were reviewed using clinicaltrial.gov and ISRCTNregistry. Randomized controlled trials, prospective and retrospective cohorts, and case reports evaluating the effect of isolated or combined physical therapy modalities in women with PVD were included in the review. Main outcome measures were pain during intercourse, sexual function, and patient's perceived improvement. The literature search resulted in 43 eligible studies including 7 randomized controlled trials, 20 prospective studies, 5 retrospective studies, 6 case reports, and 6 study protocols. Most studies had a high risk of bias mainly associated with the lack of a comparison group. Another common bias was related to insufficient sample size, non-validated outcomes, non-standardized intervention, and use of other ongoing treatment. The vast majority of studies showed that physical therapy modalities such as biofeedback, dilators, electrical stimulation, education, multimodal physical therapy, and multidisciplinary approaches were effective for decreasing pain during intercourse and improving sexual function. The positive findings for the effectiveness of physical therapy modalities in women with PVD should be investigated further in robust and well-designed randomized controlled trials. Morin M, Carroll M-S, Bergeron S. Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia. Sex Med Rev 2017;5:295-322. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Surgical Site Infiltration for Abdominal Surgery: A Novel Neuroanatomical-based Approach

PubMed Central

Janis, Jeffrey E.; Haas, Eric M.; Ramshaw, Bruce J.; Nihira, Mikio A.; Dunkin, Brian J.

2016-01-01

Background: Provision of optimal postoperative analgesia should facilitate postoperative ambulation and rehabilitation. An optimal multimodal analgesia technique would include the use of nonopioid analgesics, including local/regional analgesic techniques such as surgical site local anesthetic infiltration. This article presents a novel approach to surgical site infiltration techniques for abdominal surgery based upon neuroanatomy. Methods: Literature searches were conducted for studies reporting the neuroanatomical sources of pain after abdominal surgery. Also, studies identified by preceding search were reviewed for relevant publications and manually retrieved. Results: Based on neuroanatomy, an optimal surgical site infiltration technique would consist of systematic, extensive, meticulous administration of local anesthetic into the peritoneum (or preperitoneum), subfascial, and subdermal tissue planes. The volume of local anesthetic would depend on the size of the incision such that 1 to 1.5 mL is injected every 1 to 2 cm of surgical incision per layer. It is best to infiltrate with a 22-gauge, 1.5-inch needle. The needle is inserted approximately 0.5 to 1 cm into the tissue plane, and local anesthetic solution is injected while slowly withdrawing the needle, which should reduce the risk of intravascular injection. Conclusions: Meticulous, systematic, and extensive surgical site local anesthetic infiltration in the various tissue planes including the peritoneal, musculofascial, and subdermal tissues, where pain foci originate, provides excellent postoperative pain relief. This approach should be combined with use of other nonopioid analgesics with opioids reserved for rescue. Further well-designed studies are necessary to assess the analgesic efficacy of the proposed infiltration technique. PMID:28293525

Approach to evaluation of fever in ambulatory cancer patients receiving chemotherapy: A systematic review.

PubMed

Krzyzanowska, M K; Walker-Dilks, C; Morris, A M; Gupta, R; Halligan, R; Kouroukis, C T; McCann, K; Atzema, C L

2016-12-01

To define the optimal model of care for patients receiving outpatient chemotherapy who experience a fever. Fever is a common symptom in patients receiving chemotherapy, but the approach to evaluation of fever is not standardized. We conducted a search for existing guidelines and a systematic review of the primary literature from database inception to November 2015. Full-text reports and conference abstracts were considered for inclusion. The search focused on the following topics: the relationship between temperature and poor outcome; predictors for the development of febrile neutropenia (FN); the timing, location, and personnel involved in fever assessment; and the provision of information to patients receiving chemotherapy. Eight guidelines and 38 studies were included. None of the guidelines were directly relevant to the target population because they dealt primarily with the management of FN after diagnosis. The primary studies tended to include fever as one of many symptoms assessed in the setting of chemotherapy. Temperature level was a weak predictor of poor outcomes. We did not find validated prediction models for identifying patients at risk of FN among patients receiving chemotherapy. Several studies presented approaches to symptom management that included fever among the symptoms, but results were not mature enough to merit widespread adoption. Despite the frequency and risks of fever in the setting of chemotherapy, there is limited evidence to define who needs urgent assessment, where the assessment should be performed, and how quickly. Future research in this area is greatly needed to inform new models of care. Copyright © 2016 Elsevier Ltd. All rights reserved.

A systematic study of multiple minerals precipitation modelling in wastewater treatment.

PubMed

Kazadi Mbamba, Christian; Tait, Stephan; Flores-Alsina, Xavier; Batstone, Damien J

2015-11-15

Mineral solids precipitation is important in wastewater treatment. However approaches to minerals precipitation modelling are varied, often empirical, and mostly focused on single precipitate classes. A common approach, applicable to multi-species precipitates, is needed to integrate into existing wastewater treatment models. The present study systematically tested a semi-mechanistic modelling approach, using various experimental platforms with multiple minerals precipitation. Experiments included dynamic titration with addition of sodium hydroxide to synthetic wastewater, and aeration to progressively increase pH and induce precipitation in real piggery digestate and sewage sludge digestate. The model approach consisted of an equilibrium part for aqueous phase reactions and a kinetic part for minerals precipitation. The model was fitted to dissolved calcium, magnesium, total inorganic carbon and phosphate. Results indicated that precipitation was dominated by the mineral struvite, forming together with varied and minor amounts of calcium phosphate and calcium carbonate. The model approach was noted to have the advantage of requiring a minimal number of fitted parameters, so the model was readily identifiable. Kinetic rate coefficients, which were statistically fitted, were generally in the range 0.35-11.6 h(-1) with confidence intervals of 10-80% relative. Confidence regions for the kinetic rate coefficients were often asymmetric with model-data residuals increasing more gradually with larger coefficient values. This suggests that a large kinetic coefficient could be used when actual measured data is lacking for a particular precipitate-matrix combination. Correlation between the kinetic rate coefficients of different minerals was low, indicating that parameter values for individual minerals could be independently fitted (keeping all other model parameters constant). Implementation was therefore relatively flexible, and would be readily expandable to include other minerals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Fostering Child Development by Improving Care Quality: A Systematic Review of the Effectiveness of Structural Interventions and Caregiver Trainings in Institutional Care.

PubMed

Hermenau, Katharin; Goessmann, Katharina; Rygaard, Niels Peter; Landolt, Markus A; Hecker, Tobias

2017-12-01

Quality of child care has been shown to have a crucial impact on children's development and psychological adjustment, particularly for orphans with a history of maltreatment and trauma. However, adequate care for orphans is often impacted by unfavorable caregiver-child ratios and poorly trained, overburdened personnel, especially in institutional care in countries with limited resources and large numbers of orphans. This systematic review investigated the effects of structural interventions and caregiver trainings on child development in institutional environments. The 24 intervention studies included in this systematic review reported beneficial effects on the children's emotional, social, and cognitive development. Yet, few studies focused on effects of interventions on the child-caregiver relationship or the general institutional environment. Moreover, our review revealed that interventions aimed at improving institutional care settings have largely neglected violence and abuse prevention. Unfortunately, our findings are partially limited by constraints of study design and methodology. In sum, this systematic review sheds light on obstacles and possibilities for the improvement in institutional care. There must be greater efforts at preventing violence, abuse, and neglect of children living in institutional care. Therefore, we advocate for combining attachment theory-based models with maltreatment prevention approaches and then testing them using rigorous scientific standards. By using approaches grounded in the evidence, it could be possible to enable more children to grow up in supportive and nonviolent environments.

Knowledge Translation Efforts in Child and Youth Mental Health: A Systematic Review

PubMed Central

SCHACHTER, HOWARD M.; BENNETT, LINDSAY M.; McGOWAN, JESSIE; LY, MYLAN; WILSON, ANGELA; BENNETT, KATHRYN; BUCHANAN, DON H.; FERGUSSON, DEAN; MANION, IAN

2012-01-01

The availability of knowledge translation strategies that have been empirically studied and proven useful is a critical prerequisite to narrowing the research-to-practice gap in child and youth mental health. Through this review the authors sought to determine the current state of scientific knowledge of the effectiveness of knowledge translation approaches in child and youth mental health by conducting a systematic review of the research evidence. The findings and quality of the 12 included studies are discussed. Future work of high methodological quality that explores a broader range of knowledge translation strategies and practitioners to which they are applied and that also attends to implementation process is recommended. PMID:22830938

Identification, assessment and management of new and re-emerging animal-related risks: UK perspective.

PubMed

Kosmider, R; Gibbens, J; R, Avigad

2017-07-15

Veterinary surveillance programmes aim to reduce the burden to the public, livestock and wider society posed by animal-related ‘risks’ (referred to as ‘threats’ later in the paper in line with a definition used by the European Food Safety Authority) including the reemergence of diseases believed absent or eradicated. To achieve this, it is important to have a systematic approach to identifying and dealing with such threats rapidly and effectively. This paper describes the transparent, systematic and auditable process used for identifying, assessing, escalating and prioritising new and re-emerging animal-related threats in the UK. This has been achieved through the establishment of a Veterinary Risk Group in late 2009.

Neuropsychology in Finland - over 30 years of systematically trained clinical practice.

PubMed

Hokkanen, Laura; Nybo, Taina; Poutiainen, Erja

2016-11-01

The aim of this invited paper for a special issue of international practice in The Clinical Neuropsychologist is to provide information on training models, clinical practice, and professional issues within neuropsychology in Finland. Relevant information was gathered via literature searches, a survey by the Neuropsychology Working Group of the Finnish Psychological Association, archives of the Finnish Neuropsychological Society, and personal communication with professionals in Finland. The roots of Finnish neuropsychology are linked to the early German tradition of experimental psychology. Since the 1970s, it has been strongly influenced by both the psychometric approach in the U.S. and the qualitative approach by Luria. Systematic specialization training program began in Finland in 1983. It was first organized by the Finnish Neuropsychological Society and since 1997 by Finnish universities. At present, around 260 neuropsychologists have completed this training. According to the survey by the Finnish Psychological Association in 2014, 67% of Finnish neuropsychologists work in the public sector, 36% in the private sector, and 28% reported that they had private practice. Work includes assessments for 90% of the respondents, rehabilitation for 74%, and many are involved in teaching and research. Of the respondents, 20% worked both with adults and children, 44% with adults only and 36% with children only. Within test development, pediatric neuropsychology is an especially prominent field. A unique blend of approaches and a solid systematic training tradition has led to a strong position of neuropsychologists as distinguished experts in the Finnish health care system.

Systematic approach to preparing ceramic-glass composites with high translucency for dental restorations.

PubMed

Yoshimura, Humberto N; Chimanski, Afonso; Cesar, Paulo F

2015-10-01

Ceramic composites are promising materials for dental restorations. However, it is difficult to prepare highly translucent composites due to the light scattering that occurs in multiphase ceramics. The objective of this work was to verify the effectiveness of a systematic approach in designing specific glass compositions with target properties in order to prepare glass infiltrated ceramic composites with high translucency. First it was necessary to calculate from literature data the viscosity of glass at the infiltration temperature using the SciGlass software. Then, a glass composition was designed for targeted viscosity and refractive index. The glass of the system SiO2-B2O3-Al2O3-La2O3-TiO2 prepared by melting the oxide raw materials was spontaneously infiltrated into porous alumina preforms at 1200°C. The optical properties were evaluated using a refractometer and a spectrophotometer. The absorption and scattering coefficients were calculated using the Kubelka-Munk model. The light transmittance of prepared composite was significantly higher than a commercial ceramic-glass composite, due to the matching of glass and preform refractive indexes which decreased the scattering, and also to the decrease in absorption coefficient. The proposed systematic approach was efficient for development of glass infiltrated ceramic composites with high translucency, which benefits include the better aesthetic performance of the final prosthesis. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

The effect of a chest imaging lecture on emergency department doctors' ability to interpret chest CT images: a randomized study.

PubMed

Keijzers, Gerben; Sithirasenan, Vasugi

2012-02-01

To assess the chest computed tomography (CT) imaging interpreting skills of emergency department (ED) doctors and to study the effect of a CT chest imaging interpretation lecture on these skills. Sixty doctors in two EDs were randomized, using computerized randomization, to either attend a chest CT interpretation lecture or not to attend this lecture. Within 2 weeks of the lecture, the participants completed a questionnaire on demographic variables, anatomical knowledge, and diagnostic interpretation of 10 chest CT studies. Outcome measures included anatomical knowledge score, diagnosis score, and the combined overall score, all expressed as a percentage of correctly answered questions (0-100). Data on 58 doctors were analyzed, of which 27 were randomized to attend the lecture. The CT interpretation lecture did not have an effect on anatomy knowledge scores (72.9 vs. 70.2%), diagnosis scores (71.2 vs. 69.2%), or overall scores (71.4 vs. 69.5%). Twenty-nine percent of doctors stated that they had a systematic approach to chest CT interpretation. Overall self-perceived competency for interpreting CT imaging (brain, chest, abdomen) was low (between 3.2 and 5.2 on a 10-point Visual Analogue Scale). A single chest CT interpretation lecture did not improve chest CT interpretation by ED doctors. Less than one-third of doctors had a systematic approach to chest CT interpretation. A standardized systematic approach may improve interpretation skills.

Improving Photometry and Stellar Signal Preservation with Pixel-Level Systematic Error Correction

NASA Technical Reports Server (NTRS)

Kolodzijczak, Jeffrey J.; Smith, Jeffrey C.; Jenkins, Jon M.

2013-01-01

The Kepler Mission has demonstrated that excellent stellar photometric performance can be achieved using apertures constructed from optimally selected CCD pixels. The clever methods used to correct for systematic errors, while very successful, still have some limitations in their ability to extract long-term trends in stellar flux. They also leave poorly correlated bias sources, such as drifting moiré pattern, uncorrected. We will illustrate several approaches where applying systematic error correction algorithms to the pixel time series, rather than the co-added raw flux time series, provide significant advantages. Examples include, spatially localized determination of time varying moiré pattern biases, greater sensitivity to radiation-induced pixel sensitivity drops (SPSDs), improved precision of co-trending basis vectors (CBV), and a means of distinguishing the stellar variability from co-trending terms even when they are correlated. For the last item, the approach enables physical interpretation of appropriately scaled coefficients derived in the fit of pixel time series to the CBV as linear combinations of various spatial derivatives of the pixel response function (PRF). We demonstrate that the residuals of a fit of soderived pixel coefficients to various PRF-related components can be deterministically interpreted in terms of physically meaningful quantities, such as the component of the stellar flux time series which is correlated with the CBV, as well as, relative pixel gain, proper motion and parallax. The approach also enables us to parameterize and assess the limiting factors in the uncertainties in these quantities.

Determining when to conduct a violence risk assessment: Development and initial validation of the Fordham Risk Screening Tool (FRST).

PubMed

Rosenfeld, Barry; Foellmi, Melodie; Khadivi, Ali; Wijetunga, Charity; Howe, Jacqueline; Nijdam-Jones, Alicia; Grover, Shana; Rotter, Merrill

2017-08-01

Techniques to assess violence risk are increasingly common, but no systematic approach exists to help clinicians decide which psychiatric patients are most in need of a violence risk assessment. The Fordham Risk Screening Tool (FRST) was designed to fill this void, providing a structured, systematic approach to screening psychiatric patients and determining the need for further, more thorough violence risk assessment. The FRST was administered to a sample of 210 consecutive admissions to the civil psychiatric units of an urban medical center, 159 of whom were subsequently evaluated using the Historical Clinical Risk Management-20, version 3, to determine violence risk. The FRST showed a high degree of sensitivity (93%) in identifying patients subsequently deemed to be at high risk for violence (based on the Case Prioritization risk rating). The FRST also identified all of the patients (100%) rated high in potential for severe violence (based on the Serious Physical Harm Historical Clinical Risk Management-20, version 3, summary risk rating). Sensitivity was more modest when individuals rated as moderate risk were included as the criterion (rather than only those identified as high risk). Specificity was also moderate, screening out approximately half of all participants as not needing further risk assessment. A systematic approach to risk screening is clearly needed to prioritize psychiatric admissions for thorough risk assessment, and the FRST appears to be a potentially valuable step in that process. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

How nurses cope with patient death: A systematic review and qualitative meta-synthesis.

PubMed

Zheng, Ruishuang; Lee, Susan Fiona; Bloomer, Melissa Jane

2018-01-01

To review literature on nurses' coping strategies with patient death. Dealing with the loss of a patient was viewed as one of the most demanding and challenging encounters in clinical practice. Those nurses who are not competent in coping with patient death may be inadequate in supporting dying patients and their family members, and minimise the quality of end-of-life care. To get a broader understanding of how nurses cope with patient death and to develop meaningful and effective interventions, a systematic review which would help underpin the multidimensional approaches is needed. A systematic review. Exhaustive searching in ten databases: CINAHL Plus, EMBASE, MEDLINE, AMED, PsycINFO, ProQuest Health & Medical Complete, ProQuest Dissertations & Theses Global, Google Scholar, EThOS and CareSearch. Meta-aggregation was used to synthesise the findings of the included studies. This systematic review aggregated ten categories from the sixteen qualitative studies included, and then two synthesised findings were derived: intrinsic resources and extrinsic resources. The intrinsic resources consisted of setting boundaries, reflection, crying, death beliefs, life and work experience, and daily routines and activity. The extrinsic resources were comprised of talking and being heard, spiritual practices, education and programmes, and debriefing. This systematic review synthesised the findings about what resources nurses use when coping with patient death and made recommendations on future directions. Areas which could be developed to improve deficiencies that nurses had when faced with the losses of their patients were identified. Nurses need more support resources, which better assist them in coping with patient death. The results of this systematic review could provide evidence for nurses' coping strategies when dealing with patient death, and the recommendations could be employed by nurses to cope with the losses of patients. © 2017 John Wiley & Sons Ltd.

Targeted agents for patients with advanced/metastatic pancreatic cancer: A protocol for systematic review and network meta-analysis.

PubMed

Di, Baoshan; Pan, Bei; Ge, Long; Ma, Jichun; Wu, Yiting; Guo, Tiankang

2018-03-01

Pancreatic cancer (PC) is a devastating malignant tumor. Although surgical resection may offer a good prognosis and prolong survival, approximately 80% patients with PC are always diagnosed as unresectable tumor. National Comprehensive Cancer Network's (NCCN) recommended gemcitabine-based chemotherapy as efficient treatment. While, according to recent studies, targeted agents might be a better available option for advanced or metastatic pancreatic cancer patients. The aim of this systematic review and network meta-analysis will be to examine the differences of different targeted interventions for advanced/metastatic PC patients. We will conduct this systematic review and network meta-analysis using Bayesian method and according to Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. To identify relevant studies, 6 electronic databases including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of science, CNKI (Chinese National Knowledge Infrastructure), and CBM (Chinese Biological Medical Database) will be searched. The risk of bias in included randomized controlled trials (RCTs) will be assessed using the Cochrane Handbook version 5.1.0. And we will use GRADE approach to assess the quality of evidence from network meta-analysis. Data will be analyzed using R 3.4.1 software. To the best of our knowledge, this systematic review and network meta-analysis will firstly use both direct and indirect evidence to compare the differences of different targeted agents and targeted agents plus chemotherapy for advanced/metastatic pancreatic cancer patients. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required. We will disseminate the results of this review by submitting to a peer-reviewed journal.

