Can Broader Diffusion of Value-Based Insurance Design Increase Benefits from US Health Care without Increasing Costs? Evidence from a Computer Simulation Model

PubMed Central

Scott Braithwaite, R.; Omokaro, Cynthia; Justice, Amy C.; Nucifora, Kimberly; Roberts, Mark S.

2010-01-01

Background Evidence suggests that cost sharing (i.e.,copayments and deductibles) decreases health expenditures but also reduces essential care. Value-based insurance design (VBID) has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. Methods and Findings We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1) applying VBID solely to pharmacy benefits and (2) applying VBID to both pharmacy benefits and other health care services (e.g., devices). We assumed that cost sharing would be eliminated for high-value services (<$100,000 per life-year), would remain unchanged for intermediate- or unknown-value services ($100,000–$300,000 per life-year or unknown), and would be increased for low-value services (>$300,000 per life-year). All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80%) of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to

Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

PubMed

Braithwaite, R Scott; Omokaro, Cynthia; Justice, Amy C; Nucifora, Kimberly; Roberts, Mark S

2010-02-16

Evidence suggests that cost sharing (i.e.,copayments and deductibles) decreases health expenditures but also reduces essential care. Value-based insurance design (VBID) has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1) applying VBID solely to pharmacy benefits and (2) applying VBID to both pharmacy benefits and other health care services (e.g., devices). We assumed that cost sharing would be eliminated for high-value services (<$100,000 per life-year), would remain unchanged for intermediate- or unknown-value services ($100,000-$300,000 per life-year or unknown), and would be increased for low-value services (>$300,000 per life-year). All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80%) of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would

Has Asthma Medication Use Caught Up With the Evidence?: A 12-Year Population-Based Study of Trends.

PubMed

Sadatsafavi, Mohsen; Tavakoli, Hamid; Lynd, Larry; FitzGerald, J Mark

2017-03-01

The importance of balance between controller and reliever medications in asthma is recognized. However, to our knowledge, the extent to which real-world practice has caught up with evidence-based guidelines has not been studied. This was a retrospective cohort study of individuals 15 to 67 years of age who satisfied a validated case definition of asthma in the administrative health database of British Columbia, Canada between 2002 and 2013. Each patient-year was assessed for inappropriate and excessive prescription of short-acting beta-agonists (SABAs) and the balance between controller and reliever medications. Trends on three time axes were evaluated: calendar time, time course of asthma, and age. Poisson regression was used to test for a linear trend. Three hundred fifty-six thousand, one hundred twelve patients (56.5% female sex; mean age, 30.5 years) contributed 2.6 million patient-years. In 7.3% of the patient-years, SABAs were prescribed inappropriately. This proportion dropped by a relative rate of 5.3% per year (P < .001). In the first year of asthma, 6.3% of patients had indicators of inappropriate SABA use, which dropped within the first 3 years but increased thereafter. Excessive prescription of SABAs increased rapidly during the time course of asthma (change of 23.3% per year; P < .001) and by age (change of 5.1% per year; P < .001). Despite overwhelming evidence regarding the risks, inappropriate prescription for SABAs was prevalent. Excessive SABA use might explain high asthma mortality in older patients. Inappropriate prescriptions declined over the study period but increased over the time course of asthma. These trends might have contributed to the declining asthma hospitalization rates in British Columbia, but there remain gaps in care and potential for improvement in asthma outcomes. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Evidence-based librarianship: what might we expect in the years ahead?

PubMed

Eldredge, Jonathan D

2002-06-01

To predict the possible accomplishments of the Evidence-Based Librarianship (EBL) movement by the years 2005, 2010, 2015 and 2020. Predictive. The author draws upon recent events, relevant historical events and anecdotal accounts to detect evidence of predictable trends. The author develops a set of probable predictions for the development of EBL. Although incomplete evidence exists, some trends still seem discernible. By 2020, EBL will have become indistinguishable from mainstream health sciences librarianship/informatics practices.

Five years treatment with strontium ranelate reduces vertebral and nonvertebral fractures and increases the number and quality of remaining life-years in women over 80 years of age.

PubMed

Seeman, Ego; Boonen, Steven; Borgström, Frederik; Vellas, Bruno; Aquino, Jean-Pierre; Semler, Jutta; Benhamou, Claude-Laurent; Kaufman, Jean-Marc; Reginster, Jean-Yves

2010-04-01

Longevity has resulted in a greater proportion of the population entering a time of life when increasing bone fragility and falls predispose to fractures, particularly nonvertebral fractures. Women over 80 years of age constitute 10% of the population but contribute 30% of all fractures and 60% of all nonvertebral fractures. Despite this, few studies have examined antifracture efficacy of treatments in this high-risk group and none has provided evidence for benefits beyond 3 years. To determine whether strontium ranelate reduces the risk of vertebral and nonvertebral fractures during 5 years, we analyzed a subgroup of 1489 female patients over 80 years of age (mean 83.5+/-3.0 years) with osteoporosis from the SOTI (spinal osteoporosis therapeutic intervention) and TROPOS (treatment of peripheral osteoporosis) studies randomized to strontium ranelate 2 g/d or placebo. All received a supplement of calcium plus vitamin D. By intention to treat, vertebral fracture risk was reduced by 31% (relative risk, RR=0.69; 95% confidence interval, CI 0.52-0.92), nonvertebral fracture risk by 27% (RR=0.73; 95% CI 0.57-0.95), major nonvertebral fracture risk by 33% (RR=0.67; 95% CI 0.50-0.89) and hip fracture risk by 24% (RR=0.76; 95% CI 0.50-1.15, not significant). Treatment was cost-saving as it decreased cost and increased QALYs and life-years. Strontium ranelate safely produced a significant reduction in vertebral and nonvertebral fracture risk during 5 years in postmenopausal women over 80 years of age and was cost saving. Copyright 2009 Elsevier Inc. All rights reserved.

Conceptual fluency increases recollection: behavioral and electrophysiological evidence

PubMed Central

Wang, Wei; Li, Bingbing; Gao, Chuanji; Xu, Huifang; Guo, Chunyan

2015-01-01

It is widely established that fluency can contribute to recognition memory. Previous studies have found that enhanced fluency increases familiarity, but not recollection. The present study was motivated by a previous finding that conceptual priming affected recollection. We used event-related potentials to investigate the electrophysiological correlates of these effects with conceptually related two-character Chinese words. We found that previous conceptual priming effects on conceptual fluency only increased the incidence of recollection responses. We also found that enhanced conceptual fluency was associated with N400 attenuation, which was also correlated with the behavioral indicator of recollection. These results suggest that the N400 effect might be related to the impact of conceptual fluency on recollection recognition. These study findings provide further evidence for the relationship between fluency and recollection. PMID:26175678

Do evidence summaries increase policy-makers' use of evidence from systematic reviews: A systematic review protocol.

PubMed

Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

2015-09-28

Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.

Evidence for life on Earth more than 3850 million years ago.

PubMed

Holland, H D

1997-01-03

A recent study by Mojzsis et al., (Nature 384, 55, 1996) found evidence of life in rocks in Greenland estimated by new isotopic data to be more than 3800 million years old. The author examines this study in relation to studies conducted on rocks between 3250 and 3800 million years old and presents reasons to agree and disagree with the interpretation of data.

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

PubMed

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

2015-12-01

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

Evidence-based dentistry skill acquisition by second-year dental students.

PubMed

Marshall, T A; McKernan, S C; Straub-Morarend, C L; Guzman-Armstrong, S; Marchini, L; Handoo, N Q; Cunningham, M A

2018-05-22

Identification and assessment of Evidence-based dentistry (EBD) outcomes have been elusive. Our objective was to describe EBD skill acquisition during the second (D2) year of pre-doctoral dental education and student competency at the end of the year. The first and fourth (final) curricular-required EBD Exercises (ie, application of the first 4 steps of the 5-Step evidence-based practice process applied to a real or hypothetical situation) completed by D2 students (n = 151) during 2014-2015 and 2015-2016 were evaluated to measure skill acquisition through use of a novel rubric with measures of performance from novice to expert. Exercises were evaluated on the performance for each step, identification of manuscript details and reflective commentary on manuscript components. Changes in performance were evaluated using the chi-square test for trend and the Wilcoxon signed-rank test. Seventy-eight per cent of students scored competent or higher on the Ask step at the beginning of the D2 year; scores improved with 58% scoring proficient or expert on the fourth Exercise (P < .001). Most students were advanced beginners or higher in the Acquire, Appraise and Apply steps at the beginning of the D2 year, with minimal growth observed during the year. Identification of manuscript details improved between the first and fourth Exercises (P = .015); however, depth of commentary skills did not change. Unlike previous investigations evaluating EBD knowledge or behaviour in a testing situation, we evaluated skill acquisition using applied Exercises. Consistent with their clinical and scientific maturity, D2 students minimally performed as advanced beginners at the end of their D2 year. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of a program to increase evidence-based practice change.

PubMed

Larrabee, June H; Sions, Jacqueline; Fanning, Mary; Withrow, Mary Lynne; Ferretti, Andrea

2007-06-01

The study evaluated a nursing research program designed to achieve systematic evidence-based practice change. Specifically, change in nurse attitudes about use of research and research conduct, practice change projects, and nurse participation in research-related activities were evaluated. Evidence indicates that successful evidence-based practice change in an organization requires senior leadership support and a systematic program for practice change. Evaluation of program effectiveness provides evidence about opportunities for further improvement. Quantitative evaluation used a pretest-posttest design. The site was an academic medical center in rural West Virginia. Participants were registered nurses from all inpatients units, perioperative services, and emergency departments. Surveys used Alcock et al's Staff Nurses and Research Activities scale. Descriptive evaluation included the number of nurses who attended the workshop, practice change projects, scholarly products disseminated, and outcome of a Magnet review. First, knowledge about the availability of support services increased between 1999 and 2002 and was associated with higher attitude scores about research and research utilization. Second, registered nurses who reported participating in research-related activities had more positive scores on all attitudes than registered nurses who reported not participating. Nurse leaders may improve participation and attitudes about research and research utilization by internally marketing the support available for research-related activities.

Does Forest Loss Increase Human Disease? Evidence from Nigeria.

PubMed

Berazneva, Julia; Byker, Tanya S.

2017-05-01

It is estimated that about one quarter of the global disease burden in terms of healthy life years lost and about one quarter of all premature deaths can be attributed to modifiable environmental factors (Pruss-Ustun and Corvalan 2006). Three infectious diseases--diarrhea, respiratory infections, and malaria--account for the largest absolute burden in developing countries with children facing the greatest impacts. There is a growing body of evidence demonstrating the health burden of air and water pollution, as well as important productivity and income effects (see, for example, reviews of the literature in Pattanayak and Pfaff 2009 and Greenstone and Jack 2016). Studies that focus on the impacts of natural resource degradation are fewer. Notably, Garg (2016) provides the first causal estimates of the impact of sustained forest cover on reduced malarial incidence in Indonesia, demonstrating a large and previously understudied cost of forest cover loss. In this paper, we extend this new literature on the health impacts of environmental degradation by estimating the causal impact of forest loss on infectious disease incidence in young children using temporal and spatial variation in the last decade in Nigeria. Our estimation strategy involves geolinking a new high-resolution dataset of global forest change to child-level health data from the Nigeria Demographic and Health Surveys from 2008 and 2013. We find that forest loss significantly increases the incidence of malaria, though it does not affect the incidence of diarrhea and respiratory diseases. The impact of forest loss on malaria is large (one standard deviation of forest loss increases malaria incidence by around 4.5 percent in children under five) and the dynamic pattern of the impact suggests a temporary ecological disturbance consistent with findings in Garg (2016) and the tropical medicine literature.

Evidence-based nursing outputs and hot spot analysis of the last 5 years in mainland China: Results of a bibliometric analysis.

PubMed

Zhao, Junqiang; Liu, Xinjuan; Zhang, Wei; Xing, Yana; Cho, Sang Wouk; Hao, Yufang

2018-04-01

Evidence-based nursing has been highlighted and highly developed in recent decades in mainland China. Nevertheless, little is known about its overall development. To gain insights on the overall development of evidence-based nursing in the most recent 5 years and to inform future evidence-based nursing research in mainland China. Four Chinese and four English databases were searched with the search terms "evidence-based practice," "nurse or nursing," and "China or Chinese" from 2012 to 2016. Bibliometric and co-word cluster analysis were conducted with the final included publications. A total of 9036 papers published by 13 808 authors in 606 journals were included. Publication numbers were increasing. None of the top ten journals publishing evidence-based nursing papers were core nursing journals. The research hot spots on evidence-based nursing in the recent five years were cardiovascular disease, mental health, and complication prevention. However, little attention has been paid to education for evidence-based nursing. Evidence-based nursing has penetrated into various nursing branches in mainland China and become a well-recognized and relatively mature research domain. More importance should be attached to the study design, methodological, and reporting quality of evidence-based nursing projects. © 2018 John Wiley & Sons Australia, Ltd.

[Why evidence-based medicine? 20 years of meta-analysis].

PubMed

Ceballos, C; Valdizán, J R; Artal, A; Almárcegui, C; Allepuz, C; García Campayo, J; Fernández Liesa, R; Giraldo, P; Puértolas, T

2000-10-01

Meta-analysis, described within evidence-based medicine, has become a frequent issue in recent medical literature. An exhaustive search of reported meta-analysis from any medical specialty is described. Search of papers included in Medline or Embase between 1973-1998. A study of intra and inter-reviewers liability about selection and classification have been performed. A descriptive analysis of the reported papers (frequency tables and graphics) is described, including differences of mean of reported meta-analysis papers by medical specialty and year. 1,518 papers were selected and classified. Most frequently found (45.91%) were: methodology (15.7%), psychiatry (11.79%), cardiology (10.01%) and oncology (8.36%). Inter personal agreement was 0.93 in selecting papers and 0.72 in classifying them. Between 1977-1987 overall mean of reported studies of meta-analysis (1.67 + 4.10) was significatively inferior to the 1988-1998 (49.54 + 56.55) (p < 0.001). Global number of meta-analysis was positively correlated (p < 0.05) with the number of studies about fundamentals and methodology during the study period. The method used to identify meta-analysis reports can be considered to be adequate; however, the agreement in classifying them in medical specialties was inferior. A progressive increase in the number of reported meta-analysis since 1977 can be demonstrated. Specialties with a greater number of meta-analysis published in the literature were: psychiatry, oncology and cardiology. Diffusion of knowledge about fundamentals and methodology of meta-analysis seems to have drawn and increase in performing and reporting this kind of analysis.

Procedures and Claims among US Evidence-Producing Organisations: The Case of the Incredible Years Programme

ERIC Educational Resources Information Center

Karlsson, Patrik; Bergmark, Anders; Lundström, Tommy

2014-01-01

We explore how four evidence-producing organisations in the US go ahead when they rate the evidence base for psychosocial interventions, using the Incredible Years programme as our case study. The findings demonstrate variation in the procedures and resulting evidence claims across the organisations, with some organisations being strict and some…

Developmental changes in mental arithmetic: evidence for increased functional specialization in the left inferior parietal cortex.

PubMed

Rivera, S M; Reiss, A L; Eckert, M A; Menon, V

2005-11-01

Arithmetic reasoning is arguably one of the most important cognitive skills a child must master. Here we examine neurodevelopmental changes in mental arithmetic. Subjects (ages 8-19 years) viewed arithmetic equations and were asked to judge whether the results were correct or incorrect. During two-operand addition or subtraction trials, for which accuracy was comparable across age, older subjects showed greater activation in the left parietal cortex, along the supramarginal gyrus and adjoining anterior intra-parietal sulcus as well as the left lateral occipital temporal cortex. These age-related changes were not associated with alterations in gray matter density, and provide novel evidence for increased functional maturation with age. By contrast, younger subjects showed greater activation in the prefrontal cortex, including the dorsolateral and ventrolateral prefrontal cortex and the anterior cingulate cortex, suggesting that they require comparatively more working memory and attentional resources to achieve similar levels of mental arithmetic performance. Younger subjects also showed greater activation of the hippocampus and dorsal basal ganglia, reflecting the greater demands placed on both declarative and procedural memory systems. Our findings provide evidence for a process of increased functional specialization of the left inferior parietal cortex in mental arithmetic, a process that is accompanied by decreased dependence on memory and attentional resources with development.

What "CAM" we learn about the level of evidence from 60 years of research into manipulative and body-based therapies in sports and exercise medicine?

PubMed

Mącznik, Aleksandra K; Schneiders, Anthony G; Sullivan, S John; Athens, Josie

2014-04-01

Complementary and alternative medicine (CAM) is becoming increasingly accepted in modern western society, including amongst amateur and professional athletes, however, it has not yet been determined how CAM is reflected in scientific publications in sports and exercise medicine (SEM). The aim of this study was to identify trends in the levels of evidence for manipulative and body-based therapies within the SEM literature. The literature was systematically searched with no language restrictions in seven databases and retrieved articles were screened and classified according to their study design using the Oxford Centre for Evidence-Based Medicine system. From 6088 retrieved articles, 395 were retained for evaluation and these included 180 on massage, 96 on acupuncture and 95 on manipulation. The majority of the articles were published in English, with 88 in non-English languages. Level-1 evidence was available for acupuncture, manipulation, massage, and Pilates. From the nineteen-seventies onwards, a decreasing trend was observed for low evidence articles with a corresponding increasing trend for clinical trials. After the year 2000, over 50% of the published articles were clinical trials, RCTs or systematic reviews. This review revealed an increase in the quantity and quality of published manipulative and body-based therapy articles in SEM over the last 60 years with the evidence level varying considerably between therapies. The timeframe associated with the development of evidence in CAM may reflect the move to provide scientific support for therapies previously justified primarily by anecdotal evidence, or traditional and cultural use. Copyright © 2014. Published by Elsevier Ltd.

Increase in child behavior problems among urban Brazilian 4-year olds: 1993 and 2004 Pelotas birth cohorts

PubMed Central

Matijasevich, Alicia; Murray, Elizabeth; Stein, Alan; Anselmi, Luciana; Menezes, Ana M; Santos, Iná S; Barros, Aluísio JD; Gigante, Denise P; Barros, Fernando C; Victora, Cesar G

2014-01-01

Background There are an increasing number of reports on time trends in child and adolescent psychological problems but none from low- and middle-income countries, and very few covering the preschool period. The aim was to investigate changes in preschool behavioral/emotional problems in two birth cohorts from a middle-income country born 11 years apart. Methods We analyzed data from the 1993 and 2004 Pelotas birth cohort studies from Brazil. A subsample of 4-year olds from the 1993 cohort (634) and all 4-year olds from the 2004 cohort (3750) were assessed for behavioral/emotional problems through maternal report using the Child Behavior Checklist (CBCL). Response rates in these two population-based cohorts were above 90%. Results We found a significant increase in CBCL total problems, internalizing and externalizing mean scores over the 11-year period. For 1993 and 2004 Pelotas cohorts, respectively, CBCL mean values (SE) total problems scores were 27.9 (0.8) and 34.7 (0.3); for internalizing scores, 5.7 (0.2) and 6.3 (0.1) and for externalizing scores, 12.4 (0.4) and 15.5 (0.1). After adjusting for confounding variables, the largest increase from 1993 to 2004 was identified in the aggressive behavior syndrome score (Cohen's d = .50), followed by the externalizing problem score (Cohen's d = .40) and CBCL total problem score (Cohen's d = .36), respectively. The rise in child psychological problems was more marked in children from families with fewer assets and with less educated mothers. Conclusions Our findings provide evidence for a substantial increase in preschool behavioral problems among children in Brazil over an 11-year period. PMID:24735354

Evidence-based medicine: what has happened in the past 50 years?

PubMed

Mellis, Craig

2015-01-01

Although the phrase 'evidence-based medicine' (EBM) was used for the first time in the medical literature less than 25 years ago, the history of EBM goes back for centuries. What is remarkable is how popular and how globally accepted the EBM movement has become in such a short time. Many famous, past clinicians have played major roles in the disciplines that preceded EBM, particularly 'clinical epidemiology'. It soon became clear to the early EBM champions that 'evidence' was only part of the clinical decision-making process. Consequently, both clinical expertise and the patient's values and preferences were rapidly incorporated into the concept we now know as 'EBM'. The current need for high-quality, easily accessible 'evidence-based summaries' for busy clinicians is now apparent, as traditional EBM requires both considerable time and skill. Consequently, there is a progressive move away from the primary literature (such as randomised controlled trials) to systematic reviews and other 'evidence-based summaries'. The future of EBM will almost certainly involve widespread utilisation of 'clinical (computer)-based decision support systems'. © 2014 The Author. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Evidence-based practice guideline: increasing physical activity in schools--kindergarten through 8th grade.

PubMed

Bagby, Karen; Adams, Susan

2007-06-01

Because of the growing obesity epidemic across all age groups in the United States, interventions to increase physical activity and reduce sedentary behaviors have become a priority. Evidence is growing that interventions to increase physical activity and reduce sedentary behaviors have positive results and are generally inexpensive to implement. National and international health organizations are calling for a comprehensive approach for reducing obesity in children that includes increasing physical activity in the school setting. Although the call to increase activity levels in schools is clear, little guidance has been given to schools on specific methods to accomplish this task. This article provides an overview of an evidence-based guideline developed by a physical education teacher and a school nurse to provide inexpensive, easy-to-implement, effective strategies to increase physical activity in students. Tools are also included in the guideline to measure the effectiveness of the intervention.

Trends in adiposity in Brazilian 7-10-year-old schoolchildren: evidence for increasing overweight but not obesity between 2002 and 2007.

PubMed

Leal, Danielle Biazzi; de Assis, Maria Alice Altenburg; González-Chica, David Alejandro; da Costa, Filipe Ferreira

2014-01-01

The negative health consequences of childhood overweight/obesity (OW/OB) are well known. Therefore, an accurate monitoring of the OW/OB prevalence is essential. Anthropometry is the most practical and cost-effective method for nutritional status evaluation. To describe trends in the nutritional status among 7-10-year-old children by investigating changes in the prevalence of stunting, thinness, overweight, obesity, risk and excess abdominal adiposity, and to study changes in height-for-age, body mass index (BMI) and waist circumference (WC). A school-based sample of 7-10-year-old children participated in two cross-sectional studies in 2002 (n = 2936) and 2007 (n = 1232) in Florianopolis, southern Brazil. Prevalence of stunting, risk and excess abdominal adiposity and changes in the distribution of height-for-age, BMI-for-age, WC-for-age z-scores were evaluated. Three BMI-based references were used to define the prevalence of thinness, overweight and obesity. Between 2002-2007, the prevalence of stunting, thinness, obesity and excess abdominal adiposity remained stable, whereas overweight (including obesity) increased 10-23% in boys and 18-21% in girls, depending on the BMI reference used. The risk of abdominal adiposity increased in boys, but not in girls. No significant change was observed in mean height, BMI, WC-for-age z-scores. This study identified a potential levelling off in the prevalence of obesity and excess abdominal adiposity, but a continuing increase in the prevalence of overweight.

Observational evidence of a long-term increase in precipitation due to urbanization effects and its implications for sustainable urban living.

PubMed

Wai, K M; Wang, X M; Lin, T H; Wong, M S; Zeng, S K; He, N; Ng, E; Lau, K; Wang, D H

2017-12-01

Although projected precipitation increases in East Asia due to future climate change have aroused concern, less attention has been paid by the scientific community and public to the potential long-term increase in precipitation due to rapid urbanization. A ten-year precipitation dataset was analysed for both a rapidly urbanized megacity and nearby suburban/rural stations in southern China. Rapid urbanization in the megacity was evident from satellite observations. A statistically significant, long-term, increasing trend of precipitation existed only at the megacity station (45.6mm per decade) and not at the other stations. The increase was attributed to thermal and dynamical modifications of the tropospheric boundary layer related to urbanization, which was confirmed by the results of our WRF-SLUCM simulations. The results also suggested that a long-term regional increase in precipitation, caused by greenhouse gas-induced climate change, for instance, was not evident within the study period. The urbanization-induced increase was found to be higher than the precipitation increase (18.3mm per decade) expected from future climate change. The direct climate impacts due to rapid urbanization is highlighted with strong implications for urban sustainable development and the planning of effective adaptation strategies for issues such as coastal defenses, mosquito-borne disease spread and heat stress mortality. Copyright © 2017 Elsevier B.V. All rights reserved.

Research Trends in Evidence-Based Medicine: A Joinpoint Regression Analysis of More than 50 Years of Publication Data

PubMed Central

Hung, Bui The; Long, Nguyen Phuoc; Hung, Le Phi; Luan, Nguyen Thien; Anh, Nguyen Hoang; Nghi, Tran Diem; Van Hieu, Mai; Trang, Nguyen Thi Huyen; Rafidinarivo, Herizo Fabien; Anh, Nguyen Ky; Hawkes, David; Huy, Nguyen Tien; Hirayama, Kenji

2015-01-01

Background Evidence-based medicine (EBM) has developed as the dominant paradigm of assessment of evidence that is used in clinical practice. Since its development, EBM has been applied to integrate the best available research into diagnosis and treatment with the purpose of improving patient care. In the EBM era, a hierarchy of evidence has been proposed, including various types of research methods, such as meta-analysis (MA), systematic review (SRV), randomized controlled trial (RCT), case report (CR), practice guideline (PGL), and so on. Although there are numerous studies examining the impact and importance of specific cases of EBM in clinical practice, there is a lack of research quantitatively measuring publication trends in the growth and development of EBM. Therefore, a bibliometric analysis was constructed to determine the scientific productivity of EBM research over decades. Methods NCBI PubMed database was used to search, retrieve and classify publications according to research method and year of publication. Joinpoint regression analysis was undertaken to analyze trends in research productivity and the prevalence of individual research methods. Findings Analysis indicates that MA and SRV, which are classified as the highest ranking of evidence in the EBM, accounted for a relatively small but auspicious number of publications. For most research methods, the annual percent change (APC) indicates a consistent increase in publication frequency. MA, SRV and RCT show the highest rate of publication growth in the past twenty years. Only controlled clinical trials (CCT) shows a non-significant reduction in publications over the past ten years. Conclusions Higher quality research methods, such as MA, SRV and RCT, are showing continuous publication growth, which suggests an acknowledgement of the value of these methods. This study provides the first quantitative assessment of research method publication trends in EBM. PMID:25849641

Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players.

PubMed

Kerr, Zachary Y; Marshall, Stephen W; Harding, Herndon P; Guskiewicz, Kevin M

2012-10-01

Concussions may accelerate the progression to long-term mental health outcomes such as depression in athletes. To prospectively determine the effects of recurrent concussions on the clinical diagnosis of depression in a group of retired football players. Cohort study; Level of evidence, 2. Members of the National Football League Retired Players Association responded to a baseline General Health Survey (GHS) in 2001. They also completed a follow-up survey in 2010. Both surveys asked about demographic information, number of concussions sustained during their professional football career, physical/mental health, and prevalence of diagnosed medical conditions. A physical component summary (Short Form 36 Measurement Model for Functional Assessment of Health and Well-Being [SF-36 PCS]) was calculated from responses for physical health. The main exposure, the history of concussions during the professional playing career (self-report recalled in 2010), was stratified into 5 categories: 0 (referent), 1 to 2, 3 to 4, 5 to 9, and 10+ concussions. The main outcome was a clinical diagnosis of depression between the baseline and follow-up GHS. Classic tabular methods computed crude risk ratios. Binomial regression with a Poisson residual and robust variance estimation to stabilize the fitting algorithm estimated adjusted risk ratios. χ(2) analyses identified associations and trends between concussion history and the 9-year risk of a depression diagnosis. Of the 1044 respondents with complete data from the baseline and follow-up GHS, 106 (10.2%) reported being clinically diagnosed as depressed between the baseline and follow-up GHS. Approximately 65% of all respondents self-reported sustaining at least 1 concussion during their professional careers. The 9-year risk of a depression diagnosis increased with an increasing number of self-reported concussions, ranging from 3.0% in the "no concussions" group to 26.8% in the "10+" group (linear trend: P < .001). A strong dose

The Merits and Challenges of Three-Year Medical School Curricula: Time for an Evidence-Based Discussion

PubMed Central

Raymond, John R.; Kerschner, Joseph E.; Hueston, William J.

2015-01-01

The debate about three-year medical school curricula has resurfaced recently, driven by rising education debt burden and a predicted physician shortage. In this Perspective, the authors call for an evidence-based discussion of the merits and challenges of three-year curricula. They examine published evidence that suggests that three-year curricula are viable, including studies on three-year curricula in (1) U.S. medical schools in the 1970s and 1980s, (2) two Canadian medical schools with more than four decades of experience with such curricula, and (3) accelerated family medicine and internal medicine programs. They also briefly describe the new three-year programs that are being implemented at eight U.S. medical schools, including their own. Finally, they offer suggestions regarding how to enhance the discussion between the proponents of and those with concerns about three-year curricula. PMID:26266464

Developmental Scores at 1 Year With Increasing Gestational Age, 37–41 Weeks

PubMed Central

Rose, Olga; Blanco, Estela; Martinez, Suzanna M.; Sim, Eastern Kang; Castillo, Marcela; Lozoff, Betsy; Vaucher, Yvonne E.

2013-01-01

OBJECTIVE: To examine the relationship between gestational age and mental and psychomotor development scores in healthy infants born between 37 and 41 weeks. METHODS: The cohort included 1562 participants enrolled during infancy in an iron deficiency anemia preventive trial in Santiago, Chile. All participants were healthy, full-term (37–41 weeks) infants who weighed 3 kg or more at birth. Development at 12 months was assessed using the Bayley Scales of Infant Development. Using generalized linear modeling, we analyzed the association between gestational age and 1-year-old developmental status, taking into account potential confounders including birth weight percentile, gender, socioeconomic status, the home environment, iron status, and iron supplementation. RESULTS: For each additional week of gestation, the Mental Development Index increased by 0.8 points (95% confidence interval = 0.2–1.4), and the Psychomotor Development Index increased by 1.4 points (95% confidence interval = 0.6–2.1) controlling for birth weight percentile, gender, socioeconomic status, and home environment. CONCLUSIONS: In a large sample of healthy full-term infants, developmental scores obtained using the Bayley Scales of Infant Development at 12 months increased with gestational age (37–41 weeks). There is increasing evidence that birth at 39 to 41 weeks provides developmental advantages compared with birth at 37 to 38 weeks. Because cesarean deliveries and early-term inductions have increased to 40% of all births, consideration of ongoing brain development during the full-term period is an important medical and policy issue. PMID:23589812

Sixty years of fear appeal research: current state of the evidence.

PubMed

Ruiter, Robert A C; Kessels, Loes T E; Peters, Gjalt-Jorn Y; Kok, Gerjo

2014-04-01

Fear arousal is widely used in persuasive campaigns and behavioral change interventions. Yet, experimental evidence argues against the use of threatening health information. The authors reviewed the current state of empirical evidence on the effectiveness of fear appeals. Following a brief overview of the use of fear arousal in health education practice and the structure of effective fear appeals according to two main theoretical frameworks-protection motivation theory and the extended parallel process model-the findings of six meta-analytic studies in the effectiveness of fear appeals are summarized. It is concluded that coping information aimed at increasing perceptions of response effectiveness and especially self-efficacy is more important in promoting protective action than presenting threatening health information aimed at increasing risk perceptions and fear arousal. Alternative behavior change methods than fear appeals should be considered. © 2014 The Authors. International Journal of Psychology published by John Wiley © Sons Ltd on behalf of International Union of Psychological Science.

Abortion and mental health disorders: evidence from a 30-year longitudinal study.

PubMed

Fergusson, David M; Horwood, L John; Boden, Joseph M

2008-12-01

Research on the links between abortion and mental health has been limited by design problems and relatively weak evidence. To examine the links between pregnancy outcomes and mental health outcomes. Data were gathered on the pregnancy and mental health history of a birth cohort of over 500 women studied to the age of 30. After adjustment for confounding, abortion was associated with a small increase in the risk of mental disorders; women who had had abortions had rates of mental disorder that were about 30% higher. There were no consistent associations between other pregnancy outcomes and mental health. Estimates of attributable risk indicated that exposure to abortion accounted for 1.5% to 5.5% of the overall rate of mental disorders. The evidence is consistent with the view that abortion may be associated with a small increase in risk of mental disorders. Other pregnancy outcomes were not related to increased risk of mental health problems.

High-Frequency Binaural Beats Increase Cognitive Flexibility: Evidence from Dual-Task Crosstalk.

PubMed

Hommel, Bernhard; Sellaro, Roberta; Fischer, Rico; Borg, Saskia; Colzato, Lorenza S

2016-01-01

Increasing evidence suggests that cognitive-control processes can be configured to optimize either persistence of information processing (by amplifying competition between decision-making alternatives and top-down biasing of this competition) or flexibility (by dampening competition and biasing). We investigated whether high-frequency binaural beats, an auditory illusion suspected to act as a cognitive enhancer, have an impact on cognitive-control configuration. We hypothesized that binaural beats in the gamma range bias the cognitive-control style toward flexibility, which in turn should increase the crosstalk between tasks in a dual-task paradigm. We replicated earlier findings that the reaction time in the first-performed task is sensitive to the compatibility between the responses in the first and the second task-an indication of crosstalk. As predicted, exposing participants to binaural beats in the gamma range increased this effect as compared to a control condition in which participants were exposed to a continuous tone of 340 Hz. These findings provide converging evidence that the cognitive-control style can be systematically biased by inducing particular internal states; that high-frequency binaural beats bias the control style toward more flexibility; and that different styles are implemented by changing the strength of local competition and top-down bias.

High-Frequency Binaural Beats Increase Cognitive Flexibility: Evidence from Dual-Task Crosstalk

PubMed Central

Hommel, Bernhard; Sellaro, Roberta; Fischer, Rico; Borg, Saskia; Colzato, Lorenza S.

2016-01-01

Increasing evidence suggests that cognitive-control processes can be configured to optimize either persistence of information processing (by amplifying competition between decision-making alternatives and top-down biasing of this competition) or flexibility (by dampening competition and biasing). We investigated whether high-frequency binaural beats, an auditory illusion suspected to act as a cognitive enhancer, have an impact on cognitive-control configuration. We hypothesized that binaural beats in the gamma range bias the cognitive-control style toward flexibility, which in turn should increase the crosstalk between tasks in a dual-task paradigm. We replicated earlier findings that the reaction time in the first-performed task is sensitive to the compatibility between the responses in the first and the second task—an indication of crosstalk. As predicted, exposing participants to binaural beats in the gamma range increased this effect as compared to a control condition in which participants were exposed to a continuous tone of 340 Hz. These findings provide converging evidence that the cognitive-control style can be systematically biased by inducing particular internal states; that high-frequency binaural beats bias the control style toward more flexibility; and that different styles are implemented by changing the strength of local competition and top-down bias. PMID:27605922

Neonatal blue-light phototherapy does not increase nevus count in 9-year-old children.

PubMed

Mahé, Emmanuel; Beauchet, Alain; Aegerter, Philippe; Saiag, Philippe

2009-05-01

One of the most important risk factors for melanoma is the number of acquired common and atypical nevi in childhood. The role played by neonatal blue-light phototherapy in the increasing incidence of common and atypical melanocytic nevi in childhood or adolescence has been discussed recently with discordant results. We designed a multicenter study to assess the effects of neonatal blue-light phototherapy on nevus count in a cohort of 9-year-old children. We counted back and arm nevi as a function of size in 828 children included in a French photoprotection educational campaign. History of neonatal phototherapy, phototype, skin, hair and eye color, and sunburn were assessed through questionnaires to which both parents and children responded, and a nevus count was performed by trained nurses blinded to phototherapy history. Mean nevus count was 16.7 per child. Twenty-two percent of the children had received neonatal blue-light phototherapy. Neonatal phototherapy had no effect on the nevus count irrespective of nevi location, nevi size, or phototype of the children. A light phototype, skin, and hair color; blue/green eyes; and history of sunburn were closely correlated with an increase in nevus count. This study found no evidence for a major role of blue-light phototherapy on nevus count in 9-year-old children. It underlines the dominant effect of phototype characteristics and history of sunburn in childhood on the early development of melanocytic nevi.

Epidemiology of Achilles tendon ruptures: increasing incidence over a 33-year period.

PubMed

Lantto, I; Heikkinen, J; Flinkkilä, T; Ohtonen, P; Leppilahti, J

2015-02-01

We investigated the epidemiology of total Achilles tendon ruptures and complication rates after operative and nonoperative treatments over a 33-year period in Oulu, Finland. Patients with Achilles tendon ruptures from 1979 to 2011 in Oulu were identified from hospital patient records. Demographic data, treatment method, and complications were collected retrospectively from medical records. Overall and sex- and age-specific incidence rates were calculated with 95% confidence intervals (CIs). The overall incidence per 100,000 person-years increased from 2.1 (95% CI 0.3-7.7) in 1979 to 21.5 (95% CI 14.6-30.6) in 2011. The incidence increased in all age groups. The mean annual increase in incidence was 2.4% (95% CI 1.3-4.7) higher for non-sports-related ruptures than for sports-related ruptures (P = 0.036). The incidence of sports-related ruptures increased during the second 11-year period whereas the incidence of non-sports-related ruptures increased steadily over the entire study period. Infection was four times more common after operative treatment compared with nonoperative treatment, re-rupture rates were similar. The incidence of Achilles tendon ruptures increased in all age groups over a 33-year period. Increases were mainly due to sports-related injuries in the second 11-year period and non-sports-related injuries in the last 11-year period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evidence-Based Practice Guideline: Increasing Physical Activity in Schools--Kindergarten through 8th Grade

ERIC Educational Resources Information Center

Bagby, Karen; Adams, Susan

2007-01-01

Because of the growing obesity epidemic across all age groups in the United States, interventions to increase physical activity and reduce sedentary behaviors have become a priority. Evidence is growing that interventions to increase physical activity and reduce sedentary behaviors have positive results and are generally inexpensive to implement.…

Mortality risk after head injury increases at 30 years.

PubMed

Harris, Colin; DiRusso, Stephen; Sullivan, Tom; Benzil, Deborah L

2003-11-01

Age has long been recognized as a critical factor in predicting outcomes after head injury, with individuals older than 60 years predicted to have a worse outcome than those younger than 60. The object of this study was to determine the effect of age by decade of life beginning at birth in patients with head injuries of all levels of severity. The New York State Trauma Registry was searched for head injuries from January 1, 1994 to December 31, 1995; the 13,908 cases found were placed into age groups by decade. Data were sought for each patient on demographics, Glasgow Coma Score, ICD-9 injury code, New Injury Severity Score (NISS), and mechanism of injury. These data were analyzed with chi-square and one-way ANOVA tests, with significance set at p < 0.05. The risk of dying was significantly increased in patients beginning at 30 years of age compared with those in the younger age groups, with the greatest increases occurring after age 60 (p < 0.001). For the population with available Glasgow Coma Score data (n = 12,844), the mortality rate for patients ages 0 to 30 was 10.9%, and for patients ages 31 to 50 was 12.4%. The mean Glasgow Coma Score for nonsurvivors ages 0 to 20 (3.9) and for nonsurvivors ages 31 to 50 (5.1) were significantly different, with a risk ratio of 1.3 (p < 0.001). The risk of dying for patients suffering head injuries increases as early as 30 years of age, making it necessary for health-care providers to consider increased monitoring and treatment for patients in this younger age group.

Increasing heavy metals in the background atmosphere of central North China since the 1980s: Evidence from a 200-year lake sediment record

NASA Astrophysics Data System (ADS)

Wan, Dejun; Song, Lei; Yang, Jinsong; Jin, Zhangdong; Zhan, Changlin; Mao, Xin; Liu, Dongwei; Shao, Yue

2016-08-01

Long-term trends of atmospheric compositions are significant for assessing the influence of human activities on the atmosphere and protecting the atmospheric environment. In this study, based on heavy metal concentrations and Pb isotope ratios in a well-dated sediment core from a remote alpine lake in central North China, anthropogenic fluxes of As, Cd, Sb, and Pb were reconstructed and heavy metal evolutions in the atmosphere were revealed in the last 200 years. The heavy metals in the atmosphere were generally natural origins before 1980 A.D. Since the 1980s they began to increase gradually, but they increased the most in the 1990s resulting from rapid developments of rough and high energy-consuming industries in North China. After entering the 21st century the industries still developed rapidly, but the atmospheric Pb ceased increase and the As and Sb even decreased in the 2000s due to (1) phasing out of leaded gasoline and (2) implementing stricter industrial emission standards in 2000 A.D. in China. However, in the 2000s the atmospheric heavy metals still kept at a relatively high level and even likely began to increase again in the 2010s. Considering the lake relatively remote and seldom affected by local human activities, the results likely reflect heavy metal evolutions in the regional background atmosphere of central North China at the annual/decadal timescale in the last 200 years.

European climate reconstructed for the past 500 years based on documentary and instrumental evidence

NASA Astrophysics Data System (ADS)

Wheeler, Dennis; Brazdil, Rudolf; Pfister, Christian

2010-05-01

European climate reconstructed for the past 500 years based on documentary and instrumental evidence Dennis Wheeler, Rudolf Brázdil, Christian Pfister and the Millennium project SG1 team The paper summarises the results of historical-climatological research conducted as part of the EU-funded 6th FP project MILLENNIUM the principal focus of which was the investigation of European climate during the past one thousand years (http://www.millenniumproject.net/). This project represents a major advance in bringing together, for the first time on such a scale, historical climatologists with other palaeoclimatological communities and climate modellers from many European countries. As part of MILLENNIUM, a sub-group (SG1) of historical climatologists from ten countries had the responsibility of collating and comprehensively analysing evidence from instrumental and documentary archives. This paper presents the main results of this undertaking but confines its attention to the study of the climate of the past 500 years and represents a summary of 10 themed papers submitted for a special issue of Climatic Change. They range across a variety of topics including newly-studied documentary data sources (e.g. early instrumental records, opening of the Stockholm harbour, ship log book data), temperature reconstructions for Central Europe, the Stockholm area and Mediterranean based on different types of documentary evidence, the application of standard paleoclimatological approaches to reconstructions based on index series derived from the documentary data, the influence of circulation dynamics on January-April climate , a comparison of reconstructions based on documentary data with the model runs (ECHO-G), a study of the quality of instrumental data in climate reconstructions, a 500-year flood chronology in Europe, and selected disastrous European windstorms and their reflection in documentary evidence and human memory. Finally, perspectives of historical-climatological research

An Evaluation of Evidence-Based Interventions to Increase Compliance among Children with Autism

ERIC Educational Resources Information Center

Fischetti, Anthony T.; Wilder, David A.; Myers, Kristin; Leon-Enriquez, Yanerys; Sinn, Stephanie; Rodriguez, Rebecka

2012-01-01

We evaluated 4 evidence-based interventions to increase compliance. Three children with autism who exhibited noncompliance when asked to relinquish a preferred toy were exposed sequentially to interventions that included a reduction in response effort, differential reinforcement, and guided compliance. Results indicated that effort reduction alone…

Embedding Evidence-based Practice Education into a Post-graduate Physiotherapy Program: Eight Years of pre-Post Course Evaluations.

PubMed

Perraton, L; Machotka, Z; Grimmer, K; Gibbs, C; Mahar, C; Kennedy, K

2017-04-01

Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university. Pre-survey/post-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently. There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP. An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing

[Prevalence of myopia and increase trend in children and adolescents aged 7-18 years in Han ethnic group in China, 2005-2014].

PubMed

Dong, Y H; Liu, H B; Wang, Z H; Yang, Z P; Xu, R B; Yang, Z G; Ma, J

2017-05-10

Objective: To understand and evaluate the prevalence of myopia and its trend in children and adolescents aged 7-18 years in Han ethnic group in China from 2005 to 2014, and provide evidence for the prevention of myopia. Methods: The data of 2005, 2010 and 2014 Chinese National Students Constitution and Health Surveys were collected. The children and adolescents with complete detection data of binoculus were selected as study subjects. The sample size of three studies were 233 108, 215 319 and 212 743, respectively. The method of curve fitting was used to simulate the myopia detection increase model and analyze the gender and area specific myopia detection increase trends and characteristics from 2005 to 2014. Results: The overall myopia detection rate increased gradually in the children and adolescents aged 7 to 18, which was 47.5 % in 2005, 55.5 % in 2010 and 57.1 % in 2014, respectively. The increase slowed in 2014. A"parabola" shape of myopia detection increase rate was observed. Myopia detection rate increased with age before puberty and decreased with age after puberty gradually. A"cross phenomenon" of myopia detection increase was observed in boys and girls between urban and rural areas. The increase of myopia detection was mainly in urban students before puberty and in rural students after puberty. The age of myopia prevalence peak has become earlier constantly in children and adolescents aged 7-18 years from 2005 to 2014, which was 13 years old in 2005, 12 years old in 2010 and 11 years old in 2014. The increase rate was about 7 % . During 2005-2014, the increase rate of myopia detection gradually increased in younger students and tended to zero in older students. Conclusion: The detection rate of myopia was still high in children and adolescents in China. The age of myopia prevalence peak has become earlier gradually.

Does Parental Divorce Increase Risk Behaviors among 15/16 and 18/19 year-old Adolescents? A Study from Oslo, Norway.

PubMed

Zeratsion, Henok; Bjertness, Cecilie B; Lien, Lars; Haavet, Ole R; Dalsklev, Madeleine; Halvorsen, Jon A; Bjertness, Espen; Claussen, Bjørgulf

2014-01-01

Several studies have reported an increase in risk behaviors among adolescents after experience of parental divorce. The aim of the study was to investigate whether parental divorce is associated with risk behavior among adolescents independent of mental health problems, first when early divorce was experienced, and second after experience of late parental divorce. One prospective (n=1861) and one cross-sectional study (n=2422) were conducted using data from two Young-HUBRO surveys in Oslo, Norway. All 15/16 year-old 10(th) grade students who participated in the first survey in the school year 2000/01 were followed-up in 2004 when they were 18/19 year-olds. The follow-up rate was 68%. The prospective study investigated the influence of late parental divorce that occurred between the age of 15/16 and 18/19. In the cross-sectional study we focused on early parental divorce that occurred before the participants were 15/16 year-old. In the prospective study we could not discern a significant association between experiencing late parental divorce and an increase in risk behaviors among 18/19 year-old adolescents. In the cross-sectional study parental divorce was significantly associated with cigarette smoking and using doping agents. Parental divorce that occurs when the children of divorced parents are 15/16 year-old or younger is associated with an increase in cigarette smoking and use of doping agents. However, no evidence of significant association is found between experience of late parental divorce and risk behaviors in late adolescence.

Does Parental Divorce Increase Risk Behaviors among 15/16 and 18/19 year-old Adolescents? A Study from Oslo, Norway

PubMed Central

Zeratsion, Henok; Bjertness, Cecilie B; Lien, Lars; Haavet, Ole R; Dalsklev, Madeleine; Halvorsen, Jon A; Bjertness, Espen; Claussen, Bjørgulf

2014-01-01

Background: Several studies have reported an increase in risk behaviors among adolescents after experience of parental divorce. The aim of the study was to investigate whether parental divorce is associated with risk behavior among adolescents independent of mental health problems, first when early divorce was experienced, and second after experience of late parental divorce. Method: One prospective (n=1861) and one cross-sectional study (n=2422) were conducted using data from two Young-HUBRO surveys in Oslo, Norway. All 15/16 year-old 10th grade students who participated in the first survey in the school year 2000/01 were followed-up in 2004 when they were 18/19 year-olds. The follow-up rate was 68%. The prospective study investigated the influence of late parental divorce that occurred between the age of 15/16 and 18/19. In the cross-sectional study we focused on early parental divorce that occurred before the participants were 15/16 year-old. Results:In the prospective study we could not discern a significant association between experiencing late parental divorce and an increase in risk behaviors among 18/19 year-old adolescents. In the cross-sectional study parental divorce was significantly associated with cigarette smoking and using doping agents. Conclusion: Parental divorce that occurs when the children of divorced parents are 15/16 year-old or younger is associated with an increase in cigarette smoking and use of doping agents. However, no evidence of significant association is found between experience of late parental divorce and risk behaviors in late adolescence. PMID:25006342

Reducing Motor Vehicle-Related Injuries at an Arizona Indian Reservation: Ten Years of Application of Evidence-Based Strategies

PubMed Central

Piontkowski, Stephen R; Peabody, Jon S; Reede, Christine; Velascosoltero, José; Tsatoke, Gordon; Shelhamer, Timothy; Hicks, Kenny R

2015-01-01

Unintentional injury is a significant public health burden for American Indians and Alaska Natives and was the leading cause of death among those aged 1 to 44 years between 1999 and 2004. Of those deaths, motor vehicle-related deaths cause the most mortality, justifying the need for intervention at an American Indian Reservation in Arizona (United States). We describe motor vehicle injury prevention program operations from 2004 through 2013. This community-based approach led by a multidisciplinary team primarily comprised of environmental public health and law enforcement personnel implemented evidence-based strategies to reduce the impact of motor vehicle-related injuries and deaths, focusing on reducing impaired driving and increasing occupant restraint use. Strategies included: mass media campaigns to enhance awareness and outreach; high-visibility sobriety checkpoints; passing and enforcing 0.08% blood alcohol concentration limits for drivers and primary occupant restraint laws; and child car seat distribution and education. Routine monitoring and evaluation data showed a significant 5% to 7% annual reduction of motor vehicle crashes (MVCs), nighttime MVCs, MVCs with injuries/fatalities, and nighttime MVCs with injuries/fatalities between 2004 and 2013, but the annual percent change in arrests for driving under the influence (DUI) was not significant. There was also a 144% increase in driver/front seat passenger seat belt use, from 19% in 2011 before the primary occupant restraint law was enacted to 47% during the first full year of enforcement (2013). Car seat checkpoint data also suggested a 160% increase in car seat use, from less than 20% to 52% in 2013. Implementation of evidence-based strategies in injury prevention, along with employment of key program approaches such as strong partnership building, community engagement, and consistent staffing and funding, can narrow the public health disparity gap experienced among American Indian and Alaska Native

Increasing incidence of pyogenic spondylodiscitis: a 14-year population-based study.

PubMed

Kehrer, Michala; Pedersen, Court; Jensen, Thøger G; Lassen, Annmarie T

2014-04-01

Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008. In a population-based study we identified all patients aged ≥18 years treated for pyogenic spondylodiscitis in Funen County, Denmark (population 483 123). Annual incidences were determined. Demographics, symptoms and diagnostic methods were recorded. We found 192 cases: median age 66.6 years; 57.3% men; 76.6% culture positive cases. Staphylococcus aureus was the most common pathogen (55.1%). During 1995-2008 the overall incidence, incidence of culture negative cases, and incidence of cases due to S. aureus increased 2.2-5.8, 0.3-1.8, and 1.6-2.5 cases per 100 000 person years, respectively. The elderly had the highest incidence compared to those aged ≤70 years (rate ratio for men 5.9 (95% CI: 4.2-8.5) and for women 3.5 (95% CI: 2.3-5.3)). During 1995-2008 the overall incidence of S. aureus and culture negative cases of spondylodiscitis increased and remained highest among the elderly. Whether the increase is real or is a result of improved diagnostic methods and workup remains unknown. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Evidence that ship noise increases stress in right whales.

PubMed

Rolland, Rosalind M; Parks, Susan E; Hunt, Kathleen E; Castellote, Manuel; Corkeron, Peter J; Nowacek, Douglas P; Wasser, Samuel K; Kraus, Scott D

2012-06-22

Baleen whales (Mysticeti) communicate using low-frequency acoustic signals. These long-wavelength sounds can be detected over hundreds of kilometres, potentially allowing contact over large distances. Low-frequency noise from large ships (20-200 Hz) overlaps acoustic signals used by baleen whales, and increased levels of underwater noise have been documented in areas with high shipping traffic. Reported responses of whales to increased noise include: habitat displacement, behavioural changes and alterations in the intensity, frequency and intervals of calls. However, it has been unclear whether exposure to noise results in physiological responses that may lead to significant consequences for individuals or populations. Here, we show that reduced ship traffic in the Bay of Fundy, Canada, following the events of 11 September 2001, resulted in a 6 dB decrease in underwater noise with a significant reduction below 150 Hz. This noise reduction was associated with decreased baseline levels of stress-related faecal hormone metabolites (glucocorticoids) in North Atlantic right whales (Eubalaena glacialis). This is the first evidence that exposure to low-frequency ship noise may be associated with chronic stress in whales, and has implications for all baleen whales in heavy ship traffic areas, and for recovery of this endangered right whale population.

Evidence that ship noise increases stress in right whales

PubMed Central

Rolland, Rosalind M.; Parks, Susan E.; Hunt, Kathleen E.; Castellote, Manuel; Corkeron, Peter J.; Nowacek, Douglas P.; Wasser, Samuel K.; Kraus, Scott D.

2012-01-01

Baleen whales (Mysticeti) communicate using low-frequency acoustic signals. These long-wavelength sounds can be detected over hundreds of kilometres, potentially allowing contact over large distances. Low-frequency noise from large ships (20–200 Hz) overlaps acoustic signals used by baleen whales, and increased levels of underwater noise have been documented in areas with high shipping traffic. Reported responses of whales to increased noise include: habitat displacement, behavioural changes and alterations in the intensity, frequency and intervals of calls. However, it has been unclear whether exposure to noise results in physiological responses that may lead to significant consequences for individuals or populations. Here, we show that reduced ship traffic in the Bay of Fundy, Canada, following the events of 11 September 2001, resulted in a 6 dB decrease in underwater noise with a significant reduction below 150 Hz. This noise reduction was associated with decreased baseline levels of stress-related faecal hormone metabolites (glucocorticoids) in North Atlantic right whales (Eubalaena glacialis). This is the first evidence that exposure to low-frequency ship noise may be associated with chronic stress in whales, and has implications for all baleen whales in heavy ship traffic areas, and for recovery of this endangered right whale population. PMID:22319129

Drug Prohibition and Public Health: 25 Years of Evidence

PubMed Central

Drucker, Ernest

1999-01-01

FOR THE PAST 25 YEARS, the US has pursued a drug policy based on prohibition and the vigorous application of criminal sanctions for the use and sale of illicit drugs. The relationship of a prohibition-based drug policy to prevalence patterns and health consequences of drug use has never been fully evaluated. To explore that relationship, the author examines national data on the application of criminal penalties for illegal drugs and associated trends in their patterns of use and adverse health outcomes for 1972–1997. Over this 25-year period, the rate at which criminal penalties are imposed for drug offenses has climbed steadily, reaching 1.5 million arrests for drug offenses in 1996, with a tenfold increase in imprisonment for drug charges since 1979. Today, drug enforcement activities constitute 67% of the $16 billion Federal drug budget and more than $20 billion per year in state and local enforcement expenditures, compared with $7.6 billion for treatment, prevention, and research. Despite an overall decline in the prevalence of drug use since 1979, we have seen dramatic increases in drugrelated emergency department visits and drug-related deaths coinciding with this period of increased enforcement. Further, while black, Hispanic, and white Americans use illegal drugs at comparable rates, there are dramatic differences in the application of criminal penalties for drug offenses. African Americans are more than 20 times as likely as whites to be incarcerated for drug offenses, and drug-related emergency department visits, overdose deaths, and new HIV infections related to injecting drugs are many times higher for blacks than whites. These outcomes may be understood as public health consequences of policies that criminalize and marginalize drug users and increase drug-related risks to life and health. Imagesp14-ap15-ap16-ap21-ap24-a PMID:9925168

Climate change, extreme events and increased risk of salmonellosis in Maryland, USA: Evidence for coastal vulnerability.

PubMed

Jiang, Chengsheng; Shaw, Kristi S; Upperman, Crystal R; Blythe, David; Mitchell, Clifford; Murtugudde, Raghu; Sapkota, Amy R; Sapkota, Amir

2015-10-01

Salmonella is a leading cause of acute gastroenteritis worldwide. Patterns of salmonellosis have been linked to weather events. However, there is a dearth of data regarding the association between extreme events and risk of salmonellosis, and how this risk may disproportionately impact coastal communities. We obtained Salmonella case data from the Maryland Foodborne Diseases Active Surveillance Network (2002-2012), and weather data from the National Climatic Data Center (1960-2012). We developed exposure metrics related to extreme temperature and precipitation events using a 30 year baseline (1960-1989) and linked them with county-level salmonellosis data. Data were analyzed using negative binomial Generalized Estimating Equations. We observed a 4.1% increase in salmonellosis risk associated with a 1 unit increase in extreme temperature events (incidence rate ratio (IRR):1.041; 95% confidence interval (CI):1.013-1.069). This increase in risk was more pronounced in coastal versus non-coastal areas (5.1% vs 1.5%). Likewise, we observed a 5.6% increase in salmonellosis risk (IRR:1.056; CI:1.035-1.078) associated with a 1 unit increase in extreme precipitation events, with the impact disproportionately felt in coastal areas (7.1% vs 3.6%). To our knowledge, this is the first empirical evidence showing that extreme temperature/precipitation events-that are expected to be more frequent and intense in coming decades-are disproportionately impacting coastal communities with regard to salmonellosis. Adaptation strategies need to account for this differential burden, particularly in light of ever increasing coastal populations. Copyright © 2015. Published by Elsevier Ltd.

Predicting the Unpredictable: 75 Years of Experimental Evidence

NASA Astrophysics Data System (ADS)

Radin, Dean I.

2011-11-01

From time immemorial, people have reported foreknowledge of future events. To determine whether such experiences are best understood via conventional explanations, or whether a retrocausal phenomenon might be involved in some instances, researchers have conducted hundreds of controlled laboratory experiments over the past 75 years. These studies fall into four general classes, and each class has generated repeatable evidence consistent with retrocausation. The statistical results for a class of forced-choice studies is associated with odds against chance of about 1024; for a class of free-response studies, odds about 1020; for psychophysiological-based studies, odds about 1017; and for implicit decision studies, odds about 1010. Effect sizes observed in the latter three classes are nearly identical, indicating replication of similar underlying effects. These effects are also in close agreement with the average effect size across 25,000 conventional social psychology experiments conducted over the last century, suggesting that retrocausal phenomena may not be especially unique, at least not in terms of the magnitude of effect. Bayesian analyses of the most recent classes of experiments confirm that the evidence is strongly in favor of a genuine effect, with Bayes Factors ranging from 13,669 to 1 for implicit decision experiments, to 2.9×1013 to 1 for psychophysiological designs. For the two most recent classes of studies examining retrocausal effects via unconscious physiological or behavioral measures, 85 of 101 studies (84%) reported by 25 different laboratories from the United States, Italy, Spain, Holland, Austria, Sweden, England, Scotland, Iran, Japan, and Australia, have produced results in the direction predicted by a retrocausal effect (odds against chance = 1.3×1012, via a sign test). Assessment of the methodologies used in these studies has not identified plausible conventional alternatives for the observed outcomes, suggesting the existence of a

An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years

PubMed Central

2010-01-01

/1,280(43%) and neonatal encephalopathy 253/778(33%) had the highest case fatality. A combination of six indicators: irregular respiration, oxygen saturation of <90%, pallor, neck stiffness, weight < 1.5 kg, and abnormally elevated blood glucose > 7 mmol/l predicted inpatient neonatal death with a sensitivity of 81% and a specificity of 68%. Conclusions There is clear evidence of increasing burden in neonatal admissions at a rural district hospital in contrast to reducing numbers of non-neonatal paediatrics' admissions aged ≤ 5years. Though the inpatient case fatality for all admissions aged ≤ 5 years declined significantly, neonates now comprise close to 60% of all inpatient deaths. Simple indicators may identify neonates at risk of death. PMID:20925939

DNA evidence of bowhead whale exploitation by Greenlandic Paleo-Inuit 4,000 years ago

NASA Astrophysics Data System (ADS)

Seersholm, Frederik Valeur; Pedersen, Mikkel Winther; Søe, Martin Jensen; Shokry, Hussein; Mak, Sarah Siu Tze; Ruter, Anthony; Raghavan, Maanasa; Fitzhugh, William; Kjær, Kurt H.; Willerslev, Eske; Meldgaard, Morten; Kapel, Christian M. O.; Hansen, Anders Johannes

2016-11-01

The demographic history of Greenland is characterized by recurrent migrations and extinctions since the first humans arrived 4,500 years ago. Our current understanding of these extinct cultures relies primarily on preserved fossils found in their archaeological deposits, which hold valuable information on past subsistence practices. However, some exploited taxa, though economically important, comprise only a small fraction of these sub-fossil assemblages. Here we reconstruct a comprehensive record of past subsistence economies in Greenland by sequencing ancient DNA from four well-described midden deposits. Our results confirm that the species found in the fossil record, like harp seal and ringed seal, were a vital part of Inuit subsistence, but also add a new dimension with evidence that caribou, walrus and whale species played a more prominent role for the survival of Paleo-Inuit cultures than previously reported. Most notably, we report evidence of bowhead whale exploitation by the Saqqaq culture 4,000 years ago.