State-Space Formulation for Circuit Analysis

ERIC Educational Resources Information Center

Martinez-Marin, T.

2010-01-01

This paper presents a new state-space approach for temporal analysis of electrical circuits. The method systematically obtains the state-space formulation of nondegenerate linear networks without using concepts of topology. It employs nodal/mesh systematic analysis to reduce the number of undesired variables. This approach helps students to…

A Systematic Approach to Subgroup Classification in Intellectual Disability

ERIC Educational Resources Information Center

Schalock, Robert L.; Luckasson, Ruth

2015-01-01

This article describes a systematic approach to subgroup classification based on a classification framework and sequential steps involved in the subgrouping process. The sequential steps are stating the purpose of the classification, identifying the classification elements, using relevant information, and using clearly stated and purposeful…

Effectiveness of mHealth interventions for patients with diabetes: An overview of systematic reviews.

PubMed

Kitsiou, Spyros; Paré, Guy; Jaana, Mirou; Gerber, Ben

2017-01-01

Diabetes is a common chronic disease that places an unprecedented strain on health care systems worldwide. Mobile health technologies such as smartphones, mobile applications, and wearable devices, known as mHealth, offer significant and innovative opportunities for improving patient to provider communication and self-management of diabetes. The purpose of this overview is to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for patients with diabetes to inform policy makers, practitioners, and researchers. A comprehensive search on multiple databases was performed to identify relevant systematic reviews published between January 1996 and December 2015. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using AMSTAR. Fifteen systematic reviews published between 2008 and 2014 were eligible for inclusion. The quality of the reviews varied considerably and most of them had important methodological limitations. Focusing on systematic reviews that offered the most direct evidence, this overview demonstrates that on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8% for patients with type 2 diabetes and 0.3% for patients with type 1 diabetes, at least in the short-term (≤12 months). However, limitations in the overall quality of evidence suggest that further research will likely have an important impact in these estimates of effect. Findings are consistent with clinically relevant improvements, particularly with respect to patients with type 2 diabetes. Similar to home telemonitoring, mHealth interventions represent a promising approach for self-management of diabetes.

Use of evidence-based practice in an aid organisation: a proposal to deal with the variety in terminology and methodology.

PubMed

De Buck, Emmy; Pauwels, Nele S; Dieltjens, Tessa; Vandekerckhove, Philippe

2014-03-01

As part of its strategy Belgian Red Cross-Flanders underpins all its activities with evidence-based guidelines and systematic reviews. The aim of this publication is to describe in detail the methodology used to achieve this goal within an action-oriented organisation, in a timely and cost-effective way. To demonstrate transparency in our methods, we wrote a methodological charter describing the way in which we develop evidence-based materials to support our activities. Criteria were drawn up for deciding on project priority and the choice of different types of projects (scoping reviews, systematic reviews and evidence-based guidelines). While searching for rigorous and realistically attainable methodological standards, we encountered a wide variety in terminology and methodology used in the field of evidence-based practice. Terminologies currently being used by different organisations and institutions include systematic reviews, systematic literature searches, evidence-based guidelines, rapid reviews, pragmatic systematic reviews, and rapid response service. It is not always clear what the definition and methodology is behind these terms and whether they are used consistently. We therefore describe the terminology and methodology used by Belgian Red Cross-Flanders; criteria for making methodological choices and details on the methodology we use are given. In our search for an appropriate methodology, taking into account time and resource constraints, we encountered an enormous variety of methodological approaches and terminology used for evidence-based materials. In light of this, we recommend that authors of evidence-based guidelines and reviews are transparent and clear about the methodology used. To be transparent about our approach, we developed a methodological charter. This charter may inspire other organisations that want to use evidence-based methodology to support their activities.

Systematic Review of Studies Reporting Positive Surgical Margins After Bladder Neck Sparing Radical Prostatectomy.

PubMed

Bellangino, Mariangela; Verrill, Clare; Leslie, Tom; Bell, Richard W; Hamdy, Freddie C; Lamb, Alastair D

2017-11-07

Bladder neck preservation (BNP) during radical prostatectomy (RP) has been proposed as a method to improve early recovery of urinary continence after radical prostatectomy. However, there is concern over a possible increase in the risk of positive surgical margins and prostate cancer recurrence rate. A recent systematic review and meta-analysis reported improved early recovery and overall long-term urinary continence without compromising oncologic control. The aim of our study was to perform a critical review of the literature to assess the impact on bladder neck and base margins after bladder neck sparing radical prostatectomy. We carried out a systematic review of the literature using Pubmed, Scopus and Cochrane library databases in May 2017 using medical subject headings and free-text protocol according to PRISMA guidelines. We used the following search terms: bladder neck preservation, prostate cancer, radical prostatectomy and surgical margins. Studies focusing on positive surgical margins (PSM) in bladder neck sparing RP pertinent to the objective of this review were included. Overall, we found 15 relevant studies reporting overall and site-specific positive surgical margins rate after bladder neck sparing radical prostatectomy. This included two RCTs, seven prospective comparative studies, two retrospective comparative studies and four case series. All studies were published between 1993 and 2015 with sample sizes ranging between 50 and 1067. Surgical approaches included open, laparoscopic and robot-assisted radical prostatectomy. The overall and base-specific PSM rates ranged between 7-36% and 0-16.3%, respectively. Mean base PSM was 4.9% in those patients where bladder neck sparing was performed, but only 1.85% in those without sparing. Bladder neck preservation during radical prostatectomy may increase base-positive margins. Further studies are needed to better investigate the impact of this technique on oncological outcomes. A future paradigm could include modification of intended approach to bladder neck dissection when anterior base lesions are identified on pre-operative MRI.

Targeting Medication Non-Adherence Behavior in Selected Autoimmune Diseases: A Systematic Approach to Digital Health Program Development.

PubMed

van Mierlo, Trevor; Fournier, Rachel; Ingham, Michael

2015-01-01

29 autoimmune diseases, including Rheumatoid Arthritis, gout, Crohn's Disease, and Systematic Lupus Erythematosus affect 7.6-9.4% of the population. While effective therapy is available, many patients do not follow treatment or use medications as directed. Digital health and Web 2.0 interventions have demonstrated much promise in increasing medication and treatment adherence, but to date many Internet tools have proven disappointing. In fact, most digital interventions continue to suffer from high attrition in patient populations, are burdensome for healthcare professionals, and have relatively short life spans. Digital health tools have traditionally centered on the transformation of existing interventions (such as diaries, trackers, stage-based or cognitive behavioral therapy programs, coupons, or symptom checklists) to electronic format. Advanced digital interventions have also incorporated attributes of Web 2.0 such as social networking, text messaging, and the use of video. Despite these efforts, there has not been little measurable impact in non-adherence for illnesses that require medical interventions, and research must look to other strategies or development methodologies. As a first step in investigating the feasibility of developing such a tool, the objective of the current study is to systematically rate factors of non-adherence that have been reported in past research studies. Grounded Theory, recognized as a rigorous method that facilitates the emergence of new themes through systematic analysis, data collection and coding, was used to analyze quantitative, qualitative and mixed method studies addressing the following autoimmune diseases: Rheumatoid Arthritis, gout, Crohn's Disease, Systematic Lupus Erythematosus, and inflammatory bowel disease. Studies were only included if they contained primary data addressing the relationship with non-adherence. Out of the 27 studies, four non-modifiable and 11 modifiable risk factors were discovered. Over one third of articles identified the following risk factors as common contributors to medication non-adherence (percent of studies reporting): patients not understanding treatment (44%), side effects (41%), age (37%), dose regimen (33%), and perceived medication ineffectiveness (33%). An unanticipated finding that emerged was the need for risk stratification tools (81%) with patient-centric approaches (67%). This study systematically identifies and categorizes medication non-adherence risk factors in select autoimmune diseases. Findings indicate that patients understanding of their disease and the role of medication are paramount. An unexpected finding was that the majority of research articles called for the creation of tailored, patient-centric interventions that dispel personal misconceptions about disease, pharmacotherapy, and how the body responds to treatment. To our knowledge, these interventions do not yet exist in digital format. Rather than adopting a systems level approach, digital health programs should focus on cohorts with heterogeneous needs, and develop tailored interventions based on individual non-adherence patterns.

Neuropsychological rehabilitation in alcohol-related brain damage: a systematic review.

PubMed

Svanberg, Jenny; Evans, Jonathan J

2013-01-01

The evidence base for rehabilitating alcohol-related brain damage (ARBD) is still in its infancy. The aim of this review was to collate evidence of intervention studies for ARBD and Wernicke-Korsakoff syndrome (WKS), to offer some indication of methodological quality, and to suggest directions for future research in this area. A comprehensive search strategy resulted in systematic review of 16 studies investigating neurorehabilitation of cognitive impairment relating to ARBD. Most studies addressed rehabilitation of the memory impairments associated with Korsakoff's syndrome, although one study seeking to remediate executive functioning impairment was also included. Three studies outlining service models or approaches were included, with the aim of generating advances in service development for this population. The reviewed studies were of varying methodology, allowing only tentative conclusions. However, the available evidence suggested benefits of a number of memory rehabilitation strategies. Options for practice are suggested.

Identification of High Performance, Low Environmental Impact Materials and Processes Using Systematic Substitution (SyS)

NASA Technical Reports Server (NTRS)

Dhooge, P. M.; Nimitz, J. S.

2001-01-01

Process analysis can identify opportunities for efficiency improvement including cost reduction, increased safety, improved quality, and decreased environmental impact. A thorough, systematic approach to materials and process selection is valuable in any analysis. New operations and facilities design offer the best opportunities for proactive cost reduction and environmental improvement, but existing operations and facilities can also benefit greatly. Materials and processes that have been used for many years may be sources of excessive resource use, waste generation, pollution, and cost burden that should be replaced. Operational and purchasing personnel may not recognize some materials and processes as problems. Reasons for materials or process replacement may include quality and efficiency improvements, excessive resource use and waste generation, materials and operational costs, safety (flammability or toxicity), pollution prevention, compatibility with new processes or materials, and new or anticipated regulations.

Comprehensive Adolescent Health Programs That Include Sexual and Reproductive Health Services: A Systematic Review

PubMed Central

Parekh, Jenita; Tunçalp, Özge; Turke, Shani; Blum, Robert William

2014-01-01

We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998–2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects. PMID:25320876

The Chemistry and Pharmacology of Citrus Limonoids.

PubMed

Gualdani, Roberta; Cavalluzzi, Maria Maddalena; Lentini, Giovanni; Habtemariam, Solomon

2016-11-13

Citrus limonoids (CLs) are a group of highly oxygenated terpenoid secondary metabolites found mostly in the seeds, fruits and peel tissues of citrus fruits such as lemons, limes, oranges, pumellos, grapefruits, bergamots, and mandarins. Represented by limonin, the aglycones and glycosides of CLs have shown to display numerous pharmacological activities including anticancer, antimicrobial, antioxidant, antidiabetic and insecticidal among others. In this review, the chemistry and pharmacology of CLs are systematically scrutinised through the use of medicinal chemistry tools and structure-activity relationship approach. Synthetic derivatives and other structurally-related limonoids from other sources are include in the analysis. With the focus on literature in the past decade, the chemical classification of CLs, their physico-chemical properties as drugs, their biosynthesis and enzymatic modifications, possible ways of enhancing their biological activities through structural modifications, their ligand efficiency metrics and systematic graphical radar plot analysis to assess their developability as drugs are among those discussed in detail.

Examining the Distribution, Modularity, and Community Structure in Article Networks for Systematic Reviews.

PubMed

Ji, Xiaonan; Machiraju, Raghu; Ritter, Alan; Yen, Po-Yin

2015-01-01

Systematic reviews (SRs) provide high quality evidence for clinical practice, but the article screening process is time and labor intensive. As SRs aim to identify relevant articles with a specific scope, we propose that a pre-defined article relationship, using similarity metrics, could accelerate this process. In this study, we established the article relationship using MEDLINE element similarities and visualized the article network with the Force Atlas layout. We also analyzed the article networks with graph diameter, closeness centrality, and module classes. The results revealed the distribution of articles and found that included articles tended to aggregate together in some module classes, providing further evidence of the existence of strong relationships among included articles. This approach can be utilized to facilitate the articles selection process through early identification of these dominant module classes. We are optimistic that the use of article network visualization can help better SR work prioritization.

Examining the Distribution, Modularity, and Community Structure in Article Networks for Systematic Reviews

PubMed Central

Ji, Xiaonan; Machiraju, Raghu; Ritter, Alan; Yen, Po-Yin

2015-01-01

Systematic reviews (SRs) provide high quality evidence for clinical practice, but the article screening process is time and labor intensive. As SRs aim to identify relevant articles with a specific scope, we propose that a pre-defined article relationship, using similarity metrics, could accelerate this process. In this study, we established the article relationship using MEDLINE element similarities and visualized the article network with the Force Atlas layout. We also analyzed the article networks with graph diameter, closeness centrality, and module classes. The results revealed the distribution of articles and found that included articles tended to aggregate together in some module classes, providing further evidence of the existence of strong relationships among included articles. This approach can be utilized to facilitate the articles selection process through early identification of these dominant module classes. We are optimistic that the use of article network visualization can help better SR work prioritization. PMID:26958292

MUSiC - Model-independent search for deviations from Standard Model predictions in CMS

NASA Astrophysics Data System (ADS)

Pieta, Holger

2010-02-01

We present an approach for a model independent search in CMS. Systematically scanning the data for deviations from the standard model Monte Carlo expectations, such an analysis can help to understand the detector and tune event generators. By minimizing the theoretical bias the analysis is furthermore sensitive to a wide range of models for new physics, including the uncounted number of models not-yet-thought-of. After sorting the events into classes defined by their particle content (leptons, photons, jets and missing transverse energy), a minimally prejudiced scan is performed on a number of distributions. Advanced statistical methods are used to determine the significance of the deviating regions, rigorously taking systematic uncertainties into account. A number of benchmark scenarios, including common models of new physics and possible detector effects, have been used to gauge the power of such a method. )

The Immigrant and Hispanic Paradoxes: A Systematic Review of Their Predictions and Effects

PubMed Central

Teruya, Stacey A.; Bazargan-Hejazi, Shahrzad

2015-01-01

A survey of the literature indicates that reported advantages of the Immigrant and Hispanic Paradox are inconsistent and equivocal. The healthy migrant hypothesis also suggests that current research approaches consider only “healthy” groups. Other methodological concerns include the simple underreporting of deaths, and that commonly used databases may not include all significant attributes and characteristics. We conducted a systematic review, synthesizing and identifying themes not explicitly found in the current literature. We also employ a simple quantitative index to assess the scholarly strength of references. Paradox protection appears uneven and is not generalizable across races, ethnicities, age groups and genders. In addition, acculturation, health behaviors and diet, ethnicity, acculturative stress, adolescence, undocumented and uninsured status, age of arrival in the United States and length of exposure, gender and age appear to be significant in predicting any beneficial effects. PMID:26120244

Using systematic reviews for hazard and risk assessment of endocrine disrupting chemicals

PubMed Central

Beronius, Anna; Vandenberg, Laura N.

2016-01-01

The possibility that endocrine disrupting chemicals (EDCs) in our environment contribute to hormonally related effects and diseases observed in human and wildlife populations has caused concern among decision makers and researchers alike. EDCs challenge principles traditionally applied in chemical risk assessment and the identification and assessment of these compounds has been a much debated topic during the last decade. State of the science reports and risk assessments of potential EDCs have been criticized for not using systematic and transparent approaches in the evaluation of evidence. In the fields of medicine and health care, systematic review methodologies have been developed and used to enable objectivity and transparency in the evaluation of scientific evidence for decision making. Lately, such approaches have also been promoted for use in the environmental health sciences and risk assessment of chemicals. Systematic review approaches could provide a tool for improving the evaluation of evidence for decision making regarding EDCs, e.g. by enabling systematic and transparent use of academic research data in this process. In this review we discuss the advantages and challenges of applying systematic review methodology in the identification and assessment of EDCs. PMID:26847432

Using systematic reviews for hazard and risk assessment of endocrine disrupting chemicals.

PubMed

Beronius, Anna; Vandenberg, Laura N

2015-12-01

The possibility that endocrine disrupting chemicals (EDCs) in our environment contribute to hormonally related effects and diseases observed in human and wildlife populations has caused concern among decision makers and researchers alike. EDCs challenge principles traditionally applied in chemical risk assessment and the identification and assessment of these compounds has been a much debated topic during the last decade. State of the science reports and risk assessments of potential EDCs have been criticized for not using systematic and transparent approaches in the evaluation of evidence. In the fields of medicine and health care, systematic review methodologies have been developed and used to enable objectivity and transparency in the evaluation of scientific evidence for decision making. Lately, such approaches have also been promoted for use in the environmental health sciences and risk assessment of chemicals. Systematic review approaches could provide a tool for improving the evaluation of evidence for decision making regarding EDCs, e.g. by enabling systematic and transparent use of academic research data in this process. In this review we discuss the advantages and challenges of applying systematic review methodology in the identification and assessment of EDCs.

Relationship between sponsorship and failure rate of dental implants: a systematic approach.

PubMed

Popelut, Antoine; Valet, Fabien; Fromentin, Olivier; Thomas, Aurélie; Bouchard, Philippe

2010-04-21

The number of dental implant treatments increases annually. Dental implants are manufactured by competing companies. Systematic reviews and meta-analysis have shown a clear association between pharmaceutical industry funding of clinical trials and pro-industry results. So far, the impact of industry sponsorship on the outcomes and conclusions of dental implant clinical trials has never been explored. The aim of the present study was to examine financial sponsorship of dental implant trials, and to evaluate whether research funding sources may affect the annual failure rate. A systematic approach was used to identify systematic reviews published between January 1993 and December 2008 that specifically deal with the length of survival of dental implants. Primary articles were extracted from these reviews. The failure rate of the dental implants included in the trials was calculated. Data on publication year, Impact Factor, prosthetic design, periodontal status reporting, number of dental implants included in the trials, methodological quality of the studies, presence of a statistical advisor, and financial sponsorship were extracted by two independent reviewers (kappa = 0.90; CI(95%) [0.77-1.00]). Univariate quasi-Poisson regression models and multivariate analysis were used to identify variables that were significantly associated with failure rates. Five systematic reviews were identified from which 41 analyzable trials were extracted. The mean annual failure rate estimate was 1.09%.(CI(95%) [0.84-1.42]). The funding source was not reported in 63% of the trials (26/41). Sixty-six percent of the trials were considered as having a risk of bias (27/41). Given study age, both industry associated (OR = 0.21; CI(95%) [0.12-0.38]) and unknown funding source trials (OR = 0.33; (CI(95%) [0.21-0.51]) had a lower annual failure rates compared with non-industry associated trials. A conflict of interest statement was disclosed in 2 trials. When controlling for other factors, the probability of annual failure for industry associated trials is significantly lower compared with non-industry associated trials. This bias may have significant implications on tooth extraction decision making, research on tooth preservation, and governmental health care policies.

Review of Instructional Approaches in Ethics Education.

PubMed

Mulhearn, Tyler J; Steele, Logan M; Watts, Logan L; Medeiros, Kelsey E; Mumford, Michael D; Connelly, Shane

2017-06-01

Increased investment in ethics education has prompted a variety of instructional objectives and frameworks. Yet, no systematic procedure to classify these varying instructional approaches has been attempted. In the present study, a quantitative clustering procedure was conducted to derive a typology of instruction in ethics education. In total, 330 ethics training programs were included in the cluster analysis. The training programs were appraised with respect to four instructional categories including instructional content, processes, delivery methods, and activities. Eight instructional approaches were identified through this clustering procedure, and these instructional approaches showed different levels of effectiveness. Instructional effectiveness was assessed based on one of nine commonly used ethics criteria. With respect to specific training types, Professional Decision Processes Training (d = 0.50) and Field-Specific Compliance Training (d = 0.46) appear to be viable approaches to ethics training based on Cohen's d effect size estimates. By contrast, two commonly used approaches, General Discussion Training (d = 0.31) and Norm Adherence Training (d = 0.37), were found to be considerably less effective. The implications for instruction in ethics training are discussed.

Using a modified intervention mapping approach to develop and refine a single-session motivational intervention for methamphetamine-using men who have sex with men.

PubMed

Zule, William A; Coomes, Curtis M; Karg, Rhonda; Harris, Jennie L; Orr, Alex; Wechsberg, Wendee M

2010-05-14

There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical.

Grey Literature Searching for Health Sciences Systematic Reviews: A Prospective Study of Time Spent and Resources Utilized.

PubMed

Saleh, Ahlam A; Ratajeski, Melissa A; Bertolet, Marnie

To identify estimates of time taken to search grey literature in support of health sciences systematic reviews and to identify searcher or systematic review characteristics that may impact resource selection or time spent searching. A survey was electronically distributed to searchers embarking on a new systematic review. Characteristics of the searcher and systematic review were collected along with time spent searching and what resources were searched. Time and resources were tabulated and resources were categorized as grey or non-grey. Data was analyzed using Kruskal-Wallis tests. Out of 81 original respondents, 21% followed through with completion of the surveys in their entirety. The median time spent searching all resources was 471 minutes, and of those a median of 85 minutes were spent searching grey literature. The median number of resources used in a systematic review search was four and the median number of grey literature sources searched was two. The amount of time spent searching was influenced by whether the systematic review was grant funded. Additionally, the number of resources searched was impacted by institution type and whether systematic review training was received. This study characterized the amount of time for conducting systematic review searches including searching the grey literature, in addition to the number and types of resources used. This may aid searchers in planning their time, along with providing benchmark information for future studies. This paper contributes by quantifying current grey literature search patterns and associating them with searcher and review characteristics. Further discussion and research into the search approach for grey literature in support of systematic reviews is encouraged.

Grey Literature Searching for Health Sciences Systematic Reviews: A Prospective Study of Time Spent and Resources Utilized

PubMed Central

Saleh, Ahlam A.; Ratajeski, Melissa A.; Bertolet, Marnie

2015-01-01

Objective To identify estimates of time taken to search grey literature in support of health sciences systematic reviews and to identify searcher or systematic review characteristics that may impact resource selection or time spent searching. Methods A survey was electronically distributed to searchers embarking on a new systematic review. Characteristics of the searcher and systematic review were collected along with time spent searching and what resources were searched. Time and resources were tabulated and resources were categorized as grey or non-grey. Data was analyzed using Kruskal-Wallis tests. Results Out of 81 original respondents, 21% followed through with completion of the surveys in their entirety. The median time spent searching all resources was 471 minutes, and of those a median of 85 minutes were spent searching grey literature. The median number of resources used in a systematic review search was four and the median number of grey literature sources searched was two. The amount of time spent searching was influenced by whether the systematic review was grant funded. Additionally, the number of resources searched was impacted by institution type and whether systematic review training was received. Conclusions This study characterized the amount of time for conducting systematic review searches including searching the grey literature, in addition to the number and types of resources used. This may aid searchers in planning their time, along with providing benchmark information for future studies. This paper contributes by quantifying current grey literature search patterns and associating them with searcher and review characteristics. Further discussion and research into the search approach for grey literature in support of systematic reviews is encouraged. PMID:25914722

Interventions to enhance work participation of workers with a chronic disease: a systematic review of reviews.

PubMed

Vooijs, Marloes; Leensen, Monique C J; Hoving, Jan L; Wind, Haije; Frings-Dresen, Monique H W

2015-11-01

The aim of this systematic review was to provide an overview of the available effective interventions that enhance work participation of people with a chronic disease, irrespective of their diagnosis. A search was conducted in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library, searching for systematic reviews published between 2004 and February 2015. Systematic reviews were eligible for inclusion if they described an intervention aimed at enhancing work participation and included participants of working age (18-65 years) with a chronic disease. Reviews had to include populations having different chronic diseases. The quality of the included reviews was evaluated using the quality instrument AMSTAR. Results of reviews of medium and high quality were described in this review. The search resulted in 9 reviews, 5 of which were of medium quality. No high quality reviews were retrieved. 1 review reported inconclusive evidence for policy-based return to work initiatives. The 4 other reviews described interventions focused on changes at work, such as changes in work organisation, working conditions and work environment. Of these 4 reviews, 3 reported beneficial effects of the intervention on work participation. Interventions examined in populations having different chronic diseases were mainly focused on changes at work. The majority of the included interventions were reported to be effective in enhancing work participation of people with a chronic disease, indicating that interventions directed at work could be considered for a generic approach in order to enhance work participation in various chronic diseases. 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.

Applying systematic review methods to studies of people's views: an example from public health research.

PubMed

Harden, Angela; Garcia, Jo; Oliver, Sandy; Rees, Rebecca; Shepherd, Jonathan; Brunton, Ginny; Oakley, Ann

2004-09-01

Methods for systematic reviews are well developed for trials, but not for non-experimental or qualitative research. This paper describes the methods developed for reviewing research on people's perspectives and experiences ("views" studies) alongside trials within a series of reviews on young people's mental health, physical activity, and healthy eating. Reports of views studies were difficult to locate; could not easily be classified as "qualitative" or "quantitative"; and often failed to meet seven basic methodological reporting standards used in a newly developed quality assessment tool. Synthesising views studies required the adaptation of qualitative analysis techniques. The benefits of bringing together views studies in a systematic way included gaining a greater breadth of perspectives and a deeper understanding of public health issues from the point of view of those targeted by interventions. A systematic approach also aided reflection on study methods that may distort, misrepresent, or fail to pick up people's views. This methodology is likely to create greater opportunities for people's own perspectives and experiences to inform policies to promote their health.

Applying systematic review methods to studies of people's views: an example from public health research

PubMed Central

Harden, A.; Garcia, J.; Oliver, S.; Rees, R.; Shepherd, J.; Brunton, G.; Oakley, A.

2004-01-01

Methods for systematic reviews are well developed for trials, but not for non-experimental or qualitative research. This paper describes the methods developed for reviewing research on people's perspectives and experiences ("views" studies) alongside trials within a series of reviews on young people's mental health, physical activity, and healthy eating. Reports of views studies were difficult to locate; could not easily be classified as "qualitative" or "quantitative"; and often failed to meet seven basic methodological reporting standards used in a newly developed quality assessment tool. Synthesising views studies required the adaptation of qualitative analysis techniques. The benefits of bringing together views studies in a systematic way included gaining a greater breadth of perspectives and a deeper understanding of public health issues from the point of view of those targeted by interventions. A systematic approach also aided reflection on study methods that may distort, misrepresent, or fail to pick up people's views. This methodology is likely to create greater opportunities for people's own perspectives and experiences to inform policies to promote their health. PMID:15310807

AHA Scientific Statement Population Approaches to Improve Diet, Physical Activity, and Smoking Habits A Scientific Statement From the American Heart Association

PubMed Central

Mozaffarian, Dariush; Afshin, Ashkan; Benowitz, Neal L.; Bittner, Vera; Daniels, Stephen R.; Franch, Harold A.; Jacobs, David R.; Kraus, William E.; Kris-Etherton, Penny M.; Krummel, Debra A.; Popkin, Barry M.; Whitsel, Laurie P.; Zakai, Neil A.

2013-01-01

Background Poor lifestyle, including suboptimal diet, physical inactivity, and tobacco use are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established. Methods and Results For this American Heart Association Scientific Statement, the writing group systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use. Strategies were considered in 6 broad domains: (1) media and education campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts. Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified, providing a set of specific evidence-based strategies that deserve close attention and prioritization for wider implementation. Effective interventions included specific approaches in all 6 domains evaluated for improving diet, increasing activity, and reducing tobacco use. The writing group also identified several specific interventions in each of these domains for which current evidence was less robust, as well as other inconsistencies and evidence gaps, informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies. Conclusions This systematic review identified and graded the evidence for a range of population-based strategies to promote lifestyle change. The findings provide a framework for policy makers, advocacy groups, researchers, clinicians, communities, and other stakeholders to understand and implement the most effective approaches. New strategic initiatives and partnerships are needed to translate this evidence into action. PMID:22907934

Shared decision making within goal setting in rehabilitation settings: A systematic review.

PubMed

Rose, Alice; Rosewilliam, Sheeba; Soundy, Andrew

2017-01-01

To map out and synthesise literature that considers the extent of shared decision-making (SDM) within goal-setting in rehabilitation settings and explore participants' views of this approach within goal-setting. Four databases were systematically searched between January 2005-September 2015. All articles addressing SDM within goal-setting involving adult rehabilitation patients were included. The literature was critically appraised followed by a thematic synthesis. The search output identified 3129 studies and 15 articles met the inclusion criteria. Themes that emerged related to methods of SDM within goal-setting, participants' views on SDM, perceived benefits of SDM, barriers and facilitators to using SDM and suggestions to improve involvement of patients resulting in a better process of goal-setting. The literature showed various levels of patient involvement existing within goal-setting however few teams adopted an entirely patient-centred approach. However, since the review has identified clear value to consider SDM within goal-setting for rehabilitation, further research is required and practice should consider educating both clinicians and patients about this approach. To enhance the use of SDM within goal-setting in rehabilitation it is likely clinicians and patients will require further education on this approach. For clinicians this could commence during their training at undergraduate level. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Systematic Approach for Evaluation of Capture Zones at Pump and Treat Systems

EPA Science Inventory

This document describes a systematic approach for performing capture zone analysis associated with ground water pump and treat systems. A “capture zone” refers to the three-dimensional region that contributes the ground water extracted by one or more wells or drains. A capture ...

A Systematic Framework of Virtual Laboratories Using Mobile Agent and Design Pattern Technologies

ERIC Educational Resources Information Center

Li, Yi-Hsung; Dow, Chyi-Ren; Lin, Cheng-Min; Chen, Sheng-Chang; Hsu, Fu-Wei

2009-01-01

Innovations in network and information technology have transformed traditional classroom lectures into new approaches that have given universities the opportunity to create a virtual laboratory. However, there is no systematic framework in existing approaches for the development of virtual laboratories. Further, developing a virtual laboratory…

When New Boundaries Abound: A Systematic Approach to Redistricting.

ERIC Educational Resources Information Center

Creighton, Roger L.; Irwin, Armond J.

1994-01-01

A systematic approach to school redistricting that was developed over the past half-dozen years utilizes a computer. Crucial to achieving successful results are accuracy of data, enrollment forecasting, and citizen participation. Outlines the major steps of a typical redistricting study. One figure illustrates the redistricting process. (MLF)

A Hierarchic System for Information Usage.

ERIC Educational Resources Information Center

Lu, John; Markham, David

This paper demonstrates an approach which enables one to reduce in a systematic way the immense complexity of a large body of knowledge. This approach provides considerable insight into what is known and unknown in a given academic field by systematically and pragmatically ordering the information. As a case study, the authors selected…

A Philosophical Approach to Claims about Vaccinations and Autism

ERIC Educational Resources Information Center

Talavera, Isidoro

2017-01-01

By highlighting the critical thinking that (1) analyzes and evaluates arguments for claims about vaccinations and autism, and (2) engages in a form of methodological skepticism that systematically and continuously asks Critical Questions, a philosophical approach is introduced to deal directly and systematically with students' (and publicly…

Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research.

PubMed

Rockers, Peter C; Tugwell, Peter; Grimshaw, Jeremy; Oliver, Sandy; Atun, Rifat; Røttingen, John-Arne; Fretheim, Atle; Ranson, M Kent; Daniels, Karen; Luiza, Vera Lucia; Bärnighausen, Till

2017-09-01

Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews. Copyright © 2017 Elsevier Inc. All rights reserved.

[Utilization of tacit knowledge by maternal healthcare providers: a systematic mapping of the literature].

PubMed

Calderón Espinosa, Emmanuel; Becerril Montekio, Víctor; Alcalde Rabanal, Jacqueline; García Bello, Luis

2016-01-01

The search for efficient answers to strengthen maternal health care has included various sources of evidence for decision making. In this article, we present a systematic mapping of the scientific literature on the use of tacit knowledge in relation to maternal healthcare. A systematic mapping was conducted of scientific articles published in Spanish and English between 1971 and 2014 following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Of 793 articles, 30 met the inclusion criteria; 60% were from high-income countries and 66.7% were focused on health professionals. We identified a predominance of qualitative methodologies (62%). Four categories regarding the use of tacit knowledge were generated: proposals to improve the organization of the maternal care system (30%) and to improve the care provided to women during the continuum of pregnancy, childbirth and postpartum (26.7%), determination of health workers' perception and skill levels (26.7%) and the interactions between tacit and explicit knowledge in clinical decision making (16.7%). This mapping shows that tacit knowledge is an emerging, innovative and versatile research approach used primarily in high-income countries and that includes interesting possibilities for its use as evidence to improve maternal healthcare, particularly in middle- and low-income countries, where it needs to be strengthened. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

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.

Indices for the assessment of nutritional quality of meals: a systematic review.

PubMed

Gorgulho, B M; Pot, G K; Sarti, F M; Marchioni, D M

2016-06-01

This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs, SciELO, Scopus, Cochrane, Embase and Google Scholar. The literature search resulted in seven different meal quality indices. Each article was analysed in order to identify the following items: authors, country, year, study design, population characteristics, type of meal evaluated, dietary assessment method, characteristics evaluated (nutrients or food items), score range, index components, nutritional references, correlations performed, validation and relationship with an outcome (if existing). Two studies developed instruments to assess the quality of breakfast, three analysed lunch, one evaluated dinner and one was applied to all types of meals and snacks. All meal quality indices reviewed were based on the evaluation of presence or absence of food groups and relative contributions of nutrients, according to food-based guidelines or nutrient references, adapting the daily dietary recommendations to one specific meal. Most of the indices included three items as components for meal quality assessment: (I) total fat or some specific type of fat, (II) fruits and vegetables and (III) cereals or whole grains. This systematic review indicates aspects that need further research, particularly the numerous approaches to assessing meals considering different foods and nutrients, and the need for validation studies of meal indices.

Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: a systematic review of the literature.

PubMed

von Bremen, J; Ruf, S

2011-08-01

To systematically review the literature published on orthodontic treatment principles in patients with juvenile idiopathic arthritis (JIA). Several electronic databases (PubMed, Medpilot, Web of Science, and DIMDI) and orthodontic and rheumatologic literature were systematically searched for studies published until May 2010. The articles were rated by two independent reviewers and included after three selection steps (title-abstract-full text). Articles had to be studies performed on ≥ 5 patients with a disease onset before the age of 16. The selection process resulted in the inclusion of three publications on dentofacial orthopedics and six on combined surgical orthodontic therapy. The three studies on dentofacial orthopedics aimed to improve the mandibular retrusion by means of removable functional appliances (activator). Whereas these orthodontic approaches comprised relatively large and homogeneous patient samples (14, 22, and 72 subjects, aged 6-16), the surgical studies were basically case series with a large age span of the patients (5-12 subjects, aged 10-44). In these surgical treatment approaches, orthodontics was limited to pre-surgical leveling and post-surgical finishing, while the skeletal discrepancy was treated surgically by a variety of techniques (costochondral grafts, bilateral sagittal spilt osteotomy, Le Fort I, and genioplasty). The treatment goals of both approaches were improvement of esthetics and function and/or pain reduction, and both approaches showed satisfactory results. Because of the heterogeneity of the subject material and the low level of evidence of the papers, it is difficult to draw any conclusions on the orthodontic/dentofacial orthopedic management of JIA. It appears as if removable functional appliances may be beneficial in adolescent patients with JIA. © 2011 John Wiley & Sons A/S.

Traditional, complementary, and alternative medicine approaches to mental health care and psychological wellbeing in India and China.

PubMed

Thirthalli, Jagadisha; Zhou, Liang; Kumar, Kishore; Gao, Jie; Vaid, Henna; Liu, Huiming; Hankey, Alex; Wang, Guojun; Gangadhar, Bangalore N; Nie, Jing-Bao; Nichter, Mark

2016-07-01

India and China face the same challenge of having too few trained psychiatric personnel to manage effectively the substantial burden of mental illness within their population. At the same time, both countries have many practitioners of traditional, complementary, and alternative medicine who are a potential resource for delivery of mental health care. In our paper, part of The Lancet and Lancet Psychiatry's Series about the China-India Mental Health Alliance, we describe and compare types of traditional, complementary, and alternative medicine in India and China. Further, we provide a systematic overview of evidence assessing the effectiveness of these alternative approaches for mental illness and discuss challenges in research. We suggest how practitioners of traditional, complementary, and alternative medicine and mental health professionals might forge collaborative relationships to provide more accessible, affordable, and acceptable mental health care in India and China. A substantial proportion of individuals with mental illness use traditional, complementary, and alternative medicine, either exclusively or with biomedicine, for reasons ranging from faith and cultural congruence to accessibility, cost, and belief that these approaches are safe. Systematic reviews of the effectiveness of traditional, complementary, and alternative medicine find several approaches to be promising for treatment of mental illness, but most clinical trials included in these systematic reviews have methodological limitations. Contemporary methods to establish efficacy and safety-typically through randomised controlled trials-need to be complemented by other means. The community of practice built on collaborative relationships between practitioners of traditional, complementary, and alternative medicine and providers of mental health care holds promise in bridging the treatment gap in mental health care in India and China. Copyright © 2016 Elsevier Ltd. All rights reserved.