DNA evidence of bowhead whale exploitation by Greenlandic Paleo-Inuit 4,000 years ago

PubMed Central

Seersholm, Frederik Valeur; Pedersen, Mikkel Winther; Søe, Martin Jensen; Shokry, Hussein; Mak, Sarah Siu Tze; Ruter, Anthony; Raghavan, Maanasa; Fitzhugh, William; Kjær, Kurt H.; Willerslev, Eske; Meldgaard, Morten; Kapel, Christian M.O.; Hansen, Anders Johannes

2016-01-01

The demographic history of Greenland is characterized by recurrent migrations and extinctions since the first humans arrived 4,500 years ago. Our current understanding of these extinct cultures relies primarily on preserved fossils found in their archaeological deposits, which hold valuable information on past subsistence practices. However, some exploited taxa, though economically important, comprise only a small fraction of these sub-fossil assemblages. Here we reconstruct a comprehensive record of past subsistence economies in Greenland by sequencing ancient DNA from four well-described midden deposits. Our results confirm that the species found in the fossil record, like harp seal and ringed seal, were a vital part of Inuit subsistence, but also add a new dimension with evidence that caribou, walrus and whale species played a more prominent role for the survival of Paleo-Inuit cultures than previously reported. Most notably, we report evidence of bowhead whale exploitation by the Saqqaq culture 4,000 years ago. PMID:27824339

Mind the gap--reaching the European target of a 2-year increase in healthy life years in the next decade.

PubMed

Jagger, Carol; McKee, Martin; Christensen, Kaare; Lagiewka, Karolina; Nusselder, Wilma; Van Oyen, Herman; Cambois, Emmanuelle; Jeune, Bernard; Robine, Jean-Marie

2013-10-01

The European Innovation Partnership on Active and Healthy Ageing seeks an increase of two healthy life years (HLY) at birth in the EU27 for the next 10 years. We assess the feasibility of doing so between 2010 and 2020 and the differential impact among countries by applying different scenarios to current trends in HLY. Data comprised HLY and life expectancy (LE) at birth 2004-09 from Eurostat. We estimated HLY in 2010 in each country by multiplying the Eurostat projections of LE in 2010 by the ratio HLY/LE obtained either from country and sex-specific linear regression models of HLY/LE on year (seven countries retaining same HLY question) or extrapolating the average of HLY/LE in 2008 and 2009 to 2010 (20 countries and EU27). The first scenario continued these trends with three other scenarios exploring different HLY gap reductions between 2010 and 2020. The estimated gap in HLY in 2010 was 17.5 years (men) and 18.9 years (women). Assuming current trends continue, EU27 HLY increased by 1.4 years (men) and 0.9 years (women), below the European Innovation Partnership on Active and Healthy Ageing target, with the HLY gap between countries increasing to 18.3 years (men) and 19.5 years (women). To eliminate the HLY gap in 20 years, the EU27 must gain 4.4 HLY (men) and 4.8 HLY (women) in the next decade, which, for some countries, is substantially more than what the current trends suggest. Global targets for HLY move attention from inter-country differences and, alongside the current economic crisis, may contribute to increase health inequalities.

Impact exercise increases BMC during growth: an 8-year longitudinal study.

PubMed

Gunter, Katherine; Baxter-Jones, Adam Dg; Mirwald, Robert L; Almstedt, Hawley; Fuchs, Robyn K; Durski, Shantel; Snow, Christine

2008-07-01

Our aim was to assess BMC of the hip over 8 yr in prepubertal children who participated in a 7-mo jumping intervention compared with controls who participated in a stretching program of equal duration. We hypothesized that jumpers would gain more BMC than control subjects. The data reported come from two cohorts of children who participated in separate, but identical, randomized, controlled, school-based impact exercise interventions and reflect those subjects who agreed to long-term follow-up (N = 57; jumpers = 33, controls = 24; 47% of the original participants). BMC was assessed by DXA at baseline, 7 and 19 mo after intervention, and annually thereafter for 5 yr (eight visits over 8 yr). Multilevel random effects models were constructed and used to predict change in BMC from baseline at each measurement occasion. After 7 mo, those children that completed high-impact jumping exercises had 3.6% more BMC at the hip than control subjects whom completed nonimpact stretching activities (p < 0.05) and 1.4% more BMC at the hip after nearly 8 yr (BMC adjusted for change in age, height, weight, and physical activity; p < 0.05). This provides the first evidence of a sustained effect on total hip BMC from short-term high-impact exercise undertaken in early childhood. If the benefits are sustained into young adulthood, effectively increasing peak bone mass, fracture risk in the later years could be reduced.

Pre- and postnatal health: evidence of increased choline needs.

PubMed

Caudill, Marie A

2010-08-01

Choline, a micronutrient found in food, serves as the starting material for several important metabolites that play key roles in fetal development, particularly the brain. Although human beings' requirement for choline is unknown, an Adequate Intake level of 425 mg/day was established for women with upward adjustments to 450 and 550 mg/day during pregnancy and lactation, respectively. The importance of choline in human development is supported by observations that a human fetus receives a large supply of choline during gestation; pregnancy causes depletion of hepatic choline pools in rats consuming a normal diet; human neonates are born with blood levels that are three times higher than maternal blood concentrations; and large amounts of choline are present in human milk. The development of the central nervous system is particularly sensitive to choline availability with evidence of effects on neural tube closure and cognition. Existing data show that the majority of pregnant (and presumably lactating) women are not achieving the target intake levels and that certain common genetic variants may increase requirements for choline beyond current recommendations. Because choline is not found in most varieties of prenatal vitamins (or regular multivitamins), increased consumption of choline-rich foods may be needed to meet the high pre- and postnatal demands for choline. 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Evidence for increased glutamatergic cortical facilitation in children and adolescents with major depressive disorder.

PubMed

Croarkin, Paul E; Nakonezny, Paul A; Husain, Mustafa M; Melton, Tabatha; Buyukdura, Jeylan S; Kennard, Betsy D; Emslie, Graham J; Kozel, F Andrew; Daskalakis, Zafiris J

2013-03-01

Converging lines of evidence implicate the glutamate and γ-aminobutyric acid neurotransmitter systems in the pathophysiology of major depressive disorder. Transcranial magnetic stimulation cortical excitability and inhibition paradigms have been used to assess cortical glutamatergic and γ-aminobutyric acid-mediated tone in adults with major depressive disorder, but not in children and adolescents. To compare measures of cortical excitability and inhibition with 4 different paradigms in a group of children and adolescents with major depressive disorder vs healthy controls. Cross-sectional study examining medication-free children and adolescents (aged 9-17 years) with major depressive disorder compared with healthy controls. Cortical excitability was assessed with motor threshold and intracortical facilitation measures. Cortical inhibition was measured with cortical silent period and intracortical inhibition paradigms. University-based child and adolescent psychiatry clinic and neurostimulation laboratory. Twenty-four participants with major depressive disorder and 22 healthy controls matched for age and sex. Patients with major depressive disorder were medication naive and had moderate to severe symptoms based on an evaluation with a child and adolescent psychiatrist and scores on the Children's Depression Rating Scale-Revised. Motor threshold, intracortical facilitation, cortical silent period, and intracortical inhibition. Compared with healthy controls, depressed patients had significantly increased intracortical facilitation at interstimulus intervals of 10 and 15 milliseconds bilaterally. There were no significant group differences in cortical inhibition measures. These findings suggest that major depressive disorder in children and adolescents is associated with increased intracortical facilitation and excessive glutamatergic activity.

Examining the Evidence from TIMSS: Gender Differences in Year 8 Science Achievement in Australia

ERIC Educational Resources Information Center

Thomson, Sue

2008-01-01

Australia's continuing participation in international science studies such as TIMSS provides a useful lens through which to monitor achievement in science over time. Gender differences in science were not evident in the early years of TIMSS but appear to be growing. This article examines gender differences in science achievement in early secondary…

Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

PubMed

Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

2017-02-01

The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

Evidence for increased cardiac compliance during exposure to simulated microgravity

NASA Technical Reports Server (NTRS)

Koenig, S. C.; Convertino, V. A.; Fanton, J. W.; Reister, C. A.; Gaffney, F. A.; Ludwig, D. A.; Krotov, V. P.; Trambovetsky, E. V.; Latham, R. D.

1998-01-01

We measured hemodynamic responses during 4 days of head-down tilt (HDT) and during graded lower body negative pressure (LBNP) in invasively instrumented rhesus monkeys to test the hypotheses that exposure to simulated microgravity increases cardiac compliance and that decreased stroke volume, cardiac output, and orthostatic tolerance are associated with reduced left ventricular peak dP/dt. Six monkeys underwent two 4-day (96 h) experimental conditions separated by 9 days of ambulatory activities in a crossover counterbalance design: 1) continuous exposure to 10 degrees HDT and 2) approximately 12-14 h per day of 80 degrees head-up tilt and 10-12 h supine (control condition). Each animal underwent measurements of central venous pressure (CVP), left ventricular and aortic pressures, stroke volume, esophageal pressure (EsP), plasma volume, alpha1- and beta1-adrenergic responsiveness, and tolerance to LBNP. HDT induced a hypovolemic and hypoadrenergic state with reduced LBNP tolerance compared with the control condition. Decreased LBNP tolerance with HDT was associated with reduced stroke volume, cardiac output, and peak dP/dt. Compared with the control condition, a 34% reduction in CVP (P = 0.010) and no change in left ventricular end-diastolic area during HDT was associated with increased ventricular compliance (P = 0.0053). Increased cardiac compliance could not be explained by reduced intrathoracic pressure since EsP was unaltered by HDT. Our data provide the first direct evidence that increased cardiac compliance was associated with headward fluid shifts similar to those induced by exposure to spaceflight and that reduced orthostatic tolerance was associated with lower cardiac contractility.

The population benefit of evidence-based radiotherapy: 5-Year local control and overall survival benefits.

PubMed

Hanna, T P; Shafiq, J; Delaney, G P; Vinod, S K; Thompson, S R; Barton, M B

2018-02-01

To describe the population benefit of radiotherapy in a high-income setting if evidence-based guidelines were routinely followed. Australian decision tree models were utilized. Radiotherapy alone (RT) benefit was defined as the absolute proportional benefit of radiotherapy compared with no treatment for radical indications, and of radiotherapy over surgery alone for adjuvant indications. Chemoradiotherapy (CRT) benefit was the absolute incremental benefit of concurrent chemoradiotherapy over RT. Five-year local control (LC) and overall survival (OS) benefits were measured. Citation databases were systematically queried for benefit data. Meta-analysis and sensitivity analysis were performed. 48% of all cancer patients have indications for radiotherapy, 34% curative and 14% palliative. RT provides 5-year LC benefit in 10.4% of all cancer patients (95% Confidence Interval 9.3, 11.8) and 5-year OS benefit in 2.4% (2.1, 2.7). CRT provides 5-year LC benefit in an additional 0.6% of all cancer patients (0.5, 0.6), and 5-year OS benefit for an additional 0.3% (0.2, 0.4). RT benefit was greatest for head and neck (LC 32%, OS 16%), and cervix (LC 33%, OS 18%). CRT LC benefit was greatest for rectum (6%) and OS for cervix (3%) and brain (3%). Sensitivity analysis confirmed a robust model. Radiotherapy provides significant 5-year LC and OS benefits as part of evidence-based cancer care. CRT provides modest additional benefits. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Using Lean Quality Improvement Tools to Increase Delivery of Evidence-Based Tobacco Use Treatment in Hospitalized Neurosurgical Patients.

PubMed

Sisler, Laurel; Omofoye, Oluwaseun; Paci, Karina; Hadar, Eldad; Goldstein, Adam O; Ripley-Moffitt, Carol

2017-12-01

Health care providers routinely undertreat tobacco dependence, indicating a need for innovative ways to increase delivery of evidence-based care. Lean, a set of quality improvement (QI) tools used increasingly in health care, can help streamline processes, create buy-in for use of evidence-based practices, and lead to the identification of solutions on the basis of a problem's root causes. To date, no published research has examined the use of Lean tools in tobacco dependence. A 12-month QI project using Lean tools was conducted to increase delivery of evidence-based tobacco use treatment (TUT) to hospitalized neurosurgical patients. The study team developed a nicotine replacement therapy (NRT) and counseling protocol for neurosurgery inpatients who indicated current tobacco use and used Lean tools to increase protocol adherence. Rates of NRT prescription, referrals to counseling, and follow-up phone calls were compared pre- and postintervention. Secondary measures included patient satisfaction with intervention, quit rates, and reduction rates at 4 weeks postdischarge. Referrals to counseling doubled from 31.7% at baseline to 62.0% after implementation of the intervention, and rates of nicotine replacement therapy (NRT) prescriptions during hospitalization and at discharge increased from 15.3% to 28.5% and 9.0% to 19.3%, respectively. Follow-up phone call rates also dramatically increased. The majority of satisfaction survey respondents indicated that counseling had a positive or neutral impact on stress level and overall satisfaction. Lean tools can dramatically increase use of evidence-based TUT in hospitalized patients. This project is easily replicable by professionals seeking to improve delivery of tobacco treatment. These findings may be particularly helpful to inpatient surgical departments that have traditionally been reticent to prescribe NRT. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

[Evidence and Evidence Gaps - an Introduction].

PubMed

Dreier, G; Löhler, J

2016-04-01

Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

Results of the First Year of Active for Life: Translation of 2 Evidence-Based Physical Activity Programs for Older Adults Into Community Settings

PubMed Central

Wilcox, Sara; Dowda, Marsha; Griffin, Sarah F.; Rheaume, Carol; Ory, Marcia G.; Leviton, Laura; King, Abby C.; Dunn, Andrea; Buchner, David M.; Bazzarre, Terry; Estabrooks, Paul A.; Campbell-Voytal, Kimberly; Bartlett-Prescott, Jenny; Dowdy, Diane; Castro, Cynthia M.; Carpenter, Ruth Ann; Dzewaltowski, David A.; Mockenhaupt, Robin

2006-01-01

Objectives. Translating efficacious interventions into practice within community settings is a major public health challenge. We evaluated the effects of 2 evidence-based physical activity interventions on self-reported physical activity and related outcomes in midlife and older adults. Methods. Four community-based organizations implemented Active Choices, a 6-month, telephone-based program, and 5 implemented Active Living Every Day, a 20-week, group-based program. Both programs emphasize behavioral skills necessary to become more physically active. Participants completed pretest and posttest surveys. Results. Participants (n=838) were aged an average of 68.4 ±9.4 years, 80.6% were women, and 64.1% were non-Hispanic White. Seventy-two percent returned posttest surveys. Intent-to-treat analyses found statistically significant increases in moderate-to-vigorous physical activity and total physical activity, decreases in depressive symptoms and stress, increases in satisfaction with body appearance and function, and decreases in body mass index. Conclusions. The first year of Active for Life demonstrated that Active Choices and Active Living Every Day, 2 evidence-based physical activity programs, can be successfully translated into community settings with diverse populations. Further, the magnitudes of change in outcomes were similar to those reported in the efficacy trials. PMID:16735619

Evidence from 12-year study links ecosystem changes in the Gulf of Maine with climate change

USGS Publications Warehouse

Aiken, George R.; Huntington, Thomas G.; Balch, William; Drapeau, David; Bowler, Bruce

2012-01-01

Investigators at the Bigelow Laboratory for Ocean Sciences (East Boothbay, Maine) and the U.S. Geological Survey collaborated to study ecosystem changes in the Gulf of Maine. As part of the Gulf of Maine North Atlantic Time Series (GNATS), a comprehensive long-term study of hydrographic, biological, optical and chemical properties, multiple cruises have been conducted each year since 2001 by using a portable laboratory aboard different vessels (figure 1) and occasionally a remotely controlled glider (figure 2). Data collected during these cruises, when analyzed within the context of a century of climatological and streamflow data, document changes in temperature, salinity, and coastal ocean productivity that appear to be related to recent increases in precipitation and streamflow. These results are evidence of a link between changing hydrologic conditions on land and changes in coastal ocean productivity.

Teaching evidence-based medical care: description and evaluation.

PubMed

Grad, R; Macaulay, A C; Warner, M

2001-09-01

This paper describes and evaluates several years of a seminar series designed to stimulate residents to seek evidence-based answers to their clinical questions and incorporate this evidence into practice. At the first session, 86 of 89 (97%) residents completed a baseline needs assessment questionnaire. Post-course self-assessment questionnaires measured change from the first to the final seminar session in six domains of interest and skill, as well as residents' preferred sources of information for clinical problem solving up to 2 years after the course. Before the seminars, 48% of residents reported that textbooks were their most important source of information for solving clinical problems. A total of 58 of 75 (77%) residents completed the first post-course questionnaire. Residents reported significant increases in skill at formulating clinical questions and searching for evidence-based answers, appraising reviews, and deciding when and how to incorporate new findings into practice. Use of secondary sources of information such as "Best Evidence," moved up in importance from before the course to after the course. First-year family practice residents who completed our seminar series have reported increased skill at blending consideration of a clinical problem with the use of secondary sources of information to access evidence to support their health care decisions.

20 CFR 418.2250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false What evidence will you need to support your request that we use a more recent tax year? 418.2250 Section 418.2250 Employees' Benefits SOCIAL SECURITY... evidence will you need to support your request that we use a more recent tax year? We will follow the rules...

Twenty years of ovulation induction with metformin for PCOS; what is the best available evidence?

PubMed

Abu Hashim, Hatem

2016-01-01

The potential reproductive benefits of metformin, a drug endowed with the capacity to ameliorate insulin resistance in polycystic ovary syndrome (PCOS), has garnered much interest over the past 2 decades. In this review, randomized-controlled trials (RCT) and meta-analyses of RCT comparing metformin are critically appraised and summarized. PubMed and CENTRAL databases were consulted. Evidence is insufficient to favour the use of metformin or metformin plus clomiphene citrate instead of clomiphene citrate for ovulation induction in women with newly diagnosed PCOS. Evidence is also insufficient to recommend metformin as a primary treatment for non-obese women with PCOS. Metformin plus clomiphene citrate should be considered as an effective option in clomiphene citrate-resistant PCOS. In women with PCOS undergoing gonadotrophin ovulation induction, metformin significantly increased pregnancy and live birth rates (P < 0.0001 and P = 0.020, respectively) with reduced risk of cancelled cycles. A beneficial effect of metformin co-treatment in increasing clinical pregnancy rates and reducing the risk of OHSS in PCOS patients undergoing assisted reproduction techniques has been shown. No evidence was found of reduced risk of spontaneous abortion or increased risk of major anomalies in women with PCOS taking metformin during the first trimester. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Expert opinion vs. empirical evidence

PubMed Central

Herman, Rod A; Raybould, Alan

2014-01-01

Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

Can Population Levels of Physical Activity be Increased? Global Evidence and Experience

PubMed Central

Pratt, Michael; Perez, Lilian G.; Goenka, Shifalika; Brownson, Ross C.; Bauman, Adrian; Sarmiento, Olga Lucia; Hallal, Pedro C.

2016-01-01

Physical inactivity is one of the most important contributors to the global burden of disease and has become a global public health priority. We review the evidence on physical activity (PA) interventions, actions, and strategies that have the greatest potential to increase PA at the population level. Using the socio-ecological framework to conceptualize PA interventions, we show that PA can be targeted at multiple levels of influence and by multiple sectors outside the health system. Examples of promoting PA on a national scale are presented from Finland, Canada, Brazil, and Colombia. A strong policy framework, consistent investment in public health programs, multi-sectoral support and actions, and good surveillance characterize each of these success stories. Increasing PA globally will depend on successfully applying and adapting these lessons around the world taking into account country, culture, and context. PMID:25304047

Can population levels of physical activity be increased? Global evidence and experience.

PubMed

Pratt, Michael; Perez, Lilian G; Goenka, Shifalika; Brownson, Ross C; Bauman, Adrian; Sarmiento, Olga Lucia; Hallal, Pedro C

2015-01-01

Physical inactivity is one of the most important contributors to the global burden of disease and has become a global public health priority. We review the evidence on physical activity (PA) interventions, actions, and strategies that have the greatest potential to increase PA at the population level. Using the socio-ecological framework to conceptualize PA interventions, we show that PA can be targeted at multiple levels of influence and by multiple sectors outside the health system. Examples of promoting PA on a national scale are presented from Finland, Canada, Brazil, and Colombia. A strong policy framework, consistent investment in public health programs, multi-sectoral support and actions, and good surveillance characterize each of these success stories. Increasing PA globally will depend on successfully applying and adapting these lessons around the world taking into account country, culture, and context. Published by Elsevier Inc.

Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

PubMed

Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Valuck, Robert J

2015-12-01

In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions

Hierarchy of evidence referring to the central nervous system in a high-impact radiation oncology journal: a 10-year assessment. Descriptive critical appraisal study.

PubMed

Moraes, Fabio Ynoe; Bonifacio, Lorine Arias; Marta, Gustavo Nader; Hanna, Samir Abdallah; Atallah, Álvaro Nagib; Moraes, Vinícius Ynoe; Silva, João Luis Fernandes; Carvalho, Heloísa Andrade

2015-01-01

To the best of our knowledge, there has been no systematic assessment of the classification of scientific production within the scope of radiation oncology relating to central nervous system tumors. The aim of this study was to systematically assess the status of evidence relating to the central nervous system and to evaluate the geographic origins and major content of these published data. Descriptive critical appraisal study conducted at a private hospital in São Paulo, Brazil. We evaluated all of the central nervous system studies published in the journal Radiotherapy & Oncology between 2003 and 2012. The studies identified were classified according to their methodological design and level of evidence. Information regarding the geographical location of the study, the institutions and authors involved in the publication, main condition or disease investigated and time of publication was also obtained. We identified 3,004 studies published over the 10-year period. Of these, 125 (4.2%) were considered eligible, and 66% of them were case series. Systematic reviews and randomized clinical trials accounted for approximately 10% of all the published papers. We observed an increase in high-quality evidence and a decrease in low-quality published papers over this period (P = 0.036). The inter-rater reliability demonstrated significant agreement between observers in terms of the level of evidence. Increases in high-level evidence and in the total number of central nervous system papers were clearly demonstrated, although the overall number of such studies remained relatively small.

Experimental evidence that wildflower strips increase pollinator visits to crops.

PubMed

Feltham, Hannah; Park, Kirsty; Minderman, Jeroen; Goulson, Dave

2015-08-01

Wild bees provide a free and potentially diverse ecosystem service to farmers growing pollination-dependent crops. While many crops benefit from insect pollination, soft fruit crops, including strawberries are highly dependent on this ecosystem service to produce viable fruit. However, as a result of intensive farming practices and declining pollinator populations, farmers are increasingly turning to commercially reared bees to ensure that crops are adequately pollinated throughout the season. Wildflower strips are a commonly used measure aimed at the conservation of wild pollinators. It has been suggested that commercial crops may also benefit from the presence of noncrop flowers; however, the efficacy and economic benefits of sowing flower strips for crops remain relatively unstudied. In a study system that utilizes both wild and commercial pollinators, we test whether wildflower strips increase the number of visits to adjacent commercial strawberry crops by pollinating insects. We quantified this by experimentally sowing wildflower strips approximately 20 meters away from the crop and recording the number of pollinator visits to crops with, and without, flower strips. Between June and August 2013, we walked 292 crop transects at six farms in Scotland, recording a total of 2826 pollinators. On average, the frequency of pollinator visits was 25% higher for crops with adjacent flower strips compared to those without, with a combination of wild and commercial bumblebees (Bombus spp.) accounting for 67% of all pollinators observed. This effect was independent of other confounding effects, such as the number of flowers on the crop, date, and temperature. Synthesis and applications. This study provides evidence that soft fruit farmers can increase the number of pollinators that visit their crops by sowing inexpensive flower seed mixes nearby. By investing in this management option, farmers have the potential to increase and sustain pollinator populations over time.

Experimental evidence that wildflower strips increase pollinator visits to crops

PubMed Central

Feltham, Hannah; Park, Kirsty; Minderman, Jeroen; Goulson, Dave

2015-01-01

Wild bees provide a free and potentially diverse ecosystem service to farmers growing pollination-dependent crops. While many crops benefit from insect pollination, soft fruit crops, including strawberries are highly dependent on this ecosystem service to produce viable fruit. However, as a result of intensive farming practices and declining pollinator populations, farmers are increasingly turning to commercially reared bees to ensure that crops are adequately pollinated throughout the season. Wildflower strips are a commonly used measure aimed at the conservation of wild pollinators. It has been suggested that commercial crops may also benefit from the presence of noncrop flowers; however, the efficacy and economic benefits of sowing flower strips for crops remain relatively unstudied. In a study system that utilizes both wild and commercial pollinators, we test whether wildflower strips increase the number of visits to adjacent commercial strawberry crops by pollinating insects. We quantified this by experimentally sowing wildflower strips approximately 20 meters away from the crop and recording the number of pollinator visits to crops with, and without, flower strips. Between June and August 2013, we walked 292 crop transects at six farms in Scotland, recording a total of 2826 pollinators. On average, the frequency of pollinator visits was 25% higher for crops with adjacent flower strips compared to those without, with a combination of wild and commercial bumblebees (Bombus spp.) accounting for 67% of all pollinators observed. This effect was independent of other confounding effects, such as the number of flowers on the crop, date, and temperature. Synthesis and applications. This study provides evidence that soft fruit farmers can increase the number of pollinators that visit their crops by sowing inexpensive flower seed mixes nearby. By investing in this management option, farmers have the potential to increase and sustain pollinator populations over time

Inhibition of IL-17A by secukinumab shows no evidence of increased Mycobacterium tuberculosis infections

PubMed Central

Kammüller, Michael; Tsai, Tsen-Fang; Griffiths, Christopher EM; Kapoor, Nidhi; Kolattukudy, Pappachan E; Brees, Dominique; Chibout, Salah-Dine; Safi Jr, Jorge; Fox, Todd

2017-01-01

Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A (IL-17A), has been shown to have significant efficacy in the treatment of moderate to severe psoriasis, psoriatic arthritis and ankylosing spondylitis. Blocking critical mediators of immunity may carry a risk of increased opportunistic infections. Here we present clinical and in vitro findings examining the effect of secukinumab on Mycobacterium tuberculosis infection. We re-assessed the effect of secukinumab on the incidence of acute tuberculosis (TB) and reactivation of latent TB infection (LTBI) in pooled safety data from five randomized, double-blind, placebo-controlled, phase 3 clinical trials in subjects with moderate to severe plaque psoriasis. No cases of TB were observed after 1 year. Importantly, in subjects with a history of pulmonary TB (but negative for interferon-γ release and receiving no anti-TB medication) or positive for latent TB (screened by interferon-γ release assay and receiving anti-TB medication), no cases of active TB were reported. Moreover, an in vitro study examined the effect of the anti-tumor necrosis factor-α (TNFα) antibody adalimumab and secukinumab on dormant M. tuberculosis H37Rv in a novel human three-dimensional microgranuloma model. Auramine-O, Nile red staining and rifampicin resistance of M. tuberculosis were measured. In vitro, anti-TNFα treatment showed increased staining for Auramine-O, decreased Nile red staining and decreased rifampicin resistance, indicative of mycobacterial reactivation. In contrast, secukinumab treatment was comparable to control indicating a lack of effect on M. tuberculosis dormancy. To date, clinical and preclinical investigations with secukinumab found no evidence of increased M. tuberculosis infections. PMID:28868144

Increasing Teachers' Use of Evidence-Based Classroom Management Strategies through Consultation: Overview and Case Studies

ERIC Educational Resources Information Center

MacSuga, Ashley S.; Simonsen, Brandi

2011-01-01

Many classroom teachers are faced with challenging student behaviors that impact their ability to facilitate learning in productive, safe environments. At the same time, high-stakes testing, increased emphasis on evidence-based instruction, data-based decision making, and response-to-intervention models have put heavy demands on teacher time and…

Has the emergence of community-associated methicillin-resistant Staphylococcus aureus increased trimethoprim-sulfamethoxazole use and resistance?: a 10-year time series analysis.

PubMed

Wood, Jameson B; Smith, Donald B; Baker, Errol H; Brecher, Stephen M; Gupta, Kalpana

2012-11-01

There are an increasing number of indications for trimethoprim-sulfamethoxazole use, including skin and soft tissue infections due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Assessing the relationship between rates of use and antibiotic resistance is important for maintaining the expected efficacy of this drug for guideline-recommended conditions. Using interrupted time series analysis, we aimed to determine whether the 2005 emergence of CA-MRSA and recommendations of trimethoprim-sulfamethoxazole as the preferred therapy were associated with changes in trimethoprim-sulfamethoxazole use and susceptibility rates. The data from all VA Boston Health Care System facilities, including 118,863 inpatient admissions, 6,272,661 outpatient clinic visits, and 10,138 isolates were collected over a 10-year period. There was a significant (P = 0.02) increase in trimethoprim-sulfamethoxazole prescriptions in the post-CA-MRSA period (1,605/year) compared to the pre-CA-MRSA period (1,538/year). Although the overall susceptibility of Escherichia coli and Proteus spp. to trimethoprim-sulfamethoxazole decreased over the study period, the rate of change in the pre- versus the post-CA-MRSA period was not significantly different. The changes in susceptibility rates of S. aureus to trimethoprim-sulfamethoxazole and to methicillin were also not significantly different. The CA-MRSA period is associated with a significant increase in use of trimethoprim-sulfamethoxazole but not with significant changes in the rates of susceptibilities among clinical isolates. There is also no evidence for selection of organisms with increased resistance to other antimicrobials in relation to increased trimethoprim-sulfamethoxazole use.

Linking molar organizational climate and strategic implementation climate to clinicians' use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study.

PubMed

Williams, Nathaniel J; Ehrhart, Mark G; Aarons, Gregory A; Marcus, Steven C; Beidas, Rinad S

2018-06-25

Behavioral health organizations are characterized by multiple organizational climates, including molar climate, which encompasses clinicians' shared perceptions of how the work environment impacts their personal well-being, and strategic implementation climate, which includes clinicians' shared perceptions of the extent to which evidence-based practice implementation is expected, supported, and rewarded by the organization. Theory suggests these climates have joint, cross-level effects on clinicians' implementation of evidence-based practice and that these effects may be long term (i.e., up to 2 years); however, no empirical studies have tested these relationships. We hypothesize that molar climate moderates implementation climate's concurrent and long-term relationships with clinicians' use of evidence-based practice such that strategic implementation climate will have its most positive effects when it is accompanied by a positive molar climate. Hypotheses were tested using data collected from 235 clinicians in 20 behavioral health organizations. At baseline, clinicians reported on molar climate and implementation climate. At baseline and at a 2-year follow-up, all clinicians who were present in the organizations reported on their use of cognitive-behavioral psychotherapy techniques, an evidence-based practice for youth psychiatric disorders. Two-level mixed-effects regression models tested whether baseline molar climate and implementation climate interacted in predicting clinicians' evidence-based practice use at baseline and at 2-year follow-up. In organizations with more positive molar climates at baseline, higher levels of implementation climate predicted increased evidence-based practice use among clinicians who were present at baseline and among clinicians who were present in the organizations at 2-year follow-up; however, in organizations with less positive molar climates, implementation climate was not related to clinicians' use of evidence-based practice

Curiosity killed the cat: no evidence of an association between cat ownership and psychotic symptoms at ages 13 and 18 years in a UK general population cohort.

PubMed

Solmi, F; Hayes, J F; Lewis, G; Kirkbride, J B

2017-07-01

Congenital or early life infection with Toxoplasma gondii has been implicated in schizophrenia aetiology. Childhood cat ownership has been hypothesized as an intermediary marker of T. gondii infection and, by proxy, as a risk factor for later psychosis. Evidence supporting this hypothesis is, however, limited. We used birth cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate whether cat ownership in pregnancy and childhood (ages 4 and 10 years) was associated with psychotic experiences (PEs) in early (age 13, N = 6705) and late (age 18, N = 4676) adolescence, rated from semi-structured interviews. We used logistic regression to examine associations between cat ownership and PEs, adjusting for several sociodemographic and socioeconomic factors, household characteristics and dog ownership. Missing data were handled via multiple imputation. Cat ownership during pregnancy was not associated with PEs at age 13 years [adjusted odds ratio (OR) 1.15, 95% confidence interval (CI) 0.97-1.35] or 18 years (OR 1.08, 95% CI 0.86-1.35). Initial univariable evidence that cat ownership at ages 4 and 10 years was associated with PEs at age 13 years did not persist after multivariable adjustment (4 years: OR 1.18, 95% CI 0.94-1.48; 10 years: OR 1.12, 95% CI 0.92-1.36). There was no evidence that childhood cat ownership was associated with PEs at age 18 years. While pregnant women should continue to avoid handling soiled cat litter, given possible T. gondii exposure, our study strongly indicates that cat ownership in pregnancy or early childhood does not confer an increased risk of later adolescent PEs.

Geochemical evidence of past earthquakes in sediments of the Reloncaví fjord (Chilean Patagonia) during the last ˜ 1000 years

NASA Astrophysics Data System (ADS)

Rebolledo, Lorena; Lange, Carina; Muñoz, Práxedes; Salamanca, Marco

2014-05-01

The Chilean fjords are excellent archives of paleoearthquakes, tsunamis and landslides (St-Onge et al., 2012 in Sedimentary Geology 243-244: 89-107). Here we report on new sedimentological and geochemical evidence of past earthquakes in sediments of the Reloncavi fjord, Northern Patagonia (41° S, 72° W), during the last ~1000 years. We recovered four sediment cores from the Reloncaví fjord (RH-5B, RH-5C, RH-6B, RH7B, water depth range = 90-260 m; core length range = 45-75 cm). Age models were based on 210Pb, AMS-14C and the first appearance of the diatom Rhizosolenia setigera cf. pungens in the fossil record as statigraphic marker. The cores span the last ~122 to 800 years of sedimentation with sedimentation rates ranging between 0.1 and 0.24 cm yr-1. The cores revealed evidence of turbidites associated with the historical earthquakes of 1960, 1837, 1737 and 1575 AD, and an earlier period for which there is no historical information, 1200-1400 AD. The turbidites exhibit a grading-up pattern with sand layers, and are characterized by a decrease in organic carbon and biogenic opal, an increase in the C/N molar ratio, negative values of δ13Corg(average -27),and an increase in the relative abundance of Paralia sulcata, a diatom associated with sandy environments, being the turbite layers mainly freshwater in origen. We suggest that these turbidite layers were triggered by past earthquakes that produced movement of land from the cliff areas that surround the Reloncaví fjord. Funding: Project FONDECYT # 11110103 and COPAS Sur-Austral project PFB-31.

Evidence, Argument and Social Responsibility: First-Year Students' Experiences of Information Literacy when Researching an Essay

ERIC Educational Resources Information Center

Lupton, Mandy

2008-01-01

This paper describes a phenomenographic study of undergraduates' experiences of information literacy when researching an essay in a first-year environmental studies course. Three hierarchical categories were identified that represented students' experiences: (i) seeking evidence; (ii) developing an argument; and (iii) learning as a social…

Evidence-based causation in toxicology: A 10-year retrospective.

PubMed

James, R C; Britt, J K; Halmes, N C; Guzelian, P S

2015-12-01

We introduced Evidence-based Toxicology (EBT) in 2005 to address the disparities that exist between the various Weight-of-Evidence (WOE) methods typically applied in the regulatory hazard decision-making arena and urged toxicologists to adopt the evidence-based guidelines long-utilized in medicine (i.e., Evidence-Based Medicine or EBM). This review of the activities leading to the adoption of evidence-based methods and EBT during the last decade demonstrates how fundamental concepts that form EBT, such as the use of systematic reviews to capture and consider all available information, are improving toxicological evaluations performed by various groups and agencies. We reiterate how the EBT framework, a process that provides a method for performing human chemical causation analyses in an objective, transparent and reproducible manner, differs significantly from past and current regulatory WOE approaches. We also discuss why the uncertainties associated with regulatory WOE schemes lead to a definition of the term "risk" that contains unquantifiable uncertainties not present in this term as it is used in epidemiology and medicine. We believe this distinctly different meaning of "risk" should be clearly conveyed to those not familiar with this difference (e.g., the lay public), when theoretical/nomologic risks associated with chemical-induced toxicities are presented outside of regulatory and related scientific parlance. © The Author(s) 2015.

Effect of Increased Intensity of Physiotherapy on Patient Outcomes After Stroke: An Evidence-Based Analysis

PubMed Central

Sehatzadeh, S

2015-01-01

Background After stroke, impairment of the upper and lower limb can limit patients’ motor function and ability to perform activities of daily living (ADL). Physiotherapy (PT) is an established clinical practice for stroke patients, playing an important role in improving limb function. Recently, several randomized trials have evaluated the effect of higher-intensity physiotherapy (increased duration and/or frequency) on patients’ functional ability. Objectives Our objective is to investigate whether an increased intensity of PT after stroke results in better outcomes for patients. Data Sources A literature search was performed on June 7, 2013, for English-language randomized controlled trials published from January 1, 2003, to June 7, 2013. Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews were searched. Review Methods We reviewed the full text of articles that compared 2 or more levels of PT intensity. Outcomes of interest included motor function, ADL, and quality of life (QOL). Results High-quality evidence showed that higher-intensity upper-limb PT and higher-intensity lower-limb PT both resulted in significantly greater improvements in motor function. Moderate-quality evidence showed that higher-intensity general PT did not. Moderate-quality evidence showed a significant improvement in ADL performance with higher-intensity upper-limb PT, but no improvement with higher-intensity general PT; no studies reported on ADL outcomes on lower-limb PT specifically. According to moderate-quality evidence, patient QOL did not change significantly after increased intensity of upper-limb, lower-limb, or general PT. When considering the results, one difference should be noted: Compared with the studies examining upper- and lower-limb PT, the studies examining general PT looked at a smaller increase—2 hours or less of additional therapy per week

Policy and Evidence: A Critical Analysis of the Year 1 Phonics Screening Check in England

ERIC Educational Resources Information Center

Grundin, Hans U.

2018-01-01

This paper aims to present a critical analysis of the Year 1 Phonics Screening Check (PSC), with special focus on the relationship between the UK Department for Education's policy-making and the evidence considered in the process of developing and evaluating the PSC. The reports from the in-house Standards and Testing Agency and from commissioned…

Cigarette Taxes and Smoking Participation: Evidence from Recent Tax Increases in Canada

PubMed Central

Azagba, Sunday; Sharaf, Mesbah

2011-01-01

Using the Canadian National Population Health Survey and the recent tax variation across Canadian provinces, this paper examines the impact of cigarette taxes on smoking participation. Consistent with the literature, we find evidence of a heterogeneous response to cigarette taxes among different groups of smokers. Contrary to most studies, we find that the middle age group—which constitutes the largest fraction of smokers in our sample—is largely unresponsive to taxes. While cigarette taxes remain popular with policy makers as an anti-smoking measure, identifying the socio-demographic characteristics of smokers who respond differentially to tax increase will help in designing appropriate supplementary measures to reduce smoking. PMID:21655139

Let’s Move for Pacific Islander Communities: An Evidence-Based Intervention to Increase Physical Activity

PubMed Central

LaBreche, Mandy; Cheri, Ashley; Custodio, Harold; Fex, Cleo Carlos; Foo, Mary Anne; Lepule, Jonathan Tana; May, Vanessa Tui’one; Orne, Annette; Pang, Jane Ka’ala; Pang, Victor Kaiwi; Sablan-Santos, Lola; Schmidt-Vaivao, Dorothy; Surani, Zul; Talavou, Melevesi Fifita; Toilolo, Tupou; Palmer, Paula Healani; Tanjasiri, Sora Park

2015-01-01

Pacific Islander (PI) populations of Southern California experience high obesity and low physical activity levels. Given PI’s rich cultural ties, efforts to increase physical activity using a community tailored strategy may motivate members in a more sustainable manner. In this paper, we: 1) detail the program adaptation methodology that was utilized to develop the Weaving an Islander Network for Cancer Awareness, Research and Training (WINCART) Center’s PI Let’s Move Program, a culturally-tailored program aimed to increase physical activity levels among members of PI organizations in Southern California, and 2) share the program’s pilot evaluation results on individual and organizational changes. The WINCART Center applied the National Cancer Institute’s program adaptation guidelines to tailor the evidence-based Instant Recess program to fit the needs of PIs. The end product, the PI Let’s Move Program, was piloted in 2012 with eight PI organizations, reaching 106 PI adults. At baseline, 52% of participants reported that they were not physically active, with the average number of days engaged in medium-intensity physical activity at 2.09 days/week. After the 2-month program, participants increased the number of days that they engaged in medium-intensity physical activity from 2.09 to 2.90 days/week. Post-pilot results found that 82% of participants reported intentions to engage in physical activity for at least the next six months. At baseline, only one organization was currently implementing a physical activity program, and none had implemented an evidence-based physical activity program tailored for PIs. After the 2-month timeframe, despite varying levels of capacity, all eight organizations were able to successfully implement the program. In conclusion, results from our program provide evidence that disparity populations, such as PIs, can be successfully reached through programs that are culturally tailored to both individuals and their community

Force That Increases at Larger Distance Has Some Psychological and Astronomical Evidence Supporting its Existence

NASA Astrophysics Data System (ADS)

Struck, James

2011-09-01

Force that Increases with distance is different than dark energy as I am arguing for existence of force based on psychological and astronomical bases. Hubble shift, doppler shift, comet return, quasar zoo and quasars and psychological evidence of interest in distant objects lends support to a force like gravity, nuclear, weak, strong, virtual, decay, biological, growth forces which increases its intensity with distance unlike gravity which decreases in intensity with distance. Jane Frances Back Struck contributed to this finding with her request that her grandparents have "perfect justice" even though her grandparents had died before she was born; interest increasing with distance from grandparents.

Bilingualism and increased attention to speech: Evidence from event-related potentials.

PubMed

Kuipers, Jan Rouke; Thierry, Guillaume

2015-10-01

A number of studies have shown that from an early age, bilinguals outperform their monolingual peers on executive control tasks. We previously found that bilingual children and adults also display greater attention to unexpected language switches within speech. Here, we investigated the effect of a bilingual upbringing on speech perception in one language. We recorded monolingual and bilingual toddlers' event-related potentials (ERPs) to spoken words preceded by pictures. Words matching the picture prime elicited an early frontal positivity in bilingual participants only, whereas later ERP amplitudes associated with semantic processing did not differ between groups. These results add to the growing body of evidence that bilingualism increases overall attention during speech perception whilst semantic integration is unaffected. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Evidence and evidence gaps - an introduction.

PubMed

Dreier, Gabriele; Löhler, Jan

2016-01-01

Background: Medical treatment requires the implementation of existing evidence in the decision making process in order to be able to find the best possible diagnostic, therapeutic or prognostic measure for the individual patient based on the physician's own expertise. Clinical trials form the evidence base and ideally, their results are assembled, analyzed, summarized, and made available in systematic review articles. Beside planning, conducting, and evaluating clinical trials in conformity with GCP (good clinical practice), it is essential that all results of conducted studies are publicly available in order to avoid publication bias. This includes also the public registration of planned and cancelled trials. History: During the last 25 years, evidence-based medicine became increasingly important in medical care and research. It is closely associated with the names of Archibald Cochrane and David Sackett. About 15 years ago, the Deutsche Cochrane Zentrum (Cochrane Germany) and the Deutsche Netzwerk Evidenzbasierte Medizin e.V. (German Network for Evidence-based Medicine, DNEbM) were founded in Germany. In the International Cochrane Collaboration, clinicians and methodologists come together on an interdisciplinary level to further develop methods of evidence-based medicine and to discuss the topics of evidence generation and processing as well as knowledge transfer. Problem: Evidence is particularly important for physicians in the process of decision making, however, at the same time it is the base of a scientific proof of benefit for the patient and finally for the payers in health care. The closure of evidence gaps requires enormously high staff and financial resources, significant organizational efforts, and it is only successful when clinical and methodical expertise as well as specific knowledge in the field of clinical research are included. On the other hand, the knowledge has to be transferred into practice. For this purpose, practice guidelines, meetings

Curiosity killed the cat: No evidence of an association between cat ownership and psychotic symptoms at age 13 and 18 years in a UK general population cohort

PubMed Central

Solmi, F.; Hayes, J.F; Lewis, G.; Kirkbride, J.B

2018-01-01

Background Congenital or early life infection with Toxoplasma Gondii has been implicated in schizophrenia aetiology. Childhood cat ownership has been hypothesised as an intermediary marker of T. Gondii infection and, by proxy, as a risk factor for later psychosis. Evidence supporting this hypothesis is, however, limited. Method We used birth cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate whether cat ownership in pregnancy and childhood (4, 10 years old) was associated with psychotic experiences (PEs) in early (age 13; N=6,705) and late (age 18; N=4,676) adolescence, rated from semi-structured interviews. We used logistic regression to examine associations between cat ownership and PEs, adjusting for several sociodemographic and socioeconomic factors, household characteristics and dog ownership. Missing data were handled via multiple imputation. Results Cat ownership during pregnancy was not associated with PEs at age 13 (adjusted odds ratio [OR]: 1.15, 95% confidence interval [CI]: 0.97-1.35) or 18 years (OR: 1.08, 95%CI: 0.86-1.35). Initial univariable evidence that cat ownership at 4 and 10 years was associated with PEs at age 13 years did not persist after multivariable adjustment (4 years OR: 1.18, 95%CI: 0.94-1.48; 10 years OR 1.12, 95%CI: 0.92; 1.36). There was no evidence that childhood cat ownership was associated with PEs at 18 years old. Conclusions While pregnant women should continue to avoid handling soiled cat litter, given possible T Gondii exposure, our study strongly indicates that cat ownership in pregnancy or early childhood does not confer an increased risk of later adolescent PEs. PMID:28222824

Crop-tree release increases growth of 12-year-old yellow-poplar and black cherry

Treesearch

Neil I. Lamson; H. Clay Smith; H. Clay Smith

1989-01-01

Precommercial thinning was done in a 12-year-old Appalachian hardwood sapling stand in West Virginia. Two crop-tree release techniques were used--crown touching and crown touching plus 5 feet. Results indicated that both treatments significantly increased 5-year d.b.h. growth for released yellow-poplar and black cherry crop trees. Although there was a major increase in...

Loss of Control Increases Belief in Precognition and Belief in Precognition Increases Control

PubMed Central

Greenaway, Katharine H.; Louis, Winnifred R.; Hornsey, Matthew J.

2013-01-01

Every year thousands of dollars are spent on psychics who claim to “know” the future. The present research questions why, despite no evidence that humans are able to psychically predict the future, do people persist in holding irrational beliefs about precognition? We argue that believing the future is predictable increases one’s own perceived ability to exert control over future events. As a result, belief in precognition should be particularly strong when people most desire control–that is, when they lack it. In Experiment 1 (N = 87), people who were experimentally induced to feel low in control reported greater belief in precognition than people who felt high in control. Experiment 2 (N = 53) investigated whether belief in precognition increases perceived control. Consistent with this notion, providing scientific evidence that precognition is possible increased feelings of control relative to providing scientific evidence that precognition was not possible. Experiment 3 (N = 132) revealed that when control is low, believing in precognition helps people to feel in control once more. Prediction therefore acts as a compensatory mechanism in times of low control. The present research provides new insights into the psychological functions of seemingly irrational beliefs, like belief in psychic abilities. PMID:23951136

Increasing utilization of Internet-based resources following efforts to promote evidence-based medicine: a national study in Taiwan.

PubMed

Weng, Yi-Hao; Kuo, Ken N; Yang, Chun-Yuh; Lo, Heng-Lien; Shih, Ya-Hui; Chen, Chiehfeng; Chiu, Ya-Wen

2013-01-07

Since the beginning of 2007, the National Health Research Institutes has been promoting the dissemination of evidence-based medicine (EBM). The current study examined longitudinal trends of behaviors in how hospital-based physicians and nurses have searched for medical information during the spread of EBM. Cross-sectional postal questionnaire surveys were conducted in nationally representative regional hospitals of Taiwan thrice in 2007, 2009, and 2011. Demographic data were gathered concerning gender, age, working experience, teaching appointment, academic degree, and administrative position. Linear and logistic regression models were used to examine predictors and changes over time. Data from physicians and nurses were collected in 2007 (n = 1156), 2009 (n = 2975), and 2011 (n = 3999). There were significant increases in the use of four Internet-based resources - Web portals, online databases, electronic journals, and electronic books - across the three survey years among physicians and nurses (p < 0.001). Access to textbooks and printed journals, however, did not change over the 4-year study period. In addition, there were significant relationships between the usage of Internet-based resources and users' characteristics. Age and faculty position were important predictors in relation to the usage among physicians and nurses, while academic degree served as a critical factor among nurses only. Physicians and nurses used a variety of sources to look for medical information. There was a steady increase in use of Internet-based resources during the diffusion period of EBM. The findings highlight the importance of the Internet as a prominent source of medical information for main healthcare professionals.

Mortality In Rural China Declined As Health Insurance Coverage Increased, But No Evidence The Two Are Linked.

PubMed

Zhou, Maigeng; Liu, Shiwei; Kate Bundorf, M; Eggleston, Karen; Zhou, Sen

2017-09-01

Health insurance holds the promise of improving population health and survival and protecting people from catastrophic health spending. Yet evidence from lower- and middle-income countries on the impact of health insurance is limited. We investigated whether insurance expansion reduced adult mortality in rural China, taking advantage of differences across Chinese counties in the timing of the introduction of the New Cooperative Medical Scheme (NCMS). We assembled and analyzed newly collected data on NCMS implementation, linked to data from the Chinese Center for Disease Control and Prevention on cause-specific, age-standardized death rates and variables specific to county-year combinations for seventy-two counties in the period 2004-12. While mortality rates declined among rural residents during this period, we found little evidence that the expansion of health insurance through the NCMS contributed to this decline. However, our relatively large standard errors leave open the possibility that the NCMS had effects on mortality that we could not detect. Moreover, mortality benefits might arise only after many years of accumulated coverage. Project HOPE—The People-to-People Health Foundation, Inc.

Gravity increase at the south pole

USGS Publications Warehouse

Behrendt, John C.

1967-01-01

Abstract. Measurements made between December 1957 and January 1966 of the gravity difference between the McMurdo Sound pendulum station, which is on bedrock, and the South Pole station, which is on the Antarctic ice sheet, show a gravity increase at the South Pole of 0.11 milligals per year. The most likely hypothesis for the increase is that it was caused by ice flowing downslope across a gravity gradient and by the sinking of the South Pole station as a result of accumulation of ice. An alternate hypothesis that the gravity increase was caused by a decrease in ice thickness, of about 40 centimeters per year, is theoretically possible but is not supported by direct evidence.

Condoms for prisoners: no evidence that they increase sex in prison, but they increase safe sex

PubMed Central

Butler, Tony; Richters, Juliet; Yap, Lorraine; Donovan, Basil

2013-01-01

Objectives To determine if the provision of condoms to prisoners in two Australian state prison systems with different policies affects sexual behaviour. In New South Wales’ (NSW) prisons, condoms are freely distributed, while in Queensland prisons none are distributed. Methods We used a computer-assisted telephone interview to survey randomly selected prisoners in both states about their sexual behaviour in prison. Results Two thousand and eighteen male prisoners participated. The proportion of prisoners reporting anal sex in prison was equally low in NSW (3.3%) and Queensland (3.6%; p=0.8). A much higher proportion of prisoners who engaged in anal sex in NSW (56.8%) than Queensland (3.1%; p<0.0001) reported they had used a condom if they had had anal sex in prison. Sexual coercion was equally rare in both prison systems. Conclusions We found no evidence that condom provision to prisoners increased consensual or non-consensual sexual activity in prison. If available, condoms were much more likely to be used during anal sex. Condoms should be made available to prisoners as a basic human right. PMID:23300337

Increasing age and tear size reduce rotator cuff repair healing rate at 1 year.

PubMed

Rashid, Mustafa S; Cooper, Cushla; Cook, Jonathan; Cooper, David; Dakin, Stephanie G; Snelling, Sarah; Carr, Andrew J

2017-12-01

Background and purpose - There is a need to understand the reasons why a high proportion of rotator cuff repairs fail to heal. Using data from a large randomized clinical trial, we evaluated age and tear size as risk factors for failure of rotator cuff repair. Patients and methods - Between 2007 and 2014, 65 surgeons from 47 hospitals in the National Health Service (NHS) recruited 447 patients with atraumatic rotator cuff tendon tears to the United Kingdom Rotator Cuff Trial (UKUFF) and 256 underwent rotator cuff repair. Cuff integrity was assessed by imaging in 217 patients, at 12 months post-operation. Logistic regression analysis was used to determine the influence of age and intra-operative tear size on healing. Hand dominance, sex, and previous steroid injections were controlled for. Results - The overall healing rate was 122/217 (56%) at 12 months. Healing rate decreased with increasing tear size (small tears 66%, medium tears 68%, large tears 47%, and massive tears 27% healed). The mean age of patients with a healed repair was 61 years compared with 64 years for those with a non-healed repair. Mean age increased with larger tear sizes (small tears 59 years, medium tears 62 years, large tears 64 years, and massive tears 66 years). Increasing age was an independent factor that negatively influenced healing, even after controlling for tear size. Only massive tears were an independent predictor of non-healing, after controlling for age. Interpretation - Although increasing age and larger tear size are both risks for failure of rotator cuff repair healing, age is the dominant risk factor.

How frequent are non-evidence-based health care beliefs in chiropractic students and do they vary across the pre-professional educational years.

PubMed

Innes, Stanley I; Leboeuf-Yde, Charlotte; Walker, Bruce F

2018-01-01

Evidence suggests that a students' beliefs already prior to entering a program may be important as a determinant in sustaining unsuitable health care beliefs. Our objectives were to investigate the proportion of Australian chiropractic students who hold non-evidence-based beliefs in the first year of study and the extent to which they may be involved in non-musculoskeletal health conditions. Finally, to see if this proportion varies over the course of the chiropractic program. In 2016, students from two Australian chiropractic programs answered a questionnaire on how often they would give advice on five common health conditions in their future practices as well as their opinion on whether chiropractic spinal adjustments could prevent or help seven health-related conditions. From a possible 831 students, 444 responded (53%). Students were highly likely to offer advice (often/quite often) on a range of non-musculoskeletal conditions. The proportions were lowest in first year and highest the final year. Also, high numbers of students held non-evidence-based beliefs about 'chiropractic spinal adjustments' which tended to occur in gradually decreasing in numbers in sequential years, except for fifth year when a reversal of the pattern occurred. New strategies are required for chiropractic educators if they are to produce graduates who understand and deliver evidence-based health care and able to be part of the mainstream health care system.

Levels of Evidence in Orthopaedic Trauma Literature.

PubMed

Scheschuk, Joseph P; Mostello, Andrew J; Lombardi, Nicholas J; Maltenfort, Mitchell G; Freedman, Kevin B; Tjoumakaris, Fotios P

2016-07-01

To review and critically assess trends observed regarding the levels of evidence in published articles in orthopaedic traumatology literature. The Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery-American, and Clinical Orthopaedics and Related Research. All articles from the years 1998, 2003, 2008, and 2013 in The Journal of Orthopaedic Trauma (JOT) and orthopaedic trauma-related articles from The Journal of Bone and Joint Surgery-American (JBJS-A) and Clinical Orthopaedics and Related Research (CORR) were analyzed. Articles were categorized by type and ranked for level of evidence according to guidelines from the Centre for Evidence-Based Medicine. Study type and standardized level of evidence were determined for each article. Articles were subcategorized as high-level evidence (I, II), moderate-level evidence (III), and low-level evidence (IV, V). During the study period, Journal of Bone and Joint Surgery-American reduced its low-level studies from 80% to 40% (P = 0.00015), Clinical Orthopaedics and Related Research decreased its low-level studies from 70% to 27%, and Journal of Orthopaedic Trauma decreased its low-level studies from 78% to 45%. Level IV and V therapeutic, prognostic, and diagnostic studies demonstrated significant decreases during the study period (P = 0.0046, P < 0.0001, P = 0.026). The percentage of high-level studies increased from 13% to 19%; however, this was not significant (P = 0.42). There was a trend showing an increase in level I and II studies for therapeutic, prognostic, and diagnostic studies (P = 0.06). There has been a statistically significant decrease in lower level of evidence studies published in the orthopaedic traumatology literature over the past 15 years.

Increasing age and tear size reduce rotator cuff repair healing rate at 1 year

PubMed Central

Rashid, Mustafa S; Cooper, Cushla; Cook, Jonathan; Cooper, David; Dakin, Stephanie G; Snelling, Sarah; Carr, Andrew J

2017-01-01

Background and purpose — There is a need to understand the reasons why a high proportion of rotator cuff repairs fail to heal. Using data from a large randomized clinical trial, we evaluated age and tear size as risk factors for failure of rotator cuff repair. Patients and methods — Between 2007 and 2014, 65 surgeons from 47 hospitals in the National Health Service (NHS) recruited 447 patients with atraumatic rotator cuff tendon tears to the United Kingdom Rotator Cuff Trial (UKUFF) and 256 underwent rotator cuff repair. Cuff integrity was assessed by imaging in 217 patients, at 12 months post-operation. Logistic regression analysis was used to determine the influence of age and intra-operative tear size on healing. Hand dominance, sex, and previous steroid injections were controlled for. Results — The overall healing rate was 122/217 (56%) at 12 months. Healing rate decreased with increasing tear size (small tears 66%, medium tears 68%, large tears 47%, and massive tears 27% healed). The mean age of patients with a healed repair was 61 years compared with 64 years for those with a non-healed repair. Mean age increased with larger tear sizes (small tears 59 years, medium tears 62 years, large tears 64 years, and massive tears 66 years). Increasing age was an independent factor that negatively influenced healing, even after controlling for tear size. Only massive tears were an independent predictor of non-healing, after controlling for age. Interpretation — Although increasing age and larger tear size are both risks for failure of rotator cuff repair healing, age is the dominant risk factor. PMID:28880113

Administration of Antibiotics to Children Before Age 2 Years Increases Risk for Childhood Obesity

PubMed Central

Scott, Frank I; Horton, Daniel B.; Mamtani, Ronac; Haynes, Kevin; Goldberg, David S; Lee, Dale Y.; Lewis, James D

2016-01-01

Background & Aims Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort study to assess the association between antibiotic exposure before age 2 years and obesity at age 4 years. Methods We performed a retrospective cohort study of 21,714 children in The Health Improvement Network —a population-representative dataset of more than 10 million individuals derived from electronic medical records from 1995 through 2013 in the United Kingdom. Eligible subjects were registered within 3 months of birth with complete follow-up and height and weight were recorded within 12 months of their 4th birthday. Antibiotic exposure was assessed before age 2 years, and classified based on anti-anaerobic activity. The primary outcome was obesity at age 4 years. We performed logistic regression analyses, adjusting for maternal and sibling obesity, maternal diabetes, mode of delivery, socioeconomic status, year and country of birth, and urban dwelling. Results In the cohort, 1306 of the children (6.4%) were obese at 4 years of age. Antibiotic exposure was associated with an increased risk of obesity at 4 years (odds ratio [OR]=1.21; 95% confidence interval [CI], 1.07–1.38). Odds ratios increased with repeated exposures: for 1–2 prescriptions, OR=1.07 (95% CI, 0.91–1.23); for 3–5 prescriptions, OR=1.41 (95% CI, 1.20–1.65); for 6 or more prescriptions, OR=1.47 (95% CI, 1.19–1.82). Antifungal agents were not associated with obesity (OR=0.81; 95% CI, 0.59–1.11). Conclusions Administration of 3 or more courses of antibiotics before children reach an age of 2 years is associated with an increased risk of early childhood obesity. PMID:27003602

Administration of Antibiotics to Children Before Age 2 Years Increases Risk for Childhood Obesity.

PubMed

Scott, Frank I; Horton, Daniel B; Mamtani, Ronac; Haynes, Kevin; Goldberg, David S; Lee, Dale Y; Lewis, James D

2016-07-01

Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort study to assess the association between antibiotic exposure before age 2 years and obesity at age 4 years. We performed a retrospective cohort study of 21,714 children in The Health Improvement Network-a population-representative dataset of >10 million individuals derived from electronic medical records from 1995 through 2013 in the United Kingdom. Eligible subjects were registered within 3 months of birth with complete follow-up and height and weight were recorded within 12 months of their 4th birthday. Antibiotic exposure was assessed before age 2 years, and classified based on anti-anaerobic activity. The primary outcome was obesity at age 4 years. We performed logistic regression analyses, adjusting for maternal and sibling obesity, maternal diabetes, mode of delivery, socioeconomic status, year and country of birth, and urban dwelling. In the cohort, 1306 of the children (6.4%) were obese at 4 years of age. Antibiotic exposure was associated with an increased risk of obesity at 4 years (odds ratio [OR] = 1.21; 95% confidence interval [CI]: 1.07-1.38). ORs increased with repeated exposures: for 1-2 prescriptions, OR = 1.07 (95% CI, 0.91-1.23); for 3-5 prescriptions, OR = 1.41 (95% CI, 1.20-1.65); and for 6 or more prescriptions, OR = 1.47 (95% CI, 1.19-1.82). Antifungal agents were not associated with obesity (OR = 0.81; 95% CI, 0.59-1.11). Administration of 3 or more courses of antibiotics before children reach an age of 2 years is associated with an increased risk of early childhood obesity. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

The effect of the PROSPER partnership model on cultivating local stakeholder knowledge of evidence-based programs: a five-year longitudinal study of 28 communities.

PubMed

Crowley, D Max; Greenberg, Mark T; Feinberg, Mark E; Spoth, Richard L; Redmond, Cleve R

2012-02-01

A substantial challenge in improving public health is how to facilitate the local adoption of evidence-based interventions (EBIs). To do so, an important step is to build local stakeholders' knowledge and decision-making skills regarding the adoption and implementation of EBIs. One EBI delivery system, called PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience), has effectively mobilized community prevention efforts, implemented prevention programming with quality, and consequently decreased youth substance abuse. While these results are encouraging, another objective is to increase local stakeholder knowledge of best practices for adoption, implementation and evaluation of EBIs. Using a mixed methods approach, we assessed local stakeholder knowledge of these best practices over 5 years, in 28 intervention and control communities. Results indicated that the PROSPER partnership model led to significant increases in expert knowledge regarding the selection, implementation, and evaluation of evidence-based interventions. Findings illustrate the limited programming knowledge possessed by members of local prevention efforts, the difficulty of complete knowledge transfer, and highlight one method for cultivating that knowledge.

Thinning increases growth of 60-year-old cherry-maple stands in West Virginia

Treesearch

Neil I. Lamson; Neil I. Lamson

1985-01-01

In north-central West Virginia, previously unmanaged 60-year-old cherrymaple stands were thinned to 60 percent relative stand density. Thinning reduced mortality, redistributed growth onto fewer, larger stems, and increased individual tree growth. Five-year periodic basal-area growth per acre was 1.2 times greater in thinned stands than in unthinned stands. Periodic...

Evidence for increasingly variable Palmer Drought Severity Index in the United States since 1895.

PubMed

Rayne, Sierra; Forest, Kaya

2016-02-15

Annual and summertime trends towards increasingly variable values of the Palmer Drought Severity Index (PDSI) over a sub-decadal period (five years) were investigated within the contiguous United States between 1895 and the present. For the contiguous United States as a whole, there is a significant increasing trend in the five-year running minimum-maximum ranges for the annual PDSI (aPDSI5 yr(min|max, range)). During this time frame, the average aPDSI5 yr(min|max, range) has increased by about one full unit, indicating a substantial increase in drought variability over short time scales across the United States. The end members of the running aPDSI5 yr(min|max, range) highlight even more rapid changes in the drought index variability within the past 120 years. This increasing variability in the aPDSI5 yr(min|max, range) is driven primarily by changes taking place in the Pacific and Atlantic Ocean coastal climate regions, climate regions which collectively comprise one-third the area of the contiguous United States. Similar trends were found for the annual and summertime Palmer Hydrological Drought Index (PHDI), the Palmer Modified Drought Index (PMDI), and the Palmer Z Index (PZI). Overall, interannual drought patterns in the contiguous United States are becoming more extreme and difficult to predict, posing a challenge to agricultural and other water-resource related planning efforts. Copyright © 2015 Elsevier B.V. All rights reserved.

Increasing utilization of Internet-based resources following efforts to promote evidence-based medicine: a national study in Taiwan

PubMed Central

2013-01-01

Background Since the beginning of 2007, the National Health Research Institutes has been promoting the dissemination of evidence-based medicine (EBM). The current study examined longitudinal trends of behaviors in how hospital-based physicians and nurses have searched for medical information during the spread of EBM. Methods Cross-sectional postal questionnaire surveys were conducted in nationally representative regional hospitals of Taiwan thrice in 2007, 2009, and 2011. Demographic data were gathered concerning gender, age, working experience, teaching appointment, academic degree, and administrative position. Linear and logistic regression models were used to examine predictors and changes over time. Results Data from physicians and nurses were collected in 2007 (n = 1156), 2009 (n = 2975), and 2011 (n = 3999). There were significant increases in the use of four Internet-based resources – Web portals, online databases, electronic journals, and electronic books – across the three survey years among physicians and nurses (p < 0.001). Access to textbooks and printed journals, however, did not change over the 4-year study period. In addition, there were significant relationships between the usage of Internet-based resources and users’ characteristics. Age and faculty position were important predictors in relation to the usage among physicians and nurses, while academic degree served as a critical factor among nurses only. Conclusions Physicians and nurses used a variety of sources to look for medical information. There was a steady increase in use of Internet-based resources during the diffusion period of EBM. The findings highlight the importance of the Internet as a prominent source of medical information for main healthcare professionals. PMID:23289500

A centralized mailed program with stepped increases of support increases time in compliance with colorectal cancer screening guidelines over 5 years: A randomized trial.

PubMed

Green, Beverly B; Anderson, Melissa L; Cook, Andrea J; Chubak, Jessica; Fuller, Sharon; Meenan, Richard T; Vernon, Sally W

2017-11-15

Screening over many years is required to optimize reductions in colorectal cancer (CRC) mortality. However, no prior trials have compared strategies for obtaining long-term adherence. Systems of Support to Increase Colorectal Cancer Screening and Follow-Up was implemented in an integrated health care organization in Washington State. Between 2008 and 2009, 4675 individuals aged 50 to 74 years were randomized to receive the usual care (UC), which included clinic-based strategies to increase CRC screening (arm 1), or, in years 1 and 2, mailings with a call-in number for colonoscopy and mailed fecal tests (arm 2), mailings plus brief telephone assistance (arm 3), or mailings and assistance plus nurse navigation (arm 4). Active-intervention subjects (those in arms 2, 3, and 4 combined) who were still eligible for CRC screening were randomized to mailings being stopped or continued in years 3 and 5. The time in compliance with CRC screening over 5 years was compared for persons assigned to any intervention and persons assigned to UC. Screening tests contributed time on the basis of national guidelines for screening intervals (fecal tests annually, sigmoidoscopy every 5 years, and colonoscopy every 10 years). All participants contributed data, but they were censored at disenrollment, death, the age of 76 years, or a diagnosis of CRC. Compared with UC participants, intervention participants had 31% more adjusted covered time over 5 years (incidence rate ratio, 1.31; 95% confidence interval, 1.25-1.37; covered time, 47.5% vs 62.1%). Fecal testing accounted for almost all additional covered time. In a health care organization with clinic-based activities to increase CRC screening, a centralized program led to increased CRC screening adherence over 5 years. Longer term data on screening adherence and its impact on CRC outcomes are needed. Cancer 2017;123:4472-80. © 2017 American Cancer Society. © 2017 American Cancer Society.

Increased Leg Bone Mineral Density and Content During the Initial Years of College Sport.

PubMed

Scerpella, John J; Buehring, Bjoern; Hetzel, Scott J; Heiderscheit, Bryan C

2018-04-01

Scerpella, JJ, Buehring, B, Hetzel, SJ, and Heiderscheit, BC. Increased leg bone mineral density and content during the initial years of college sport. J Strength Cond Res 32(4): 1123-1130, 2018-Bone mineral density (BMD) and bone mineral content (BMC) data are useful parameters for evaluating how training practices promote bone health. We used dual-energy X-ray absorptiometry (DXA) to longitudinally assess sport-specific growth in leg and total body BMD/BMC over the initial 2 years of collegiate training. Eighty-five Division 1 collegiate basketball, hockey, and soccer athletes (50 males and 35 females; age 19.0 [0.8] years) underwent annual DXA scans. Leg and total body BMD/BMC were compared within and across two 1-year intervals (periods 1 and 2) using repeated-measures analysis of variance, adjusting for age, sex, race, and sport. Leg BMD, leg BMC, and total body BMC all increased over period 1 (0.05 g·cm [p = 0.001], 0.07 kg [p = 0.002], and 0.19 kg [p < 0.001] respectively). Changes in period 2 compared with period 1 were smaller for leg BMD (p = 0.001), leg BMC (p < 0.001), leg fat mass (p = 0.028), and total BMC (p = 0.005). Leg lean mass increased more during period 2 than period 1 (p = 0.018). Sports participation was the only significant predictor of change in leg BMD. Significant increases in both leg BMD and BMC were demonstrated over both 2-year periods, with greater gains during period 1. These gains highlight the importance of attentive training procedures, capitalizing on attendant physical benefits of increased BMD/BMC. Additional research in young adults, evaluating bone mass acquisition, will optimize performance and decrease risk of bone stress injury among collegiate athletes.

20 CFR 418.1250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2014 CFR

2014-04-01

... request that we use a more recent tax year? 418.1250 Section 418.1250 Employees' Benefits SOCIAL SECURITY... More Recent Tax Year's Modified Adjusted Gross Income § 418.1250 What evidence will you need to support your request that we use a more recent tax year? When you request that we use a more recent tax year to...

20 CFR 418.1250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2013 CFR

2013-04-01

... request that we use a more recent tax year? 418.1250 Section 418.1250 Employees' Benefits SOCIAL SECURITY... More Recent Tax Year's Modified Adjusted Gross Income § 418.1250 What evidence will you need to support your request that we use a more recent tax year? When you request that we use a more recent tax year to...

20 CFR 418.1250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2012 CFR

2012-04-01

... request that we use a more recent tax year? 418.1250 Section 418.1250 Employees' Benefits SOCIAL SECURITY... More Recent Tax Year's Modified Adjusted Gross Income § 418.1250 What evidence will you need to support your request that we use a more recent tax year? When you request that we use a more recent tax year to...

Caregiver's HIV disclosure to children 12 years and under: a review and analysis of the evidence.

PubMed

Krauss, Beatrice J; Letteney, Susan; De Baets, Anniek J; Baggaley, Rachel; Okero, F Amolo

2013-01-01

A systematic review and analysis of the empirical evidence through June 2010 on HIV disclosure to children 12 and under was conducted using methods validated by the Cochrane group. Fifteen articles focusing on caregiver disclosure (255 total) were analyzed using GradePro 3 software. Results suggest that there is evidence of health and future care planning benefit for HIV+ and healthy children (12 and under) of HIV+ caregivers if the caregiver discloses his/her HIV status to them. Children of the maturity of school age youth (e.g., beginning at 6 years and continuing through 12) can be told of their caregivers' HIV status, while younger children may be informed partially in an age-appropriate manner.

20 CFR 418.1250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2010 CFR

2010-04-01

... request that we use a more recent tax year? 418.1250 Section 418.1250 Employees' Benefits SOCIAL SECURITY... determine your income-related monthly adjustment amount, we will ask for evidence of the major life-changing..., additional evidence documenting the major life-changing event(s) will not be needed. ...

20 CFR 418.1250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2011 CFR

2011-04-01

... request that we use a more recent tax year? 418.1250 Section 418.1250 Employees' Benefits SOCIAL SECURITY... determine your income-related monthly adjustment amount, we will ask for evidence of the major life-changing..., additional evidence documenting the major life-changing event(s) will not be needed. ...

Overt and Latent Cardiac Effects of Ozone Inhalation in Rats: Evidence for Autonomic Modulation and Increased Myocardial Vulnerability

EPA Science Inventory

Background: Ozone (03) is a well-documented respiratory oxidant, but increasing epidemiologic evidence points to extra-pulmonary effects including positive associations between ambient 03 concentrations and cardiovascular morbidity/mortality. Objectives: With preliminary reports ...

Role of contrast-enhanced ultrasonography with Sonazoid for hepatocellular carcinoma: evidence from a 10-year experience.

PubMed

Maruyama, Hitoshi; Sekimoto, Tadashi; Yokosuka, Osamu

2016-05-01

Hepatocellular carcinoma (HCC) represents primary liver cancer. Because the development of HCC limits the prognosis as well as the quality of life of the patients, its management should be properly conducted based on an accurate diagnosis. The liver is the major target organ of ultrasound (US), which is the simple, non-invasive, and real-time imaging method available worldwide. Microbubble-based contrast agents are safe and reliable and have become popular, which has resulted in the improvement of diagnostic performances of US due to the increased detectability of the peripheral blood flow. Sonazoid (GE Healthcare, Waukesha, WI, USA), a second-generation contrast agent, shows the unique property of accumulation in the liver and spleen. Contrast-enhanced US with Sonazoid is now one of the most frequently used modalities in the practical management of liver tumors, including the detection and characterization of the nodule, evaluation of the effects of non-surgical treatment, intraoperative support, and post-treatment surveillance. This article reviews the 10-year evidence for contrast-enhanced US with Sonazoid in the practical management of HCC.

Classification and appraisal of the level of clinical evidence of publications from the Canadian Association of Pediatric Surgeons for the past 10 years.

PubMed

Al-Harbi, Khalad; Farrokhyar, Forough; Mulla, Sohail; Fitzgerald, Peter

2009-05-01

Increasing evidence is placed on the evidence-based quality of publications. We classified the publication type and assessed the reporting quality of the highest evidence level publications from the Canadian Association of Pediatric Surgeons between 1998 and 2007. All publications from Canadian Association of Pediatric Surgeons issues in the Journal of Pediatric Surgery from 1998 to 2007 were classified by study type and level of evidence (Oxford Center for Evidence-based Medicine Levels of Evidence). Cohort studies (level 2) were evaluated by 2 independent assessors using the Newcastle-Ottawa Quality Assessment Scale (NOQAS). Reliability and chi(2) analyses were performed. Three hundred two publications were classified by level of evidence as follows: level 2, 46; level 3, 13; level 4, 109; and level 5, 134. The median NOQAS score of the 46 level-2 cohort studies was 8 (range, 5-9), and the interrater reliability was 0.94 (95% confidence interval, 0.89-0.96). There was a significant increase in the number of level-2 evidence publications (P = .001) over the study period. Level-2 evidence cohort studies met a high scientific standard as assessed by the NOQAS and significantly increased in number over the study period. However, there were no level-1 evidence (randomized controlled trial) publications, and most were in the lower evidence classification levels (3-5).

Evaluation of a 3year intervention to increase adoption of safer nursery crop production practices.

PubMed

Chapman, Larry J; Newenhouse, Astrid C; Karsh, Ben-Tzion

2010-01-01

We conducted a 3year intervention to increase awareness and adoption of eight more profitable nursery crop production practices that reduced certain traumatic and musculoskeletal injury hazards. We disseminated information to nursery managers across seven states using information channels they were known to rely on (e.g. trade publications, public events, university Extension, other managers). We evaluated rolling, independent, probability samples (n=1200) with mail questionnaires before the intervention and after each of 3 intervention years. We also evaluated samples (n=250) from a comparison group of New Zealand nursery managers. The intervention was associated with increased awareness of four of the eight practices among US managers after year 3 compared to their baseline: zippers (20 vs. 32%, pincreased for hoes after year 2 compared to their baseline (35 vs. 52%, pincreased awareness, but not adoption.

Synergistic effects of the components of global change: Increased vegetation dynamics in open, forest-steppe grasslands driven by wildfires and year-to-year precipitation differences

PubMed Central

Aszalós, Réka; Lengyel, Attila

2017-01-01

Climate change and land use change are two major elements of human-induced global environmental change. In temperate grasslands and woodlands, increasing frequency of extreme weather events like droughts and increasing severity of wildfires has altered the structure and dynamics of vegetation. In this paper, we studied the impact of wildfires and the year-to-year differences in precipitation on species composition changes in semi-arid grasslands of a forest-steppe complex ecosystem which has been partially disturbed by wildfires. Particularly, we investigated both how long-term compositional dissimilarity changes and species richness are affected by year-to-year precipitation differences on burnt and unburnt areas. Study sites were located in central Hungary, in protected areas characterized by partially-burnt, juniper-poplar forest-steppe complexes of high biodiversity. Data were used from two long-term monitoring sites in the Kiskunság National Park, both characterized by the same habitat complex. We investigated the variation in species composition as a function of time using distance decay methodology. In each sampling area, compositional dissimilarity increased with the time elapsed between the sampling events, and species richness differences increased with increasing precipitation differences between consecutive years. We found that both the long-term compositional dissimilarity, and the year-to-year changes in species richness were higher in the burnt areas than in the unburnt ones. The long-term compositional dissimilarities were mostly caused by perennial species, while the year-to-year changes of species richness were driven by annual and biennial species. As the effect of the year-to-year variation in precipitation was more pronounced in the burnt areas, we conclude that canopy removal by wildfires and extreme inter-annual variability of precipitation, two components of global environmental change, act in a synergistic way. They enhance the effect of

Synergistic effects of the components of global change: Increased vegetation dynamics in open, forest-steppe grasslands driven by wildfires and year-to-year precipitation differences.

PubMed

Kertész, Miklós; Aszalós, Réka; Lengyel, Attila; Ónodi, Gábor

2017-01-01

Climate change and land use change are two major elements of human-induced global environmental change. In temperate grasslands and woodlands, increasing frequency of extreme weather events like droughts and increasing severity of wildfires has altered the structure and dynamics of vegetation. In this paper, we studied the impact of wildfires and the year-to-year differences in precipitation on species composition changes in semi-arid grasslands of a forest-steppe complex ecosystem which has been partially disturbed by wildfires. Particularly, we investigated both how long-term compositional dissimilarity changes and species richness are affected by year-to-year precipitation differences on burnt and unburnt areas. Study sites were located in central Hungary, in protected areas characterized by partially-burnt, juniper-poplar forest-steppe complexes of high biodiversity. Data were used from two long-term monitoring sites in the Kiskunság National Park, both characterized by the same habitat complex. We investigated the variation in species composition as a function of time using distance decay methodology. In each sampling area, compositional dissimilarity increased with the time elapsed between the sampling events, and species richness differences increased with increasing precipitation differences between consecutive years. We found that both the long-term compositional dissimilarity, and the year-to-year changes in species richness were higher in the burnt areas than in the unburnt ones. The long-term compositional dissimilarities were mostly caused by perennial species, while the year-to-year changes of species richness were driven by annual and biennial species. As the effect of the year-to-year variation in precipitation was more pronounced in the burnt areas, we conclude that canopy removal by wildfires and extreme inter-annual variability of precipitation, two components of global environmental change, act in a synergistic way. They enhance the effect of

20 CFR 418.2250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2012 CFR

2012-04-01

... request that we use a more recent tax year? 418.2250 Section 418.2250 Employees' Benefits SOCIAL SECURITY... Premiums Determinations Using A More Recent Tax Year's Modified Adjusted Gross Income § 418.2250 What evidence will you need to support your request that we use a more recent tax year? We will follow the rules...

20 CFR 418.2250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2014 CFR

2014-04-01

... request that we use a more recent tax year? 418.2250 Section 418.2250 Employees' Benefits SOCIAL SECURITY... Premiums Determinations Using A More Recent Tax Year's Modified Adjusted Gross Income § 418.2250 What evidence will you need to support your request that we use a more recent tax year? We will follow the rules...

20 CFR 418.2250 - What evidence will you need to support your request that we use a more recent tax year?

Code of Federal Regulations, 2013 CFR

2013-04-01

... request that we use a more recent tax year? 418.2250 Section 418.2250 Employees' Benefits SOCIAL SECURITY... Premiums Determinations Using A More Recent Tax Year's Modified Adjusted Gross Income § 418.2250 What evidence will you need to support your request that we use a more recent tax year? We will follow the rules...

Rapidly increasing methyl mercury in endangered ivory gull (Pagophila eburnea) feathers over a 130 year record

PubMed Central

Bond, Alexander L.; Hobson, Keith A.; Branfireun, Brian A.

2015-01-01

Mercury (Hg) is increasing in marine food webs, especially at high latitudes. The bioaccumulation and biomagnification of methyl mercury (MeHg) has serious effects on wildlife, and is most evident in apex predators. The MeHg body burden in birds is the balance of ingestion and excretion, and MeHg in feathers is an effective indicator of overall MeHg burden. Ivory gulls (Pagophila eburnea), which consume ice-associated prey and scavenge marine mammal carcasses, have the highest egg Hg concentrations of any Arctic bird, and the species has declined by more than 80% since the 1980s in Canada. We used feathers from museum specimens from the Canadian Arctic and western Greenland to assess whether exposure to MeHg by ivory gulls increased from 1877 to 2007. Based on constant feather stable-isotope (δ13C, δ15N) values, there was no significant change in ivory gulls' diet over this period, but feather MeHg concentrations increased 45× (from 0.09 to 4.11 µg g−1 in adults). This dramatic change in the absence of a dietary shift is clear evidence of the impact of anthropogenic Hg on this high-latitude threatened species. Bioavailable Hg is expected to increase in the Arctic, raising concern for continued population declines in high-latitude species that are far from sources of environmental contaminants. PMID:25788594

Evidence for negative selection of gene variants that increase dependence on dietary choline in a Gambian cohort

PubMed Central

Silver, Matt J.; Corbin, Karen D.; Hellenthal, Garrett; da Costa, Kerry-Ann; Dominguez-Salas, Paula; Moore, Sophie E.; Owen, Jennifer; Prentice, Andrew M.; Hennig, Branwen J.; Zeisel, Steven H.

2015-01-01

Choline is an essential nutrient, and the amount needed in the diet is modulated by several factors. Given geographical differences in dietary choline intake and disparate frequencies of single-nucleotide polymorphisms (SNPs) in choline metabolism genes between ethnic groups, we tested the hypothesis that 3 SNPs that increase dependence on dietary choline would be under negative selection pressure in settings where choline intake is low: choline dehydrogenase (CHDH) rs12676, methylenetetrahydrofolate reductase 1 (MTHFD1) rs2236225, and phosphatidylethanolamine-N-methyltransferase (PEMT) rs12325817. Evidence of negative selection was assessed in 2 populations: one in The Gambia, West Africa, where there is historic evidence of a choline-poor diet, and the other in the United States, with a comparatively choline-rich diet. We used 2 independent methods, and confirmation of our hypothesis was sought via a comparison with SNP data from the Maasai, an East African population with a genetic background similar to that of Gambians but with a traditional diet that is higher in choline. Our results show that frequencies of SNPs known to increase dependence on dietary choline are significantly reduced in the low-choline setting of The Gambia. Our findings suggest that adequate intake levels of choline may have to be reevaluated in different ethnic groups and highlight a possible approach for identifying novel functional SNPs under the influence of dietary selective pressure.—Silver, M. J., Corbin, K. D., Hellenthal, G., da Costa, K.-A., Dominguez-Salas, P., Moore, S. E., Owen, J., Prentice, A. M., Hennig, B. J., Zeisel, S. H. Evidence for negative selection of gene variants that increase dependence on dietary choline in a Gambian cohort. PMID:25921832

Effect of increased opiate exposure on three years neurodevelopmental outcome in extremely preterm infants.

PubMed

Giordano, V; Deindl, P; Fuiko, R; Unterasinger, L; Waldhoer, T; Cardona, F; Berger, A; Olischar, M

2018-06-20

International guidelines recommend the use of item based scales for the assessment of pain and sedation. In our previous study, the implementation of the Neonatal Pain Agitation and Sedation Scale (N-PASS), and the associated systematic assessment and treatment of pain and sedation reduced pain and over-sedation in our intervention group, but lead to a significant increase of individual opiate exposure. This increased opiate exposure was not associated with impaired motor and mental development at one year of age. As one-year follow-up is not necessarily representative for future outcomes, we retested our sample at three years of age. Fifty-three patients after (intervention group) and 61 before implementation (control group) of the N-PASS and the Vienna Protocol for the Management of Neonatal Pain and Sedation (VPNPS), were compared for motor, mental and behavioural development at three-years follow-up using the Bayley Scales of Infant Development. Cumulative opiate exposure was not associated with mental (p = .31) and motor (p = .20) problems when controlling for other important medical conditions, but was associated to lower behavioural scores (p = .007). No statistically significant differences were found with regard to mental (p = .65), psychomotor (p = .12) and behavioural (p = .61) development before and after the implementation of the N-PASS and the VPNPS. Implementing a neonatal pain and sedation protocol increased opiate exposure without affecting neurodevelopmental outcome at three-years of age. Copyright © 2018. Published by Elsevier B.V.

Overt and Latent Cardiac Effects of Ozone Inhalation in Rats: Evidence for Autonomic Modulation and Increased Myocardial Vulnerability*

EPA Science Inventory

Ozone (O3) is a well-documented respiratory oxidant, but increasing epidemiologic evidence points to extra-pulmonary effects including positive associations between ambient O3 concentrations and cardiovascular morbidity/mortality. With preliminary reports linking O3 exposure wit...

Evidence for the effect of disease management: is $1 billion a year a good investment?

PubMed

Mattke, Soeren; Seid, Michael; Ma, Sai

2007-12-01

To assess the evidence for the effect of disease management on quality of care, disease control, and cost, with a focus on population-based programs. Literature review. We conducted a literature search for and a structured review of studies on population-based disease management programs, as well as for reviews and meta-analyses of disease management interventions. We identified 3 evaluations of large-scale population-based programs, as well as 10 meta-analyses and 16 systematic reviews, covering 317 unique studies. We found consistent evidence that disease management improves processes of care and disease control but no conclusive support for its effect on health outcomes. Overall, disease management does not seem to affect utilization except for a reduction in hospitalization rates among patients with congestive heart failure and an increase in outpatient care and prescription drug use among patients with depression. When the costs of the intervention were appropriately accounted for and subtracted from any savings, there was no conclusive evidence that disease management leads to a net reduction of direct medical costs. Although disease management seems to improve quality of care, its effect on cost is uncertain. Most of the evidence to date addresses small-scale programs targeting high-risk individuals, while only 3 studies evaluate large population-based interventions, implying that little is known about their effect. Payers and policy makers should remain skeptical about vendor claims and should demand supporting evidence based on transparent and scientifically sound methods.

Increasing insulin resistance accentuates the effect of triglyceride-associated loci on serum triglycerides during 5 years.

PubMed

Justesen, Johanne M; Andersson, Ehm A; Allin, Kristine H; Sandholt, Camilla H; Jørgensen, Torben; Linneberg, Allan; Jørgensen, Marit E; Hansen, Torben; Pedersen, Oluf; Grarup, Niels

2016-12-01

Blood concentrations of triglycerides are influenced by genetic factors as well as a number of environmental factors, including adiposity and glucose homeostasis. The aim was to investigate the association between a serum triglyceride weighted genetic risk score (wGRS) and changes in fasting serum triglyceride level over 5 years and to test whether the effect of the wGRS was modified by 5 year changes of adiposity, insulin resistance, and lifestyle factors. A total of 3,474 nondiabetic individuals from the Danish Inter99 cohort participated in both the baseline and 5 year follow-up physical examinations and had information on the wGRS comprising 39 genetic variants. In a linear regression model adjusted for age, sex, and baseline serum triglyceride, the wGRS was associated with increased serum triglyceride levels over 5 years [per allele effect = 1.3% (1.0-1.6%); P = 1.0 × 10 -17 ]. This triglyceride-increasing effect of the wGRS interacted with changes in insulin resistance (P interaction = 1.5 × 10 -6 ). This interaction indicated that the effect of the wGRS was stronger in individuals who became more insulin resistant over 5 years. In conclusion, our findings suggest that increased genetic risk load is associated with a larger increase in fasting serum triglyceride levels in nondiabetic individuals during 5 years of follow-up. This effect of the wGRS is accentuated by increasing insulin resistance. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

Hurricane Sandy's flood frequency increasing from year 1800 to 2100.

PubMed

Lin, Ning; Kopp, Robert E; Horton, Benjamin P; Donnelly, Jeffrey P

2016-10-25

Coastal flood hazard varies in response to changes in storm surge climatology and the sea level. Here we combine probabilistic projections of the sea level and storm surge climatology to estimate the temporal evolution of flood hazard. We find that New York City's flood hazard has increased significantly over the past two centuries and is very likely to increase more sharply over the 21st century. Due to the effect of sea level rise, the return period of Hurricane Sandy's flood height decreased by a factor of ∼3× from year 1800 to 2000 and is estimated to decrease by a further ∼4.4× from 2000 to 2100 under a moderate-emissions pathway. When potential storm climatology change over the 21st century is also accounted for, Sandy's return period is estimated to decrease by ∼3× to 17× from 2000 to 2100.

Long-term (5 years), high daily dosage of dietary agmatine--evidence of safety: a case report.

PubMed

Gilad, Gad M; Gilad, Varda H

2014-11-01

There is presently a great interest in the therapeutic potential of agmatine, decarboxylated arginine, for various diseases. Recent clinical studies have already shown that oral agmatine sulfate given for up to 3 weeks provides a safe and, as compared with current therapeutics, more effective treatment for neuropathic pain. These studies have ushered in the use of dietary agmatine as a nutraceutical. However, in view of information paucity, assessment of long-term safety of oral agmatine treatment is now clearly required. The authors of this report undertook to assess their own health status during ongoing consumption of a high daily dosage of oral agmatine over a period of 4-5 years. A daily dose of 2.67 g agmatine sulfate was encapsulated in gelatin capsules; the regimen consists of six capsules daily, each containing 445 mg, three in the morning and three in the evening after meals. Clinical follow-up consists of periodic physical examinations and laboratory blood and urine analyses. All measurements thus far remain within normal values and good general health status is sustained throughout the study period, up to 5 years. This case study shows for the first time that the recommended high dosage of agmatine may be consumed for at least 5 years without evidence of any adverse effects. These initial findings are highly important as they provide significant evidence for the extended long-term safety of a high daily dosage of dietary agmatine--a cardinal advantage for its utility as a nutraceutical.

Stable isotope evidence for increasing dietary breadth in the European mid-Upper Paleolithic

PubMed Central

Richards, Michael P.; Pettitt, Paul B.; Stiner, Mary C.; Trinkaus, Erik

2001-01-01

New carbon and nitrogen stable isotope values for human remains dating to the mid-Upper Paleolithic in Europe indicate significant amounts of aquatic (fish, mollusks, and/or birds) foods in some of their diets. Most of this evidence points to exploitation of inland freshwater aquatic resources in particular. By contrast, European Neandertal collagen carbon and nitrogen stable isotope values do not indicate significant use of inland aquatic foods but instead show that they obtained the majority of their protein from terrestrial herbivores. In agreement with recent zooarcheological analyses, the isotope results indicate shifts toward a more broad-spectrum subsistence economy in inland Europe by the mid-Upper Paleolithic period, probably associated with significant population increases. PMID:11371652

Stable isotope evidence for increasing dietary breadth in the European mid-Upper Paleolithic.

PubMed

Richards, M P; Pettitt, P B; Stiner, M C; Trinkaus, E

2001-05-22

New carbon and nitrogen stable isotope values for human remains dating to the mid-Upper Paleolithic in Europe indicate significant amounts of aquatic (fish, mollusks, and/or birds) foods in some of their diets. Most of this evidence points to exploitation of inland freshwater aquatic resources in particular. By contrast, European Neandertal collagen carbon and nitrogen stable isotope values do not indicate significant use of inland aquatic foods but instead show that they obtained the majority of their protein from terrestrial herbivores. In agreement with recent zooarcheological analyses, the isotope results indicate shifts toward a more broad-spectrum subsistence economy in inland Europe by the mid-Upper Paleolithic period, probably associated with significant population increases.

Crohn's disease: increased mortality 10 years after diagnosis in a Europe-wide population based cohort.

PubMed

Wolters, F L; Russel, M G; Sijbrandij, J; Schouten, L J; Odes, S; Riis, L; Munkholm, P; Bodini, P; O'Morain, C; Mouzas, I A; Tsianos, E; Vermeire, S; Monteiro, E; Limonard, C; Vatn, M; Fornaciari, G; Pereira, S; Moum, B; Stockbrügger, R W

2006-04-01

No previous correlation between phenotype at diagnosis of Crohn's disease (CD) and mortality has been performed. We assessed the predictive value of phenotype at diagnosis on overall and disease related mortality in a European cohort of CD patients. Overall and disease related mortality were recorded 10 years after diagnosis in a prospectively assembled, uniformly diagnosed European population based inception cohort of 380 CD patients diagnosed between 1991 and 1993. Standardised mortality ratios (SMRs) were calculated for geographic and phenotypic subgroups at diagnosis. Thirty seven deaths were observed in the entire cohort whereas 21.5 deaths were expected (SMR 1.85 (95% CI 1.30-2.55)). Mortality risk was significantly increased in both females (SMR 1.93 (95% CI 1.10-3.14)) and males (SMR 1.79 (95% CI 1.11-2.73)). Patients from northern European centres had a significant overall increased mortality risk (SMR 2.04 (95% CI 1.32-3.01)) whereas a tendency towards increased overall mortality risk was also observed in the south (SMR 1.55 (95% CI 0.80-2.70)). Mortality risk was increased in patients with colonic disease location and with inflammatory disease behaviour at diagnosis. Mortality risk was also increased in the age group above 40 years at diagnosis for both total and CD related causes. Excess mortality was mainly due to gastrointestinal causes that were related to CD. This European multinational population based study revealed an increased overall mortality risk in CD patients 10 years after diagnosis, and age above 40 years at diagnosis was found to be the sole factor associated with increased mortality risk.

Evidence-based practice: the importance of education and leadership.

PubMed

Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro

2010-01-01

To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.

Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up.

PubMed

Feldman, Adina L; Long, Gráinne H; Johansson, Ingegerd; Weinehall, Lars; Fhärm, Eva; Wennberg, Patrik; Norberg, Margareta; Griffin, Simon J; Rolandsson, Olov

2017-03-29

Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes

Psychological and Cognitive Determinants of Mortality: Evidence from a Nationally Representative Sample Followed over Thirty-five Years

PubMed Central

Karraker, Amelia; Schoeni, Robert F.; Cornman, Jennifer C.

2015-01-01

Growing evidence suggests that psychological factors, such as conscientiousness and anger, as well as cognitive ability are related to mortality. Less is known about 1) the relative importance of each of these factors in predicting mortality, 2) through what social, economic, and behavioral mechanisms these factors influence mortality, and 3) how these processes unfold over long periods of time in nationally-representative samples. We use 35 years (1972–2007) of data from men (ages 20–40) in the Panel Study of Income Dynamics (PSID), a nationally representative sample in the United States, and discrete time event history analysis (n=27,373 person-years) to examine the importance of measures of follow-through (a dimension of conscientiousness), anger, and cognitive ability in predicting mortality. We also assess the extent to which income, marriage, and smoking explain the relationship between psychological and cognitive factors with mortality. We find that while follow-through, anger, and cognitive ability are all associated with subsequent mortality when modeled separately, when they are modeled together and baseline demographic characteristics are controlled, only anger remains associated with mortality: being in the top quartile for anger is associated with a 1.57 fold increase in the risk of dying at follow-up compared with those in the bottom quartile. This relationship is robust to the inclusion of income, marriage, and smoking as mediators. PMID:26397865

Youths Treated for Non-Suicidal Self Harm at Increased Risk of Suicide Within a Year

MedlinePlus

... Non-Suicidal Self Harm at Increased Risk of Suicide Within a Year Page Content New research in ... likely than demographically matched peers to die from suicide within the following year. The study, " Suicide Following ...

Increase in body weight over a two-year period is associated with an increase in midfoot pressure and foot pain.

PubMed

Walsh, Tom P; Butterworth, Paul A; Urquhart, Donna M; Cicuttini, Flavia M; Landorf, Karl B; Wluka, Anita E; Michael Shanahan, E; Menz, Hylton B

2017-01-01

There is a well-recognised relationship between body weight, plantar pressures and foot pain, but the temporal association between these factors is unknown. The aim of this study was to investigate the relationships between increasing weight, plantar pressures and foot pain over a two-year period. Fifty-one participants (33 women and 18 men) completed the two-year longitudinal cohort study. The sample had a mean (standard deviation (SD)) age of 52.6 (8.5) years. At baseline and follow-up, participants completed the Manchester Foot Pain and Disability Index questionnaire, and underwent anthropometric measures, including body weight, body mass index, and dynamic plantar pressures. Within-group analyses examined differences in body weight, foot pain and plantar pressures between baseline and follow up, and multivariate regression analysis examined associations between change in body weight, foot pain and plantar pressure. Path analysis assessed the total impact of both the direct and indirect effects of change in body weight on plantar pressure and pain variables. Mean (SD) body weight increased from 80.3 (19.3), to 82.3 (20.6) kg, p  = 0.016 from baseline to follow up. The change in body weight ranged from -16.1 to 12.7 kg. The heel was the only site to exhibit increased peak plantar pressures between baseline and follow up. After adjustment for age, gender and change in contact time (where appropriate), there were significant associations between: (i) change in body weight and changes in midfoot plantar pressure ( B  = 4.648, p  = 0.038) and functional limitation ( B  = 0.409, p  = 0.010), (ii) plantar pressure change in the heel and both functional limitation ( B =  4.054, p  = 0.013) and pain intensity ( B =  1.831, p  = 0.006), (iii) plantar pressure change in the midfoot and both functional limitation ( B =  4.505 , p  = 0.018) and pain intensity ( B =  1.913 , p  = 0.015) . Path analysis indicated that the effect of increasing body

Cognitive Effects of Two-Year and Four-Year Colleges: Some New Evidence.

ERIC Educational Resources Information Center

Pascarella, Ernest; And Others

This study investigated the relative freshman-year cognitive impacts of five two-year and six four-year colleges and universities drawn from all sections of the United States. The overall sample was 2,685 freshmen students participating in a national longitudinal study and of these the final sample contained 811 students, 280 attending five…

Evidence of increased STI/HIV-related risk behavior among male perpetrators of intimate partner violence in Guatemala: results from a national survey.

PubMed

Hembling, John; Andrinopoulos, Katherine

2014-01-01

Intimate partner violence (IPV) is a significant public health problem with a demonstrated link to increased sexually transmitted infection (STI)/HIV-related risk and vulnerability. While IPV is an important issue in Central America, the link to STI/HIV risk has not been explored in this region. In this study, the relationship between emotional and physical/sexual IPV and the STI/HIV-related risk behaviors of sex worker patronage and infidelity is assessed among male IPV perpetrators using data from a national survey conducted in 2009 in Guatemala (n = 4773 married/partnered men). Bivariate associations between background characteristics and emotional and physical IPV perpetration were explored. Logistic regression models were run to test associations between IPV for each sexual risk behavior. Perpetration of emotional and physical/sexual IPV was more common among married/partnered men who were older than 24, had more education, lived in urban areas, or were in common law versus married unions. Reports of past-year emotional IPV perpetration increased as wealth quintile increased. After adjusting for demographics and other characteristics, physical/sexual IPV perpetration was associated with past-year infidelity (AOR 1.9, 95% CI: 1.1-3.6). Lifetime emotional IPV (AOR 1.4, 95% CI: 1.1-1.7) and physical/sexual IPV 1.6 (95% CI 1.2-2.0) were positively associated with a history of sex worker patronage. Endorsement of traditional gender role norms showed a marginally positive association with past-year infidelity in the adjusted model (AOR 1.3, 95% CI 1.0-1.8). The study findings from Guatemala reinforce the growing evidence globally that male IPV perpetrators are more likely to engage in risky sexual behavior, including sex worker patronage and main partner infidelity. The concurrency of violence and increased STI/HIV risk may compound the health risks for female victims of IPV who also face injury and psychological trauma. Integration of prevention and screening of

Crohn's disease: increased mortality 10 years after diagnosis in a Europe‐wide population based cohort

PubMed Central

Wolters, F L; Russel, M G; Sijbrandij, J; Schouten, L J; Odes, S; Riis, L; Munkholm, P; Bodini, P; O'Morain, C; Mouzas, I A; Tsianos, E; Vermeire, S; Monteiro, E; Limonard, C; Vatn, M; Fornaciari, G; Pereira, S; Moum, B; Stockbrügger, R W

2006-01-01

Background No previous correlation between phenotype at diagnosis of Crohn's disease (CD) and mortality has been performed. We assessed the predictive value of phenotype at diagnosis on overall and disease related mortality in a European cohort of CD patients. Methods Overall and disease related mortality were recorded 10 years after diagnosis in a prospectively assembled, uniformly diagnosed European population based inception cohort of 380 CD patients diagnosed between 1991 and 1993. Standardised mortality ratios (SMRs) were calculated for geographic and phenotypic subgroups at diagnosis. Results Thirty seven deaths were observed in the entire cohort whereas 21.5 deaths were expected (SMR 1.85 (95% CI 1.30–2.55)). Mortality risk was significantly increased in both females (SMR 1.93 (95% CI 1.10–3.14)) and males (SMR 1.79 (95% CI 1.11–2.73)). Patients from northern European centres had a significant overall increased mortality risk (SMR 2.04 (95% CI 1.32–3.01)) whereas a tendency towards increased overall mortality risk was also observed in the south (SMR 1.55 (95% CI 0.80–2.70)). Mortality risk was increased in patients with colonic disease location and with inflammatory disease behaviour at diagnosis. Mortality risk was also increased in the age group above 40 years at diagnosis for both total and CD related causes. Excess mortality was mainly due to gastrointestinal causes that were related to CD. Conclusions This European multinational population based study revealed an increased overall mortality risk in CD patients 10 years after diagnosis, and age above 40 years at diagnosis was found to be the sole factor associated with increased mortality risk. PMID:16150857

Long term self esteem assessment after height increase by lengthening and then nailing.

PubMed

Emara, K; Al Kersh, M A; Emara, A K

2017-03-01

The purpose of the study is to assess the long term psychosocial functioning after height increase, using the external fixation then nailing method. Rosenberg Self-esteem scale and a questionnaire to assess social functioning were completed by 28 patients both preoperatively and at a mean follow-up of 7 years. The mean total score of RSE self-esteem for the 28 patients before lengthening was 21.5 (SD 1.03) (20-24). The mean total score of RSE for the patients 1 year after lengthening was 22 (SD 1.17) (20-24) with highly significant difference (p = 0.002).The mean total RSE self-esteem score after 7 years was 21.7 (SD 1.12) (21-25) with no significant difference (p = 0.11) Improvement was an evident in the short term self esteem after 1 year of follow up of the patients with height increase. On the other hand, there was an evident deterioration in the long term psychosocial evaluation during follow up after 7 years of height increase, returning to near pre-operative levels of self esteem.

Anomalous increase of diffuse CO_{2} emission from Brava (Cape Verde): evidence of volcanic unrest or increase gas release from a stationary magma body?

NASA Astrophysics Data System (ADS)

García-Merino, Marta; García-Hernández, Rubén; Montrond, Eurico; Dionis, Samara; Fernandes, Paulo; Silva, Sonia V.; Alfama, Vera; Cabral, Jeremías; Pereira, Jose M.; Padrón, Eleazar; Pérez, Nemesio M.

2017-04-01

Brava (67 km2) is the southwestern most and the smallest inhabited island of the Cape Verde archipelago. It is located 18 km west of Fogo Island and rises 976 m from the sea level. Brava has not any documented historical eruptions, but its Holocene volcanism and relatively high seismic activity clearly indicate that it is an active volcanic island. Since there have been no historic eruptions in Brava, volcanic hazard awareness among the population and the authorities is very low; therefore, its volcano monitoring program is scarce. With the aim of helping to provide a multidisciplinary monitoring program for the volcanic surveillance of the island, diffuse CO2 emission surveys have been carried out since 2010; approximately every 2 years. Soil CO2 efflux measurements are periodically performed at ˜ 275 observation sites all over the island and after taking into consideration their accessibility and the island volcano-structural characteristics. At each sampling site, soil CO2 efflux measurement was performed by means of a portable NDIR sensor according to the accumulation chamber method. To quantify the total diffuse CO2 emission from Brava volcanic system, soil CO2 efflux maps were constructed using sequential Gaussian simulations (sGs). An increase trend of diffuse CO2 emission rate from 42 to 681 t d-1at Brava was observed; just one year prior the 2014-2015 Fogo eruption and almost three years before the anomalous seismic activity recorded on August 2016 with more than 1000 seismic events registered by the INMG on August 1st, 2016 (Bruno Faria, personal communication). Due to this anomalous seismic activity, a diffuse CO2 emission survey at Brava was performed from August 2 to 10, 2016, and the estimated degassing rate yield a value about 72 t d-1; typical background values. An additional survey was carried out from October 22 to November 6, 2016. For this last survey, the estimated diffuse CO2 emission from Brava showed the highest observed value with a

Level of clinical evidence presented at the International Society for Hip Arthroscopy Annual Scientific Meeting over 5 years (2010–2014)

PubMed Central

Kay, Jeffrey; de SA, Darren; Shallow, Scott; Simunovic, Nicole; Safran, Marc R.; Philippon, Marc J.; Ayeni, Olufemi R.

2015-01-01

The International Society for Hip Arthroscopy (ISHA) Annual Scientific Meeting is at the forefront of informing today’s orthopaedic surgeons and society of the rapid advances in the exponentially growing field of hip arthroscopy. The purpose of this study was to evaluate and observe any trends in the level of clinical evidence in the papers and posters presented at the ISHA Annual Scientific Meeting from 2010 to 2014. The online abstracts of the paper and poster presentations presented at the ISHA Annual Scientific Meetings were independently evaluated by two reviewers (582 total resulting presentations). Two reviewers screened these results for clinical studies and graded the quality of evidence from level I (i.e. randomized trials) to IV (i.e. case series) based on the American Academy of Orthopaedic Surgeons classification system. Four hundred and twenty-eight presentations met the inclusion criteria and were evaluated. Overall, 10.1% of the presentations were level I, 12.8% were level II, 30.1% were level III and 47.0% were level IV evidence. Over time, from 2010 to 2014, we observed an increase in the percentage of level II paper presentations, an increase in the proportion of level III poster presentations, and a decrease in the proportion of both level IV paper and poster presentations. Significant non-random improvement in the level of evidence presented was noted for the poster presentations (P = 0.012) but not for the paper presentations (P = 0.61) over the study period. Statistical trends demonstrate ISHA’s increased awareness and commitment to presenting higher quality evidence as the availability of this evidence increases. PMID:27011857

Twenty Years of Evidence on the Outcomes of Malpractice Claims

PubMed Central

2008-01-01

Two decades of social science research on the outcomes of medical malpractice claims show malpractice outcomes bear a surprisingly good correlation with the quality of care provided to the patient as judged by other physicians. Physicians win 80% to 90% of the jury trials with weak evidence of medical negligence, approximately 70% of the borderline cases, and even 50% of the trials in cases with strong evidence of medical negligence. With only one exception, all of the studies of malpractice settlements also find a correlation between the odds of a settlement payment and the quality of care provided to the plaintiff. Between 80% and 90% of the claims rated as defensible are dropped or dismissed without payment. In addition, the amount paid in settlement drops as the strength of the patient’s evidence weakens. PMID:19048355

Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components

PubMed Central

Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

2016-01-01

ABSTRACT Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30–70 percentage points within 1–3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women

Are female monarch butterflies declining in eastern North America? Evidence of a 30-year change in sex ratios at Mexican overwintering sites

PubMed Central

Davis, Andrew K.; Rendón-Salinas, Eduardo

2010-01-01

Every autumn the entire eastern North American population of monarch butterflies (Danaus plexippus) undergoes a spectacular migration to overwintering sites in the mountains of central Mexico, where they form massive clusters and can number in the millions. Since their discovery, these sites have been extensively studied, and in many of these studies, monarchs were captured and sexes recorded. In a recent effort to compile the sex ratio data from these published records, a surprising trend was found, which appears to show a gradual decline in proportion of females over time. Sex ratio data from 14 collections of monarchs, all spanning 30 years and totaling 69 113 individuals, showed a significant negative correlation between proportion of females and year (r = −0.69, p = 0.007). Between 1976 and 1985, 53 per cent of overwintering monarchs were female, whereas in the last decade, 43 per cent were female. The relationship was significant with and without weighting the analyses by sampling effort. Moreover, analysis of a recent three-year dataset of sex ratios revealed no variation among nine separate colonies, so differences in sampling location did not influence the trend. Additional evidence from autumn migration collections appears to confirm that proportions of females are declining, and also suggests the sex ratio is shifting on breeding grounds. While breeding monarchs face a number of threats, one possibility is an increase in prevalence of the protozoan parasite, Ophryocystis elektroscirrha, which recent evidence shows affects females more so than males. Further study will be needed to determine the exact cause of this trend, but for now it should be monitored closely. PMID:19776062

Adapting evidence-based strategies to increase physical activity among African Americans, Hispanics, Hmong, and Native Hawaiians: a social marketing approach.

PubMed

Van Duyn, Mary Ann S; McCrae, Tarsha; Wingrove, Barbara K; Henderson, Kimberly M; Boyd, Jamie K; Kagawa-Singer, Marjorie; Ramirez, Amelie G; Scarinci-Searles, Isabel; Wolff, Lisa S; Penalosa, Tricia L; Maibach, Edward W

2007-10-01

Using a social marketing approach, we studied how best to adapt proven, evidence-based strategies to increase physical activity for use with underserved racial or ethnic groups. We conducted focus groups with low-income Hispanic women in Texas, Hmong parents and their children in California, low-income African American women and men in the Mississippi Delta, and Native Hawaiian college students in Hawaii. We also interviewed key leaders of these communities. Topics of discussion were participants' perceptions about 1) the benefits of engaging in physical activity, 2) the proposed evidence-based strategies for increasing each community's level of physical activity, and 3) the benefits and barriers to following the proposed interventions for increasing physical activity. A total of 292 individuals participated in the study. All groups considered that being physically active was part of their culture, and participants found culturally relevant suggestions for physical activities appealing. Overwhelmingly, strategies that aimed to create or improve social support and increase access to physical activity venues received the most positive feedback from all groups. Barriers to physical activity were not culturally specific; they are common to all underserved people (lack of time, transportation, access, neighborhood safety, or economic resources). Results indicate that evidence-based strategies to increase physical activity need to be adapted for cultural relevance for each racial or ethnic group. Our research shows that members of four underserved populations are likely to respond to strategies that increase social support for physical activity and improve access to venues where they can be physically active. Further research is needed to test how to implement such strategies in ways that are embraced by community members.

Earliest Archaeological Evidence of Persistent Hominin Carnivory

PubMed Central

Ferraro, Joseph V.; Plummer, Thomas W.; Pobiner, Briana L.; Oliver, James S.; Bishop, Laura C.; Braun, David R.; Ditchfield, Peter W.; Seaman, John W.; Binetti, Katie M.; Seaman, John W.; Hertel, Fritz; Potts, Richard

2013-01-01

The emergence of lithic technology by ∼2.6 million years ago (Ma) is often interpreted as a correlate of increasingly recurrent hominin acquisition and consumption of animal remains. Associated faunal evidence, however, is poorly preserved prior to ∼1.8 Ma, limiting our understanding of early archaeological (Oldowan) hominin carnivory. Here, we detail three large well-preserved zooarchaeological assemblages from Kanjera South, Kenya. The assemblages date to ∼2.0 Ma, pre-dating all previously published archaeofaunas of appreciable size. At Kanjera, there is clear evidence that Oldowan hominins acquired and processed numerous, relatively complete, small ungulate carcasses. Moreover, they had at least occasional access to the fleshed remains of larger, wildebeest-sized animals. The overall record of hominin activities is consistent through the stratified sequence – spanning hundreds to thousands of years – and provides the earliest archaeological evidence of sustained hominin involvement with fleshed animal remains (i.e., persistent carnivory), a foraging adaptation central to many models of hominin evolution. PMID:23637995

Increased alcohol consumption as a cause of alcoholism, without similar evidence for depression: a Mendelian randomization study.

PubMed

Wium-Andersen, Marie Kim; Ørsted, David Dynnes; Tolstrup, Janne Schurmann; Nordestgaard, Børge Grønne

2015-04-01

Increased alcohol consumption has been associated with depression and alcoholism, but whether these associations are causal remains unclear. We tested whether alcohol consumption is causally associated with depression and alcoholism. We included 78,154 men and women aged 20-100 years randomly selected in 1991-2010 from the general population of Copenhagen, Denmark, and genotyped 68,486 participants for two genetic variants in two alcohol dehydrogenase (ADH) genes, ADH-1B (rs1229984) and ADH-1C (rs698). We performed observational and causal analyses using a Mendelian randomization design with antidepressant medication use and hospitalization/death, with depression and alcoholism as outcomes. In prospective analyses, the multifactorially adjusted hazard ratio for participants reporting >6 drinks/day vs participants reporting 0.1-1 drinks/day was 1.28 (95% confidence interval, 1.00-1.65) for prescription antidepressant use, with a corresponding hazard ratio of 0.80 (0.45-1.45) for hospitalization/death with depression and of 11.7 (8.77-15.6) for hospitalization/death with alcoholism. For hospitalization/death with alcoholism, instrumental variable analysis yielded a causal odds ratio of 28.6 (95 % confidence interval 6.47-126) for an increase of 1 drink/day estimated from the combined genotype combination, whereas the corresponding multifactorially adjusted observational odds ratio was 1.28 (1.25-1.31). Corresponding odds ratios were 1.11 (0.67-1.83) causal and 1.04 (1.03-1.06) observational for prescription antidepressant use, and 4.52 (0.99-20.5) causal and 0.98 (0.94-1.03) observational for hospitalization/death with depression. These data indicate that the association between increased alcohol consumption and alcoholism is causal, without similar strong evidence for depression. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Fulfilling the Promise of the Community College: Increasing First-Year Student Engagement and Success. The First-Year Experience Monograph Series Number 56

ERIC Educational Resources Information Center

Brown, Thomas, Ed.; King, Margaret C., Ed.; Stanley, Patricia, Ed.

2011-01-01

For the past three decades, American higher education has paid increasing attention to the beginning college experience--to ensuring that entering students make a successful transition to college. Yet, much of the extant research and practice literature focuses on the experience of first-year students entering four-year colleges and universities.…

Poverty, inequality, and increased consumption of high calorie food: Experimental evidence for a causal link.

PubMed

Bratanova, Boyka; Loughnan, Steve; Klein, Olivier; Claassen, Almudena; Wood, Robert

2016-05-01

Rising obesity represents a serious, global problem. It is now well established that obesity is associated with poverty and wealth inequality, suggesting that these factors may promote caloric intake. Whereas previous work has examined these links from an epidemiological perspective, the current paper examined them experimentally. In Study 1 we found that people experimentally induced to view themselves as poor (v. wealthy) exhibited increased calorie intake. In Study 2, participants who believed that they were poorer or wealthier than their interaction partners exhibited higher levels of anxiety compared to those in an equal partners condition; this anxiety in turn led to increased calorie consumption for people who had a strong need to belong. The findings provide causal evidence for the poverty-intake and inequality-intake links. Further, we identify social anxiety and a strong need to belong as important social psychological factors linking inequality to increased calorie intake. Copyright © 2016. Published by Elsevier Ltd.

Global health-related publications in otolaryngology are increasing.

PubMed

Chambers, Kyle J; Creighton, Francis; Abdul-Aziz, Dunia; Cheney, Mack; Randolph, Gregory W

2015-04-01

Determine trends in global health-related publication in otolaryngology. A review of research databases. A search of publications available on PubMed and nine additional databases was undertaken reviewing two time periods 10 years apart for the timeframes 1998 to 2002 (early time period) and 2008 to 2012 (recent time period) using specific search terms to identify global health-related publications in otolaryngology. Publications were examined for region of origin, subspecialty, type of publication, and evidence of international collaboration. χ and t test analyses were used to identify trends. In the 1998 to 2002 time period, a total of 26 publications met inclusion criteria for the study, with a mean of 5.2 ± 2.8 publications per year. In the 2008 to 2012 time period, a total of 61 publications met inclusion criteria, with a mean of 12.3 ± 5.6 publications per year. The 235% increase in global health-related publications identified between the two study periods was statistically significant (P = .02). The absolute number of publications in which collaboration occurred between countries increased from three in the early time period to nine the recent time period. There has been a significant increase in the volume of global health-related publications in English language otolaryngology journals over the past decade, providing strong evidence of the increasing trend of global health as an academic pursuit within the field of otolaryngology. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study.

PubMed

Chen, Ping-Jen; Huang, Charles Lung-Cheng; Weng, Shih-Feng; Wu, Ming-Ping; Ho, Chung-Han; Wang, Jhi-Joung; Tsai, Wan-Chi; Hsu, Ya-Wen

2017-10-01

We investigated the longitudinal impacts of insomnia on the subsequent developments of anxiety and depression during a four-year follow-up. We further categorized individuals with insomnia into different insomnia subgroups to examine whether the risk of anxiety and depression varies by subtype. Participants were identified from National Health Insurance enrollees in Taiwan during 2002-2009. The study included 19,273 subjects with insomnia and 38,546 matched subjects without insomnia. All subjects did not have previous diagnosis of insomnia, sleep apnea, anxiety, or depression. Compared with non-insomniacs, insomniacs had a higher risk of developing anxiety only [adjusted hazard ratio (HR) = 8.83, 95% CI = 7.59-10.27], depression only (adjusted HR = 8.48, 95% CI = 6.92-10.39), and both anxiety and depression (adjusted HR = 17.98, 95% CI = 12.65-25.56). When breaking down the insomnia subgroups, individuals with a relapse of insomnia (adjusted HR = 10.42-26.80) had the highest risk of anxiety only, depression only, and both anxiety and depression, followed by persistent insomnia (adjusted HR = 9.82-18.98), then remitted insomnia (adjusted HR = 4.50-8.27). All three insomnia subgroups had a greater four-year cumulative incidence rate than the non-insomnia group for anxiety only, depression only, and both anxiety and depression (p < 0.0001). Our findings reinforce the clinical predictor role of insomnia in the future onset of anxiety or/and depression. Awareness of insomnia and treatment of insomnia should be recommended at clinics, and patterns of insomnia should be monitored to help treatment and control of subsequent psychiatric disorders. Future research with comprehensive data collection is needed to identify factors that contribute to different insomnia subtypes. Copyright © 2017 Elsevier B.V. All rights reserved.