Tuning a climate model using nudging to reanalysis.

NASA Astrophysics Data System (ADS)

Cheedela, S. K.; Mapes, B. E.

2014-12-01

Tuning a atmospheric general circulation model involves a daunting task of adjusting non-observable parameters to adjust the mean climate. These parameters arise from necessity to describe unresolved flow through parametrizations. Tuning a climate model is often done with certain set of priorities, such as global mean temperature, net top of the atmosphere radiation. These priorities are hard enough to reach let alone reducing systematic biases in the models. The goal of currently study is to explore alternate ways to tune a climate model to reduce some systematic biases that can be used in synergy with existing efforts. Nudging a climate model to a known state is a poor man's inverse of tuning process described above. Our approach involves nudging the atmospheric model to state of art reanalysis fields thereby providing a balanced state with respect to the global mean temperature and winds. The tendencies derived from nudging are negative of errors from physical parametrizations as the errors from dynamical core would be small. Patterns of nudging are compared to the patterns of different physical parametrizations to decipher the cause for certain biases in relation to tuning parameters. This approach might also help in understanding certain compensating errors that arise from tuning process. ECHAM6 is a comprehensive general model, also used in recent Coupled Model Intercomparision Project(CMIP5). The approach used to tune it and effect of certain parameters that effect its mean climate are reported clearly, hence it serves as a benchmark for our approach. Our planned experiments include nudging ECHAM6 atmospheric model to European Center Reanalysis (ERA-Interim) and reanalysis from National Center for Environmental Prediction (NCEP) and decipher choice of certain parameters that lead to systematic biases in its simulations. Of particular interest are reducing long standing biases related to simulation of Asian summer monsoon.

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

Protocol for a qualitative synthesis of barriers and facilitators in implementing guidelines for diagnosis of tuberculosis.

PubMed

Ochodo, Eleanor; Kredo, Tamara; Young, Taryn; Wiysonge, Charles Shey

2017-06-09

Despite the introduction of new tests and guidelines for diagnosis of tuberculosis (TB), worldwide case detection rate of TB is still suboptimal. This could be in part explained by the poor implementation of TB diagnostic guidelines. We aim to identify, appraise and synthesise qualitative evidence exploring the barriers and facilitators to implementing TB diagnostic guidelines. A systematic review of qualitative studies will be conducted. Relevant electronic databases will be searched and studies included based on predefined inclusion criteria. We will also search reference lists, grey literature, conduct forward citation searches and contact relevant content experts. An adaptation of the Critical Appraisal Skills Programme tool will be used to assess the methodological quality of included studies. Two authors will review the search output, extract data and assess methodological quality independently, resolving any disagreements by consensus. We will use the thematic framework analysis approach based on the Supporting the Use of Research Evidence thematic framework to analyse and synthesise our data. We will apply the Confidence in the Evidence from Reviews of Qualitative research approach to transparently assess our confidence in the findings of the systematic review. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016039790 TRIAL REGISTRATION NUMBER: PROSPERO 2016: CRD42016039790. Available from http://www.crd.york.ac.uk/PROSPERO/. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Nurses on health care governing boards: An integrative review.

PubMed

Sundean, Lisa J; Polifroni, E Carol; Libal, Kathryn; McGrath, Jacqueline M

Nurses are key change agents in health care; yet, nurses have not been sufficiently engaged on boards to shape decision making. Without an equal voice in the boardroom, nurses cannot fulfill their professional obligation to society. The purpose of this study was to understand the progression in research focus and recommendations over time about nurses on boards (NOB), identify research gaps, and make research/practice recommendations. An integrative review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (2009) for data evaluation and analysis. Eleven studies (six quantitative, three qualitative, and two quasi-mixed methods) were included in the review. The focus/recommendations of research about NOB have changed from passive observation to action-oriented inquiry that considers nurse expertise and value but lacks a coordinated approach to advance board appointments for nurses. A systematic approach to the research is needed to advance NOB as key agents in health care transformation and social justice. Copyright © 2017 Elsevier Inc. All rights reserved.

Improving a Synechocystis-based photoautotrophic chassis through systematic genome mapping and validation of neutral sites.

PubMed

Pinto, Filipe; Pacheco, Catarina C; Oliveira, Paulo; Montagud, Arnau; Landels, Andrew; Couto, Narciso; Wright, Phillip C; Urchueguía, Javier F; Tamagnini, Paula

2015-12-01

The use of microorganisms as cell factories frequently requires extensive molecular manipulation. Therefore, the identification of genomic neutral sites for the stable integration of ectopic DNA is required to ensure a successful outcome. Here we describe the genome mapping and validation of five neutral sites in the chromosome of Synechocystis sp. PCC 6803, foreseeing the use of this cyanobacterium as a photoautotrophic chassis. To evaluate the neutrality of these loci, insertion/deletion mutants were produced, and to assess their functionality, a synthetic green fluorescent reporter module was introduced. The constructed integrative vectors include a BioBrick-compatible multiple cloning site insulated by transcription terminators, constituting robust cloning interfaces for synthetic biology approaches. Moreover, Synechocystis mutants (chassis) ready to receive purpose-built synthetic modules/circuits are also available. This work presents a systematic approach to map and validate chromosomal neutral sites in cyanobacteria, and that can be extended to other organisms. © The Author 2015. Published by Oxford University Press on behalf of Kazusa DNA Research Institute.

Anticipatory nausea and vomiting due to chemotherapy.

PubMed

Kamen, Charles; Tejani, Mohamedtaki A; Chandwani, Kavita; Janelsins, Michelle; Peoples, Anita R; Roscoe, Joseph A; Morrow, Gary R

2014-01-05

As a specific variation of chemotherapy-induced nausea and vomiting, anticipatory nausea and vomiting (ANV) appears particularly linked to psychological processes. The three predominant factors related to ANV are classical conditioning; demographic and treatment-related factors; and anxiety or negative expectancies. Laboratory models have provided some support for these underlying mechanisms for ANV. ANV may be treated with medical or pharmacological interventions, including benzodiazepines and other psychotropic medications. However, behavioral treatments, including systematic desensitization, remain first line options for addressing ANV. Some complementary treatment approaches have shown promise in reducing ANV symptoms. Additional research into these approaches is needed. This review will address the underlying models of ANV and provide a discussion of these various treatment options. © 2013 Published by Elsevier B.V.

On mitigating rapid onset natural disasters: Project THRUST (Tsunami Hazards Reduction Utilizing Systems Technology)

NASA Astrophysics Data System (ADS)

Bernard, E. N.; Behn, R. R.; Hebenstreit, G. T.; Gonzalez, F. I.; Krumpe, P.; Lander, J. F.; Lorca, E.; McManamon, P. M.; Milburn, H. B.

Rapid onset natural hazards have claimed more than 2.8 million lives worldwide in the past 20 years. This category includes such events as earthquakes, landslides, hurricanes, tornados, floods, volcanic eruptions, wildfires, and tsunamis. Effective hazard mitigation is particularly difficult in such cases, since the time available to issue warnings can be very short or even nonexistent. This paper presents the concept of a local warning system that exploits and integrates the existing technologies of risk evaluation, environmental measurement, and telecommunications. We describe Project THRUST, a successful implementation of this general, systematic approach to tsunamis. The general approach includes pre-event emergency planning, real-time hazard assessment, and rapid warning via satellite communication links.

Management of recurrent depression.

PubMed

Howell, Cate; Marshall, Charlotte; Opolski, Melissa; Newbury, Wendy

2008-09-01

Depression is a potentially recurring or chronic disorder. The provision of evidence based treatment and effective practice organisation is central to chronic disease management, and these principles can be applied to managing depression. This article outlines the principles of chronic disease management, including the use of management plans and a team care approach, and their application to the management of depression. Treatment approaches that systematically assist patients in managing their chronic disease are more effective than those based on acute care. Depression treatment guidelines are available, as well as primary care initiatives which facilitate comprehensive and long term mental health care, including relapse prevention strategies. A number of risk factors for depression relapse have been identified, and research has recommended that novel intensive relapse prevention programs need to be developed.

A Framework for Fibromyalgia Management for Primary Care Providers

PubMed Central

Arnold, Lesley M.; Clauw, Daniel J.; Dunegan, L. Jean; Turk, Dennis C.

2012-01-01

Fibromyalgia is a chronic widespread pain disorder commonly associated with comorbid symptoms, including fatigue and nonrestorative sleep. As in the management of other chronic medical disorders, the approach for fibromyalgia management follows core principles of comprehensive assessment, education, goal setting, multimodal treatment including pharmacological (eg, pregabalin, duloxetine, milnacipran) and nonpharmacological therapies (eg, physical activity, behavioral therapy, sleep hygiene, education), and regular education and monitoring of treatment response and progress. Based on these core management principles, this review presents a framework for primary care providers through which they can develop a patient-centered treatment program for patients with fibromyalgia. This proactive and systematic treatment approach encourages ongoing education and patient self-management and is designed for use in the primary care setting. PMID:22560527

Systematic review of dietary interventions with college students: directions for future research and practice.

PubMed

Kelly, Nichole R; Mazzeo, Suzanne E; Bean, Melanie K

2013-01-01

To clarify directions for research and practice, research literature evaluating nutrition and dietary interventions in college and university settings was reviewed. Systematic search of database literature. Postsecondary education. Fourteen research articles evaluating randomized controlled trials or quasi-experimental interventions targeting dietary outcomes. Diet/nutrition intake, knowledge, motivation, self-efficacy, barriers, intentions, social support, self-regulation, outcome expectations, and sales. Systematic search of 936 articles and review of 14 articles meeting search criteria. Some in-person interventions (n = 6) show promise in improving students' dietary behaviors, although changes were minimal. The inclusion of self-regulation components, including self-monitoring and goal setting, may maximize outcomes. Dietary outcomes from online interventions (n = 5) were less promising overall, although they may be more effective with a subset of college students early in their readiness to change their eating habits. Environmental approaches (n = 3) may increase the sale of healthy food by serving as visual cues-to-action. A number of intervention approaches show promise for improving college students' dietary habits. However, much of this research has methodological limitations, rendering it difficult to draw conclusions across studies and hindering dissemination efforts. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

National Nutritional Programs for the 2012 London Olympic Games: a systematic approach by three different countries.

PubMed

Burke, Louise M; Meyer, Nanna L; Pearce, Jeni

2013-01-01

Preparing a national team for success at major sporting competitions such as the Olympic Games has become a systematic and multi-faceted activity. Sports nutrition contributes to this success via strategic nutritional interventions that optimize the outcomes from both the training process and the competitive event. This review summarizes the National Nutrition Programs involved with the 2012 London Olympic Games preparation of the Australian, British and American sports systems from the viewpoints of three key agencies: the Australian Institute of Sport, the English Institute of Sport and the United States Olympic Committee. Aspects include development of a nutrition network involving appropriately qualified sports dietitians/nutritionists within a multi-disciplinary team, recognition of continual updates in sports nutrition knowledge, and a systematic approach to service delivery, education and research within the athlete's daily training environment. Issues of clinical nutrition support must often be integrated into the performance nutrition matrix. Food service plays an important role in the achievement of nutrition goals during the Olympic Games, both through the efforts of the Athlete Dining Hall and catering activities of the host Olympic Games Organizing Committees as well as adjunct facilities often provided by National Olympic Committees for their own athletes. Copyright © 2013 Nestec Ltd., Vevey/S. Karger AG, Basel.

Methodological Review of Studies on Educational Leaders and Emotions (1992-2012): Insights into the Meaning of an Emerging Research Field in Educational Administration

ERIC Educational Resources Information Center

Berkovich, Izhak; Eyal, Ori

2017-01-01

Purpose: The purpose of this paper is to do methodological review of the literature on educational leaders and emotions that includes 49 empirical studies published in peer-reviewed journals between 1992 and 2012. Design/methodology/approach: The work systematically analyzes descriptive information, methods, and designs in these studies, and their…

Nonlinear dynamics and predictability in the atmospheric sciences

NASA Technical Reports Server (NTRS)

Ghil, M.; Kimoto, M.; Neelin, J. D.

1991-01-01

Systematic applications of nonlinear dynamics to studies of the atmosphere and climate are reviewed for the period 1987-1990. Problems discussed include paleoclimatic applications, low-frequency atmospheric variability, and interannual variability of the ocean-atmosphere system. Emphasis is placed on applications of the successive bifurcation approach and the ergodic theory of dynamical systems to understanding and prediction of intraseasonal, interannual, and Quaternary climate changes.

Approaching Career Criminals With An Intelligence Cycle

DTIC Science & Technology

2015-12-01

including arrest statistics and “arrest statistics have been used as the main barometer of juvenile delinquent activity, (but) many juvenile... Statistical Briefing Book,” 187. 26 guided by theories about the causes of delinquent behavior, but there was no determination if those efforts achieved the...children.”110 However, the most evidence-based comparison of juvenile delinquency reduction programs is the statistical meta-analysis (a systematic

PubMed Central

Bourque, André; Steben, Marc

1985-01-01

The family physician's role in health promotion must be looked at in a broader perspective than the traditional clinical setting, and better articulated to public health organizations. Medical faculties should consider including sociology, medical anthropology, and communication skills in both the undergraduate and postgraduate curriculum. Family physicians of the future will be called upon for more community-wide basis interventions and a more systematic approach to health promotion in patient care. PMID:21279148

Do Something, Even if It's Wrong! An Approach to Better Management and Planning in Public Schools through a Systematic Approach to Improvement of Basic Skills.

ERIC Educational Resources Information Center

Noggle, Vernon R.

Maintaining that lack of action is one of the biggest errors school managers make, this author describes development of competency based education (CBE) programs as one example of how action can be taken by identifying a problem area and systematically approaching it. He defines CBE programs as those involving identification of basic skills, a…

Choosing important health outcomes for comparative effectiveness research: An updated systematic review and involvement of low and middle income countries.

PubMed

Davis, Katherine; Gorst, Sarah L; Harman, Nicola; Smith, Valerie; Gargon, Elizabeth; Altman, Douglas G; Blazeby, Jane M; Clarke, Mike; Tunis, Sean; Williamson, Paula R

2018-01-01

Core outcome sets (COS) comprise a minimum set of outcomes that should be measured and reported in all trials for a specific health condition. The COMET (Core Outcome Measures in Effectiveness Trials) Initiative maintains an up to date, publicly accessible online database of published and ongoing COS. An annual systematic review update is an important part of this process. This review employed the same, multifaceted approach that was used in the original review and the previous two updates. This approach has identified studies that sought to determine which outcomes/domains to measure in clinical trials of a specific condition. This update includes an analysis of the inclusion of participants from low and middle income countries (LMICs) as identified by the OECD, in these COS. Eighteen publications, relating to 15 new studies describing the development of 15 COS, were eligible for inclusion in the review. Results show an increase in the use of mixed methods, including Delphi surveys. Clinical experts remain the most common stakeholder group involved. Overall, only 16% of the 259 COS studies published up to the end of 2016 have included participants from LMICs. This review highlights opportunities for greater public participation in COS development and the involvement of stakeholders from a wider range of geographical settings, in particular LMICs.

Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review.

PubMed

D'Egidio, V; Sestili, C; Mancino, M; Sciarra, I; Cocchiara, R; Backhaus, I; Mannocci, A; De Luca, Alessandro; Frusone, Federico; Monti, Massimo; La Torre, G

2017-10-01

Higher survival rates for breast cancer patients have led to concerns in dealing with short- and long-term side effects. The most common complications are impairment of shoulder functions, pain, lymphedema, and dysesthesia of the injured arm; psychological consequences concern: emotional distress, anxiety, and depression, thereby, deeply impacting/affecting daily living activity, and health-related quality of life. To perform a systematic review for assessing the efficacy or effectiveness of interventions aiming at improving health-related quality of life, return to daily activity, and correct lifestyles among breast cancer patients. A literature search was conducted in December 2016 using the databases PubMed and Scopus. Search terms included: (counseling) AND (breast cancer) AND (quality of life). Articles on counseling interventions to improve quality of life, physical and psychological outcomes were included. Thirty-five articles met the inclusion criteria. The interventions were grouped in five main areas: concerning lifestyle counseling interventions, related to combined interventions (physical activity and nutritional counseling), physical therapy, peer counseling, multidisciplinary approach, included psychological, psycho-educational interventions, and cognitive-behavior therapy (CBT). Exercise counseling as well as physical therapy are effective to improve shoulder mobility, healing wounds, and limb strength. Psychological therapies such as psychoeducation and CBT may help to realize a social and psychological rehabilitation. A multidisciplinary approach can help in sustaining and restoring impaired physical, psychosocial, and occupational outcomes of breast cancer patients.

Managing xerostomia and salivary gland hypofunction: executive summary of a report from the American Dental Association Council on Scientific Affairs.

PubMed

Plemons, Jacqueline M; Al-Hashimi, Ibtisam; Marek, Cindy L

2014-08-01

Xerostomia, also known as "dry mouth," is a common but frequently overlooked condition that is typically associated with salivary gland hypofunction, which is the objective measurement of reduced salivary flow. Patients with dry mouth exhibit symptoms of variable severity that are commonly attributed to medication use, chronic disease and medical treatment, such as radiotherapy to the head and neck region. Chronic xerostomia significantly increases the risk of experiencing dental caries, demineralization, tooth sensitivity, candidiasis and other oral diseases that may affect quality of life negatively. This article presents a multidisciplinary approach to the clinical management of xerostomia, consistent with the findings of published systematic reviews on this key clinical issue. Initial evaluation of patients with dry mouth should include a detailed health history to facilitate early detection and identify underlying causes. Comprehensive evaluation, diagnostic testing and periodic assessment of salivary flow, followed by corrective actions, may help prevent significant oral disease. A systematic approach to xerostomia management can facilitate interdisciplinary patient care, including collaboration with physicians regarding systemic conditions and medication use. Comprehensive management of xerostomia and hyposalivation should emphasize patient education and lifestyle modifications. It also should focus on various palliative and preventive measures, including pharmacological treatment with salivary stimulants, topical fluoride interventions and the use of sugar-free chewing gum to relieve dry-mouth symptoms and improve the patient's quality of life.

Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools.