Expectations for antibiotics increase their prescribing: Causal evidence about localized impact.

PubMed

Sirota, Miroslav; Round, Thomas; Samaranayaka, Shyamalee; Kostopoulou, Olga

2017-04-01

Clinically irrelevant but psychologically important factors such as patients' expectations for antibiotics encourage overprescribing. We aimed to (a) provide missing causal evidence of this effect, (b) identify whether the expectations distort the perceived probability of a bacterial infection either in a pre- or postdecisional distortions pathway, and (c) detect possible moderators of this effect. Family physicians expressed their willingness to prescribe antibiotics (Experiment 1, n₁ = 305) or their decision to prescribe (Experiment 2, n₂ = 131) and assessed the probability of a bacterial infection in hypothetical patients with infections either with low or high expectations for antibiotics. Response order of prescribing/probability was manipulated in Experiment 1. Overall, the expectations for antibiotics increased intention to prescribe (Experiment 1, F(1, 301) = 25.32, p < .001, η p ² = .08, regardless of the response order; Experiment 2, odds ratio [OR] = 2.31, and OR = 0.75, Vignettes 1 and 2, respectively). Expectations for antibiotics did not change the perceived probability of a bacterial infection (Experiment 1, F(1, 301) = 1.86, p = .173, η p ² = .01, regardless of the response order; Experiment 2, d = -0.03, and d = +0.25, Vignettes 1 and 2, respectively). Physicians' experience was positively associated with prescribing, but it did not moderate the expectations effect on prescribing. Patients' and their parents' expectations increase antibiotics prescribing, but their effect is localized-it does not leak into the perceived probability of a bacterial infection. Interventions reducing the overprescribing of antibiotics should target also psychological factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Increase of body mass index (BMI) from 1.5 to 3 years of age augments the degree of insulin resistance corresponding to BMI at 12 years of age.

PubMed

Arisaka, Osamu; Sairenchi, Toshimi; Ichikawa, Go; Koyama, Satomi

2017-04-01

To elucidate the effect of early growth patterns on the metabolic sensitivity to adiposity, we examined the relationship between the homeostatic model assessment of insulin resistance (HOMA-IR) and body mass index (BMI) levels at 12 years of age in 101 boys and 91 girls in a birth cohort. Children with an increase in BMI from the ages of 1.5 to 3 years exhibited a greater increase of HOMA-IR per BMI increase at 12 years of age compared to those with a decrease in BMI or stable BMI from 1.5 to 3 years. This suggests that children who show an increase in BMI from 1.5 to 3 years, a period normally characterized by a decreased or stable BMI, are more prone to developing insulin resistance at 12 years of age.

Physical Activity and Personality Development over Twenty Years: Evidence from Three Longitudinal Samples.

PubMed

Stephan, Yannick; Sutin, Angelina R; Luchetti, Martina; Bosselut, Grégoire; Terracciano, Antonio

2018-04-01

A physically inactive lifestyle is associated with maladaptive patterns of personality development over relatively short follow-up periods. The present study extends existing research by examining whether this association persists over 20 years. Participants (total N = 8,723) were drawn from the Wisconsin Longitudinal Study Graduates and Siblings samples and the Midlife in the United States Study. Controlling for demographic factors and disease burden, baseline physical inactivity was related to steeper declines in conscientiousness in all three samples and a meta-analysis (β=-.06). The meta-analysis further showed that lower physical activity was associated with declines in openness (β=-.05), extraversion (β=-.03), and agreeableness (β=-.03). These findings provide evidence that a physically inactive lifestyle is associated with long-term detrimental personality trajectories.

Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment.

PubMed

Upasani, Vidyadhar V; Caltoum, Christine; Petcharaporn, Maty; Bastrom, Tracey P; Pawelek, Jeff B; Betz, Randal R; Clements, David H; Lenke, Lawrence G; Lowe, Thomas G; Newton, Peter O

2008-05-01

.003) and a trend toward worsening scores in 4 other domains was observed; however, Patient Satisfaction scores remained unchanged. Lowest instrumented vertebrae and surgical approach could not be correlated to changes in the pain score. In addition, no correlation was found between changes in any of the 21 radiographic measures evaluated and changes in SRS scores. There was a statistically significant increase in reported pain from 2 to 5 years after surgical treatment; however, the etiology of worsening pain scores could not be elucidated. Given continued patient satisfaction, the clinical relevance of this small reduction remains unknown. Nevertheless, this observation deserves further evaluation and must be considered in relation to the natural history of this disease.

Nitrogen availability increases in a tundra ecosystem during five years of experimental permafrost thaw.

PubMed

Salmon, Verity G; Soucy, Patrick; Mauritz, Marguerite; Celis, Gerardo; Natali, Susan M; Mack, Michelle C; Schuur, Edward A G

2016-05-01

Perennially frozen soil in high latitude ecosystems (permafrost) currently stores 1330-1580 Pg of carbon (C). As these ecosystems warm, the thaw and decomposition of permafrost is expected to release large amounts of C to the atmosphere. Fortunately, losses from the permafrost C pool will be partially offset by increased plant productivity. The degree to which plants are able to sequester C, however, will be determined by changing nitrogen (N) availability in these thawing soil profiles. N availability currently limits plant productivity in tundra ecosystems but plant access to N is expected improve as decomposition increases in speed and extends to deeper soil horizons. To evaluate the relationship between permafrost thaw and N availability, we monitored N cycling during 5 years of experimentally induced permafrost thaw at the Carbon in Permafrost Experimental Heating Research (CiPEHR) project. Inorganic N availability increased significantly in response to deeper thaw and greater soil moisture induced by Soil warming. This treatment also prompted a 23% increase in aboveground biomass and a 49% increase in foliar N pools. The sedge Eriophorum vaginatum responded most strongly to warming: this species explained 91% of the change in aboveground biomass during the 5 year period. Air warming had little impact when applied alone, but when applied in combination with Soil warming, growing season soil inorganic N availability was significantly reduced. These results demonstrate that there is a strong positive relationship between the depth of permafrost thaw and N availability in tundra ecosystems but that this relationship can be diminished by interactions between increased thaw, warmer air temperatures, and higher levels of soil moisture. Within 5 years of permafrost thaw, plants actively incorporate newly available N into biomass but C storage in live vascular plant biomass is unlikely to be greater than losses from deep soil C pools. © 2015 John Wiley & Sons Ltd.

Measuring the Effectiveness of Knowledge Creation as a Means of Facilitating Evidence-Informed Practice in Early Years Settings in One London Borough

ERIC Educational Resources Information Center

Brown, Chris; Rogers, Sue

2014-01-01

This paper examines our use of knowledge-creation activity as a way of developing evidence-informed practice among a learning community of 36 early years practitioners in one London borough. It also seeks to illustrate how we approached the idea of measuring evidence use and our engagement with, and adapted use of, two separate measurement scales:…

Just-in-Time Training of the Evidence-Based Public Health Framework, Oklahoma, 2016-2017.

PubMed

Douglas, Malinda R; Lowry, Jon P; Morgan, Latricia A

2018-03-07

Training of practitioners on evidence-based public health has shown to be beneficial, yet overwhelming. Chunking information and proximate practical application are effective techniques to increase retention in adult learning. Evidence-based public health training for practitioners from African American and Hispanic/Latino community agencies and tribes/tribal nations incorporated these 2 techniques. The community-level practitioners alternated attending training and implementing the steps of the evidence-based public health framework as they planned state-funded programs. One year later, survey results showed that participants reported increased confidence in skills that were reinforced by practical and practiced application as compared with posttraining survey results. In addition, at 1 year, reported confidence in skills that were not fortified by proximate application decreased when compared with posttraining confidence levels. All 7 community programs successfully created individualized evidence-based action plans that included evidence-based practices and policies across socioecological levels that fit with the unique culture and climate of their own community.

Teaching Argument Writing to 7- to 14-Year-Olds: An International Review of the Evidence of Successful Practice

ERIC Educational Resources Information Center

Andrews, Richard; Torgerson, Carole; Low, Graham; McGuinn, Nick

2009-01-01

A systematic review was undertaken in 2006 to answer the question "What is the evidence for successful practice in teaching and learning with regard to non-fiction writing (specifically argumentational writing) for 7- to 14-year-olds?", using EPPI-Centre methodology. Results showed that certain conditions have to be in place. These…

A 4-year intervention to increase adoption of safer dairy farming work practices.

PubMed

Chapman, Larry J; Brunette, Christopher M; Karsh, Ben-Tzion; Taveira, Alvaro D; Josefsson, K Gunnar

2011-03-01

Traumatic and musculoskeletal injury rates have been high in dairy farming compared to other industries. Previous work has shown that social marketing efforts can persuade farm managers to adopt practices that reduce injury hazards compared to traditional practices if the new practices maintain profits. The intervention disseminated information to 4,300 Northeast Wisconsin dairy farm managers about three safer and more profitable production practices (barn lights, silage bags, and calf feed mixing sites) using information channels that these managers were known to rely on. We evaluated rolling, independent, community-based samples, at baseline and then again after each of four intervention years. We also evaluated samples from Maryland's 1,200 dairy farms after the second through the fourth year of the intervention. Maryland dairy managers read many of the same nationally distributed print mass media that we used in the intervention and so were a "partially exposed" comparison group. The intervention to disseminate information about the innovations was successful. In comparisons before and after the intervention, Wisconsin managers reported getting more information about calf sites from public events and equipment dealers, about silage bags from other farmers and equipment dealers, and about barn lights from public events, other farmers, equipment dealers, consultants, and electrical suppliers. Wisconsin managers also reported getting more information than Maryland managers from public events for barn lights and silage bags. During years three and four, the intervention managed to sustain, but not improve, earlier increases in adoption and awareness from the first 2 years. After adjusting for farm manager and operation variables, intervention years was associated with increased Wisconsin manager adoption of two of three practices in comparisons between the baseline and the fourth intervention year: barn lights (odds ratio = 5.58, 95% confidence interval = 3

Mild neonatal hyperthyrotrophinaemia: 10-year experience suggests the condition is increasingly common but often transient.

PubMed

Oren, Asaf; Wang, Michael K; Brnjac, Lori; Mahmud, Farid H; Palmert, Mark R

2013-12-01

To examine a large population of infants with mild neonatal hyperthyrotrophinaemia (MNH) and determine prevalence, clinical characteristics and treatment history. Retrospective study of infants with MNH followed at The Hospital for Sick Children between 2000 and 2011. MNH was defined by an abnormal newborn screen followed by thyroid-stimulating hormone (TSH) between 5 and 30 mU/l and normal free T4 (FT4) on confirmatory tests. Mild neonatal hyperthyrotrophinaemia represented 22·3% of patients (103/462; 60 boys, 43 girls) within our clinic. Incidence increased from two of 20 in 2000 to 31 of 74 cases in 2010. Seventy eight percent of patients started L-thyroxine (initial dose: 8·3 ± 2·5 mcg/kg). The treated group had higher confirmatory TSH levels (P = 0·001) and had undergone thyroid scintigraphy more often (P = 0·0001) compared with the nontreated group. Evidence of overtreatment was detected in 45% of thyroid function tests obtained during treatment. Among the treated infants who had reached 3 years of age, 45% (N = 14) underwent a trial-off medication. Compared with those not trialled-off therapy, these infants were less likely to have had dose escalations during treatment (P = 0·001). The trial-off treatment was successful in 50% of cases. In the subset of infants with confirmatory TSH >10 mU/l, trial-off therapy was successful in 40%. None of the assessed variables predicted success of trial-off therapy. Mild neonatal hyperthyrotrophinaemia is an increasingly common diagnosis. It is more common in males and is often transient, but predictors of success of trial-off therapy were not identified. Further studies are needed to determine optimum L-thyroxine dosing and to determine whether treatment improves neurocognitive outcomes. © 2013 John Wiley & Sons Ltd.

Psychological and cognitive determinants of mortality: Evidence from a nationally representative sample followed over thirty-five years.

PubMed

Karraker, Amelia; Schoeni, Robert F; Cornman, Jennifer C

2015-11-01

Growing evidence suggests that psychological factors, such as conscientiousness and anger, as well as cognitive ability are related to mortality. Less is known about 1) the relative importance of each of these factors in predicting mortality, 2) through what social, economic, and behavioral mechanisms these factors influence mortality, and 3) how these processes unfold over long periods of time in nationally-representative samples. We use 35 years (1972-2007) of data from men (ages 20-40) in the Panel Study of Income Dynamics (PSID), a nationally representative sample in the United States, and discrete time event history analysis (n = 27,373 person-years) to examine the importance of measures of follow-through (a dimension of conscientiousness), anger, and cognitive ability in predicting mortality. We also assess the extent to which income, marriage, and smoking explain the relationship between psychological and cognitive factors with mortality. We find that while follow-through, anger, and cognitive ability are all associated with subsequent mortality when modeled separately, when they are modeled together and baseline demographic characteristics are controlled, only anger remains associated with mortality: being in the top quartile for anger is associated with a 1.57 fold increase in the risk of dying at follow-up compared with those in the bottom quartile. This relationship is robust to the inclusion of income, marriage, and smoking as mediators. Copyright © 2015 Elsevier Ltd. All rights reserved.

Increasing insulin resistance accentuates the effect of triglyceride-associated loci on serum triglycerides during 5 years[S

PubMed Central

Justesen, Johanne M.; Andersson, Ehm A.; Allin, Kristine H.; Sandholt, Camilla H.; Jørgensen, Torben; Linneberg, Allan; Jørgensen, Marit E.; Hansen, Torben; Pedersen, Oluf; Grarup, Niels

2016-01-01

Blood concentrations of triglycerides are influenced by genetic factors as well as a number of environmental factors, including adiposity and glucose homeostasis. The aim was to investigate the association between a serum triglyceride weighted genetic risk score (wGRS) and changes in fasting serum triglyceride level over 5 years and to test whether the effect of the wGRS was modified by 5 year changes of adiposity, insulin resistance, and lifestyle factors. A total of 3,474 nondiabetic individuals from the Danish Inter99 cohort participated in both the baseline and 5 year follow-up physical examinations and had information on the wGRS comprising 39 genetic variants. In a linear regression model adjusted for age, sex, and baseline serum triglyceride, the wGRS was associated with increased serum triglyceride levels over 5 years [per allele effect = 1.3% (1.0–1.6%); P = 1.0 × 10−17]. This triglyceride-increasing effect of the wGRS interacted with changes in insulin resistance (Pinteraction = 1.5 × 10−6). This interaction indicated that the effect of the wGRS was stronger in individuals who became more insulin resistant over 5 years. In conclusion, our findings suggest that increased genetic risk load is associated with a larger increase in fasting serum triglyceride levels in nondiabetic individuals during 5 years of follow-up. This effect of the wGRS is accentuated by increasing insulin resistance. PMID:27777317

Higher price, fewer packs: evaluating a tobacco tax increase with cigarette sales data.

PubMed

Amato, Michael S; Boyle, Raymond G; Brock, Betsy

2015-03-01

In 2013, Minnesota increased cigarette taxes by $1.75, the largest US state increase since 2000. We obtained convenience store data of cigarette sales from January 2012 to December 2013 from the Nielsen Company. Analysis revealed significantly greater year-to-year reductions in numbers of packs purchased during posttax (-12.1%) than pretax (-3.2%; P<.001) periods. The results provide contemporary evidence that, despite reduced prevalence and increased tobacco control efforts, tax increases remain an effective tobacco control strategy.

Increasing seat belt use among 8- to 15-year-olds. Volume II, appendices

DOT National Transportation Integrated Search

2008-05-01

The broad aim of this research project was to determine the nature and causes of non-use of seat belts among 8- to 15year- olds, and to recommend interventions and strategic approaches to increase usage among this age group. This report summarizes fi...

Increasing seat belt use among 8- to 15-year-olds. Volume I, findings

DOT National Transportation Integrated Search

2008-05-01

The broad aim of this research project was to determine the nature and causes of non-use of seat belts among 8- to 15year- olds, and to recommend interventions and strategic approaches to increase usage among this age group. This report summarizes fi...

Epidemiologic Evidence That Excess Body Weight Increases Risk of Cervical Cancer by Decreased Detection of Precancer.

PubMed

Clarke, Megan A; Fetterman, Barbara; Cheung, Li C; Wentzensen, Nicolas; Gage, Julia C; Katki, Hormuzd A; Befano, Brian; Demarco, Maria; Schussler, John; Kinney, Walter K; Raine-Bennett, Tina R; Lorey, Thomas S; Poitras, Nancy E; Castle, Philip E; Schiffman, Mark

2018-04-20

Purpose Obesity has been inconsistently linked to increased cervical cancer incidence and mortality; however, the effect of obesity on cervical screening has not been explored. We investigated the hypothesis that increased body mass might decrease detection of cervical precancer and increase risk of cervical cancer even in women undergoing state-of-the-art screening. Methods We conducted a retrospective cohort study of 944,227 women age 30 to 64 years who underwent cytology and human papillomavirus DNA testing (ie, cotesting) at Kaiser Permanente Northern California (January 2003 to December 2015). Body mass index was categorized as normal/underweight (< 25 kg/m 2 ), overweight (25 to < 30 kg/m 2 ), or obese (≥ 30 kg/m 2 ). We estimated 5-year cumulative risks of cervical precancer and cancer by category of body mass index using logistic Weibull survival models. Results We observed lower risk of cervical precancer (n = 4,489) and higher risk of cervical cancer (n = 490) with increasing body mass index. Specifically, obese women had the lowest 5-year risk of precancer (0.51%; 95% CI, 0.48% to 0.54% v 0.73%; 95% CI, 0.70% to 0.76% in normal/underweight women; P trend < .001). In contrast, obese women had the highest 5-year risk of cancer (0.083%; 95% CI, 0.072% to 0.096% v 0.056%; 95% CI, 0.048% to 0.066% in normal/underweight women; P trend < .001). Results were consistent in subgroups defined by age (30 to 49 v 50 to 64 years), human papillomavirus status (positive v negative), and histologic subtype (glandular v squamous). Approximately 20% of cervical cancers could be attributed to overweight or obesity in the women in our study who underwent routine cervical screening. Conclusion In this large, screened population, overweight and obese women had an increased risk of cervical cancer, likely because of underdiagnosis of cervical precancer. Improvements in equipment and/or technique to assure adequate sampling and visualization of women with elevated body mass

Thirty thousand-year-old evidence of plant food processing

PubMed Central

Revedin, Anna; Aranguren, Biancamaria; Becattini, Roberto; Longo, Laura; Marconi, Emanuele; Lippi, Marta Mariotti; Skakun, Natalia; Sinitsyn, Andrey; Spiridonova, Elena; Svoboda, Jiří

2010-01-01

European Paleolithic subsistence is assumed to have been largely based on animal protein and fat, whereas evidence for plant consumption is rare. We present evidence of starch grains from various wild plants on the surfaces of grinding tools at the sites of Bilancino II (Italy), Kostenki 16–Uglyanka (Russia), and Pavlov VI (Czech Republic). The samples originate from a variety of geographical and environmental contexts, ranging from northeastern Europe to the central Mediterranean, and dated to the Mid-Upper Paleolithic (Gravettian and Gorodtsovian). The three sites suggest that vegetal food processing, and possibly the production of flour, was a common practice, widespread across Europe from at least ~30,000 y ago. It is likely that high energy content plant foods were available and were used as components of the food economy of these mobile hunter–gatherers. PMID:20956317

Longitudinal Study of Language and Speech of Twins at 4 and 6 Years: Twinning Effects Decrease, Zygosity Effects Disappear, and Heritability Increases

ERIC Educational Resources Information Center

Rice, Mabel L.; Zubrick, Stephen R.; Taylor, Catherine L.; Hoffman, Lesa; Gayán, Javier

2018-01-01

Purpose: This study investigates the heritability of language, speech, and nonverbal cognitive development of twins at 4 and 6 years of age. Possible confounding effects of twinning and zygosity, evident at 2 years, were investigated among other possible predictors of outcomes. Method: The population-based twin sample included 627 twin pairs and 1…

Physical Activity and Personality Development over Twenty Years: Evidence from Three Longitudinal Samples

PubMed Central

Stephan, Yannick; Sutin, Angelina R.; Luchetti, Martina; Bosselut, Grégoire; Terracciano, Antonio

2018-01-01

A physically inactive lifestyle is associated with maladaptive patterns of personality development over relatively short follow-up periods. The present study extends existing research by examining whether this association persists over 20 years. Participants (total N = 8,723) were drawn from the Wisconsin Longitudinal Study Graduates and Siblings samples and the Midlife in the United States Study. Controlling for demographic factors and disease burden, baseline physical inactivity was related to steeper declines in conscientiousness in all three samples and a meta-analysis (β=−.06). The meta-analysis further showed that lower physical activity was associated with declines in openness (β=−.05), extraversion (β=−.03), and agreeableness (β=−.03). These findings provide evidence that a physically inactive lifestyle is associated with long-term detrimental personality trajectories. PMID:29651189

Dose intraarticular steroid injection increase the rate of infection in subsequent arthroplasty: grading the evidence through a meta-analysis.

PubMed

Xing, Dan; Yang, Yang; Ma, Xinlong; Ma, Jianxiong; Ma, Baoyi; Chen, Yang

2014-11-13

Intraarticular steroid injections are widely used in joint arthritis. However, the data regarding an association between an increased risk for arthroplasty infection after an intraarticular steroid injection are still conflicting. We conducted a meta-analysis to evaluate the evidence from relevant studies that examine the relation between intraarticular steroid injections and infection rates in subsequent joint arthroplasty and to develop GRADE based recommendations for using the steroid before arthroplasty. A systematic search of all studies published through August 2014 was conducted using the MEDLINE, EMBASE, OVID, ScienceDirect and Cochrane CENTRAL databases. The relevant studies that examined the relation between intraarticular steroid injections and infection rates in subsequent joint arthroplasty were identified. Demographic characteristics, infection rates and clinical outcomes were manually extracted from all of the selected studies. The evidence quality levels and recommendations were assessed using the GRADE system. Eight studies looking at hip and knee arthroplasties were included. Meta-analysis showed that patients with steroid injection before arthroplasty had a higher deep infection rate than patients without steroid injection (OR = 2.13, 95% CI 1.02-4.45), but no significant effect on superficial infection rate (OR = 1.75, 95% CI 0.74-4.16). The overall GRADE system evidence quality was very low, which lowers our confidence in their recommendations. Intraarticular steroid injections may lead to increased deep infection rates of subsequent joint arthroplasty but not the superficial infection rates. Due to the poor quality of the evidence currently available, further studies are still required.

Does the Blazar Gamma-ray Spectrum Harden with Increasing Flux? - Analysis of Nine Years of EGRET Data

NASA Technical Reports Server (NTRS)

Nandikotkur, Giridhar; Jahoda, Keith M.; Hartman, R. C.; Mukherjee, R.; Sreekumar, P.; Boettcher, M.

2007-01-01

The Energetic Gamma Ray Experiment Telescope (EGRET) on the Compton Gamma Ray Observatory (CGRO) discovered gamma-ray emission from more than 67 blazars during its nine-year lifetime. We conducted an exhaustive search of the EGRET archives and selected all the blazars that were observed multiple times and were bright enough to enable a spectral analysis using standard powerlaw models. The sample consists of 18 flat-spectrum radio quasars (FSRQs), 6 low-frequency-peaked BL Lacs (LBLs) and 2 high-frequency-peaked BL Lacs (HBLs). We do not detect any clear pattern in'the variation of spectral index with flux. Some of the blazars do not show any statistical evidence for spectral variability. The spectrum hardens with increasing flux in a few cases. There is also evidence for a flux-hardness anticorrelation at lo\\v fluxes in five blazars. The well observed blazars (3C 279,3C 273, PKS 0528-i-134, PKS 1622-297, PKS 0208- 512) do not show any overall trend in the long-term spectral dependence on flux, but the sample shows a mixture of hard and soft states. We observed spectral hysteresis at weekly timescales in all the three FSRQs for which data from flares lasting for 3 approx. 4 weeks were available. All three sources show a counterclockwise rotation despite the widely different flux profiles. Hysteresis in the spectral index vs. flux space has never been observed in FSRQs in gamma-rays at weekly timescales. itre analyze the observed spectral behavior in the context of various inverse-Compton mechanisms believed to be responsible for emission in the EGRET energy range. Our analysis uses the EGRET skymaps that were regenerated to include the changes in performance during the mission.

Increasing summer rainfall in arid eastern-Central Asia over the past 8500 years

PubMed Central

Hong, Bing; Gasse, Françoise; Uchida, Masao; Hong, Yetang; Leng, Xuetian; Shibata, Yasuyuki; An, Ning; Zhu, Yongxuan; Wang, Yu

2014-01-01

A detailed and well-dated proxy record of summer rainfall variation in arid Central Asia is lacking. Here, we report a long-term, high resolution record of summer rainfall extracted from a peat bog in arid eastern-Central Asia (AECA). The record indicates a slowly but steadily increasing trend of summer rainfall in the AECA over the past 8500 years. On this long-term trend are superimposed several abrupt increases in rainfall on millennial timescales that correspond to rapid cooling events in the North Atlantic. During the last millennium, the hydrological climate pattern of the AECA underwent a major change. The rainfall in the past century has reached its highest level over the 8500-year history, highlighting the significant impact of the human-induced greenhouse effect on the hydrological climate in the AECA. Our results demonstrate that even in very dry eastern-Central Asia, the climate can become wetter under global warming. PMID:24923304

No childhood development of viewpoint-invariant face recognition: evidence from 8-year-olds and adults.

PubMed

Crookes, Kate; Robbins, Rachel A

2014-10-01

Performance on laboratory face tasks improves across childhood, not reaching adult levels until adolescence. Debate surrounds the source of this development, with recent reviews suggesting that underlying face processing mechanisms are mature early in childhood and that the improvement seen on experimental tasks instead results from general cognitive/perceptual development. One face processing mechanism that has been argued to develop slowly is the ability to encode faces in a view-invariant manner (i.e., allowing recognition across changes in viewpoint). However, many previous studies have not controlled for general cognitive factors. In the current study, 8-year-olds and adults performed a recognition memory task with two study-test viewpoint conditions: same view (study front view, test front view) and change view (study front view, test three-quarter view). To allow quantitative comparison between children and adults, performance in the same view condition was matched across the groups by increasing the learning set size for adults. Results showed poorer memory in the change view condition than in the same view condition for both adults and children. Importantly, there was no quantitative difference between children and adults in the size of decrement in memory performance resulting from a change in viewpoint. This finding adds to growing evidence that face processing mechanisms are mature early in childhood. Copyright © 2014 Elsevier Inc. All rights reserved.

Getting to Scale: Evidence, Professionalism, and Community

ERIC Educational Resources Information Center

Slavin, Robert E.

2016-01-01

Evidence-based reform, in which proven programs are scaled up to reach many students, is playing an increasing role in American education. This article summarizes articles in this issue to explain how Reading Recovery has managed to sustain itself and go to scale over more than 30 years. It argues that Reading Recovery has succeeded due to a focus…

[Glocalization: the outlook for Taiwan evidence based health care].

PubMed

Chen, Chiehfeng

2014-12-01

Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.

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

NASA Astrophysics Data System (ADS)

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

2017-01-01

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

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

PubMed

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

2017-01-31

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

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

PubMed Central

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

2017-01-01

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

Evidence-informed massage therapy - an Australian practitioner perspective.

PubMed

Ooi, Soo Liang; Smith, Lauren; Pak, Sok Cheon

2018-05-01

Massage therapy (MT) is the most popular complementary and alternative medicine therapy used by the Australian public. With the growing emphasis by the Australian health authority on evidence-informed healthcare decision-making, there is an increasing demand for massage therapists to move towards the evidence-informed practice (EIP). With MT research gaining significant attention over the last 30 years, clinical evidence exists to support the efficacies of MT on many health conditions, including chronic low back pain. This growing body of research supports MT to become an evidence-informed therapeutic modality. The evidence utilization process of asking clinical questions, searching for available research evidence, and appraising the evidence critically can be incorporated into the clinical practice of MT. Moreover, integrating practitioners' skills and experience with research evidence enables the best treatment plan to address the clients' needs and stated goals. No dichotomy exists between scientific research and the humanistic client care of MT. A massage therapist can gain greater confidence in practice, improve critical thinking and decision-making skills, and increase career satisfaction through EIP. Despite its high public utilization, massage therapists in Australia remain a low-paying profession dominated by part-time workers who rarely utilize research evidence in practice. Professional associations of massage therapists in Australia need to play a key role in promoting EIP through continuing professional education, providing the access to research information and resources, as well as fostering a culture of EIP. Copyright © 2018 Elsevier Ltd. All rights reserved.

Increasing Participation in the Earth Sciences A 35 year Journey

NASA Astrophysics Data System (ADS)

Blueford, J. R.

2006-12-01

In the 1970's the fact that woman and ethnic minorities men made up approximately10% of the workforce in the geosciences created concern. Determining ways to increase the participation became a topic of discussion amongst many of the geosciences agencies in the United States. Many created scholarships and work opportunities for students. One of the most successful projects was the MPES (Minority Participation in the Earth Science) Program implemented by the U.S. Geological Survey. A key factor in its success was its outreach programs which used employees to work in elementary schools to get children excited about earth sciences. Successive years added teacher workshops and developing career day presentations to help school districts increase the awareness of the earth sciences. However, cutbacks prevented the continuation of these programs, but from the ashes a new non-profit organization of scientists, the Math Science Nucleus, developed curriculum and implementation strategies that used Earth Sciences as a core content area. Using the power of the internet, it provided teachers and parents around the world content driven curriculum. The Integrating Science, Math, and Technology Reference Curriculum is used around the world to help teachers understand how children learn science content.

Subfertility Increases Risk of Testicular Cancer: Evidence from Population-Based Semen Samples

PubMed Central

Hanson, Heidi A; Anderson, Ross E; Aston, Kenneth I; Carrell, Douglas T; Smith, Ken R; Hotaling, James M

2015-01-01

Objective To further understand the association between semen quality and cancer risk using well-defined semen parameters. Design Retrospective cohort study. Setting Subfertility Heath and Assisted Reproduction (SHARE) study in Utah from 1994 to 2011. Patients 20,433 men from that underwent semen analysis (SA) and a sample of 20,433 fertile controls matched on age and birth year Interventions none. Main Outcome Measures Risk of all cancers, as well as site-specific results for prostate, testicular, and melanoma. Results Relative to fertile men, men with SA have an increased risk of testicular cancer (Hazard Rate Ratio (HR) =3.3). When the characterization of infertility is refined using individual semen parameters, we find that oligozoospermic men have an increased risk of cancer relative to fertile controls. This association is particularly strong for testicular cancer, with increased risk in men with oligozoospermia based on concentration (HR=11.9) and sperm count (HR=10.3). Men in the in the lowest quartile of motility (HR=4.1), viability (HR=6.6), morphology (HR=4.2) or total motile count (HR=6.9) have higher risk of testicular compared to fertile men. Men with sperm concentration and count in the 90th percentile of the distribution (≥178 M/ml and ≥579, respectively) and total motile count (TMC) have an increased risk of melanoma (HRConcentration=2.1; HRCount=2.7; HRTMC=2.0). We find no differences in cancer risk between azoospermic and fertile men. Conclusions Men with SA have an increased risk of testicular cancer that varies by semen quality. Unlike prior work, we did not find an association between azoospermia and increased cancer or testicular cancer risk. Capsule Subfertile men have an increased risk of testicular cancer that varies by semen quality. We did not find an association between azoospermia and increased cancer or testicular cancer risk. PMID:26604070

Hematopoietic Stem Cell Transplantation in Late-Onset Krabbe Disease: No Evidence of Worsening Demyelination and Axonal Loss 4 Years Post-allograft.

PubMed

Laule, Cornelia; Vavasour, Irene M; Shahinfard, Elham; Mädler, Burkhard; Zhang, Jing; Li, David K B; MacKay, Alex L; Sirrs, Sandra M

2018-05-01

Late-onset adult Krabbe disease is a very rare demyelinating leukodystrophy, affecting less than 1 in a million people. Hematopoietic stem cell transplantation (HSCT) strategies can stop the accumulation of toxic metabolites that damage myelin-producing cells. We used quantitative advanced imaging metrics to longitudinally assess the impact of HSCT on brain abnormalities in adult-onset Krabbe disease. A 42-year-old female with late-onset Krabbe disease and an age/sex-matched healthy control underwent annual 3T MRI (baseline was immediately prior to HSCT for the Krabbe subject). Imaging included conventional scans, myelin water imaging, diffusion tensor imaging, and magnetic resonance spectroscopy. Brain abnormalities far beyond those visible on conventional imaging were detected, suggesting a global pathological process occurs in Krabbe disease with adult-onset etiology, with myelin being more affected than axons, and evidence of wide-spread gliosis. After HSCT, our patient showed clinical stability in all measures, as well as improvement in gait, dysarthria, and pseudobulbar affect at 7.5 years post-transplant. No MRI evidence of worsening demyelination and axonal loss was observed up to 4 years post-allograft. Clinical evidence and stability of advanced MR measures related to myelin and axons supports HSCT as an effective treatment strategy for stopping progression associated with late-onset Krabbe disease. Copyright © 2018 by the American Society of Neuroimaging.

Abortion, substance abuse and mental health in early adulthood: Thirteen-year longitudinal evidence from the United States

PubMed Central

Sullins, Donald Paul

2016-01-01

Objective: To examine the links between pregnancy outcomes (birth, abortion, or involuntary pregnancy loss) and mental health outcomes for US women during the transition into adulthood to determine the extent of increased risk, if any, associated with exposure to induced abortion. Method: Panel data on pregnancy history and mental health history for a nationally representative cohort of 8005 women at (average) ages 15, 22, and 28 years from the National Longitudinal Study of Adolescent to Adult Health were examined for risk of depression, anxiety, suicidal ideation, alcohol abuse, drug abuse, cannabis abuse, and nicotine dependence by pregnancy outcome (birth, abortion, and involuntary pregnancy loss). Risk ratios were estimated for time-dynamic outcomes from population-averaged longitudinal logistic and Poisson regression models. Results: After extensive adjustment for confounding, other pregnancy outcomes, and sociodemographic differences, abortion was consistently associated with increased risk of mental health disorder. Overall risk was elevated 45% (risk ratio, 1.45; 95% confidence interval, 1.30–1.62; p < 0.0001). Risk of mental health disorder with pregnancy loss was mixed, but also elevated 24% (risk ratio, 1.24; 95% confidence interval, 1.13–1.37; p < 0.0001) overall. Birth was weakly associated with reduced mental disorders. One-eleventh (8.7%; 95% confidence interval, 6.0–11.3) of the prevalence of mental disorders examined over the period were attributable to abortion. Conclusion: Evidence from the United States confirms previous findings from Norway and New Zealand that, unlike other pregnancy outcomes, abortion is consistently associated with a moderate increase in risk of mental health disorders during late adolescence and early adulthood. PMID:27781096

Climate-driven environmental changes around 8,200 years ago favoured increases in cetacean strandings and Mediterranean hunter-gatherers exploited them

NASA Astrophysics Data System (ADS)

Mannino, Marcello A.; Talamo, Sahra; Tagliacozzo, Antonio; Fiore, Ivana; Nehlich, Olaf; Piperno, Marcello; Tusa, Sebastiano; Collina, Carmine; di Salvo, Rosaria; Schimmenti, Vittoria; Richards, Michael P.

2015-11-01

Cetacean mass strandings occur regularly worldwide, yet the compounded effects of natural and anthropogenic factors often complicate our understanding of these phenomena. Evidence of past stranding episodes may, thus, be essential to establish the potential influence of climate change. Investigations on bones from the site of Grotta dell’Uzzo in North West Sicily (Italy) show that the rapid climate change around 8,200 years ago coincided with increased strandings in the Mediterranean Sea. Stable isotope analyses on collagen from a large sample of remains recovered at this cave indicate that Mesolithic hunter-gatherers relied little on marine resources. A human and a red fox dating to the 8.2-kyr-BP climatic event, however, acquired at least one third of their protein from cetaceans. Numerous carcasses should have been available annually, for at least a decade, to obtain these proportions of meat. Our findings imply that climate-driven environmental changes, caused by global warming, may represent a serious threat to cetaceans in the near future.

Climate-driven environmental changes around 8,200 years ago favoured increases in cetacean strandings and Mediterranean hunter-gatherers exploited them.

PubMed

Mannino, Marcello A; Talamo, Sahra; Tagliacozzo, Antonio; Fiore, Ivana; Nehlich, Olaf; Piperno, Marcello; Tusa, Sebastiano; Collina, Carmine; Di Salvo, Rosaria; Schimmenti, Vittoria; Richards, Michael P

2015-11-17

Cetacean mass strandings occur regularly worldwide, yet the compounded effects of natural and anthropogenic factors often complicate our understanding of these phenomena. Evidence of past stranding episodes may, thus, be essential to establish the potential influence of climate change. Investigations on bones from the site of Grotta dell'Uzzo in North West Sicily (Italy) show that the rapid climate change around 8,200 years ago coincided with increased strandings in the Mediterranean Sea. Stable isotope analyses on collagen from a large sample of remains recovered at this cave indicate that Mesolithic hunter-gatherers relied little on marine resources. A human and a red fox dating to the 8.2-kyr-BP climatic event, however, acquired at least one third of their protein from cetaceans. Numerous carcasses should have been available annually, for at least a decade, to obtain these proportions of meat. Our findings imply that climate-driven environmental changes, caused by global warming, may represent a serious threat to cetaceans in the near future.

Climate-driven environmental changes around 8,200 years ago favoured increases in cetacean strandings and Mediterranean hunter-gatherers exploited them

PubMed Central

Mannino, Marcello A.; Talamo, Sahra; Tagliacozzo, Antonio; Fiore, Ivana; Nehlich, Olaf; Piperno, Marcello; Tusa, Sebastiano; Collina, Carmine; Di Salvo, Rosaria; Schimmenti, Vittoria; Richards, Michael P.

2015-01-01

Cetacean mass strandings occur regularly worldwide, yet the compounded effects of natural and anthropogenic factors often complicate our understanding of these phenomena. Evidence of past stranding episodes may, thus, be essential to establish the potential influence of climate change. Investigations on bones from the site of Grotta dell’Uzzo in North West Sicily (Italy) show that the rapid climate change around 8,200 years ago coincided with increased strandings in the Mediterranean Sea. Stable isotope analyses on collagen from a large sample of remains recovered at this cave indicate that Mesolithic hunter-gatherers relied little on marine resources. A human and a red fox dating to the 8.2-kyr-BP climatic event, however, acquired at least one third of their protein from cetaceans. Numerous carcasses should have been available annually, for at least a decade, to obtain these proportions of meat. Our findings imply that climate-driven environmental changes, caused by global warming, may represent a serious threat to cetaceans in the near future. PMID:26573384

Application of a multidisciplinary and integrative weight-of-evidence approach to a 1-year monitoring survey of the Seine River.

PubMed

Barjhoux, Iris; Fechner, Lise C; Lebrun, Jérémie D; Anzil, Adriana; Ayrault, Sophie; Budzinski, Hélène; Cachot, Jérôme; Charron, Laetitia; Chaumot, Arnaud; Clérandeau, Christelle; Dedourge-Geffard, Odile; Faburé, Juliette; François, Adeline; Geffard, Olivier; George, Isabelle; Labadie, Pierre; Lévi, Yves; Munoz, Gabriel; Noury, Patrice; Oziol, Lucie; Quéau, Hervé; Servais, Pierre; Uher, Emmanuelle; Urien, Nastassia; Geffard, Alain

2016-06-08

Quality assessment of environments under high anthropogenic pressures such as the Seine Basin, subjected to complex and chronic inputs, can only be based on combined chemical and biological analyses. The present study integrates and summarizes a multidisciplinary dataset acquired throughout a 1-year monitoring survey conducted at three workshop sites along the Seine River (PIREN-Seine program), upstream and downstream of the Paris conurbation, during four seasonal campaigns using a weight-of-evidence approach. Sediment and water column chemical analyses, bioaccumulation levels and biomarker responses in caged gammarids, and laboratory (eco)toxicity bioassays were integrated into four lines of evidence (LOEs). Results from each LOE clearly reflected an anthropogenic gradient, with contamination levels and biological effects increasing from upstream to downstream of Paris, in good agreement with the variations in the structure and composition of bacterial communities from the water column. Based on annual average data, the global hazard was summarized as "moderate" at the upstream station and as "major" at the two downstream ones. Seasonal variability was also highlighted; the winter campaign was least impacted. The model was notably improved using previously established reference and threshold values from national-scale studies. It undoubtedly represents a powerful practical tool to facilitate the decision-making processes of environment managers within the framework of an environmental risk assessment strategy.

Long-Term Sustainability of Evidence-Based Prevention Interventions and Community Coalitions Survival: a Five and One-Half Year Follow-up Study.

PubMed

Johnson, Knowlton; Collins, David; Shamblen, Steve; Kenworthy, Tara; Wandersman, Abraham

2017-07-01

This study examines (1) coalition survival, (2) prevalence of evidence-based prevention interventions (EBPIs) to reduce substance abuse implemented as part of the Tennessee Strategic Prevention Framework (SPF) State Incentive Grant (SIG), (3) EBPI sustainability, and (4) factors that predict EBPI sustainability. Secondary data were collected on 27 SPF SIG-funded coalitions and 88 EBPI and non-EBPI implementations. Primary data were collected by a telephone interview/web survey five and one-half years after the SPF SIG ended. Results from secondary data show that 25 of the 27 coalitions survived beyond the SPF SIG for one to five and one-half years; 19 coalitions (70%) were still active five and one-half years later. Further, 88 EBPIs and non-EBPIs were implemented by 27 county SPF SIG coalitions. Twenty-one (21) of 27 coalitions (78%) implemented one to three EBPIs, totaling 37 EBPI implementations. Based on primary survey data on 29 of the 37 EBPI implementations, 28 EBPIs (97%) were sustained between two and five and one-half years while 22 EBPI implementations (76%) were sustained for five and one-half years. When controlling for variability among coalitions (nesting of EBPIs in coalitions), increases in data resources (availability of five types of prevention data) was a strong predictor of length of EBPI sustainability. Positive change in extramural funding resources and level of expertise during SPF SIG implementation, as well as level of coalition formalization at the end of the SPF SIG predicted EBPI sustainability length. One intervention attribute (trialability) also predicted length of sustainability. Implications are discussed.

Behavioral and ERP evidence of word and pseudoword superiority effects in 7- and 11-year-olds

PubMed Central

Coch, Donna; Mitra, Priya; George, Elyse

2012-01-01

In groups of 7-year-olds and 11-year-olds, event-related potentials (ERPs) were recorded to briefly presented, masked letter strings that included real word (DARK/PARK), pronounceable pseudoword (DARL/PARL), unpronounceable nonword (RDKA/RPKA), and letter-in-xs (DXXX, PXXX) stimuli in a variant of the Reicher-Wheeler paradigm. Behaviorally, participants decided which of two letters occurred at a given position in each string (here, forced-choice alternatives D and P). Both groups showed evidence of behavioral word (more accurate choices for letters in words than in baseline nonwords or letter-in-xs) and pseudoword (more accurate choices for letters in pseudowords than in baseline nonwords or letter-in-xs) superiority effects. Electrophysiologically, 11-year-olds evidenced superiority effects on P150 and N400 peak amplitude, while 7-year-olds showed effects only on N400 amplitude. These findings suggest that the mechanisms underlying the observed behavioral superiority effects may be lexical in younger children but both sublexical and lexical in older children. These results are consistent with a lengthy developmental time course for automatic sublexical orthographic specialization, extending beyond the age of 11. PMID:23036274

Urea fertilizer increases growth of 20-year-old, thinned Douglas-fir on poor quality site

Treesearch

Richard E. Miller; Donald L. Reukema

1977-01-01

In 20-year-old, site V Douglas-fir in southwest Washington, fertilizing with nitrogen increased average 5-year diameter and height growth of concurrently released dominant trees by about 85 percent. There was no additional response when phosphorus, potassium, and sulfur were added with the nitrogen fertilizer. Thinning with no other treatment in this moderately stocked...

Anthropogenic Black Carbon Emission Increase during the Last 150 Years at Coastal Jiangsu, China

PubMed Central

Bao, Kunshan; Shen, Ji; Wang, Guoping; Gao, Chuanyu

2015-01-01

Black carbon (BC) is one of the major drivers of climate change and a useful indicator of environmental pollution from industrialization, and thus it is essential to reconstruct the historical trend in BC flux to better understand its impact. The Yancheng coastal wetland reserve in Jiangsu province is an area sensitive to global sea level change and is also located in the most developed as well as most polluted region of China. We investigated the concentration and historical flux of BC over the past 150 years through geochemical analysis of two 210Pb-dated sediment cores from Yancheng coastal wetland. Measured BC contents ranged from 0.24 mg g-1 to 1.41 mg g-1 with average values of 0.51mg g-1-0.69 mg g-1, and BC fluxes ranged from 0.69 g m-2 yr-1 to 11.80 g m-2 yr-1 with averages of 2.94g m-2 yr-1-3.79 g m-2 yr-1. These values are consistent with other records worldwide. Both BC content and flux show a gradual and continuous increase over time and clearly reflect increased emissions from anthropogenic activities. The BC records have a significant peak in recent years (from 2000 to 2007), which is accompanied by the sharp increase of energy consumption and total carbon emission in the region. It is reasonable to conclude that changes in BC from increasing human activities have controlled BC fluxes during the last 150 years. Industrial contamination, especially BC emission, in the coastal region of eastern China should be taken into account when developing management strategies for protecting the natural environment. PMID:26200665

[Changes in skiing accidents during the last 20 years].

PubMed

Röthlisberger, M

1990-01-01

Since 23 years the skiing-accidents are statistically surveyed in the private practice of the author. The number of injured patients is continuously decreasing. Specially the injuries in years with little snow fall are analyzed. It is evident that leg fractures are quite rare but severe injuries of the knee are increasing. 50% of ski accidents are minor injuries.

Hurricane Sandy’s flood frequency increasing from year 1800 to 2100

PubMed Central

Horton, Benjamin P.; Donnelly, Jeffrey P.

2016-01-01

Coastal flood hazard varies in response to changes in storm surge climatology and the sea level. Here we combine probabilistic projections of the sea level and storm surge climatology to estimate the temporal evolution of flood hazard. We find that New York City’s flood hazard has increased significantly over the past two centuries and is very likely to increase more sharply over the 21st century. Due to the effect of sea level rise, the return period of Hurricane Sandy’s flood height decreased by a factor of ∼3× from year 1800 to 2000 and is estimated to decrease by a further ∼4.4× from 2000 to 2100 under a moderate-emissions pathway. When potential storm climatology change over the 21st century is also accounted for, Sandy’s return period is estimated to decrease by ∼3× to 17× from 2000 to 2100. PMID:27790992

Increased diagnostic activity in general practice during the year preceding colorectal cancer diagnosis.

PubMed

Hansen, Pernille Libach; Hjertholm, Peter; Vedsted, Peter

2015-08-01

Accurate diagnostic activity in general practice before colorectal cancer (CRC) diagnosis is crucial for an early detection of CRC. This study aimed to investigate the rates of daytime consultations, hemoglobin (Hb) measurements and medicine prescriptions for hemorrhoids in general practice in the year preceding CRC diagnosis. Using Danish registries, we conducted a population-based matched cohort study including CRC patients aged 40-80 years (n = 19,209) and matched references (n = 192,090). We calculated odds ratios (ORs) using a conditional logistical regression model and incidence rate ratios (IRRs) using a negative binomial regression model. The CRC patients had significantly more consultations from 9 months before diagnosis and significantly increased rates of Hb measurements from up to 17 months before diagnosis compared with references. Furthermore, up to 18 months before diagnosis, CRC patients had significantly higher rates of prescriptions for hemorrhoids; and 2 months before diagnosis, the IRR was 12.24 (95% confidence interval (CI): 10.29-14.55) for men. The positive predictive value (PPV) of CRC for having a first-time prescription for hemorrhoids was highest among men aged 70-80 years [PPV = 3.2% (95% CI: 2.8-3.7)]. High prescription rates were predominantly seen among rectal cancer patients, whereas colon cancer patients had higher rates of consultations and Hb measurements. This study revealed a significant increase in healthcare seeking and diagnostic activity in general practice in the year prior to CRC diagnosis, which indicates the presence of a "diagnostic time window" and a potential for earlier diagnosis of CRC based on clinical signs and symptoms. © 2015 UICC.

Increasing access into higher education: Insights from the 2011 African Network on Evidence-to-Action on Disability Symposium - Education Commission.

PubMed

Lyner-Cleophas, Marcia; Swart, Estelle; Chataika, Tsitsi; Bell, Diane

2014-01-01

This article provides some insights into the challenges regarding inclusion in higher education of students with disabilities. It does this by elucidating aspects of the proceedings of the Education Commission at the African Network on Evidence-to-Action on Disability (AfriNEAD) Symposium, which took place in Zimbabwe in November 2011. The presentations specifically focused on the education of people with disabilities from early childhood through to higher education. This article, however, is informed by presentations focusing on increasing access to higher education. The article is focused on the implementation of evidence in practice, research and policies stemming from rigorous debate and scientific foundations, whilst taking into account the dynamic realities of the higher education context. Themes such as the systemic approach needed for inclusion to be successful, increasing access and the dynamic role of students with disabilities are highlighted.

Cardiovascular risk in systemic lupus erythematosus--evidence of increased oxidative stress and dyslipidaemia.

PubMed

Nuttall, S L; Heaton, S; Piper, M K; Martin, U; Gordon, C

2003-06-01

Systemic lupus erythematosus (SLE) is associated with severe and premature cardiovascular disease, which is not explained by traditional risk factors alone. This study aimed to investigate markers of oxidative stress, lipid metabolism and inflammation as potential cardiovascular risk factors in women with SLE. Venous blood samples were taken from 53 female Caucasian patients with SLE and from healthy age- and sex-matched controls. Samples were analysed for markers of oxidative stress, lipid metabolism [including low-density lipoprotein (LDL) subfraction profile] and C-reactive protein (CRP). Female SLE patients had an atherogenic lipid profile characterized by raised total cholesterol and triglycerides, and the presence of small, dense LDL subfractions compared with healthy controls. These changes were associated with increased oxidative damage and a moderately raised CRP. The results provide evidence for free radical and inflammatory activity in SLE and suggest potential targets to reduce the risk of cardiovascular disease in these patients.

Eighteen-year follow-up of hyperopic photorefractive keratectomy.

PubMed

Wagh, Vijay K; Dave, Reena; O'Brart, David P S; Lim, Wei S; Patel, Parul; Tam, Connan; Lee, Jennifer; Marshall, John

2016-02-01

To investigate the long-term efficacy of hyperopic photorefractive keratectomy (PRK). University Hospital, London, United Kingdom. Prospective case series. Patients with a follow-up of 18 years ± 0.7 (SD) attended for examination. All had spherical corrections with a 6.5 mm optical zone and 1.5 mm blend zone. Twenty-five patients (45 eyes) were included. The mean preoperative spherical equivalent (SE) refractive error was +4.11 ± 1.8 diopters (D) (range +1.125 to +7.25 D). Between 1 year and 18 years, in eyes that had no cataract surgery (n = 34), there was a +1.14 ± 1.48 D increase in the mean SE (P < .0002). The increase between 7.5 years and 18.0 years did not reach clinical significance (P = .1). Uncorrected distance visual acuity improved at 18 years (P < .02). Corrected distance visual acuity (CDVA) was reduced (P < .001). The efficacy index was 0.47, and the safety index was 0.83. Six eyes (18%) lost 2 lines of CDVA, of which 4 eyes had preexisting cataract. Keratometry remained stable between 1 year and 18 years (P = .2). Forty percent still had traces of peripheral haze, and 4 (9%) had Salzmann-like changes. Eleven eyes (24%) had cataract surgery and 4 (9%) had laser iridotomy. There was no evidence of ectasia. Hyperopic PRK showed an increase in hyperopic SE between 1.0 year and 7.5 years but was generally stable thereafter. The efficacy was limited. Peripheral haze was evident in 40% of cases with Salzmann-like changes in some. Ocular comorbidity in relationship to cataract was common and reduced CDVA. Dr. Marshall was a consultant to Summit Technology, Inc. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Orbital Period Increase in ES Ceti

NASA Astrophysics Data System (ADS)

de Miguel, Enrique; Patterson, Joseph; Kemp, Jonathan; Myers, Gordon; Rea, Robert; Krajci, Thomas; Monard, Berto; Cook, Lewis M.

2018-01-01

We report a long-term study of the eclipse times in the 10 minute helium binary ES Ceti. The binary period increases rapidly, with P/\\dot{P}=6.2× {10}6 years. This is consistent with the assumption that gravitational radiation (GR) drives the mass transfer, and it appears to be the first dynamical evidence that GR is indeed the driver of evolution in this class of very old cataclysmic variables—the AM Canum Venaticorum stars.

Subfertility increases risk of testicular cancer: evidence from population-based semen samples.

PubMed

Hanson, Heidi A; Anderson, Ross E; Aston, Kenneth I; Carrell, Douglas T; Smith, Ken R; Hotaling, James M

2016-02-01

To further understand the association between semen quality and cancer risk by means of well defined semen parameters. Retrospective cohort study. Not applicable. A total of 20,433 men who underwent semen analysis (SA) and a sample of 20,433 fertile control subjects matched by age and birth year. None. Risk of all cancers as well as site-specific results for prostate cancer, testicular cancer, and melanoma. Compared with fertile men, men with SA had an increased risk of testicular cancer (hazard rate [HR] 3.3). When the characterization of infertility was refined using individual semen parameters, we found that oligozoospermic men had an increased risk of cancer compared with fertile control subjects. This association was particularly strong for testicular cancer, with increased risk in men with oligozoospermia based on concentration (HR 11.9) and on sperm count (HR 10.3). Men in the in the lowest quartile of motility (HR 4.1), viability (HR 6.6), morphology (HR 4.2), or total motile count (HR 6.9) had higher risk of testicular cancer compared with fertile men. Men with sperm concentration and count in the 90th percentiles of the distribution (≥178 and ≥579 × 10(6)/mL, respectively), as well as total motile count, had an increased risk of melanoma (HRs 2.1, 2.7, and 2.0, respectively). We found no differences in cancer risk between azoospermic and fertile men. Men with SA had an increased risk of testicular cancer which varied by semen quality. Unlike earlier work, we did not find an association between azoospermia and increased cancer risk. Published by Elsevier Inc.

Increasing temperature cuts back crop yields in Hungary over the last 90 years.

PubMed

Pinke, Zsolt; Lövei, Gábor L

2017-12-01

The transformation of climatic regime has an undeniable impact on plant production, but we rarely have long enough date series to examine the unfolding of such effects. The clarification of the relationship between crop plants and climate has a near-immediate importance due to the impending human-made global change. This study investigated the relationship between temperature, precipitation, drought intensity and the yields of four major cereals in Hungary between 1921 and 2010. The analysis of 30-year segments indicated a monotonously increasing negative impact of temperature on crop yields. A 1°C temperature increase reduced the yield of the four main cereals by 9.6%-14.8% in 1981-2010, which revealed the vulnerability of Eastern European crop farming to recent climate change. Climate accounted for 17%-39% of yield variability over the past 90 years, but this figure reached 33%-67% between 1981 and 2010. Our analysis supports the claim that the mid-20th century green revolution improved yields "at the mercy of the weather": during this period, the impact of increasing fertilization and mechanisation coincided with climatic conditions that were more favourable than today. Crop yields in Eastern Europe have been stagnating or decreasing since the mid-1980s. Although usually attributed to the large socio-economic changes sweeping the region, our analysis indicates that a warming climate is at least partially responsible for this trend. Such a robust impact of increasing temperatures on crop yields also constitutes an obvious warning for this core grain-growing region of the world. © 2017 John Wiley & Sons Ltd.

Levels of Evidence in the Clinical Sports Medicine Literature: Are We Getting Better Over Time?

PubMed

Grant, Heather M; Tjoumakaris, Fotios P; Maltenfort, Mitchell G; Freedman, Kevin B

2014-07-01

There has been an increased emphasis on improving the level of evidence used as the basis for clinical treatment decisions. Several journals now require a statement of the level of evidence as a basic gauge of the study's strength. To review the levels of evidence in published articles in the clinical sports medicine literature and to determine if there has been an improvement in the levels of evidence published over the past 15 years. Systematic review. All articles from the years 1995, 2000, 2005, and 2010 in The American Journal of Sports Medicine (AJSM), Arthroscopy, and sports medicine-related articles from The Journal of Bone and Joint Surgery-American (JBJS-A) were analyzed. Articles were categorized by type and ranked for level of evidence according to guidelines from the Centre for Evidence-Based Medicine. Excluded were animal, cadaveric, and basic science articles; editorials; surveys; special topics; letters to the editor; and correspondence. Statistical analysis was performed with chi-square. A total of 1580 articles over the 4 periods met the inclusion criteria. The percentage of level 1 and 2 studies increased from 6.8% to 12.6%, 22.9%, and 23.5%, respectively (P < .0001), while level 4 and 5 studies decreased from 78.9% to 72.4%, 63.9%, and 53.0% (P < .0001). JBJS-A had a significant increase in level 1 and 2 studies (4.1%, 5.1%, 28.2%, 27.8%; P < .0001), as did AJSM (9.4%, 17.1%, 36.1%, 30.1%; P < .0001). Arthroscopy showed no significant change over time. Diagnostic, therapeutic, and prognostic studies all showed significant increases in level 1 and 2 studies over time (P < .05). There has been a statistically significant increase in the percentage of level 1 and 2 studies published in the sports medicine literature over the past 15 years, particularly in JBJS-A and AJSM. The largest increase was seen in diagnostic studies, while therapeutic and prognostic studies demonstrated modest improvement. The emphasis on increasing levels of evidence to

Evidence-Based Psychological Assessment.

PubMed

Bornstein, Robert F

2017-01-01

In recent years there has been increasing emphasis on evidence-based practice in psychology (EBPP), and as is true in most health care professions, the primary focus of EBPP has been on treatment. Comparatively little attention has been devoted to applying the principles of EBPP to psychological assessment, despite the fact that assessment plays a central role in myriad domains of empirical and applied psychology (e.g., research, forensics, behavioral health, risk management, diagnosis and classification in mental health settings, documentation of neuropsychological impairment and recovery, personnel selection and placement in organizational contexts). This article outlines the central elements of evidence-based psychological assessment (EBPA), using the American Psychological Association's tripartite definition of EBPP as integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. After discussing strategies for conceptualizing and operationalizing evidence-based testing and evidence-based assessment, 6 core skills and 3 meta-skills that underlie proficiency in psychological assessment are described. The integration of patient characteristics, culture, and preferences is discussed in terms of the complex interaction of patient and assessor identities and values throughout the assessment process. A preliminary framework for implementing EBPA is offered, and avenues for continued refinement and growth are described.

Invasive disease caused by Haemophilus influenzae in Sweden 1997-2009; evidence of increasing incidence and clinical burden of non-type b strains.

PubMed

Resman, F; Ristovski, M; Ahl, J; Forsgren, A; Gilsdorf, J R; Jasir, A; Kaijser, B; Kronvall, G; Riesbeck, K

2011-11-01

Introduction of a conjugated vaccine against encapsulated Haemophilus influenzae type b (Hib) has led to a dramatic reduction of invasive Hib disease. However, an increasing incidence of invasive disease by H. influenzae non-type b has recently been reported. Non-type b strains have been suggested to be opportunists in an invasive context, but information on clinical consequences and related medical conditions is scarce. In this retrospective study, all H. influenzae isolates (n = 410) from blood and cerebrospinal fluid in three metropolitan Swedish regions between 1997 and 2009 from a population of approximately 3 million individuals were identified. All available isolates were serotyped by PCR (n = 250). We observed a statistically significant increase in the incidence of invasive H. influenzae disease, ascribed to non-typeable H. influenzae (NTHi) and encapsulated strains type f (Hif) in mainly individuals >60 years of age. The medical reports from a subset of 136 cases of invasive Haemophilus disease revealed that 48% of invasive NTHi cases and 59% of invasive Hif cases, respectively, met the criteria of severe sepsis or septic shock according to the ACCP/SCCM classification of sepsis grading. One-fifth of invasive NTHi cases and more than one-third of invasive Hif cases were admitted to intensive care units. Only 37% of patients with invasive non-type b disease had evidence of immunocompromise, of which conditions related to impaired humoral immunity was the most common. The clinical burden of invasive non-type b H. influenzae disease, measured as days of hospitalization/100 000 individuals at risk and year, increased significantly throughout the study period. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

Increasing evidence that bats actively forage at wind turbines

PubMed Central

Foo, Cecily F.; Bennett, Victoria J.; Korstian, Jennifer M.; Schildt, Alison J.; Williams, Dean A.

2017-01-01

Although the ultimate causes of high bat fatalities at wind farms are not well understood, several lines of evidence suggest that bats are attracted to wind turbines. One hypothesis is that bats would be attracted to turbines as a foraging resource if the insects that bats prey upon are commonly present on and around the turbine towers. To investigate the role that foraging activity may play in bat fatalities, we conducted a series of surveys at a wind farm in the southern Great Plains of the US from 2011–2016. From acoustic monitoring we recorded foraging activity, including feeding buzzes indicative of prey capture, in the immediate vicinity of turbine towers from all six bat species known to be present at this site. From insect surveys we found Lepidoptera, Coleoptera, and Orthoptera in consistently high proportions over several years suggesting that food resources for bats were consistently available at wind turbines. We used DNA barcoding techniques to assess bat diet composition of (1) stomach contents from 47 eastern red bat (Lasiurus borealis) and 24 hoary bat (Lasiurus cinereus) carcasses collected in fatality searches, and (2) fecal pellets from 23 eastern red bats that were found on turbine towers, transformers, and tower doors. We found that the majority of the eastern red bat and hoary bat stomachs, the two bat species most commonly found in fatality searches at this site, were full or partially full, indicating that the bats were likely killed while foraging. Although Lepidoptera and Orthoptera dominated the diets of these two bat species, both consumed a range of prey items with individual bats having from one to six insect species in their stomachs at the time of death. The prey items identified from eastern red bat fecal pellets showed similar results. A comparison of the turbine insect community to the diet analysis results revealed that the most abundant insects at wind turbines, including terrestrial insects such as crickets and several

Increasing evidence that bats actively forage at wind turbines.

PubMed

Foo, Cecily F; Bennett, Victoria J; Hale, Amanda M; Korstian, Jennifer M; Schildt, Alison J; Williams, Dean A

2017-01-01

Although the ultimate causes of high bat fatalities at wind farms are not well understood, several lines of evidence suggest that bats are attracted to wind turbines. One hypothesis is that bats would be attracted to turbines as a foraging resource if the insects that bats prey upon are commonly present on and around the turbine towers. To investigate the role that foraging activity may play in bat fatalities, we conducted a series of surveys at a wind farm in the southern Great Plains of the US from 2011-2016. From acoustic monitoring we recorded foraging activity, including feeding buzzes indicative of prey capture, in the immediate vicinity of turbine towers from all six bat species known to be present at this site. From insect surveys we found Lepidoptera, Coleoptera, and Orthoptera in consistently high proportions over several years suggesting that food resources for bats were consistently available at wind turbines. We used DNA barcoding techniques to assess bat diet composition of (1) stomach contents from 47 eastern red bat ( Lasiurus borealis ) and 24 hoary bat ( Lasiurus cinereus ) carcasses collected in fatality searches, and (2) fecal pellets from 23 eastern red bats that were found on turbine towers, transformers, and tower doors. We found that the majority of the eastern red bat and hoary bat stomachs, the two bat species most commonly found in fatality searches at this site, were full or partially full, indicating that the bats were likely killed while foraging. Although Lepidoptera and Orthoptera dominated the diets of these two bat species, both consumed a range of prey items with individual bats having from one to six insect species in their stomachs at the time of death. The prey items identified from eastern red bat fecal pellets showed similar results. A comparison of the turbine insect community to the diet analysis results revealed that the most abundant insects at wind turbines, including terrestrial insects such as crickets and several

Eudaimonic growth: Narrative growth goals predict increases in ego development and subjective well-being 3 years later.

PubMed

Bauer, Jack J; McAdams, Dan P

2010-07-01

We examine (a) the normative course of eudaimonic well-being in emerging adulthood and (b) whether people's narratives of major life goals might prospectively predict eudaimonic growth 3 years later. We define eudaimonic growth as longitudinal increases in eudaimonic well-being, which we define as the combination of psychosocial maturity and subjective well-being (SWB). College freshmen and seniors took measures of ego development (ED; to assess maturity; Loevinger, 1976) and SWB at Time 1 (T1) and again 3 years later (Time 2). ED levels increased longitudinally across that time for men and T1 freshmen, but SWB levels did not change. Participants also wrote narratives of 2 major life goals at T1 that were coded for an explicit emphasis on specific kinds of personal growth. Participants' intellectual-growth goals (especially agentic ones) predicted increases in ED 3 years later, whereas participants' socioemotional-growth goals (especially communal ones) predicted increases in SWB 3 years later. These findings were independent of the effects of Big Five personality traits-notably conscientiousness, which on its own predicted increases in SWB. We discuss (a) emerging adulthood as the last stop for normative eudaimonic growth in modern society and (b) empirical and theoretical issues surrounding the relations among narrative identity, life planning, dispositional traits, eudaimonia, and 2 paths of personal growth.

Evidence based practice readiness: A concept analysis.

PubMed

Schaefer, Jessica D; Welton, John M

2018-01-15

To analyse and define the concept "evidence based practice readiness" in nurses. Evidence based practice readiness is a term commonly used in health literature, but without a clear understanding of what readiness means. Concept analysis is needed to define the meaning of evidence based practice readiness. A concept analysis was conducted using Walker and Avant's method to clarify the defining attributes of evidence based practice readiness as well as antecedents and consequences. A Boolean search of PubMed and Cumulative Index for Nursing and Allied Health Literature was conducted and limited to those published after the year 2000. Eleven articles met the inclusion criteria for this analysis. Evidence based practice readiness incorporates personal and organisational readiness. Antecedents include the ability to recognize the need for evidence based practice, ability to access and interpret evidence based practice, and a supportive environment. The concept analysis demonstrates the complexity of the concept and its implications for nursing practice. The four pillars of evidence based practice readiness: nursing, training, equipping and leadership support are necessary to achieve evidence based practice readiness. Nurse managers are in the position to address all elements of evidence based practice readiness. Creating an environment that fosters evidence based practice can improve patient outcomes, decreased health care cost, increase nurses' job satisfaction and decrease nursing turnover. © 2018 John Wiley & Sons Ltd.

Increased West Antarctic and unchanged East Antarctic ice discharge over the last 7 years

NASA Astrophysics Data System (ADS)

Gardner, Alex S.; Moholdt, Geir; Scambos, Ted; Fahnstock, Mark; Ligtenberg, Stefan; van den Broeke, Michiel; Nilsson, Johan

2018-02-01

Ice discharge from large ice sheets plays a direct role in determining rates of sea-level rise. We map present-day Antarctic-wide surface velocities using Landsat 7 and 8 imagery spanning 2013-2015 and compare to earlier estimates derived from synthetic aperture radar, revealing heterogeneous changes in ice flow since ˜ 2008. The new mapping provides complete coastal and inland coverage of ice velocity north of 82.4° S with a mean error of < 10 m yr-1, resulting from multiple overlapping image pairs acquired during the daylight period. Using an optimized flux gate, ice discharge from Antarctica is 1929 ± 40 Gigatons per year (Gt yr-1) in 2015, an increase of 36 ± 15 Gt yr-1 from the time of the radar mapping. Flow accelerations across the grounding lines of West Antarctica's Amundsen Sea Embayment, Getz Ice Shelf and Marguerite Bay on the western Antarctic Peninsula, account for 88 % of this increase. In contrast, glaciers draining the East Antarctic Ice Sheet have been remarkably constant over the period of observation. Including modeled rates of snow accumulation and basal melt, the Antarctic ice sheet lost ice at an average rate of 183 ± 94 Gt yr-1 between 2008 and 2015. The modest increase in ice discharge over the past 7 years is contrasted by high rates of ice sheet mass loss and distinct spatial patters of elevation lowering. The West Antarctic Ice Sheet is experiencing high rates of mass loss and displays distinct patterns of elevation lowering that point to a dynamic imbalance. We find modest increase in ice discharge over the past 7 years, which suggests that the recent pattern of mass loss in Antarctica is part of a longer-term phase of enhanced glacier flow initiated in the decades leading up to the first continent-wide radar mapping of ice flow.

Evidence and evidence gaps in therapies of nasal obstruction and rhinosinusitis

PubMed Central

Rotter, Nicole

2016-01-01

Therapeutic decisions in otorhinolaryngology are based on clinical experience, surgical skills, and scientific evidence. Recently, evidence-based therapies have gained increased attention and importance due to their potential to improve the individual patient’s treatment and their potential at the same time to reduce treatment costs. In clinical practice, it is almost impossible to stay ahead of the increasing mass of literature and on the other hand critically assess the presented data. A solid scientific and statistical knowledge as well as a significant amount of spare time are required to detect systematic bias and other errors in study designs, also with respect to assessing whether or not a study should be part of an individual therapeutic decision. Meta-analyses, reviews, and clinical guidelines are, therefore, of increasing importance for evidence-based therapy in clinical practice. This review is an update of the availability of external evidence for the treatment of nasal obstruction and rhinosinusitis. It becomes evident that both groups of diseases differ significantly in the availability of external evidence. Furthermore, it becomes obvious that surgical treatment options are normally based on evidence of significantly lower quality than medical treatment options. PMID:28025606

Trends in Physical Medicine and Rehabilitation Publications Over the Past 16 Years.

PubMed

Mimouni, Michael; Cismariu-Potash, Keren; Ratmansky, Motti; Shaklai, Sharon; Amir, Hagay; Mimouni-Bloch, Aviva

2016-06-01

To test the hypothesis that the number of publications in the field of physical medicine and rehabilitation (PMR) has increased over the last 16 years in a linear fashion, and to compare the trends in publication between the pediatric and adult literature. We evaluated all MEDLINE articles from January 1, 1998, to December 31, 2013, using Medical Subject Headings categories of rehabilitation. An age filter separated adult and pediatric articles. We divided articles into those with a low level of scientific evidence such as letters and editorials, and those with a high level of evidence such as controlled trials and meta-analyses. We used regression analysis to evaluate the effect of the year of publication on the number of publications of each type. Not applicable. Not applicable. Not applicable. Not applicable. MEDLINE reported a total of 98,501 adult publications and 30,895 pediatric publications during the evaluated period. There was a significant linear increase in the total number of publications in adult and pediatric rehabilitation publications with multiplication factors of 3.3 and 2.9, respectively. Importantly, publications with a high level of evidence showed larger multiplication factors compared with those with a low level of evidence (5.5 and 5.1 vs 2.1 and 2.0) for the adult and pediatric literature. The number of publications in the PMR field, especially those with a high level of scientific evidence, has increased linearly over the years, reflecting the rapid evolution of both adult and pediatric PMR. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The use of team-based learning in a second year undergraduate pre-registration nursing course on evidence-informed decision making.

PubMed

Morris, Jenny

2016-11-01

More engaging teaching and learning strategies are needed to teach research-related courses to pre-registration nursing students. Team-based learning was implemented within a second year pre-registration nursing evidence-informed decision making course. Results from a questionnaire survey indicated that 70% believed team-based learning was appropriate for the course, 60% that it was an effective and motivating learning strategy, and 54% recommended using team-based learning in other courses. The results from ten student interviews illustrated the positive way in which team-based learning was perceived, and how the students thought it contributed to their learning. Test results were improved with an increase in the numbers of students achieving 70% or higher; and higher scores for students in the lowest quartile. Team-based learning was shown to be an effective strategy that preserved the benefits of small group teaching with large student groups. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Measuring the Effectiveness of Knowledge Creation Activity as a Means to Facilitate Evidence-Informed Practice: A Study of Early Years Settings in Camden, London

ERIC Educational Resources Information Center

Brown, Chris; Rogers, Sue

2015-01-01

This paper has two key aims. First, it examines the authors' attempts to use knowledge creation activity as a way of developing evidence-informed practice amongst a learning community of 36 early years practitioners in Camden, London. Second, it illustrates how the authors approached the idea of measuring evidence use and our engagement with two…

Longitudinal Evidence Linking Processing Speed to the Development of Reasoning

ERIC Educational Resources Information Center

Kail, Robert V.; Lervåg, Arne; Hulme, Charles

2016-01-01

Age-related change in processing speed has been linked directly to increases in reasoning as well as indirectly via increases in the capacity of working memory (WM). Most of the evidence linking change in speed to reasoning has come from cross-sectional research; in this article we present the findings from a 2½-year longitudinal study of 277 6-…

75 FR 22095 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff-Rate... announced a reassignment of surplus sugar under domestic cane sugar allotments of 200,000 short tons raw value (STRV) to imports, and increased the fiscal year (FY) 2010 raw sugar tariff-rate quota (TRQ) by...

75 FR 38764 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2010 Raw Sugar Tariff-Rate... announced a reassignment of surplus sugar under domestic cane sugar allotments of 300,000 short tons raw value (STRV) to imports, and increased the fiscal year (FY) 2010 raw sugar tariff-rate quota (TRQ) by...

76 FR 20305 - USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2011 Raw Sugar Tariff...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... USDA Reassigns Domestic Cane Sugar Allotments and Increases the Fiscal Year 2011 Raw Sugar Tariff-Rate... announced a reassignment of surplus sugar under domestic cane sugar allotments of 325,000 short tons raw value (STRV) to imports, and increased the fiscal year (FY) 2011 raw sugar tariff-rate quota (TRQ) by...

Emotional Experience Improves With Age: Evidence Based on Over 10 Years of Experience Sampling

PubMed Central

Carstensen, Laura L.; Turan, Bulent; Scheibe, Susanne; Ram, Nilam; Ersner-Hershfield, Hal; Samanez-Larkin, Gregory R.; Brooks, Kathryn P.; Nesselroade, John R.

2012-01-01

Recent evidence suggests that emotional well-being improves from early adulthood to old age. This study used experience-sampling to examine the developmental course of emotional experience in a representative sample of adults spanning early to very late adulthood. Participants (N = 184, Wave 1; N = 191, Wave 2; N = 178, Wave 3) reported their emotional states at five randomly selected times each day for a one week period. Using a measurement burst design, the one-week sampling procedure was repeated five and then ten years later. Cross-sectional and growth curve analyses indicate that aging is associated with more positive overall emotional well-being, with greater emotional stability and with more complexity (as evidenced by greater co-occurrence of positive and negative emotions). These findings remained robust after accounting for other variables that may be related to emotional experience (personality, verbal fluency, physical health, and demographic variables). Finally, emotional experience predicted mortality; controlling for age, sex, and ethnicity, individuals who experienced relatively more positive than negative emotions in everyday life were more likely to have survived over a 13 year period. Findings are discussed in the theoretical context of socioemotional selectivity theory. PMID:20973600

Cover crops do not increase C sequestration in production crops: evidence from 12 years of continuous measurements

NASA Astrophysics Data System (ADS)

Buysse, Pauline; Bodson, Bernard; Debacq, Alain; De Ligne, Anne; Heinesch, Bernard; Manise, Tanguy; Moureaux, Christine; Aubinet, Marc

2017-04-01

The numerous reports on carbon (C) loss from cropland soils have recently raised awareness on the climate change mitigation potential of these ecosystems, and on the necessity to improve C sequestration in these soils. Among the multiple solutions that are proposed, several field measurement and modelling studies reported that growing cover crops over fall and winter time could appear as an efficient solution. However, while the large majority of these studies are based on SOC stock inventories and very few information exists from the CO2 flux dynamics perspective. In the present work, we use the results from long-term (12 years) eddy-covariance measurements performed at the Lonzée Terrestrial Observatory (LTO, candidate ICOS site, Belgium) and focus on six intercrop periods managed with (3) and without (3) cover crops after winter wheat main crops, in order to compare their response to environmental factors and to investigate the impact of cover crops on Net Ecosystem Exchange (NEE). Our results showed that cumulated NEE was not significantly affected by the presence of cover crops. Indeed, while larger CO2 assimilation occurred during cover crop growth, this carbon gain was later lost by larger respiration rates due to larger crop residue amounts brought to the soil. As modelled by a Q10-like relationship, significantly larger R10 values were indeed observed during the three intercrop periods cultivated with cover crops. These CO2 flux-based results therefore tend to moderate the generally acknowledged positive impact of cover crops on net C sequestration by croplands. Our results indicate that the effect of growing cover crops on C sequestration could be less important than announced, at least at certain sites.

Do Inactive Older Adults who Increase Physical Activity Experience Less Disability: Evidence from the Osteoarthritis Initiative

PubMed Central

Song, Jing; Gilbert, Abigail L.; Chang, Rowland W.; Pellegrini, Christine A.; Ehrlich-Jones, Linda S.; Lee, Jungwha; Pinto, Daniel; Semanik, Pamela A.; Sharma, Leena; Kwoh, C. Kent; Jackson, Rebecca D.; Dunlop, Dorothy D.

2016-01-01

Background Physical inactivity is a leading risk factor for developing disability. Although randomized clinical trials have demonstrated improving physical activity can reduce this risk in older adults with arthritis, these studies did not specifically evaluate inactive adults. Objectives To evaluate the relationship of changes in physical activity with disability changes among initially inactive adults with or at high risk of knee OA from Osteoarthritis Initiative. Methods Inactive persons were identified at baseline based on the U.S. Department of Health and Human Services classification (no [zero] 10-minute session of moderate-to-vigorous activity over one week) from objective accelerometer monitoring. Two years later physical activity change status was classified as: (1) met Federal physical activity guidelines (≥150 moderate-to-vigorous minutes/week acquired in bouts ≥10 minutes), (2) insufficiently increased activity (some but <150 moderate-to-vigorous bout minutes/week) or (3) remained inactive. Disability at baseline and two years was assessed by Late Life Disability Instrument (LLDI) limitation and frequency scores. Multiple regression evaluated the relationship of physical activity change status with baseline-to-2 year changes in disability scores adjusting for socioeconomics, health factors, and baseline disability score. Results Increased physical activity showed a graded relationship with improved disability scores in LLDI limitation (P<0.001) and frequency scores (P=0.027). While increasing moderate-to-vigorous activity to guideline levels showed the greatest reduction, even insufficiently increased physical activity was related to reduced disability. Conclusions Findings support advice to increase moderate-to-vigorous physical activity to reduce disability among inactive adults with or at high risk for knee osteoarthritis, even when guidelines are not met. PMID:28002153

How robust is the evidence of an emerging or increasing female excess in physical morbidity between childhood and adolescence? Results of a systematic literature review and meta-analyses

PubMed Central

MacLean, Alice; Sweeting, Helen; Egan, Matt; Der, Geoff; Adamson, Joy; Hunt, Kate

2013-01-01

For asthma and psychological morbidity, it is well established that higher prevalence among males in childhood is replaced by higher prevalence among females by adolescence. This review investigates whether there is evidence for a similar emerging female ‘excess’ in relation to a broad range of physical morbidity measures. Establishing whether this pattern is generalised or health outcome-specific will further understandings of the aetiology of gender differences in health. Databases (Medline; Embase; CINAHL; PsycINFO; ERIC) were searched for English language studies (published 1992–2010) presenting physical morbidity prevalence data for males and females, for at least two age-bands within the age-range 4–17 years. A three-stage screening process (initial sifting; detailed inspection; extraction of full papers), was followed by study quality appraisals. Of 11 245 identified studies, 41 met the inclusion criteria. Most (n = 31) presented self-report survey data (five longitudinal, 26 cross-sectional); 10 presented routinely collected data (GP/hospital statistics). Extracted data, supplemented by additional data obtained from authors of the included studies, were used to calculate odds ratios of a female excess, or female:male incident rate ratios as appropriate. To test whether these changed with age, the values were logged and regressed on age in random effects meta-regressions. These showed strongest evidence of an emerging/increasing female excess for self-reported measures of headache, abdominal pain, tiredness, migraine and self-assessed health. Type 1 diabetes and epilepsy, based on routinely collected data, did not show a significant emerging/increasing female excess. For most physical morbidity measures reviewed, the evidence broadly points towards an emerging/increasing female excess during the transition to adolescence, although results varied by morbidity measure and study design, and suggest that this may occur at a younger age than previously

Integrating critical thinking and evidence-based dentistry across a four-year dental curriculum: a model for independent learning.

PubMed

Marshall, Teresa A; Straub-Morarend, Cheryl L; Handoo, Nidhi; Solow, Catherine M; Cunningham-Ford, Marsha A; Finkelstein, Michael W

2014-03-01

Introducing critical thinking and evidence-based dentistry (EBD) content into an established dental curriculum can be a difficult and challenging process. Over the past three years, the University of Iowa College of Dentistry has developed and implemented a progressive four-year integrated critical thinking and EBD curriculum. The objective of this article is to describe the development and implementation process to make it available as a model for other dental schools contemplating introduction of critical thinking and EBD into their curricula. The newly designed curriculum built upon an existing problem-based learning foundation, which introduces critical thinking and the scientific literature in the D1 year, in order to expose students to the rationale and resources for practicing EBD in the D2 and D3 years and provide opportunities to practice critical thinking and apply the EBD five-step process in the D2, D3, and D4 years. All curricular content is online, and D3 and D4 EBD activities are integrated within existing clinical responsibilities. The curricular content, student resources, and student activities are described.

An experimental study of the job demand-control model with measures of heart rate variability and salivary alpha-amylase: Evidence of increased stress responses to increased break autonomy.

PubMed

O'Donnell, Emma; Landolt, Kathleen; Hazi, Agnes; Dragano, Nico; Wright, Bradley J

2015-01-01

We assessed in an experimental design whether the stress response towards a work task was moderated by the autonomy to choose a break during the assigned time to complete the task. This setting is defined in accordance with the theoretical framework of the job-demand-control (JDC) model of work related stress. The findings from naturalistic investigations of a stress-buffering effect of autonomy (or 'buffer hypothesis') are equivocal and the experimental evidence is limited, especially with relation to physiological indices of stress. Our objective was to investigate if increased autonomy in a particular domain (break time control) was related with adaptive physiology using objective physiological markers of stress; heart rate variability (HRV) and salivary alpha amylase (sAA). We used a within-subject design and the 60 female participants were randomly assigned to an autonomy (free timing of break) and standard conditions (fixed timing of break) of a word processing task in a simulated office environment in a random order. Participants reported increased perceptions of autonomy, no difference in demand and performed worse in the task in the break-time autonomy versus the standard condition. The results revealed support for the manipulation of increased autonomy, but in the opposing direction. Increased autonomy was related with dysregulated physiological reactivity, synonymous with typical increased stress responses. Potentially, our findings may indicate that autonomy is not necessary a resource but could become an additional stressor when it adds additional complexity while the amount of work (demands) remains unchanged. Further, our findings underscore the need to collect objective physiological evidence of stress to supplement self-reported information. Self-report biases may partially explain the inconsistent findings with the buffer hypothesis. Copyright © 2014 Elsevier Ltd. All rights reserved.

An increasing incidence of type 1 diabetes mellitus in Romanian children aged 0 to 17 years.

PubMed

Serban, Viorel; Brink, Stuart; Timar, Bogdan; Sima, Alexandra; Vlad, Mihaela; Timar, Romulus; Vlad, Adrian

2015-03-01

The epidemiology of type 1 diabetes mellitus may provide insights into the pathogenesis of the disease. The aim of this work was to characterize the trend of the incidence of type 1 diabetes mellitus in Romanian children aged from 0 to 17 years over a 10-year interval. Data regarding new cases were obtained from two sources: (1) The Romanian Childhood Diabetes Registry and (2) Records of the Medical Center "Cristian Serban", Buzias. The demographic data were retrieved from the National Institute for Statistics. The incidence was calculated for the age groups 0-4, 5-9, 10-14, and 15-17 years. A total of 3196 new cases, aged below 18 years, were found by both the sources. There were significant differences between the groups (p=0.012), the mean incidence being highest in the age group 10-14 years (9.6/100,000/year, 95% CI 9-10.1) and lowest in children aged from 0 to 4 years (4.8/100,000/year, 95% CI 4.4-5.3). Boys were slightly more frequently affected than girls (p=0.038). The age and gender adjusted incidence of type 1 diabetes mellitus increased significantly (p<0.001) from 6.2/100,000/year (95% CI 5.5-6.9) in 2002 to 9.3/100,000/year (95% CI 8.4-10.3) in 2011. The raise in incidence was noticed in all age groups except for 15-17 years. Romania is a country with an intermediate incidence of type 1 diabetes mellitus in children, which is slightly higher in boys than in girls. The incidence of type 1 diabetes mellitus increased continuously during the 10-year survey, with the exception of the oldest teens.

Does Green Investment Increase Financial Performance? Empirical Evidence from Indonesian Companies

NASA Astrophysics Data System (ADS)

Chariri, Anis; Bukit, Gretta Ratna Sari Br; Eklesia, Octrine Bethary; Christi, Bourinta Uly; Tarigan, Daisy Meirisa

2018-02-01

The negative effects of globalization and rapid growth of industries on environment have changed the business paradigm from profit issues to profit, people and planet (triple bottom line). Consequently, a number of companies have invested their money in environmental issues (called as green investment). This study aims to investigate the effect of firm characteristics on green investment and how green investment influences financial performance. Using annual reports of companies receiving the Program for Pollution Control, Evaluation and Rating (PROPER) award and listed on the Indonesia Stock Exchanges in the year of 2009-2014 as research data, the findings showed that firm size, foreign ownership, industry profile, and frequency of audit committee meeting significantly influenced green investment whereas ISO14001 management certification had no effect on it. Interestingly, green investment positively determined an increase in firm financial performance. This reveals that the better the green investment, the higher the financial performance of the companies. The findings contribute to the importance of adopting green investment as a company's strategy to increase profit without destroying the environment. Secondly, this finding can be used by government as a reference for formulating any regulations concerning business and environment. Finally, the finding contributes to the importance of including environmental issues in business education.

Why was there increased moisture in the eastern Caribbean when Europe was cold? Evidence from Speleothems

NASA Astrophysics Data System (ADS)

Winter, Amos; Vieten, Rolf-martin; Miller, Thomas; Mangini, Augusto; Scholz, Denis; Kushnir, Yochanan; Black, David

2014-05-01

We present evidence for the last 10,000 years from speleothems collected from the eastern Caribbean showing that this region was anomalously moist at the same time that Europe and the north Atlantic were unusually cold. The most noticeable period for this association was during the 8.2ka event when Greenland ice cores (GISP2) show that northern Europe and the north Atlantic were cooler by 3 - 6 deg C. The trigger for the 8.2ka event is thought to be pulsed melt water discharges from a multi-event drainage of proglacial lakes associated with the decaying Laurentide Ice Sheet margin. The melt water apparently slowed the thermohaline circulation decreasing warmth to northern Europe. At the same time moisture transfer to the northern latitudes may have slowed resulting in the observed lower latitude precipitation patterns. The eastern Caribbean seems to be especially sensitive to the changes in the strength of the Atlantic meridional overturning circulation (AMOC). Higher precipitation values may also have increased lowland flooding along the coastal areas of north eastern South America, already affected by early Holocene sea-level change, and are linked to social territory reshuffling which stimulated the earliest migrations into the Caribbean Archipelago shortly afterwards. Our age models based on precise MC ICPMS 230ThU dating indicate that the eastern Caribbean stalagmites all grew at about the same rate of 15 cm through the 8.2ka event, much faster than during any other growth period, except today when they are also growing at an accelerated rate.

Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007-2016.

PubMed

Griffin, Eve; McMahon, Elaine; McNicholas, Fiona; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

2018-05-02

Rates of hospital-treated self-harm are highest among young people. The current study examined trends in rates of self-harm among young people in Ireland over a 10-year period, as well as trends in self-harm methods. Data from the National Self-Harm Registry Ireland on presentations to hospital emergency departments (EDs) following self-harm by those aged 10-24 years during the period 2007-2016 were included. We calculated annual self-harm rates per 100,000 by age, gender and method of self-harm. Poisson regression models were used to examine trends in rates of self-harm. The average person-based rate of self-harm among 10-24-year-olds was 318 per 100,000. Peak rates were observed among 15-19-year-old females (564 per 100,000) and 20-24-year-old males (448 per 100,000). Between 2007 and 2016, rates of self-harm increased by 22%, with increases most pronounced for females and those aged 10-14 years. There were marked increases in specific methods of self-harm, including those associated with high lethality. The findings indicate that the age of onset of self-harm is decreasing. Increasing rates of self-harm, along with increases in highly lethal methods, indicate that targeted interventions in key transition stages for young people are warranted.

Preteen insulin levels interact with caloric intake to predict increases in obesity at ages 18 to 19 years: a 10-year prospective study of black and white girls.

PubMed

Morrison, John A; Glueck, Charles J; Wang, Ping

2010-05-01

We evaluated the associations of teenage insulin and adolescent diet with 10-year weight gain in an analysis sample of black and white girls matched for pubertal stage, body mass index (BMI) (or fat mass), and insulin at ages 9 to 10 years. We hypothesized that preteen insulin and insulin resistance would interact with dietary factors to positively predict increases in BMI. Furthermore, we hypothesized that increased insulin and insulin resistance, interacting with higher caloric intake during adolescence, would lead to greater increments in BMI in black girls than in white girls. Prospective 10-year follow-up was performed on 215 pairs of black and white schoolgirls matched at baseline by BMI (or fat mass), insulin, and pubertal stage, with repeated measures of body habitus, insulin, and dietary intake. When matched for BMI, black girls had higher fat-free mass and white girls had higher fat mass at ages 9 to 10 years. Black-white differences in caloric intake were not significant at ages 9 to 10 years, but black girls consumed more calories at age 19 years. Black girls consumed a greater percentage of calories from fat throughout. At age 19 years, black girls had higher BMI, fat mass index, and insulin. When matched at ages 9 to 10 years for fat mass, black girls were heavier, had higher BMI, and had greater fat-free mass. By ages 18 to 19 years, black girls continued to have higher BMI, but had accrued higher fat mass and a higher percentage of body fat. By stepwise multiple regression, 10-year increases in BMI were predicted by ages 9 to 10 years BMI, 10-year change in insulin, and a 3-way interaction between ages 9 to 10 years insulin, adolescent caloric intake, and race (higher in black girls) (all Ps < .0001). Insulin at ages 9 to 10 years interacts with caloric intake to increase BMI by age 19 years. There appear to be intrinsic black-white metabolic differences that lead to greater gains in fat during adolescence in black girls. Evaluating BMI and insulin

The increase in melanoma: are dietary furocoumarins responsible?

PubMed

Sayre, Robert M; Dowdy, John C

2008-01-01

According to most cancer registries the incidence of cutaneous melanoma (CM) has been increasing for several decades. Unlike other skin cancers, CM does not clearly correlate with exposure to ultraviolet radiation. The strongest etiological evidence for CM in man is genetic predisposition, evidenced by very high risks in primary relatives of melanoma patients, and photochemotherapy with 8-methoxy psoralen in combination with ultraviolet-A radiation (PUVA) to treat psoriasis and vitiligo. Retrospective studies of PUVA patients show significantly increased incidence of CM. Psoralens, and other furocoumarins, are phototoxic and photocarcinogenic, intercalate DNA and photochemically induce mutations. Furocoumarins are botanical phytoalexins found to varying extents in a variety of vegetables and fruits, notably citrus fruits. The levels of furocoumarins present in our diets, while normally well below that causing evident acute phototoxicity, do cause pharmacologically relevant drug interactions. For the past approximately 50 years CM has increased at similar rates as the increased availability and consumption of citrus products. Recently in a large study of nurses, only orange juice drinking, indicative of dietary preference for citrus, was positively associated with significantly increased risk of developing CM. We hypothesize that the increases in cutaneous melanoma incidence may be in part related to concomitant increases in dietary photocarcinogenic furocoumarins.

Diagnosis of a 64-year-old patient presenting with suspected lumbar spinal stenosis: an evidence-based case report

PubMed Central

Emary, Peter C.

2015-01-01

Objective: To present an evidence-based case report on the diagnosis of a patient with suspected lumbar spinal stenosis (LSS). Case: A 64-year-old man presented with signs and symptoms suggestive of LSS, but physical examination and diagnostic imaging findings were inconclusive. Other co-morbidities included diabetes, congestive heart failure, and left hip joint osteoarthritis. Outcome: PubMed was searched for systematic reviews of diagnostic studies on LSS. Two recent articles were found and appraised with respect to their validity, importance, and applicability in diagnosing the current patient. Copies of his magnetic resonance imaging were also obtained and used in combination with the appraised literature, including diagnostic test specificities and likelihood ratios, to confirm an LSS diagnosis. Summary: This case illustrates how research evidence can be used in clinical practice, particularly in the diagnosis of an individual patient. PMID:25729085

Evidence and evidence gaps of laryngeal cancer surgery

PubMed Central

Wiegand, Susanne

2016-01-01

Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number or organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery, and transoral robotic surgery have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the US. Improving the evidence base of laryngeal cancer surgery by successful establishment of surgical trials should be the future goal. PMID:28025603

Increasing access into higher education: Insights from the 2011 African Network on Evidence-to-Action on Disability Symposium – Education Commission

PubMed Central

Swart, Estelle; Chataika, Tsitsi; Bell, Diane

2014-01-01

This article provides some insights into the challenges regarding inclusion in higher education of students with disabilities. It does this by elucidating aspects of the proceedings of the Education Commission at the African Network on Evidence-to-Action on Disability (AfriNEAD) Symposium, which took place in Zimbabwe in November 2011. The presentations specifically focused on the education of people with disabilities from early childhood through to higher education. This article, however, is informed by presentations focusing on increasing access to higher education. The article is focused on the implementation of evidence in practice, research and policies stemming from rigorous debate and scientific foundations, whilst taking into account the dynamic realities of the higher education context. Themes such as the systemic approach needed for inclusion to be successful, increasing access and the dynamic role of students with disabilities are highlighted. PMID:28730011

Increases in alcohol consumption in women and elderly groups: evidence from an epidemiological study

PubMed Central

2013-01-01

Background In most Western countries, alcohol consumption continues to increase, specifically among women and older adults. Insight into these trends may aid intervention strategies. Here we present data on alcohol consumption by age and sex as well as associations between alcohol use and demographic lifestyle/traits. The data are from a large (N>16,000) population-based Dutch sample, ascertained based on the presence of twins in the family. Methods A set of 16 indicators of normative and problematic alcohol use was assessed in participants of the Netherlands Twin Register between 2009–2012 (ages 18–97; 6,052 men; 10,535 women). Alcohol consumption and demographic/lifestyle traits, including educational attainment, work-related/financial stress, urbanization, religiousness, smoking/cannabis initiation, and BMI were described by age and sex. Associations were examined by regressing aspects of alcohol use on age, sex, their interaction, and demographic/lifestyle variables. Results Age, sex, and initiation of cigarette and cannabis use were the most important predictors of alcohol use. Frequency of alcohol use was lowest between 18–25 years, with 3.2% of men and .6% of women drinking 6–7 times/week, and highest above age 65 years, with 30.6-32.7% of men and 20.2-22.0% of women drinking 6–7 times/week. Women consumed the lowest quantities of alcohol between 25–45 years, with a 5.7-5.9% prevalence of excessive drinking (>14 glasses/week), and the largest quantities between 55–65 years (15.5% excessive drinkers). Age at alcohol initiation, onset of regular drinking, and first alcohol intoxication were lowest between ages 18–25 years and highest above age 65 years. Among older participants, men initiated alcohol use and regular drinking earlier, and had lower age at first intoxication than women, but among young adults, no sex differences were observed. Conclusions Alcohol consumption was high in the elderly Dutch population, especially among women

Increased frequency of gestational and delivery-related complications in women of 35 years of age and above.

PubMed

Bereczky, L-K; Kiss, Sz-L; Szabó, B

2015-02-01

This retrospective study evaluated gestational and delivery-related characteristics focusing on women aged 35 and above (≥ 35 years). Data were collected on maternal (n = 8,407) and newborn records during a 4-year admission period (2008-11) at the County Emergency Hospital, Tîrgu-Mureş, Romania. The prevalence of preterm deliveries increased in all age groups, from 19.5% to 27.8% (p = 0.006) in mothers ≥ 35 years. Twinning rate showed a highly significant increase, being 2.6% in 2008 and 9.5% in 2011 (p = 0.005), while caesarean delivery incidence increased from 46.3% to 51.0% in women aged ≥ 35. Our study revealed a highly significant decrease of mean gestational age and mean fetal weight, as well as a higher incidence of comorbidities and pregnancy-related complications in those aged ≥ 35 years. We assume that comorbidities, maternal and fetal indications to perform caesarean section (CS), in the more mature age group, were a main determinant of the elective or iatrogenic preterm deliveries, which might have contributed to further complications; moreover, previous CSs were likely a promoting factor for further CSs.

Does methamphetamine use increase violent behaviour? Evidence from a prospective longitudinal study.

PubMed

McKetin, Rebecca; Lubman, Dan I; Najman, Jake M; Dawe, Sharon; Butterworth, Peter; Baker, Amanda L

2014-05-01

To determine whether violent behaviour increases during periods of methamphetamine use and whether this is due to methamphetamine-induced psychotic symptoms. A fixed-effects (within-subject) analysis of four non-contiguous 1-month observation periods from a longitudinal prospective cohort study. Sydney and Brisbane, Australia. A total of 278 participants aged 16 years or older who met DSM-IV criteria for methamphetamine dependence on entry to the study but who did not meet DSM-IV criteria for life-time schizophrenia or mania. Violent behaviour was defined as severe hostility in the past month on the Brief Psychiatric Rating Scale (BPRS) (corresponding to assault/damage to property). Days of methamphetamine and other substance use in the past month were assessed using the Opiate Treatment Index. Positive psychotic symptoms in the past month were identified using the BPRS. There was a dose-related increase in violent behaviour when an individual was using methamphetamine compared with when they were not after adjusting for other substance use and socio-demographics [cf. no use in the past month: 1-15 days of use odds ratio (OR) = 2.8, 95% confidence interval (CI) =1.6-4.9; 16+ days of use OR = 9.5, 95% CI = 4.8-19.1]. The odds of violent behaviour were further increased by psychotic symptoms (OR = 2.0, 95% CI = 1.1-3.6), which accounted for 22-30% of violent behaviour related to methamphetamine use. Heavy alcohol consumption also increased the risk of violent behaviour (OR = 3.1, 95% CI = 1.4-7.0) and accounted for 12-18% of the violence risk related to methamphetamine use. There is a dose-related increase in violent behaviour during periods of methamphetamine use that is largely independent of the violence risk associated with psychotic symptoms. © 2014 Society for the Study of Addiction.

Increasing Incidence of Herpes Zoster Over a 60-year Period From a Population-based Study

PubMed Central

Kawai, Kosuke; Yawn, Barbara P.; Wollan, Peter; Harpaz, Rafael

2016-01-01

Background. Temporal increases in the incidence of herpes zoster (HZ) have been reported but studies have examined short study periods, and the cause of the increase remains unknown. We examined the long-term trend of HZ. Methods. A population-based cohort study was conducted in Olmsted County, Minnesota, using data from 1945–1960 and 1980–2007. Medical records review of possible cases was performed to confirm incident cases of HZ, the patient's immune status, and prescribing of antivirals for HZ. We examined the relative change in the temporal trend in the incidence rates before and after the introduction of the varicella vaccination program. Results. Of the 8017 patients with HZ, 58.7% were females and 6.6% were immunocompromised. The age- and sex-adjusted incidence rate of HZ increased from 0.76 per 1000 person-years (PY) (95% confidence interval [CI], .63–.89) in 1945–1949 to 3.15 per 1000 PY (95% CI, 3.04–3.26) in 2000–2007. The rate of increase across the time period was 2.5% per year after adjusting for age and sex (adjusted incidence rate ratio, 1.025 [95% CI, 1.023–1.026]; P < .001). The incidence of HZ significantly increased among all age groups and both sexes. We found no change in the rate of increase before vs after the introduction of the varicella vaccination program. Conclusions. The incidence of HZ has increased >4-fold over the last 6 decades. This increase is unlikely to be due to the introduction of varicella vaccination, antiviral therapy, or change in the prevalence of immunocompromised individuals. PMID:27161774

Hip surgery and its evidence base: progress over a decade?

PubMed

Hasan, Kamrul; Shankar, Shivakumar; Sharma, Aadhar; Carter, Alison; Zaidi, Razi; Cro, Suzie; Skinner, John; Goldberg, Andy

2016-12-01

The burden of traumatic and elective hip surgery is set to grow. With an increasing number of techniques and implants against the background of an aging population, the emphasis on evidence-based treatment has never been greater. The purpose of this study was to assess changes in the levels of evidence in the hip literature over a decade. Articles pertaining to hip surgery from the years 2000 and 2010 in Hip International, Journal of Arthroplasty, Journal of Bone and Joint Surgery and The Bone and Joint Journal were analysed. Articles were ranked by a five-point level of evidence scale and by type of study, according to guidelines from the Centre for Evidence-based Medicine. 531 articles were analysed from 48 countries. The kappa value for the inter-observer reliability showed excellent agreement between the reviewers for study type (κ = 0.956, P < 0.01) and for levels of evidence (κ = 0.772, P < 0.01). Between 2000 and 2010, the overall percentage of high-level evidence (levels I and II) studies more than doubled (12 to 31 %, P < 0.001). The most frequent study type was therapeutic; the USA and UK were the largest producers of published work in these journals, with contributions from other countries increasing markedly over the decade. There has been a significant increase in high levels of evidence in hip surgery over a decade (P < 0.001). We recommend that all orthopaedic journals consider implementing compulsory declaration by authors of the level of evidence to help enhance quality of evidence. Level 2: economic and decision analysis.

Peer-teaching of evidence-based medicine.

PubMed

Rees, Eliot; Sinha, Yashashwi; Chitnis, Abhishek; Archer, James; Fotheringham, Victoria; Renwick, Stephen

2014-07-01

Many medical schools teach the principles of evidence-based medicine (EBM) as part of their undergraduate curriculum. Medical students perceive that EBM is valuable to their undergraduate and postgraduate career. Students may experience barriers to applying EBM principles, especially when searching for evidence or identifying high-quality resources. The UK National Institute for Health and Care Excellence (NICE) Evidence Search is a service that enables access to authoritative clinical and non-clinical evidence and best practice through a web-based portal. Evidence-based medicine workshops were organised and delivered by fourth-year medical students, having first received training from NICE to become NICE student champions. The workshops covered the basic principles of EBM and focused on retrieving EBM resources for study through the NICE Evidence Search portal. The scheme was evaluated using a pre-workshop survey and an 8-12 week post-workshop survey. Self-reported confidence in searching for evidence-based resources increased from 29 per cent before the workshop to 87 per cent after the workshop. Only 1 per cent of students rated evidence-based resources as their first preference pre-workshop, compared with 31 per cent post-workshop. The results show that although many students were aware of evidence-based resources, they tended not to use them as their preferred resource. Despite appreciating the value of evidence-based resources, few students were confident in accessing and using such resources for pre-clinical study. A peer-taught workshop in EBM improved students' confidence with, and use of, evidence-based resources. © 2014 John Wiley & Sons Ltd.

Increasing Access by Waiving Tuition: Evidence from Haiti

ERIC Educational Resources Information Center

Adelman, Melissa; Holland, Peter; Heidelk, Tillmann

2017-01-01

Despite recent gains in increasing access, an estimated 58 million children worldwide are still out of school. Abolishing school fees has increased enrollment rates in several countries where enrollments were low and fees were high. However, such policies may be less effective, or even have negative consequences, when supply-side responses are…

Ambulatory Blood Pressure Variability Increases Over a 10-Year Follow-Up in Community-Dwelling Older People

PubMed Central

Pearce, Mark S.; Wincenciak, Joanna; Kerr, Simon R.J.; Newton, Julia L.

2016-01-01

Abstract BACKGROUND Greater ambulatory blood pressure variability (ABPV) is associated with end-organ damage and increased mortality. Age-related changes in the cardiovascular and autonomic nervous systems make age-associated increases in ABPV likely. Cross-sectional studies support this hypothesis, showing greater ABPV among older compared to younger adults. The only longitudinal study to examine changes in ABPV, however, found ABPV decreased over 5 years follow-up. This unexpected observation probably reflected the highly selected nature of the study participants. METHODS In this longitudinal study, we assessed changes in ABPV over 10 years in a community-cohort of older people. In addition, we examined the extent to which ABPV was predicted by demographics, cardiovascular risk factors, and medication. Clinical examination and 24-hour ambulatory blood pressure monitoring were carried out at baseline and at 10 years follow-up in 83 people, median age 70 years. ABPV was calculated using SD and coefficient of variation (Cv). Three time periods were examined: daytime, nighttime, and 24 hours. RESULTS Daytime and 24-hour, systolic and diastolic, SD, and Cv were significantly greater at follow-up than at baseline ( P < 0.001 in all cases). Mean BP did not change. CONCLUSIONS Multilevel modeling showed follow-up interval had a significant, positive effect on SD and Cv ( P < 0.004), independent of age, sex, and medication. ABPV increased over a 10-year follow-up despite stable mean BP. ABPV may therefore be an additional target for treatment in older people. Future studies should examine what degree of ABPV is harmful and if control of ABPV reduces adverse outcome. PMID:26310662

A 6-year-old girl with fever, rash, and increased intracranial pressure.

PubMed

Ravish, Matthew E; Krowchuk, Daniel P; Zapadka, Michael; Shetty, Avinash K

2013-08-01

Rocky Mountain spotted fever (RMSF) is a well-described, potentially lethal, tick-borne zoonotic infection and has very effective therapy. However, the diagnosis might not be made early enough, often leading to worse outcomes. Our aim was to discuss the diagnostic dilemmas facing the physician when evaluating patients with suspected RMSF. We report a case of RMSF in a 6-year-old girl who presented to our hospital with a 7-day history of fever, headache, and a petechial rash. After blood cultures were obtained, the patient was treated empirically with doxycycline, vancomycin, and ceftriaxone. During the next 24 h, her clinical status worsened, with acute onset of altered mental status, posturing, and fixed and dilated pupils. A computed tomography scan of the brain demonstrated diffuse cerebral edema with evidence of tonsillar herniation. She died 24 h after admission. A serum specimen tested positive for immunoglobulin G to Rickettsia rickettsii at a titer of 128 dilutions, confirming recent infection. We present this case to raise awareness of RMSF in patients who present with a nonspecific febrile illness in tick-endemic areas in the United States. Early diagnosis and treatment with doxycycline before day 5 of illness is essential and can prevent morbidity and mortality. Copyright © 2013 Elsevier Inc. All rights reserved.

Increased amino acids levels and the risk of developing of hypertriglyceridemia in a 7-year follow-up.

PubMed

Mook-Kanamori, D O; Römisch-Margl, W; Kastenmüller, G; Prehn, C; Petersen, A K; Illig, T; Gieger, C; Wang-Sattler, R; Meisinger, C; Peters, A; Adamski, J; Suhre, K

2014-04-01

Recently, five branched-chain and aromatic amino acids were shown to be associated with the risk of developing type 2 diabetes (T2D). We set out to examine whether amino acids are also associated with the development of hypertriglyceridemia. We determined the serum amino acids concentrations of 1,125 individuals of the KORA S4 baseline study, for which follow-up data were available also at the KORA F4 7 years later. After exclusion for hypertriglyceridemia (defined as having a fasting triglyceride level above 1.70 mmol/L) and diabetes at baseline, 755 subjects remained for analyses. Increased levels of leucine, arginine, valine, proline, phenylalanine, isoleucine and lysine were significantly associated with an increased risk of hypertriglyceridemia. These associations remained significant when restricting to those individuals who did not develop T2D in the 7-year follow-up. The increase per standard deviation of amino acid level was between 26 and 40 %. Seven amino acids were associated with an increased risk of developing hypertriglyceridemia after 7 years. Further studies are necessary to elucidate the complex role of these amino acids in the pathogenesis of metabolic disorders.

No evidence for increased performance of a specialist psyllid on invasive French broom

NASA Astrophysics Data System (ADS)

Herrera, Angelica M.; Carruthers, Raymond I.; Mills, Nicholas J.

2011-03-01

Some invasive plants perform better in their area of introduction than in their native region. This may be a consequence of rapid evolutionary change due to different selection pressures encountered in introduced regions. The Evolution of Increased Competitive Ability hypothesis (EICA) suggests that release from natural enemies results in selection of more vigorous plant genotypes as a result of plants allocating resources away from costly herbivore-resistance traits and toward increased growth. We tested the prediction that introduced plant genotypes of Genista monspessulana (Fabaceae) are less resistant to herbivory by a specialist psyllid, Arytinnis hakani (Hemiptera: Psyllidae) by measuring and comparing A. hakani performance on plants from native (southern France) and introduced (California, U.S.) populations. A. hakani performed equally well on plants from the native and introduced regions; there were no significant differences in psyllid egg and nymphal development, nymphal survival rates, female longevity or fecundity between the test plants. Egg survival rates were significantly higher on native populations, but the difference was minimal. These results provide preliminary evidence that native and introduced G. monspessulana populations are equally resistant to A. hakani and do not support the EICA hypothesis prediction of reduced investment in defense in introduced plant populations. Possible explanations for the lack of effects found in this study include the type of parameters measured and the feeding ecology of the herbivore used to test EICA, and finally, that evolutionary changes in plant defense in introduced G. monspessulana populations may not have occurred.

Five Years of Experimental Warming Increases the Biodiversity and Productivity of Phytoplankton

PubMed Central

Yvon-Durocher, Gabriel; Allen, Andrew P.; Cellamare, Maria; Dossena, Matteo; Gaston, Kevin J.; Leitao, Maria; Montoya, José M.; Reuman, Daniel C.; Woodward, Guy; Trimmer, Mark

2015-01-01

Phytoplankton are key components of aquatic ecosystems, fixing CO2 from the atmosphere through photosynthesis and supporting secondary production, yet relatively little is known about how future global warming might alter their biodiversity and associated ecosystem functioning. Here, we explore how the structure, function, and biodiversity of a planktonic metacommunity was altered after five years of experimental warming. Our outdoor mesocosm experiment was open to natural dispersal from the regional species pool, allowing us to explore the effects of experimental warming in the context of metacommunity dynamics. Warming of 4°C led to a 67% increase in the species richness of the phytoplankton, more evenly-distributed abundance, and higher rates of gross primary productivity. Warming elevated productivity indirectly, by increasing the biodiversity and biomass of the local phytoplankton communities. Warming also systematically shifted the taxonomic and functional trait composition of the phytoplankton, favoring large, colonial, inedible phytoplankton taxa, suggesting stronger top-down control, mediated by zooplankton grazing played an important role. Overall, our findings suggest that temperature can modulate species coexistence, and through such mechanisms, global warming could, in some cases, increase the species richness and productivity of phytoplankton communities. PMID:26680314

Does Deinstitutionalization Increase Suicide?

PubMed Central

Yoon, Jangho; Bruckner, Tim A

2009-01-01

Objectives (1) To test whether public psychiatric bed reduction may increase suicide rates; (2) to investigate whether the supply of private hospital psychiatric beds—separately for not-for-profit and for-profit—can substitute for public bed reduction without increasing suicides; and (3) to examine whether the level of community mental health resources moderates the relationship between public bed reduction and suicide rates. Methods We examined state-level variation in suicide rates in relation to psychiatric beds and community mental health spending in the United States for the years 1982–1998. We categorize psychiatric beds separately for public, not-for-profit, and for-profit hospitals. Principal Findings Reduced public psychiatric bed supply was found to increase suicide rates. We found no evidence that not-for-profit or for-profit bed supply compensates for public bed reductions. However, greater community mental health spending buffers the adverse effect of public bed reductions on suicide. We estimate that in 2008, an additional decline in public psychiatric hospital beds would raise suicide rates for almost all states. Conclusions Downsizing of public inpatient mental health services may increase suicide rates. Nevertheless, an increase in community mental health funding may be promising. PMID:19500164

In the teeth of the evidence: the curious case of evidence-based medicine.

PubMed

Davidoff, F

1999-03-01

For a very long time, evidence from research has contributed to clinical decision making. Over the past 50 years, however, the nature of clinical research evidence has drastically changed compared with previous eras: its standards are higher, the tools for assembling and analyzing it are more powerful, and the context in which it is used is less authoritarian. The consequence has been a shift in both the concept and the practice of clinical decision making known as evidence-based medicine. Evidence-based decisions, by definition, use the strongest available evidence, are often more quantitatively informed than decisions made in the traditional fashion; and sometimes run counter to expert opinion. The techniques of evidence-based medicine are also helpful in resolving conflicting opinions. Evidence-based medicine did not simply appear in vacuo; its roots extend back at least as far as the great French Encyclopedia of the 18th century, and the subsequent work of Pierre Louis in Paris in the early 19th century. The power of the evidence-based approach has been enhanced in recent years by the development of the techniques of systematic review and meta-analysis. While this approach has its critics, we would all want the best available evidence used in making decisions about our care if we got sick. It is only fair that the patients under our care receive nothing less.

Atmospheric evidence for a global secular increase in isotopic discrimination of land photosynthesis

NASA Astrophysics Data System (ADS)

Keeling, R. F.; Graven, H. D.; Welp, L.; Piper, S. C.; Bollenbacher, A.; Resplandy, L.; Meijer, H. A. J.

2016-12-01

A decrease in the 13C/12C ratio of atmospheric CO2 owing to the addition of fossil-fuel derived CO2, known as the 13C-Suess effect, has been documented by direct observations since 1977 and from ice-core measurements since the industrial revolution. Measurements of this decrease have previously been used to constrain land and ocean carbon sinks. Here we show, however, that no plausible combination of land and ocean sinks can explain the 13C/12C decrease unless an increase has occurred in the isotopic discrimination of land photosynthesis, i.e. the tendency of land plants to preferentially assimilate 12CO2 compared to 13CO2. A trend toward greater discrimination at higher CO2 levels is broadly consistent with geological evidence for the response of C3 plants at times of altered atmospheric CO2 as well as with tree-ring studies over the past century. The discrimination trend will be discussed in the context of theories for optimal stomatal behavior under changing atmospheric CO2.

Increasing Psychotherapists’ Adoption and Implementation of the Evidence-based Practice of Progress Monitoring

PubMed Central

Persons, Jacqueline B.; Koerner, Kelly; Eidelman, Polina; Thomas, Cannon; Liu, Howard

2015-01-01

Evidence-based practices (EBPs) reach consumers slowly because practitioners are slow to adopt and implement them. We hypothesized that giving psychotherapists a tool + training intervention that was designed to help the therapist integrate the EBP of progress monitoring into his or her usual way of working would be associated with adoption and sustained implementation of the particular progress monitoring tool we trained them to use (the Depression Anxiety Stress Scales on our Online Progress Tracking tool) and would generalize to all types of progress monitoring measures. To test these hypotheses, we developed an online progress monitoring tool and a course that trained psychotherapists to use it, and we assessed progress monitoring behavior in 26 psychotherapists before, during, immediately after, and 12 months after they received the tool and training. Immediately after receiving the tool + training intervention, participants showed statistically significant increases in use of the online tool and of all types of progress monitoring measures. Twelve months later, participants showed sustained use of any type of progress monitoring measure but not the online tool. PMID:26618237

To what extent have relaxed eligibility requirements and increased generosity of disability benefits acted as disincentives for employment? A systematic review of evidence from countries with well-developed welfare systems.

PubMed

Barr, Ben; Clayton, Stephen; Whitehead, Margaret; Thielen, Karsten; Burström, Bo; Nylén, Lotta; Dahl, Espen

2010-12-01

Reductions in the eligibility requirements and generosity of disability benefits have been introduced in several Organisation for Economic Cooperation and Development (OECD) countries in recent years, on the assumption that this will increase work incentives for people with chronic illness and disabilities. This paper systematically reviews the evidence for this assumption in the context of well-developed welfare systems. Systematic review of all empirical studies from five OECD countries from 1970 to December 2009 investigating the effect of changes in eligibility requirements or level of disability benefits on employment of disabled people. Sixteen studies were identified. Only one of five studies found that relaxed eligibility was significantly associated with a decline in employment. The most robust study found no significant effect. On generosity, eight out of 11 studies reported that benefit levels had a significant negative association with employment. The most robust study demonstrated a small but significant negative association. There was no firm evidence that changes in benefit eligibility requirements affected employment. While there was some evidence indicating that benefit level was negatively associated with employment, there was insufficient evidence of a high enough quality to determine the extent of that effect. Policy makers and researchers need to address the lack of a robust empirical basis for assessing the employment impact of these welfare reforms as well as potentially wider poverty impacts.

Evidence of Urban-Induced Precipitation Variability in Arid Climate Regimes

NASA Technical Reports Server (NTRS)

Shepherd, J. Marshall

2005-01-01

Water is essential to life in the Earth system. The water cycle components that sustain life are becoming more scarce and polluted. The most recent (1999-2004) drought experienced in the southwestern United States is the seventh worst in the approximately 500-year proxy tree-ring record. As a result, many regions contemplated drought emergencies in which severe water restrictions are implemented. Though larger weather and climate processes likely control drought processes, there is increasing evidence that anthropogenic or human-related activities can significantly alter precipitation processes. Urbanization is an example of anthropogenic forcing. Recent studies continue to provide evidence that urban environments can modify or induce precipitation under a specific set of conditions. Arid and semi-arid regions of the southwestern United States and other parts of the world are rapidly developing and placing greater demands on the environmental system. In the past fifty years, Phoenix has expanded from a predominantly agricultural center to an urbanized region with extent 700 percent larger than its size in the middle of the twentieth century. Riyadh's population grew from about a half million people in 1972 to almost two million by 2000. Saudi Arabia experienced urbanization later than many other countries; in the early 1970s its urban-rural ratio was still about 1:3. By 1990 the ratio had reversed to about 3:l. In the mid-1970s Riyadh's population was increasing by about 10 percent a year. Irrigation also significantly increased between 1972 and 1990 southeast of Riyadh. The study employs a 108-year precipitation historical data record, global climate observing network observations and satellite data to identify possible anomalies in rainfall in and around two major arid urban areas, Phoenix, Arizona and Riyadh, Saudi Arabia. It provides statistically sound evidence that rainfall distribution and magnitude is statistically different in post-urban than in pre

Community Partnerships, Food Pantries, and an Evidence-Based Intervention to Increase Mammography among Rural Women

ERIC Educational Resources Information Center

Bencivenga, Marcyann; DeRubis, Susan; Leach, Patricia; Lotito, Lisa; Shoemaker, Charles; Lengerich, Eugene J.

2008-01-01

Context: Multiple national agencies and organizations recommend that women age 40 years and older have an annual screening mammogram. Women who are poor, less educated, lack a usual source of care, and reside in rural Appalachia are less likely to have had a recent mammogram. Purpose: To increase use of mammography among a rural Appalachian…

Familial Mediterranean Fever Is Associated With Increased Mortality After Kidney Transplantation-A 19 Years' Single Center Experience.