PubMed

King, Daniel L; Haagsma, Maria C; Delfabbro, Paul H; Gradisar, Michael; Griffiths, Mark D

2013-04-01

Pathological video-gaming, or its proposed DSM-V classification of "Internet Use Disorder", is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to Cicchetti (1994) and Groth-Marnat's (2009) criteria and guidelines for sound psychometric assessment. A total of 63 quantitative studies, including eighteen instruments and representing 58,415 participants, were evaluated. Results indicated that reviewed instrumentation may be broadly characterized as inconsistent. Strengths of available measures include: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggests that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict. It is concluded that a unified approach to assessment of pathological video-gaming is needed. A synthesis of extant research efforts by meta-analysis may be difficult in the context of several divergent approaches to assessment. Copyright © 2013 Elsevier Ltd. All rights reserved.

A systematic appraisal of the Evidence-Based Dentistry Journal.

PubMed

Mehta, Nikisha; Marshman, Zoe

2016-09-01

BackgroundThis systematic appraisal was conducted to determine if the Evidence-Based Dentistry Journal (EBDJ) acts as a reliable and contemporary source of knowledge for practitioners across all disciplines within dentistry.ObjectivesThe main objectives were to determine i) the year the articles were published and included in the EBDJ; ii) if the articles published covered all fields equally within dentistry; iii) the type of study design of the articles reported in the journal and; iv) the level of expertise of the writers of the commentaries.MethodsThis study used a systematic approach to assess the articles included in the journal. Data were extracted on the difference in the year the article was originally published and the year the article was included in the EBDJ, the number of articles in each dental discipline, the type of study designs included in the journal and the expertise of the commentators of each article. The information provided by the journal was validated by accessing the original articles through electronic databases.ResultsThe appraisal considered the 582 articles that met the inclusion criteria. Overall, 45.3% of the articles were included in the EBDJ in the same year and 44.8% of the articles were included a year after they were originally published. The number of articles varied across disciplines within dentistry: 23.7% from dental public health, 18.4% from periodontology and 11.8% from orthodontics, with only 4.6% from prosthodontics, 1% from oral pathology and 0.5% from dental materials. Most of the articles were systematic reviews and randomised controlled trials at 72% and 22.3% respectively. The writers of the commentaries were mostly academics and hospital consultants (71.2% and 13.6% commentators).ConclusionsOn the whole, it can be concluded that the journal acts as a reliable and contemporary source of knowledge/evidence for dentists, however, not all specialities within dentistry had equal coverage.

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review.

PubMed

Taylor, Deanna J; Hobby, Angharad E; Binns, Alison M; Crabb, David P

2016-12-02

To review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature. Systematic review. A systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome. Two researchers screened studies for eligibility. Details of eligible studies including study design, characteristics of study population and outcomes measured were recorded in a data extraction table. All included studies underwent quality appraisal using the Mixed Methods Appraisal Tool 2011 Version (MMAT). From 5284 studies, 123 were eligible for inclusion. A range of approaches were identified, including performance-based methods, quantitative and qualitative patient-reported outcome measures (PROMs). AMD negatively affects tasks including mobility, face recognition, perception of scenes, computer use, meal preparation, shopping, cleaning, watching TV, reading, driving and, in some cases, self-care. There is evidence for higher rates of depression among people with AMD than among community dwelling elderly. A number of adaptation strategies have been associated with AMD of varying duration. Much of the research fails to report the type of AMD studied (59% of included studies) or the duration of disease in participants (74%). Of those that do report type studied, the breakdown is as follows: wet AMD 20%, dry AMD 4% and both types 17%. There are many publications highlighting the negative effects of AMD in various domains of life. Future research should focus on delivering some of this research knowledge into patient management and clinical trials and differentiating between the types of AMD. 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/.

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

PubMed Central

Taylor, Deanna J; Hobby, Angharad E; Binns, Alison M; Crabb, David P

2016-01-01

Objectives To review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature. Design Systematic review. Methods A systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome. Two researchers screened studies for eligibility. Details of eligible studies including study design, characteristics of study population and outcomes measured were recorded in a data extraction table. All included studies underwent quality appraisal using the Mixed Methods Appraisal Tool 2011 Version (MMAT). Results From 5284 studies, 123 were eligible for inclusion. A range of approaches were identified, including performance-based methods, quantitative and qualitative patient-reported outcome measures (PROMs). AMD negatively affects tasks including mobility, face recognition, perception of scenes, computer use, meal preparation, shopping, cleaning, watching TV, reading, driving and, in some cases, self-care. There is evidence for higher rates of depression among people with AMD than among community dwelling elderly. A number of adaptation strategies have been associated with AMD of varying duration. Much of the research fails to report the type of AMD studied (59% of included studies) or the duration of disease in participants (74%). Of those that do report type studied, the breakdown is as follows: wet AMD 20%, dry AMD 4% and both types 17%. Conclusions There are many publications highlighting the negative effects of AMD in various domains of life. Future research should focus on delivering some of this research knowledge into patient management and clinical trials and differentiating between the types of AMD. PMID:27913556

Systems science and systems thinking for public health: a systematic review of the field

PubMed Central

Carey, Gemma; Malbon, Eleanor; Carey, Nicole; Joyce, Andrew; Crammond, Brad; Carey, Alan

2015-01-01

Objectives 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. Design 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. Data analysis 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. Results 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. Conclusions 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. PMID:26719314

Interactive and independent associations between the socioeconomic and objective built environment on the neighbourhood level and individual health: a systematic review of multilevel studies.

PubMed

Schüle, Steffen Andreas; Bolte, Gabriele

2015-01-01

The research question how contextual factors of neighbourhood environments influence individual health has gained increasing attention in public health research. Both socioeconomic neighbourhood characteristics and factors of the built environment play an important role for health and health-related behaviours. However, their reciprocal relationships have not been systematically reviewed so far. This systematic review aims to identify studies applying a multilevel modelling approach which consider both neighbourhood socioeconomic position (SEP) and factors of the objective built environment simultaneously in order to disentangle their independent and interactive effects on individual health. The three databases PubMed, PsycINFO, and Web of Science were systematically searched with terms for title and abstract screening. Grey literature was not included. Observational studies from USA, Canada, Australia, New Zealand, and Western European countries were considered which analysed simultaneously factors of neighbourhood SEP and the objective built environment with a multilevel modelling approach. Adjustment for individual SEP was a further inclusion criterion. Thirty-three studies were included in qualitative synthesis. Twenty-two studies showed an independent association between characteristics of neighbourhood SEP or the built environment and individual health outcomes or health-related behaviours. Twenty-one studies found cross-level or within-level interactions either between neighbourhood SEP and the built environment, or between neighbourhood SEP or the built environment and individual characteristics, such as sex, individual SEP or ethnicity. Due to the large variation of study design and heterogeneous reporting of results the identification of consistent findings was problematic and made quantitative analysis not possible. There is a need for studies considering multiple neighbourhood dimensions and applying multilevel modelling in order to clarify their causal relationship towards individual health. Especially, more studies using comparable characteristics of neighbourhood SEP and the objective built environment and analysing interactive effects are necessary to disentangle health impacts and identify vulnerable neighbourhoods and population groups.

Interactive and Independent Associations between the Socioeconomic and Objective Built Environment on the Neighbourhood Level and Individual Health: A Systematic Review of Multilevel Studies

PubMed Central

Schüle, Steffen Andreas; Bolte, Gabriele

2015-01-01

Background The research question how contextual factors of neighbourhood environments influence individual health has gained increasing attention in public health research. Both socioeconomic neighbourhood characteristics and factors of the built environment play an important role for health and health-related behaviours. However, their reciprocal relationships have not been systematically reviewed so far. This systematic review aims to identify studies applying a multilevel modelling approach which consider both neighbourhood socioeconomic position (SEP) and factors of the objective built environment simultaneously in order to disentangle their independent and interactive effects on individual health. Methods The three databases PubMed, PsycINFO, and Web of Science were systematically searched with terms for title and abstract screening. Grey literature was not included. Observational studies from USA, Canada, Australia, New Zealand, and Western European countries were considered which analysed simultaneously factors of neighbourhood SEP and the objective built environment with a multilevel modelling approach. Adjustment for individual SEP was a further inclusion criterion. Results Thirty-three studies were included in qualitative synthesis. Twenty-two studies showed an independent association between characteristics of neighbourhood SEP or the built environment and individual health outcomes or health-related behaviours. Twenty-one studies found cross-level or within-level interactions either between neighbourhood SEP and the built environment, or between neighbourhood SEP or the built environment and individual characteristics, such as sex, individual SEP or ethnicity. Due to the large variation of study design and heterogeneous reporting of results the identification of consistent findings was problematic and made quantitative analysis not possible. Conclusions There is a need for studies considering multiple neighbourhood dimensions and applying multilevel modelling in order to clarify their causal relationship towards individual health. Especially, more studies using comparable characteristics of neighbourhood SEP and the objective built environment and analysing interactive effects are necessary to disentangle health impacts and identify vulnerable neighbourhoods and population groups. PMID:25849569

Barriers and Enablers of Kangaroo Mother Care Practice: A Systematic Review

PubMed Central

Seidman, Gabriel; Unnikrishnan, Shalini; Kenny, Emma; Myslinski, Scott; Cairns-Smith, Sarah; Mulligan, Brian; Engmann, Cyril

2015-01-01

Kangaroo mother care (KMC) is an evidence-based approach to reducing mortality and morbidity in preterm infants. Although KMC is a key intervention package in newborn health initiatives, there is limited systematic information available on the barriers to KMC practice that mothers and other stakeholders face while practicing KMC. This systematic review sought to identify the most frequently reported barriers to KMC practice for mothers, fathers, and health practitioners, as well as the most frequently reported enablers to practice for mothers. We searched nine electronic databases and relevant reference lists for publications reporting barriers or enablers to KMC practice. We identified 1,264 unique publications, of which 103 were included based on pre-specified criteria. Publications were scanned for all barriers / enablers. Each publication was also categorized based on its approach to identification of barriers / enablers, and more weight was assigned to publications which had systematically sought to understand factors influencing KMC practice. Four of the top five ranked barriers to KMC practice for mothers were resource-related: “Issues with the facility environment / resources,” “negative impressions of staff attitudes or interactions with staff,” “lack of help with KMC practice or other obligations,” and “low awareness of KMC / infant health.” Considering only publications from low- and middle-income countries, “pain / fatigue” was ranked higher than when considering all publications. Top enablers to practice were included “mother-infant attachment” and “support from family, friends, and other mentors.” Our findings suggest that mother can understand and enjoy KMC, and it has benefits for mothers, infants, and families. However, continuous KMC may be physically and emotionally difficult, and often requires support from family members, health practitioners, or other mothers. These findings can serve as a starting point for researchers and program implementers looking to improve KMC programs. PMID:25993306

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/

Addressing the evidence to practice gap for complex interventions in primary care: a systematic review of reviews protocol.

PubMed

Lau, Rosa; Stevenson, Fiona; Ong, Bie Nio; Dziedzic, Krysia; Eldridge, Sandra; Everitt, Hazel; Kennedy, Anne; Kontopantelis, Evangelos; Little, Paul; Qureshi, Nadeem; Rogers, Anne; Treweek, Shaun; Peacock, Richard; Murray, Elizabeth

2014-06-23

Getting the results of research implemented into routine healthcare is often a challenge. The disconnect between the development and implementation of evidence into practice is called the 'second translational gap' and is particularly apparent in primary care. To address this gap, we plan to identify, summarise and synthesise currently available evidence by undertaking a systematic review of reviews to: (1) explore barriers and facilitators of implementation of research evidence or complex interventions, and (2) assess the effectiveness of strategies in facilitating implementation of complex interventions in primary care. This is a protocol for a systematic review of reviews. We will search MEDLINE, EMBASE, the Cochrane Library, CINAHL and PsycINFO up until December 2013. We will check reference lists of included studies for further studies. Two authors will independently screen the titles and abstracts identified from the search; any discrepancies will be resolved by discussion and consensus. Full-text papers will be obtained and relevant reviews will be selected against inclusion criteria. Eligible reviews have to be based on predominantly primary care in developed countries and examine either factors to implementation or, the effectiveness of strategies to optimise implementation. Data from eligible reviews will be extracted using standardised data abstraction forms. For barriers and facilitators, data will be synthesised using an interpretative meta-synthesis approach. For implementation strategies, findings will be summarised and described narratively and synthesised using a framework approach. All findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ethical approval is not required. The review findings will inform the work of the design and implementation of future studies and will be of interest to a wide audience including health professionals, researchers, health service or commissioning managers and policymakers. Protocol registration number (PROSPERO CRD42014009410). 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.

Quantum chemical approach to estimating the thermodynamics of metabolic reactions.

PubMed

Jinich, Adrian; Rappoport, Dmitrij; Dunn, Ian; Sanchez-Lengeling, Benjamin; Olivares-Amaya, Roberto; Noor, Elad; Even, Arren Bar; Aspuru-Guzik, Alán

2014-11-12

Thermodynamics plays an increasingly important role in modeling and engineering metabolism. We present the first nonempirical computational method for estimating standard Gibbs reaction energies of metabolic reactions based on quantum chemistry, which can help fill in the gaps in the existing thermodynamic data. When applied to a test set of reactions from core metabolism, the quantum chemical approach is comparable in accuracy to group contribution methods for isomerization and group transfer reactions and for reactions not including multiply charged anions. The errors in standard Gibbs reaction energy estimates are correlated with the charges of the participating molecules. The quantum chemical approach is amenable to systematic improvements and holds potential for providing thermodynamic data for all of metabolism.

Towards an Early Software Effort Estimation Based on Functional and Non-Functional Requirements

NASA Astrophysics Data System (ADS)

Kassab, Mohamed; Daneva, Maya; Ormandjieva, Olga

The increased awareness of the non-functional requirements as a key to software project and product success makes explicit the need to include them in any software project effort estimation activity. However, the existing approaches to defining size-based effort relationships still pay insufficient attention to this need. This paper presents a flexible, yet systematic approach to the early requirements-based effort estimation, based on Non-Functional Requirements ontology. It complementarily uses one standard functional size measurement model and a linear regression technique. We report on a case study which illustrates the application of our solution approach in context and also helps evaluate our experiences in using it.

A systematic approach to engineering ethics education.

PubMed

Li, Jessica; Fu, Shengli

2012-06-01

Engineering ethics education is a complex field characterized by dynamic topics and diverse students, which results in significant challenges for engineering ethics educators. The purpose of this paper is to introduce a systematic approach to determine what to teach and how to teach in an ethics curriculum. This is a topic that has not been adequately addressed in the engineering ethics literature. This systematic approach provides a method to: (1) develop a context-specific engineering ethics curriculum using the Delphi technique, a process-driven research method; and (2) identify appropriate delivery strategies and instructional strategies using an instructional design model. This approach considers the context-specific needs of different engineering disciplines in ethics education and leverages the collaboration of engineering professors, practicing engineers, engineering graduate students, ethics scholars, and instructional design experts. The proposed approach is most suitable for a department, a discipline/field or a professional society. The approach helps to enhance learning outcomes and to facilitate ethics education curriculum development as part of the regular engineering curriculum.

How much is the cost of multiple sclerosis--systematic literature review.

PubMed

Kolasa, Katarzyna

2013-01-01

In Poland, a data on MS costs is lacking. The systematic review of cost of illness studies was conducted to estimate the average annual cost of MS patient and its breakdown. The PubMed database was searched for relevant literature. Following search criteria were used: "multiple sclerosis", "costs", "cost of illness" and "disease burden". Articles written in English including total costs published 2002-2012 were included. In total 17 studies were classified. The costs were re-calculated into USD Purchasing Power Parity (PPP). The available approach from the literature was used for the cost breakdown presentation. The average patient was 47 years old with EDSS equals 4 and 13 years from the date of diagnosis. The average annual cost was 41 133 US$ PPP. The direct costs did not exceed 70% of total costs in any study. The pharmaceutical expenses were one of the most important contributors to the direct costs. Only 40% of patients were active on the labor market what translated into the loss of productivity and consequently an increase in total costs. The preformed systematic review revealed that multiple sclerosis imposes a huge economic burden on the healthcare system and society. It happens due to productivity loss and caregiver burden.

Strategies used for the promotion of critical thinking in nursing undergraduate education: A systematic review.

PubMed

Carvalho, Diana P S R P; Azevedo, Isabelle C; Cruz, Giovanna K P; Mafra, Gabriela A C; Rego, Anna L C; Vitor, Allyne F; Santos, Viviane E P; Cogo, Ana L P; Ferreira Júnior, Marcos A

2017-10-01

Identifying the strategies used to promote critical thinking (CT) during undergraduate education in nursing courses. Systematic review. Five electronic databases were searched without language, publication time or geographic filters. A systematic review of the literature. Including experimental studies that considered at least one teaching strategy to promote critical thinking of undergraduate students in Nursing courses. The search for studies occurred in three phases: title and summary review, complete text and implementation of a clinical form of selection according to predetermined criteria. All included studies were assessed for quality through a classification tool for experimental studies. Six studies were selected. The results were grouped into three key themes: an evaluation of the quality of the selected studies, characterization of the studies and the strategies used to promote critical thinking. All selected studies were in English, with significant conceptual similarity of Critical Thinking and dominance in choosing the approached theme during strategies in clinical nursing education with an emphasis on the nursing process. The most widely used teaching intervention was Problem-Based Learning. Nursing education mediated by strategies that stimulate CT is considered a positive difference in undergraduate curriculums. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematic reviews.

PubMed

Anderson, L J; Taylor, R S

2014-12-15

Overviews are a new approach to summarising evidence and synthesising results from related systematic reviews. To conduct an overview of Cochrane systematic reviews to provide a contemporary review of the evidence for cardiac rehabilitation (CR), identify opportunities for merging or splitting existing Cochrane reviews, and identify current evidence gaps to inform new review titles. The Cochrane Database of Systematic Reviews was searched to identify reviews that address the objectives of this overview. Data presentation is descriptive with tabular presentations of review- and trial-level characteristics and results. The six included Cochrane systematic reviews were of high methodological quality and included 148 randomised controlled trials in 97,486 participants. Compared to usual care alone, exercise-based CR reduces hospital admissions and improves patient health related quality of life (HRQL) in low to moderate risk heart failure and coronary heart disease (CHD) patients. At 12 months or more follow-up, there was evidence of some reduction in mortality in patients with CHD. Psychological- and education-based interventions appear to have little impact on mortality or morbidity but may improve HRQL. Home- and centre-based programmes are equally effective in improving HRQL at similar costs. Selected interventions can increase the uptake of CR programmes but evidence to support interventions that improve adherence is weak. This overview confirms that exercise-based CR is effective and safe in the management of clinically stable heart failure and post-MI and PCI patients. We discuss the implications of this overview on the future direction of the Cochrane CR reviews portfolio. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Assessing Technical Competence in Surgical Trainees: A Systematic Review.

PubMed

Szasz, Peter; Louridas, Marisa; Harris, Kenneth A; Aggarwal, Rajesh; Grantcharov, Teodor P

2015-06-01

To systematically examine the literature describing the methods by which technical competence is assessed in surgical trainees. The last decade has witnessed an evolution away from time-based surgical education. In response, governing bodies worldwide have implemented competency-based education paradigms. The definition of competence, however, remains elusive, and the impact of these education initiatives in terms of assessment methods remains unclear. A systematic review examining the methods by which technical competence is assessed was conducted by searching MEDLINE, EMBASE, PsychINFO, and the Cochrane database of systematic reviews. Abstracts of retrieved studies were reviewed and those meeting inclusion criteria were selected for full review. Data were retrieved in a systematic manner, the validity and reliability of the assessment methods was evaluated, and quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation classification. Of the 6814 studies identified, 85 studies involving 2369 surgical residents were included in this review. The methods used to assess technical competence were categorized into 5 groups; Likert scales (37), benchmarks (31), binary outcomes (11), novel tools (4), and surrogate outcomes (2). Their validity and reliability were mostly previously established. The overall Grading of Recommendations Assessment, Development and Evaluation for randomized controlled trials was high and low for the observational studies. The definition of technical competence continues to be debated within the medical literature. The methods used to evaluate technical competence predominantly include instruments that were originally created to assess technical skill. Very few studies identify standard setting approaches that differentiate competent versus noncompetent performers; subsequently, this has been identified as an area with great research potential.

Using MEDLINE Elemental Similarity to Assist in the Article Screening Process for Systematic Reviews.

PubMed

Ji, Xiaonan; Yen, Po-Yin

2015-08-31

Systematic reviews and their implementation in practice provide high quality evidence for clinical practice but are both time and labor intensive due to the large number of articles. Automatic text classification has proven to be instrumental in identifying relevant articles for systematic reviews. Existing approaches use machine learning model training to generate classification algorithms for the article screening process but have limitations. We applied a network approach to assist in the article screening process for systematic reviews using predetermined article relationships (similarity). The article similarity metric is calculated using the MEDLINE elements title (TI), abstract (AB), medical subject heading (MH), author (AU), and publication type (PT). We used an article network to illustrate the concept of article relationships. Using the concept, each article can be modeled as a node in the network and the relationship between 2 articles is modeled as an edge connecting them. The purpose of our study was to use the article relationship to facilitate an interactive article recommendation process. We used 15 completed systematic reviews produced by the Drug Effectiveness Review Project and demonstrated the use of article networks to assist article recommendation. We evaluated the predictive performance of MEDLINE elements and compared our approach with existing machine learning model training approaches. The performance was measured by work saved over sampling at 95% recall (WSS95) and the F-measure (F1). We also used repeated analysis over variance and Hommel's multiple comparison adjustment to demonstrate statistical evidence. We found that although there is no significant difference across elements (except AU), TI and AB have better predictive capability in general. Collaborative elements bring performance improvement in both F1 and WSS95. With our approach, a simple combination of TI+AB+PT could achieve a WSS95 performance of 37%, which is competitive to traditional machine learning model training approaches (23%-41% WSS95). We demonstrated a new approach to assist in labor intensive systematic reviews. Predictive ability of different elements (both single and composited) was explored. Without using model training approaches, we established a generalizable method that can achieve a competitive performance.

Three approaches to investigating the multidimensional nature of a science assessment

NASA Astrophysics Data System (ADS)

Gokiert, Rebecca Jayne

The purpose of this study was to investigate a multi-method approach for collecting validity evidence about the underlying knowledge and skills measured by a large-scale science assessment. The three approaches included analysis of dimensionality, differential item functioning (DIF), and think-aloud interviews. The specific research questions addressed were: (1) Does the 4-factor model previously found by Hamilton et al. (1995) for the grade 8 sample explain the data? (2) Do the performances of male and female students systematically differ? Are these performance differences captured in the dimensions? (3) Can think-aloud reports aid in the generation of hypotheses about the underlying knowledge and skills that are measured by this test? A confirmatory factor analysis of the 4-factor model revealed good model data fit for both the AB and AC tests. Twenty-four of the 83 AB test items and 16 of the 77 AC test items displayed significant DIF, however, items were found, on average, to favour both males and females equally. There were some systematic differences found across the 4-factors; items favouring males tended to be related to earth and space sciences, stereotypical male related activities, and numerical operations. Conversely, females were found to outperform males on items that required careful reading and attention to detail. Concurrent and retrospective verbal reports (Ericsson & Simon, 1993) were collected from 16 grade 8 students (9 male and 7 female) while they solved 12 DIF items. Four general cognitive processing themes were identified from the student protocols that could be used to explain male and female problem solving. The themes included comprehension (verbal and visual), visualization, background knowledge/experience (school or life), and strategy use. There were systematic differences in cognitive processing between the students that answered the items correctly and the students who answered the items incorrectly; however, this did not always correspond with the statistical gender DIF results. Although the multifaceted approach produced interpretable and meaningful validity evidence about the knowledge and skills, these forms of validity evidence only begin to provide a basic understanding of the underlying construct(s) that are being measured.

Hemiarch versus total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis

PubMed Central

Poon, Shi Sum; Theologou, Thomas; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung

2016-01-01

Background Despite recent advances in aortic surgery, acute type A aortic dissection remains a surgical emergency associated with high mortality and morbidity. Appropriate management is crucial to achieve satisfactory outcomes but the optimal surgical approach is controversial. The present systematic review and meta-analysis sought to access cumulative data from comparative studies between hemiarch and total aortic arch replacement in patients with acute type A aortic dissection. Methods A systematic review of the literature using six databases. Eligible studies include comparative studies on hemiarch versus total arch replacement reporting short, medium and long term outcomes. A meta-analysis was performed on eligible studies reporting outcome of interest to quantify the effects of hemiarch replacement on mortality and morbidity risk compared to total arch replacement. Result Fourteen retrospective studies met the inclusion criteria and 2,221 patients were included in the final analysis. Pooled analysis showed that hemiarch replacement was associated with a lower risk of post-operative renal dialysis [risk ratio (RR) =0.72; 95% confidence interval (CI): 0.56–0.94; P=0.02; I2=0%]. There was no significant difference in terms of in-hospital mortality between the two groups (RR =0.84; 95% CI: 0.65–1.09; P=0.20; I2=0%). Cardiopulmonary bypass, aortic cross clamp and circulatory arrest times were significantly longer in total arch replacement. During follow up, no significant difference was reported from current studies between the two operative approaches in terms of aortic re-intervention and freedom from aortic reoperation. Conclusions Within the context of publication bias by high volume aortic centres and non-randomized data sets, there was no difference in mortality outcomes between the two groups. This analysis serves to demonstrate that for those centers doing sufficient total aortic arch activity to allow for publication, excellent and equivalent outcomes are achievable. Conclusions on differences in longer term outcome data are required. We do not, however, advocate total arch as a primary approach by all centers and surgeons irrespective of patient characteristics, but rather, a tailored approach based on surgeon and center experience and patient presentation. PMID:27386403

The effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence?

PubMed

Kollen, Boudewijn J; Lennon, Sheila; Lyons, Bernadette; Wheatley-Smith, Laura; Scheper, Mark; Buurke, Jaap H; Halfens, Jos; Geurts, Alexander C H; Kwakkel, Gert

2009-04-01

In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation, yet the superiority of the Bobath Concept as the optimal type of treatment has not been established. This systematic review of randomized, controlled trials aimed to evaluate the available evidence for the effectiveness of the Bobath Concept in stroke rehabilitation. Method- A systematic literature search was conducted in the bibliographic databases MEDLINE and CENTRAL (March 2008) and by screening the references of selected publications (including reviews). Studies in which the effects of the Bobath Concept were investigated were classified into the following domains: sensorimotor control of upper and lower limb; sitting and standing, balance control, and dexterity; mobility; activities of daily living; health-related quality of life; and cost-effectiveness. Due to methodological heterogeneity within the selected studies, statistical pooling was not considered. Two independent researchers rated all retrieved literature according to the Physiotherapy Evidence Database (PEDro) scale from which a best evidence synthesis was derived to determine the strength of the evidence for both effectiveness of the Bobath Concept and for its superiority over other approaches. The search strategy initially identified 2263 studies. After selection based on predetermined criteria, finally, 16 studies involving 813 patients with stroke were included for further analysis. There was no evidence of superiority of Bobath on sensorimotor control of upper and lower limb, dexterity, mobility, activities of daily living, health-related quality of life, and cost-effectiveness. Only limited evidence was found for balance control in favor of Bobath. Because of the limited evidence available, no best evidence synthesis was applied for the health-related quality-of-life domain and cost-effectiveness. This systematic review confirms that overall the Bobath Concept is not superior to other approaches. Based on best evidence synthesis, no evidence is available for the superiority of any approach. This review has highlighted many methodological shortcomings in the studies reviewed; further high-quality trials need to be published. Evidence-based guidelines rather than therapist preference should serve as a framework from which therapists should derive the most effective treatment.

Measurement of locus copy number by hybridisation with amplifiable probes

PubMed Central

Armour, John A. L.; Sismani, Carolina; Patsalis, Philippos C.; Cross, Gareth

2000-01-01

Despite its fundamental importance in genome analysis, it is only recently that systematic approaches have been developed to assess copy number at specific genetic loci, or to examine genomic DNA for submicroscopic deletions of unknown location. In this report we show that short probes can be recovered and amplified quantitatively following hybridisation to genomic DNA. This simple observation forms the basis of a new approach to determining locus copy number in complex genomes. The power and specificity of multiplex amplifiable probe hybridisation is demonstrated by the simultaneous assessment of copy number at a set of 40 human loci, including detection of deletions causing Duchenne muscular dystrophy and Prader–Willi/Angelman syndromes. Assembly of other probe sets will allow novel, technically simple approaches to a wide variety of genetic analyses, including the potential for extension to high resolution genome-wide screens for deletions and amplifications. PMID:10606661

Measurement of locus copy number by hybridisation with amplifiable probes.

PubMed

Armour, J A; Sismani, C; Patsalis, P C; Cross, G

2000-01-15

Despite its fundamental importance in genome analysis, it is only recently that systematic approaches have been developed to assess copy number at specific genetic loci, or to examine genomic DNA for submicro-scopic deletions of unknown location. In this report we show that short probes can be recovered and amplified quantitatively following hybridisation to genomic DNA. This simple observation forms the basis of a new approach to determining locus copy number in complex genomes. The power and specificity of multiplex amplifiable probe hybridisation is demonstrated by the simultaneous assessment of copy number at a set of 40 human loci, including detection of deletions causing Duchenne muscular dystrophy and Prader-Willi/Angelman syndromes. Assembly of other probe sets will allow novel, technically simple approaches to a wide variety of genetic analyses, including the potential for extension to high resolution genome-wide screens for deletions and amplifications.

PCR-based Approaches for the Detection of Clinical Methicillin-resistant Staphylococcus aureus

PubMed Central

Liu, Ying; Zhang, Jiang; Ji, Yinduo

2016-01-01

Staphylococcus aureus is an important pathogen that can cause a variety of infections, including superficial and systematic infections, in humans and animals. The persistent emergence of multidrug resistant S. aureus, particularly methicillin-resistant S. aureus, has caused dramatically economic burden and concerns in the public health due to limited options of treatment of MRSA infections. In order to make a correct choice of treatment for physicians and understand the prevalence of MRSA, it is extremely critical to precisely and timely diagnose the pathogen that induces a specific infection of patients and to reveal the antibiotic resistant profile of the pathogen. In this review, we outlined different PCR-based approaches that have been successfully utilized for the rapid detection of S. aureus, including MRSA and MSSA, directly from various clinical specimens. The sensitivity and specificity of detections were pointed out. Both advantages and disadvantages of listed approaches were discussed. Importantly, an alternative approach is necessary to further confirm the detection results from the molecular diagnostic assays. PMID:27335617

User involvement in adolescents' mental healthcare: protocol for a systematic review.

PubMed

Viksveen, Petter; Bjønness, Stig Erlend; Berg, Siv Hilde; Cardenas, Nicole Elizabeth; Game, Julia Rose; Aase, Karina; Storm, Marianne

2017-12-21

User involvement has become a growing importance in healthcare. The United Nations state that adolescents have a right to be heard, and user involvement in healthcare is a legal right in many countries. Some research provides an insight into the field of user involvement in somatic and mental healthcare for adults, but little is known about user involvement in adolescents' mental healthcare, and no overview of the existing research evidence exists. The aim of this systematic review is to provide an overview of existing research reporting on experiences with and the effectiveness and safety issues associated with user involvement for adolescents' mental healthcare at the individual and organisational level. A systematic literature search and assessment of published research in the field of user involvement in adolescents' mental healthcare will be carried out. Established guidelines will be used for data extraction (Cochrane Collaboration guidelines, Strengthening the Reporting of Observational studies in Epidemiology and Critical Appraisal Skills Programme (CASP)), critical appraisal (Cochrane Collaboration guidelines and Pragmatic-Explanatory Continuum Indicator Summary) and reporting of results (Preferred Reporting Items for Systematic reviews and Meta-Analyses, Consolidated Standards of Reporting Trials and CASP). Confidence in the research evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Adolescents are included as coresearchers for the planning and carrying out of this systematic review. This systematic review will provide an overview of the existing research literature and thereby fill a knowledge gap. It may provide various stakeholders, including decision-makers, professionals, individuals and their families, with an overview of existing knowledge in an underexplored field of research. Ethics approval is not required for this systematic review as we are not collecting primary data. The results will be published in a peer-reviewed journal and at conference presentations and will be shared with stakeholder groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Robotic-assisted laparoscopic repair of ureteral injury: an evidence-based review of techniques and outcomes.

PubMed

Tracey, Andrew T; Eun, Daniel D; Stifelman, Michael D; Hemal, Ashok K; Stein, Robert J; Mottrie, Alexandre; Cadeddu, Jeffrey A; Stolzenburg, J Uwe; Berger, Andre K; Buffi, Niccolò; Zhao, Lee C; Lee, Ziho; Hampton, Lance; Porpiglia, Francesco; Autorino, Riccardo

2018-06-01

Iatrogenic ureteral injuries represent a common surgical problem encountered by practicing urologists. With the rapidly expanding applications of robotic-assisted laparoscopic surgery, ureteral reconstruction has been an important field of recent advancement. This collaborative review sought to provide an evidence-based analysis of the latest surgical techniques and outcomes for robotic-assisted repair of ureteral injury. A systematic review of the literature up to December 2017 using PubMed/Medline was performed to identify relevant articles. Those studies included in the systematic review were selected according to Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria. Additionally, expert opinions were included from study authors in order to critique outcomes and elaborate on surgical techniques. A cumulative outcome analysis was conducted analyzing comparative studies on robotic versus open ureteral repair. Thirteen case series have demonstrated the feasibility, safety, and success of robotic ureteral reconstruction. The surgical planning, timing of intervention, and various robotic reconstructive techniques need to be tailored to the specific case, depending on the location and length of the injury. Fluorescence imaging can represent a useful tool in this setting. Recently, three studies have shown the feasibility and technical success of robotic buccal mucosa grafting for ureteral repair. Soon, additional novel and experimental robotic reconstructive approaches might become available. The cumulative analysis of the three available comparative studies on robotic versus open ureteral repair showed no difference in operative time or complication rate, with a decreased blood loss and hospital length of stay favoring the robotic approach. Current evidence suggests that the robotic surgical platform facilitates complex ureteral reconstruction in a minimally invasive fashion. High success rates of ureteral repair using the robotic approach mirror those of open surgery, with the additional advantage of faster recovery. Novel techniques in development and surgical adjuncts show promise as the role of robotic surgery evolves.

A mixed-methods approach to systematic reviews.

PubMed

Pearson, Alan; White, Heath; Bath-Hextall, Fiona; Salmond, Susan; Apostolo, Joao; Kirkpatrick, Pamela

2015-09-01

There are an increasing number of published single-method systematic reviews that focus on different types of evidence related to a particular topic. As policy makers and practitioners seek clear directions for decision-making from systematic reviews, it is likely that it will be increasingly difficult for them to identify 'what to do' if they are required to find and understand a plethora of syntheses related to a particular topic.Mixed-methods systematic reviews are designed to address this issue and have the potential to produce systematic reviews of direct relevance to policy makers and practitioners.On the basis of the recommendations of the Joanna Briggs Institute International Mixed Methods Reviews Methodology Group in 2012, the Institute adopted a segregated approach to mixed-methods synthesis as described by Sandelowski et al., which consists of separate syntheses of each component method of the review. Joanna Briggs Institute's mixed-methods synthesis of the findings of the separate syntheses uses a Bayesian approach to translate the findings of the initial quantitative synthesis into qualitative themes and pooling these with the findings of the initial qualitative synthesis.

Calculation of the detection limit in radiation measurements with systematic uncertainties

NASA Astrophysics Data System (ADS)

Kirkpatrick, J. M.; Russ, W.; Venkataraman, R.; Young, B. M.

2015-06-01

The detection limit (LD) or Minimum Detectable Activity (MDA) is an a priori evaluation of assay sensitivity intended to quantify the suitability of an instrument or measurement arrangement for the needs of a given application. Traditional approaches as pioneered by Currie rely on Gaussian approximations to yield simple, closed-form solutions, and neglect the effects of systematic uncertainties in the instrument calibration. These approximations are applicable over a wide range of applications, but are of limited use in low-count applications, when high confidence values are required, or when systematic uncertainties are significant. One proposed modification to the Currie formulation attempts account for systematic uncertainties within a Gaussian framework. We have previously shown that this approach results in an approximation formula that works best only for small values of the relative systematic uncertainty, for which the modification of Currie's method is the least necessary, and that it significantly overestimates the detection limit or gives infinite or otherwise non-physical results for larger systematic uncertainties where such a correction would be the most useful. We have developed an alternative approach for calculating detection limits based on realistic statistical modeling of the counting distributions which accurately represents statistical and systematic uncertainties. Instead of a closed form solution, numerical and iterative methods are used to evaluate the result. Accurate detection limits can be obtained by this method for the general case.

Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis.