PubMed

Green, Hefziba; Lichtenberg, Shelly; Rahamimov, Ruth; Livneh, Avi; Chagnac, Avry; Mor, Eytan; Rozen-Zvi, Benaya

2017-10-01

Current data regarding the outcome of kidney transplantation in patients with familial Mediterranean fever (FMF) who reach end-stage renal disease (ESRD) due to reactive amyloidosis A (AA) are scarce and inconclusive. The outcomes of 20 patients with FMF and biopsy-proven AA amyloidosis that were transplanted between 1995 and 2014 were compared with 82 control patients (32 with diabetes mellitus and 50 with nondiabetic kidney disease). Major outcome data included overall patient and graft survivals. During a mean overall follow-up of 116.6 ± 67.5 months 11 patients (55%) with FMF died versus 26 patients (31%) in the control group. Median time of death for patients with FMF was 61 months (range, 16-81) after transplantation. Estimated 5-year, 10-year, and actuarial 15-year overall patients survival rates were 73%, 45%, and 39%, respectively, for patients with FMF, versus 84%, 68% and 63%, respectively, for the control group (P = 0.028). FMF was associated with more than twofold increased risk for death after transplantation, and with a threefold increased risk for hospitalization because of infections during the first year. Infections and cardiovascular disease were the cause of death in the majority of patients with FMF. Overall graft survival was similar between the groups. Recurrence of AA amyloidosis was diagnosed in 2 patients during the first year after transplantation. FMF is associated with increased risk of mortality after kidney transplantation.

Early rheumatoid arthritis 6 years after diagnosis is still associated with high direct costs and increasing loss of productivity: the Swedish TIRA project.

PubMed

Hallert, E; Husberg, M; Kalkan, A; Skogh, T; Bernfort, L

2014-01-01

To calculate total costs over 6 years after diagnosis of early rheumatoid arthritis (RA). In the longitudinal prospective multicentre TIRA study, 239 patients from seven units, diagnosed in 1996-98, reported regularly on health-care utilization and the number of days lost from work. Costs were obtained from official databases and calculated using unit costs (Swedish kronor, SEK) from 2001. Indirect costs were calculated using the human capital approach (HCA). Costs were inflation adjusted to Euro June 2012, using the Swedish Consumer Price Index and the exchange rate of June 2012. Statistical analyses were based on linear mixed models (LMMs) for changes over time. The mean total cost per patient was EUR 14,768 in year 1, increasing to EUR 18,438 in year 6. Outpatient visits and hospitalization decreased but costs for surgery increased from EUR 92/patient in year 1 to EUR 444/patient in year 6. Drug costs increased from EUR 429/patient to EUR 2214/patient, mainly because of the introduction of biologics. In year 1, drugs made up for 10% of direct costs, and increased to 49% in year 6. Sick leave decreased during the first years but disability pensions increased, resulting in unchanged indirect costs. Over the following years, disability pensions increased further and indirect costs increased from EUR 10,284 in year 1 to EUR 13,874 in year 6. LMM analyses showed that indirect costs were unchanged whereas direct costs, after an initial fall, increased over the following years, leading to increasing total costs. In the 6 years after diagnosis of early RA, drug costs were partially offset by decreasing outpatient visits but indirect costs remained unchanged and total costs increased.

Climate change: the evidence and our options.

PubMed

Thompson, Lonnie G

2010-01-01

Glaciers serve as early indicators of climate change. Over the last 35 years, our research team has recovered ice-core records of climatic and environmental variations from the polar regions and from low-latitude high-elevation ice fields from 16 countries. The ongoing widespread melting of high-elevation glaciers and ice caps, particularly in low to middle latitudes, provides some of the strongest evidence to date that a large-scale, pervasive, and, in some cases, rapid change in Earth's climate system is underway. This paper highlights observations of 20th and 21st century glacier shrinkage in the Andes, the Himalayas, and on Mount Kilimanjaro. Ice cores retrieved from shrinking glaciers around the world confirm their continuous existence for periods ranging from hundreds of years to multiple millennia, suggesting that climatological conditions that dominate those regions today are different from those under which these ice fields originally accumulated and have been sustained. The current warming is therefore unusual when viewed from the millennial perspective provided by multiple lines of proxy evidence and the 160-year record of direct temperature measurements. Despite all this evidence, plus the well-documented continual increase in atmospheric greenhouse gas concentrations, societies have taken little action to address this global-scale problem. Hence, the rate of global carbon dioxide emissions continues to accelerate. As a result of our inaction, we have three options: mitigation, adaptation, and suffering.

Climate Change: The Evidence and Our Options

PubMed Central

Thompson, Lonnie G

2010-01-01

Glaciers serve as early indicators of climate change. Over the last 35 years, our research team has recovered ice-core records of climatic and environmental variations from the polar regions and from low-latitude high-elevation ice fields from 16 countries. The ongoing widespread melting of high-elevation glaciers and ice caps, particularly in low to middle latitudes, provides some of the strongest evidence to date that a large-scale, pervasive, and, in some cases, rapid change in Earth's climate system is underway. This paper highlights observations of 20th and 21st century glacier shrinkage in the Andes, the Himalayas, and on Mount Kilimanjaro. Ice cores retrieved from shrinking glaciers around the world confirm their continuous existence for periods ranging from hundreds of years to multiple millennia, suggesting that climatological conditions that dominate those regions today are different from those under which these ice fields originally accumulated and have been sustained. The current warming is therefore unusual when viewed from the millennial perspective provided by multiple lines of proxy evidence and the 160-year record of direct temperature measurements. Despite all this evidence, plus the well-documented continual increase in atmospheric greenhouse gas concentrations, societies have taken little action to address this global-scale problem. Hence, the rate of global carbon dioxide emissions continues to accelerate. As a result of our inaction, we have three options: mitigation, adaptation, and suffering. PMID:22532707

Alemtuzumab CARE-MS II 5-year follow-up

PubMed Central

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

2017-01-01

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

Ecosystem sentinels for climate change? Evidence of wetland cover changes over the last 30 years in the tropical Andes.

PubMed

Dangles, Olivier; Rabatel, Antoine; Kraemer, Martin; Zeballos, Gabriel; Soruco, Alvaro; Jacobsen, Dean; Anthelme, Fabien

2017-01-01

While the impacts of climate change on individual species and communities have been well documented there is little evidence on climate-mediated changes for entire ecosystems. Pristine alpine environments can provide unique insights into natural, physical and ecological response to climate change yet broad scale and long-term studies on these potential 'ecosystem sentinels' are scarce. We addressed this issue by examining cover changes of 1689 high-elevation wetlands (temporarily or perennial water-saturated grounds) in the Bolivian Cordillera Real, a region that has experienced significant warming and glacier melting over the last 30 years. We combined high spatial resolution satellite images from PLEIADES with the long-term images archive from LANDSAT to 1) examine environmental factors (e.g., glacier cover, wetland and watershed size) that affected wetland cover changes, and 2) identify wetlands' features that affect their vulnerability (using habitat drying as a proxy) in the face of climate change. Over the (1984-2011) period, our data showed an increasing trend in the mean wetland total area and number, mainly related to the appearance of wet grassland patches during the wetter years. Wetland cover also showed high inter-annual variability and their area for a given year was positively correlated to precipitation intensities in the three months prior to the image date. Also, round wetlands located in highly glacierized catchments were less prone to drying, while relatively small wetlands with irregularly shaped contours suffered the highest rates of drying over the last three decades. High Andean wetlands can therefore be considered as ecosystem sentinels for climate change, as they seem sensitive to glacier melting. Beyond the specific focus of this study, our work illustrates how satellite-based monitoring of ecosystem sentinels can help filling the lack of information on the ecological consequences of current and changing climate conditions, a common and

The use of neuroscientific evidence in Canadian criminal proceedings

PubMed Central

Chandler, Jennifer A.

2015-01-01

This article addresses the question of how neuroscientific evidence is currently used in the Canadian criminal justice system, with a view to identifying the main contexts in which this evidence is raised, as well as to discern the impact of this evidence on judgements of responsibility, dangerousness, and treatability. The most general Canadian legal database was searched for cases in the five-year period between 2008 and 2012 in which neuroscientific evidence related to the responsibility and recidivism risk of criminal offenders was considered. Canadian courts consider neuroscientific evidence of many types, particularly evidence of prenatal alcohol exposure, traumatic brain injury, and neuropsychological testing. The majority of the cases are sentencing decisions, which is useful given that it offers an opportunity to observe how judges wrestle with the tension that evidence of diminished capacity due to brain damage tends to reduce moral blameworthiness, while it also tends to increase perceptions of risk and dangerousness. This so-called double-edged sword of the biological explanation of criminal behavior was reflected in this study, and raises questions about whether and when the pursuit of such evidence is advisable from the defense perspective. PMID:27774212

Five Years Later: A Look at Building and Triangulating Evidence in a School Library

ERIC Educational Resources Information Center

Yutzey, Susan D.

2010-01-01

Participating in an evidence-based practice workshop in 2005 was a transforming experience for the author. She realized that the traditional statistics that she had painstakingly gathered and recorded for her annual report did not provide evidence of actual learning. Evidence acquired through assessment, both formative and summative, provides the…

Age-dependent increase in ortho-tyrosine and methionine sulfoxide in human skin collagen is not accelerated in diabetes. Evidence against a generalized increase in oxidative stress in diabetes.

PubMed Central

Wells-Knecht, M C; Lyons, T J; McCance, D R; Thorpe, S R; Baynes, J W

1997-01-01

The glycoxidation products Nepsilon-(carboxymethyl)lysine and pentosidine increase in skin collagen with age and at an accelerated rate in diabetes. Their age-adjusted concentrations in skin collagen are correlated with the severity of diabetic complications. To determine the relative roles of increased glycation and/or oxidation in the accelerated formation of glycoxidation products in diabetes, we measured levels of amino acid oxidation products, distinct from glycoxidative modifications of amino acids, as independent indicators of oxidative stress and damage to collagen in aging and diabetes. We show that ortho-tyrosine and methionine sulfoxide are formed in concert with Nepsilon-(carboxymethyl)lysine and pentosidine during glycoxidation of collagen in vitro, and that they also increase with age in human skin collagen. The age-adjusted levels of these oxidized amino acids in collagen was the same in diabetic and nondiabetic subjects, arguing that diabetes per se does not cause an increase in oxidative stress or damage to extracellular matrix proteins. These results provide evidence for an age-dependent increase in oxidative damage to collagen and support previous conclusions that the increase in glycoxidation products in skin collagen in diabetes can be explained by the increase in glycemia alone, without invoking a generalized, diabetes-dependent increase in oxidative stress. PMID:9259583

Increase in number of helminth species from Dutch red foxes over a 35-year period.

PubMed

Franssen, Frits; Nijsse, Rolf; Mulder, Jaap; Cremers, Herman; Dam, Cecile; Takumi, Katsuhisa; van der Giessen, Joke

2014-04-03

The red fox (Vulpes vulpes) is host to a community of zoonotic and other helminth species. Tracking their community structure and dynamics over decades is one way to monitor the long term risk of parasitic infectious diseases relevant to public and veterinary health. We identified 17 helminth species from 136 foxes by mucosal scraping, centrifugal sedimentation/flotation and the washing and sieving technique. We applied rarefaction analysis to our samples and compared the resulting curve to the helminth community reported in literature 35 years ago. Fox helminth species significantly increased in number in the last 35 years (p-value <0.025). Toxascaris leonina, Mesocestoides litteratus, Trichuris vulpis and Angiostrongylus vasorum are four new veterinary-relevant species. The zoonotic fox tapeworm (E. multilocularis) was found outside the previously described endemic regions in the Netherlands. Helminth fauna in Dutch red foxes increased in biodiversity over the last three decades.

Team development interventions: Evidence-based approaches for improving teamwork.

PubMed

Lacerenza, Christina N; Marlow, Shannon L; Tannenbaum, Scott I; Salas, Eduardo

2018-01-01

The rate of teamwork and collaboration within the workforce has burgeoned over the years, and the use of teams is projected to continue increasing. With the rise of teamwork comes the need for interventions designed to enhance teamwork effectiveness. Successful teams produce desired outcomes; however, it is critical that team members demonstrate effective processes to achieve these outcomes. Team development interventions (TDIs) increase effective team competencies and processes, thereby leading to improvements in proximal and distal outcomes. The effectiveness of TDIs is evident across domains (e.g., education, health care, military, aviation), and they are applicable in a wide range of settings. To stimulate the adoption and effective use of TDIs, the current article provides a review of four types of evidence-based TDIs including team training, leadership training, team building, and team debriefing. In doing so, we aim to provide psychologists with an understanding of the scientific principles underlying TDIs and their impact on team dynamics. Moreover, we provide evidence-based recommendations regarding how to increase the effectiveness of TDIs as well as a discussion on future research needed within this domain. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Education does not slow cognitive decline with aging: 12-year evidence from the victoria longitudinal study.

PubMed

Zahodne, Laura B; Glymour, M Maria; Sparks, Catharine; Bontempo, Daniel; Dixon, Roger A; MacDonald, Stuart W S; Manly, Jennifer J

2011-11-01

Although the relationship between education and cognitive status is well-known, evidence regarding whether education moderates the trajectory of cognitive change in late life is conflicting. Early studies suggested that higher levels of education attenuate cognitive decline. More recent studies using improved longitudinal methods have not found that education moderates decline. Fewer studies have explored whether education exerts different effects on longitudinal changes within different cognitive domains. In the present study, we analyzed data from 1014 participants in the Victoria Longitudinal Study to examine the effects of education on composite scores reflecting verbal processing speed, working memory, verbal fluency, and verbal episodic memory. Using linear growth models adjusted for age at enrollment (range, 54-95 years) and gender, we found that years of education (range, 6-20 years) was strongly related to cognitive level in all domains, particularly verbal fluency. However, education was not related to rates of change over time for any cognitive domain. Results were similar in individuals older or younger than 70 at baseline, and when education was dichotomized to reflect high or low attainment. In this large longitudinal cohort, education was related to cognitive performance but unrelated to cognitive decline, supporting the hypothesis of passive cognitive reserve with aging.

Increased risk of diabetes development in individuals with weight cycling over 4 years: The Kangbuk Samsung Health study.

PubMed

Rhee, Eun-Jung; Cho, Jung Hwan; Kwon, Hyemi; Park, Se Eun; Park, Cheol-Young; Oh, Ki-Won; Park, Sung-Woo; Lee, Won-Young

2018-05-01

Weight cycling is defined as cyclical loss and gain of weight and recent studies suggest deleterious effects of weight cycling on cardiometabolic health. We aimed to analyze the risk for diabetes development in association with weight cycling over 4 years of follow-up. A retrospective study performed in 4,818 non-diabetic participants (mean age 43 years, 78.3% men) in a health screening program in whom serial health examinations were performed in 5 consecutive years from 2010 to 2014. Average successive variability of weight (ASVW) was defined by the amount of body weight change in absolute value between the successive years over 5 years summed and divided by four. The subjects were divided into two groups according to body mass index (BMI), normal weight (<23 kg/m 2 ) and overweight (≥23 kg/m 2 ). Over 4 years, 3.2% developed diabetes. When the subjects were divided into 3 groups according to tertile groups of ASVW, those in the highest tertile showed significantly increased risk for diabetes development compared to those with the lowest tertile {odds ratio (OR) 1.860; 95% CI 1.130-3.063}. When similar analyses were performed according to the 4 groups divided by baseline body weight and ASVW over four years, those who were more than overweight at baseline with high ASVW showed significantly increased risk of diabetes development compared to those had normal weight and low ASVW (OR 2.266; 95% 1.123-4.572). When the subjects were divided into six group according to weight change and ASVW, those with increased weight over 4 years and high ASVW showed the highest risk for diabetes development among the groups compared to those with stable weight and low ASVW over four years (OR 3.660; 95% CI 1.402-9.553). Those with high ASVW showed significantly increased risk for diabetes development over four years compared with those who had low ASVW. Weight cycling was significantly associated with increased risk for diabetes. Copyright © 2018 Elsevier B.V. All

Increased Physical Activity Associated with Less Weight Regain Six Years After "The Biggest Loser" Competition.

PubMed

Kerns, Jennifer C; Guo, Juen; Fothergill, Erin; Howard, Lilian; Knuth, Nicolas D; Brychta, Robert; Chen, Kong Y; Skarulis, Monica C; Walter, Peter J; Hall, Kevin D

2017-11-01

The aim of this study was to explore how physical activity (PA) and energy intake (EI) changes were related to weight loss and regain following "The Biggest Loser" competition. At baseline, week 6 and week 30 of the competition, and 6 years after the competition, body composition was measured via dual-energy x-ray absorptiometry, resting energy expenditure was measured by using indirect calorimetry, and EI and PA were measured by using doubly labeled water. Six years after the competition, median weight loss in 14 of "The Biggest Loser" participants was 13%, with those maintaining a greater weight loss (mean ± SE) of 24.9% ± 3.8% having increased PA by 160% ± 23%, compared with a PA increase of 34% ± 25% (P = 0.0033) in the weight regainers who were 1.1% ± 4.0% heavier than the precompetition baseline. EI changes were similar between weight loss maintainers and regainers (-8.7% ± 5.6% vs. -7.4% ± 2.7%, respectively; P = 0.83). Weight regain was inversely associated with absolute changes in PA (r = -0.82; P = 0.0003) but not with changes in EI (r = -0.15; P = 0.61). EI and PA changes explained 93% of the individual weight loss variability at 6 years. Consistent with previous reports, large and persistent increases in PA may be required for long-term maintenance of lost weight. © 2017 The Obesity Society.

Cognition in Patients With a Clinical Diagnosis of Parkinson Disease and Scans Without Evidence of Dopaminergic Deficit (SWEDD): 2-Year Follow-Up.

PubMed

Wyman-Chick, Kathryn A; Martin, Phillip K; Minár, Michal; Schroeder, Ryan W

2016-12-01

More than 10% of patients clinically diagnosed with Parkinson disease demonstrate normal dopamine uptake on dopamine transporter single-photon emission computed tomography (DaTscan), but little is known about how cognitive function differs between patients with dopamine deficiency on DaTscan and patients with scans without evidence of dopaminergic deficit (SWEDD). We compared the cognitive function of these two groups of patients over 2 years. We retrospectively analyzed data obtained from the Parkinson's Progression Markers Initiative on 309 participants clinically diagnosed with idiopathic Parkinson disease who had scored in the normal range on the Montreal Cognitive Assessment at baseline and had completed 1- and 2-year follow-up visits. We compared the Montreal Cognitive Assessment scores at 1 and 2 years between the 42 participants with SWEDD and the 267 with dopamine deficiency. Mean cognitive scores did not differ significantly between groups at 1 year, but at 2 years the participants with SWEDD performed more poorly. At 2 years, 31% of the participants with SWEDD versus 15% of those with dopamine deficiency had statistically reliable cognitive impairment. This study provides evidence that some individuals clinically diagnosed with idiopathic Parkinson disease but with SWEDD demonstrate early cognitive decline. The results also suggest that recently diagnosed patients with SWEDD may be at even greater risk for cognitive decline than patients with DaTscan-confirmed early-stage Parkinson disease. While patients with SWEDD likely represent a heterogeneous group of etiologies, our results highlight the need to monitor these patients' cognitive function over time.

Expert opinion vs. empirical evidence: the precautionary principle applied to GM crops.

PubMed

Herman, Rod A; Raybould, Alan

2014-01-01

Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops.

Evidence, education and practice.

PubMed

Kaste, Markku

2006-01-01

Stroke causes greater loss of quality-adjusted life years than any other disease and is also one of the most expensive disorders. The burden of stroke will increase in the future due to change in the age structure of populations. We have a vast body of evidence on how to prevent stroke and how to treat stroke patients. Good examples are treatment of hypertension, antithrombotic agents and carotid surgery in stroke prevention, thrombolysis in ischaemic stroke and stroke unit care for all stroke patients. We only have to translate scientific evidence into daily practice. If some pieces are missing, it is our duty to generate them through research. While taking part in randomized clinical trials (RCTs), the discipline, an essential part of RCTs, will improve the daily care of all stroke patients. Besides RCTs there are many other sources of scientific evidence for stroke management, one of which is the European Stroke Initiative (EUSI). The mission of the EUSI is to improve and optimize stroke management in Europe through education and by offering best practice guidelines. Also national and international societies and organizations play an important role in providing education. The human factor is one obstacle to more successful stroke management because to be more effective we must change our own clinical routine. We can make a difference by applying available evidence to our daily practice. Copyright (c) 2006 S. Karger AG, Basel.

Is Student Pathology Really Increasing? Seven Measures of the Acuity of Counseling Center Clients, 1992-2007

ERIC Educational Resources Information Center

Schwartz, Allan J.

2015-01-01

Since 1992, an overwhelming consensus among counseling center directors has asserted that, year after year, the severity or psychopathology of counseling center clients has been increasing. In contrast to this perceptual consensus, the search for confirming evidence using client self-report measures has been frustrating. These studies have…

Evidence-based neurosurgery

PubMed Central

Esene, Ignatius N.; Baeesa, Saleh S.; Ammar, Ahmed

2016-01-01

Medical evidence is obtainable from approaches, which might be descriptive, analytic and integrative and ranked into levels of evidence, graded according to quality and summarized into strengths of recommendation. Sources of evidence range from expert opinions through well-randomized control trials to meta-analyses. The conscientious, explicit, and judicious use of current best evidence in making decisions related to the care of individual patients defines the concept of evidence-based neurosurgery (EBN). We reviewed reference books of clinical epidemiology, evidence-based practice and other previously related articles addressing principles of evidence-based practice in neurosurgery. Based on existing theories and models and our cumulative years of experience and expertise conducting research and promoting EBN, we have synthesized and presented a holistic overview of the concept of EBN. We have also underscored the importance of clinical research and its relationship to EBN. Useful electronic resources are provided. The concept of critical appraisal is introduced. PMID:27356649

A vascular disease educational program in the preclinical years of medical school increases student interest in vascular disease.

PubMed

Godshall, Christopher J; Moore, Phillip S; Fleming, Shawn H; Andrews, Jeanette S; Hansen, Kimberley J; Hoyle, John R; Edwards, Matthew S

2010-09-01

surgery (60%) rotation. Enrollment in the vascular surgery third-year clerkship increased significantly to a mean of 3.0 students/month from 1.16 students/month in the prior year (P = .0032, postintervention year vs 8 prior years). A vascular disease educational program administered to second-year medical students increases interest in vascular disease and interest in further training. The increased interest translates to greater student enrollment in the vascular surgery clerkship in the subsequent academic year.

Climate, environment and society in southern Italy during the last 2000 years. A review of the environmental, historical and archaeological evidence

NASA Astrophysics Data System (ADS)

Sadori, Laura; Giraudi, Carlo; Masi, Alessia; Magny, Michel; Ortu, Elena; Zanchetta, Giovanni; Izdebski, Adam

2016-03-01

This paper examines the interrelationship between the natural and human history of Sicily over the last 2000 years. It presents a close comparison of the data from the key multi-proxy site of Lago di Pergusa - located inland in the eastern part of Sicily - with the existing archaeological and textual evidence on the socio-economic processes. The article also includes a review of the available natural proxy archives from the Central Mediterranean. On the basis of the isotope and pollen data from the Lago di Pergusa core PRG2, we identified two humid periods (ca. 450-750 AD and ca. 1400-1800 AD) as well as a dry one (ca. 1100-1350 AD); our evidence corresponds closely with other environmental palaeoclimate proxies from the Mediterranean region. In our synthesis of the environmental, historical and archaeological evidence from southern Italy, we argue that during both periods of increased humidity - that is during the late antique-Byzantine times and during the late medieval and early modern periods - intense agricultural use of the Sicilian landscape developed on an unprecedented scale. This in turn contributed to the impressive demographic and economic expansion visible during these periods. A sudden period of aridity followed the first of these eras of humidity-related agricultural growth. This climatic shift, dated to around 750 AD, corresponds to a decrease in synanthropic taxa and a recovery of arboreal vegetation. We argue that in this case a climatic change contributed to socio-economic decline. Moreover, as this change occurred prior to the Arab invasion of Sicily in AD 827, the environmental processes may help to explain the collapse of Byzantine society on Sicily which, in turn made the Muslim conquest possible. After this event, there occurred a longer period of agricultural decline, lasting until around 1000 AD, after which we see the first signs of a slow recovery. Ongoing research in nearby archaeological sites will help defining if it was a local

Increasing bicycle helmet use in the community. Measuring response to a wide-scale, 2-year effort.

PubMed

Morris, B A; Trimble, N E; Fendley, S J

1994-06-01

To determine whether a wide-scale, long-term community promotional effort would increase the use of bicycle helmets among children. Over 2 years, a non-profit group coordinated a range of activities to promote helmet use. On one date before the intervention began and three dates during the intervention, observers surveyed students riding bicycles. Cyclists were observed at 5 elementary schools, three secondary schools, and two community college entrances. A total of 851 cyclists were observed, 536 of them at elementary schools in a convenience sample. Print, radio, and television advertising; posters; pamphlets; bicycle rodeos; and a play were used in a public awareness campaign. Health promotion activities included education, social marketing, community development, and legislative action. Number of cyclists and whether they wore helmets. Combining the two observation dates for each year, helmet use increased from 5.4% in 1990 to 15.4% in 1991. The greatest increase was observed among elementary school students, the group most at risk of serious head injury or death. Overall, girls were twice as likely to wear helmets as boys. Wide-scale, long-term community promotion appears to be effective in increasing the use of bicycle helmets.

Synergy between publication and promotion: comparing adoption of new evidence in Canada and the United States.

PubMed

Majumdar, Sumit R; McAlister, Finlay A; Soumerai, Stephen B

2003-10-15

Few studies have examined the effect of new evidence from clinical trials on physician practice. We took advantage of differences in promotional activity in Canada and the United States for the Heart Outcomes Prevention and Evaluation (HOPE) study and the Randomized Aldactone Evaluation Study (RALES) to determine if publication of new evidence changes practice, and the extent to which promotion influences adoption of new evidence. We used longitudinal dispensing data, collected from 1998 to 2001, to examine changes in prescribing patterns for ramipril and other angiotensin-converting enzyme (ACE) inhibitors before and after the HOPE study. We also obtained estimates for promotional expenditures. We stratified analyses by country, to isolate the effect of promotion, and used interrupted time series methods to adjust for pre-existing prescribing trends. Similar analyses were conducted for spironolactone use before and after RALES. Publication of the HOPE study results was associated with rapid increases in the use of ramipril. After adjusting for pre-existing prescribing trends, ramipril prescribing increased by 12% per month (P = 0.001) in Canada versus 5% per month (P = 0.001) in the United States after the study results were presented and published. One year later, ramipril accounted for 30% of the ACE inhibitor market in Canada versus 6% in the United States. The year before publication of these results, expenditures for detailing increased by 20% in Canada (to 18 US dollars per physician) but decreased by 7% in the United States (to 13 US dollars per physician); the year after publication, spending increased to 27 US dollars per physician in Canada versus 23 US dollars per physician in the United States. In the absence of promotional activity for RALES in either country, publication of results was associated with more modest but similar increases of 2% per month (P = 0.001) in spironolactone use in both countries. Publication of new evidence is associated with

Strategic Communication Intervention to Stimulate Interest in Research and Evidence-Based Practice: A 12-Year Follow-Up Study With Registered Nurses.

PubMed

Morténius, Helena; Hildingh, Cathrine; Fridlund, Bengt

2016-02-01

Bridging the research-practice gap is a challenge for health care. Fostering awareness of and interest in research and development (R & D) can serve as a platform to help nurses and others bridge this gap. Strategic communication is an interdisciplinary field that has been used to achieve long-term interest in adopting and applying R & D in primary care. The aim of the study was to evaluate the impact of a strategic communication intervention on long-term interest in R & D among primary care staff members (PCSMs) in general and registered nurses (RNs) in particular. This prospective intervention study included all members of the PCSMs, including RNs, in a Swedish primary care area. The interest of PCSMs in R & D was measured on two occasions, at 7 and 12 years, using both bivariate and multivariate tests. A total of 99.5% of RNs gained awareness of R & D after the first 7 years of intervention versus 95% of the remaining PCSMs (p = .004). A comparison of the two measurements ascertained stability and improvement of interest in R & D among RNs, compared with all other PCSMs (odds ratio 1.81; confidence interval 1.08-3.06). Moreover, the RNs who did become interested in R & D also demonstrated increased intention to adopt innovative thinking in their work over time (p = .005). RNs play an important role in reducing the gap between theory and practice. Strategic communication was a significant tool for inspiring interest in R & D. Application of this platform to generate interest in R & D is a unique intervention and should be recognized for future interventions in primary care. Positive attitudes toward R & D may reinforce the use of evidence-based practice in health care, thereby making a long-term contribution to the patient benefit. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Do Continental Shelf Strata Contain Evidence of Rapid Late 20th Century Glacial Melting and Increased Runoff in Alaska?

NASA Astrophysics Data System (ADS)

Jaeger, J. M.; Vienne, W.; Channell, J. E.; Stoner, J.; Finney, B.

2006-12-01

Over the past two decades coincident with Arctic climate warming, Alaskan glaciers have accelerated their melt rate. This potentially large release of Alaskan meltwater might be reflected in an increased fluvial discharge of both freshwater and sediment to the ocean. To test this hypothesis, historical (1950-2002) fluvial discharge records from rivers in south-central Alaska were compared to sedimentary proxy records of discharge in the Gulf of Alaska to ascertain if (1) increased glacial wastage has increased fluvial discharge and (2) if any increase in fluvial discharge correlates with a change in the type or magnitude of sediment delivered to the coastal ocean. We propose a set of textural and rock magnetic proxies that allow us to differentiate the relative contributions of fluvial discharge from marine transport processes to the resultant stratal record preserved in shelf strata, which provide a more regional and longer temporal record of sediment discharge. Cores were collected at a series of coast-proximal to coast-distal locations, focusing on the Copper River drainage basin, the largest in the region. Chronologies for the past 400 years were established using 210Pb and 137Cs, coupled with a sedimentary paleomagnetic record that is correlated to the Sitka geomagnetic observatory record for the last century and extended using the Jackson et al. 400-year global field model. All cores show an increased silt-sized sediment flux and magnetic susceptibility over the past 50 years, peaking in the early 1990s. There is no change in sediment mineralogy or U-Th-K ratios over this period, suggesting no change in sediment sources. Proxies sensitive to variability in bottom boundary layer shear stress (e.g., mean sortable silt, disaggregated inorganic grain size (DIGS) distributions) also show no change over this 50-year period. Magnetic grain size (kARM/k) is in the micron-size range, suggesting the primary incorporation of magnetite into the floc fraction. DIGS

Increase in number of helminth species from Dutch red foxes over a 35-year period

PubMed Central

2014-01-01

Background The red fox (Vulpes vulpes) is host to a community of zoonotic and other helminth species. Tracking their community structure and dynamics over decades is one way to monitor the long term risk of parasitic infectious diseases relevant to public and veterinary health. Methods We identified 17 helminth species from 136 foxes by mucosal scraping, centrifugal sedimentation/flotation and the washing and sieving technique. We applied rarefaction analysis to our samples and compared the resulting curve to the helminth community reported in literature 35 years ago. Results Fox helminth species significantly increased in number in the last 35 years (p-value <0.025). Toxascaris leonina, Mesocestoides litteratus, Trichuris vulpis and Angiostrongylus vasorum are four new veterinary-relevant species. The zoonotic fox tapeworm (E. multilocularis) was found outside the previously described endemic regions in the Netherlands. Conclusions Helminth fauna in Dutch red foxes increased in biodiversity over the last three decades. PMID:24708710

Evidence of a Conserved Molecular Response to Selection for Increased Brain Size in Primates

PubMed Central

Harrison, Peter W.; Caravas, Jason A.; Raghanti, Mary Ann; Phillips, Kimberley A.; Mundy, Nicholas I.

2017-01-01

The adaptive significance of human brain evolution has been frequently studied through comparisons with other primates. However, the evolution of increased brain size is not restricted to the human lineage but is a general characteristic of primate evolution. Whether or not these independent episodes of increased brain size share a common genetic basis is unclear. We sequenced and de novo assembled the transcriptome from the neocortical tissue of the most highly encephalized nonhuman primate, the tufted capuchin monkey (Cebus apella). Using this novel data set, we conducted a genome-wide analysis of orthologous brain-expressed protein coding genes to identify evidence of conserved gene–phenotype associations and species-specific adaptations during three independent episodes of brain size increase. We identify a greater number of genes associated with either total brain mass or relative brain size across these six species than show species-specific accelerated rates of evolution in individual large-brained lineages. We test the robustness of these associations in an expanded data set of 13 species, through permutation tests and by analyzing how genome-wide patterns of substitution co-vary with brain size. Many of the genes targeted by selection during brain expansion have glutamatergic functions or roles in cell cycle dynamics. We also identify accelerated evolution in a number of individual capuchin genes whose human orthologs are associated with human neuropsychiatric disorders. These findings demonstrate the value of phenotypically informed genome analyses, and suggest at least some aspects of human brain evolution have occurred through conserved gene–phenotype associations. Understanding these commonalities is essential for distinguishing human-specific selection events from general trends in brain evolution. PMID:28391320

Adversity, cannabis use and psychotic experiences: evidence of cumulative and synergistic effects.

PubMed

Morgan, Craig; Reininghaus, Ulrich; Reichenberg, Abraham; Frissa, Souci; Hotopf, Matthew; Hatch, Stephani L

2014-01-01

There is robust evidence that childhood adversity is associated with an increased risk of psychosis. There is, however, little research on intervening factors that might increase or decrease risk following childhood adversity. To investigate main effects of, and synergy between, childhood abuse and life events and cannabis use on odds of psychotic experiences. Data on psychotic experiences and childhood abuse, life events and cannabis use were collected from 1680 individuals as part of the South East London Community Health Study (SELCoH), a population-based household survey. There was strong evidence that childhood abuse and number of life events combined synergistically to increase odds of psychotic experiences beyond the effects of each individually. There was similar, but weaker, evidence for cannabis use (past year). Our findings are consistent with the hypothesis that childhood abuse creates an enduring vulnerability to psychosis that is realised in the event of exposure to further stressors and risk factors.

Adversity, cannabis use and psychotic experiences: evidence of cumulative and synergistic effects

PubMed Central

Morgan, Craig; Reininghaus, Ulrich; Reichenberg, Abraham; Frissa, Souci; Hotopf, Matthew; Hatch, Stephani L.

2014-01-01

Background There is robust evidence that childhood adversity is associated with an increased risk of psychosis. There is, however, little research on intervening factors that might increase or decrease risk following childhood adversity. Aims To investigate main effects of, and synergy between, childhood abuse and life events and cannabis use on odds of psychotic experiences. Method Data on psychotic experiences and childhood abuse, life events and cannabis use were collected from 1680 individuals as part of the South East London Community Health Study (SELCoH), a population-based household survey. Results There was strong evidence that childhood abuse and number of life events combined synergistically to increase odds of psychotic experiences beyond the effects of each individually. There was similar, but weaker, evidence for cannabis use (past year). Conclusions Our findings are consistent with the hypothesis that childhood abuse creates an enduring vulnerability to psychosis that is realised in the event of exposure to further stressors and risk factors. PMID:24627297

Using policy to increase prescribing of smoking cessation medications in the VA healthcare system.

PubMed

Smith, Mark W; Chen, Shuo; Siroka, Andrew M; Hamlett-Berry, Kim

2010-12-01

Since 2002 the US Veterans Affairs (VA) healthcare system has initiated national policies and programmes to reduce smoking among its patients and to increase evidence-based treatment for smoking. To document changes in dispensing rates of cessation-related medications in VA from 2004 to 2008. Retrospective analysis of VA administrative data. Prescription fills for nicotine replacement therapy (NRT), and for bupropion among NRT users, each grew more than 60% in four years. The increase stemmed primarily from treating more people rather than from filling more prescriptions per person. The results provide strong support for the efficacy of these policies and illustrate how healthcare systems can successfully employ multiple strategies to increase evidence-based smoking-cessation treatment.

Seventy years of continuous encroachment substantially increases 'blue carbon' capacity as mangroves replace intertidal salt marshes.

PubMed

Kelleway, Jeffrey J; Saintilan, Neil; Macreadie, Peter I; Skilbeck, Charles G; Zawadzki, Atun; Ralph, Peter J

2016-03-01

Shifts in ecosystem structure have been observed over recent decades as woody plants encroach upon grasslands and wetlands globally. The migration of mangrove forests into salt marsh ecosystems is one such shift which could have important implications for global 'blue carbon' stocks. To date, attempts to quantify changes in ecosystem function are essentially constrained to climate-mediated pulses (30 years or less) of encroachment occurring at the thermal limits of mangroves. In this study, we track the continuous, lateral encroachment of mangroves into two south-eastern Australian salt marshes over a period of 70 years and quantify corresponding changes in biomass and belowground C stores. Substantial increases in biomass and belowground C stores have resulted as mangroves replaced salt marsh at both marine and estuarine sites. After 30 years, aboveground biomass was significantly higher than salt marsh, with biomass continuing to increase with mangrove age. Biomass increased at the mesohaline river site by 130 ± 18 Mg biomass km(-2)  yr(-1) (mean ± SE), a 2.5 times higher rate than the marine embayment site (52 ± 10 Mg biomass km(-2) yr(-1) ), suggesting local constraints on biomass production. At both sites, and across all vegetation categories, belowground C considerably outweighed aboveground biomass stocks, with belowground C stocks increasing at up to 230 ± 62 Mg C km(-2) yr(-1) (± SE) as mangrove forests developed. Over the past 70 years, we estimate mangrove encroachment may have already enhanced intertidal biomass by up to 283 097 Mg and belowground C stocks by over 500 000 Mg in the state of New South Wales alone. Under changing climatic conditions and rising sea levels, global blue carbon storage may be enhanced as mangrove encroachment becomes more widespread, thereby countering global warming. © 2015 John Wiley & Sons Ltd.

Increasing psychotherapists' adoption and implementation of the evidence-based practice of progress monitoring.

PubMed

Persons, Jacqueline B; Koerner, Kelly; Eidelman, Polina; Thomas, Cannon; Liu, Howard

2016-01-01

Evidence-based practices (EBPs) reach consumers slowly because practitioners are slow to adopt and implement them. We hypothesized that giving psychotherapists a tool + training intervention that was designed to help the therapist integrate the EBP of progress monitoring into his or her usual way of working would be associated with adoption and sustained implementation of the particular progress monitoring tool we trained them to use (the Depression Anxiety Stress Scales on our Online Progress Tracking tool) and would generalize to all types of progress monitoring measures. To test these hypotheses, we developed an online progress monitoring tool and a course that trained psychotherapists to use it, and we assessed progress monitoring behavior in 26 psychotherapists before, during, immediately after, and 12 months after they received the tool and training. Immediately after receiving the tool + training intervention, participants showed statistically significant increases in use of the online tool and of all types of progress monitoring measures. Twelve months later, participants showed sustained use of any type of progress monitoring measure but not the online tool. Copyright © 2015 Elsevier Ltd. All rights reserved.

Age-related cognitive decline in hypercholesterolemic LDL receptor knockout mice (LDLr-/-): evidence of antioxidant imbalance and increased acetylcholinesterase activity in the prefrontal cortex.

PubMed

Moreira, Eduardo Luiz Gasnhar; de Oliveira, Jade; Nunes, Jean Costa; Santos, Danúbia Bonfanti; Nunes, Fernanda Costa; Vieira, Daniella Serafim Couto; Ribeiro-do-Valle, Rosa Maria; Pamplona, Fabrício Alano; de Bem, Andreza Fabro; Farina, Marcelo; Walz, Roger; Prediger, Rui Daniel

2012-01-01

There is increasing evidence that hypercholesterolemia during midlife may represent a predictor of subsequent mild cognitive impairments and dementia decades later. However, the exact mechanism underlying this phenomenon remains unknown since plasmatic cholesterol is not able to cross the blood-brain barrier. In the present study, we evaluated the hypothesis that cognitive impairments triggered by hypercholesterolemia during aging may be related to brain oxidative stress and altered brain acetylcholinesterase (AChE) activity. We also performed a neuropathological investigation in order to analyze whether the cognitive impairments may be associated with stroke-related features. To address these questions we used three- and fourteen-month-old low-density lipoprotein receptor-deficient mice (LDLr-/-). The current findings provide new evidence that aged LDLr-/- mice, exposed to over three-fold cholesterol levels from early life, show working, spatial reference, and procedural memory impairments, without alterations in motor function. Antioxidant imbalance and oxidative damage were evidenced by a marked increase in lipid peroxidation (thiobarbituric acid reactive substances levels) and glutathione metabolism (increase in glutathione levels, glutathione reductase, and glutathione peroxidase activities) together with a significant increase in the AChE activity in the prefrontal cortex of aged hypercholesterolemic LDLr-/- mice. Notably, hypercholesterolemia was not related to brain infarcts and neurodegeneration in mice, independent of their age. These observations provide new evidence that hypercholesterolemia during aging triggers cognitive impairments on different types of learning and memory, accompanied by antioxidant imbalance, oxidative damage, and alterations of cholinergic signaling in brain areas associated with learning and memory processes, particularly in the prefrontal cortex.

Long-term increases in young-of-the-year growth of Arctic cisco Coregonus autumnalis and environmental influences

USGS Publications Warehouse

von Biela, Vanessa R.; Zimmerman, Christian E.; Moulton, L. L.

2011-01-01

Arctic cisco Coregonus autumnalis young-of-year (YOY) growth was used as a proxy to examine the long-term response of a high-latitude fish population to changing climate from 1978 to 2004. YOY growth increased over time (r2 = 0·29) and was correlated with monthly averages of the Arctic oscillation index, air temperature, east wind speed, sea-ice concentration and river discharge with and without time lags. Overall, the most prevalent correlates to YOY growth were sea-ice concentration lagged 1 year (significant correlations in 7 months; r2 = 0·14-0·31) and Mackenzie River discharge lagged 2 years (significant correlations in 8 months; r2 = 0·13-0·50). The results suggest that decreased sea-ice concentrations and increased river discharge fuel primary production and that life cycles of prey species linking increased primary production to fish growth are responsible for the time lag. Oceanographic studies also suggest that sea ice concentration and fluvial inputs from the Mackenzie River are key factors influencing productivity in the Beaufort Sea. Future research should assess the possible mechanism relating sea ice concentration and river discharge to productivity at upper trophic levels.

Implementation of evidence-based treatment for schizophrenic disorders: two-year outcome of an international field trial of optimal treatment

PubMed Central

Falloon, Ian RH; Montero, Isabel; Sungur, Mehmet; Mastroeni, Antonino; Malm, Ulf; Economou, Marina; Grawe, Rolf; Harangozo, Judit; Mizuno, Masafumi; Murakami, Masaaki; Hager, Bert; Held, Tilo; Veltro, Franco; Gedye, Robyn

2004-01-01

According to clinical trials literature, every person with a schizophrenic disorder should be provided with the combination of optimal dose antipsychotics, strategies to educate himself and his carers to cope more efficiently with environmental stresses, cognitive-behavioural strategies to enhance work and social goals and reducing residual symptoms, and assertive home-based management to help prevent and resolve major social needs and crises, including recurrent episodes of symptoms. Despite strong scientific support for the routine implementation of these 'evidence-based' strategies, few services provide more than the pharmacotherapy component, and even this is seldom applied in the manner associated with the best results in the clinical trials. An international collaborative group, the Optimal Treatment Project (OTP), has been developed to promote the routine use of evidence-based strategies for schizophrenic disorders. A field trial was started to evaluate the benefits and costs of applying evidence-based strategies over a 5-year period. Centres have been set up in 18 countries. This paper summarises the outcome after 24 months of 'optimal' treatment in 603 cases who had reached this stage in their treatment by the end of 2002. On all measures the evidence-based OTP approach achieved more than double the benefits associated with current best practices. One half of recent cases had achieved full recovery from clinical and social morbidity. These advantages were even more striking in centres where a random-control design was used. PMID:16633471

Implementation of evidence-based treatment for schizophrenic disorders: two-year outcome of an international field trial of optimal treatment.

PubMed

Falloon, Ian R H; Montero, Isabel; Sungur, Mehmet; Mastroeni, Antonino; Malm, Ulf; Economou, Marina; Grawe, Rolf; Harangozo, Judit; Mizuno, Masafumi; Murakami, Masaaki; Hager, Bert; Held, Tilo; Veltro, Franco; Gedye, Robyn

2004-06-01

According to clinical trials literature, every person with a schizophrenic disorder should be provided with the combination of optimal dose antipsychotics, strategies to educate himself and his carers to cope more efficiently with environmental stresses, cognitive-behavioural strategies to enhance work and social goals and reducing residual symptoms, and assertive home-based management to help prevent and resolve major social needs and crises, including recurrent episodes of symptoms. Despite strong scientific support for the routine implementation of these 'evidence-based' strategies, few services provide more than the pharmacotherapy component, and even this is seldom applied in the manner associated with the best results in the clinical trials. An international collaborative group, the Optimal Treatment Project (OTP), has been developed to promote the routine use of evidence-based strategies for schizophrenic disorders. A field trial was started to evaluate the benefits and costs of applying evidence-based strategies over a 5-year period. Centres have been set up in 18 countries. This paper summarises the outcome after 24 months of 'optimal' treatment in 603 cases who had reached this stage in their treatment by the end of 2002. On all measures the evidence-based OTP approach achieved more than double the benefits associated with current best practices. One half of recent cases had achieved full recovery from clinical and social morbidity. These advantages were even more striking in centres where a random-control design was used.

Dopamine effects on evidence gathering and integration

PubMed Central

Andreou, Christina; Schneider, Brooke C.; Braun, Vivien; Kolbeck, Katharina; Gallinat, Jürgen; Moritz, Steffen

2015-01-01

Background Disturbances in evidence gathering and disconfirmatory evidence integration have been associated with the presence of or propensity for delusions. Previous evidence suggests that these 2 types of reasoning bias might be differentially affected by antipsychotic medication. We aimed to investigate the effects of a dopaminergic agonist (L-dopa) and a dopaminergic antagonist (haloperidol) on evidence gathering and disconfirmatory evidence integration after single-dose administration in healthy individuals. Methods The study used a randomized, double-blind, placebo-controlled, 3-way crossover design. Participants were healthy individuals aged 18–40 years. We administered a new data-gathering task designed to increase sensitivity to change compared with traditional tasks. The Bias Against Disconfirmatory Evidence (BADE) task was used as a measure of disconfirmatory evidence integration. Results We included 30 individuals in our study. In the data-gathering task, dopaminergic modulation had no significant effect on the amount of evidence gathered before reaching a decision. In contrast, the ability of participants to integrate disconfirmatory evidence showed a significant linear dopaminergic modulation pattern (highest with haloperidol, intermediate with placebo, lowest with L-dopa), with the difference between haloperidol and L-dopa marginally reaching significance. Limitations Although the doses used for haloperidol and L-dopa were similar to those used in previous studies, drug plasma level measurements would have added to the validity of findings. Conclusion Evidence gathering and disconfirmatory evidence integration might be differentially influenced by dopaminergic agents. Our findings are in support of a dual-disturbance account of delusions and provide a plausible neurobiological basis for the use of interventions targeted at improving reasoning biases as an adjunctive treatment in patients with psychotic disorders. PMID:26197302

Paleoparasitological evidence of pinworm (Enterobius vermicularis) infection in a female adolescent residing in ancient Tehran (Iran) 7000 years ago.

PubMed

Paknazhad, Niloofar; Mowlavi, Gholamreza; Dupouy Camet, Jean; Jelodar, Mohammad Esmaeili; Mobedi, Iraj; Makki, Mahsasadat; Kia, Eshrat Beigom; Rezaeian, Mostafa; Mohebali, Mehdi; Sarlak, Siamak; Najafi, Faezeh

2016-01-22

The Molavi street archeological site south of Tehran accidentally provided a unique opportunity for paleoparasitological studies in Iran. A female skeleton was unearthed and evaluated to be 7000 years old. Soil samples were collected around the pelvic and sacrum bones. Careful microscopic investigation of rehydrated soil samples revealed the presence of one Enterobius vermicularis egg attached to the skeleton sacral region. The present finding likely represents the oldest evidence of a human pinworm infection in Asia.

Reconstructing patterns of temperature, phenology, and frost damage over 124 years: spring damage risk is increasing.

PubMed

Augspurger, Carol K

2013-01-01

Climate change, with both warmer spring temperatures and greater temperature fluctuations, has altered phenologies, possibly leading to greater risk of spring frost damage to temperate deciduous woody plants. Phenological observations of 20 woody species from 1993 to 2012 in Trelease Woods, Champaign County, Illinois, USA, were used to identify years with frost damage to vegetative and reproductive phases. Local temperature records were used in combination with the phenological observations to determine what combinations of the two were associated with damage. Finally, a long-term temperature record (1889-1992) was evaluated to determine if the frequency of frost damage has risen in recent decades. Frost < or = -1.7 degrees C occurred after bud-break in 14 of the 20 years of observation. Frost damage occurred in five years in the interior and in three additional years at only the forest edge. The degree of damage varied with species, life stage, tissue (vegetative or reproductive), and phenological phase. Common features associated with the occurrence of damage to interior plants were (1) a period of unusual warm temperatures in March, followed by (2) a frost event in April with a minimum temperature < or = -6.1 degrees C with (3) a period of 16-33 days between the extremes. In the long-term record, 10 of 124 years met these conditions, but the yearly probability of frost damage increased significantly, from 0.03 during 1889-1979 to 0.21 during 1980-2012. When the criteria were "softened" to < or = -1.7 degrees C in April and an interval of 16-37 days, 31 of 124 years met the conditions, and the yearly damage probability increased significantly to 0.19 for 1889-1979 and 0.42 for 1980-2012. In this forest, the combination of warming trends and temperature variability (extremes) associated with climate change is having ecologically important effects, making previously rare frost damage events more common.

76 FR 61074 - USDA Increases the Fiscal Year 2011 Tariff-Rate Quota for Refined Sugar

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

... Quota for Refined Sugar AGENCY: Office of the Secretary, USDA. ACTION: Notice. SUMMARY: The Secretary of Agriculture today announced an increase in the fiscal year (FY) 2011 refined sugar tariff-rate quota (TRQ) of... INFORMATION: A quantity of 22,000 MTRV for sugars, syrups, and molasses (collectively referred to as refined...

Role of Ideas and Ideologies in Evidence-Based Health Policy

PubMed Central

Prinja, S

2010-01-01

Policy making in health is largely thought to be driven by three ‘I’s namely ideas, interests and institutions. Recent years have seen a shift in approach with increasing reliance being placed on role of evidence for policy making. The present article ascertains the role of ideas and ideologies in shaping evidence which is used to aid in policy decisions. The article discusses different theories of research-policy interface and the relative freedom of research-based evidence from the influence of ideas. Examples from developed and developed countries are cited to illustrate the contentions made. The article highlights the complexity of the process of evidence-based policy making, in a world driven by existing political, social and cultural ideologies. Consideration of this knowledge is paramount where more efforts are being made to bridge the gap between the ‘two worlds’ of researchers and policy makers to make evidence-based policy as also for policy analysts. PMID:23112991

Role of ideas and ideologies in evidence-based health policy.

PubMed

Prinja, S

2010-01-01

Policy making in health is largely thought to be driven by three 'I's namely ideas, interests and institutions. Recent years have seen a shift in approach with increasing reliance being placed on role of evidence for policy making. The present article ascertains the role of ideas and ideologies in shaping evidence which is used to aid in policy decisions. The article discusses different theories of research-policy interface and the relative freedom of research-based evidence from the influence of ideas. Examples from developed and developed countries are cited to illustrate the contentions made. The article highlights the complexity of the process of evidence-based policy making, in a world driven by existing political, social and cultural ideologies. Consideration of this knowledge is paramount where more efforts are being made to bridge the gap between the 'two worlds' of researchers and policy makers to make evidence-based policy as also for policy analysts.

Evidence-informed policymaking in practice: country-level examples of use of evidence for iCCM policy

PubMed Central

Rodríguez, Daniela C; Shearer, Jessica; Mariano, Alda RE; Juma, Pamela A; Dalglish, Sarah L; Bennett, Sara

2015-01-01

Integrated Community Case Management of Childhood Illness (iCCM) is a policy for providing treatment for malaria, diarrhoea and pneumonia for children below 5 years at the community level, which is generating increasing evidence and support at the global level. As countries move to adopt iCCM, it becomes important to understand how this growing evidence base is viewed and used by national stakeholders. This article explores whether, how and why evidence influenced policy formulation for iCCM in Niger, Kenya and Mozambique, and uses Carol Weiss’ models of research utilization to further explain the use of evidence in these contexts. A documentary review and in-depth stakeholder interviews were conducted as part of retrospective case studies in each study country. Findings indicate that all three countries used national monitoring data to identify the issue of children dying in the community prior to reaching health facilities, whereas international research evidence was used to identify policy options. Nevertheless, policymakers greatly valued local evidence and pilot projects proved critical in advancing iCCM. World Health Organization and United Nations Children's Fund (UNICEF) functioned as knowledge brokers, bringing research evidence and experiences from other countries to the attention of local policymakers as well as sponsoring site visits and meetings. In terms of country-specific findings, Niger demonstrated both Interactive and Political models of research utilization by using iCCM to capitalize on the existing health infrastructure. Both Mozambique and Kenya exhibit Problem-Solving research utilization with different outcomes. Furthermore, the persistent quest for additional evidence suggests a Tactical use of research in Kenya. Results presented here indicate that while evidence from research studies and other contexts can be critical to policy development, local evidence is often needed to answer key policymaker questions. In the end, evidence may not

Building Synergy for High-Impact Educational Initiatives: First-Year Seminars and Learning Communities

ERIC Educational Resources Information Center

Schmidt, Lauren Chism, Ed.; Graziano, Janine, Ed.

2016-01-01

Over the years, a number of interventions aimed at increasing student engagement and performance have been implemented in higher education. Some of these, labeled high-impact practices (HIPs), when done well, have led to documented evidence of student success. Two approaches that have been identified as HIPs--first-year seminars and learning…

Increasing bicycle helmet use in the community. Measuring response to a wide-scale, 2-year effort.

PubMed Central

Morris, B. A.; Trimble, N. E.; Fendley, S. J.

1994-01-01

OBJECTIVE: To determine whether a wide-scale, long-term community promotional effort would increase the use of bicycle helmets among children. DESIGN: Over 2 years, a non-profit group coordinated a range of activities to promote helmet use. On one date before the intervention began and three dates during the intervention, observers surveyed students riding bicycles. SETTING: Cyclists were observed at 5 elementary schools, three secondary schools, and two community college entrances. PARTICIPANTS: A total of 851 cyclists were observed, 536 of them at elementary schools in a convenience sample. INTERVENTIONS: Print, radio, and television advertising; posters; pamphlets; bicycle rodeos; and a play were used in a public awareness campaign. Health promotion activities included education, social marketing, community development, and legislative action. MAIN OUTCOME MEASURES: Number of cyclists and whether they wore helmets. RESULTS: Combining the two observation dates for each year, helmet use increased from 5.4% in 1990 to 15.4% in 1991. The greatest increase was observed among elementary school students, the group most at risk of serious head injury or death. Overall, girls were twice as likely to wear helmets as boys. CONCLUSIONS: Wide-scale, long-term community promotion appears to be effective in increasing the use of bicycle helmets. PMID:8019189

Between-year variation in population sex ratio increases with complexity of the breeding system in Hymenoptera.

PubMed

Kümmerli, Rolf; Keller, Laurent

2011-06-01

While adaptive adjustment of sex ratio in the function of colony kin structure and food availability commonly occurs in social Hymenoptera, long-term studies have revealed substantial unexplained between-year variation in sex ratio at the population level. In order to identify factors that contribute to increased between-year variation in population sex ratio, we conducted a comparative analysis across 47 Hymenoptera species differing in their breeding system. We found that between-year variation in population sex ratio steadily increased as one moved from solitary species, to primitively eusocial species, to single-queen eusocial species, to multiple-queen eusocial species. Specifically, between-year variation in population sex ratio was low (6.6% of total possible variation) in solitary species, which is consistent with the view that in solitary species, sex ratio can vary only in response to fluctuations in ecological factors such as food availability. In contrast, we found significantly higher (19.5%) between-year variation in population sex ratio in multiple-queen eusocial species, which supports the view that in these species, sex ratio can also fluctuate in response to temporal changes in social factors such as queen number and queen-worker control over sex ratio, as well as factors influencing caste determination. The simultaneous adjustment of sex ratio in response to temporal fluctuations in ecological and social factors seems to preclude the existence of a single sex ratio optimum. The absence of such an optimum may reflect an additional cost associated with the evolution of complex breeding systems in Hymenoptera societies.

THE RESPONSE OF DRUG EXPENDITURE TO NON-LINEAR CONTRACT DESIGN: EVIDENCE FROM MEDICARE PART D*

PubMed Central

Einav, Liran; Finkelstein, Amy; Schrimpf, Paul

2016-01-01

We study the demand response to non-linear price schedules using data on insurance contracts and prescription drug purchases in Medicare Part D. We exploit the kink in individuals’ budget set created by the famous “donut hole,” where insurance becomes discontinuously much less generous on the margin, to provide descriptive evidence of the drug purchase response to a price increase. We then specify and estimate a simple dynamic model of drug use that allows us to quantify the spending response along the entire non-linear budget set. We use the model for counterfactual analysis of the increase in spending from “filling” the donut hole, as will be required by 2020 under the Affordable Care Act. In our baseline model, which considers spending decisions within a single year, we estimate that “filling” the donut hole will increase annual drug spending by about $150, or about 8 percent. About one-quarter of this spending increase reflects “anticipatory” behavior, coming from beneficiaries whose spending prior to the policy change would leave them short of reaching the donut hole. We also present descriptive evidence of cross-year substitution of spending by individuals who reach the kink, which motivates a simple extension to our baseline model that allows – in a highly stylized way – for individuals to engage in such cross year substitution. Our estimates from this extension suggest that a large share of the $150 drug spending increase could be attributed to cross-year substitution, and the net increase could be as little as $45 per year. PMID:26769984

Factors associated with opioid dose increases: a chart review of patients’ first year on long-term opioids

PubMed Central

Bautista, Christopher A.; Iosif, Ana-Maria; Wilsey, Barth L.; Melnikow, Joy A.; Crichlow, Althea; Henry, Stephen G.

2016-01-01

OBJECTIVE To examine encounter-level factors associated with opioid dose increases during patients’ first year on opioid therapy for chronic pain. DESIGN Case-control study analyzing all opioid prescriptions for patients with chronic pain during their first year after opioid initiation. Cases were patients who experienced an overall dose escalation of ≥30 mg morphine equivalents over the 1-year period; controls did not experience overall dose escalation. Main measures were encounter type; opioid dose change; documented prescribing rationale; documentation of guideline-concordant opioid prescribing practices. Two coders reviewed all encounters associated with opioid prescriptions. Analysis of factors associated with dose increases and provider documentation of prescribing rationale was conducted using multiple logistic regression. RESULTS 674 encounters were coded for 66 patients (22 cases, 44 controls). Fifty-three percent of opioid prescriptions were associated with telephone encounters; 13% were associated with email encounters. No prescribing rationale was documented for 43% of all opioid prescriptions and 25% of dose increases. Likelihood of dose increase and documentation of prescribing rationale did not significantly differ for cases versus controls. Compared to face-to-face encounters, dose increases were significantly less likely for telephone (OR 0.18, 95%CI 0.11 – 0.28) and email (OR 0.23, 95%CI 0.12 – 0.47) encounters; documentation of prescribing rationale was significantly more likely for email (OR 5.06, 95%CI 1.87–13.72) and less likely for telephone (OR 0.30, 95%CI 0.18–0.51) encounters. CONCLUSION Most opioid prescriptions were written without face-to-face encounters. One quarter of dose increases contained no documented prescribing rationale. Documented encounter-level factors were not significantly associated with overall opioid dose escalation. PMID:27477581

Extended Year, Extended Contracts: Increasing Teacher Salary Options.