PubMed

Elshaer, Mohamed; Gravante, Gianpiero; Thomas, Katie; Sorge, Roberto; Al-Hamali, Salem; Ebdewi, Hamdi

2015-02-01

Subtotal cholecystectomy (SC) is a procedure that removes portions of the gallbladder when structures of the Calot triangle cannot be safely identified in "difficult gallbladders." To conduct a systematic review and meta-analysis to evaluate current studies and present an evidence-based assessment of the outcomes for the techniques available for SC. A literature search of the PubMed/MEDLINE (1954 to November 2013) and EMBASE (1974 to November 2013) databases was conducted. Search criteria included the words subtotal, partial, insufficient or incomplete, and cholecystectomy. Inclusion criteria were all randomized, nonrandomized, and retrospective studies with data on SC techniques and outcomes. Exclusion criteria were studies that reported data on SC along with other interventions (eg, cholecystostomy) without the possibility to discriminate results specific to SC. This systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The primary outcome of the study was the occurrence of common bild duct injury. Secondary outcomes included the occurrence of other SC-related morbidities, such as hemorrhage, subhepatic collection, bile leak, retained stones, postoperative endoscopic retrograde cholangiopancreatography, wound infection, reoperation, and mortality. Thirty articles were included. Subtotal cholecystectomy was typically performed using the laparoscopic technique (72.9%), followed by the open (19.0%) and laparoscopic converted to open (8.0%) techniques. The most common indications were severe cholecystitis (72.1%), followed by cholelithiasis in liver cirrhosis and portal hypertension (18.2%) and empyema or perforated gallbladder (6.1%). Morbidity rates were relatively low (postoperative hemorrhage, 0.3%; subhepatic collections, 2.9%; bile duct injury, 0.08%; and retained stones, 3.1%); the rate for bile leaks was higher (18.0%). Reoperations were necessary in 1.8% of the cases; the 30-day mortality rate was 0.4%. The laparoscopic approach produced less risk of subhepatic collection (odds ratio [OR], 0.4; 95% CI, 0.2-0.9), retained stones (OR, 0.5; 95% CI, 0.3-0.9), wound infection (OR, 0.07; 95% CI, 0.04-0.2), reoperation (OR, 0.5; 95% CI, 0.3-0.9), and mortality (OR, 0.2; 95% CI, 0.05-0.9) but more bile leaks (OR, 5.3; 95% CI, 3.9-7.2) compared with the open approach. Subtotal cholecystectomy is an important tool for use in difficult gallbladders and achieves morbidity rates comparable to those reported for total cholecystectomy in simple cases. The various technical differences appear to influence outcomes only for the laparoscopic approach.

A strategic approach for Water Safety Plans implementation in Portugal.

PubMed

Vieira, Jose M P

2011-03-01

Effective risk assessment and risk management approaches in public drinking water systems can benefit from a systematic process for hazards identification and effective management control based on the Water Safety Plan (WSP) concept. Good results from WSP development and implementation in a small number of Portuguese water utilities have shown that a more ambitious nationwide strategic approach to disseminate this methodology is needed. However, the establishment of strategic frameworks for systematic and organic scaling-up of WSP implementation at a national level requires major constraints to be overcome: lack of legislation and policies and the need for appropriate monitoring tools. This study presents a framework to inform future policy making by understanding the key constraints and needs related to institutional, organizational and research issues for WSP development and implementation in Portugal. This methodological contribution for WSP implementation can be replicated at a global scale. National health authorities and the Regulator may promote changes in legislation and policies. Independent global monitoring and benchmarking are adequate tools for measuring the progress over time and for comparing the performance of water utilities. Water utilities self-assessment must include performance improvement, operational monitoring and verification. Research and education and resources dissemination ensure knowledge acquisition and transfer.

Network meta-analysis in health psychology and behavioural medicine: a primer.

PubMed

Molloy, G J; Noone, C; Caldwell, D; Welton, N J; Newell, J

2018-04-05

Progress in the science and practice of health psychology depends on the systematic synthesis of quantitative psychological evidence. Meta-analyses of experimental studies have led to important advances in understanding health-related behaviour change interventions. Fundamental questions regarding such interventions have been systematically investigated through synthesising relevant experimental evidence using standard pairwise meta-analytic procedures that provide reliable estimates of the magnitude, homogeneity and potential biases in effects observed. However, these syntheses only provide information about whether particular types of interventions work better than a control condition or specific alternative approaches. To increase the impact of health psychology on health-related policy-making, evidence regarding the comparative efficacy of all relevant intervention approaches - which may include biomedical approaches - is necessary. With the development of network meta-analysis (NMA), such evidence can be synthesised, even when direct head-to-head trials do not exist. However, care must be taken in its application to ensure reliable estimates of the effect sizes between interventions are revealed. This review paper describes the potential importance of NMA to health psychology, how the technique works and important considerations for its appropriate application within health psychology.

Kangfuxinye Enema Combined with Mesalamine for Ulcerative Colitis: A Systematic Review and GRADE Approach

PubMed Central

Ren, Peng-wei; Yang, Wen-jie; Shan, Jing-yan; Hong, Qi; Wen, Shu

2017-01-01

Objectives To critically appraise the efficacy and safety of Kangfuxinye enema combined with mesalamine for the ulcerative colitis (UC) patients and in addition to grade the quality of evidence by using the GRADE (grading of recommendations, assessment, development, and evaluation) approach. Methods A literature search was performed in the Cochrane Library, MEDLINE, EMBASE, CBM, CNKI, VIP, and WanFang Databases. The search restrictions were patients with UC and RCTs. Studies including other treatments except Kangfuxinye with mesalamine were excluded. Results Nineteen studies met the inclusion criteria. We found significant benefits of Kangfuxinye combined with mesalamine against mesalamine alone in improving response rate as well as reducing the recurrence rate and inflammation rate; meanwhile, the increase of the adverse events rate was not observed. Furthermore, the symptoms remission rate and the cure time were insignificant statistically. Additionally, GRADE results indicated that the quality of evidence regarding the above 6 outcomes was rated from very low to moderate quality. Conclusions Although Kangfuxinye enema seems effective and safe for treating UC patients in this systematic review, Kangfuxinye enema combined with mesalamine was weakly recommended due to very low to moderate quality of available evidence by the GRADE approach. PMID:28848616

Next-generation systematics: An innovative approach to resolve the structure of complex prokaryotic taxa

NASA Astrophysics Data System (ADS)

Sangal, Vartul; Goodfellow, Michael; Jones, Amanda L.; Schwalbe, Edward C.; Blom, Jochen; Hoskisson, Paul A.; Sutcliffe, Iain C.

2016-12-01

Prokaryotic systematics provides the fundamental framework for microbiological research but remains a discipline that relies on a labour- and time-intensive polyphasic taxonomic approach, including DNA-DNA hybridization, variation in 16S rRNA gene sequence and phenotypic characteristics. These techniques suffer from poor resolution in distinguishing between closely related species and often result in misclassification and misidentification of strains. Moreover, guidelines are unclear for the delineation of bacterial genera. Here, we have applied an innovative phylogenetic and taxogenomic approach to a heterogeneous actinobacterial taxon, Rhodococcus, to identify boundaries for intrageneric and supraspecific classification. Seven species-groups were identified within the genus Rhodococcus that are as distantly related to one another as they are to representatives of other mycolic acid containing actinobacteria and can thus be equated with the rank of genus. It was also evident that strains assigned to rhodococcal species-groups are underspeciated with many misclassified using conventional taxonomic criteria. The phylogenetic and taxogenomic methods used in this study provide data of theoretical value for the circumscription of generic and species boundaries and are also of practical significance as they provide a robust basis for the classification and identification of rhodococci of agricultural, industrial and medical/veterinary significance.

Cross Deployment Networking and Systematic Performance Analysis of Underwater Wireless Sensor Networks.

PubMed

Wei, Zhengxian; Song, Min; Yin, Guisheng; Wang, Hongbin; Ma, Xuefei; Song, Houbing

2017-07-12

Underwater wireless sensor networks (UWSNs) have become a new hot research area. However, due to the work dynamics and harsh ocean environment, how to obtain an UWSN with the best systematic performance while deploying as few sensor nodes as possible and setting up self-adaptive networking is an urgent problem that needs to be solved. Consequently, sensor deployment, networking, and performance calculation of UWSNs are challenging issues, hence the study in this paper centers on this topic and three relevant methods and models are put forward. Firstly, the normal body-centered cubic lattice to cross body-centered cubic lattice (CBCL) has been improved, and a deployment process and topology generation method are built. Then most importantly, a cross deployment networking method (CDNM) for UWSNs suitable for the underwater environment is proposed. Furthermore, a systematic quar-performance calculation model (SQPCM) is proposed from an integrated perspective, in which the systematic performance of a UWSN includes coverage, connectivity, durability and rapid-reactivity. Besides, measurement models are established based on the relationship between systematic performance and influencing parameters. Finally, the influencing parameters are divided into three types, namely, constraint parameters, device performance and networking parameters. Based on these, a networking parameters adjustment method (NPAM) for optimized systematic performance of UWSNs has been presented. The simulation results demonstrate that the approach proposed in this paper is feasible and efficient in networking and performance calculation of UWSNs.

Cross Deployment Networking and Systematic Performance Analysis of Underwater Wireless Sensor Networks

PubMed Central

Wei, Zhengxian; Song, Min; Yin, Guisheng; Wang, Hongbin; Ma, Xuefei

2017-01-01

Underwater wireless sensor networks (UWSNs) have become a new hot research area. However, due to the work dynamics and harsh ocean environment, how to obtain an UWSN with the best systematic performance while deploying as few sensor nodes as possible and setting up self-adaptive networking is an urgent problem that needs to be solved. Consequently, sensor deployment, networking, and performance calculation of UWSNs are challenging issues, hence the study in this paper centers on this topic and three relevant methods and models are put forward. Firstly, the normal body-centered cubic lattice to cross body-centered cubic lattice (CBCL) has been improved, and a deployment process and topology generation method are built. Then most importantly, a cross deployment networking method (CDNM) for UWSNs suitable for the underwater environment is proposed. Furthermore, a systematic quar-performance calculation model (SQPCM) is proposed from an integrated perspective, in which the systematic performance of a UWSN includes coverage, connectivity, durability and rapid-reactivity. Besides, measurement models are established based on the relationship between systematic performance and influencing parameters. Finally, the influencing parameters are divided into three types, namely, constraint parameters, device performance and networking parameters. Based on these, a networking parameters adjustment method (NPAM) for optimized systematic performance of UWSNs has been presented. The simulation results demonstrate that the approach proposed in this paper is feasible and efficient in networking and performance calculation of UWSNs. PMID:28704959

Citation of previous meta-analyses on the same topic: a clue to perpetuation of incorrect methods?

PubMed

Li, Tianjing; Dickersin, Kay

2013-06-01

Systematic reviews and meta-analyses serve as a basis for decision-making and clinical practice guidelines and should be carried out using appropriate methodology to avoid incorrect inferences. We describe the characteristics, statistical methods used for meta-analyses, and citation patterns of all 21 glaucoma systematic reviews we identified pertaining to the effectiveness of prostaglandin analog eye drops in treating primary open-angle glaucoma, published between December 2000 and February 2012. We abstracted data, assessed whether appropriate statistical methods were applied in meta-analyses, and examined citation patterns of included reviews. We identified two forms of problematic statistical analyses in 9 of the 21 systematic reviews examined. Except in 1 case, none of the 9 reviews that used incorrect statistical methods cited a previously published review that used appropriate methods. Reviews that used incorrect methods were cited 2.6 times more often than reviews that used appropriate statistical methods. We speculate that by emulating the statistical methodology of previous systematic reviews, systematic review authors may have perpetuated incorrect approaches to meta-analysis. The use of incorrect statistical methods, perhaps through emulating methods described in previous research, calls conclusions of systematic reviews into question and may lead to inappropriate patient care. We urge systematic review authors and journal editors to seek the advice of experienced statisticians before undertaking or accepting for publication a systematic review and meta-analysis. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Project Management, Critical Praxis, and Process-Oriented Approach to Teamwork

ERIC Educational Resources Information Center

Ding, Huiling; Ding, Xin

2008-01-01

To help alleviate issues of free-riding and conflicts in team projects, this study proposes the systematic incorporation of project management methods to introduce a process-oriented approach to and a critical praxis in team projects. We examined how the systematic use of project management methods influenced students' performance in team…

The Effect of Cooperative Learning Method and Systematic Teaching on Students' Achievement and Retention of Knowledge in Social Studies Lesson

ERIC Educational Resources Information Center

Korkmaz Toklucu, Selma; Tay, Bayram

2016-01-01

Problem Statement: Many effective instructional strategies, methods, and techniques, which were developed in accordance with constructivist approach, can be used together in social studies lessons. Constructivist education comprises active learning processes. Two active learning approaches are cooperative learning and systematic teaching. Purpose…

Using a Systematic Approach to Develop a Chemistry Course Introducing Students to Instrumental Analysis

ERIC Educational Resources Information Center

Shen, Hao-Yu; Shen, Bo; Hardacre, Christopher

2013-01-01

A systematic approach to develop the teaching of instrumental analytical chemistry is discussed, as well as a conceptual framework for organizing and executing lectures and a laboratory course. Three main components are used in this course: theoretical knowledge developed in the classroom, simulations via a virtual laboratory, and practical…

SU-E-J-87: Building Deformation Error Histogram and Quality Assurance of Deformable Image Registration.

PubMed

Park, S B; Kim, H; Yao, M; Ellis, R; Machtay, M; Sohn, J W

2012-06-01

To quantify the systematic error of a Deformable Image Registration (DIR) system and establish Quality Assurance (QA) procedure. To address the shortfall of landmark approach which it is only available at the significant visible feature points, we adapted a Deformation Vector Map (DVM) comparison approach. We used two CT image sets (R and T image sets) taken for the same patient at different time and generated a DVM, which includes the DIR systematic error. The DVM was calculated using fine-tuned B-Spline DIR and L-BFGS optimizer. By utilizing this DVM we generated R' image set to eliminate the systematic error in DVM,. Thus, we have truth data set, R' and T image sets, and the truth DVM. To test a DIR system, we use R' and T image sets to a DIR system. We compare the test DVM to the truth DVM. If there is no systematic error, they should be identical. We built Deformation Error Histogram (DEH) for quantitative analysis. The test registration was performed with an in-house B-Spline DIR system using a stochastic gradient descent optimizer. Our example data set was generated with a head and neck patient case. We also tested CT to CBCT deformable registration. We found skin regions which interface with the air has relatively larger errors. Also mobile joints such as shoulders had larger errors. Average error for ROIs were as follows; CTV: 0.4mm, Brain stem: 1.4mm, Shoulders: 1.6mm, and Normal tissues: 0.7mm. We succeeded to build DEH approach to quantify the DVM uncertainty. Our data sets are available for testing other systems in our web page. Utilizing DEH, users can decide how much systematic error they would accept. DEH and our data can be a tool for an AAPM task group to compose a DIR system QA guideline. This project is partially supported by the Agency for Healthcare Research and Quality (AHRQ) grant 1R18HS017424-01A2. © 2012 American Association of Physicists in Medicine.

Systematic mechanism-orientated approach to chronic pancreatitis pain.

PubMed

Bouwense, Stefan A W; de Vries, Marjan; Schreuder, Luuk T W; Olesen, Søren S; Frøkjær, Jens B; Drewes, Asbjørn M; van Goor, Harry; Wilder-Smith, Oliver H G

2015-01-07

Pain in chronic pancreatitis (CP) shows similarities with other visceral pain syndromes (i.e., inflammatory bowel disease and esophagitis), which should thus be managed in a similar fashion. Typical causes of CP pain include increased intrapancreatic pressure, pancreatic inflammation and pancreatic/extrapancreatic complications. Unfortunately, CP pain continues to be a major clinical challenge. It is recognized that ongoing pain may induce altered central pain processing, e.g., central sensitization or pro-nociceptive pain modulation. When this is present conventional pain treatment targeting the nociceptive focus, e.g., opioid analgesia or surgical/endoscopic intervention, often fails even if technically successful. If central nervous system pain processing is altered, specific treatment targeting these changes should be instituted (e.g., gabapentinoids, ketamine or tricyclic antidepressants). Suitable tools are now available to make altered central processing visible, including quantitative sensory testing, electroencephalograpy and (functional) magnetic resonance imaging. These techniques are potentially clinically useful diagnostic tools to analyze central pain processing and thus define optimum management approaches for pain in CP and other visceral pain syndromes. The present review proposes a systematic mechanism-orientated approach to pain management in CP based on a holistic view of the mechanisms involved. Future research should address the circumstances under which central nervous system pain processing changes in CP, and how this is influenced by ongoing nociceptive input and therapies. Thus we hope to predict which patients are at risk for developing chronic pain or not responding to therapy, leading to improved treatment of chronic pain in CP and other visceral pain disorders.

Posing the research question: not so simple.

PubMed

Thabane, Lehana; Thomas, Tara; Ye, Chenglin; Paul, James

2009-01-01

The success of any research process relies, in part, on how well investigators are able to translate a clinical problem into a research question-a task that is not so simple for novice investigators. The PICOT approach requires that the framing of the research question specify the target Population, the Intervention of interest, the Comparator intervention, key Outcomes, and the Time frame over which the outcomes are assessed. This paper describes the use of the PICOT structure in framing research questions and examines PICOT criteria as applied to the anesthesia literature. We also provide a roadmap for applying the PICOT format in identifying and framing clear research questions. In addition to searching MEDLINE for the literature on framing research questions, we performed a systematic review of articles published in four key anesthesia journals in 2006, including Anesthesiology, Anesthesia & Analgesia, the British Journal of Anaesthesia, and the Canadian Journal of Anesthesia. Three hundred thirteen articles (n = 313) were included in this review, with the following distribution by study design: 139 (44%) randomized controlled trials, 129 (41%) cohort studies, and 45 (15%) case-controlled, cross-sectional studies or systematic reviews. Overall, 96% (95% confidence interval: 91,100) of articles did not apply the PICOT approach in reporting the research question. The PICOT approach may be helpful in defining and clearly stating the research question. It remains to be determined whether or not compliance with the PICOT style, or any other format for framing research questions, is associated with a higher quality of research reporting.

Ensuring Quality in AFRINEST and SATT

PubMed Central

2013-01-01

Background: Three randomized open-label clinical trials [Simplified Antibiotic Therapy Trial (SATT) Bangladesh, SATT Pakistan and African Neonatal Sepsis Trial (AFRINEST)] were developed to test the equivalence of simplified antibiotic regimens compared with the standard regimen of 7 days of parenteral antibiotics. These trials were originally conceived and designed separately; subsequently, significant efforts were made to develop and implement a common protocol and approach. Previous articles in this supplement briefly describe the specific quality control methods used in the individual trials; this article presents additional information about the systematic approaches used to minimize threats to validity and ensure quality across the trials. Methods: A critical component of quality control for AFRINEST and SATT was striving to eliminate variation in clinical assessments and decisions regarding eligibility, enrollment and treatment outcomes. Ensuring appropriate and consistent clinical judgment was accomplished through standardized approaches applied across the trials, including training, assessment of clinical skills and refresher training. Standardized monitoring procedures were also applied across the trials, including routine (day-to-day) internal monitoring of performance and adherence to protocols, systematic external monitoring by funding agencies and external monitoring by experienced, independent trial monitors. A group of independent experts (Technical Steering Committee/Technical Advisory Group) provided regular monitoring and technical oversight for the trials. Conclusions: Harmonization of AFRINEST and SATT have helped to ensure consistency and quality of implementation, both internally and across the trials as a whole, thereby minimizing potential threats to the validity of the trials’ results. PMID:23945575

Comparison between the retropubic and transobturator approaches in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications

PubMed Central

Sun, Xincheng; Yang, Qingsong; Sun, Feng; Shi, Qinglu

2015-01-01

Objective This study aimed to compare the effectiveness and complications between the retropubic and transobturator approaches for the treatment of female stress urinary incontinence (SUI) by conducting a systematic review. Materials and Methods We selected all randomized controlled trials (RCTs) that compared retropubic and transobturator sling placements for treatment of SUI. We estimated pooled odds ratios and 95% confidence intervals for intraoperative and postoperative outcomes and complications. Results Six hundred twelve studies that compared retropubic and transobturator approaches to midurethral sling placement were identified, of which 16 were included in our research. Our study was based on results from 2646 women. We performed a subgroup analysis to compare outcomes and complications between the two approaches. The evidence to support the superior approach that leads to better objective/subjective cure rate was insufficient. The transobturator approach was associated with lower risks of bladder perforation (odds ratio (OR) 0.17, 95% confidence interval (CI) 0.09-0.32), retropubic/vaginal hematoma (OR 0.32, 95% CI 0.16-0.63), and long-term voiding dysfunction (OR 0.32, 95% CI 0.17-0.61). However, the risk of thigh/groin pain seemed higher in the transobturator group (OR 2.53, 95% CI 1.72-3.72). We found no statistically significant differences in the risks of other complications between the two approaches. Conclusions This meta-analysis shows analogical objective and subjective cure rates between the retropubic and transobturator approaches to midurethral sling placement. The transobturator approach was associated with lower risks of several complications. However, good-quality studies with long-term follow-ups are warranted for further research. PMID:26005962

Prevalence of suicidal ideation, attempts, and completed suicide rate in Chinese aging populations: a systematic review.

PubMed

Simon, Melissa; Chang, E-Shien; Zeng, Ping; Dong, XinQi

2013-01-01

As one of the leading causes of death around the world, suicide is a global public health threat. Due to the paucity of systematic studies, there exist vast variations in suicide ideation, attempts and suicide rates between various regions of Chinese aging communities. Our systematic study aims to (1) identify studies describing the epidemiology of suicidal ideation, suicide attempts and behaviors among global Chinese communities; (2) conduct systematic review of suicide prevalence; (3) provide cross-cultural insights on this public health issue in the diverse Chinese elderly in China, Hong Kong, Taiwan, Asian societies and Western countries. Using the PRISMA statement, we performed systematic review including studies describing suicidal ideation, attempts, and behavior among Chinese older adults in different communities. Literature searches were conducted by using both medical and social science data bases in English and Chinese. Forty-nine studies met inclusion criteria. Whereas suicide in Chinese aging population is a multifaceted issue, culturally appropriate and inter-disciplinary approach to improve the quality of life for the Chinese older adults is critical. Future research is needed to explore the risk and protective factors associated with suicidal thoughts, attempts and behaviors in representative Chinese aging populations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Specific immunotherapy in ovarian cancer: a systematic review.

PubMed

Alipour, Soroush; Zoghi, Samaneh; Khalili, Nastaran; Hirbod-Mobarakeh, Armin; Emens, Leisha A; Rezaei, Nima

2016-10-01

Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Several approaches of active and passive immunotherapy for EOC have been studied. The aim of this systematic review was to assess the clinical efficacy of specific immunotherapy in patients with EOC. We found 4524 references in seven databases and we included ten controlled clinical trials with 2285 patients with EOC reporting five active immunotherapeutic agents and three passive immunotherapies. Meta-analysis of six studies showed that overall there was not any significant difference in overall survival and recurrence-free survival between patients undergoing specific immunotherapy and those in control group. Most of the studies we evaluated reported a positive outcome from treatment with specific immunotherapy, although this was not significant.

Autism and Equine-Assisted Interventions: A Systematic Mapping Review.

PubMed

McDaniel Peters, B Caitlin; Wood, Wendy

2017-10-01

This systematic mapping review mapped current knowledge of equine-assisted interventions for people with autism to help guide future practice and research. Thirty-three studies including children and adolescents with autism, 3 of which confirmed diagnoses, were reviewed. Five types of equine-assisted activities were identified across 25 studies, with reported improvements in behavior, social interaction, and communication. Four types of equine-assisted therapies were identified across 8 studies, with reported improvements in motor control and self-care. Different approaches to therapeutic riding and hippotherapy, the most studied interventions, were evident. While this literature reflected early scientific development, it offered broad proof of concept that equine-assisted interventions can benefit children and adolescents with autism. Promising outcomes support continued investigation focused on standardization, appropriateness, and efficacy.

Kinetoplastid phylogenetics, with special reference to the evolution of parasitic trypanosomes.

PubMed

Stevens, J R

2008-09-01

To fully understand the evolutionary history of parasitic kinetoplastids and to understand the context within which the evolution of each parasite group has developed, an understanding not just of the parasites, but of all kinetoplastids is required. Accordingly, this paper provides an overview of kinetoplastid evolution and systematics, including coverage of the proposal by Moreira et al. (2004) to divide kinetoplasts into Prokinetoplastina (Ichthyobodo and Perkinsiella) and Metakinetoplastina (other bodonids and trypanosomatids). The implications of such a revision, with regard to correctly identifying outgroup taxa for studies of evolution within taxa of medical importance, are addressed, together with a more detailed review of the evolution and origins of the trypanosomes in the light of new phylogenies, new approaches and revisions in kinetoplastid systematics.

Approaches to capturing the financial cost of family care-giving within a palliative care context: a systematic review.

PubMed

Gardiner, Clare; Brereton, Louise; Frey, Rosemary; Wilkinson-Meyers, Laura; Gott, Merryn

2016-09-01

The economic burden faced by family caregivers of people at the end of life is well recognised. Financial burden has a significant impact on the provision of family care-giving in the community setting, but has seen limited research attention. A systematic review with realist review synthesis and thematic analysis was undertaken to identify literature relating to the financial costs and impact of family care-giving at the end of life. This paper reports findings relating to previously developed approaches which capture the financial costs and implications of caring for family members receiving palliative/end-of-life care. Seven electronic databases were searched from inception to April 2012, for original research studies relating to the financial impact of care-giving at the end of life. Studies were independently screened to identify those which met the study inclusion criteria, and the methodological quality of included studies was appraised using realist review criteria of relevance and rigour. A descriptive thematic approach was used to synthesise data. Twelve articles met the inclusion criteria for the review. Various approaches to capturing data on the financial costs of care-giving at the end of life were noted; however, no single tool was identified with the sole purpose of exploring these costs. The majority of approaches used structured questionnaires and were administered by personal interview, with most studies using longitudinal designs. Calculation of costs was most often based on recall by patients and family caregivers, in some studies combined with objective measures of resource use. While the studies in this review provide useful data on approaches to capturing costs of care-giving, more work is needed to develop methods which accurately and sensitively capture the financial costs of caring at the end of life. Methodological considerations include study design and method of administration, contextual and cultural relevance, and accuracy of cost estimates. © 2015 John Wiley & Sons Ltd.

Procedural instruction in invasive bedside procedures: a systematic review and meta-analysis of effective teaching approaches.

PubMed

Huang, Grace C; McSparron, Jakob I; Balk, Ethan M; Richards, Jeremy B; Smith, C Christopher; Whelan, Julia S; Newman, Lori R; Smetana, Gerald W

2016-04-01

Optimal approaches to teaching bedside procedures are unknown. To identify effective instructional approaches in procedural training. We searched PubMed, EMBASE, Web of Science and Cochrane Library through December 2014. We included research articles that addressed procedural training among physicians or physician trainees for 12 bedside procedures. Two independent reviewers screened 9312 citations and identified 344 articles for full-text review. Two independent reviewers extracted data from full-text articles. We included measurements as classified by translational science outcomes T1 (testing settings), T2 (patient care practices) and T3 (patient/public health outcomes). Due to incomplete reporting, we post hoc classified study outcomes as 'negative' or 'positive' based on statistical significance. We performed meta-analyses of outcomes on the subset of studies sharing similar outcomes. We found 161 eligible studies (44 randomised controlled trials (RCTs), 34 non-RCTs and 83 uncontrolled trials). Simulation was the most frequently published educational mode (78%). Our post hoc classification showed that studies involving simulation, competency-based approaches and RCTs had higher frequencies of T2/T3 outcomes. Meta-analyses showed that simulation (risk ratio (RR) 1.54 vs 0.55 for studies with vs without simulation, p=0.013) and competency-based approaches (RR 3.17 vs 0.89, p<0.001) were effective forms of training. This systematic review of bedside procedural skills demonstrates that the current literature is heterogeneous and of varying quality and rigour. Evidence is strongest for the use of simulation and competency-based paradigms in teaching procedures, and these approaches should be the mainstay of programmes that train physicians to perform procedures. Further research should clarify differences among instructional methods (eg, forms of hands-on training) rather than among educational modes (eg, lecture vs simulation). 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/

Sugar-sweetened beverage consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review protocol

PubMed Central

Avery, Jodie C; Bowden, Jacqueline A; Dono, Joanne; Gibson, Odette R; Brownbill, Aimee; Keech, Wendy; Miller, Caroline L

2017-01-01

Introduction Aboriginal and Torres Strait Islander communities of Australia experience poorer health outcomes in the areas of overweight and obesity, diabetes and cardiovascular disease. Contributing to this burden of disease in the Australian community generally and in Aboriginal and Torres Strait Islander communities, is the consumption of sugar-sweetened beverages (SSBs). We have described a protocol for a review to systematically scope articles that document use of SSBs and interventions to reduce their consumption with Aboriginal and Torres Strait Islander people. These results will inform future work that investigates interventions aimed at reducing harm associated with SSB consumption. Methods and analysis This scoping review draws on a methodology that uses a six-step approach to search databases including PubMed, SCOPUS, CINAHL, Informit (including Informit: Indigenous Peoples), Joanna Briggs Institute EBP Database and Mura, between January 1980 and February 2017. Two reviewers will be engaged to search for and screen studies independently, using formulated selection criteria, for inclusion in our review. We will include primary research studies, systematic reviews including meta-analysis or meta-synthesis, reports and unpublished grey literature. Results will be entered into a table identifying study details and characteristics, summarised using a Preferred Reporting Items for Systematic Reviews and Meta-Analysis chart and then critically analysed. Ethics and dissemination This review will not require ethics committee review. Results will be disseminated at appropriate scientific meetings, as well as through the Aboriginal and Torres Strait Islander community. PMID:28760797

Singing for Lung Health-a systematic review of the literature and consensus statement.

PubMed

Lewis, Adam; Cave, Phoene; Stern, Myra; Welch, Lindsay; Taylor, Karen; Russell, Juliet; Doyle, Anne-Marie; Russell, Anne-Marie; McKee, Heather; Clift, Stephen; Bott, Julia; Hopkinson, Nicholas S

2016-12-01

There is growing interest in Singing for Lung Health (SLH), an approach where patients with respiratory disease take part in singing groups, intended to improve their condition. A consensus group was convened in early 2016 to address issues including: the specific features that make SLH distinct from other forms of participation in singing; the existing evidence base via a systematic review; gaps in the evidence base including the need to define value-based outcome measures for sustainable commissioning of SLH; defining the measures needed to evaluate both individuals' responses to SLH and the quality of singing programmes. and core training, expertise and competencies required by singing group leaders to deliver high-quality programmes. A systematic review to establish the extent of the evidence base for SLH was undertaken. Electronic databases, including Pubmed, OVID Medline and Embase, Web of Science, Cochrane central register of controlled trials and PEDro, were used. Six studies were included in the final review. Quantitative data suggest that singing has the potential to improve health-related quality of life, particularly related to physical health, and levels of anxiety without causing significant side effects. There is a significant risk of bias in many of the existing studies with small numbers of subjects overall. Little comparison can be made between studies owing to their heterogeneity in design. Qualitative data indicate that singing is an enjoyable experience for patients, who consistently report that it helps them to cope with their condition better. Larger and longer-term trials are needed.

Gaps in the evidence for prevention and treatment of maternal anaemia: a review of systematic reviews.

PubMed

Parker, Jacqui A; Barroso, Filipa; Stanworth, Simon J; Spiby, Helen; Hopewell, Sally; Doree, Carolyn J; Renfrew, Mary J; Allard, Shubha

2012-06-24

Anaemia, in particular due to iron deficiency, is common in pregnancy with associated negative outcomes for mother and infant. However, there is evidence of significant variation in management. The objectives of this review of systematic reviews were to analyse and summarise the evidence base, identify gaps in the evidence and develop a research agenda for this important component of maternity care. Multiple databases were searched, including MEDLINE, EMBASE and The Cochrane Library. All systematic reviews relating to interventions to prevent and treat anaemia in the antenatal and postnatal period were eligible. Two reviewers independently assessed data inclusion, extraction and quality of methodology. 27 reviews were included, all reporting on the prevention and treatment of anaemia in the antenatal (n = 24) and postnatal periods (n = 3). Using AMSTAR as the assessment tool for methodological quality, only 12 of the 27 were rated as high quality reviews. The greatest number of reviews covered antenatal nutritional supplementation for the prevention of anaemia (n = 19). Iron supplementation was the most extensively researched, but with ongoing uncertainty about optimal dose and regimen. Few identified reviews addressed anaemia management post-partum or correlations between laboratory and clinical outcomes, and no reviews reported on clinical symptoms of anaemia. The review highlights evidence gaps including the management of anaemia in the postnatal period, screening for anaemia, and optimal interventions for treatment. Research priorities include developing standardised approaches to reporting of laboratory outcomes, and information on clinical outcomes relevant to the experiences of pregnant women.

Protocol - realist and meta-narrative evidence synthesis: Evolving Standards (RAMESES)

PubMed Central

2011-01-01

Background There is growing interest in theory-driven, qualitative and mixed-method approaches to systematic review as an alternative to (or to extend and supplement) conventional Cochrane-style reviews. These approaches offer the potential to expand the knowledge base in policy-relevant areas - for example by explaining the success, failure or mixed fortunes of complex interventions. However, the quality of such reviews can be difficult to assess. This study aims to produce methodological guidance, publication standards and training resources for those seeking to use the realist and/or meta-narrative approach to systematic review. Methods/design We will: [a] collate and summarise existing literature on the principles of good practice in realist and meta-narrative systematic review; [b] consider the extent to which these principles have been followed by published and in-progress reviews, thereby identifying how rigour may be lost and how existing methods could be improved; [c] using an online Delphi method with an interdisciplinary panel of experts from academia and policy, produce a draft set of methodological steps and publication standards; [d] produce training materials with learning outcomes linked to these steps; [e] pilot these standards and training materials prospectively on real reviews-in-progress, capturing methodological and other challenges as they arise; [f] synthesise expert input, evidence review and real-time problem analysis into more definitive guidance and standards; [g] disseminate outputs to audiences in academia and policy. The outputs of the study will be threefold: 1. Quality standards and methodological guidance for realist and meta-narrative reviews for use by researchers, research sponsors, students and supervisors 2. A 'RAMESES' (Realist and Meta-review Evidence Synthesis: Evolving Standards) statement (comparable to CONSORT or PRISMA) of publication standards for such reviews, published in an open-access academic journal. 3. A training module for researchers, including learning outcomes, outline course materials and assessment criteria. Discussion Realist and meta-narrative review are relatively new approaches to systematic review whose overall place in the secondary research toolkit is not yet fully established. As with all secondary research methods, guidance on quality assurance and uniform reporting is an important step towards improving quality and consistency of studies. PMID:21843376

A method for inferring the rate of evolution of homologous characters that can potentially improve phylogenetic inference, resolve deep divergence and correct systematic biases.

PubMed

Cummins, Carla A; McInerney, James O

2011-12-01

Current phylogenetic methods attempt to account for evolutionary rate variation across characters in a matrix. This is generally achieved by the use of sophisticated evolutionary models, combined with dense sampling of large numbers of characters. However, systematic biases and superimposed substitutions make this task very difficult. Model adequacy can sometimes be achieved at the cost of adding large numbers of free parameters, with each parameter being optimized according to some criterion, resulting in increased computation times and large variances in the model estimates. In this study, we develop a simple approach that estimates the relative evolutionary rate of each homologous character. The method that we describe uses the similarity between characters as a proxy for evolutionary rate. In this article, we work on the premise that if the character-state distribution of a homologous character is similar to many other characters, then this character is likely to be relatively slowly evolving. If the character-state distribution of a homologous character is not similar to many or any of the rest of the characters in a data set, then it is likely to be the result of rapid evolution. We show that in some test cases, at least, the premise can hold and the inferences are robust. Importantly, the method does not use a "starting tree" to make the inference and therefore is tree independent. We demonstrate that this approach can work as well as a maximum likelihood (ML) approach, though the ML method needs to have a known phylogeny, or at least a very good estimate of that phylogeny. We then demonstrate some uses for this method of analysis, including the improvement in phylogeny reconstruction for both deep-level and recent relationships and overcoming systematic biases such as base composition bias. Furthermore, we compare this approach to two well-established methods for reweighting or removing characters. These other methods are tree-based and we show that they can be systematically biased. We feel this method can be useful for phylogeny reconstruction, understanding evolutionary rate variation, and for understanding selection variation on different characters.

Novel keyword co-occurrence network-based methods to foster systematic reviews of scientific literature.

PubMed

Radhakrishnan, Srinivasan; Erbis, Serkan; Isaacs, Jacqueline A; Kamarthi, Sagar

2017-01-01

Systematic reviews of scientific literature are important for mapping the existing state of research and highlighting further growth channels in a field of study, but systematic reviews are inherently tedious, time consuming, and manual in nature. In recent years, keyword co-occurrence networks (KCNs) are exploited for knowledge mapping. In a KCN, each keyword is represented as a node and each co-occurrence of a pair of words is represented as a link. The number of times that a pair of words co-occurs in multiple articles constitutes the weight of the link connecting the pair. The network constructed in this manner represents cumulative knowledge of a domain and helps to uncover meaningful knowledge components and insights based on the patterns and strength of links between keywords that appear in the literature. In this work, we propose a KCN-based approach that can be implemented prior to undertaking a systematic review to guide and accelerate the review process. The novelty of this method lies in the new metrics used for statistical analysis of a KCN that differ from those typically used for KCN analysis. The approach is demonstrated through its application to nano-related Environmental, Health, and Safety (EHS) risk literature. The KCN approach identified the knowledge components, knowledge structure, and research trends that match with those discovered through a traditional systematic review of the nanoEHS field. Because KCN-based analyses can be conducted more quickly to explore a vast amount of literature, this method can provide a knowledge map and insights prior to undertaking a rigorous traditional systematic review. This two-step approach can significantly reduce the effort and time required for a traditional systematic literature review. The proposed KCN-based pre-systematic review method is universal. It can be applied to any scientific field of study to prepare a knowledge map.