ERIC Educational Resources Information Center

Gandara, Patricia

1992-01-01

Reports on an attempt to raise teacher salaries through an extended contract made possible through year-round school schedules. Teacher satisfaction with the 1987 experiment in three California schools (the Orchard Plan) has been high. Elements that have contributed to job satisfaction are discussed. (SLD)

Evidence for a twelfth large earthquake on the southern hayward fault in the past 1900 years

USGS Publications Warehouse

Lienkaemper, J.J.; Williams, P.L.; Guilderson, T.P.

2010-01-01

We present age and stratigraphic evidence for an additional paleoearthquake at the Tyson Lagoon site. The acquisition of 19 additional radiocarbon dates and the inclusion of this additional event has resolved a large age discrepancy in our earlier earthquake chronology. The age of event E10 was previously poorly constrained, thus increasing the uncertainty in the mean recurrence interval (RI), a critical factor in seismic hazard evaluation. Reinspection of many trench logs revealed substantial evidence suggesting that an additional earthquake occurred between E10 and E9 within unit u45. Strata in older u45 are faulted in the main fault zone and overlain by scarp colluviums in two locations.We conclude that an additional surfacerupturing event (E9.5) occurred between E9 and E10. Since 91 A.D. (??40 yr, 1??), 11 paleoearthquakes preceded the M 6:8 earthquake in 1868, yielding a mean RI of 161 ?? 65 yr (1??, standard deviation of recurrence intervals). However, the standard error of the mean (SEM) is well determined at ??10 yr. Since ~1300 A.D., the mean rate has increased slightly, but is indistinguishable from the overall rate within the uncertainties. Recurrence for the 12-event sequence seems fairly regular: the coefficient of variation is 0.40, and it yields a 30-yr earthquake probability of 29%. The apparent regularity in timing implied by this earthquake chronology lends support for the use of time-dependent renewal models rather than assuming a random process to forecast earthquakes, at least for the southern Hayward fault.

Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE).

PubMed

Lannerö, Eva; Wickman, Magnus; Pershagen, Goran; Nordvall, Lennart

2006-01-05

Exposure to cigarette smoking during foetal and early postnatal life may have implications for lung health. The aim of this study was to assess the possible effects of such exposure in utero on lower respiratory disease in children up to two years of age. A birth cohort of 4089 newborn infants was followed for two years using parental questionnaires. When the infant was two months old the parents completed a questionnaire on various lifestyle factors, including maternal smoking during pregnancy and after birth. At one and two years of age information was obtained by questionnaire on symptoms of allergic and respiratory diseases as well as on environmental exposures, particularly exposure to environmental tobacco smoke (ETS). Adjustments were made for potential confounders. When the mother had smoked during pregnancy but not after that, there was an increased risk of recurrent wheezing up to two years' age, ORadj = 2.2, (95% CI 1.3-3.6). The corresponding OR was 1.6, (95% CI 1.2-2.3) for reported exposure to ETS with or without maternal smoking in utero. Maternal smoking during pregnancy but no exposure to ETS also increased the risk of doctor's diagnosed asthma up to two years of age, ORadj = 2.1, (95% CI 1.2-3.7). Exposure to maternal cigarette smoking in utero is a risk factor for recurrent wheezing, as well as doctor's diagnosed asthma in children up to two years of age.

Scabies increased the risk of chronic kidney disease: a 5-year follow-up study.

PubMed

Chung, S-D; Wang, K-H; Huang, C-C; Lin, H-C

2014-03-01

The most documented complication of scabies has been reported to be infection by group A streptococci, which has in turn been suggested to contribute to the development of glomerulonephritis. This study aimed to investigate the risk of chronic kidney disease (CKD) subsequent to scabies utilizing a population-based dataset in Taiwan. This retrospective matched-cohort study included 5071 subjects with scabies and 25 355 randomly selected comparison subjects. We individually tracked each subject for a 5-year period to identify those who subsequently received a diagnosis of CKD during the follow-up period. Stratified Cox proportional hazards regressions were performed to compute the hazard ratio (HR) of CKD during the 5-year follow-up period. The incidence rate of CKD during the 5-year follow-up period was 9.66 (8.51-10.93) per 1,000 person-years and 6.24 (5.82-6.69) per 1000 person-years for subjects with and without scabies respectively. The HR for CKD during the 5-year follow-up period for subjects with scabies was 1.34 (95% CI = 1.15-1.56) that of comparison subjects after adjusting for monthly income, hypertension, diabetes, obesity, stroke, coronary heart disease, chronic obstructive pulmonary disease, tobacco use disorder, hyperlipidemia and alcohol abuse during the 5-year follow-up period. Male subjects with scabies were 1.40 (95% CI = 1.14-1.71) times more likely than comparison subjects to suffer from subsequent CKD, and female study subjects were 1.27 (95% CI = 1.05-1.61) times more likely. We concluded that there was an increased risk for CKD among patients suffering from scabies. © 2013 The Authors Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology.

NICU nurse educators: what evidence supports your teaching strategies?

PubMed

Pilcher, Jobeth

2013-01-01

One of our roles as nurse educators is to teach best practices related to patient care. However, have you ever stopped to think about what evidence supports your teaching strategies? Just as our patients deserve care that is based on the best available evidence, our learners also deserve education that is based on evidence.1-3 With so many advances in knowledge, technology, and even life itself, it is interesting that education has changed very little over the past 100 years. A study among 946 nurse educators documented that most teach the way they were taught.4 In addition, even after learning new strategies, educators often continue teaching in the manner they are most comfortable. However, this trend is beginning to change. Nurse educators are becoming increasingly aware of and willing to try new and innovative teaching strategies. Educators are also seeking out evidence-based teaching strategies and are becoming more involved in nursing education research.

Health benefits of tai chi: What is the evidence?

PubMed

Huston, Patricia; McFarlane, Bruce

2016-11-01

To summarize the evidence on the health benefits of tai chi. A literature review was conducted on the benefits of tai chi for 25 specific conditions, as well as for general health and fitness, to update a 2014 review of systematic reviews. Systematic reviews and recent clinical trials were assessed and organized into 5 different groups: evidence of benefit as excellent, good, fair, or preliminary, or evidence of no direct benefit. During the past 45 years more than 500 trials and 120 systematic reviews have been published on the health benefits of tai chi. Systematic reviews of tai chi for specific conditions indicate excellent evidence of benefit for preventing falls, osteoarthritis, Parkinson disease, rehabilitation for chronic obstructive pulmonary disease, and improving cognitive capacity in older adults. There is good evidence of benefit for depression, cardiac and stroke rehabilitation, and dementia. There is fair evidence of benefit for improving quality of life for cancer patients, fibromyalgia, hypertension, and osteoporosis. Current evidence indicates no direct benefit for diabetes, rheumatoid arthritis, or chronic heart failure. Systematic reviews of general health and fitness benefits show excellent evidence of benefit for improving balance and aerobic capacity in those with poor fitness. There is good evidence for increased strength in the lower limbs. There is fair evidence for increased well-being and improved sleep. There were no studies that found tai chi worsened a condition. A recent systematic review on the safety of tai chi found adverse events were typically minor and primarily musculoskeletal; no intervention-related serious adverse events have been reported. There is abundant evidence on the health and fitness effects of tai chi. Based on this, physicians can now offer evidence-based recommendations to their patients, noting that tai chi is still an area of active research, and patients should continue to receive medical follow-up for any

Colorectal Specialization Increases Lymph Node Yield: Evidence from a National Database.

PubMed

Jeganathan, Arjun N; Shanmugan, Skandan; Bleier, Joshua I S; Hall, Glenn M; Paulson, Emily C

2016-07-01

Current guidelines recommend the evaluation of at least 12 lymph nodes (LNs) in the pathologic specimen following surgery for colorectal cancer (CRC). We sought to examine the role of colorectal specialization on nodal identification. We conducted a retrospective cohort study using SEER-Medicare data to examine the association between colorectal specialization and LN identification following surgery for colon and rectal adenocarcinoma between 2001 and 2009. Our dataset included patients >65 years who underwent surgical resection for CRC. We excluded patients with rectal cancer who had received neoadjuvant therapy. The primary outcome measure was the number of LNs identified in the pathologic specimen following surgery for CRC. Multivariate analysis was used to identify the association between surgical specialization and LN identification in the pathologic specimen. In multivariate analysis, odds of an adequate lymphadenectomy following surgery with a colorectal specialist were 1.32 and 1.41 times greater for colon and rectal cancer, respectively, than following surgery by a general surgeon (p < 0.001). These odds increased to 1.36 and 1.58, respectively, when analysis was limited to board-certified colorectal surgeons. Hospital factors associated with ≥12 LNs identified included high-volume CRC surgery (colon OR 1.84, p < 0.001; rectal OR 1.78, p < 0.001) and NCI-designated Cancer Centers (colon OR 1.75, p < 0.001; rectal OR 1.64; p = 0.007). Colorectal specialization and, in particular, board-certification in colorectal surgery, is significantly associated with increased LN identification following surgery for colon and rectal adenocarcinoma since the adoption of the 12-LN guideline in 2001.

Observational evidence and strength of evidence domains: case examples

PubMed Central

2014-01-01

Background Systematic reviews of healthcare interventions most often focus on randomized controlled trials (RCTs). However, certain circumstances warrant consideration of observational evidence, and such studies are increasingly being included as evidence in systematic reviews. Methods To illustrate the use of observational evidence, we present case examples of systematic reviews in which observational evidence was considered as well as case examples of individual observational studies, and how they demonstrate various strength of evidence domains in accordance with current Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) methods guidance. Results In the presented examples, observational evidence is used when RCTs are infeasible or raise ethical concerns, lack generalizability, or provide insufficient data. Individual study case examples highlight how observational evidence may fulfill required strength of evidence domains, such as study limitations (reduced risk of selection, detection, performance, and attrition); directness; consistency; precision; and reporting bias (publication, selective outcome reporting, and selective analysis reporting), as well as additional domains of dose-response association, plausible confounding that would decrease the observed effect, and strength of association (magnitude of effect). Conclusions The cases highlighted in this paper demonstrate how observational studies may provide moderate to (rarely) high strength evidence in systematic reviews. PMID:24758494

[Bibliometric analysis of scientific articles on evidence-based nursing of burn in the mainland of China].

PubMed

Yue, L Q; Pi, X Q; Fan, X G

2016-07-20

To analyze the current research status of evidence-based nursing of burn in the mainland of China, in order to provide basis for the improvement of scientificity of burn nursing practice. Chinese scientific articles on evidence-based nursing of burn in the mainland of China published from January 1997 to December 2015 were retrieved from Chinese Biology Medicine disc, Chinese Journals Full-text Database, Wanfang Database, and VIP Database. From the results retrieved, date with regard to publication year, region of affiliation of the first author, journal distribution, literature type, literature quality assessment, topic of evidence-based research, fund program support, implementation of evidence-based practice steps, and language and quantity of reference. Data were processed with Microsoft Excel software. A total of 50 articles conforming to the criteria were retrieved. (1) Articles about evidence-based nursing of burn arose in 2004. Compared with that in the previous year, there was no obvious increase in the number of relevant articles in each year from 2004 to 2011. The number of literature in 2012 was obviously increased than that in each year from 2004 to 2011, while the number of literature in each year from 2012 to 2015 was not obviously increased compared with that in the previous year. (2) The regions of affiliation of the first author were distributed in 13 provinces, 3 minority autonomous regions, and 3 municipalities, with the largest distribution in East China, and Northwest China and Southwest China in the follow. (3) The articles were published in 32 domestic journals, with 9 (28.12%) nursing journals, 5 (15.62%) burn medical related journals, and 18 (56.25%) other journals. Twenty (40%) articles were published in Source Journal for Chinese Scientific and Technical Papers. (4) Regarding the literature type, 31 (62%) articles dealt with clinical experiences, 17 (34%) articles dealt with scientific research, and 2 (4%) articles dealt with case report

Interventions for increasing fruit and vegetable consumption in children aged 5 years and under

PubMed Central

Wolfenden, Luke; Wyse, Rebecca J; Britton, Ben I; Campbell, Karen J; Hodder, Rebecca K; Stacey, Fiona G; McElduff, Patrick; James, Erica L

2014-01-01

Background Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases including cardiovascular disease. Objectives To assess the effectiveness, cost-effectiveness and associated adverse events of interventions designed to increase the consumption of fruit and/or vegetables amongst children aged five years and under. Search methods The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library Issue 2, 2010, MEDLINE (1950 to 2010 April week 4), EMBASE (1947 to 2010 week 18), CINAHL (up to 12 May 2010), PsycINFO (up to 12 May 2010) and Proquest Dissertations and Theses (up to February 2011) were searched to identify eligible trials, as well as electronic trial registers (also up to February 2011). The reference lists of included trials were reviewed and handsearches of three international nutrition journals were also performed. Authors of all included trials were contacted in order to identify further potentially relevant trials. Selection criteria We included randomised controlled trials (RCTs), including cluster-randomised controlled trials, of any intervention primarily targeting fruit and/or vegetable consumption among children aged five years and under and incorporating a biochemical or dietary assessment of fruit and/or vegetable consumption. Two review authors independently screened the titles and abstracts of identified papers. A third review author with expertise in review methodology resolved any disagreements regarding study eligibility. Data collection and analysis Two review authors independently extracted data and assessed the risk of bias of the included studies. A third reviewer resolved disagreements between review authors. Fixed-effect models were used to perform meta-analysis for the primary review outcomes where a sufficient number of trials with suitable data and homogeneity were identified. Main results Five trials, with 13 trial arms and 3967 participants were included in

1.4 times increase in atrial fibrillation-related ischemic stroke and TIA over 12years in a stroke center.

PubMed

Yang, Qiong; Churilov, Leonid; Fan, Dongsheng; Davis, Stephen; Yan, Bernard

2017-08-15

Prevalence of atrial fibrillation (AF) has quadrupled in the past 50years in the general population. However, there is uncertainty regarding prevalence of AF over time in ischemic stroke patients given the aging population and enhanced surveillance of AF. We aimed to explore the changing prevalence of AF as well as other risk factors, stroke subtypes, investigations and pre-stroke medications among ischemic stroke and transient ischemic attack (TIA) patients. We performed a retrospective analysis of data from a prospective database of consecutive patients with acute ischemic stroke and TIA from 2004 to 2015. Trends in risk factors and other variables year by year were analyzed using logistic regression or median regression. Among 6275 patients (median age [interquartile range] 74 [62-82] years, 56% males), the prevalence of AF increased 1.4 times over 12years (from 23.3% to 32.7%, P<0.001). The increase in the prevalence of AF remained significant after adjustment for age and the use of Holter monitoring. There was also a significant increase in prevalence of hypertension (67.4% to 77.3%), structural heart disease (9.8% to 10.5%), and previous TIA (10.9% to 13.7%) and a significant decrease in prevalence of dyslipidemia (71.8% to 49.4%). There was a 1.4 times increase in the prevalence of AF among consecutive ischemic stroke and TIA patients in the past 12years in a hospital-based registry. More active screening of the general population for AF may be warranted in order to decrease the overall stroke burden. Copyright © 2017 Elsevier B.V. All rights reserved.

Long-term increases in young-of-the-year growth of Arctic cisco Coregonus autumnalis and environmental influences

USGS Publications Warehouse

Von Biela, V.R.; Zimmerman, C.E.; Moulton, L.L.

2011-01-01

Arctic cisco Coregonus autumnalis young-of-year (YOY) growth was used as a proxy to examine the long-term response of a high-latitude fish population to changing climate from 1978 to 2004. YOY growth increased over time (r2 = 0??29) and was correlated with monthly averages of the Arctic oscillation index, air temperature, east wind speed, sea-ice concentration and river discharge with and without time lags. Overall, the most prevalent correlates to YOY growth were sea-ice concentration lagged 1 year (significant correlations in 7 months; r2 = 0??14-0??31) and Mackenzie River discharge lagged 2 years (significant correlations in 8 months; r2 = 0??13-0??50). The results suggest that decreased sea-ice concentrations and increased river discharge fuel primary production and that life cycles of prey species linking increased primary production to fish growth are responsible for the time lag. Oceanographic studies also suggest that sea ice concentration and fluvial inputs from the Mackenzie River are key factors influencing productivity in the Beaufort Sea. Future research should assess the possible mechanism relating sea ice concentration and river discharge to productivity at upper trophic levels. Journal of Fish Biology ?? 2010 The Fisheries Society of the British Isles. No claim to original US government works.

Geochemical evidence for a comet shower in the late Eocene

USGS Publications Warehouse

Farley, K.A.; Montanari, A.; Shoemaker, E.M.; Shoemaker, C.S.

1998-01-01

Analyses of pelagic limestones indicate that the flux of extraterrestrial helium-3 to Earth was increased for a 2.5-million year (My) period in the late Eocene. The enhancement began ~1 My before and ended ~1.5 My after the major impact events that produced the large Popigai and Chesapeake Bay craters ~36 million years ago. The correlation between increased concentrations of helium-3, a tracer of fine-grained interplanetary dust, and large impacts indicates that the abundance of Earth-crossing objects and dustiness in the inner solar system were simultaneously but only briefly enhanced. These observations provide evidence for a comet shower triggered by an impulsive perturbation of the Oort cloud.

Knowledge Creation as an Approach to Facilitating Evidence Informed Practice: Examining Ways to Measure the Success of Using This Method with Early Years Practitioners in Camden (London)

ERIC Educational Resources Information Center

Brown, Chris; Rogers, Sue

2015-01-01

This paper has three key aims. First it examines the authors' attempts to use knowledge creation activity as a way of developing evidence informed practice amongst a learning community of 36 early years practitioners in the London Borough of Camden. Second, it seeks to illustrate how the authors approached the idea of measuring evidence use and…

Fatigue and Sleep Among Employees With Prospective Increase in Work Time Control: A 1-Year Observational Study With Objective Assessment.

PubMed

Kubo, Tomohide; Takahashi, Masaya; Liu, Xinxin; Ikeda, Hiroki; Togo, Fumiharu; Shimazu, Akihito; Tanaka, Katsutoshi; Kamata, Naoki; Kubo, Yoshiko; Uesugi, Junko

2016-11-01

This observational study aimed to determine how 1-year changes in work time control (WTC) have an impact upon objectively measured fatigue and sleep among employees. Thirty-nine employees were divided into two groups according to whether or not their WTC increased from baseline to 1 year later. Psychomotor vigilance task (PVT) and wrist actigraphy were used to objectively measure fatigue and sleep, respectively. Self-reported outcomes were also measured. The increased WTC group showed gradual improvements in PVT performance and sleep quality over the course of the follow-up period compared with the not-increased WTC group. Between-group differences were statistically significant for PVT lapses and tended to be significant for PVT speed after 1 year. A progressive increase in WTC could play a crucial role in reducing fatigue and promoting sleep among employees.

Increases in the prevalence of reduced visual acuity and myopia in Chinese children in Guangzhou over the past 20 years.

PubMed

Xiang, F; He, M; Zeng, Y; Mai, J; Rose, K A; Morgan, I G

2013-12-01

To estimate the prevalence of myopia based on reduced unaided visual acuity (VA) in Chinese school children over the past 20 years. Guangzhou school health authorities have measured VA on Grade 1-12 students from 1988 to 2007 annually, using a LogMAR tumbling E chart. VA is reported as Snellen categories: normal (VA ≥ 6/6), mildly reduced (6/9 < VA <6/6), moderately reduced (6/18 < VA ≤ 6/9), and severely reduced VA (VA ≤ 6/18). In 1988, over 80% of children in Grade 1 (age 6 years) and about 30% in Grade 12 (age 17 years) had normal unaided VA. By 2007, this dropped to only 60% in Grade 1 and about 10% in Grade 12. Conversely, the prevalence of moderately and severely reduced unaided VA increased from 6.2% in Grade 1 and 62.5% in Grade 12 in 1988 to 14.5% in Grade 1 and 84.11% in Grade 12 in 2007. This rate was unchanged from 2003 to 2007 at both the Grade 1 and Grade 12 levels. In Guangzhou, the prevalence of reduced unaided VA has increased markedly in the past 20 years, but has stabilized in the past few years. This increase may result from environmental changes, such as increased schooling intensity and urbanization.

Deep-Sea coral evidence for rapid change in ventilation of the deep north atlantic 15,400 years Ago

PubMed

Adkins; Cheng; Boyle; Druffel; Edwards

1998-05-01

Coupled radiocarbon and thorium-230 dates from benthic coral species reveal that the ventilation rate of the North Atlantic upper deep water varied greatly during the last deglaciation. Radiocarbon ages in several corals of the same age, 15.41 +/- 0.17 thousand years, and nearly the same depth, 1800 meters, in the western North Atlantic Ocean increased by as much as 670 years during the 30- to 160-year life spans of the samples. Cadmium/calcium ratios in one coral imply that the nutrient content of these deep waters also increased. Our data show that the deep ocean changed on decadal-centennial time scales during rapid changes in the surface ocean and the atmosphere.

Increasing Dengue Incidence in Singapore over the Past 40 Years: Population Growth, Climate and Mobility

PubMed Central

Struchiner, Claudio Jose; Rocklöv, Joacim; Wilder-Smith, Annelies; Massad, Eduardo

2015-01-01

In Singapore, the frequency and magnitude of dengue epidemics have increased significantly over the past 40 years. It is important to understand the main drivers for the rapid increase in dengue incidence. We studied the relative contributions of putative drivers for the rise of dengue in Singapore: population growth, climate parameters and international air passenger arrivals from dengue endemic countries, for the time period of 1974 until 2011. We used multivariable Poisson regression models with the following predictors: Annual Population Size; Aedes Premises Index; Mean Annual Temperature; Minimum and Maximum Temperature Recorded in each year; Annual Precipitation and Annual Number of Air Passengers arriving from dengue-endemic South-East Asia to Singapore. The relative risk (RR) of the increase in dengue incidence due to population growth over the study period was 42.7, while the climate variables (mean and minimum temperature) together explained an RR of 7.1 (RR defined as risk at the end of the time period relative to the beginning and goodness of fit associated with the model leading to these estimates assessed by pseudo-R2 equal to 0.83). Estimating the extent of the contribution of these individual factors on the increasing dengue incidence, we found that population growth contributed to 86% while the residual 14% was explained by increase in temperature. We found no correlation with incoming air passenger arrivals into Singapore from dengue endemic countries. Our findings have significant implications for predicting future trends of the dengue epidemics given the rapid urbanization with population growth in many dengue endemic countries. It is time for policy-makers and the scientific community alike to pay more attention to the negative impact of urbanization and urban climate on diseases such as dengue. PMID:26322517

Increasing Dengue Incidence in Singapore over the Past 40 Years: Population Growth, Climate and Mobility.

PubMed

Struchiner, Claudio Jose; Rocklöv, Joacim; Wilder-Smith, Annelies; Massad, Eduardo

2015-01-01

In Singapore, the frequency and magnitude of dengue epidemics have increased significantly over the past 40 years. It is important to understand the main drivers for the rapid increase in dengue incidence. We studied the relative contributions of putative drivers for the rise of dengue in Singapore: population growth, climate parameters and international air passenger arrivals from dengue endemic countries, for the time period of 1974 until 2011. We used multivariable Poisson regression models with the following predictors: Annual Population Size; Aedes Premises Index; Mean Annual Temperature; Minimum and Maximum Temperature Recorded in each year; Annual Precipitation and Annual Number of Air Passengers arriving from dengue-endemic South-East Asia to Singapore. The relative risk (RR) of the increase in dengue incidence due to population growth over the study period was 42.7, while the climate variables (mean and minimum temperature) together explained an RR of 7.1 (RR defined as risk at the end of the time period relative to the beginning and goodness of fit associated with the model leading to these estimates assessed by pseudo-R2 equal to 0.83). Estimating the extent of the contribution of these individual factors on the increasing dengue incidence, we found that population growth contributed to 86% while the residual 14% was explained by increase in temperature. We found no correlation with incoming air passenger arrivals into Singapore from dengue endemic countries. Our findings have significant implications for predicting future trends of the dengue epidemics given the rapid urbanization with population growth in many dengue endemic countries. It is time for policy-makers and the scientific community alike to pay more attention to the negative impact of urbanization and urban climate on diseases such as dengue.

Sustained consumer response: evidence from two-years after implementing the sugar sweetened beverage tax in Mexico

PubMed Central

Colchero, M. Arantxa; Rivera, Juan A.; Popkin, Barry M.

2017-01-01

In the first year of a 1 peso per liter excise tax on sugar-sweetened beverages, there was a 6% reduction in purchases of taxed beverages in Mexico. This paper estimates changes in beverage purchases two years after tax implementation. We used household store purchase data for 6,645 households from January 2012 to December 2015. Changes in purchases of taxed and untaxed beverages in the post-tax years were estimated using two separate models: comparing 2014 with predicted volumes (counterfactual) based on pre-tax (2012-2013) trends, and comparing 2015 with the same counterfactual. Purchases of taxed beverages decreased by 8.2% over the two years on average (-5.5% in 2014; -9.7% in 2015). The lowest socioeconomic group had the largest decreases in taxed beverages in both years. Untaxed beverage purchases increased 2.1% in the post-tax period. In Mexico, lower purchases of taxed beverages was sustained and grew in the second year of the tax. PMID:28228484

Photorespiratory Bypasses Lead to Increased Growth in Arabidopsis thaliana: Are Predictions Consistent with Experimental Evidence?

PubMed Central

Basler, Georg; Küken, Anika; Fernie, Alisdair R.; Nikoloski, Zoran

2016-01-01

Arguably, the biggest challenge of modern plant systems biology lies in predicting the performance of plant species, and crops in particular, upon different intracellular and external perturbations. Recently, an increased growth of Arabidopsis thaliana plants was achieved by introducing two different photorespiratory bypasses via metabolic engineering. Here, we investigate the extent to which these findings match the predictions from constraint-based modeling. To determine the effect of the employed metabolic network model on the predictions, we perform a comparative analysis involving three state-of-the-art metabolic reconstructions of A. thaliana. In addition, we investigate three scenarios with respect to experimental findings on the ratios of the carboxylation and oxygenation reactions of Ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO). We demonstrate that the condition-dependent growth phenotypes of one of the engineered bypasses can be qualitatively reproduced by each reconstruction, particularly upon considering the additional constraints with respect to the ratio of fluxes for the RuBisCO reactions. Moreover, our results lend support for the hypothesis of a reduced photorespiration in the engineered plants, and indicate that specific changes in CO2 exchange as well as in the proxies for co-factor turnover are associated with the predicted growth increase in the engineered plants. We discuss our findings with respect to the structure of the used models, the modeling approaches taken, and the available experimental evidence. Our study sets the ground for investigating other strategies for increase of plant biomass by insertion of synthetic reactions. PMID:27092301

Scaling Up: Adapting a Phage-Hunting Course to Increase Participation of First-Year Students in Research

ERIC Educational Resources Information Center

Staub, Nancy L.; Poxleitner, Marianne; Braley, Amanda; Smith-Flores, Helen; Pribbenow, Christine M.; Jaworski, Leslie; Lopatto, David; Anders, Kirk R.

2016-01-01

Authentic research experiences are valuable components of effective undergraduate education. Research experiences during the first years of college are especially critical to increase persistence in science, technology, engineering, and mathematics fields. The Science Education Alliance Phage Hunters Advancing Genomics and Evolutionary Science…

Asthma hospitalization trends in Charleston, South Carolina, 1956 to 1997: twenty-fold increase among black children during a 30-year period.

PubMed

Crater, D D; Heise, S; Perzanowski, M; Herbert, R; Morse, C G; Hulsey, T C; Platts-Mills, T

2001-12-01

The increase in asthma prevalence has been documented worldwide, affecting many races living in many different climates. Multiple studies have demonstrated that the most striking prevalence and morbidity of asthma in the United States has been in black children, but little research has determined the scale of the increase, or specifically when the disease became severe in this group. This study sought to determine exactly when the rise in asthma hospitalizations among black patients began and what the pattern of asthma hospitalizations has been in different races and age groups over a 40-year period in 1 urban area. A retrospective chart review of discharges from the Medical University of South Carolina was conducted from 1956 to 1997. Charts with the primary discharge diagnosis of asthma were examined for discharge date, race, and age group (0- to 4-year-olds, 5- to 18-year-olds, 19- to 50-year-olds, > or =51-year-olds). The diagnostic codes used were based on the International Classification of Diseases (ICD)-6, 1956-1957; ICD-7, 1958-1967; ICD-8, 1968-1978; and ICD-9, 1979-1997. Over the period studied, this hospital was the primary inpatient provider for children in this area, and the only provider for uninsured children. Between 1960 and 1990, the racial makeup of the area remained stable, as did the percentage of blacks living at the poverty level. The raw number of asthma discharges, rate per 10 000 discharges of the same race, and rate per 100 000 population in Charleston County were tabulated for each age group and racial category. Over the time period examined, there has been a progressive increase in asthma hospitalizations in black individuals of all age groups and in whites under 18 years. The most striking increase has been in black children 0 to 18 years old (figure). The increase either as raw values or as a rate per 100 000 began around 1970, and was linear. This increase in black children discharged with asthma as a rate per 100 000 population was

Evidence-based tailoring of behavior-change campaigns: increasing fluoride-free water consumption in rural Ethiopia with persuasion.

PubMed

Huber, Alexandra C; Tobias, Robert; Mosler, Hans-Joachim

2014-03-01

Two hundred million people worldwide are at risk of developing dental and skeletal fluorosis due to excessive fluoride uptake from their water. Since medical treatment of the disease is difficult and mostly ineffective, preventing fluoride uptake is crucial. In the Ethiopian Rift Valley, a fluoride-removal community filter was installed. Despite having access to a fluoride filter, the community used the filter sparingly. During a baseline assessment, 173 face-to-face interviews were conducted to identify psychological factors that influence fluoride-free water consumption. Based on the results, two behavior-change campaigns were implemented: a traditional information intervention targeting perceived vulnerability, and an evidence-based persuasion intervention regarding perceived costs. The interventions were tailored to household characteristics. The campaigns were evaluated with a survey and analyzed in terms of their effectiveness in changing behavior and targeted psychological factors. While the intervention targeting perceived vulnerability showed no desirable effects, cost persuasion decreased the perceived costs and increased the consumption of fluoride-free water. This showed that altering subjective perceptions can change behavior even without changing objective circumstances. Moreover, interventions are more effective if they are based on evidence and tailored to specific households. © 2013 The International Association of Applied Psychology.

Paleoenvironmental changes during the past 2000 years, evidence from Kongsfjorden, Svalbard

NASA Astrophysics Data System (ADS)

Jernas, P.; Kristensen, D.; Koc, N.; Skirbekk, K.

2009-04-01

of fine grained sediment and decrease in ice rafting indicating less influence from glaciers. The foraminiferal species composition show decreasing content of agglutinated foraminifera down core caused by their low preservation potential. For this core site it confirms the importance of calcareous foraminifera as a fossil record tool. The two dominant species in the core are Elphidium excavatum and Nonionellina labradorica. During the last 2000 years the percentage of E. excavatum shows a general tendency to decrease while N. labradorica increases toward present. Elphidium excavatum is typical for arctic glaciomarine environments close to glaciers and ice caps, indicating harsh conditions (cold bottom waters temperatures, lower salinity) and probably extensive ice cover. Nonionellina labradorica indicates the vicinity of oceanographic fronts and high productivity. Another species Islandiella spp., often associated with increased productivity and presence of the sea ice edge, shows significant increase in percentage from 1000 to 800 cal yr BP. From 600 to 400 cal yr BP Bucella spp. start to decline suggesting increased sea ice cover and diminished influence of the Coastal Current on the inner shelf of Svalbard.

Synthesizing Quantitative Evidence for Evidence-based Nursing: Systematic Review.

PubMed

Oh, Eui Geum

2016-06-01

As evidence-based practice has become an important issue in healthcare settings, the educational needs for knowledge and skills for the generation and utilization of healthcare evidence are increasing. Systematic review (SR), a way of evidence generation, is a synthesis of primary scientific evidence, which summarizes the best evidence on a specific clinical question using a transparent, a priori protocol driven approach. SR methodology requires a critical appraisal of primary studies, data extraction in a reliable and repeatable way, and examination for validity of the results. SRs are considered hierarchically as the highest form of evidence as they are a systematic search, identification, and summarization of the available evidence to answer a focused clinical question with particular attention to the methodological quality of studies or the credibility of opinion and text. The purpose of this paper is to introduce an overview of the fundamental knowledge, principals and processes in SR. The focus of this paper is on SR especially for the synthesis of quantitative data from primary research studies that examines the effectiveness of healthcare interventions. To activate evidence-based nursing care in various healthcare settings, the best and available scientific evidence are essential components. This paper will include some examples to promote understandings. Copyright © 2016. Published by Elsevier B.V.

Ecosystem sentinels for climate change? Evidence of wetland cover changes over the last 30 years in the tropical Andes

PubMed Central

Dangles, Olivier; Rabatel, Antoine; Kraemer, Martin; Zeballos, Gabriel; Soruco, Alvaro; Jacobsen, Dean; Anthelme, Fabien

2017-01-01

While the impacts of climate change on individual species and communities have been well documented there is little evidence on climate-mediated changes for entire ecosystems. Pristine alpine environments can provide unique insights into natural, physical and ecological response to climate change yet broad scale and long-term studies on these potential ‘ecosystem sentinels’ are scarce. We addressed this issue by examining cover changes of 1689 high-elevation wetlands (temporarily or perennial water-saturated grounds) in the Bolivian Cordillera Real, a region that has experienced significant warming and glacier melting over the last 30 years. We combined high spatial resolution satellite images from PLEIADES with the long-term images archive from LANDSAT to 1) examine environmental factors (e.g., glacier cover, wetland and watershed size) that affected wetland cover changes, and 2) identify wetlands’ features that affect their vulnerability (using habitat drying as a proxy) in the face of climate change. Over the (1984–2011) period, our data showed an increasing trend in the mean wetland total area and number, mainly related to the appearance of wet grassland patches during the wetter years. Wetland cover also showed high inter-annual variability and their area for a given year was positively correlated to precipitation intensities in the three months prior to the image date. Also, round wetlands located in highly glacierized catchments were less prone to drying, while relatively small wetlands with irregularly shaped contours suffered the highest rates of drying over the last three decades. High Andean wetlands can therefore be considered as ecosystem sentinels for climate change, as they seem sensitive to glacier melting. Beyond the specific focus of this study, our work illustrates how satellite-based monitoring of ecosystem sentinels can help filling the lack of information on the ecological consequences of current and changing climate conditions, a

Global, Regional, and Megacity Trends in the Highest Temperature of the Year: Diagnostics and Evidence for Accelerating Trends

NASA Astrophysics Data System (ADS)

Papalexiou, Simon Michael; AghaKouchak, Amir; Trenberth, Kevin E.; Foufoula-Georgiou, Efi

2018-01-01

Trends in short-lived high-temperature extremes record a different dimension of change than the extensively studied annual and seasonal mean daily temperatures. They also have important socioeconomic, environmental, and human health implications. Here, we present analysis of the highest temperature of the year for approximately 9000 stations globally, focusing on quantifying spatially explicit exceedance probabilities during the recent 50- and 30-year periods. A global increase of 0.19°C per decade during the past 50 years (through 2015) accelerated to 0.25°C per decade during the last 30 years, a faster increase than in the mean annual temperature. Strong positive 30-year trends are detected in large regions of Eurasia and Australia with rates higher than 0.60°C per decade. In cities with more than 5 million inhabitants, where most heat-related fatalities occur, the average change is 0.33°C per decade, while some east Asia cities, Paris, Moscow, and Houston have experienced changes higher than 0.60°C per decade.

Global, Regional, and Megacity Trends in the Highest Temperature of the Year: Diagnostics and Evidence for Accelerating Trends.

PubMed

Papalexiou, Simon Michael; AghaKouchak, Amir; Trenberth, Kevin E; Foufoula-Georgiou, Efi

2018-01-01

Trends in short-lived high-temperature extremes record a different dimension of change than the extensively studied annual and seasonal mean daily temperatures. They also have important socioeconomic, environmental, and human health implications. Here, we present analysis of the highest temperature of the year for approximately 9000 stations globally, focusing on quantifying spatially explicit exceedance probabilities during the recent 50- and 30-year periods. A global increase of 0.19°C per decade during the past 50 years (through 2015) accelerated to 0.25°C per decade during the last 30 years, a faster increase than in the mean annual temperature. Strong positive 30-year trends are detected in large regions of Eurasia and Australia with rates higher than 0.60°C per decade. In cities with more than 5 million inhabitants, where most heat-related fatalities occur, the average change is 0.33°C per decade, while some east Asia cities, Paris, Moscow, and Houston have experienced changes higher than 0.60°C per decade.

Human-induced river runoff overlapping natural climate variability over the last 150 years: Palynological evidence (Bay of Brest, NW France)

NASA Astrophysics Data System (ADS)

Lambert, Clément; Penaud, Aurélie; Vidal, Muriel; Klouch, Khadidja; Gregoire, Gwendoline; Ehrhold, Axel; Eynaud, Frédérique; Schmidt, Sabine; Ragueneau, Olivier; Siano, Raffaele

2018-01-01

For the first time a very high resolution palynological study (mean resolution of 1 to 5 years) was carried out over the last 150 years in a French estuarine environment (Bay of Brest; NW France), allowing direct comparison between the evolution of landscapes, surface water, and human practices on Bay of Brest watersheds, through continental (especially pollen grains) and marine (phytoplanktonic microalgae: cysts of dinoflagellates or dinocysts) microfossils. Thanks to the small size of the watersheds and the close proximity of the depositional environment to the mainland, the Bay of Brest represents an ideal case study for palynological investigations. Palynological data were then compared to published palaeo-genetic analyses conducted on the same core and to various available instrumental data, allowing us to better characterize past environmental variability since the second half of the 19th century in Western Brittany. We provide evidence of some clues of recent eutrophication and/or pollution that affected phytoplankton communities and which appears linked with increased runoff (higher precipitations, higher percentages of riparian forest pollen, decline of salt marsh-type indicators, and higher values of the XRF Ti/Ca signal), mainly explained by the evolution of agricultural practices since 1945 superimposed on the warming climate trend. We assume that the significant relay observed between dinocyst taxa: Lingulodinium machaerophorum and Spiniferites bentorii around 1965 then followed by Spiniferites membranaceus after 1985, attests to a strong and recent eutrophication of Bay of Brest surface waters induced by high river runoff combined with abnormally elevated air temperatures, especially obvious in the data from 1990. The structure of the dinocyst community has thus been deeply altered, accompanied by an unprecedented increase of Alexandrium minutum toxic form at the same period, as confirmed by the genetic quantification. Despite this recent major

Neurodevelopmental surveillance in the first 2 years after extremely preterm birth: evidence, challenges, and guidelines.

PubMed

Msall, Michael E

2006-03-01

During the past decade, major advances in maternal-fetal medicine and neonatology have resulted in unprecedented survival of very preterm babies. These babies represent a small fraction of infants born preterm, but present significant challenges with respect to respiratory, nutritional, and developmental vulnerabilities. Several efforts involving the UK, US, Canada, Australia, and the Netherlands have provided information on regional trends over time with respect to neonatal morbidities and neurodevelopmental outcomes through the first two years of life. Historically gross and fine motor, cognitive and communicative skills, vision and hearing performance have been the focus of assessment. Indicators of major neurodevelopmental disabilities at 2 years have included presence of severe neurosensory impairment, i.e. cerebral palsy, sensorineural hearing loss requiring aides, and blindness. In addition cognitive developmental disability has been generally defined as a Bayley MDI or developmental quotient <70, i.e. lower than 2 standard deviations below the mean. However these outcomes cannot reliably capture trajectories of resiliency as well as more complex developmental challenges in the domains of coordination, perception, attention, communication, and learning. Recently tools have become available for assessing functional status in gross motor, communicative, adaptive and social-emotional behaviours of imitation, regulation, and play. This review will describe the major progress in assessing early neurodevelopmental status of vulnerable survivors receiving new biomedical technologies, highlight challenges, and propose guidelines based on current best evidence.

Long-term increases in young-of-the-year growth of Arctic cisco Coregonus autumnalis and environmental influences.

PubMed

von Biela, V R; Zimmerman, C E; Moulton, L L

2011-01-01

Arctic cisco Coregonus autumnalis young-of-year (YOY) growth was used as a proxy to examine the long-term response of a high-latitude fish population to changing climate from 1978 to 2004. YOY growth increased over time (r² = 0·29) and was correlated with monthly averages of the Arctic oscillation index, air temperature, east wind speed, sea-ice concentration and river discharge with and without time lags. Overall, the most prevalent correlates to YOY growth were sea-ice concentration lagged 1 year (significant correlations in 7 months; r² = 0·14-0·31) and Mackenzie River discharge lagged 2 years (significant correlations in 8 months; r² = 0·13-0·50). The results suggest that decreased sea-ice concentrations and increased river discharge fuel primary production and that life cycles of prey species linking increased primary production to fish growth are responsible for the time lag. Oceanographic studies also suggest that sea ice concentration and fluvial inputs from the Mackenzie River are key factors influencing productivity in the Beaufort Sea. Future research should assess the possible mechanism relating sea ice concentration and river discharge to productivity at upper trophic levels. Journal of Fish Biology © 2010 The Fisheries Society of the British Isles. No claim to original US government works.

Hazardous factories: Nigerian evidence.

PubMed

Oloyede, Olajide

2005-06-01

The past 15 years have seen an increasing governmental and corporate concern for the environment worldwide. For governments, information about the environmental performance of the industrial sector is required to inform macro-level decisions about environmental targets such as those required to meet UN directives. However, in many African, Asian, and Latin American countries, researching and reporting company environmental performance is limited. This article serves as a contribution to filling the gap by presenting evidence of physical and chemical risk in Nigerian factories. One hundred and three factories with a total of 5,021 workers were studied. One hundred and twenty physical and chemical hazards were identified and the result shows a high number of workers exposed to such hazards. The study also reveals that workers' awareness level of chemical hazards was high. Yet the danger was perceived in behavioral terms, especially by manufacturing firms, which tend to see environmental investment in an increasingly global economy as detrimental to profitability.

Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE)

PubMed Central

Lannerö, Eva; Wickman, Magnus; Pershagen, Goran; Nordvall, Lennart

2006-01-01

Background Exposure to cigarette smoking during foetal and early postnatal life may have implications for lung health. The aim of this study was to assess the possible effects of such exposure in utero on lower respiratory disease in children up to two years of age. Methods A birth cohort of 4089 newborn infants was followed for two years using parental questionnaires. When the infant was two months old the parents completed a questionnaire on various lifestyle factors, including maternal smoking during pregnancy and after birth. At one and two years of age information was obtained by questionnaire on symptoms of allergic and respiratory diseases as well as on environmental exposures, particularly exposure to environmental tobacco smoke (ETS). Adjustments were made for potential confounders. Results When the mother had smoked during pregnancy but not after that, there was an increased risk of recurrent wheezing up to two years' age, ORadj = 2.2, (95% CI 1.3 – 3.6). The corresponding OR was 1.6, (95% CI 1.2 – 2.3) for reported exposure to ETS with or without maternal smoking in utero. Maternal smoking during pregnancy but no exposure to ETS also increased the risk of doctor's diagnosed asthma up to two years of age, ORadj = 2.1, (95% CI 1.2 – 3.7). Conclusion Exposure to maternal cigarette smoking in utero is a risk factor for recurrent wheezing, as well as doctor's diagnosed asthma in children up to two yearsof age. PMID:16396689

Increased temperatures negatively affect Juniperus communis seeds: evidence from transplant experiments along a latitudinal gradient.

PubMed

Gruwez, R; De Frenne, P; Vander Mijnsbrugge, K; Vangansbeke, P; Verheyen, K

2016-05-01

With a distribution range that covers most of the Northern hemisphere, common juniper (Juniperus communis) has one of the largest ranges of all vascular plant species. In several regions in Europe, however, populations are decreasing in size and number due to failing recruitment. One of the main causes for this failure is low seed viability. Observational evidence suggests that this is partly induced by climate warming, but our mechanistic understanding of this effect remains incomplete. Here, we experimentally assess the influence of temperature on two key developmental phases during sexual reproduction, i.e. gametogenesis and fertilisation (seed phase two, SP2) and embryo development (seed phase three, SP3). Along a latitudinal gradient from southern France to central Sweden, we installed a transplant experiment with shrubs originating from Belgium, a region with unusually low juniper seed viability. Seeds of both seed phases were sampled during three consecutive years, and seed viability assessed. Warming temperatures negatively affected the seed viability of both SP2 and SP3 seeds along the latitudinal gradient. Interestingly, the effect on embryo development (SP3) only occurred in the third year, i.e. when the gametogenesis and fertilisation also took place in warmer conditions. We found strong indications that this negative influence mostly acts via disrupting growth of the pollen tube, the development of the female gametophyte and fertilisation (SP2). This, in turn, can lead to failing embryo development, for example, due to nutritional problems. Our results confirm that climate warming can negatively affect seed viability of juniper. © 2015 German Botanical Society and The Royal Botanical Society of the Netherlands.

Getting physicians to open the survey: little evidence that an envelope teaser increases response rates.

PubMed

Ziegenfuss, Jeanette Y; Burmeister, Kelly; James, Katherine M; Haas, Lindsey; Tilburt, Jon C; Beebe, Timothy J

2012-03-31

Physician surveys are an important tool to assess attitudes, beliefs and self-reported behaviors of this policy relevant group. In order for a physician to respond to a mailed survey, they must first open the envelope. While there is some evidence that package elements can impact physician response rates, the impact of an envelope teaser is unknown. Here we assess this by testing the impact of adding a brightly colored "$25 incentive" sticker to the outside of an envelope on response rates and nonresponse bias in a survey of physicians. In the second mailing of a survey assessing physicians' moral beliefs and views on controversial health care topics, initial nonrespondents were randomly assigned to receive a survey in an envelope with a colored "$25 incentive" sticker (teaser group) or an envelope without a sticker (control group). Response rates were compared between the teaser and control groups overall and by age, gender, region of the United States, specialty and years in practice. Nonresponse bias was assessed by comparing the demographic composition of the respondents to the nonrespondents in the experimental and control condition. No significant differences in response rates were observed between the experimental and control conditions overall (p = 0.38) or after stratifying by age, gender, region, or practice type. Within the teaser condition, there was some variation in response rate by years since graduation. There was no independent effect of the teaser on response when simultaneously controlling for demographic characteristics (OR = 0.875, p = 0.4112). Neither response rates nor nonresponse bias were impacted by the use of an envelope teaser in a survey of physicians in the United States.

Multiple sclerosis in the province of Ferrara : evidence for an increasing trend.

PubMed

Granieri, E; Economou, N-T; De Gennaro, R; Tola, M R; Caniatti, L; Govoni, V; Fainardi, E; Casetta, I

2007-12-01

Epidemiological studies on the distribution of multiple sclerosis (MS) conducted in the Mediterranean area in the last two decades have disclosed a significant increase in frequency of the disease, indicating caution when a latitude-related model of MS is accepted. Previous descriptive surveys in the province of Ferrara, northern Italy, carried out by our own epidemiological research group, have established that this area is at high risk for MS. To confirm the above assumption and to update MS frequency estimates in this area. We conducted a community-based intensive prevalence and incidence study, by adopting a complete enumeration approach. On December 31, 2004, 423 patients (300 women and 123 men) suffering from definite or probable MS (Poser's criteria) living in the province of Ferrara, yielded a crude prevalence rate of 120.93 (95 % CI, 110.05-134.23) per 100,000, 164.26 for women and 73.59 for men. The average incidence from 1990 to 2003 was 4.35 per 100,000 (95 % CI, 3.77-4.99), 5.91 for women and 2.63 for men. The incidence rate,which was relatively stable during the previous 25 years (1965-1989) with a mean rate of 2.3 per 100,000, increased to a value of 3.39 per 100,000 in the period 1990-1994, 4.09 per 100,000 in the period 1995-1999 and 3.84 per 100,000 in the period 2000-2003. These results confirm that in Ferrara MS occurs more frequently than suggested by the geographic- related distribution model and, based on other recent national surveys, support the view that northern Italy is a high-risk area for the disease. The marked increase in MS prevalence rate, in comparison with previous investigations, is in part due to the increasing survival of patients as a result of improved supportive care and the accumulation of new incidence cases owing to the reduction in diagnostic latency for better quality of neurological diagnostic procedures. The incidence in the province of Ferrara was found to slowly change with an incremental trend,which cannot only be

Development of a universal approach to increase physical activity among adolescents: the GoActive intervention.

PubMed

Corder, Kirsten; Schiff, Annie; Kesten, Joanna M; van Sluijs, Esther M F

2015-08-25

To develop a physical activity (PA) promotion intervention for adolescents using a process addressing gaps in the literature while considering participant engagement. We describe the initial development stages; (1) existing evidence, (2) large scale opinion gathering and (3) developmental qualitative work, aiming (A) to gain insight into how to increase PA among the whole of year 9 (13-14 years-old) by identifying elements for intervention inclusion (B) to improve participant engagement and (C) to develop and refine programme design. Relevant systematic reviews and longitudinal analyses of change were examined. An intervention was developed iteratively with older adolescents (17.3 ± 0.5 years) and teachers, using the following process: (1) focus groups with (A) adolescents (n=26) and (B) teachers (n=4); (2) individual interviews (n=5) with inactive and shy adolescents focusing on engagement and programme acceptability. Qualitative data were analysed thematically. Limitations of the existing literature include lack of evidence on whole population approaches, limited adolescent involvement in intervention development, and poor participant engagement. Qualitative work suggested six themes which may encourage adolescents to do more PA; choice, novelty, mentorship, competition, rewards and flexibility. Teachers discussed time pressures as a barrier to encouraging adolescent PA and suggested between-class competition as a strategy. GoActive aims to increase PA through increased peer support, self-efficacy, group cohesion, self-esteem and friendship quality, and is implemented in tutor groups using a student-led tiered-leadership system. We have followed an evidence-based iterative approach to translate existing evidence into an adolescent PA promotion intervention. Qualitative work with adolescents and teachers supported intervention design and addressed lack of engagement with health promotion programmes within this age group. Future work will examine the feasibility

Development of a universal approach to increase physical activity among adolescents: the GoActive intervention

PubMed Central

Corder, Kirsten; Schiff, Annie; Kesten, Joanna M; van Sluijs, Esther M F

2015-01-01

Objectives To develop a physical activity (PA) promotion intervention for adolescents using a process addressing gaps in the literature while considering participant engagement. We describe the initial development stages; (1) existing evidence, (2) large scale opinion gathering and (3) developmental qualitative work, aiming (A) to gain insight into how to increase PA among the whole of year 9 (13–14 years-old) by identifying elements for intervention inclusion (B) to improve participant engagement and (C) to develop and refine programme design. Methods Relevant systematic reviews and longitudinal analyses of change were examined. An intervention was developed iteratively with older adolescents (17.3±0.5 years) and teachers, using the following process: (1) focus groups with (A) adolescents (n=26) and (B) teachers (n=4); (2) individual interviews (n=5) with inactive and shy adolescents focusing on engagement and programme acceptability. Qualitative data were analysed thematically. Results Limitations of the existing literature include lack of evidence on whole population approaches, limited adolescent involvement in intervention development, and poor participant engagement. Qualitative work suggested six themes which may encourage adolescents to do more PA; choice, novelty, mentorship, competition, rewards and flexibility. Teachers discussed time pressures as a barrier to encouraging adolescent PA and suggested between-class competition as a strategy. GoActive aims to increase PA through increased peer support, self-efficacy, group cohesion, self-esteem and friendship quality, and is implemented in tutor groups using a student-led tiered-leadership system. Conclusions We have followed an evidence-based iterative approach to translate existing evidence into an adolescent PA promotion intervention. Qualitative work with adolescents and teachers supported intervention design and addressed lack of engagement with health promotion programmes within this age group

Insecure Attachment Patterns at Five Years. What Do They Tell Us?

ERIC Educational Resources Information Center

Priddis, Lynn; Howieson, Noel D.

2012-01-01

Developmental outcomes for children whose primary caregivers are misattuned but not considered abusive are unclear. This paper argues that if by the pre-school years, insecure patterns of attachment are evident then a continuing dysfunctional attachment relationship is indicated and the likelihood of later difficulties is increased. The current…

Ten Years after the Spellings Commission: From Accountability to Internal Improvement

ERIC Educational Resources Information Center

Liu, Ou Lydia

2017-01-01

Student learning outcomes assessment has been increasingly used in U.S. higher education institutions over the last 10 years, partly fueled by the recommendation from the Spellings Commission that institutions need to demonstrate more direct evidence of student learning. To respond to the Commission's call, various accountability initiatives have…

Impact on Smoking Behavior of the New Zealand Annual Increase in Tobacco Tax: Data for the Fifth and Sixth Year of Increases.

PubMed

Li, Judy; Newcombe, Rhiannon; Guiney, Hayley; Walton, Darren

2017-11-07

New Zealand has implemented a series of seven annual increases in tobacco tax since 2010. All tax increases, except for the first in the series, were preannounced. It is unusual for governments to introduce small, persistent, and predictable increases in tobacco tax, and little is known about the impact of such a strategy. This paper evaluates the impact of the fifth and sixth annual increases. Smokers' behaviors were self-reported during the 3-month period before, and the 3-month period after, the two annual increases. Responses to the two increases were analyzed separately, and generalized estimating equations models were used to control for sociodemographic variables, recent quit attempts, and the research design. Findings were consistent across years. The proportion of participants who made a smoking-related (54%-56% before and after each tax increase) or product-related change (fifth tax increase: 17%-19%; sixth tax increase: 21%-22%) did not significantly alter from before to after each tax increase. However, it should be noted that the proportion of participants making smoking-related changes was generally high, even prior to each increase. For example, before the 2015 tax increase, 1% reported quitting completely, 21% trying to quit, and 53% cutting down. In New Zealand, with its series of annual tobacco tax increases since 2010, there were no significant changes in smoking- or product-related behavior associated with the fifth and sixth increases. Nevertheless, overall cessation-related activity was high, with a majority of participants reporting either quitting and/or cutting down recently. Little is known about the impact of small, persistent, predictable tobacco tax increases on smoking behavior. This study evaluated the impact of the fifth (in 2014) and sixth (2015) tax increases in an annual series implemented in New Zealand. Although there were no detectable changes in smoking behaviors from before to after each tax increase, self-reported cessation

Prokinetics prescribing in paediatrics: evidence on cisapride, domperidone, and metoclopramide.

PubMed

Mt-Isa, Shahrul; Tomlin, Stephen; Sutcliffe, Alastair; Underwood, Martin; Williamson, Paula; Croft, Nicholas M; Ashby, Deborah

2015-04-01

Domperidone and metoclopramide are prokinetics commonly prescribed off-label to infants and younger children in an attempt to treat gastro-oesophageal reflux symptoms. Another prokinetic drug, cisapride, was used but withdrawn in 2000 in the United Kingdom because of serious arrhythmic adverse events. Medicines and Healthcare Products Regulatory Agency issued safety warnings for domperidone in May 2012 and restricted its indications. We report here national primary care prescribing trends and safety signals of these drugs in children. We used data from the General Practice Research Database between 1990 and 2006 for children <18 years. Descriptive statistics and Poisson regressions were performed to characterise prescribing trends. We examined safety signals in nested case-control studies. The proportion of children <2 years old being prescribed one of the medications doubled during the study period. Prescriptions of domperidone increased 10-fold, mainly following the withdrawal of cisapride in 2000. Prescriptions of metoclopramide did not change significantly. Despite the increase in prescriptions of domperidone, no new safety signals were identified. These data showed dramatic changes in prescribing of cisapride and domperidone despite the lack of good-quality supporting evidence. It is possible that these prescribing trends were influenced by published guidelines. Even if produced without robust efficacy and safety evidence, published guidelines can influence clinicians and consequently affect prescribing. Therefore, improving the evidence base on prokinetics to inform future guidelines is vital. The lack of new safety signals during this period would support the development of suitable powered clinical studies.

Increased symptom reporting persists in 1990-1991 Gulf War veterans 20 years post deployment.

PubMed

Gwini, Stella M; Forbes, Andrew B; Kelsall, Helen L; Ikin, Jillian F; Sim, Malcolm R

2015-12-01

Following the 1990-1991 Gulf War, Gulf War veterans (veterans) reported health symptoms more commonly than non-deployed groups. This article examines symptom persistence, incidence and prevalence 20 years on. In 2000-2003 and 2011-2012, a 63-item symptom checklist was administered to 697 veterans and 659 comparison group. Symptomatology was compared using log-binomial regression. Both veterans and comparison group reported significantly increased prevalence (3-52%) over time in more than half the symptoms, with a similar overall rate of increase. Half the symptoms had higher incidence (risk-ratios ranged 1.43-1.50) and a quarter were more persistent (risk-ratios ranged 1.12-1.20) in veterans than the comparison group. Symptomatology increased in both groups over time, but persisted to a similar extent and had higher incidence among veterans than the comparison group. The gap in symptom prevalence between the two groups remained unchanged. These findings suggest enduring health consequences of Gulf War service. © 2015 Commonwealth of Australia. American Journal of Industrial Medicine © 2015 Wiley Periodicals, Inc.

MPNs as Inflammatory Diseases: The Evidence, Consequences, and Perspectives

PubMed Central

Hasselbalch, Hans Carl; Bjørn, Mads Emil

2015-01-01

In recent years the evidence is increasing that chronic inflammation may be an important driving force for clonal evolution and disease progression in the Philadelphia-negative myeloproliferative neoplasms (MPNs), essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF). Abnormal expression and activity of a number of proinflammatory cytokines are associated with MPNs, in particular MF, in which immune dysregulation is pronounced as evidenced by dysregulation of several immune and inflammation genes. In addition, chronic inflammation has been suggested to contribute to the development of premature atherosclerosis and may drive the development of other cancers in MPNs, both nonhematologic and hematologic. The MPN population has a substantial inflammation-mediated comorbidity burden. This review describes the evidence for considering the MPNs as inflammatory diseases, A Human Inflammation Model of Cancer Development, and the role of cytokines in disease initiation and progression. The consequences of this model are discussed, including the increased risk of second cancers and other inflammation-mediated diseases, emphasizing the urgent need for rethinking our therapeutic approach. Early intervention with interferon-alpha2, which as monotherapy has been shown to be able to induce minimal residual disease, in combination with potent anti-inflammatory agents such as JAK-inhibitors is foreseen as the most promising new treatment modality in the years to come. PMID:26604428

Increase of Stroke Incidence in Young Adults in a Middle-Income Country: A 10-Year Population-Based Study.

PubMed

Cabral, Norberto Luiz; Freire, Aracélli Tavares; Conforto, Adriana Bastos; Dos Santos, Nayara; Reis, Felipe Ibiapina; Nagel, Vivian; Guesser, Vanessa V; Safanelli, Juliana; Longo, Alexandre L

2017-11-01

The incidence of stroke is on the rise in young adults in high-income countries. However, there is a gap of knowledge about trends in stroke incidence in young adults from low- and middle-income countries. We aimed to measure trends in incidence of ischemic stroke (IS) and intracerebral hemorrhage (IH) in young people from 2005 to 2015 in Joinville, Brazil. We retrospectively ascertained all first-ever IS subtypes and IH that occurred in Joinville in the periods of 2005 to 2006, 2010 to 2011, and 2014 to 2015. Poisson regression was used to calculate incidence rate ratios of all strokes, IS, and IH. We also compared the prevalence of risk factors and extension of diagnostic work-up across the 3 periods. For 10 years, we registered 2483 patients (7.5% aged <45 years). From 2005 to 2006 to 2014 to 2015, overall stroke incidence significantly increased by 62% (incidence rate ratios, 1.62; 95% confidence interval, 1.10-2.40) in subjects <45 years and by 29% in those <55 years (incidence rate ratios, 1.29; 95% confidence interval, 1.04-1.60). Incidence of IS increased by 66% (incidence rate ratios, 1.66; 95% confidence interval, 1.09-2.54), but there was no significant change in incidence of IH in subjects <45 years. Smoking rates decreased by 71% (odds ratio, 0.29; 95% confidence interval, 0.12-0.68). Stroke incidence is rising in young adults in Joinville, Brazil, because of increase in rates of ischemic but not hemorrhagic strokes. We urgently need better policies of cardiovascular prevention in the young. © 2017 American Heart Association, Inc.

The role of evidence based medicine in neurotrauma.

PubMed

Honeybul, S; Ho, K M

2015-04-01

The introduction of evidence based medicine de-emphasised clinical experience and so-called "background information" and stressed the importance of evidence gained from clinical research when making clinical decisions. For many years randomised controlled trials have been seen to be the only way to advance clinical practice, however, applying this methodology in the context of severe trauma can be problematic. In addition, it is increasingly recognised that considerable clinical experience is required in order to critically evaluate the quality of the evidence and the validity of the conclusions as presented. A contemporary example is seen when considering the role of decompressive craniectomy in the management of neurotrauma. Although there is a considerable amount of evidence available attesting to the efficacy of the procedure, considerable clinical expertise is required in order to properly interpret the results of these studies and the implications for clinical practice. Given these limitations the time may have come for a redesign of the traditional pyramid of evidence, to a model that re-emphasises the importance of "background information" such as pathophysiology and acknowledges the role of clinical experience such that the evidence can be critically evaluated in its appropriate context and the subsequent implications for clinical practice be clearly and objectively defined. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Aging without Dementia is Achievable: Current Evidence from Epidemiological Research.

PubMed

Qiu, Chengxuan; Fratiglioni, Laura

2018-01-01

Both the incidence and the prevalence of dementia increase exponentially with increasing age. This raises the question of whether dementia is an inevitable consequence of aging or whether aging without dementia is achievable. In this review article, we sought to summarize the current evidence from epidemiological and neuropathological studies that investigated this topic. Epidemiological studies have shown that dementia could be avoided even at extreme old ages (e.g., centenarians or supercentenarians). Furthermore, clinico-neuropathological studies found that nearly half of centenarians with dementia did not have sufficient brain pathology to explain their cognitive symptoms, while intermediate-to-high Alzheimer pathology was present in around one-third of very old people without dementia or cognitive impairment. This suggests that certain compensatory mechanisms (e.g., cognitive reserve or resilience) may play a role in helping people in extreme old ages escape dementia syndrome. Finally, evidence has been accumulating in recent years indicating that the incidence of dementia has declined in Europe and North America, which supports the view that the risk of dementia in late life is modifiable. Evidence has emerged that intervention strategies that promote general health, maintain vascular health, and increase cognitive reserve are likely to help preserve cognitive function till late life, thus achieving the goal of aging without dementia.

Aging without Dementia is Achievable: Current Evidence from Epidemiological Research

PubMed Central

Qiu, Chengxuan; Fratiglioni, Laura

2018-01-01

Both the incidence and the prevalence of dementia increase exponentially with increasing age. This raises the question of whether dementia is an inevitable consequence of aging or whether aging without dementia is achievable. In this review article, we sought to summarize the current evidence from epidemiological and neuropathological studies that investigated this topic. Epidemiological studies have shown that dementia could be avoided even at extreme old ages (e.g., centenarians or supercentenarians). Furthermore, clinico-neuropathological studies found that nearly half of centenarians with dementia did not have sufficient brain pathology to explain their cognitive symptoms, while intermediate-to-high Alzheimer pathology was present in around one-third of very old people without dementia or cognitive impairment. This suggests that certain compensatory mechanisms (e.g., cognitive reserve or resilience) may play a role in helping people in extreme old ages escape dementia syndrome. Finally, evidence has been accumulating in recent years indicating that the incidence of dementia has declined in Europe and North America, which supports the view that the risk of dementia in late life is modifiable. Evidence has emerged that intervention strategies that promote general health, maintain vascular health, and increase cognitive reserve are likely to help preserve cognitive function till late life, thus achieving the goal of aging without dementia. PMID:29562544

Major limitations to achieving "4 per 1000" increases in soil organic carbon stock in temperate regions: Evidence from long-term experiments at Rothamsted Research, United Kingdom.

PubMed

Poulton, Paul; Johnston, Johnny; Macdonald, Andy; White, Rodger; Powlson, David

2018-01-21

We evaluated the "4 per 1000" initiative for increasing soil organic carbon (SOC) by analysing rates of SOC increase in treatments in 16 long-term experiments in southeast United Kingdom. The initiative sets a goal for SOC stock to increase by 4‰ per year in the 0-40 cm soil depth, continued over 20 years. Our experiments, on three soil types, provided 114 treatment comparisons over 7-157 years. Treatments included organic additions (incorporated by inversion ploughing), N fertilizers, introducing pasture leys into continuous arable systems, and converting arable land to woodland. In 65% of cases, SOC increases occurred at >7‰ per year in the 0-23 cm depth, approximately equivalent to 4‰ per year in the 0-40 cm depth. In the two longest running experiments (>150 years), annual farmyard manure (FYM) applications at 35 t fresh material per hectare (equivalent to approx. 3.2 t organic C/ha/year) gave SOC increases of 18‰ and 43‰ per year in the 23 cm depth during the first 20 years. Increases exceeding 7‰ per year continued for 40-60 years. In other experiments, with FYM applied at lower rates or not every year, there were increases of 3‰-8‰ per year over several decades. Other treatments gave increases between zero and 19‰ per year over various periods. We conclude that there are severe limitations to achieving the "4 per 1000" goal in practical agriculture over large areas. The reasons include (1) farmers not having the necessary resources (e.g. insufficient manure); (2) some, though not all, practices favouring SOC already widely adopted; (3) practices uneconomic for farmers-potentially overcome by changes in regulations or subsidies; (4) practices undesirable for global food security. We suggest it is more realistic to promote practices for increasing SOC based on improving soil quality and functioning as small increases can have disproportionately large beneficial impacts, though not necessarily translating into increased crop yield

Self-reported and observed punitive parenting prospectively predicts increased error-related brain activity in six-year-old children

PubMed Central

Meyer, Alexandria; Proudfit, Greg Hajcak; Bufferd, Sara J.; Kujawa, Autumn J.; Laptook, Rebecca S.; Torpey, Dana C.; Klein, Daniel N.

2017-01-01

The error-related negativity (ERN) is a negative deflection in the event-related potential (ERP) occurring approximately 50 ms after error commission at fronto-central electrode sites and is thought to reflect the activation of a generic error monitoring system. Several studies have reported an increased ERN in clinically anxious children, and suggest that anxious children are more sensitive to error commission—although the mechanisms underlying this association are not clear. We have previously found that punishing errors results in a larger ERN, an effect that persists after punishment ends. It is possible that learning-related experiences that impact sensitivity to errors may lead to an increased ERN. In particular, punitive parenting might sensitize children to errors and increase their ERN. We tested this possibility in the current study by prospectively examining the relationship between parenting style during early childhood and children’s ERN approximately three years later. Initially, 295 parents and children (approximately 3 years old) participated in a structured observational measure of parenting behavior, and parents completed a self-report measure of parenting style. At a follow-up assessment approximately three years later, the ERN was elicited during a Go/No-Go task, and diagnostic interviews were completed with parents to assess child psychopathology. Results suggested that both observational measures of hostile parenting and self-report measures of authoritarian parenting style uniquely predicted a larger ERN in children 3 years later. We previously reported that children in this sample with anxiety disorders were characterized by an increased ERN. A mediation analysis indicated that ERN magnitude mediated the relationship between harsh parenting and child anxiety disorder. Results suggest that parenting may shape children’s error processing through environmental conditioning and thereby risk for anxiety, although future work is needed to

One year B-vitamins increases serum and whole blood folate forms and lowers plasma homocysteine in older Germans.

PubMed

Kirsch, Susanne H; Herrmann, Wolfgang; Kruse, Vera; Eckert, Rudolf; Gräber, Stefan; Geisel, Jürgen; Obeid, Rima

2015-02-01

We aimed to study the effect of long-term supplementation of B-vitamins on folate forms in serum and whole blood (WB) in elderly German subjects. 59 participants (mean age 67 years) were randomized to daily receive either vitamin D3 (1200 IU), folic acid (500 μg), vitamin B12 (500 μg), vitamin B6 (50 mg), and calcium carbonate (456 mg) or vitamin D3 plus calcium carbonate. Serum and WB folate forms were measured before and after 6 and 12 months. B-vitamins supplementation for 6 months led to higher concentrations of 5-methyltetrahydrofolate (5-methylTHF) in serum (mean 49.1 vs. 19.6 nmol/L) and WB (1332 vs. 616 nmol/L). Also non-methyl-folate concentrations in serum and WB were higher after 6 months with B-vitamins supplementation. Unmetabolized folic acid (UFA) increased after supplementation. tHcy concentration was lowered after 1 year of B-vitamin supplementation (mean 13.1 vs. 9.6 μmol/L). A stronger reduction of tHcy after 1 year was found in participants who had baseline level >12.5 μmol/L (mean 17.0 vs. 11.9 μmol/L) compared to those with baseline tHcy lower than this limit (mean 9.1 vs. 7.4 μmol/L). In contrast, the increases in serum and WB 5-methylTHF were comparable between the two groups. One year B-vitamins supplementation increased the levels of 5-methylTHF and non-methyl-folate in serum and WB, normalized tHcy, but caused an increase in the number of cases with detectable UFA in serum. Lowering of tHcy was predicted by baseline tHcy, but not by baseline serum or WB 5-methylTHF.

Self-Reported and Observed Punitive Parenting Prospectively Predicts Increased Error-Related Brain Activity in Six-Year-Old Children.

PubMed

Meyer, Alexandria; Proudfit, Greg Hajcak; Bufferd, Sara J; Kujawa, Autumn J; Laptook, Rebecca S; Torpey, Dana C; Klein, Daniel N

2015-07-01

The error-related negativity (ERN) is a negative deflection in the event-related potential (ERP) occurring approximately 50 ms after error commission at fronto-central electrode sites and is thought to reflect the activation of a generic error monitoring system. Several studies have reported an increased ERN in clinically anxious children, and suggest that anxious children are more sensitive to error commission--although the mechanisms underlying this association are not clear. We have previously found that punishing errors results in a larger ERN, an effect that persists after punishment ends. It is possible that learning-related experiences that impact sensitivity to errors may lead to an increased ERN. In particular, punitive parenting might sensitize children to errors and increase their ERN. We tested this possibility in the current study by prospectively examining the relationship between parenting style during early childhood and children's ERN approximately 3 years later. Initially, 295 parents and children (approximately 3 years old) participated in a structured observational measure of parenting behavior, and parents completed a self-report measure of parenting style. At a follow-up assessment approximately 3 years later, the ERN was elicited during a Go/No-Go task, and diagnostic interviews were completed with parents to assess child psychopathology. Results suggested that both observational measures of hostile parenting and self-report measures of authoritarian parenting style uniquely predicted a larger ERN in children 3 years later. We previously reported that children in this sample with anxiety disorders were characterized by an increased ERN. A mediation analysis indicated that ERN magnitude mediated the relationship between harsh parenting and child anxiety disorder. Results suggest that parenting may shape children's error processing through environmental conditioning and thereby risk for anxiety, although future work is needed to confirm this

Familial polyposis coli: no evidence for increased sensitivity to mitomycin C.

PubMed Central

Mazzullo, H A; Attwood, J; Delhanty, J D

1988-01-01

Spontaneous chromosome instability is well established for the dominantly inherited cancer prone condition, familial polyposis coli (FPC), but conflicting results have been obtained regarding sensitivity to mitomycin C (MMC). We have investigated cell survival in fibroblasts and the induction of sister chromatid exchanges and chromosome damage in lymphocytes and fibroblasts after MMC treatment. We can find no evidence for a differential response of FPC cells as measured by any of these parameters, although individual FPC fibroblast cultures did show an enhanced chromosomal response. Overall, the FPC mutation does not appear to result in defective DNA repair in response to MMC. PMID:2835481

Evidence of a long-term increase in tropospheric ozone from Pic du Midi data series: Consequences: Positive radiative forcing

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

Marenco, A.; Gouget, H.; Nedelec, P.

1994-08-01

The rate at which ozone is increasing in the troposphere is uncertain due to the lack of accurate long-term measurements. Old ozone measurements obtained at the Pic du Midi Observatory (3000 m high, southwestern France) were recently rediscovered. Four sets of data available at this station are presented. The results show an increase in ozone by a factor of 5 since the beginning of the twentieth century, corresponding to an exponential increase of 1.6% per year, although this trend is probably higher (2.4% per year) for the last few decades. A stable 10 ppb ozone mixing ratio is observed duringmore » the first 20 years of the series, which is representative to the preindustrial era ozone level. The increase is seen to start around 1895. Other data, obtained at various European high-altitude stations between 1920 and 1980, tie in closely with the Pic du Midi observations. A tentative evaluation of the impact of tropospheric ozone on radiative forcing confirms that ozone is currently the second most significant greenhouse gas, responsible for 22% and 13% of radiative forcing changes since 1800 in the northern and southern hemispheres, respectively. If these rates were to be maintained in the future, ozone would continue to evolve differently in the two hemispheres (maximum level in the northern hemisphere) and could make an even more significant contribution to the radiative forcing of the northern hemisphere.« less

Promoting community practitioners' use of evidence-based approaches to increase breast cancer screening.

PubMed

Leeman, Jennifer; Moore, Alexis; Teal, Randall; Barrett, Nadine; Leighton, Ashely; Steckler, Allan

2013-07-01

Many women do not get mammography screenings at the intervals recommended for early detection and treatment of breast cancer. The Guide to Community Preventive Services (Community Guide) recommends a range of evidence-based strategies to improve mammography rates. However, nurses and others working in community-based settings make only limited use of these strategies. We report on a dissemination intervention that partnered the University of North Carolina with the Susan G. Komen Triangle Affiliate to disseminate Community Guide breast cancer screening strategies to community organizations. The intervention was guided by social marketing and diffusion of innovation theory and was designed to provide evidence and support via Komen's existing relationships with grantee organizations. The present study reports the findings from a formative evaluation of the intervention, which included a content analysis of 46 grant applications pre- and post intervention and focus groups with 20 grant recipients. © 2013 Wiley Periodicals, Inc.

Factors influencing the development of evidence-based practice among nurses: a self-report survey

PubMed Central

2012-01-01

Background Health authorities in several countries have decided that the health care services should be evidence-based. Recent research indicates that evidence-based practice may be more successfully implemented if the interventions overcome identified barriers. Aims The present study aimed to examine factors influencing the implementation of evidence-based practice among nurses in a large Norwegian university hospital. Methods Cross-sectional data was collected from 407 nurses during the period November 8 to December 3, 2010, using the Norwegian version of Developing Evidence-based Practice questionnaire (DEBP). The DEBP included data on various sources of information used for support in practice, on potential barriers for evidence-based practice, and on self-reported skills on managing research-based evidence. The DEBP was translated into Norwegian in accordance with standardized guidelines for translation and cultural adaptation. Results Nurses largely used experienced-based knowledge collected from their own observations, colleagues and other collaborators for support in practice. Evidence from research was seldom used. The greatest barriers were lack of time and lack of skills to find and manage research evidence. The nurse’s age, the number of years of nursing practice, and the number of years since obtaining the last health professional degree influenced the use of sources of knowledge and self-reported barriers. Self-reported skills in finding, reviewing and using different sources of evidence were positively associated with the use of research evidence and inversely related to barriers in use of research evidence. Conclusion Skills in evidence-based practice seem to reduce barriers to using research evidence and to increase use of research evidence in clinical practice. PMID:23092366

Increased Serum Al Levels in Hemodialysis Patients Kept Enhanced during a 2-Year Prospective Study.

PubMed

Reina de la Torre, Maria L; Lopez García de la Serrana, Herminia; Martí Del Moral, Loreto; Palomares Bayo, Magdalena; Navarro-Alarcón, Miguel

2017-07-01

The regulation of mineral homeostasis is altered in hemodialysis patients with renal insufficiency, producing increased risk for secondary diseases like cardiovascular ones. We hypothesized that risen serum aluminum (Al) concentration in hemodialysis patients kept enhanced during a 2-year longitudinal study is associated with enhanced cardiovascular risk and influenced by medical treatments. This study reports the prospective monitoring of serum Al levels in six-monthly samplings over 2 years in 116 hemodialysis patients and a control group of 50 healthy adults. The influence of other factors like sex, age, kidney transplant, disease etiology, and drug consumption was also considered. At each sampling, serum Al levels were significantly higher in the patients than in the healthy controls (P < 0.05). Levels in the patient group were statistically significantly lower at the third and fourth versus first and second samplings, which may be related to Al accumulation in tissues. Increased Al levels in patients were positively and significantly related to serum calcium (Ca) and uric acid levels. Serum Al concentrations were significantly lower in patients receiving vasodilators and diuretics. Higher serum Al levels in hemodialyzed patients administered with phosphate binders or anti-hyperkalemics are attributable to their usual Al salt content. The consumption of antianemic drugs increases Al absorption by forming more bioavailable complexes with the compounds in these drugs. In conclusion, this is the first study to indicate that cardiovascular problems associated with elevated serum Al levels in hemodialysis patients may be in part mitigated by administrating vasodilators and diuretics, which reduce these levels.

Toward Evidence-Based Chinese Medicine: Status Quo, Opportunities and Challenges.

PubMed

Chen, Yao-Long; Zhao, Chen; Zhang, Li; Li, Bo; Wu, Chuan-Hong; Mu, Wei; Wang, Jia-Ying; Yang, Ke-Hu; Li, You-Ping; Chen, Chiehfeng; Wang, Yong-Yan; Wang, Chen; Bian, Zhao-Xiang; Shang, Hong-Cai

2018-03-01

How to test the treatments of Chinese medicine (CM) and make them more widely accepted by practitioners of Western medicine and the international healthcare community is a major concern for practitioners and researchers of CM. For centuries, various approaches have been used to identify and measure the efficacy and safety of CM. However, the high-quality evidence related to CM that produced in China is still rare. Over the recent years, evidence-based medicine (EBM) has been increasingly applied to CM, strengthening its theoretical basis. This paper reviews the past and present state of CM, analyzes the status quo, challenges and opportunities of basic research, clinical trials, systematic reviews, clinical practice guidelines and clinical pathways and evidence-based education developed or conducted in China, pointing out how EBM can help to make CM more widely used and recognized worldwide.

Evidence-Based Medicine: Rhinoplasty.

PubMed

Lee, Matthew K; Most, Sam P

2015-08-01

Evidence-based medicine has become increasingly prominent in the climate of modern day healthcare. The practice of evidence-based medicine involves the integration of the best available evidence with clinical experience and expertise to help guide clinical decision-making. The essential tenets of evidence-based medicine can be applied to both functional and aesthetic rhinoplasty. Current outcome measures in functional and aesthetic rhinoplasty, including objective, subjective, and clinician-reported measures, is summarized and the current data is reviewed. Copyright © 2015 Elsevier Inc. All rights reserved.

Integrating research evidence and physical activity policy making-REPOPA project.

PubMed

Aro, Arja R; Bertram, Maja; Hämäläinen, Riitta-Maija; Van De Goor, Ien; Skovgaard, Thomas; Valente, Adriana; Castellani, Tommaso; Chereches, Razvan; Edwards, Nancy

2016-06-01

Evidence shows that regular physical activity is enhanced by supporting environment. Studies are needed to integrate research evidence into health enhancing, cross-sector physical activity (HEPA) policy making. This article presents the rationale, study design, measurement procedures and the initial results of the first phase of six European countries in a five-year research project (2011-2016), REsearch into POlicy to enhance Physical Activity (REPOPA). REPOPA is programmatic research; it consists of linked studies; the first phase studied the use of evidence in 21 policies in implementation to learn more in depth from the policy making process and carried out 86 qualitative stakeholder interviews. The second, ongoing phase builds on the central findings of the first phase in each country; it consists of two sets of interventions: game simulations to study cross-sector collaboration and organizational change processes in the use of evidence and locally tailored interventions to increase knowledge integration. The results of the first two study phases will be tested and validated among policy makers and other stakeholders in the third phase using a Delphi process. Initial results from the first project phase showed the lack of explicit evidence use in HEPA policy making. Facilitators and barriers of the evidence use were the availability of institutional resources and support but also networking between researchers and policy makers. REPOPA will increase understanding use of research evidence in different contexts; develop guidance and tools and establish sustainable structures such as networks and platforms between academics and policy makers across relevant sectors. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence'

PubMed Central

2009-01-01

Background In 1999 a four-level hierarchy of evidence was promoted by the National Health and Medical Research Council in Australia. The primary purpose of this hierarchy was to assist with clinical practice guideline development, although it was co-opted for use in systematic literature reviews and health technology assessments. In this hierarchy interventional study designs were ranked according to the likelihood that bias had been eliminated and thus it was not ideal to assess studies that addressed other types of clinical questions. This paper reports on the revision and extension of this evidence hierarchy to enable broader use within existing evidence assessment systems. Methods A working party identified and assessed empirical evidence, and used a commissioned review of existing evidence assessment schema, to support decision-making regarding revision of the hierarchy. The aim was to retain the existing evidence levels I-IV but increase their relevance for assessing the quality of individual diagnostic accuracy, prognostic, aetiologic and screening studies. Comprehensive public consultation was undertaken and the revised hierarchy was piloted by individual health technology assessment agencies and clinical practice guideline developers. After two and a half years, the hierarchy was again revised and commenced a further 18 month pilot period. Results A suitable framework was identified upon which to model the revision. Consistency was maintained in the hierarchy of "levels of evidence" across all types of clinical questions; empirical evidence was used to support the relationship between study design and ranking in the hierarchy wherever possible; and systematic reviews of lower level studies were themselves ascribed a ranking. The impact of ethics on the hierarchy of study designs was acknowledged in the framework, along with a consideration of how harms should be assessed. Conclusion The revised evidence hierarchy is now widely used and provides a common

Long-term use of cellular phones and brain tumours: increased risk associated with use for > or =10 years.

PubMed

Hardell, Lennart; Carlberg, Michael; Söderqvist, Fredrik; Mild, Kjell Hansson; Morgan, L Lloyd

2007-09-01

To evaluate brain tumour risk among long-term users of cellular telephones. Two cohort studies and 16 case-control studies on this topic were identified. Data were scrutinised for use of mobile phone for > or =10 years and ipsilateral exposure if presented. The cohort study was of limited value due to methodological shortcomings in the study. Of the 16 case-control studies, 11 gave results for > or =10 years' use or latency period. Most of these results were based on low numbers. An association with acoustic neuroma was found in four studies in the group with at least 10 years' use of a mobile phone. No risk was found in one study, but the tumour size was significantly larger among users. Six studies gave results for malignant brain tumours in that latency group. All gave increased odd ratios (OR), especially for ipsilateral exposure. In a meta-analysis, ipsilateral cell phone use for acoustic neuroma was OR = 2.4 (95% CI 1.1 to 5.3) and OR = 2.0, (1.2 to 3.4) for glioma using a tumour latency period of > or =10 years. Results from present studies on use of mobile phones for > or =10 years give a consistent pattern of increased risk for acoustic neuroma and glioma. The risk is highest for ipsilateral exposure.

Decreasing Sports Activity with Increasing Age? Findings from a 20-Year Longitudinal and Cohort Sequence Analysis

ERIC Educational Resources Information Center

Breuer, Christoph; Wicker, Pamela

2009-01-01

According to cross-sectional studies in sport science literature, decreasing sports activity with increasing age is generally assumed. In this paper, the validity of this assumption is checked by applying more effective methods of analysis, such as longitudinal and cohort sequence analyses. With the help of 20 years' worth of data records from the…

Increased productivity in the subantarctic ocean during Heinrich events.

PubMed

Sachs, Julian P; Anderson, Robert F

2005-04-28

Massive iceberg discharges from the Northern Hemisphere ice sheets, 'Heinrich events', coincided with the coldest periods of the last ice age. There is widespread evidence for Heinrich events and their profound impact on the climate and circulation of the North Atlantic Ocean, but their influence beyond that region remains uncertain. Here we use a combination of molecular fingerprints of algal productivity and radioisotope tracers of sedimentation to document eight periods of increased productivity in the subpolar Southern Ocean during the past 70,000 years that occurred within 1,000-2,000 years of a Northern Hemisphere Heinrich event. We discuss possible causes for such a link, including increased supply of iron from upwelling and increased stratification during the growing season, which imply an alteration of the global ocean circulation during Heinrich events. The mechanisms linking North Atlantic iceberg discharges with subantarctic productivity remain unclear at this point. We suggest that understanding how the Southern Ocean was altered during these extreme climate perturbations is critical to understanding the role of the ocean in climate change.

The recent increase of atmospheric methane from 10 years of ground-based NDACC FTIR observations since 2005

DOE PAGES

Bader, Whitney; Bovy, Benoît; Conway, Stephanie; ...

2017-02-14

Changes of atmospheric methane total columns (CH 4) since 2005 have been evaluated using Fourier transform infrared (FTIR) solar observations carried out at 10 ground-based sites, affiliated to the Network for Detection of Atmospheric Composition Change (NDACC). From this, we find an increase of atmospheric methane total columns of 0.31 ± 0.03 % year –1 (2 σ level of uncertainty) for the 2005–2014 period. Comparisons with in situ methane measurements at both local and global scales show good agreement. We used the GEOS-Chem chemical transport model tagged simulation, which accounts for the contribution of each emission source and one sinkmore » in the total methane, simulated over 2005–2012. After regridding according to NDACC vertical layering using a conservative regridding scheme and smoothing by convolving with respective FTIR seasonal averaging kernels, the GEOS-Chem simulation shows an increase of atmospheric methane total columns of 0.35 ± 0.03 % year –1 between 2005 and 2012, which is in agreement with NDACC measurements over the same time period (0.30 ± 0.04 % year –1, averaged over 10 stations). Analysis of the GEOS-Chem-tagged simulation allows us to quantify the contribution of each tracer to the global methane change since 2005. We find that natural sources such as wetlands and biomass burning contribute to the interannual variability of methane. However, anthropogenic emissions, such as coal mining, and gas and oil transport and exploration, which are mainly emitted in the Northern Hemisphere and act as secondary contributors to the global budget of methane, have played a major role in the increase of atmospheric methane observed since 2005. Furthermore based on the GEOS-Chem-tagged simulation, we discuss possible cause(s) for the increase of methane since 2005, which is still unexplained.« less

The recent increase of atmospheric methane from 10 years of ground-based NDACC FTIR observations since 2005

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

Bader, Whitney; Bovy, Benoît; Conway, Stephanie

Changes of atmospheric methane total columns (CH 4) since 2005 have been evaluated using Fourier transform infrared (FTIR) solar observations carried out at 10 ground-based sites, affiliated to the Network for Detection of Atmospheric Composition Change (NDACC). From this, we find an increase of atmospheric methane total columns of 0.31 ± 0.03 % year –1 (2 σ level of uncertainty) for the 2005–2014 period. Comparisons with in situ methane measurements at both local and global scales show good agreement. We used the GEOS-Chem chemical transport model tagged simulation, which accounts for the contribution of each emission source and one sinkmore » in the total methane, simulated over 2005–2012. After regridding according to NDACC vertical layering using a conservative regridding scheme and smoothing by convolving with respective FTIR seasonal averaging kernels, the GEOS-Chem simulation shows an increase of atmospheric methane total columns of 0.35 ± 0.03 % year –1 between 2005 and 2012, which is in agreement with NDACC measurements over the same time period (0.30 ± 0.04 % year –1, averaged over 10 stations). Analysis of the GEOS-Chem-tagged simulation allows us to quantify the contribution of each tracer to the global methane change since 2005. We find that natural sources such as wetlands and biomass burning contribute to the interannual variability of methane. However, anthropogenic emissions, such as coal mining, and gas and oil transport and exploration, which are mainly emitted in the Northern Hemisphere and act as secondary contributors to the global budget of methane, have played a major role in the increase of atmospheric methane observed since 2005. Furthermore based on the GEOS-Chem-tagged simulation, we discuss possible cause(s) for the increase of methane since 2005, which is still unexplained.« less

The importance of scientific evaluation of biological evidence--data from eight years of case review.

PubMed

Coyle, Heather Miller

2012-12-01

In 2009, the National Research Council published a report stating that the addition of more science and technology into the field of forensic science in the United States would be of great benefit to the judicial system. As a starting point to address this NRC report, one needs to make an assessment of the system. One factor that is continuously requested is an estimate of an error rate. In any given scientific area of forensics that is difficult to quantitate except by external review and audits. After eight years of requested defense review of cases with biological and DNA evidence, most cases appear to be scientifically sound in test methods and procedures. However, there were some cases where errors in the forensic science process did occur. This article takes information compiled from those eight years of defense review and summarizes the cases where errors have been discovered and discusses the scientific implications of these errors. The scope of this article is limited to crime scene collection and forensic science laboratory testing of biological materials for body fluid identification and DNA individualization to a source. The greatest value of defense review comes from (a) providing effective balance and independent oversight to the judicial process and (b) collecting data into a format that can be useful as a guide in training programs. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

Can repair increase the longevity of composite resins? Results of a 10-year clinical trial.

PubMed

Fernández, E; Martín, J; Vildósola, P; Oliveira Junior, O B; Gordan, V; Mjor, I; Bersezio, C; Estay, J; de Andrade, M F; Moncada, G

2015-02-01

The aim of this double-blind clinical trial was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement. Twenty-eight patients aged 18-80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were "clinically judged" to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n=25) or Replacement (n=25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. The restorations were blind and two examiners scored them at baseline (Cohen Kappa agreement score 0.74) and at ten years (Cohen Kappa agreement score 0.87) restorations. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group. Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (MA) (p>0.05), secondary caries (SC) (p>0.05), anatomy (A) (p<0.05), and colour (C) (p>0.05). Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations. The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evidence for Increased Beta-Adrenoreceptor Responsiveness Induced by 14 Days of Simulated Microgravity in Humans

NASA Technical Reports Server (NTRS)

Convertino, Victor A.; Polet, Jill L.; Engelke, Keith A.; Hoffler, G. W.; Lane, Lynda D.

1996-01-01

We studied hemodynamic responses to alpha and beta receptor agonists in 8 healthy men ( 38+- 2 yrs) before and after 14 days of 6 degree head-down tilt (HDT) to test the hypothesis that increased adrenergic responsiveness is induced by prolonged exposure to microgravity. Immediately following a 30-min baseline period, a steady-state infusion of isoproterenol (ISO) was used to assess beta 1- and beta 2-adrenergic responsiveness. ISO was infused at three graded constant rates of 0.005, 0.01 and 0.02 ug/kg/min. After heart rate and blood pressure had been allowed to return to baseline levels following ISO infusion graded infusion of phenylephrine (PE) was used to assess responsiveness of alpha I-vascular receptors. PE was infused at three graded constant rates of 0.25, 0.50 and 1.00 ug/kg/min. Each infusion interval for both drugs was 9 min. During the infusions, constant monitoring of beat-to-beat blood pressure and heart rate was performed and leg blood flow was measured with occlusion plethysmography at each infusion level. The slopes calculated from linear regressions between ISO and PE doses and changes in heart rate, blood pressure, and leg vascular resistance for each subject were used to represent alpha- and beta- adrenoreceptor responsiveness. Fourteen days HDT increased the slopes of heart rate (1056 +- 107 to 1553 +- 83 beats/ug/kg/min; P= 0.014) and vasodilation (-469ft +- 111 to -l446 +- 309 PRU/ug/kg/min; P =0.0224) to ISO infusion. There was no alteration in blood pressure or vascular resistance responses to PE infusion after HDT. Our results provide evidence that microgravity causes selective increases in beta 1- and beta 2-adrenergic responsiveness without affecting alpha 1-vascular responses.

Long-Term Effects of Individual Development Accounts on Postsecondary Education: Follow-Up Evidence from a Randomized Experiment

ERIC Educational Resources Information Center

Grinstein-Weiss, Michal; Sherraden, Michael; Gale, William G.; Rohe, William M.; Schreiner, Mark; Key, Clinton

2013-01-01

This paper presents evidence from a randomized field experiment testing the impact of a 3-year matched savings program on educational outcomes 10 years after the start of the experiment. We examine the effect of an Individual Development Account (IDA) program on (1) educational enrollment, (2) degree completion, and (3) increased education level.…

Can exercise increase fitness and reduce weight in patients with schizophrenia and depression?

PubMed

Krogh, Jesper; Speyer, Helene; Nørgaard, Hans Christian Brix; Moltke, Ane; Nordentoft, Merete

2014-01-01

Psychiatric patients have a reduced life expectancy of 15-20 years compared with the general population. Most years of lost life are due to the excess mortality from somatic diseases. Sedentary lifestyle and medication is partly responsible for the high frequency of metabolic syndrome in this patient group and low levels of physical activity is associated with increased risk of cardiovascular disease, diabetes, and all-cause mortality. This study aimed to review trials allocating patients with either schizophrenia or depression to exercise interventions for effect on cardiovascular fitness, strength, and weight. We searched PubMed, Embase, and PsycINFO including randomized clinical trial allocating patients with either schizophrenia or depression to isolated exercise interventions. We identified five trials including patients with schizophrenia (n = 94) and found little evidence that exercise could increase cardiovascular fitness or decrease weight. Nine exercise trials for patients with depression (n = 892) were identified increasing cardiovascular fitness by 11-30% and strength by 33-37%. No evidence in favor of exercise for weight reduction was found. Based on the current evidence isolated exercise interventions are unlikely to improve cardiovascular fitness or induce weight loss in patients with schizophrenia. In patients with depression, exercise interventions are likely to induce clinically relevant short term effects, however, due to lack of reporting, little is known about the effect on weight reduction and cardiovascular fitness. Future exercise trials regarding patients with mental illness should preferably measure changes in cardiovascular strength, repetition maximum, and anthropometric outcomes. Ideally, participants should be assessed beyond the intervention to identify long lasting effects.

Proterozoic and early Cambrian protists: evidence for accelerating evolutionary tempo

NASA Technical Reports Server (NTRS)

Knoll, A. H.

1994-01-01

In rocks of late Paleoproterozoic and Mesoproterozoic age (ca. 1700-1000 million years ago), probable eukaryotic microfossils are widespread and well preserved, but assemblage and global diversities are low and turnover is slow. Near the Mesoproterozoic-Neoproterozoic boundary (1000 million years ago), red, green, and chromophytic algae diversified; molecular phylogenies suggest that this was part of a broader radiation of "higher" eukaryotic phyla. Observed diversity levels for protistan microfossils increased significantly at this time, as did turnover rates. Coincident with the Cambrian radiation of marine invertebrates, protistan microfossils again doubled in diversity and rates of turnover increased by an order of magnitude. Evidently, the Cambrian diversification of animals strongly influenced evolutionary rates, within clades already present in marine communities, implying an important role for ecology in fueling a Cambrian explosion that extends across kingdoms.

When All Signs Point to You: Lies Told in the Face of Evidence

PubMed Central

Evans, Angela D.; Xu, Fen; Lee, Kang

2012-01-01

Young children’s ability to tell a strategic lie by making it consistent with the physical evidence of their transgression was investigated along with the sociocognitive correlates of such lie-telling behaviors. In Experiment 1, 247 Chinese children between 3 and 5 years of age (126 boys) were left alone in a room and asked not to lift a cup to see the contents. If children lifted up the cup, the contents would be spilled and evidence of their transgression would be left behind. Upon returning to the room, the experimenter asked children whether they peeked and how the contents of the cup ended up on the table. Experiment 1 revealed that young children are able to tell strategic lies to be consistent with the physical evidence by about 4 or 5 years of age, and this ability increases in sophistication with age. Experiment 2, which included 252 Chinese 4-year-olds (127 boys), identified 2 sociocognitive factors related to children’s ability to tell strategic lies. Specifically, both children’s theory-of-mind understanding and inhibitory control skills were significantly related to their ability to tell strategic lies in the face of physical evidence. The present investigation reveals that contrary to the prevailing views, even young children are able to tell strategic lies in some contexts. PMID:21244148

Dynapenic Abdominal Obesity Increases Mortality Risk among English and Brazilian Older Adults: A 10-Year Follow-Up of the ELSA and SABE Studies.

PubMed

da Silva Alexandre, T; Scholes, S; Ferreira Santos, J L; de Oliveira Duarte, Y A; de Oliveira, C

2018-01-01

There is little epidemiological evidence demonstrating that dynapenic abdominal obesity has higher mortality risk than dynapenia and abdominal obesity alone. Our main aim was to investigate whether dynapenia combined with abdominal obesity increases mortality risk among English and Brazilian older adults over ten-year follow-up. Cohort study. United Kingdom and Brazil. Data came from 4,683 individuals from the English Longitudinal Study of Ageing (ELSA) and 1,490 from the Brazilian Health, Well-being and Aging study (SABE), hence the final sample of this study was 6,173 older adults. The study population was categorized into the following groups: non-dynapenic/non-abdominal obese, abdominal obese, dynapenic, and dynapenic abdominal obese according to their handgrip strength (< 26 kg for men and < 16 kg for women) and waist circumference (> 102 cm for men and > 88 cm for women). The outcome was all-cause mortality over a ten-year follow-up. Adjusted hazard ratios by sociodemographic, behavioural and clinical characteristics were estimated using Cox proportional hazards models. The fully adjusted model showed that dynapenic abdominal obesity has a higher mortality risk among the groups. The hazard ratios (HR) were 1.37 for dynapenic abdominal obesity (95% CI = 1.12 - 1.68), 1.15 for abdominal obesity (95% CI = 0.98 - 1.35), and 1.23 for dynapenia (95% CI = 1.04 - 1.45). Dynapenia is an important risk factor for mortality but dynapenic abdominal obesity has the highest mortality risk among English and Brazilian older adults.

Increasing Need for Uniqueness in Contemporary China: Empirical Evidence

PubMed Central

Cai, Huajian; Zou, Xi; Feng, Yi; Liu, Yunzhi; Jing, Yiming

2018-01-01

Past research has documented various cultural and psychological changes in contemporary China. In two studies, we examine how Chinese people’s need for uniqueness (NFU) also has changed. In Study 1, we found a significant cross-generational increase in Chinese participants’ self-reported NFU. In Study 2, we sampled the names of Chinese newborn babies over the last five decades and found that parents have been increasingly likely to use unique characters to name their children. These findings suggest that the NFU has been rising in China, a historically collectivistic-oriented society. Theoretical and practical implications of our findings were discussed. PMID:29867619

Suicide mortality trends in young people aged 15 to 19 years in Lithuania.

PubMed

Strukcinskiene, B; Andersson, R; Janson, S

2011-11-01

This paper considers the suicide mortality trends from 1990-2009 in young people aged 15 to 19 years in Lithuania. Suicide and injury mortality data, plus mortality data from all causes, were used to compare the trend lines. Suicide mortality rate in young people aged 15-19 years and in all population showed a rising trend from 1990, and then a decreasing trend from 2002 year. This trend was significant exclusively in boys. When comparing suicide deaths as a percentage of injury deaths and of all deaths in the age group 15-19 years, rising trends for boys were evident, whilst in girls, there was no evidence of change. In Lithuania, from early 1990s, the frequency of suicide increased amongst adults and young people aged 15-19 years. After 2002, a decrease in deaths by suicide was observed both for the whole population and for young people aged 15-19 years. The rise and fall was obvious for boys. The reasons for different trends may have been influenced by the political and socioeconomic instability in the 1990-2002 period, and the socioeconomic stability, together with active preventive measures, from 2002. Although the consumption of modern Selective serotonin reuptake inhibitors (SSRIs) increased during the same time, suicide mortality was again high during the economic crisis in 2008-2009. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

Abrupt and severe 20th Century changes in the fire regimes of southeastern Australia: Evidence from a 3000 year multi-proxy analysis

NASA Astrophysics Data System (ADS)

Baker, Patrick; Mooney, Scott; Allen, Kathryn; Willersdorf, Timothy

2015-04-01

Fire is the dominant natural disturbance in southeastern Australia. For millennia it has been the driving force shaping terrestrial ecosystems in the region -- simultaneously killing vegetation and initiating regeneration across whole landscapes. Fire regimes across the region are driven by several factors including climate, vegetation, and ignition sources. Humans have been a significant contributing factor to past and present fire regimes. Prior to European settlement in the late 1700s, Aboriginal Australians used frequent, low-intensity fires to manage vegetation across much of the landscape. European settlement led to the displacement of Aboriginal communities and a shift to active fire suppression and control. This changing approach to fire management is widely believed to have initiated a fundamental shift towards extreme, high-intensity fire events as fuel loads increased. In addition, during the 20th Century prolonged periods of warm, dry conditions have occurred with greater frequency and intensity. The relative importance of climate and fire management practices on contemporary fire regimes is vigorously debated in Australia and is directly relevant to land management policies and their implementation. To put the current fire regime into historical context, we used a multi-proxy approach combining palaeo-charcoal and tree-ring analyses to assess how fire regimes have changed over the last 3000 years in the Snowy Mountains region of southeastern Australia. We found almost no evidence of high-intensity fires in the 3000 years that preceded the 20th Century. However, in the mid-20th Century there is a sudden and dramatic increase in the presence of charcoal and the pulsed establishment of trees across the landscape, suggesting a recent shift from low-intensity fires with minimal charcoal signatures to moderate- to high-intensity fires with substantial charcoal inputs. Importantly, the tree-ring data demonstrate that most of these fires were not stand

Which Target Blood Pressure in Year 2018? Evidence from Recent Clinical Trials.

PubMed

Heimark, Sondre; Mariampillai, Julian E; Narkiewicz, Krzysztof; Nilsson, Peter M; Kjeldsen, Sverre E

2018-06-01

The Systolic Blood Pressure Intervention Trial (SPRINT) suggested a favourable effect of lowering blood pressure to < 120/80 mmHg in high-risk hypertensive patients; however, new American guidelines in 2017 have not followed SPRINT but lowered its recommended treatment target to < 130/80 mmHg. We aimed to review the latest research from large randomised controlled trials and observational analyses in order to investigate the evidence for new treatment targets. We assessed recent data from the Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD) study, the International Verapamil-Trandolapril Study (INVEST), the Telmisartan, Ramipril or Both in Patients at High Risk for Vascular Events trial (ONTARGET)/the Telmisartan Randomised AssessmenNt Study in aCE iNtolerant participants with cardiovascular Disease (TRANSCEND) study and The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) study. These studies confirm a positive effect on cardiovascular protection with blood pressure lowering treatment to between 120-140 mmHg in patients with and without diabetes, but no additional effect of lowering blood pressure to < 120 mmHg; possibly too aggressive treatment may increase both cardiovascular morbidity and mortality. Thus, a target blood pressure < 130/80 mmHg appears appropriate in most high-risk hypertensive patients. Additionally, early and sustained BP control below this target is required for optimal cardiovascular protection.

Evidence for the stability of the West Antarctic Ice Sheet divide for 1.4 million years

NASA Astrophysics Data System (ADS)

Hein, Andrew S.; Woodward, John; Marrero, Shasta M.; Dunning, Stuart A.; Steig, Eric J.; Freeman, Stewart P. H. T.; Stuart, Finlay M.; Winter, Kate; Westoby, Matthew J.; Sugden, David E.

2016-02-01

Past fluctuations of the West Antarctic Ice Sheet (WAIS) are of fundamental interest because of the possibility of WAIS collapse in the future and a consequent rise in global sea level. However, the configuration and stability of the ice sheet during past interglacial periods remains uncertain. Here we present geomorphological evidence and multiple cosmogenic nuclide data from the southern Ellsworth Mountains to suggest that the divide of the WAIS has fluctuated only modestly in location and thickness for at least the last 1.4 million years. Fluctuations during glacial-interglacial cycles appear superimposed on a long-term trajectory of ice-surface lowering relative to the mountains. This implies that as a minimum, a regional ice sheet centred on the Ellsworth-Whitmore uplands may have survived Pleistocene warm periods. If so, it constrains the WAIS contribution to global sea level rise during interglacials to about 3.3 m above present.

Evidence-based nursing leadership: Evaluation of a Joint Academic-Service Journal Club.

PubMed

Duffy, Joanne R; Thompson, Diane; Hobbs, Terry; Niemeyer-Hackett, Nancy Lee; Elpers, Susan

2011-10-01

This article describes the importance of evidence-based nursing leadership in the development and evaluation of a joint academic-service nursing leadership journal club. The use of scientific evidence and the embracing of an environment of continuous learning are essential to quality practice; however, nursing leadership has been slow to apply evidence-based practice to their own work. A noontime monthly meeting schedule, incentivized by lunch, was organized as a nursing leadership journal club. Articles were selected and reviewed monthly, and the process was formally evaluated using a written evaluation at the end of year 1. Eighteen articles were appraised by the group with 6 topics identified. Positive results included increased knowledge, competence of the leader, and attainment of goals. Recommendations include revision of goals, plans to share leadership of the group, development of a rigorous evaluation of outcomes, and dissemination of findings. The journal club was valuable in increasing awareness of nursing leadership research, promoting leadership development, and improving competence in the performance of research appraisals. Process improvement and further study are needed to increase understanding regarding the benefits of leadership journal clubs.

Breast cancer risk is increased in the years following false-positive breast cancer screening.

PubMed

Goossens, Mathijs C; De Brabander, Isabel; De Greve, Jacques; Vaes, Evelien; Van Ongeval, Chantal; Van Herck, Koen; Kellen, Eliane

2017-09-01

A small number of studies have investigated breast cancer (BC) risk among women with a history of false-positive recall (FPR) in BC screening, but none of them has used time-to-event analysis while at the same time quantifying the effect of false-negative diagnostic assessment (FNDA). FNDA occurs when screening detects BC, but this BC is missed on diagnostic assessment (DA). As a result of FNDA, screenings that detected cancer are incorrectly classified as FPR. Our study linked data recorded in the Flemish BC screening program (women aged 50-69 years) to data from the national cancer registry. We used Cox proportional hazards models on a retrospective cohort of 298 738 women to assess the association between FPR and subsequent BC, while adjusting for potential confounders. The mean follow-up was 6.9 years. Compared with women without recall, women with a history of FPR were at an increased risk of developing BC [hazard ratio=2.10 (95% confidence interval: 1.92-2.31)]. However, 22% of BC after FPR was due to FNDA. The hazard ratio dropped to 1.69 (95% confidence interval: 1.52-1.87) when FNDA was excluded. Women with FPR have a subsequently increased BC risk compared with women without recall. The risk is higher for women who have a FPR BI-RADS 4 or 5 compared with FPR BI-RADS 3. There is room for improvement of diagnostic assessment: 41% of the excess risk is explained by FNDA after baseline screening.

Time discounting and the body mass index. Evidence from the Netherlands.

PubMed

Borghans, Lex; Golsteyn, Bart H H

2006-01-01

In many Western countries, the relative weight of people -- measured by the body mass index (BMI) -- has increased substantially in recent years, leading to an increasing incidence of overweight and related health problems. As with many forms of risky behavior, it is plausible that overweight is related to the individual discount rate. Increases in credit card debts, the rise in gambling and the development of a more hedonic life style, suggest that the average discount rate has increased over time. An increase in time discounting may be a contributing factor in the rise in BMI. Applying a large set of indicators for the individual discount rate from a Dutch survey, this paper analyzes whether changes in time discounting can account for differences in body mass between individuals at a given point in time and whether changes in the average individual discount rate can explain the remarkable increase in BMI experienced in recent years in the Netherlands. We find some evidence for a link between time discounting and differences in BMI between people, but this relationship depends strongly on the choice of the proxy for the discount rate. Giving our hypothesis the best chance, we analyze the development of the time discounting proxies that are most strongly related to BMI. We find no evidence for a change of these proxies over time. Our main conclusion therefore is that overweight might be related to the way people discount future health benefits, but the increase in BMI is more likely explained by shifts in other parameters that determine the intertemporal decisions regarding the trade-off of current and future health and satisfaction.

Fever as a risk factor for increased response to vitamin K antagonists: a review of the evidence and potential mechanisms.

PubMed

Self, Timothy H; Oliphant, Carrie S; Reaves, Anne B; Richardson, Amy M; Sands, Christopher W

2015-01-01

Numerous factors affect the response to vitamin K antagonists (VKA) including age, dietary vitamin K, other drugs, pharmacogenetics, and disease states. In antithrombotic guidelines, fever is mentioned as a factor that may increase response to VKA. The purpose of this article is to review the available evidence regarding the effect of fever on response to VKA, and to discuss possible mechanisms of this effect. We performed a search of the English literature from 1943 to June 2014, using the key words fever AND warfarin, acenocoumarol, phenprocoumon, coumarin anticoagulants and VKA; fever AND vitamin K dependent clotting factors II, VII, IX, and X. One animal investigation and 6 studies in humans suggest fever increases response to VKA, but one study did not find a significant effect. The magnitude of this effect is variable. Possible mechanisms for the increased effect of VKA associated with fever are increased catabolism of vitamin K dependent clotting factors, decreased vitamin K intake, and inhibition of VKA metabolism. More rigorous studies are needed to confirm that fever increases response to warfarin and other VKA. Copyright © 2014 Elsevier Ltd. All rights reserved.

Three Years and Counting--The Economic Crisis Is Still with Us

ERIC Educational Resources Information Center

Lowry, Charles B.

2011-01-01

Where library budgets are concerned, there is every evidence now, after three years, that research libraries have arrived at "the new normal." That is, they do not expect a return to systematic and regular additions to Association of Research Libraries' (ARL) budgets in order to support ever-increasing prices that are out of proportion to…

Delay and déjà vu: timing and repetition increase the power of false evidence.

PubMed

Wright, Deborah S; Wade, Kimberley A; Watson, Derrick G

2013-08-01

False images and videos can induce people to believe in and remember events that never happened. Using a novel method, we examined whether the timing of false evidence would influence its effect (Experiment 1) and determined the relationship between timing and repetition (Experiment 2). Subjects completed a hazard perception driving test and were falsely accused of cheating. Some subjects were shown a fake video or photograph of the cheating either after a 9-min delay (Experiment 1) or more than once with or without a delay (Experiment 2). Subjects were more likely to falsely believe that they had cheated and to provide details about how the cheating happened when the false evidence was delayed or repeated-especially when repeated over time-relative to controls. The results show that even a strikingly short delay between an event and when false evidence is disclosed can distort people's beliefs and that repeating false evidence over a brief delay fosters false beliefs more so than without a delay. These findings have theoretical implications for metacognitive models of autobiographical memory and practical implications for police interrogations.

The "PHS Increased Risk" Label Is Associated With Nonutilization of Hundreds of Organs per Year.

PubMed

Volk, Michael L; Wilk, Amber R; Wolfe, Cameron; Kaul, Daniel R

2017-07-01

The Public Health Service "Increased Risk" (PHS IR) designation identifies donors at increased risk of transmitting hepatitis B, C, and human immunodeficiency virus. Although the risk remains very low in the era of nucleic acid testing, we hypothesized that this label may result in decreased organ utilization. Organ Procurement and Transplantation Network data were used to compare utilization rates between PHS-IR and non-PHS-IR donors, as well as to compare export rates and variation in utilization. Among adult standard criteria donors between 2010 and 2013 with a known PHS-IR status, covariate-adjusted utilization rates were lower among PHS-IR donors than non-PHS-IR donors for all organs. For example, 4073 (76.7%) of 5314 PHS-IR kidneys were used, compared with 25 490 (83.7%) of 30 456 non-PHS-IR kidneys-an absolute difference of 7%. Furthermore, all PHS-IR organs had higher export rates than non-PHS-IR organs. For example, 28.7% of PHS-IR kidneys were exported versus 19.7% of non-PHS-IR kidneys. Finally, the utilization rate of PHS-IR organs varied by Donation Service Area; utilization ranged from 20% to 100% among adult kidneys, suggesting significant variation in practices. Similar patterns were seen among pediatric donors. Based on the covariate-adjusted model, if the PHS-IR label did not exist, there could be an additional 313 transplants performed in the United States each year. The PHS "increased risk" label appears to be associated with nonutilization of hundreds of organs per year, despite the very low risk of disease transmission. Better tools are needed to communicate the magnitude of risk to patients and their families.

The Development of Experimentation and Evidence Evaluation Skills at Preschool Age

NASA Astrophysics Data System (ADS)

Piekny, Jeanette; Grube, Dietmar; Maehler, Claudia

2014-01-01

Researchers taking a domain-general approach to the development of scientific reasoning long thought that the ability to engage in scientific reasoning did not develop until adolescence. However, more recent studies have shown that preschool children already have a basic ability to evaluate evidence and a basic understanding of experimentation. Data providing insights into when exactly in the preschool years significant gains in these abilities occur are scarce. Drawing on a sample of 138 preschool children, this longitudinal study therefore examined how children's ability to evaluate evidence and their understanding of experimentation develop between the ages of four and six. Findings showed that the ability to evaluate evidence was already well developed at age four and increased steadily and significantly over time as long as the pattern of covariation was perfect. In the case of imperfect covariation, the proportion of correct answers was low over the period of observation, but showed a significant increase between the ages of four and five. If the data did not allow relationship between variables to be inferred, the proportion of correct answers was low, with a significant increase between the ages of five and six. The children's understanding of experimentation increased significantly between the ages of five and six. The implications of these findings for age-appropriate science programs in preschool are discussed.

Exploring the Evidence: Initiatives in the First College Year. The First-Year Experience Monograph Series No. 49

ERIC Educational Resources Information Center

Troxel, Wendy G., Ed.; Cutright, Marc, Ed.

2008-01-01

For more than 25 years, educators have developed and institutionalized efforts to help first-year students succeed. This monograph collects case studies from 22 institutions that have created programs and initiatives to support their first-year students. The programs range from encouraging civic engagement and academic achievements to…

Brain development during the preschool years

PubMed Central

Brown, Timothy T.; Jernigan, Terry L.

2012-01-01

The preschool years represent a time of expansive psychological growth, with the initial expression of many psychological abilities that will continue to be refined into young adulthood. Likewise, brain development during this age is characterized by its “blossoming” nature, showing some of its most dynamic and elaborative anatomical and physiological changes. In this article, we review human brain development during the preschool years, sampling scientific evidence from a variety of sources. First, we cover neurobiological foundations of early postnatal development, explaining some of the primary mechanisms seen at a larger scale within neuroimaging studies. Next, we review evidence from both structural and functional imaging studies, which now accounts for a large portion of our current understanding of typical brain development. Within anatomical imaging, we focus on studies of developing brain morphology and tissue properties, including diffusivity of white matter fiber tracts. We also present new data on changes during the preschool years in cortical area, thickness, and volume. Physiological brain development is then reviewed, touching on influential results from several different functional imaging and recording modalities in the preschool and early school-age years, including positron emission tomography (PET), electroencephalography (EEG) and event-related potentials (ERP), functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), and near-infrared spectroscopy (NIRS). Here, more space is devoted to explaining some of the key methodological factors that are required for interpretation. We end with a section on multimodal and multidimensional imaging approaches, which we believe will be critical for increasing our understanding of brain development and its relationship to cognitive and behavioral growth in the preschool years and beyond. PMID:23007644

Trends in Rhinoplasty Research: A 20-Year Bibliometric Analysis.

PubMed

Lalezari, Shadi; Daar, David A; Mathew, Prakash J; Mowlds, Donald S; Paydar, Keyianoosh Z; Wirth, Garrett A

2018-05-01

Rhinoplasty is a popular aesthetic and reconstructive surgical procedure. It is one of the top five surgical cosmetic procedures performed worldwide. To evaluate global trends in rhinoplasty research spanning 20 years between 1994 and 2013. The top 15 plastic surgery and otolaryngology journals containing rhinoplasty research were determined using impact factors (IF). A database of rhinoplasty articles from 1994 to 2013 was created to include the following classifications: IF, authors' geographic location, study design, level of evidence (LOE), and pertinence to aesthetic or reconstructive rhinoplasty. Productivity index and productivity share were calculated for each region. A total of 1244 rhinoplasty articles were included in the database. The mean IF among the 15 journals increased from 0.75 in 1994 to 1.90 in 2013 (p < 0.001). The majority of rhinoplasty publications were clinical in study design (91.0%) and were predominantly of weaker LOE (level IV: 42.4%; level V: 33.2%). The USA led in proportion of total rhinoplasty publications by volume and productivity index (37.9%, 41.2%), followed by Asia (29.1%, 28.2%) and Western Europe (18.8%, 18.2%). The majority of articles published were classified as aesthetic (60.4%), whereas 30.6% were reconstructive; there was a significant increase in the proportion of aesthetic rhinoplasty articles published per year (p = 0.009). The USA has consistently been the most productive country in rhinoplasty research. However, its lead has diminished over the last 20 years. The trend in rhinoplasty research appears to be toward aesthetic rather than reconstructive topics. Attention should be given to producing stronger LOE studies. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Interventions to increase tuberculosis case detection at primary healthcare or community-level services

PubMed Central

Mhimbira, Francis A; Cuevas, Luis E.; Dacombe, Russell; Mkopi, Abdallah; Sinclair, David

2017-01-01

detection impact on long-term tuberculosis prevalence; this was evaluated in one study, which indicated little or no effect after four years of either contact tracing, extensive health promotion activities, or both (RR 1.31, 95% CI 0.75 to 2.30; 1 study, 405,788 participants in 12 clusters, very low-certainty evidence). Authors' conclusions The available evidence demonstrates that when used in appropriate settings, active case-finding approaches may result in increase in tuberculosis case detection in the short term. The effect of active case finding on treatment outcome needs to be further evaluated in sufficiently powered studies. Interventions to increase the number of tuberculosis cases being diagnosed This review summarized trials evaluating the effects of interventions aiming to increase the diagnosis of tuberculosis and reduce the number of undiagnosed tuberculosis cases in communities. After searching for relevant trials up to 19 December 2016, we included 17 studies conducted in sub-Saharan Africa (nine studies), Asia (six studies), and South America (two studies). Why does tuberculosis go undiagnosed and how might programmes improve this? Tuberculosis is a chronic infectious disease that affects over 10 million people worldwide, with an estimated four million tuberculosis patients remaining undiagnosed each year. Interventions such as outreach tuberculosis screening with or without health promotion that actively screen for tuberculosis among individuals presenting with symptoms of tuberculosis, may increase detection of microbiologically confirmed tuberculosis cases. These interventions may improve treatment outcomes by increasing the number of tuberculosis patients who are cured and complete treatment. However, we do not know if these interventions reduce either tuberculosis treatment failure, or tuberculosis-associated death or long-term tuberculosis burden in moderate- and high-tuberculosis settings. What the research says House-to-house screening for active

Association Between the Duration of Periodontitis and Increased Cardiometabolic Risk Factors: A 9-Year Cohort Study.

PubMed

Morita, Toyoko; Yamazaki, Yoji; Fujiharu, Chika; Ishii, Takanori; Seto, Misae; Nishinoue, Norihide; Sasaki, Yoshiyuki; Nakai, Kumiko; Tanaka, Hideki; Kawato, Takayuki; Maeno, Masao